Izhodišča: Samoocena zdravja predstavlja bolnikov občutek lastnega zdravja; vključuje biološke, sociološke in psihološke dejavnike. Pogosto se uporablja v populacijskih raziskavah, osebni zdravnik pa ...lahko z njeno pomočjo pridobi dodatne informacije o bolniku in njegovih potrebah.
A fungicide is a chemical pesticide compound that kills or inhibits the growth of fungi. In agriculture, fungicide is used to control fungi that threaten to destroy or compromise crops. Fungicides ...for Plant and Animal Diseases is a book that has been written to present the most significant advances in disciplines related to fungicides. This book comprises of 14 chapters considering the application of fungicides in the control and management of fungal diseases, which will be very helpful to the undergraduate and postgraduate students, researchers, teachers of microbiology, biotechnology, agriculture and horticulture.
Paediatric endocrinology started its independent development early in the general development of this specialty, with a strong focus on research and clinical excellence. Slovenian paediatric ...endocrinology was an integral part of the European paediatric endocrinology from its beginnings and a founding member of the first ‘International Study Group for Diabetes in Children and Adolescents’. After the pioneering work of Prof. Lev Matajc, Prof. Ciril Kržišnik firmly integrated the Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases at the University Children’s Hospital in Ljubljana in the international scientific community. In the last decade, the department participates in cutting-edge research and provides clinical services at highest international standards.
Pediatrična endokrinologija je začela s svojim neodvisnim razvojem zgodaj v splošnem razvoju te specilanosti, z izrazitim poudarkom na raziskovalnemu delu in klinični odličnosti. Slovenska pediatrična endokrinologija je bila že od začetkov evropske pediatrične endokrinologije njen sestavni del, še posebej kot soustanoviteljica prve mednarodne skupine ‘International Study Group for Diabetes in Children and Adolescents’. Po pionirskem delu prof. dr. Leva Matajca je prof. dr. Ciril Kržišnik KO za endokrinologijo, diabetes in bolezni presnove Pediatrične klinike v Ljubljani trdno vpel v mednarodno znanstveno skupnost. V zadnjem desetletju KO sodeluje pri vrhunskem raziskovalnem delu in zagotavlja klinično oskrbo po najvišjih mednarodnih standardih.
Introduction. In May of 2012, we investigated a food-borne Clostridium perfringens outbreak in Slovenia involving a single kitchen and five venues, with 477 exposed persons.
Methods. In order to ...identify the causative agent, vehicle of infection and source of contamination, we conducted microbiological and environmental investigations and an analytical cohort study (n = 138).
Results. The case definition in the outbreak was met by 104 persons. Predominant symptoms were diarrhoea, nausea and abdominal cramps. Median incubation time and duration of illness were 12 and 22.5 hours respectively. Stool samples were collected from 18 persons and in 13 C. perfringens spores were present; enterotoxin was detected in 9 persons. PCR and PFGE analysis of isolates from a cook with earlier onset time, who did not consume the implicated food, and cases from four venues showed the same strain of C. perfringens type A (with cpe-gene), indistinguishable by PFGE analysis. No food samples could be obtained. An analytical study showed that one food item (French salad) was the most likely vehicle of infection (RR: 6.35; 95% CI: 1.62-24.90).
Conclusions. This was the largest C. perfringens outbreak in Slovenia to date. Proper analytical study in combination with detailed laboratory investigation with genotypisation enabled us to identify a causative agent, vehicle of infection and possible source of contamination. Fast response and interdisciplinary collaboration led to timely implementation of control measures. These have led to the kitchen acquiring new equipment and improving staff knowledge of risks and processes, thus reducing the likelihood of future reoccurrences
Uvod. V maju 2012 smo preiskovali izbruh okužb s Clostridium perfringens, prenesenih s hrano, v katerega so bile vpletene ena kuhinja in pet lokaciji s 477 izpostavljenimi osebami.
Metode. Da bi ugotovili povzročitelja, pot prenosa in vir kontaminacije, smo izvedli laboratorijsko in okoljsko preiskavo ter analitično kohortno raziskavo (n = 138).
