Enterovirus D68 circulation between 2014 and 2022 in Slovenian children

IntroductionEnterovirus D68 (EV-D68) belongs to the Picornaviridae family, genus Enterovirus. It is mostly known as a respiratory virus causing upper and lower respiratory tract infections, but it is also rarely associated with a variety of central nervous system complications, with acute flaccid myelitis being reported most frequently. This study assesses the incidence, seasonality, clinical presentation, and molecular epidemiology of the EV-D68 strain in EV-positive children hospitalized between 2014 and 2022 at the largest pediatric medical center in Slovenia.MethodsEV-D68 was detected using specific qRT-PCR, whereas partial VP1 sequences were obtained with Sanger sequencing, and further analyzed using the software CLC Main Workbench version 7 and MEGA version X.ResultsEV-D68 was detected in 154 out of 1,145 (13.4%) EV-positive children. In the two epidemic years, 2014 and 2016, EV-D68 was most frequently detected in the summer and early autumn, peaking in September. The median age of EV-D68–infected children was 3 years (IQR 1–3 years), with a female: male ratio of 1:1.17. Rhinorrhea was present in 74.0% of children, respiratory distress in 82.5%, and hypoxemia requiring supplemental oxygen in 44.1%. Out of 154 patients, 80.0% were hospitalized, with a median stay of 2 days (IQR 1–3 days). Lower respiratory tract infection was observed in 89.0% of EV-D68–positive patients, with bronchitis and bronchiolitis being most frequently diagnosed. No central nervous system manifestations of EV-D68 infection were observed in the study cohort. Phylogenetic analysis of partial VP1 sequences of EV-D68 revealed close similarity to the EV-D68 variants that were circulating in other European countries in these years.DiscussionSlovenia faced two EV-D68 epidemics in 2014 and 2016; however, after 2016 only nine more cases were detected until the end of the study period. Based on the results of this study, EV-D68 was a frequent cause of lower respiratory tract infection among EV-positive patients. However, none of the patients we studied needed ICU treatment, and none developed acute flaccid paralysis. Our results indicate that EV-D68 is not present constantly, so additional monitoring studies should be conducted in the future to better understand the implications of this EV type in human disease

COMPARISON OF ATTACHMENT, OBJECT RELATIONS AND THE PROCESS OF SEPARATION-INDIVIDUATION AMONG ONLY CHILDREN AND INDIVIDUALS WITH SIBLINGS

Psihični svet posameznika se gradi v otroštvu na podlagi odnosov s pomembnimi drugimi. Ta trditev je zelo pomembna za vse teoretične koncepte v naši nalogi: navezanost, objektni odnosi, separacija in individualizacija. Obravnavani so bili že v nekaj študijah, a nobena ni zajemala edincev kot preučevane skupine. Ti se nam zdijo specifična skupina, vredna globljega raziskovanja. O edincih je napisanih mnogo trditev, največkrat gre le za stereotipe in posploševanja. Zato smo se v magistrski nalogi odločili to skupino podrobneje raziskati in obenem primerjati s posamezniki, ki imajo sorojence. Namen raziskave je bil ugotoviti, ali prihaja do razlik v navezanosti, objektnih odnosih in procesu separacije in individualizacije med edinci in osebami s sorojenci. V raziskavi je sodelovalo 200 udeležencev, starih od 18 do 27 let. Od tega je bilo 59 edincev in 141 oseb s sorojenci. Uporabljeni so bili Vprašalnik medosebnih odnosov (Bartholomew in Horowitz, 1991), Test objektnih odnosov (Žvelc, 1998) in Slikovni test separacije in individualizacije (Žvelc in Žvelc, 2000). Rezultati so pokazali, da obstajajo razlike med edinci, in tistimi, ki imajo sorojence, v procesu separacije in individualizacije v odnosu do matere in očeta. Edinci so nekoliko bolj avtonomni v odnosu s starši. Rezultati raziskave tako ne potrjujejo stereotipov o edincih.The psychic world of the individual is being built on the basis of relations in childhood with significant others. This is very important for all theoretical concepts in our thesis: attachment, object relations, separation and individualization. They have already been studied in a few former studies, but none of them have included the only children as the study group. In our opinion, the only children seem to be a specific group, worth of deeper exploration. There are many arguments written about only children but they are only stereotypes and generalizations. Therefore, we have decided in our master’s to study this group a bit more in details and at the same time to compare this group to individuals who have siblings. The purpose of the research was to determine whether there are any differences in attachment, object relations and the process of separation and individualization among only children and people with siblings. There are 200 participants included into the research, aged 18 to 27. 59 of them are only children and 141 people have siblings. Relationship Questionnaire (Bartholomew and Horowitz, 1991), The object relations test (Žvelc, 1998) and the Pictorial test of separation and individualization were used. The results showed that there are some differences in the process of separation and individualization among only children and people with siblings. Only children are more autonomous in their relationship with parents. Our results do not confirm stereotypes about the only children

