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1.
Surgical treatment of acute patellar dislocation associated with bony avulsion in children
Samo K. Fokter, Andraž Dovnik, Nina Fokter Dovnik, 2013, izvirni znanstveni članek

Opis: Purpose: The management of acute patellar dislocation in children and adolescents is controversial. Traditionally,most first time traumatic patellar dislocations have been treated nonoperatively. However, due to new knowledge about medial patellar stabilizers some authors have advocated for surgical repair. The present report describes the midterm subjective and functional results of operative treatment of acute patellar dislocation in children less than eighteen years of age with concomitant osteochondral fracture. Methods: Data on a cohort of sixteen patients (eight girls and eight boys) aged 14.9 years (mean, range12-17 years) with acute patellar dislocation were retrospectively collected. Intraarticular fragments were detected in all patients in conventional radiographs. Operative treatment consisted of arthroscopic removal (12cases) or refixation (4 cases) of the osteochondral fragments and direct repair of the damaged medial patellofemoral ligament (MPFL) if that was still feasible (13 cases). All patients were seen at six months, and a telephone interview with twelve patients (75%) was conductedat four years (mean, range 27 years). Results: Of the sixteen patients, two (12.5%) had a recurrent patellar luxation. The subjective IKDC score at the time of the most recent follow up was 86 (mean, range 63-100), and the Marx Activity Rating Scale score was 9.2 (mean, range 216).Conclusions: Direct surgical repair of the injured MPFLmay be considered an option to prevent subsequent dislocation and subluxation in first time traumatic dislocation of the patella in children and adolescents with osteochondral fractures and substantial disruption of medial patellar stabilizers.
Ključne besede: akutni izpah pogačice, patelofemoralna kostna avulzija, izpah pri otrocih, pediatrične poškodbe, kirurško zdravljenje
Objavljeno v DKUM: 12.04.2024; Ogledov: 162; Prenosov: 12
.pdf Celotno besedilo (457,50 KB)
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Survival of node-negative breast cancer patients treated at the University Medical Centre Maribor in the period 2000-2009
Nina Fokter Dovnik, Darja Arko, Nina Čas-Sikošek, Iztok Takač, 2017, izvirni znanstveni članek

Opis: Introduction: Breast cancer is increasingly diagnosed in the early stages without regional nodal involvement. The aim of the present study was to determine the 5-year overall (OS) and breast cancer specific survival (BCSS) for patients with node-negative breast cancer treated at the University Medical Centre Maribor, and compare it with survival at the national level. Methods: Medical records were searched for information on patients with lymph node-negative invasive breast cancer who received primary treatment at the University Medical Centre Maribor in the period 2000–2009. Information on all Slovenian node-negative breast cancer patients diagnosed in the same period was obtained from the Cancer Registry of Republic of Slovenia. Time trends in survival were assessed by comparing the periods 2000–2004 and 2005–2009. Results: The 5-year OS and BCSS of patients treated in Maribor in the period 2000–2009 were 92.3% (95% CI, 90.5%– 94.1%) and 96.4% (95% CI, 95.2%–97.6%), respectively, and did not differ from the corresponding OS and BCSS for Slovenian patients. Although the improvement in OS for patients from Maribor diagnosed in the period 2005–2009 compared to 2000–2004 did not reach statistical significance (HR 0.73; 95% CI, 0.51–1.05; p=0.086), BCSS significantly improved over the same time periods (HR 0.53; 95% CI, 0.30–0.94; p=0.028). Conclusions: Survival of node-negative breast cancer patients treated at the University Medical Centre Maribor is comparable to survival of corresponding patients at the national level. The rising number of long-term breast cancer survivors places additional importance on survivorship care.
Ključne besede: breast cancer, survival, time trends, regional differences, Slovenia
Objavljeno v DKUM: 26.06.2017; Ogledov: 1639; Prenosov: 369
.pdf Celotno besedilo (854,97 KB)
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Prognostic significance of uPA/PAI-1 level, HER2 status, and traditional histologic factors for survival in node-negative breast cancer patients
Nina Fokter Dovnik, Iztok Takač, 2017, izvirni znanstveni članek