Rezultati. Definiciji primera v izbruhu so ustrezale 104 osebe. Prevladujoči simptomi so bili: driska, slabost in trebušni krči. Mediana časa inkubacije in trajanja bolezni je bila 12 ur in 22,5 ure. Vzorci blata so bili odvzeti 18 osebam; pri 13 so bile prisotne spore C. perfringens, enterotoksin je bil zaznan pri 9 osebah. PCR- in PFGE-analiza izolatov kuharja z zgodnejšim časom pojava obolenja, ki ni užival impliciranih živil, in primerov s štirih lokacij sta pokazali enak sev C. perfringens tipa A (s cpe genom), ki se ni razlikoval pri analizi PFGE. Vzorcev živil ni bilo mogoče pridobiti. Analitična študija je pokazala, da je bila najverjetnejša pot prenosa okužbe eno izmed živil (francoska solata) (RT: 6,35; 95% IZ: 1,62-24,90).
Zaključek. To je bil največji izbruh s C. perfringens v Sloveniji do zdaj. Ustrezna analitična raziskava v kombinaciji s podrobno laboratorijsko preiskavo z genotipizacijo nam je omogočila identifikacijo povzročitelja, pot prenosa okužbe in mogoč vir kontaminacije. Hiter odziv in interdisciplinarno sodelovanje je pripeljalo do pravočasne implementacije nadzornih ukrepov. Ti so privedli do nabave nove opreme v kuhinji, izboljšanja znanja osebja o tveganjih in procesih ter s tem zmanjšali verjetnost za ponovitve v prihodnje
Objectives. Health-related quality of life (HRQoL) measures a patient’s subjective experience of his or her health status. We aimed to show how the presence of chronic diseases and satisfaction with ...family physicians (FPs) were associated with the HRQoL of a Roma population.
Methods. A cross-sectional study was carried out in May 2011 on a representative sample of 650 Roma living in Prekmurje, Slovenia. The EQ-5D questionnaire was used for measuring the HRQoL of the Roma. Demographical data, 12 groups of diseases diagnosed in the last 12 months and satisfaction with FPs were included in the questionnaire.
Results. The response rate was 88.3% (574), of which 56.4% were female, and the average age of the participants had a mean value of 40.2±12.7 years. The presence of cardiovascular problems with risk factors for them or presence of musculoskeletal disorders were strongly associated with the presence of pain (Cramer’s V = 0.40 and 0.46 respectively).There was a strong association between the presence of mental disorders and anxiety and depression (Cramer´s V = 0.58). The average satisfaction with the family physician was 3.9 (mean±1.10) on a five-point Likert scale. There was no significant association between HRQoL and satisfaction with the family physician.
Conclusions. Roma with chronic mental health problems had the lowest HRQoL in the Roma population. More attention should be paid to this subgroup of Roma in family medicine, and interventions should be provided. High satisfaction with their FPs is not associated with the observed quality of life variables
Uvod. Z zdravjem povezana kakovost življenja (HRQoL) je odraz pacientove subjektivne ocene lastnega zdravstvenega stanja. V naši raziskavi smo skušali ugotoviti, kakšen je vpliv nekaterih kroničnih bolezni in zadovoljstva z izbranim zdravnikom na HRQoL med romskim prebivalstvom.
Metode. Maja 2011 smo izvedli presečno raziskavo v reprezentativnem vzorcu 650 pomurskih Romov. HRQoL smo merili z vprašalnikom EQ-5D; vključili smo še demografske podatke, zadovoljstvo z izbranim družinskim zdravnikom in 12 bolezenskih stanj, ki so bila diagnosticirana v zadnjih 12 mesecih.
Rezultati. Odzivnost je bila 88,3-odstotna (574), 56,4 % je bilo žensk in povprečna starost sodelujočih je bila 40,2 +/- 12,7 leta. Nizek HRQoL v skupini s srčno-žilnimi boleznimi z dejavniki tveganja zanje in kostnomišičnimi boleznimi je bil močno povezan s prisotnostjo bolečine (Cramer z V = 0,40 in 0,46). V skupini z duševnimi težavami pa je bila močna povezava nizkega HRQoL s prisotnimi znaki anksioznosti in depresije (Cramer z V = 0,58). Povprečno zadovoljstvo z zdravnikom družinske medicine je bilo 3,9 (mediana +/- 1,10) na pettočkovni Likertovi lestvici. Ni bilo statistične povezave med HRQoL in zadovoljstvom z zdravnikom družinske medicine.
