Acta Medico-Biotechnica

Celebrating the 20th anniversary of the establishment of the Faculty of Medicine at the University of Maribor

2023-12-17T12:36:35+01:00

After many years of various endeavours and efforts, the Faculty of Medicine at the University of Maribor (the MF UM) was established in 2003. All of us who were fortunate enough to have taken part in this, remember this event fondly. After many decades the goal was achieved—a new Faculty of Medicine has emerged, the second in our country.

The Faculty of Medicine of the University of Maribor Celebrates 20 Years

2023-12-17T12:53:17+01:00

The Faculty of Medicine of the University of Maribor (MF UM) was established on October 2nd, 2003. The Council of the Republic of Slovenia for Higher Education ratified the university study programme “General Medicine” on December 3rd, 2003, whereupon in autumn 2004, the first 89 students enrolled in this programme. Since then, and until the end of the year 2023, 1,090 students will have completed their studies with a degree. The Council of the Republic of Slovenia for Higher Education gave consent, with an agreement, to the implementation of the new doctoral study programme “Biomedical Technology” at the MF UM on April 15th, 2005. In the academic year 2005/06, the first generation of postgraduate doctoral students was enrolled, specifically, 29 students in the first and 16 students in the second study year. From then, and until the end of 2023, there will have been 156 Doctors of Science promoted at the MF UM. The Slovenian Quality Assurance Agency for Higher Education bestowed the accreditation of the UMSP “Dental Medicine” programme on the MF UM on January 9th, 2020. The first generation of 20 students of “Dental Medicine” enrolled in the academic year 2021/22. In the beginning, the MF UM operated in numerous locations. On April 30th, 2004, the renewed building at Ljubljanska Ulica 5 was handed over for use, and on January 27th, 2006, the building at Magdalena Trg 5 followed. The foundation stone for the new building at Taborska Ulica 8 was laid on June 20th, 2011. The construction lasted for two years and three months, whereupon it was handed over for use on September 18th, 2013. The MF UM includes 36 university departments and 11 institutes. Professional services are organized into three departments: the Student and Study Affairs and the International Cooperation Department, the Economic and General Affairs Department and the Legal and General Affairs Department.

Access to innovative medicines in Slovenia

2023-12-20T07:07:45+01:00

Reimbursement is acknowledged to be a critical determinant of patient access to innovative medicines, necessitating a balance between accessibility and financial viability. Approximately 35 new innovative medicines and an additional 20 therapeutic indications are assessed from clinical and economical aspects during the reimbursement procedure every year in Slovenia. At the European Union level, ongoing efforts to unify assessment procedures of clinical domains are underway. These initiatives should improve the reimbursement process and ensure timely access to innovative therapies that will be aligned to the evolving needs of healthcare systems across the European Union.

Myocutaneous bipedicled flap, a free tarsoconjunctival graft, and a free skin graft for reconstruction of subtotal upper lid defects

2023-12-17T12:39:51+01:00

Purpose: To evaluate and present the outcomes of a single-step approach using a free tarsoconjunctival graft, a myocutaneous bipedicled flap, and a free skin graft for the reconstruction of subtotal upper eyelid defects following tumor excision.

Methods: This retrospective case series involved four patients who underwent upper eyelid reconstruction after tumor surgery. The defect affected 50%─75% and > 75% of the eyelid in two patients each. Among the latter patients, the lateral and medial canthus were involved in one patient each. The posterior lamella was reconstructed using the contralateral upper eyelid tarsoconjunctival graft, which was attached to the levator muscle at the site of the defect. The levator was weakened and elongated using small myotomies in one patient. The anterior lamella was reconstructed with a myocutaneous bipedicled flap based laterally and medially, leaving an exposed area beneath the brow, which was covered with a free skin graft.

Results: The patients had successful non-necrotizing healing and achieved satisfactory cosmetic outcomes. None of the patients developed clinically significant lagophthalmos, which would have required lubrication. Normal levator function was achieved in all patients. Two patients required additional surgery to repair pseudotrichiasis.

Conclusion: Subtotal upper eyelid defects could be effectively reconstructed using a combination of a free tarsoconjunctival graft, a bipedicled myocutaneous flap, and a free skin graft. Two-step procedures could be avoided in most cases by using this method.

In-hospital bleeding occurring while treating ST-segment elevation myocardial infarction during the COVID-19 pandemic: STEMI during the COVID-19 pandemic

2023-12-17T12:41:34+01:00

Pursose. Our purpose was to evaluate less well known factors and outcome associated to bleeding in STEMI patients after primary PCI and concomitant antithrombotic therapy during Covid-19 pandemic.

Methods. This was a retrospective, observational study of the prevalence and factors associated to hospital bleeding in 317 STEMI patients (74.8% men, mean age 65.7±11.9 years) and of the impact of bleeding on 30-day and 6-month survival in STEMI patients during the Covid-19 pandemic from January-October 2021. The leading reperfusion strategy was primary PCI; we registered all significant bleeding events.

