Abstract Purpose Excessive tachycardia in resuscitated septic shock can impair hemodynamics and worsen patient outcome. We asked whether heart rate (HR) control can be achieved without increased vasopressor requirements by using a titrated highly selective, ultra-short acting β1-blocker landiolol. Methods This randomized, open-label, controlled trial was conducted at 20 sites in 7 European countries from 2018 to 2022 and investigated the efficacy and safety of landiolol in adult patients with septic shock and persistent tachycardia. Patients were randomly assigned to receive either landiolol along with standard treatment (n = 99) or standard treatment alone (n = 101). The combined primary endpoint was HR response (i.e. HR within the range of 80 − 94 beats per minute) and its maintenance without increasing vasopressor requirements during the first 24 h after treatment start. Key secondary endpoints were 28-day mortality and adverse events. Results Of 196 included septic shock patients, 98 received standard treatment combined with landiolol and 98 standard treatment alone. A significantly larger proportion of patients met the combined primary endpoint in the landiolol group than in the control group (39.8% [39/98] vs. 23.5% [23/98]), with a between-group difference of 16.5% (95% CI: 3.4–28.8%; p = 0.013). There were no statistically significant differences between study groups in tested secondary outcomes and adverse events. Conclusion The ultra-short acting betablocker landiolol was effective in reducing and maintaining HR without increasing vasopressor requirements after 24 h in patients with septic shock and persistent tachycardia. Mortality rates and safety were comparable to standard treatment alone. TRIAL REGISTRATION: EU Clinical Trial Register; EudraCT Number: 2017-002138-22

Urinary tract infections (UTI) are frequent bacterial infections in childhood. Considering the known beneficial effects of probiotics in the gastrointestinal field, they could also help to alleviate UTIs. In our clinical pilot study, we sought to verify the positive effects of the specific probiotic strain on the course and prevention of UTI in children. Thirty children with UTIs were enrolled and sequentially sampled into two groups (placebo/control and probiotic/test) in a double-blind, randomized, placebo-controlled clinical pilot study. We chose Lactobacillus plantarum PCS 26 (Lp26) derived from local Slovenian cheese in Pathogen Combat Project, which showed a good in vitro antimicrobial effect on Escherichia coli (E. coli). Several parameters were followed to look for differences between both groups in the acute phase of the UTI and after 6 months of taking probiotic or placebo supplementation. Our results showed no statistically significant differences between both groups; however, two children in the placebo group suffered a recurrence of febrile UTI within 6 months of the follow-up period, while there were no recurrences of UTI in the probiotic group. In the test group, the number of febrile days after the initiation of antibiotics with probiotics was shorter, although not reaching statistical significance (p = 0.084). According to our results, probiotics might be helpful in alleviating UTI symptoms and in UTI prevention. Further research with a larger sample size is warranted. Additionally, basic scientific studies for the selection of proper immunobiotic strains of probiotics should be performed.

Liver steatosis is a chronic liver disease that is becoming one of the most important global health problems, due to its direct connection with metabolic syndrome, its significant impact on patients' socioeconomic status and frailty, and the occurrence of advanced chronic liver disease. In recent years, there has been rapid technological progress in the ultrasound-based diagnostics field that can help us to quantitatively assess liver steatosis, including continuous attenuation parameters in A and B ultrasound modes, backscatter coefficients (e.g., speed of sound) and ultrasound envelope statistic parametric imaging. The methods used in this field are widely available, have favorable time and financial profiles, and are well accepted by patients. Less is known about their reliability in defining the presence and degree of liver steatosis. Numerous study reports have shown the methods' favorable negative and positive predictive values in comparison with reference investigations (liver biopsy and MRI). Important research has also evaluated the role of these methods in diagnosing and monitoring non-alcoholic fatty liver disease (NAFLD). Since NAFLD is becoming the dominant global cause of liver cirrhosis, and due to the close but complex interplay of liver steatosis with the coexistence of liver fibrosis, knowledge regarding NAFLD's influence on the progression of liver fibrosis is of crucial importance. Study findings, therefore, indicate the possibility of using these same diagnostic methods to evaluate the impact of NAFLD on the patient's liver fibrosis progression risk, metabolic risk factors, cardiovascular complications, and the occurrence of hepatocellular carcinoma. The mentioned areas are particularly important in light of the fact that most of the known chronic liver disease etiologies are increasingly intertwined with the simultaneous presence of NAFLD.