Zaključki. Romi s prisotnostjo duševnih težav imajo najnižji HRQoL v romskem prebivalstvu. Več pozornosti bi v družinski medicini morali posvetiti tej podskupini Romov. Zadovoljstvo z zdravnikom družinske medicine ni povezano z opazovanimi spremenljivkami kakovosti življenja
Background. Gastrointestinal disorders account for 7-10% of all consultations in primary care. General practitioners’ management of digestive disorders in Central and Eastern European countries is ...largely unknown.
Aims. To identify and compare variations in the self-perceived responsibilities of general practitioners in the management of digestive disorders in Central and Eastern Europe.
Methods. A cross-sectional survey of a randomized sample of primary care physicians from 9 countries was conducted. An anonymous questionnaire was sent via post to primary care doctors.
Results. We received 867 responses; the response rate was 28.9%. Over 70% of respondents reported familiarity with available guidelines for gastrointestinal diseases. For uninvestigated dyspepsia in patients under 45 years, the “test and treat” strategy was twice as popular as “test and scope”. The majority (59.8%) of family physicians would refer patients with rectal bleeding without alarm symptoms to a specialist (from 7.6% of doctors in Slovenia to 85.1% of doctors in Bulgaria; p<0.001). 93.4% of respondents declared their involvement in colorectal cancer screening. In the majority of countries, responding doctors most often reported that they order fecal occult blood tests. The exceptions were Estonia and Hungary, where the majority of family physicians referred patients to a specialist (p<0.001).
Conclusions. Physicians from Central and Eastern European countries understood the need for the use of guidelines for the care of patients with gastrointestinal problems, but there is broad variation between countries in their management. Numerous efforts should be undertaken to establish and implement international standards for digestive disorders’ management in general practice.
Uvod. 7-10 % vseh posvetov v primarni zdravstveni oskrbi se nanaša na bolezni prebavil. O zdravljenju bolezni prebavil s strani splošnih zdravnikov v Srednji in Vzhodni Evropi ni na razpolago veliko podatkov.
Cilji. Ugotoviti in primerjati razlike v samozaznani odgovornosti splošnih zdravnikov pri zdravljenju bolezni prebavil v Srednji in Vzhodni Evropi.
Metode. Naredili smo presečne ankete na randomiziranem vzorcu splošnih zdravnikov v primarni zdravstveni oskrbi iz devetih držav. Po pošti smo zdravnikom v primarni zdravstveni oskrbi poslali anonimni vprašalnik.
Rezultati. Prejeli smo 867 odgovorov, stopnja odzivnosti je bila 28,9 %. Več kot 70 % anketirancev je v odgovorih navedlo, da so seznanjeni z razpoložljivimi smernicami za bolezni prebavil. Za neraziskano dispepsijo pri bolnikih, mlajših od 45 let, je bila dvakrat bolj priljubljena strategija »testiranja in zdravljenja« kot pa strategija »testiranja in gastroskopije«. Večina (59,8 %) zdravnikov v primarni zdravstveni oskrbi bi bolnike z rektalnimi krvavitvami brez znakov alarma napotila k specialistu (od 7,6 % zdravnikov v Sloveniji do 85,1 % zdravnikov v Bolgariji; p<0.001). 93,4 % anketirancev je potrdilo svojo udeležbo pri presejalnih pregledih za odkrivanje raka debelega črevesa in danke. V večini držav so zdravniki najpogosteje poročali, da naročajo testiranje za odkrivanje prikritih krvavitev v blatu. Izjema pri tem sta bili Estonija in Madžarska, kjer večina zdravnikov v primarni zdravstveni oskrbi napoti paciente k specialistu (p<0.001).
Zaključki. Zdravniki iz Srednje in Zahodne Evrope razumejo potrebo po uporabi smernic za nego bolnikov z boleznimi prebavil, vendar pa je pri obravnavi veliko razlik med posameznimi državami. Treba si je prizadevati in sprejeti ukrepe za vzpostavitev in izvajanje mednarodnih standardov za obravnavo bolezni prebavil v splošni praksi.
