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Lipoprotein(a) as a risk factor in a cohort of hospitalised cardiovascular patients : A retrospective clinical routine data analysis
David Šuran, Tadej Završnik, Peter Kokol, Marko Kokol, Andreja Sinkovič, Franjo Naji, Jernej Završnik, Helena Blažun Vošner, Vojko Kanič, 2023, original scientific article

Abstract: Lipoprotein(a) (Lp(a)) is a well-recognised risk factor for ischemic heart disease (IHD) and calcific aortic valve stenosis (AVS). Methods: A retrospective observational study of Lp(a) levels (mg/dL) in patients hospitalised for cardiovascular diseases (CVD) in our clinical routine was performed. The Lp(a)-associated risk of hospitalisation for IHD, AVS, and concomitant IHD/AVS versus other non-ischemic CVDs (oCVD group) was assessed by means of logistic regression. Results: In total of 11,767 adult patients, the association with Lp(a) was strongest in the IHD/AVS group (eβ = 1.010, p < 0.001), followed by the IHD (eβ = 1.008, p < 0.001) and AVS group (eβ = 1.004, p < 0.001). With increasing Lp(a) levels, the risk of IHD hospitalisation was higher compared with oCVD in women across all ages and in men aged ≤75 years. The risk of AVS hospitalisation was higher only in women aged ≤75 years (eβ = 1.010 in age < 60 years, eβ = 1.005 in age 60–75 years, p < 0.05). Conclusions: The Lp(a)-associated risk was highest for concomitant IHD/AVS hospitalisations. The differential impact of sex and age was most pronounced in the AVS group with an increased risk only in women aged ≤75 years.
Keywords: acute myocardial infarction, aortic valve stenosis, atherosclerosis, cardiovascular diseases, cardiovascular risk, ischemic heart disease, lipoprotein(a), postmenopausal women
Published in DKUM: 12.06.2024; Views: 14; Downloads: 0
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Digital tools in behavior change support education in health and other students : a systematic review
Lucija Gosak, Gregor Štiglic, Leona Cilar Budler, Isa B. Félix, Katja Braam, Nino Fijačko, Mara Pereira Guerreiro, Mateja Lorber, 2022, review article

Abstract: Due to the increased prevalence of chronic diseases, behavior changes are integral to self-management. Healthcare and other professionals are expected to support these behavior changes, and therefore, undergraduate students should receive up-to-date and evidence-based training in this respect. Our work aims to review the outcomes of digital tools in behavior change support education. A secondary aim was to examine existing instruments to assess the effectiveness of these tools. A PIO (population/problem, intervention, outcome) research question led our literature search. The population was limited to students in nursing, sports sciences, and pharmacy; the interventions were limited to digital teaching tools; and the outcomes consisted of knowledge, motivation, and competencies. A systematic literature review was performed in the PubMed, CINAHL, MEDLINE, Web of Science, SAGE, Scopus, and Cochrane Library databases and by backward citation searching. We used PRISMA guidelines 2020 to depict the search process for relevant literature. Two authors evaluated included studies using the Mixed Methods Appraisal Tool (MMAT) independently. Using inclusion and exclusion criteria, we included 15 studies in the final analysis: six quantitative descriptive studies, two randomized studies, six mixed methods studies, and one qualitative study. According to the MMAT, all studies were suitable for further analysis in terms of quality. The studies resorted to various digital tools to improve students’ knowledge of behavior change techniques in individuals with chronic disease, leading to greater self-confidence, better cooperation, and practical experience and skills. The most common limitations that have been perceived for using these tools are time and space constraints.
Keywords: digital tools, didactics, noncommunicable diseases, chronic diseases, behavior change support education, health science
Published in DKUM: 28.09.2023; Views: 290; Downloads: 22
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Protective role of mitochondrial uncoupling proteins against age-related oxidative stress in type 2 diabetes mellitus
Maša Čater, Lidija Križančić Bombek, 2022, review article

