In the last two decades, the introduction of tandem mass spectrometry in clinical laboratories has enabled simultaneous testing of numerous acylcarnitines and amino acids from dried blood spots for ...detecting many aminoacidopathies, organic acidurias and fatty acid oxidation disorders. The expanded newborn screening was introduced in Slovenia in September 2018. Seventeen metabolic diseases have been added to the pre-existing screening panel for congenital hypothyroidism and phenylketonuria, and the newborn screening program was substantially reorganized and upgraded.
Tandem mass spectrometry was used for the screening of dried blood spot samples. Next-generation sequencing was introduced for confirmatory testing. Existing heterogeneous hospital information systems were connected to the same laboratory information system to allow barcode identification of samples, creating reports, and providing information necessary for interpreting the results.
In t he first y ear of t he expanded newborn screening a total of 15,064 samples w ere screened. Four patients were confirmed positive with additional testing.
An expanded newborn screening program was successfully implemented with the first patients diagnosed before severe clinical consequences.
The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease.
A total of 272 patients ...with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed.
Cronbach's alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations.
The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.
Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially ...implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.
This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries.
Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals.
This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
The aim of our study was to examine the scabies incidence in the Croatian population and to analyse potential related factors.
This mixed ecological study is based on a retrospective medical record ...review. National data from communicable disease reports was sourced and analysed for an 11-year period (2007-2017), with more focus on the period 2014-2017. Descriptive statistics were used to calculate trends. Differences between the groups were studied using Chi-square test and Kendall's tau (τ) correlation coefficient. Levels of significance were set at p<0.05 or p<0.01.
From 2007 to 2017, scabies infestation in Croatia increased by 6-fold, particularly affecting children and young adults (19 years or younger). In the period 2014-2017, border counties which are part of migration flows were the counties with the highest average scabies incidences. A linear trend of increase in the number of tourists, immigrants and scabies infestations was noted on the national level for the analysed period, although a significant association was not observed. Regarding outbreaks of scabies within institutions, more than 80% of outbreaks occurred in institutions for adults. In the capital, Zagreb, the crude incidence rate increased 3-fold between 2014 and 2017.
The increased incidence of scabies, large disparities between counties, and prolonged outbreaks within families due to under-recognition and misdiagnoses points to a need for increased awareness among health practitioners. To the best of our knowledge, this is the first recent epidemiologic analysis on this topic, not only in Croatia but within the wider geographic region as well.
Particulate matter (PM) is a major component of urban air pollution and has a significant effect on human health. Natural PM sources are volcanic eruptions, dust storms, forest and grassland fires, ...living vegetation and sea spray. Traffic, domestic heating, power plants and various industrial processes generate significant amounts of anthropogenic PM. PM consists of a complex mixture of solid and liquid particles of organic and inorganic substances suspended in the air. The chemical composition of particles is very complex and depends on emission sources, meteorological conditions and their aerodynamic diameter. Several epidemiological studies have demonstrated that exposure to PM of varying size fractions is associated with an increased risk of respiratory and cardiovascular diseases. Adverse health effects have been documented from studies of both acute and chronic exposure. The most severe effects in terms of overall health burden include a significant reduction in life expectancy by a several months for the average population, which is linked to long-term exposure to moderate concentrations of PM. Nevertheless, numerous deaths and serious cardiovascular and respiratory problems have also been attributed to short-term exposure to peak levels of PM. Although many studies attribute greater toxicity to smaller size fractions, which are able to penetrate deeper into the lung, the molecular mechanisms and the size fractions of the PM that are responsible for the observed diseases are not completely understood.
Prašni delci so eden najpogostejših onesnaževal zraka in imajo velik vpliv na zdravje ljudi. Kemijska sestava prašnih delcev je zelo zapletena in je odvisna od vira emisij, meteoroloških okoliščin in od aerodinamskega premera delcev. Naravni izvori prašnih delcev so vulkanski izbruhi, puščavski pesek, naravni požari in morska sol. Promet, domača kurišča, termoelektrarne in industrijski obrati pa so glavni vir antropogenih prašnih delcev. Prašni delci so sestavljeni iz zapletene mešanice trdnih in tekočih delcev, sestavljenih iz organskih in anorganskih snovi. Številne epidemiološke študije so pokazale, da je izpostavljenost prašnim delcem različnih velikosti povezana s povečanim tveganjem za razvoj dihalnih in srčno-žilnih obolenj. Škodljiv učinek na zdravje je bil ugotovljen na osnovi raziskav, ki so proučevale akutno, in na osnovi raziskav, ki so proučevale kronično izpostavljenost prašnim delcem. Najbolj škodljiv učinek prašnih delcev je skrajšanje življenjske dobe povprečne populacije za nekaj mesecev, kar je povezano z dolgoročno izpostavljenostjo prašnim delcem zmernih koncentracij. Kljub temu pa so vzroki za številne smrti in resne dihalne ter srčno-žilne bolezni povezane s kratkoročno izpostavljenostjo visokim koncentracijam prašnih delcev. Številne raziskave pripisujejo večje negativne učinke na zdravje ljudi manjšim prašnim delcem, ker lahko globlje prodrejo v pljuča. Kljub številnim raziskavam še ni popolnoma pojasnjeno, kateri prašni delci so ključni za povzročene neželene učinke in prek katerih molekularnih mehanizmov sprožajo neželene učinke.
Migraine is associated with significant morbidity and a significantly negative impact on the quality of life. A better understanding of the economic impact of migraine is becoming increasingly ...important. This paper aims to shed light on absenteeism and presenteeism costs of migraine in Slovenia.
We use the administrative national-level database on sick leave due to migraine for 2016. The absenteeism cost estimate is based on the number of patients with migraine on physician-determined sick leave and average daily labour costs. We calculate productivity costs from a social perspective regardless of who incurs them. Data from the national registry on sick leave are coupled with data from a web-based self-reported survey to also include the cost of presenteeism. MIDAS and WPAI presenteeism items were used and several different scenarios were designed to assess presenteeism costs.
We estimated annual absenteeism costs per absentee due to migraine at the amount of EUR 531 in 2016 using the NIPH's administrative data on sick leave. Annual absenteeism costs per absentee due to migraine based on self-reported data amounted to EUR 626. The estimated annual presenteeism costs per patient range from EUR 344 - 900.
Estimating the economic burden of a disease is becoming increasingly important. This paper is an insight into the absenteeism and presenteeism costs of migraine in Slovenia.
Health-related quality of life (HRQoL) is measuring a patient's experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is ...positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.
A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient's HRQoL as an independent variable.
871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2).
This study has been performed on a specific group of patients, not being "really sick", but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.
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