Opis: Background: The association of HER2 status with urokinase plasminogen activator (uPA) and plasminogen activator inhibitor 1 (PAI-1) levels raises the question whether uPA/PAI-1 level carries additional clinically relevant prognostic information independently from HER2 status. The aim of our study was to compare the prognostic value of uPA/PAI-1 level, HER2 status, and traditional prognostic factors for survival in node-negative breast cancer patients. Patients and methods: A retrospective analysis of 858 node-negative breast cancer patients treated in Maribor University Clinical Center, Slovenia, in the years 2000-2009 was performed. Data were obtained from patient medical records. The median follow-up time was 100 months. Univariate and multivariate analyses of disease-free (DFS) and overall survival (OS) were performed using the Cox regression and the Cox proportional hazards model. Results: In univariate analysis, age, tumor size, grade, lymphovascular invasion, HER2 status and UPA/PAI-1 level were associated with DFS, and age, tumor size, grade, and uPA/PAI-1 level were associated with OS. In the multivariate model, the most important determinants of DFS were age, estrogen receptor status and uPA/PAI-1 level, and the most important factors for OS were patient age and tumor grade. The HR for death from any cause in the multivariate model was 1.98 (95% CI 0.83-4.76) for patients with high uPA and/or PAI-1 compared to patients with both values low. Conclusions: uPA/PAI-1 level clearly carries an independent prognostic value regardless of HER2 status in node-negative breast cancer and could be used in addition to HER2 and other markers to guide clinical decisions in this setting.
Ključne besede: node-negative breast cancer, adjuvant systemic treatment, survival, uPA/PAI-1, HER2 status
Objavljeno v DKUM: 10.05.2017; Ogledov: 1357; Prenosov: 416
.pdf Celotno besedilo (577,15 KB)
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5.
Urokinase plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) in breast cancer : correlation with traditional prognostic factors
Maja Lampelj, Darja Arko, Nina Čas-Sikošek, Rajko Kavalar, Maja Ravnik, Barbara Jezeršek Novaković, Sarah Dobnik, Nina Fokter Dovnik, Iztok Takač, 2015, izvirni znanstveni članek

Opis: Background: Urokinase plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) play a key role in tumour invasion and metastasis. High levels of both proteolytic enzymes are associated with poor prognosis in breast cancer patients. The purpose of this study was to evaluate the correlation between traditional prognostic factors and uPA and PAI-1 expression in primary tumour of breast cancer patients. Patients and methods: 606 primary breast cancer patients were enrolled in the prospective study in the Department of gynaecological oncology and breast oncology at the University Medical Centre Maribor between the years 2004 and 2010. We evaluated the traditional prognostic factors (age, menopausal status, tumour size, pathohistological type, histologic grade, lymph node status, lymphovascular invasion and hormone receptor status), together with uPA and PAI-1. We used Spearman%s rank correlation, Mann Whitney U test and X2 test for statistical analysis. Results: Our findings indicate a positive correlation between uPA and tumour size (p < 0.001), grade (p < 0.001), histological type (p < 0.001), lymphovascular invasion (p = 0.01) and a negative correlation between uPA and hormone receptor status (p < 0.001). They also indicate a positive correlation between PAI-1 and tumour size (p = 0.004), grade (p < 0.001), pathohistological type (p < 0.001) and negative correlation between PAI-1 and hormone receptor status (p = 0.002). Conclusions: Our study showed a relationship between uPA and PAI-1 and traditional prognostic factors. Their role as prognostic and predictive factors remains to be further evaluated.
Ključne besede: urokinase plasminogen activator, plasminogen activator inhibitor, breast cancer
Objavljeno v DKUM: 05.04.2017; Ogledov: 1304; Prenosov: 157
.pdf Celotno besedilo (597,75 KB)
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6.
Napovedna moč nekaterih kliničnih, histopatoloških in bioloških parametrov za preživetje bolnic z rakom dojk brez zasevkov v bezgavkah, zdravljenih v Univerzitetnem kliničnem centru Maribor v letih 2000–2009
Nina Fokter Dovnik, 2017, doktorsko delo/naloga