Abstract: The accumulation of oxidative damage to DNA and other biomolecules plays an important role in the etiology of aging and age-related diseases such as type 2 diabetes mellitus (T2D), atherosclerosis, and neurodegenerative disorders. Mitochondrial DNA (mtDNA) is especially sensitive to oxidative stress. Mitochondrial dysfunction resulting from the accumulation of mtDNA damage impairs normal cellular function and leads to a bioenergetic crisis that accelerates aging and associated diseases. Age-related mitochondrial dysfunction decreases ATP production, which directly affects insulin secretion by pancreatic beta cells and triggers the gradual development of the chronic metabolic dysfunction that characterizes T2D. At the same time, decreased glucose oxidation in skeletal muscle due to mitochondrial damage leads to prolonged postprandial blood glucose rise, which further worsens glucose homeostasis. ROS are not only highly reactive by-products of mitochondrial respiration capable of oxidizing DNA, proteins, and lipids but can also function as signaling and effector molecules in cell membranes mediating signal transduction and inflammation. Mitochondrial uncoupling proteins (UCPs) located in the inner mitochondrial membrane of various tissues can be activated by ROS to protect cells from mitochondrial damage. Mitochondrial UCPs facilitate the reflux of protons from the mitochondrial intermembrane space into the matrix, thereby dissipating the proton gradient required for oxidative phosphorylation. There are five known isoforms (UCP1-UCP5) of mitochondrial UCPs. UCP1 can indirectly reduce ROS formation by increasing glutathione levels, thermogenesis, and energy expenditure. In contrast, UCP2 and UCP3 regulate fatty acid metabolism and insulin secretion by beta cells and modulate insulin sensitivity. Understanding the functions of UCPs may play a critical role in developing pharmacological strategies to combat T2D. This review summarizes the current knowledge on the protective role of various UCP homologs against age-related oxidative stress in T2D.
Keywords: uncoupling proteins, reactive oxygen species, aging, age-related diseases, diabetes
Published in DKUM: 23.08.2023; Views: 360; Downloads: 23
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Impacts of the 2019 pandemic of severe acute respiratory syndrome–coronavirus 2 on the quality of life of patients with inflammatory rheumatic diseases
Domen Lah, Iztok Holc, 2023, original scientific article

Keywords: severe acute respiratory syndrome–coronavirus 2, rheumatic diseases, quality of life, pandemic, telemedicine
Published in DKUM: 18.07.2023; Views: 331; Downloads: 28
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High resolution melting curve analysis for high-throughput SNP genotyping in IL23R gene and association of IL23R with Slovenian inflammatory bowel diseases patients
Mitja Mitrovič, Uroš Potočnik, 2010, original scientific article

Abstract: Single nucleotide polymorphism (SNP) analysis is important tool in the studies of genetic factors associated with complex diseases and with genetically influenced response to drug therapy (pharmacogenetics). Recently, a new generation of generic dsDNA binding dyes (LCGreen$^{TM}$) contributed to the development of fast and low-cost method for SNP detection and/or genotyping based on high resolution melting (HRM) analysis. The aim of our study was to develop HRM assay for IL23R gene (rs7517847) and to perform association study in Slovenian inflammatory bowel diseases (IBD) patients. We genotyped 345 Slovenian healthy controls and 295 IBD patients including 159 with Crohn's disease (CD) and 136 with ulcerative colitis (UC) for rs7517847 polymorphism in IL23R gene using standard RFLP and optimized HRM methods. In this study, we showed, that HRM is a simple, fast and reliable method for genotyping of clinical samples where homozygotes (GG and TT) were determined by Tm calling method and difference between homozygotes and heterozygotes was determined by different melting curve shape using gene scanning method. With combination of results from Tm calling and gene scanning methods, we achieved 98,6% concordance between PCR-RFLP and PCRHRM results, based on the analysis of 640 samples. We found statistically significant association of IL23R polymorphism with Slovenian Crohn's disease patients when comparing genotype and allele frequencies between CD patients and controls. Allele frequency of minor allele G was 0,46 in controls and was reduced to 0,33 in CD patients (p < 0,001, OR = 0,588). The frequency of T/T genotype carriers was higher in CD patients (50,3%) than in controls (26,7%, p = 0,002, OR = 2,558). We found weak association between IL23R polymorphism and Slovenian UC patients. Carriers of T/T genotype have higher risk for UC (p = 0,035, OR = 1,599). These results suggest IL23R plays important role in CD and UC development in Slovenian patients.
Keywords: SNP genotyping, high resolution melting, DNA dyes, inflammatory bowel diseases, LC Green Plus
Published in DKUM: 18.08.2017; Views: 1845; Downloads: 101
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Towards a low-cost mobile subcutaneous vein detection solution using near-infrared spectroscopy
Simon Jurič, Vojko Flis, Matjaž Debevc, Andreas Holzinger, Borut Žalik, 2014, review article

Abstract: Excessive venipunctures are both time- and resource-consuming events, which cause anxiety, pain, and distress in patients, or can lead to severe harmful injuries. We propose a low-cost mobile health solution for subcutaneous vein detection using near-infrared spectroscopy, along with an assessment of the current state of the art in this field. The first objective of this study was to get a deeper overview of the research topic, through the initial team discussions and a detailed literature review (using both academic and grey literature). The second objective, that is, identifying the commercial systems employing near-infrared spectroscopy, was conducted using the PubMed database. The goal of the third objective was to identify and evaluate (using the IEEE Xplore database) the research efforts in the field of low-cost near-infrared imaging in general, as a basis for the conceptual model of the upcoming prototype. Although the reviewed commercial devices have demonstrated usefulness and value for peripheral veins visualization, other evaluated clinical outcomes are less conclusive. Previous studies regarding low-cost near-infrared systems demonstrated the general feasibility of developing cost-effective vein detection systems; however, their limitations are restricting their applicability to clinical practice. Finally, based on the current findings, we outline the future research direction.
Keywords: subcutaneous vein detection, diagnostic methods and procedures, infrared rays, spectroscopy, vascular diseases, mobile devices
Published in DKUM: 15.06.2017; Views: 1484; Downloads: 358
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High-resolution melting curve analysis for high-throughput genotyping of NOD2/CARD15 mutations and distribution of these mutations in Slovenian inflammatory bowel diseases patients
Mitja Mitrovič, Uroš Potočnik, 2011, original scientific article

