Search the digital library catalog

Abstract: Background: Two prospective randomized studies analysing cutaneous melanoma (CM) patients with sentinel lymph node (SLN) metastases and rapid development of systemic adjuvant therapy have changed our approach to stage III CM treatment. The aim of this study was to compare results of retrospective survival analysis of stage III CM patients% treatment from Slovenian national CM register to leading international clinical guidelines. Patients and methods: Since 2000, all Slovenian CM patients with primary tumour % TIb are treated at the Institute of Oncology Ljubljana and data are prospectively collected into a national CM registry. A retrospective analysis of 2426 sentinel lymph node (SLN) biopsies and 789 lymphadenectomies performed until 2015 was conducted using Kaplan-Meier survival curves and log-rank tests. Results: Positive SLN was found in 519/2426 (21.4%) of patients and completion dissection (CLND) was performed in 455 patients. The 5-year overall survival (OS) of CLND group was 58% vs. 47% of metachronous metastases group (MLNM) (p = 0.003). The 5-year OS of patients with lymph node (LN) metastases and unknown primary site (UPM) was 45% vs. 21% of patients with synchronous LN metastasis. Patients with SLN tumour burden < 0.3 mm had 5-year OS similar to SLN negative patients (86% vs. 85%; p = 0.926). The 5-year OS of patients with burden > 1.0 mm was similar to the MLNM group (49% vs. 47%; p = 0.280). Conclusions: Stage III melanoma patients is a heterogeneous group with significant OS differences. CLND after positive SLNB might still remain a method of treatment for selected patients with stage III.
Keywords: cutaneous melanoma, surgery treatment, sentinel node biopsy, completion lymph node dissection, overall surviva
Published in DKUM: 08.10.2024; Views: 0; Downloads: 2
Full text (412,50 KB)
This document has many files! More...

Abstract: In heart failure (HF), acute decompensation can occur quickly and unexpectedly because of worsening of chronic HF or to new-onset HF diagnosed for the first time ('de novo'). Patients presenting with acute HF (AHF) have a poor prognosis comparable with those with acute myocardial infarction, and any delay of treatment initiation is associated with worse outcomes. Recent HF guidelines and recommendations have highlighted the importance of a timely diagnosis and immediate treatment for patients presenting with AHF to decrease disease progression and improve prognosis. However, based on the available data, there is still uncertainty regarding the optimal 'time-to-treatment' effect in AHF. Furthermore, the immediate post-worsening HF period plays an important role in clinical outcomes in HF patients after hospitalization and is known as the 'vulnerable phase' characterized by high risk of readmission and early death. Early and intensive treatment for HF patients in the 'vulnerable phase' might be associated with lower rates of early readmission and mortality. Additionally, in the chronic stable HF outpatient, treatments are often delayed or not initiated when symptoms are stable, ignoring the risk for adverse outcomes such as sudden death. Consequently, there is a dire need to better identify HF patients during hospitalization and after discharge and treating them adequately to improve their prognosis. HF is an urgent clinical scenario along all its stages and disease conditions. Therefore, time plays a significant role throughout the entire patient's journey. Therapy should be optimized as soon as possible, because this is beneficial regardless of severity or duration of HF. Time lavished before treatment initiation is recognized as important modifiable risk factor in HF.
Keywords: heart failure, prognosis, treatment
Published in DKUM: 05.08.2024; Views: 99; Downloads: 9
Full text (5,64 MB)
This document has many files! More...

Abstract: Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across the globe gradually identified the need to focus more on ensuring the appropriate use of medicines to improve patient outcomes rather than being engaged in manufacturing and supply. Since that time numerous studies have shown the positive impact of clinical pharmacy services (CPS). The need for wider adoption of CPS worldwide becomes urgent, as the global population ages, and the prevalence of polypharmacy as well as shortage of healthcare professionals is rising. At the same time, there is great pressure to provide both high-quality and cost-effective health services. All these challenges urgently require the adoption of a new paradigm of healthcare system architecture. One of the most appropriate answers to these challenges is to increase the utilization of the potential of highly educated and skilled professionals widely available in these countries, i.e., pharmacists, who are well positioned to prevent and manage drug-related problems together with ensuring safe and effective use of medications with further care relating to medication adherence. Unfortunately, CPS are still underdeveloped and underutilized in some parts of Europe, namely, in most of the Central and Eastern European (CEE) countries. This paper reviews current situation of CPS development in CEE countries and the prospects for the future of CPS in that region.
Keywords: clinical pharmacy, cost-effective treatment, drug safety, drug utilization, health policy, medication adherence, medication errors, polypharmacy
Published in DKUM: 27.05.2024; Views: 190; Downloads: 11
Full text (828,13 KB)
This document has many files! More...

Abstract: The impact of the microstructural properties of a Ti6Al4V alloy on its electrochemical properties, as well as the effect of the α- and β-phases present within it, is still unclear. With the introduction of new, emerging technologies, such as selective laser melting and post heat treatments, the effect of the microstructure on an alloy's corrosion properties has become increasingly interesting from a scientific perspective. When these alloys are produced through different methods, despite an identical chemical composition they have diverse microstructures, and consequently display varying resistance to corrosion. In the present research study, Ti–6Al–4V alloy specimens produced by three different processes, leading to the formation of three different microstructures were investigated: heat treated specimen fabricated by selective laser melting, wrought and cast specimens. The impact of the microstructure of these alloys when immersed in artificial saliva was studied through the use of various electrochemical techniques, by microscopical examinations, and time-of-flight secondary ion mass spectrometry. Corrosion properties were investigated by the measurement of open circuit potential, linear polarization, and potentiodynamic curve measurements followed by microscopical examinations, and time-of-flight secondary ion mass spectrometry examination was conducted to reveal spatial distribution of alloying species on oxide film. It was found that the difference between specimens containing an α+β microstructure was small and not dependent on the aspect ratio of the β-phase, alloy grain size, and vanadium partitioning coefficient, but rather on the size, shape, and content of this phase.
Keywords: Ti6Al4V, dental alloy, microstructure, corrosion resistance, heat treatment, ToF-SIMS
Published in DKUM: 07.05.2024; Views: 198; Downloads: 13
Full text (8,12 MB)
This document has many files! More...

Keywords: aluminijeve zlitine, toplotna obdelava, mikrostruktura, disperzoidi, dilatometrija, trdota, aluminium alloy, heat treatment, microstructure, dispersoids, dilatometry, DSC, hardness
Published in DKUM: 05.04.2024; Views: 183; Downloads: 19
Full text (11,03 MB)
This document has many files! More...