As in other Slovenian towns and market towns, in the Middle Ages, handicrafts also began to develop in Ljutomer and its surroundings, which boasted numerous craftsmen. Most handicrafts in Ljutomer reached their zenith at the end of the nineteenth century. The greatest boom was experienced by joinery as well as the tanning and brickmaking trades, which gradually evolved from small handicrafts workshops into semi-industrial and industrial plants that continue to be in operation today. Among many handicrafts, the article focuses primarily on the development of tailoring, well digging, pottery, shoemaking, joinery, ropemaking, blacksmithing, wheelwrighting, milling, confectionery, and gingerbread making.

As in other Slovenian towns and market towns, in the Middle Ages, handicrafts also began to develop in Ljutomer and its surroundings, which boasted numerous craftsmen. Most handicrafts in Ljutomer reached their zenith at the end of the nineteenth century. The greatest boom was experienced by joinery as well as the tanning and brickmaking trades, which gradually evolved from small handicrafts workshops into semi-industrial and industrial plants that continue to be in operation today. Among many handicrafts, the article focuses primarily on the development of tailoring, well digging, pottery, shoemaking, joinery, ropemaking, blacksmithing, wheelwrighting, milling, confectionery, and gingerbread making.

The Mauerburg family appeared in the Ljutomer area in the second half of the seventeenth century with the arrival of Dr Thomas Ignaz († 1688), who initially bore the family name Maurer. Apart from numerous estates, he also bought Branek Castle, which flourished under the new family. Thomas Ignaz bequeathed to his descendants a tremendous estate with a value estimated at 230,000 gulden at that time. The inherited property paved his successor’s way to becoming the lord of not only Branek Castle but also of the entire Ljutomer seigniory, including the market town of Ljutomer. This is also confirmed by The Land Register of Estates and Vineyard Taxes in the Wine-Growing Hills of Ormož–Ljutomer, which was compiled on the death of Baron Thomas Ignaz Mauerburg in 1688 and serves as an excellent source for understanding the division of immense inheritance between his descendants.

The Mauerburg family appeared in the Ljutomer area in the second half of the seventeenth century with the arrival of Dr Thomas Ignaz († 1688), who initially bore the family name Maurer. Apart from numerous estates, he also bought Branek Castle, which flourished under the new family. Thomas Ignaz bequeathed to his descendants a tremendous estate with a value estimated at 230,000 gulden at that time. The inherited property paved his successor’s way to becoming the lord of not only Branek Castle but also of the entire Ljutomer seigniory, including the market town of Ljutomer. This is also confirmed by The Land Register of Estates and Vineyard Taxes in the Wine-Growing Hills of Ormož–Ljutomer, which was compiled on the death of Baron Thomas Ignaz Mauerburg in 1688 and serves as an excellent source for understanding the division of immense inheritance between his descendants.