Opis: Izhodišča. Enega izmed največjih izzivov pri zdravljenju raka dojk v zgodnjem stadiju predstavlja izbor bolnic s predvidenim agresivnejšim potekom bolezni, ki potrebujejo dopolnilno sistemsko zdravljenje. O tem se odločamo na podlagi različnih napovednih dejavnikov, kot so status pazdušnih bezgavk, velikost tumorja, stopnja diferenciacije, limfovaskularna invazija, starost bolnic, status hormonskih receptorjev, status HER2, v zadnjem času pa v ta namen ponekod uporabljajo tudi urokinazni aktivator plazminogena (uPA) in inhibitor aktivatorja plazminogena 1 (PAI-1). Vloga novejših napovednih dejavnikov v primerjavi s tradicionalnimi še ni povsem razjasnjena. Namen raziskave je bil ugotoviti vpliv posameznih dejavnikov na preživetje bolnic z rakom dojk brez zasevkov v bezgavkah, zdravljenih v Univerzitetnem kliničnem centru (UKC) Maribor. Hkrati sem želela tudi primerjati preživetje bolnic, zdravljenih v UKC Maribor, s slovenskim povprečjem. Bolnice in metode. Opravila sem retrospektivno analizo bolnic z invazivnim rakom dojk brez zasevkov v bezgavkah, ki so bile primarno zdravljene v UKC Maribor v letih 2000–2009. Podatke sem pridobila iz medicinske dokumentacije in jih dopolnila s podatki iz Registra raka Republike Slovenije, od koder sem pridobila tudi podatke o vseh primerljivih slovenskih bolnicah, zdravljenih v istem obdobju. Analizirala sem korelacije med napovednimi dejavniki in s pomočjo Coxove regresije in Coxovega modela sorazmernih tveganj opravila univariatne in multivariatne analize preživetja brez bolezni, celokupnega in specifičnega preživetja. Rezultati. Študijsko skupino je sestavljalo 858 bolnic s srednjim časom sledenja 101 mesec. Med bolnicami, zdravljenimi v UKC Maribor, in vsemi slovenskimi bolnicami ni bilo razlik v celokupnem (HR 1,07; 95 % CI 0,91–1,27; p = 0,413) in specifičnem preživetju (HR 0,85; 95 % CI 0,66–1,11; p = 0,234). Preživetje brez bolezni (HR 0,67; 95 % CI 0,50–0,91; p = 0,010) in specifično preživetje (HR 0,53; 95 % CI 0,30–0,94; p = 0,031) je bilo statistično značilno boljše v obdobju 2005–2009 v primerjavi z 2000–2004, pri celokupnem preživetju pa se je kazal enako usmerjen statistično neznačilen trend (HR 0,73; 95 % CI 0,51–1,05; p = 0,087). Med napovednimi dejavniki so bile prisotne številne korelacije. V multivariatnih analizah so na preživetje brez bolezni najbolj vplivali starost ob diagnozi, vrednost uPA/PAI-1 in status estrogenskih receptorjev, na celokupno preživetje starost, stopnja diferenciacije in vrednost uPA/PAI-1, na specifično preživetje pa stopnja diferenciacije. Zaključki. Preživetje bolnic z rakom dojk brez zasevkov v bezgavkah, primarno zdravljenih v UKC Maribor v letih 2000–2009, je zelo visoko in enakovredno preživetju vseh primerljivih bolnic na ravni Slovenije. Kot najpomembnejša napovedna dejavnika sta se pri tej skupini bolnic izkazala vrednost uPA/PAI-1 in stopnja diferenciacije, ki sta klinično pomembno vplivala na preživetje brez bolezni, celokupno in specifično preživetje.
Ključne besede: rak dojk brez zasevkov v bezgavkah, dopolnilno zdravljenje, stadij, stopnja diferenciacije, status HER2, status hormonskih receptorjev, urokinazni aktivator plazminogena, inhibitor aktivatorja plazminogena 1
Objavljeno v DKUM: 14.03.2017; Ogledov: 1919; Prenosov: 190
.pdf Celotno besedilo (5,97 MB)

7.
A prospective study of the correlation between infection of the uterine cervix and secondary bleeding after large loop excision of the transformation zone (LLETZ)
Darja Arko, Andraž Dovnik, Nina Fokter Dovnik, Iztok Takač, 2011, izvirni znanstveni članek

Opis: Purpose: A prospective study was undertaken to evaluate the role of genital pathogens in postoperative bleeding necessitating secondary intervention after large loop excision of the transformation zone (LLETZ) of the uterine cervix. Methods: A total of 1419 patients with cervical intraepithelial neoplasia (CIN) who underwent LLETZ were included in the study. To determine the presence of genital pathogens, cervical swabs were collected before the procedure. Postoperatively, patients were followed up for bleeding necessitating secondary interventions. Results: Among 1419 patients, genital pathogens were present in 714 (50.3%) cases and absent in 705 (49.7%) cases. The most frequently isolated groups of microorganisms were group-B ß-haemolytic streptococci, alpha-haemolytic streptococci, Enterococcus sp. and coliforms. Secondary procedures due to severe bleeding were required in 48 (6.8 %) patients without and in 63 (8.8%) patients with genital pathogens, but this difference was not significant (chi-square test = 1.72; P>0.05). Conclusion: These data suggest that genital pathogens are very common in patients with CIN and are not an important cause of postoperative bleeding necessitating secondary intervention after LLETZ.
Ključne besede: cervikalna intraepitelijska neoplazija, genitalni patogeni, LLETZ, krvavitev, genitalna okužba
Objavljeno v DKUM: 10.07.2015; Ogledov: 1662; Prenosov: 70
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