Analyse der chirurgischen und antibiotischen Therapie bei der medikamentenassoziierten Osteonekrose der Kieferknochen im Stadium II und III

Das Krankheitsbild der medikamentenassoziierten Osteonekrose des Kiefers (MRONJ), welche im Zusammenhang mit der Gabe von Bisphosphonaten und antiresorptiven Medikamenten auftritt, ist seit 2003 bekannt. Dennoch konnte bislang kein „Gold-Standard“ für die Behandlung der Erkrankung, die eine hohe Rezidivrate aufweist, etabliert werden. Die vorliegende Studie beschäftigt sich mit dem Therapiekonzept der MRONJ im Stadium II und III im Hinblick auf das Infektionsmanagement des Hart- und Weichgewebes im Kieferbereich sowie das Ausmaß notwendiger chirurgischer Interventionen. Im Fokus steht dabei die Optimierung des perioperativen antibiotischen Regimes. Die Datenerhebung erfolgte retrospektiv aus den Krankheitsverläufen von 143 Patienten, die sich zwischen 2006 und 2015 mit dem Krankheitsbild der MRONJ im Stadium II und III in der Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie des Universitätsklinikums Köln behandeln ließen. Erfasst wurden neben den demografischen Daten der Patienten der Erkrankungszeitpunkt sowie die Lokalisation der MRONJ. Wir betrachteten in diesem Zusammenhang die ursächliche Grunderkrankung, die damit einhergehende Medikation und die therapeutischen Interventionen, einschließlich dem antibiotischen Behandlungskonzept. Weitere wichtige Datenmengen sammelten wir aus der histopathologischen Auswertung konkomitanter, submuköser Infektionen. Hierbei konnten wir Zusammenhänge zwischen der Wahl der therapeutischen chirurgischen Intervention, dem perioperativen antibiotischen Regime und der Wundremission der MRONJ aufzeigen. Gemäß dieser Studie sollte Clindamycin nicht mehr als zweckmäßige Option für die initiale perioperative antibiotische Behandlung von Patienten mit MRONJ-Stadium II und III angesehen werden. Aufgrund des breiten Wirkungsspektrums gegen grampositive, gramnegative und anaerobe Bakterien bevorzugen wir Piperacillin/Tazobactam für die initiale Therapie. Dennoch sollte das verabreichte Antibiotikum nach Eingang der mikrobiologischen Gutachten zum Resistenzverhalten der kultivierten Bakterien umgehend angepasst werden. Die erweiterte Dekortikation birgt ein großes Potenzial, um die Progression der MRONJ zu hemmen und die Symptome der Patienten zu lindern. Neben den konservativen Behandlungsansätzen, welche die frühe Detektion und die Verbesserung der oralen Hygiene beinhalten, kann diese Therapieform zur Prävention der Patienten vor der Segmentresektion oder der marginalen Resektion des Kiefers genutzt werden. Dennoch ist in vielen Fällen mehr als eine Intervention notwendig, um dieses Ziel zu erreichen

Professionalization Processes in the Field of Protection, Rescue and Relief in Slovenia

