University Medical Centre Maribor Research Articles

Ugotavljanje dehidracije pri starostnikih, ki so bili obravnavani na nujni medicinski pomoči: akcijska raziskava

Uvod: Skrb za zadostno hidracijo starostnikov je pogosto izražena, vendar v praksi velikokrat pozabljena. Z raziskavo smo želeli ugotoviti stanje hidracije pri starostnikih, starejših od 65 let, ki živijo v socialnovarstvenih institucijah v Mariboru in okolici. 
 Metode: V retrospektivni raziskavi smo ugotavljali vrednosti označevalcev dehidracije pri 107 starostnikih, starejših od 65 let. Med njimi je bilo 70 (65 %) žensk, povprečne starosti 84,1 let, in 37 (35 %) moških, povprečne starosti 80,4 let. Vzorec je zajemal starostnike, napotene v ambulanto za Internistično nujno pomoč Univerzitetnega kliničnega centra Maribor v obdobju od 1. 11. 2013 do 24. 1. 2014. Analizirali smo laboratorijske rezultate, zbrane v medicinsko-informacijskem sistemu. Kriterije dehidracije so predstavljali: natrij v serumu nad 145 mmol/L, sečnina nad 20 mg/ml oz. razmerje sečnina/kreatinin nad 20 : 1. 
 Rezultati: Raziskava je potrdila prisotnost povišanih vrednosti označevalcev dehidracije pri 73,8 % obravnavanih starostnikov. En kriterij dehidracije je dosegalo 35 starostnikov, dva kriterija 39 in tri kriterije 5 starostnikov.
 Diskusija in zaključek: Ugotovili smo, da povišane vrednosti označevalcev dehidracije ne dajo zanesljivega odgovora o stanju hidracije starostnikov, saj se le-ta lahko glede na uporabljene kriterije preceni ali podceni. Za boljšo oceno hidracije je v nadaljnjih raziskavah potrebno uporabiti natančnejše označevalce v kombinaciji s starostnikovimi kliničnimi znaki in anamnestičnimi podatki.

Uspešnost histeroskopske sterilizacije s sistemom Essure in zadovoljstvo pacientk s posegom

BACKGROUND: Essure is a permanent transcervical sterilisationprocedure. Three months after the procedure a confirmation test is performed to evaluate tubal occlusion or microinsert location. During this period the tubal lumen is occluded by benign tissue ingrowth stimulated by the microinsert. Since 2007, 169 procedures have been performed at University Medical Centre Maribor. The purpose of our study was to evaluate the efficacy, satisfaction, and complications of the procedure.METHODS: Thirty-eight consecutive patients were included in prospective study. All procedures were performed between August 2012 and March 2013 by the same experienced hysteroscopist in an outpatient setting. Transvaginal 2D ultrasound was performed 3 months after the procedure to asses the position of microinserts. Hysterosalpingo foam sonography (HyFoSy) was performed in 5 cases and hysterosalpingography (HSG) was performed once in a total of 6 cases with indeterminate position of microinserts.RESULTS: Thirty-eight patients with 75 Fallopian tubes were included. Essure microinsert was successfully placed in 73 of 75 Fallopian tubes in 37 patients (97,3%). Transvaginal ultrasound demonstrated a correct placement of 67 microinserts (67/73, 91,8%). Tubal occlusion was confirmed in all 6 cases with indeterminate position of microinserts. The overall patient satisfactory rate was 9,92 on a scale from 0 to 10.CONSCLUSION: Essure is a method for permanent female contraception that has a very high rate of success and patient satisfaction, a low rate of complications and is well tolerated. In cases of indeterminate position of microinserts on transvaginal ultrasound, HyFoSy could be an alternative to HSG.

AB1149-HPR Pretreatment Education of Patients Treated with Biologicals

BackgroundThe introduction and rapid escalation in the use of biologicals has required a steep learning curve for rheumatology specialist nurses, who are at the forefront of patient assessment and long-term...