Ob pojavu kronične bolezni, ki prizadene vsakega šestega od desetih odraslih, je treba poskrbeti tako za zdravstveno urejenost bolezni kot za obvladovanje čustvenih odzivov nanjo (jeza, strah, ...frustracije, žalost), ne nazadnje pa je treba ohraniti oz. (pre)oblikovati (nove) vloge na delovnem mestu, v družini in med prijatelji. Na poti iskanja primernih strategij obvladovanja kronične bolezni in življenja kroničnega bolnika ima zdravstveno osebje zelo pomembno vlogo. Obolelim bi morali ponuditi kakovostne zdravstvenovzgojne programe, ki se ne osredinjajo le na značilnosti kroničnih bolezni in na možnosti zdravljenja, marveč upoštevajo tudi človeško stisko ob sprejemanju kronične bolezni, pa tudi njen vpliv na preostala področja posameznikovega življenja. Raziskave kažejo, da ima pri vseh teh nalogah za obolele- ga zelo veliko vlogo sposobnost empatičnega komuniciranja zdravstvenega osebja.
The aim of our study was to assess the temporal association between the number of consultations in the primary health care unit due to respiratory diseases in children and the level of particular ...matter of 10 micrometres in diameter (PM10) pollution in the Zasavje region.
A time-trend ecological study was carried out for the period between 1 January 2006 and 31 December 2011. The daily number of first consultations for respiratory diseases among children in the Zasavje region was observed as the outcome. Poisson regression analysis was used to investigate the association between the observed outcome and the daily PM
concentrations, adjusted to other covariates.
The results showed that the daily number of first consultations were highly significantly associated with the daily concentrations of PM
in the Zagorje (p<0.001) and Trbovlje (p<0.001) municipalities. In the Hrastnik municipality, a significant association was not observed in all models.
It can be concluded that evidence of association between the daily PM10 concentration and the daily number of first consultations for respiratory diseases among children exists, indicating that there is still a need for public health activities in the sense of reduction of harmful environmental factors in the region. Additionally, on the basis of these results, it can be assumed that with some improvements linkage of existing health and environmental data in Slovenia in general could be feasible in identifying a grounded need for future public health action.
Namen: Namen študije je bil oceniti časovno povezanost med številom obiskov v primarnem zdravstvenem varstvu zaradi bolezni dihal pri otrocih in prašnimi delci premera 10 mikrometrov (PM10) v Zasavju.
Ekološka študija časovnega trenda je bila izvedena za obdobje od 1. januarja 2006 do 31. decembra 2011. Opazovani izid je bil dnevno število prvih obiskov zaradi bolezni dihal pri otrocih v Zasavju. Za oceno povezanosti med opazovanim izidom in dnevnimi koncentracijami PM10, standardizirano na preostale pojasnjevalne dejavnike, je bila uporabljena Poissonova regresijska analiza.
Rezultati so pokazali močno statistično povezanost med dnevnim številom prvih obiskov in dnevnimi koncentracijami PM
v občinah Zagorje (p < 0,001) in Trbovlje (p < 0,001). V občini Hrastnik nismo opazili značilne povezanosti pri vseh modelih.
Sklenemo lahko, da v Zasavju obstaja povezanost med boleznimi dihal pri otrocih in koncentracijo PM
, kar kaže na to, da je v tej slovenski regiji še vedno prisotna potreba po javnozdravstvenih ukrepih v smislu zmanjševanja škodljivih okoljskih dejavnikov. Dodatno lahko na podlagi rezultatov študije sklepamo, da bi bilo lahko v prihodnje v Sloveniji povezovanje okoljskih in zdravstvenih podatkov z nekaterimi izboljšavami uporabno pri ocenjevanju utemeljenih potreb za javnozdravstveno ukrepanje.
This multicentre, cross-sectional observational study aimed to determine the prevalence of depression among the working population of Slovenia and identify factors correlating with higher prevalence ...of depression. It was conducted in three occupational medicine practices within major Slovenian primary health care centres. The study population consisted of 1,474 respondents 73.7 % of the invited participants, 889 (60.3 %) men and 585 (39.7 %) women with mean age of (40.5±9.8) years who visited these practices for their regular check-ups from November 2010 to June 2012 and were asked to fill in a self-developed questionnaire and score depression on the Zung’s self-rating depression scale. According to the rating, 50 (3.4 %) respondents suffered from depression. In the multivariate analysis, depression correlated with the following independent variables: self-perceived exposure to chronic stress, positive family history of depression, and primary school education.