Abstract: Inflammatory bowel diseases (IBD) are usually classified into Crohn's disease (CD) and ulcerative colitis (UC). NOD2/CARD15 was the first identified CD-susceptibility gene and was confirmed as the most potent disease gene in CD pathogenesis. Three NOD2/CARD15 variants, namely two missense polymorphisms R702W (rs2066844) and G908R (rs2066845), and a frame shift polymorphism L1007fs (rs2066847), were associated with CD in Caucasian populations. High resolution melting analysis (HRMA) with saturation LCGreen dyes was previously reported as a simple, inexpensive, accurate and sensitive method for genotyping and/or scanning of rare variants. For this reasons we used qPCR-HRMA for genotyping NOD2/CARD15 variants in 588 Slovenian IBD patients and 256 healthy controls. PCR-RFLP was used as a reference method for genotyping of clinical samples. The optimization of an HRM experiment required careful design and adjustment of main parameters, such as primer concentration, MgCl_{2} concentration, probe design and template DNA concentration. Different HRMA approaches were tested and used to develop a reliable and low-cost SNP genotyping assays for polymorphisms in NOD2/CARD15 gene. Direct HRMA was the fastest and cheapest HRMA approach for L1007fs and R702W polymorphisms, yet for G908R polymorphism sufficient reliability was achieved after introduction of unlabeled probe. In association analysis, we found statistically significant association of L1007fs (p =0.001, OR=3.011, CI95%=1.494-6.071) and G908R (p=2.62 * 10^{-4}, OR=14.117, CI95%= 1.884-105.799) polymorphisms with CD patients. At least one of NOD2/CARD15 polymorphisms was found in 78/354 (22.03% (12.69%) in UC patients and in 26/256 (10.15%) in healthy controls. We have successfully implemented NOD2/CARD15 HRMA assays, which may contribute to the development of genetic profiles for risk prediction of developing CD and for differential diagnosis of CD vs. UC.
Keywords: high-resolution melting analysis, NOD2/CARD15, inflammatory bowel diseases
Published in DKUM: 14.06.2017; Views: 1414; Downloads: 337
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The impact of patientʼs socio-demographic characterictics, comorbidities and attitudes on flu vaccination uptake in family practice settings
Andrej Kravos, Lucija Kračun, Klara Kravos, Rade Iljaž, 2015, original scientific article

Abstract: Objectives: In Slovenia, the role of family physicians in primary care and preventive procedures is very important. Influenza vaccination rates in Slovenia are low. The reasons for low vaccination rates in Slovenia were not clear. We suppose that patient’s beliefs and attitudes are important factors. We assessed patients’ opinions regarding the acceptance of flu vaccination by their family physicians and their beliefs and attitudes about flu and vaccination. The aim was to check out factors that influence the decision to take the vaccine in family physician offices. Methods: This was a cross-sectional, multicenter, observational study in the Styria region in Slovenia. We included patients from seven family physicians during regular office visits. They filled in a questionnaire about their general demographic data and attitudes regarding influenza and vaccination. The main outcome was the decision to be vaccinated. Results: The logistic regression model identified five predictors for influenza vaccination, namely: heart disease, previous vaccination, an agreement with the beliefs ‘the vaccination is an efficient measure to prevent influenza’, ‘after the vaccination there are usually no important side effects’ and ‘the vaccination is also recommended for a healthy adult person’. The belief that vaccinations harm the immune system is negatively associated with vaccination. Conclusions: Patients’ beliefs are an important factor to decide for vaccination or not. Family physician teams should discuss with patients their beliefs and concerns about vaccination.
Keywords: vaccination, influenza, family practice, attitudes, chronic diseases
Published in DKUM: 05.04.2017; Views: 1224; Downloads: 124
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Correlates of depression in the slovenian working population
Zalika Klemenc-Ketiš, Borut Peterlin, 2013, original scientific article

Abstract: This multicentre, cross-sectional observational study aimed to determine the prevalence of depression among the working population of Slovenia and identify factors correlating with higher prevalence of depression. It was conducted in three occupational medicine practices within major Slovenian primary health care centres. The study population consisted of 1,474 respondents [73.7 % of the invited participants, 889 (60.3 %) men and 585 (39.7 %) women with mean age of (40.5±9.8) years] who visited these practices for their regular check-ups from November 2010 to June 2012 and were asked to fill in a self-developed questionnaire and score depression on the Zung’s self-rating depression scale. According to the rating, 50 (3.4 %) respondents suffered from depression. In the multivariate analysis, depression correlated with the following independent variables: self-perceived exposure to chronic stress, positive family history of depression, and primary school education.
Keywords: mental diseases, primary health care, cross-sectional study, demographic data, family history
Published in DKUM: 30.03.2017; Views: 1349; Downloads: 339
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