Namen prispevka: Namen članka je predstaviti dejavnike, ki vplivajo na stopnjo profesionalnosti področja zaščite, reševanja in pomoči v Sloveniji. Proces profesionalizacije razumemo v strukturnem in funkcionalnem smislu. Metode: Pri proučevanju smo uporabili metodo analize vsebine normativnih dokumentov, programov izobraževanja in usposabljanja ter publikacij, ki jih izdajajo ustanove sistema ter raziskovalni inštituti. Analizirali smo podatke Uprave Republike Slovenije za zaščito in reševanje (URSZR) o strukturi zaposlenih na obravnavanem področju ter njihovem izobraževanju in usposabljanju. Nestrukturiran intervju smo izvedli s tremi predstavniki URSZR in dvema predstavnikoma gasilske organizacije. S sekundarno analizo javnomnenjskih podatkov in njihovo interpretacijo smo predstavili odnos javnosti do sistema varstva pred nesrečami in njegovih posameznih akterjev. Ugotovitve: Z raziskavo smo ugotovili, da področje zaščite, reševanja in pomoči ni v celoti profesionalizirano niti v strukturnem niti v funkcionalnem pogledu. Popolna strukturna profesionalnost ni smotrn cilj, saj sistem v veliki meri temelji na visoko razvitem prostovoljstvu, ki je potrebno za spoprijemanje sistema z nesrečami. Temu navkljub bi bilo treba poklicne strukture okrepiti, vsaj primerljivo z ravnjo izpred dveh desetletij in več oziroma glede na njihove obstoječe sistemizacije delovnih mest. K povečanju stopnje funkcionalne profesionalnosti bi prispevala uporaba vseh obstoječih možnosti izobraževanja in usposabljanja ter oblikovanje specialističnih programov na področju zaščite, reševanja in pomoči. Oblikovanje enotnega profesionalnega združenja bi prispevalo k poenotenju standardov na področju izobraževanja in usposabljanja ter k oblikovanju skupnega etičnega kodeksa. Omejitve: Avtorja članka v analizo nista mogla vključiti vseh struktur, ki delujejo na področju varstva pred naravnimi in drugimi nesrečami, temveč sta se osredotočila zgolj na ključne akterje s področja zaščite, reševanja in pomoči ob nesreči. Praktična uporabnost: Praktična uporabnost analize je v pričakovanju, da bi uresničenje vseh predlogov, ki izhajajo iz ugotovitev, omogočilo uspešnejše spoprijemanje z izzivi na področju odziva na nesreče in še povečalo ugled sistema varstva pred naravnimi in drugimi nesrečami v javnosti. Izvirnost: Članek je izviren, vendar temelji na citirani literaturi, virih in podatkih.Purpose: The purpose of the article is to introduce the factors that influence the level of professionalization in the field of protection, rescue and relief in Slovenia. Professionalization is understood in structural and functional terms. Design/Methods/Approach: Research was based upon content analysis of legal documents, training and educational programmes, and publications released by the institutions of the system itself and research institutes. We also analysed the Administration for Civil Protection and Disaster Relief (ACPDR) data on the structure of personnel employed in the field and on their training and education. Unstructured interview was conducted with three representatives of ACPDR and two representatives of firefighting organization. By applying secondary analysis of public opinion data and their interpretation, we introduced the attitude of the public towards the system of protection against disasters and its individual actors. Findings: The research revealed that the protection, rescue and relief system is not structurally nor functionally fully professionalized. Full structural professionalization is not a reasonable objective due to the fact that the system is based upon highly developed voluntarism coping with bigger disasters. Nevertheless, the professional structures should be strengthened at least to the level comparable to the one we witnessed twenty and more years ago or according to the current systemization of job positions. The use of all existing training and educational possibilities and forming of specialist programmes in the field of protection, rescue and relief would contribute to higher level of functional professionalization. Forming of single professional association of personnel would contribute to standardization in the training and educational field and to forming of common ethical code. Research Limitations/Implications: The limitation of the article is in the fact that the authors in their analysis could not include all structures that operate in the field of disaster management, but focussed only on the key actors that provide protection, rescue and relief in case of disaster. Practical Implications: Practical applicability of the analysis is in the expectation that the implementation of all suggestions based upon findings would increase the level of success in coping with disaster response challenges and would additionally increase the reputation of the system of protection against natural and other disasters in the eyes of the public. Originality/Value: The article is original, however it is based upon quoted literature, sources and data

