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1.
Layered additive manufacturing in clinical medicine
Igor Drstvenšek, Nataša Ihan Hren, Tadej Strojnik, Vojko Pogačar, Tjaša Zupančič Hartner, Andreja Sinkovič, 2008, izvirni znanstveni članek

Opis: The use of contemporary technologies of Computer Assisted Design (CAD), combined with latest rapid prototyping, tooling and manufacturing, with traditional CT scanning techniques and high medical skills are used as instruments for better diagnostic visualization, simulation of procedures and treatment of patients with craniofacial deformities. They also improve the overall performances of medical and nursing staff thus influencing the quality of medical service. Patients with congenital defects, orthognathic deformities, deformities after malignancy treatment or after craniofacial traumatic injuries of different severities are of particular interests due to both aesthetic and functional alterations. The paper presents two clinical cases - a patient with scull bone defect after brain hemorrhage and brain edema as well as a patient with hemifacial microsomia treated by surgery followed by implantation of titanium angular implant prepared by means of computer tomography scans, Computer Aided Design and Rapid Manufacturing technologies.
Ključne besede: rapid prototyping, computer assisted design, maxilla, scull, reconstructive surgery
Objavljeno: 31.05.2012; Ogledov: 1354; Prenosov: 83
URL Povezava na celotno besedilo

2.
Dejavniki 30-dnevne umrljivosti pri bolnikih s hudo sepso in septičnim šokom
Jure Fluher, Damjana Rehar, Andreja Sinkovič, 2013, druge monografije in druga zaključena dela

Opis:
Ključne besede: sepsa, septični šok, 30-dnevna umrljivost, dejavniki umrljivosti
Objavljeno: 11.03.2014; Ogledov: 1060; Prenosov: 415
.pdf Celotno besedilo (420,25 KB)

3.
Dejavniki bolnišnične umrljivosti bolnikov z akutno obilno krvavitvijo iz zgornjega dela prebavne cevi
Andreja Sinkovič, 2006, strokovni članek

Opis: Izhodišča. Dejavniki umrljivosti akutne težke krvavitve iz zgornjega dela prebavne cevi so visoka starost, spremljajoče bolezni in endoskopski dokaz aktivne krvavitve. Naš cilj je prikaz neodvisnih dejavnikov bolnišnične umrljivosti pri naših bolnikih s težko akutno krvavitvijo iz zgornje prebavne cevi. Metode. Retrospektivno smo pregledali popise 54 bolnikov, sprejetih zaradi akutne krvavitve iz zgornjega dela prebavil, dokazano endoskopsko in/ali s hipotenzijo in/ali tahikardijo. Dejavniki umrljivosti so bili testirani z univariantno in multivariantno statistično metodo. Rezultati. Najpogostejši vzrok krvavitve so bile varice in erozije, nato peptična razjeda. Umrljivost naših bolnikov je bila 31,5 %. Med umrljimi in preživelimiso bile statistično pomembne razlike v prisotnosti hemoragičnega šoka (82,4 % vs. 27 %, p<0,001), odpovedi srca (76,5 % vs. 18,9 %, p<0,001), okužbi (47 % vs. 10,8 %, p=0,005), sprejemnem diastoličnem krvnem tlaku (55,4 +/- 22 mm Hg vs. 69,7 +/- 17,7 mmHg, p=0,016), sprejemnem hemoglobinu (74,2 +/- 25,7 g/L vs. 94,2 +/- 22,2 g/L, p=0,005) in eritrocitih (2,4 +/-0,7 10, 10 [na] 12/L vs. 3 +/- 0,7 10.10 [na] 12 /L, p=0,005, v najnižjem hemoglobinu (65,8 +/- 24,3 g/L vs. 80 +/- 18,3 g/L, p=0,02) in eritrocitih (2 +/- 0,7 10.10 [na] 12/L vs.2,5 +/- 0,6 10.10 [na] 12/L, p=0,007) med zdravljenjem. Glede na logistično regresijo je najpomembnejši neodvisni dejavnik umrljivosti naših bolnikov odpoved srca in ožilja, nato najnižji hemoglobin in eritrociti med zdravljenjem. Zaključki. Krvavitve iz varic so bile najpogostejši vzrok akutne krvavitve iz zgornjih prebavil. Najpomembnejši neodvisni dejavnik bolnišnične umrljivosti, ki je bila 31.5 %, je bolezen srca in ožilja.
Objavljeno: 21.12.2015; Ogledov: 385; Prenosov: 24
URL Povezava na celotno besedilo

4.
Nenadna kardiocirkulatorna odpoved pri primarnem možganskem tumorju - prikaz primera in pregled literature
Jožef Magdič, Andreja Sinkovič, 2003, strokovni članek