Namen raziskave je bil določiti prevalence depresije med delovno aktivno populacijo in odkriti morebitne dejavnike, povezane z večjo prevalence depresije. Izvedli smo multicentrično presečno opazovalno raziskavo v ambulantah medicine dela, prometa in športa v treh večjih zdravstvenih domovih v Sloveniji. Opazovana populacija je bila sestavljena iz zaporednih obiskov delavcev, ki so prišli na redni preventivni pregled od novembra 2010 do junija 2012. Podatke smo zbirali s pomočjo vprašalnika, depresijo pa smo ugotavljali na podlagi Zungovega vprašalnika. V vzorcu je bilo 1.474 (73,7 %) posameznikov, od katerih je bilo 889 (60,3 %) moških. Povprečna starost vzorca je bila (40,5±9,8) let. V vzorcu je bilo 590 (3,4 %) posameznikov z depresijo. V multivariatni analizi so bile naslednje spremenljivke neodvisno povezane s prisotnostjo depresije: izpostavljenost stresu, pozitivna družinska anamneza depresije in osnovnošolska izobrazba.
Recent efforts to increase Ascochyta blight resistance of pea have focused on the introduction of foreign genes by genetic engineering. The rpgip1 gene from Rubus idaeus was introduced by ...Agrobacterium-mediated transformation into Pisum sativum, cv. Baroness with the aim to increase pea resistance to fungal diseases. Notwithstanding this success, practical applications have to be preceded by the development of analytical methods for screening. Singleplex and multiplex PCR assays were employed to test primer efficiency in identifying the rpgip1 transgene in 11 pea genotypes. Five from ten primer combinations were effective in identifying transgene or insert sequences. PCR amplification using five other primer pairs revealed unspecific amplicons. According to in silico analyses, they arose from retrotransposons and pea genes including homologues of rpgip1. Two sets of primers were prepared with the aim of simultaneous amplification of different rpgip1 fragments. Fingerprints were sums of bands observed from individual pairs so the utility of multiplex assays was demonstrated. An additional advantage of multiplex PCR was clear differentiation between the transgene and endogenous pgip genes present in the donor species, R. idaeus. Sequencing of two PCR products confirms that no substantial rearrangements at the rpgip1 transgene arose during development of transgenic plants. However, a deletion occurred at 59 bp in the PGIP+VST line and a substitution at 392 bp in the PGIP line. The frequency of point mutations was not high (1.1 × 10-3) and comparable with the frequency expected for host genes based on the neutral theory of molecular evolution.
Novejši dosežki pri povečanju odpornosti graha na Ascochyta so povezani z uvajanjem tujih genov s pomočjo genskega inženiringa. Gen rpgip1 iz malinjaka (Rubus idaeus) je vključen v grah, cv. Baroness, s transformacijo z bakterijo Agrobacterium, da bi se povečalo odpornost graha na to glivično bolezen. Pred praktično uporabo te metode je potrebno razviti načine za spremljanje dedovanja tega transgena. Enojna in multipleks PCR sta bili uporabljeni za testiranje učinkovitosti začetnikov in za identificiranje transgena rpgip1 pri 11 genotipih graha. Pet od desetih začetnikov je bilo uporabnih za identifikacijo transgenov ali za vključevanje sekvenc. PCR namnoževanje z drugimi petimi začetniki je dalo nespecifične namnožke. Glede na in silico analize so ti nastali zaradi retrotranspozonov in grahovih genov, ki vključujejo homologe rpgip1. Dva seta začetnikov sta bila pripravljena za istočasno namnoževanje različnih odlomkov rpgip1. Elektroferogrami so bili vsote črt individualnih parov, tako je prikazana uporabnost multipleksnega poskusa. Dodatna prednost multipleksnega PCR je razločna diferenciacija med transgenom in genom pgip prisotnim v donorski vrsti R. idaeus. Sekvenciranje dveh PCR produktov potrjuje, da ni pri rpgip1 bistvenega prerazporejanja tekom razvoja transgenih rastlin. Toda pojavila se je delecija pri 59 bp v liniji PGIP+VST in substitucija pri 392 bp v liniji PGIP. Relativna pogostnost točkovnih mutacij ni bila visoka (1.1 × 10-3) in je bila primerljiva z pogostnostjo pri gostiteljivih genih, glede na nevtralno teorijo molekulske evolucije.
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