Dietary Supplements and Sport Performance - A Comprehensive Review

Comprehensive articles on dietary supplements and their impact of on sport performance which would enable professional and recreational sportsmen evidence based information are sparse. Therefore, we investigated eight different dietary supplements, commonly used among recreative and endurance sportsmen according to available literature were analyzed, namely: Antioxidants, B-alanine, Branched chain amino acids (BCAAs), Caffeine, Carbohydrates, Creatine, Nitric oxide /nitrates, and proteins. Their mechanisms of action was shortly presented along with their potential beneficial and harmful side effects and safety. i.) Antioxidants: Sufficient amount of antioxidants is available in a balanced diet ii.) B-alanine: Supplementation is likely to be beneficial in high-intensity exercises. iii.) BCAAs: No review articles in English were available iv.) Caffeine: Caffeine supplementation is beneficial in endurance exercises v.) Carbohydrates: Carbohydrate supplementation is probably beneficial in exercises of durations longer than one hour vi.) Creatine: Creatine supplementation is effective in high intensity, short-lasting exercises, while it does not seem to have any ergogenic effect in aerobic exercises. vii.) Nitric oxide/nitrates: Nitrate supplementation has a small but meaningful performance enhancing effect, most apparent in situations of insufficient perfusion (hypoxia…). viii.) Proteins: Protein supplementation, in combination with resistance exercise, most likely has beneficial effects on lean body mass and muscle strength. Studies on the long term safety of the above supplements are mostly lacking. Most of the revised dietary supplements, if used for intended exercise regime, provide some sort of sport performance enhancement. On the other hand, the studies about the safety of the long term supplementation are mostly lacking

continuous glucose monitoring use and glucose variability in pre school children with type 1 diabetes

Abstract Aims The objective of this nationwide population-based cohort study was to evaluate the correlation between continuous glucose monitoring (CGM) use and glucose variability in pre-schoolers with type 1 diabetes. Methods We analysed data from the Slovenian National Registry. The primary endpoint was the difference in glucose variability between periods, during which participants were using CGM and periods, during which CGM was not used, over 5 years. Results A total of 40 children 5 days/week) was associated with a 0.4% [4.4 mmol/mol] reduction in glycated haemoglobin level (7.6% compared to 7.2%, p = 0.047). Conclusions Our results indicate that the use of CGM was associated with reduced glucose variability during a 5 year follow-up period among pre-schoolers with type 1 diabetes. Trial Registration Clinicaltrials.gov: NCT-03293082

Dinamika populacije kvasca pri spontanim i induciranim alkoholnim fermentacijama vinskog mošta Zametovka

Inoculated fermentations, which are more rapid and more reliable than spontaneous fermentations, and assure predictable wine quality, are nowadays prevalent in Slovenia’s large-scale wine production. However, spontaneous fermentation strengthens local characteristics of wine and offers opportunities for technological innovation. In the 1999 vintage, spontaneous and inoculated fermentations of Zametovka (Vitis vinifera) grape must were studied. Zametovka is the main red variety in production of traditional Slovene red blend wine, Cvicek. The diversity of yeast species and strains in both of the investigated fermentations was determined by molecular and traditional identification methods. The outset of alcoholic fermentation, yeast growth kinetics, and yeast population dynamics presents the main differences between the examined fermentations. Yeast population diversity was higher in the spontaneous process. Dominant yeast isolates from spontaneous fermentation were identified as Candida stellata, Hanseniaspora uvarum and Saccharomyces cerevisiae; whereas Saccharomyces bayanus, Pichia kluyveri, Pichia membranifaciens and Torulaspora delbrueckiim were found less frequently. Dominant species in the inoculated fermentation was Saccharomyces cerevisiae; other species found in smaller numbers were Candida stellata, Hanseniaspora uvarum and Debaryomyces hansenii var. hansenii. Using PFGE, we were able to distinguish among 15 different Saccharomyces cerevisiae strains and three different Saccharomyces bayanus strains isolated from spontaneous fermentation, whereas, in the case of inoculated fermentation, only two Saccharomyces cerevisiae strains were found. Their chromosomal patterns coincide with the chromosomal patterns of the starter culture strains.U dana{njoj industrijskoj proizvodnji vina u Sloveniji prevladava inducirana fermentacija koja je brža i pouzdanija od spontane, a osigurava predvidivu kvalitetu vina. Spontana fermentacija pospješuje lokalne specifičnosti vina i omogućuje tehnološke inovacije. U berbi 1999. provedena je spontana i inducirana fermentacija mošta Zametovka (Vitis vinifera). Zametovka je glavna sorta crnog vina u proizvodnji Cvičeka, tradicionalnog slovenskog crnog vina. Raznolikost vrsta i sojeva kvasca u obje ispitivane fermentacije utvrđena je primjenom fizioloških i molekularnih testova. Glavne razlike između ispitivanih fermentacija sastojale su se u različitom početku alkoholne fermentacije, u kinetici rasta i dinamici populacije kvasca. Raznolikost u populaciji kvasca bila je veća pri spontanom procesu. Kao dominantni izolati kvasca pri spontanoj fermentaciji utvrđeni su Candida stellata, Hanseniaspora uvarum i Saccharomyces cerevisiae a rjeđe su se pojavljivali Saccharomyces bayanus, Pichia kluyveri, Pichia membranifaciens i Torulaspora delbrueckii. Pri induciranoj fermentaciji dominantna je vrsta Saccharomyces cerevisiae, a nađen je manji broj vrsta Candida stellata, Hanseniaspora uvarum i Debaryomyces hansenii var. hansenii. Koristeći gel-elektroforezu u pulsirajućem polju (PFGE), iz mošta pri spontanoj fermentaciji izolirano je 15 razli~itih sojeva Saccharomyces cerevisiae i tri različita soja Saccharomyces bayanus, a u induciranoj fermentaciji opažena su samo dva soja Saccharomyces cerevisiae. Njihova kromosomska struktura podudara se sa strukturom kromosoma soja starter-kulture