Opis: Izhodišča. Prikazan je primer 62-letne bolnice z nenadno odpovedjo srca in cirkulacije zaradi obstruktivnega šoka. Metode. Po uspešnem oživljanju je bila z opravljenim spiralnim CT prsnega koša izključena masivna trombembolija, s CT možganov pa ugotovljen možganski tumor z izrazitim edemom okolne možganovine. Glede na opravljene preiskave, klinično sliko, potek in odziv na zdravljenje je verjetno šlo za nevrogeno povzročen obstruktivni šok. Rezultati. Po operativni odstranitvi glioblastoma je bila bolnica odpuščena v domačo oskrbo delno samostojna za dnevna opravila. Zaključki. V poteku možganskih tumorjev je možen nenadni razvoj obstruktivnega šoka z odpovedjo srca in krvnega obtoka zaradi draženja vazomotornih centrov o osrednjem živčevju.
Objavljeno: 21.12.2015; Ogledov: 516; Prenosov: 12
URL Povezava na celotno besedilo

5.
Zastrupitve s plini
Andreja Sinkovič, 2009, pregledni znanstveni članek

Opis: Le 5,5 % vseh zastrupitev je posledica zastrupitve z vdihavanjem strupenih snovi (plinov, hlapov, par ali aerosolov), največ zaradi dražečih ali dušljivih plinov. Po resorpciji skozi dihala se v telesu metabolizirajo pod vplivom metabolnih procesov. Izločijo se z izdihanim zrakom skozi pljuča (ogljikov monoksid, cianidi, vodikov sulfid) ali v spremenjeni obliki s sečem ali blatom. Enostavni dušljivci (ogljikov dioksid) povzročajo v visokih koncentracijah anoksično, kemični dušljivci (ogljikov monoksid, žveplovodik, cianidi) pa tkivno hipoksijo. Največ smrtnih primerov je zaradi akutne zastrupitve z ogljikovim monoksidom, ki lahko povzroča tudi pozne nevrološke okvare. Dražeči vodotopni ali v maščobah topni plini dražijo sluznice dihal in so pogosto vzrok akutnih in kroničnih zastrupitev v industriji, gospodinjstvih in prometu. Ob lokalnem draženju (kašelj, hripavost, težka sapa, traheobronhitis, edem glasilk, akutna zapora zgornjih dihal, kemični pnevmonitis, toksični pljučni edem) povzročajo tudi sistemske učinke, kot so glavobol, slabost, bruhanje, zmedenost, omotičnost, v hudih primerih celo nezavest, zastoj dihanja in prekatne, življenje ogrožajoče aritmije. Pri oskrbi bolnika je prvi ukrep odstranitev zastrupljenca s kontaminiranega področja, nato vzdrževanje življenjskih funkcij, vključno z dajanjem kisika, protistrupa in simptomatskim zdravljenjem.
Objavljeno: 21.12.2015; Ogledov: 698; Prenosov: 47
URL Povezava na celotno besedilo

6.
Dejavniki bolnišničnega preživetja bolnikov po uspešnem oživljanju na terenu
Tadej Jalšovec, Denis Sraka, 2015, druge monografije in druga zaključena dela

Ključne besede: srčni zastoj, oživljanje, možganska okvara, ishemična, preživetje
Objavljeno: 28.07.2016; Ogledov: 656; Prenosov: 68
.pdf Celotno besedilo (1,47 MB)

7.
Early predictors of 30-day mortality in non-ST-elevation acute coronary syndrome patients
Suzana Rožič, Melanija Županić, Andreja Sinkovič, 2008, izvirni znanstveni članek

Opis: Background: The incidence of non-ST-elevation acute coronary syndrome (ACS), including unstable angina pectoris and non-ST-elevation myocardial infarction (MI), is increasing in comparison to ST-elevation ACS. Our aim was to evaluate predictive role of admission variables for 30-day mortality in non-ST-elevation ACS patients. Patients and methods: We retrospectively analysed the data of 415 patients, admitted to University Clinical Center Maribor in 2006 due to non-ST-elevation ACS. Inclusion criteria were rest chest pain, ECG changes (ST-segment depression > or = 0.1 mV, and/or negative T wave > or = 0.1 mV and/or pathologic Q and/or non-specific ECG) and/or increased troponin T levels. Predictors of 30-day mortality were analysed by univariate and multivariate logistic regression. Results: 30-day mortality was 4.3 %. Between nonsurvivors and survivors there were significant differences in mean age, the incidence of arterial hypertension, positive family history of coronary artery disease, in mean admission systolic and diastolic blood pressure, pulse, mean admission troponin T, leukocyte count, CRP, creatinine and the incidence of admission heart failure. Multivariate logistic regression proved that most significant independent early predictor of 30-day mortality was admission heart failure (OR 41.21, 95 % CI 3.50 to 484.66, p = 0.003), followed by admission serum creatinine (OR 0.989, 95 % CI 0.981 to 0.997, p = 0.008) and troponin T (OR 0.263, 95 % CI 0.080 to 0.861). Conclusion: Most significant independent predictor of 30-day mortality of patients with non-ST-elevation ACS, being 4.5 %, was heart failure on admission.
Ključne besede: mortality, non-ST-elevation acute coronary syndrome, predictors
Objavljeno: 27.03.2017; Ogledov: 312; Prenosov: 36
.pdf Celotno besedilo (111,63 KB)
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8.
Optimization of induction of mild therapeutic hypothermia with cold saline infusion
Jure Fluher, Andrej Markota, Andraž Stožer, Andreja Sinkovič, 2015, izvirni znanstveni članek