Evaluation of coagulation abnormalities among women with vaginal bleeding in the first trimester of pregnancy

ObjectiveTo compare blood coagulation parameters between pregnant women with vaginal bleeding in the first trimester of pregnancy and pregnant women with normal pregnancy in the first trimester. MethodsA prospective controlled study of 98 women in the first trimester of vital pregnancy was conducted at the University Medical Centre Maribor, Slovenia. The study group comprised women with vaginal bleeding (n=50) while the control group women with normal pregnancy, admitted for artificial abortion (n=48). Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, number of platelets, hemogram, coagulation factor VIII (FVIII) and von Willebrand factor (VWF) activity were compared between the 2 groups. ResultsNo significant between-group differences were detected in mean PT, fibrinogen concentration, FVIII, and VWF activity. Mean aPTT was significantly higher in the control group than the study group (32.47 versus 30.46seconds; P<0.05). The mean number of platelets was significantly lower in the study group than the control group (181.69 versus 203.52×109/L; P<0.05). All measured coagulation parameters, except VWF activity, were within normal ranges. ConclusionCoagulation abnormalities are rarely the cause of vaginal bleeding in the first trimester of pregnancy among women with no previous symptoms of bleeding disorders.

Comparison of point-of-care and laboratory troponin I assays.

BACKGROUND In recent years a number of pointof- care troponin assays have emerged. There have been reports of discrepancies between the results of point-of-care and laboratory assays. We sought to compare the results of point-ofcare and laboratory troponin I assays in patients with suspected acute coronary syndromes. METHODS A retrospective study was performed comparing the results of point-of-care (i-STAT cardiac troponin I test, Abbott Point of Care) and laboratory troponin I analysis in patients with suspected acute coronary syndrome treated in the Internal Medicine Emergency Department, University Medical Centre Maribor, between 23 November and 21 December 2010, who had blood samples drawn simultaneously for pointof- care and laboratory troponin I analysis. RESULTS 112 patients were included in the analysis. There was an agreement between the results of point-of-care and laboratory troponin analysis in 105 (93.8 %) patients. If we consider the laboratory results as »gold standard« (diagnosis was based on laboratory troponin results), then 6 (5.4 %) false negative results and 1 (0.9 %) false positive result were found (sensitivity 81.2 %, specificity 98.7 %). However, there was no statistically significant difference between point-of-care and laboratory troponin I analysis (p = 0.125). CONCLUSIONS We detected lower sensitivity of point-of-care assay, but there was no statistically significant difference between point-of-care and laboratory troponin I analysis. We adopted a strategy of using point-of-care troponin assay primarily in patients at high-risk for acute coronary syndrome without ST elevation.

The hospital treatment of alcoholics in Eastern Slovenia

Background: The purpose of this study was to evaluate the number and types of hospitalized alcohol dependents with and without withdrawal symptoms and their laboratory markers in the hospitals of Eastern Slovenia in the years 2002 and 2007. Results: There were 776 alcohol dependent patients in the year 2002 and 672 in the year 2007 discharged from all hospitals. The hospitals differed from each other with respect to the profile of dismissed patients. Apparent is a low number of patients with withdrawal symptoms at the Department of Psychiatry of the University Medical Centre Maribor. In the complex of laboratory examinations in all three hospitals there were only gamma-Glutamyltransferase (GGT), Aspartat-Aminotransferase (AST) and Alanin-Aminotransferase (ALT) as well as mean corpuscular volume (MCV) determined. In the year 2007, all the mean values of alcohol dependency markers were statistically significantly increased as compared to the year 2002, except for MCV in women. Even the shares of pathological values were higher in the year 2007. Conclusions: The number of hospitalized alcoholics and all patients in psychiatric hospitals of the Eastern Slovenia was statistically significantly lower in the year 2007 than in 2002. Even the percentage of hospitalized alcoholics was decreased. The alcoholics hospitalized in 2007 were physically statistically significantly more affected than the alcoholics hospitalized in 2002. The differences in pathological marker values were not so pronounced that they could be used as a predictor of withdrawal symptoms. The most specific laboratory markers of alcoholism, i.e. carbohydrate deficient trasferrin (CDT) and Glutamate Dehydrogenase (GLDH) had not been used in any of the three hospitals.