Catàleg de serveis i recursos lingüístics de la Universitat de Barcelona per a l’alumnat

Podeu consultar altres versions del catàleg: tots els serveis i recursos lingüístics (http://hdl.handle.net/2445/122498), serveis i recursos lingüístics per al PAS (http://hdl.handle.net/2445/122500) i serveis i recursos lingüístics per al PDI (http://hdl.handle.net/2445/122501).El desplegament del Pla de llengües preveu desenvolupar el catàleg de tots els serveis i recursos que la Universitat de Barcelona ofereix a l’alumnat, i fer visible una descripció breu i la llengua o llengües del servei o recurs, que esdevé un element clau de tria de l’usuari

Use of microfluidic devices for cell culturing

Mikropretočne naprave predstavljajo učinkovito platformo za gojenje celic in študij njihovega obnašanja in medsebojnih interakcij. Izdelati jih je mogoče iz različnih materialov, med njimi pa prevladujejo polimeri, za spremljanje procesov v njih pa so potrebne miniaturizirane merilne naprave. Nadzor nad procesnimi spremenljivkami v mikropretočnih napravah je precej boljši kot pri velikih reaktorjih, hkrati pa te naprave omogočajo hitrejše in cenejše izvajanje raznih študij, kot sta preučevanje kemotaksije in testiranje učinkovitosti antimikrobnih sredstev. V mikropretočnih napravah je mogoče gojiti različne vrste mikroorganizmov, od bakterij in gliv do mikroalg, mikroorganizmi pa v njih pogosto uspevajo bolje kot v konvencionalih reaktorjih. Poseben tip mikropretočnih naprav so kapljične mikropretočne naprave, pri katerih se mikroorganizme ujame v kapljice tekočine, ki delujejo kot samostojni reaktorji.Microfluidic devices provide an effective platform for cell culture and the study of their behavior and interactions. They can be made of various materials, among which polymers predominate, and miniaturized measuring devices are needed to monitor the processes in them. The control of process variables in microfluidic devices is much better than in large reactors, and at the same time these devices enable faster and cheaper implementation of various studies, such as studying chemotaxis and testing the effectiveness of antimicrobial agents. Various types of microorganisms can be grown in microfluidic devices, from bacteria and fungi to microalgae, and microorganisms often thrive better in them than in conventional reactors. A special type of microfluidic devices are droplet microfluidic devices, in which microorganisms are trapped in liquid droplets that act as stand-alone reactors