Namen: Kraniotomija je osnovni nevrokirurški pristop, ki je povezan z zapleti, med katere spada okužba kirurške rane, za pojav katere so dejavniki tveganja še vedno nepopolno definirani. Namen raziskave je bil prepoznati dejavnike tveganja za pojav okužbe kirurške rane pri odraslih bolnikih, operiranih na Oddelku za nevrokirurgijo Univerzitetnega kliničnega centra v Mariboru.
 Metode: Izvedli smo retrospektivno kohortno študijo, v kateri smo analizirali podatke za obdobje od januarja 2009 do avgusta 2019. Primerjali smo podatke bolnikov, ki so razvili okužbo kirurške rane, s podatki tistih, ki okužbe niso razvili. 66 bolnikov je razvilo okužbo kirurške rane, v kontrolno skupino smo naključno uvrstili 70 bolnikov brez omenjene rane. V raziskavo smo vključili le bolnike, ki so po opravljeni elektivni kraniotomiji potrebovali kirurško zdravljenje okužene kirurške rane.
 Rezultati: Med 1192 bolniki, ki so v opazovanem obdobju imeli opravljeno kraniotomijo, je 66 (5,5 %) bolnikov razvilo okužbo kirurške rane. Najpogosteje je prišlo do razvoja osteomielitisa (66,7 %) in epiduralnega abscesa (63,6 %), najpogosteje izoliran povzročitelj pa je bil Propionibacterium acnes (54,5 %). V raziskavi so se kot dejavniki, povezani s pojavom okužbe kirurške rane, izkazali uporaba izdelka Surgicel® (p = 0,0019, Fisherjev natančni test), duralni nadomestki (p = 0,0028, Fisherjev natančni test), samolepilna dura (p = 0,0274, Fisherjev natančni test), zapiranje kože s šivi (p = 0,0001, Fisherjev natančni test), opravljena frontalna kraniotomija (p = 0,0328, Fisherjev natančni test) in pooperativno predpisovanje glukokortikoidov (p = 0,04, Fisherjev natančni test).
 Zaključek: Z našo študijo smo prepoznali določene dejavnike tveganja, povezane s pojavi okužbe kirurške rane, ki jih lahko odpravimo in tako znižamo pojavnost tovrstnega operativnega zapleta oz. zaplet hitreje prepoznamo.

Abstract Background Point-of-care ultrasound (POCUS) is a useful diagnostic tool for non-invasive assessment of critically ill patients. Mortality of elderly patients with COVID-19 pneumonia is high and there is still scarcity of definitive predictors. Aim of our study was to assess the prediction value of combined lung and heart POCUS data on mortality of elderly critically ill patients with severe COVID-19 pneumonia. Methods This was a retrospective observational study. Data of patients older than 70 years, with severe COVID-19 pneumonia admitted to 25-bed mixed, level 3, intensive care unit (ICU) was analyzed retrospectively. POCUS was performed at admission; our parameters of interest were pulmonary artery systolic pressure (PASP) and presence of diffuse B-line pattern (B-pattern) on lung ultrasound. Results Between March 2020 and February 2021, 117 patients aged 70 years or more (average age 77±5 years) were included. Average length of ICU stay was 10.7±8.9 days. High-flow oxygenation, non-invasive ventilation and invasive mechanical ventilation were at some point used to support 36/117 (31%), 39/117 (33%) and 75/117 (64%) patients respectively. ICU mortality was 50.9%. ICU stay was shorter in survivors (8.8±8.3 vs 12.6±9.3 days, p=0.02). PASP was lower in ICU survivors (32.5±9.8 vs. 40.4±14.3 mmHg, p=0.024). B-pattern was more often detected in non-survivals (35/59 (59%) vs. 19/58 (33%), p=0.005). PASP and B-pattern at admission were both univariate predictors of mortality. PASP at admission was an independent predictor of ICU (OR 1.0683, 95%CI: 1.0108-1.1291, p=0.02) and hospital (OR 1.0813, 95%CI 1.0125-1.1548, p=0.02) mortality. Ventilator associated pneumonia (VAP) was a strong predictor of ICU and hospital mortality. Conclusions PASP at admission is an independent predictor of ICU and hospital mortality of elderly patients with severe COVID-19 pneumonia. During ICU stay development of VAP was a strong predictor of ICU and hospital mortality.

Purpose: Particulate debris created by accelerated polyethylene wear in totally replaced hips causes adverse local reactions. We report an extreme form of such a reaction in a patient who developed progressive thigh pain, weakness and numbness after total arthroplasty of his left hip.
 Methods: An abdominopelvic computed tomogram showed a large intrapelvic cystic mass interpreted as a malignant tumor. Dark grayish-green fluid was aspirated from the cyst and cytopathologic examination showed necrotic debris without malignant cells. Biopsy revealed necrosis and abundant foreign body granulation tissue with polarizable debris.
 Results: During surgical removal of the cyst a defect of the inner acetabular wall was noted. After successful revision arthroplasty with allograft bone the clinical symptoms improved.
 Conclusion: A foreign-body reaction to wear debris may produce an intrapelvic mass and corresponding symptoms. Cytologic and histologic examination of the mass or fluid may aid in interpreting the clinical picture and imaging studies.