Results: Concomittant Covid-19 was observed in 3.2% of STEMI patients. Primary PCI was performed in 94.3% of all cases, but only in 17% within the first 3 hours of chest pain. Bleeding was observed in 11.4% of all STEMI patients and was associated significantly with out-of-hospital cardiac arrests (OHCA), hospital complications and mortality. In bleeding and nonbleeding patients the prevalence of age, sex, comorbidities, Covid-19 cases, the use and start of primary PCI was similar.

Conclusions: The prevalence of hospital bleeding in treatment of STEMI patients during Covid-19 pandemic was 11.4% and was associated significantly to OHCA, hospital complications and early mortality of STEMI patients.

Impact of covid-19 pandemic on the epidemiology and etiology of lower respiratory tract infections in children

2023-12-17T12:44:29+01:00

Purpose: Changes in the epidemiology of communicable diseases in children are one of the direct and measurable consequences of the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study aimed to evaluate the impact of the recent pandemic on the epidemiology of lower respiratory tract infections and the relevant causative pathogens other than severe acute respiratory syndrome coronavirus 2.

Methods: In this retrospective study, all children hospitalized due to lower respiratory tract infections in 2019 and 2021 were enrolled. The nasopharyngeal swab test was performed using polymerase chain reaction to identify prevalent respiratory viruses and atypical bacteria.

Results: A total of 356 children were hospitalized due to lower respiratory tract infections in 2019 and 250 children in 2021 (a reduction of 29.8%). The proportion of children hospitalized due to atypical pneumonia and bacterial pneumonia decreased from 10.1% and 21.9% in 2019 to 2.8% and 12.0% in 2021, respectively (P <0.01 for both). A complete disappearance of influenza viral infections was observed in 2021. Moreover, a profound decrease in the proportion of Mycoplasma pneumoniae–positive specimens from 9.0% in 2019 to 2.7% in 2021 was observed (P <0.01). However, the proportion of rhinovirus-positive specimens increased from 8.2% in 2019 to 41.2% in 2021 (P <0.01).

Conclusions: The COVID-19 pandemic affected the incidence and etiology of lower respiratory tract infections in children, resulting in a decrease in atypical and bacterial pneumonia, a complete disappearance of influenza, and a seasonal shift in the epidemiology of the respiratory syncytial virus. These observations are important for planning healthcare resources and preventive measures for future pandemics, which will undoubtedly occur.

Borrelial lymphocytoma of the areola in a 9-year-old boy: a case report

2023-12-17T12:36:39+01:00

Purpose: This study presents a rare skin manifestation of Lyme borreliosis, specifically affecting the areola in a child in the absence of a history of a tick bite or erythema migrans.

Case report: A 9-year-old boy presented with symptomless erythematous swelling of the breast areola for one month. Initial treatment for gynecomastia and then mastitis proved ineffective. A biopsy was performed, with histological findings revealing lymphocytoma, likely stemming from an insect bite. Serology for Borrelia burgdorferi was positive. Following a two-week course of oral amoxicillin, the lesion completely resolved.

Conclusion: The consideration of Lyme disease should be a component of the differential diagnosis of skin lesions localised in typical areas, particularly in patients living in endemic regions.

Traumatic L5-S1 spondylolisthesis: A case report

2023-12-17T12:36:40+01:00

Purpose: Here, we report the diagnosis and management of a patient with a traumatic lumbosacral spondylolisthesis, a rare clinical entity that is characterized by unilateral or bilateral facet dislocations causing displacement at the level of the fifth lumbar vertebra in relation to the sacrum.

Case presentation: We report a case of a traumatic L5-S1 unilateral lumbosacral dislocation. Based on the preoperative CT and MRI findings, the patient sustained a right-side unilateral L5–S1 subluxation with an L5 right inferior articular process fracture, a torn anterior longitudinal ligament and posterior ligamentous complex, and L5-S1 disc protrusion. Decompression, reduction with L4, L5, S1 pedicular screw fixation, L5-S1 disc excision, and interbody cage insertion were performed. The patient had an uneventful recovery and returned to his previous activities 6 months after surgery.

A rare anatomical variation of the circle of Willis in a patient with an ischemic stroke

2023-12-17T12:46:40+01:00

Purpose

The cerebral arterial circuit provides collateral circulation to the brain and protects the brain from ischemia, by sustaining tissue perfusion in case of reduced or impaired blood flow through its branches. Although many random anatomical variations in the circle of Willis (CoW) are of minor importance, some increase the risk of ischemic events, aneurysm, and atherosclerosis, and play an important role in endovascular and surgical treatment planning.

Case presentation

We report a rare arterial variation of the CoW diagnosed by computed tomography angiography in a patient with ischemic stroke. We found aplasia of the A1 segment of the left anterior cerebral artery and ipsilateral hypoplasia of the P1 segment of the left posterior cerebral artery.

Conclusion

For neurosurgeons, neurologists, and neuroradiologists, detailed knowledge of the numerous anatomical variations in the arterial supply to the brain is crucial to make a correct diagnosis and choose the appropriate treatment. The type of CoW variation influences stroke severity and outcome, with an incomplete CoW related to more severe conditions (higher National Institutes of Health Stroke Scale scores, more severe neurological deficits, and worse neurological outcomes) and poor prognosis.