Gestational diabetes (GDM) is one of the most common complications in pregnancy, with a prevalence that continues to rise. At the time of the COVID-19 epidemic, immediate reorganisation and ...adjustment of the system was needed. Telemedicine support was offered in order to provide high-quality treatment to pregnant women. However, the success of the treatment is unknown. We therefore aimed to evaluate COVID-19 epidemic effects on pregnancy outcomes in GDM.
The maternal outcomes (insulin treatment, gestational weight gain, caesarean section, hypertensive disorders) and perinatal outcomes (rates of large and small for gestational age, preterm birth and a composite child outcome) of women visiting a university hospital diabetes clinic from March to December 2020 were compared with those treated in the same period in 2019.
Women diagnosed with GDM during the COVID-19 epidemic (n=417), were diagnosed earlier (23.9 11.7-26.0 vs. 25.1 21.8-26.7 gestational week), had higher fasting glucose (5.2 5.0-5.4 vs. 5.1 4.8-5.3 mmol/l) and earlier pharmacological therapy initiation, and had achieved lower HbA1c by the end of followup (5.1% (32.2 mmol/mol) 4.9% (30.1 mmol/mol)-5.4% (35.0 mmol/mol) vs. 5.2% (33.3 mmol/mol) 5.0% (31.1 mmol/mol) - 5.4%·(35.5 mmol/mol), p<0.001) compared to a year before (n=430). No significant differences in perinatal outcomes were found.
Although GDM was diagnosed at an earlier gestational age and higher fasting glucose concentration was present at the time of diagnosis, the COVID-19 epidemic did not result in worse glucose control during pregnancy or worse pregnancy outcomes in Slovenia.
Introduction: To estimate the procedure-related risks of pregnancy loss following chorionic villus sampling (CVS) and amniocentesis (AC) compared to pregnancies without procedure.
This cohort study ...enrolled all women who underwent CVS or AC at the Department of Perinatology, University Medical Centre, Ljubljana, Slovenia (from January 2013 to June 2015). For each group we obtained a maternal age and gestational age (11-14 weeks for CVS and >15 weeks for AC) for a matched control group without invasive procedures from the national database. The data was obtained from hospital records and telephone surveys concerning pregnancy outcomes. Pregnancy loss rates in intervention vs. control groups were compared by generating relative risk (RR) with a 95% confidence interval.
During the study period, 828 women underwent CVS and 2,164 women underwent AC. Complete outcome data was available in 2,798 cases (93.5%, 770 CVS, 2,028 AC). Pregnancy loss occurred in 8/770 (1.04%, 95% CI 0.4-2.0%) after CVS vs. 15/1130 (1.33%, 95% CI 0.8-2.2%) in matched control (RR 0.8, 95% CI 0.33-1.8, p=0.6). It occurred in 16/2028 (0.79%, 95% CI 0.5-1.3%) after AC vs. 14/395 (3.29%, 95% CI 2.1-5.8%) in matched control (RR 0.2, 95% CI 0.11-0.45, p<0.0001).
The pregnancy loss rates after CVS and AC were comparable to losses in pregnancies without these procedures. With the increasing use of non-invasive prenatal testing, information that the invasive procedures are safe when indicated is essential.
Zika: an old virus with a new face Avšic Županc, Tatjana; Petrovec, Miroslav
Zdravstveno varstvo,
12/2016, Letnik:
55, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. This obscure virus was limited to sporadic cases in Africa and Asia, until the emergence ...of Zika virus in Brazil in 2015, when it rapidly spread throughout the Americas. Most Zika virus infections are subclinical or characterized by mild febrile illness. However, neurological complications, including Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a grave concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Thus, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.
The objective of the study was to determine the course and outcomes of pregnancy and childbirth in adolescents compared to women aged 20-24 years in Slovenia.
In the retrospective study, the course ...of pregnancy and labour and the perinatal outcome of newborns in primiparous adolescents aged ≤19 years (study group) have been compared to the control group of primiparous women aged 20-24 years. The study group was further divided into a study subgroup of adolescents aged ≤17 years. Data were retrieved from the National Perinatal Information System in Slovenia for the period 2008-2012. Altogether, 13,663 women and their newborns were included.
Adolescent pregnancy was associated with increased rates of unknown estimated date of delivery, preterm labour, low birth weight newborns, small for gestational age newborns and low gestational weight gain. Spontaneous labour was more common in adolescents, while emergency and elective Caesarean sections were less common than in women aged 20-24 years. In addition, pregnancy in adolescents aged ≤17 years was associated with increased rate of maternal anaemia and labour without complications. Higher rates of smoking, lower rates of parenting school attendance, lower rates of pregnancy check-ups and screening tests in pregnancy such as nuchal translucency in adolescents were found.
The results of the study show that adolescent pregnancy is related to higher health risks for pregnant adolescents and their newborns. In addition, adolescents are subject to poorer prenatal care comparing to older women.