Opis: Cold fluid infusions can be used to induce mild therapeutic hypothermia after cardiac arrest. Fluid temperature higher than 4°C can increase the volume of fluid needed, prolong the induction phase of hypothermia and thus contribute to complications. We performed a laboratory experiment with two objectives. The first objective was to analyze the effect of wrapping fluid bags in ice packs on the increase of fluid temperature with time in bags exposed to ambient conditions. The second objective was to quantify the effect of insulating venous tubing and adjusting flow rate on fluid temperature increase from bag to the level of an intravenous cannula during a simulated infusion. The temperature of fluid in bags wrapped in ice packs was significantly lower compared to controls at all time points during the 120 minutes observation. The temperature increase from the bag to the level of intravenous cannula was significantly lower for insulated tubing at all infusion rates (median temperature differences between bag and intravenous cannula were: 8.9, 4.8, 4.0, and 3.1°C, for non-insulated and 5.9, 3.05, 1.1, and 0.3°C, for insulated tubing, at infusion rates 10, 30, 60, and 100 mL/minute, respectively). The results from this study could potentially be used to decrease the volume of fluid infused when inducing mild hypothermia with an infusion of cold fluids.
Ključne besede: cardiac arrest, intravenous infusion, therapeutic hypothermia
Objavljeno: 03.08.2017; Ogledov: 275; Prenosov: 49
.pdf Celotno besedilo (232,18 KB)
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9.
Efficacy of a bundle approach in preventing the incidence of ventilator associated pneumonia (VAP)
Sandra Burja, Tina Belec, Nika Bizjak, Jernej Mori, Andrej Markota, Andreja Sinkovič, 2017, izvirni znanstveni članek

Opis: Ventilator-associated pneumonia (VAP) is a potentially preventable iatrogenic illness that may develop following mechanical ventilation. A bundle for the prevention of VAP consists of different measures which may vary between institutions, and may include: elevation of the head of the bed, oral care with chlorhexidine, subglottic suctioning, daily assessment for extubation and the need for proton-pump inhibitors, use of closed suction systems, and maintaining endotracheal cuff pressure at 25 cmH2O. Our aim was to determine the efficacy of a VAP prevention bundle, consisting of the above-mentioned measures, by evaluating the incidence of VAP before (no-VAP-B group) and after (VAP-B group) the introduction of the bundle. We retrospectively evaluated the data for patients who were mechanically ventilated with an endotracheal tube, in the period between 1 September and 31 December 2014 (no-VAP-B group, n = 55, 54.5% males, mean age 67.8 ± 14.5 years) and between 1 January to 30 April 2015 (VAP-B group, n = 74, 62.1% males, mean age 64.8 ± 13.7 years). There were no statistically significant differences between no-VAP-B and VAP-B groups in demographic data, intensive care unit (ICU) mortality, hospital mortality, duration of ICU treatment, and duration of mechanical ventilation. No significant differences in the rates of VAP and early VAP (onset ≤7 days after intubation) were found between no-VAP-B and VAP-B groups (41.8% versus 25.7%, p = 0.06 and 10.9% versus 12.2%, p > 0.99, respectively). However, a significant decrease in the late VAP (onset >8 days after intubation) was found in VAP-B group compared to no-VAP-B group (13.5% versus 30.9%, p = 0.027). Overall, our results support the use of VAP prevention bundle in clinical practice.
Ključne besede: ventilator-associated pneumonia, VAP, primary prevention, epidemiology, medical devices, intratracheal intubation, bundle
Objavljeno: 13.11.2017; Ogledov: 443; Prenosov: 162
.pdf Celotno besedilo (96,15 KB)
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10.
Pojav akutne ledvične odpovedi pri bolnikih z akutnim miokardnim infarktom z dvigom veznice ST
Klara Masnik, Matic Mihevc, 2017, končno poročilo o rezultatih raziskav

Objavljeno: 23.07.2018; Ogledov: 282; Prenosov: 16
.pdf Celotno besedilo (1,65 MB)

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