THE IMPORTANCE OF SCINTIGRAPHY OF THE SENTINEL NODE IN BREAST CANCER PATIENTS

Izhodišča: Scintigrafija varovalne bezgavke je preiskava, ki z uporabo radioizotopov prikaže najbližjo bezgavko, v katero teče limfa iz tumorja. Prikaz varovalne bezgavke je samo del diagnostično-terapevtskega postopka, pomembna je tudi dobra seznanjenost pacientov, če zbolijo, o celotnem poteku zdravljenja. Namen: Namen diplomskega dela je predstaviti pomen scintigrafije varovalne bezgavke pri pacientkah z rakom dojke in vlogo medicinske sestre pri scintigrafiji in pri kirurškem zdravljenju raka dojke. Metodologija: V diplomskem delu je uporabljena deskriptivna metoda dela. Opravili smo pregled ter primerjavo podatkov, pridobljenih v slovenski in tuji strokovni literaturi ter virih. Uporabljena literatura se nanaša na obdobje 1999 - 2013. Iskala se je s pomočjo bibliografskega sistema COBISS in svetovnega spleta GOOGLE. Diskusija: Vloga medicinske sestre pri pripravi pacientke z rakom dojke na scintigrafijo varovalne bezgavke je pomembna. Pred preiskavo velikokrat opazimo pri pacientkah strah, zato jim razložimo, da poseg ni nevaren in da ni boleč. Pojasnimo jim, da si je potrebno pred samo preiskavo odstraniti vsa oblačila in nakit nad pasom. Po opravljeni preiskavi jim razložimo, da ni nobenih omejitev in da so reakcije in stranski pojavi zaradi vnosa radiofarmaka zelo redki. Preiskave ne izvajajo pri pacientkah, ki so noseče ali dojijo. Sklep: Ker je obolevnost za rakom dojke v porastu, pomeni zgodnje odkrivanje, uspešnejše zdravljenje. V procesu zdravljenja pacientk z rakom dojke, je pomembna tudi scintigrafija varovalne bezgavke kot diagnostično-terapevtski poseg.Starting point: Scintigraphy of the sentinel node is an examination that, with the help of the radio-isotope, shows the nearest node with the lymph that runs from the tumour. The display of the sentinel node is only a part of the diagnostic-therapeutic procedureit is also important that the patient is informed about the whole treatment process in case of getting cancer. Purpose: The purpose of the diploma paper is to present the meaning of scintigraphy of the sentinel node in patients with breast cancer, and the role of the nurse in scintigraphy and in surgical treatment of breast cancer. Methodology: The descriptive method is used in the diploma paper. An overview, and data comparison from Slovene and foreign technical literature and sources have been carried out. The used literature includes information of the time period from 1999 to 2013. The literature has been found with the help of COBISS and the search engine GOOGLE. Discussion: The role of the nurse in the procedure of preparing the patient with breast cancer for scintigraphy of the sentinel node is very important. During the examination patients often show fear, which is why they receive an explanation about the procedure being a safe and painless process. We clarify that it is necessary to remove all clothes and jewellery above the waist before the examination. After the finished examination we explain that there are no limitations, and that reactions and side effects of radiopharmaceutical are rare. The examination is not carried out in pregnant patients and by those in the period of breast-feeding. Conclusion: Because the number of breast cancer patients is increasing, an early detection of cancer means a more successful treatment. During the process of treating breast-cancer patients, scintigraphy of sentinel node is also important as a diagnostic-therapeutic procedure

Human Herpesvirus 6 Infection Presenting as an Acute Febrile Illness Associated with Thrombocytopenia and Leukopenia

We present an infant with acute fever, thrombocytopenia, and leukopenia, coming from an endemic region for tick-borne encephalitis, human granulocytic anaplasmosis, and hantavirus infection. The primary human herpesvirus 6 infection was diagnosed by seroconversion of specific IgM and IgG and by identification of viral DNA in the acute patient’s serum. The patient did not show skin rash suggestive of exanthema subitum during the course of illness

Changes in HRSV Epidemiology but Not Circulating Variants in Hospitalized Children due to the Emergence of SARS-CoV-2

This study assesses the circulation of human respiratory syncytial virus (HRSV) genotypes before, during, and toward the end of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in children and determines the influence of the pandemic on HRSV circulation patterns and evolution. Phylogenetic analysis of the hypervariable glycoprotein G gene was performed on 221/261 (84.7%) HRSV-positive samples and shows two separated clusters, one belonging to HRSV-A (129/221) and another to HRSV-B (92/221). All Slovenian HRSV-A strains contained the 72-nucleotide-long duplicated region in the attachment glycoprotein G gene and were classified as lineage GA2.3.5. All Slovenian HRSV-B strains similarly contained a 60-nucleotide-long duplicated region in the attachment glycoprotein G gene and were classified as lineage GB5.0.5a. During the 3-year period (2018–2021) covered by the study, no significant differences were observed within strains detected before the SARS-CoV-2 pandemic, during it, and after the implementation of nonpharmaceutical preventive measures. Slovenian HRSV-A strains seem to be more diverse than HRSV-B strains. Therefore, further whole-genome investigations would be required for better monitoring of the long-term impact of SARS-CoV-2 endemic circulation and the formation of new HRSV lineages and epidemiological patterns