This book provides an insight into the emerging trends in pathogenesis, diagnosis and management of endometriosis. Key features of the book include overviews of endometriosis; endometrial ...angiogenesis, stem cells involvement, immunological and hormonal aspects related to the disease pathogenesis; recent research reports on infertility, endometrial receptivity, ovarian cancer and altered gene expression associated with endometriosis; various predictive markers, and imaging modalities including MRI and ultrasound for efficient diagnosis; as well as current non-hormonal and hormonal treatment strategies This book is expected to be a valuable resource for clinicians, scientists and students who would like to have an improved understanding of endometriosis and also appreciate recent research trends associated with this disease.
Diabetes prevalence and costs are rising on aglobal scale. Therefore, it is necessary to periodically conduct cost studies for assessing the healthcare burden impact. In Slovenia, the last type 2 ...diabetes cost assessment was conducted in 2006, not including all diabetes complication costs. The aim of this study was to revise, update and compare to previously published datadirect healthcare costs of type 2 diabetes in Slovenia with additional complications costs consideration.
The study was performed from the healthcare payer perspective using the bottom-up approach, was prevalence based and estimated direct medical costs.
We estimated total yearly direct medical costs of type 2 diabetes in Slovenia to 99,120,419 euro with annual per capita costs of 834.70 euro. The highest cost shares were attributed to cardiovascular complication costs (21,683,919 euro), diabetes co-medication (20,977,269 euro) and diabetes treatment medication (18,505,015 euro). Highest yearly costs per complication (all cases, all occurrences) were estimated for dialysis I and III (9,162,635 euro), stroke first year costs (4,951,306 euro) and congestive heart failure first year costs (4,879,533 euro). Yearly per one patient, the complication costs were highest for kidney transplantation, followed by dialysis I and III (78,621.25 euro and 36,797.73 euro)
In comparison to the costs published in the literature before, our estimated total yearly direct medical costs were comparable, although annual per capita costs were assessed lower than elsewhere. Further, regarding the complication costs estimations, our assessed expenses were comparable to those published in other countries.
Prevalenca in stroški sladkorne bolezni v globalnem merilu naraščajo. Zato je treba redno izvajati študije stroškovnega bremena za oceno vpliva na zdravstvo. V Sloveniji je bila zadnja študija bremena sladkorne bolezni tipa 2 izvedena leta 2006 in ni upoštevala vseh stroškov diabetičnih zapletov. Cilj te raziskave je bil pregledati, posodobiti in primerjati s prej objavljenimi podatki neposredne medicinske stroške sladkorne bolezni tipa 2 v Sloveniji z upoštevanjem dodatnih diabetičnih zapletov.
Študija je bila izvedena z vidika plačnika zdravstvenega varstva; uporabljen je bil pristop »bottom-up« s prevalenčnim vidikom in ocenjeni so bili neposredni medicinski stroški.
Letne neposredne medicinske stroške sladkorne bolezni tipa 2 smo ocenili na 99,120.419 evrov z 834,70 evra letnih stroškov na osebo. Najvišji delež je pripadal stroškom srčno-žilnih zapletov (21,683.919 evrov), stroškom sočasno uporabljenih zdravil (20,977.269 evrov) in stroškom antidiabetikov in inzulinov (18,505.015 evrov). Najvišji letni stroški za diabetični zaplet (vse ponovitve in vsi primeri) so bili ocenjeni za dializo I in III (9,162.635 evrov), prvo leto možganske kapi (4.951.306 evrov) in prvo leto srčnega popuščanja (4,879.533 evrov). Najdražji zaplet sladkorne bolezni (letno na posameznega bolnika) je bila transplantacija ledvic (78.621,25 evra), sledili sta dializa I in III (letno na osebo 36.797,73 evra).
V primerjavi s prej objavljenimi podatki v literaturi so v tej raziskavi objavljeni letni neposredni medicinski stroški primerljivi, čeprav so letni stroški na osebo ocenjeni nižje kot drugje. Prav tako so stroškovne ocene posameznih zapletov sladkorne bolezni primerljive s prej objavljenimi.
Ime Kate Mijić (Kate Mitchell) ima osobito mjesto u kontekstu popularne i trivijalne književnosti. Riječ je o autorici koju zbog začudne produktivnosti i čita¬teljske recepcije drže svojevrsnim ...kulturološkim fenomenom našeg (književnog) vremena pa je nazivaju i kraljicom hrvatskih ljubića, neokrunjenom kraljicom ljubavnih romana te ženom koja ljudima želi dati nadu. Predmetom našeg raz¬matranja dva su, za spisateljsku praksu paradigmatska, romana iz njezine obilne produkcije, a karakterizira ih jednostavnost fabula, karakteristične događajne sheme, predvidljivi zapleti i raspleti te (o)laka komunikacija sa čitateljem građena na njihovoj identifikaciji sa svijetom i sudbinama likova.
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