Acta Medico-Biotechnica

Women doctors in medicine

Dušica Pahor (Author) — Thu, 11 Jul 2024 00:00:00 +0200

According to Eurostat data, the gender ratio among physicians is changing in favour of women. In the year 2021, the share of women among doctors in Europe was 52.2%. The data refer to the 26 EU states for which data are available.

Robot-assisted deep brain stimulation

Hojka Rowbottom, Tomaž Šmigoc, Janez Ravnik, Vojko Flis (Author) — Thu, 11 Jul 2024 15:18:08 +0200

Deep brain stimulation (DBS) is recognised as a safe and effective treatment for several movement disorders, namely essential tremor, Parkinson's disease, and dystonia, as well as for obsessive–compulsive disorder and refractory epilepsy. The main anatomical target of DBS is the basal ganglia. The DBS system comprises a pulse generator and surgically implanted electrodes. Lead placements must be accurate because the effects of DBS rely on the spatial restriction of the stimulation. Neurosurgical centres have started adopting robot-assisted DBS surgery. The results so far have been promising, with lead placement accuracy comparable to that of frame-based procedures. Additionally, robot-assisted procedures are shorter and less demanding on patients. Robot-assisted DBS can be used on patients who are fully awake or under general anaesthesia, as well as on children.

Use of the PRECLUDE® pericardial e-PTFE membrane in ophthalmology

Aneja Gorišek, Dušica Pahor (Author) — Thu, 11 Jul 2024 15:14:26 +0200

This article provides an overview of the diverse applications of the PRECLUDE® pericardial e-PTFE membrane in ophthalmology.

The e-PTFE membrane was found to be safe and effective as an alternative surgical procedure for perforating corneal ulcer closures. It could be a method of choice for eye preservation or during delayed corneal transplantation, especially in immunocompromised patients. After membrane removal, penetrating keratoplasty can be performed as a definitive treatment with better prognosis as “à-chaud” keratoplasty in all eyes, as a prognosis of visual acuity improvement is expected.

E-PTFE membrane implantation for use after uneventfully performed trabeculectomy with still-uncontrolled postoperative intraocular pressure (IOP) in severe refractory glaucoma represents an additional approach for treating uncontrolled secondary glaucoma. This modified trabeculectomy can be used as surgical treatment and for refractory traumatic glaucoma cases. The e-PTFE membrane can be used in cases where antimetabolite-related risk must be avoided. Our new surgical treatment after trabeculectomy is a simple and safe procedure and can be used as a filtration-modulating device in all refractory glaucomas.

Supercritical fluids for the isolation and formulation of bioactive substances

Maša Knez Marevci, Katja Andrina Kravanja, Željko Knez (Author) — Thu, 11 Jul 2024 15:16:00 +0200

Technologies involving sub- and supercritical fluids offer the possibility to obtain new products with special characteristics, which are especially needed in the pharmaceutical industry. The use of sub- or supercritical fluids for processing can also address legal limits for solvent residues and restrictions on the use of conventional solvents, while enabling new processes that are environmentally friendly and sustainable. Extraction of substances from plant materials, their in situ formulation in products with specific properties, particle formation, foaming, deposition, and sterilization have attracted much attention among the applications of supercritical fluids. This short overview reports the current status and expected future developments of research into sub- and supercritical fluid technologies.

Patient Satisfaction with Electronic Sick Leave Certificates: Survey of Family Medicine Outpatient Clinics

Ksenija Tušek Bunc, Primož Bobek (Author) — Thu, 11 Jul 2024 15:17:10 +0200

Purpose: In Slovenia, the transition from paper-based to electronic sick leave certificates (hereafter referred to as eBOLs) started at the beginning of 2020. While paper sick leave certificates are still widely used worldwide, many European countries are already reaping the benefits of using the eBOL system. This survey aimed to determine patients' satisfaction with the new eBOLs and highlight the most significant advantages and disadvantages from the patient's viewpoint.

Methods: A quantitative cross-sectional survey was conducted in Maribor, Slovenia, and the surrounding area to collect quantitative data from family medicine outpatient clinics. Two hundred and fifty patients were randomly selected among those receiving either paper or electronic sick leave certificates. The survey was conducted online with a web survey link and consisted of two parts. The first part included eight items measuring patients’ experiences with electronic and paper sick leave certificates, rated on a five-point Likert scale. The second part consisted of two multiple-choice questions regarding the advantages and disadvantages of eBOLs. The data were analysed using bivariate statistical analysis.

Results: Out of the 250 patients invited to participate in the study, 80 responded, resulting in a response rate of 32%. The mean age of the participants was 46.2 ± 11.2 years, with 56 (70%) women and 24 (30%) men. After more than a year of usage, 57 (71.3%) respondents expressed complete agreement that the eBOL system makes it easier for patients to manage their sick leave. Furthermore, 55 (68.8%) participants considered eBOLs as a good alternative to paper sick leave certificates. Most participants (76 (95%)) considered avoiding additional outpatient visits to manage their sick leave as the most significant advantage of using eBOLs. However, 64 (80%) respondents expressed uncertainty about the data sent by the eBOL system as the most significant disadvantage.

Summary: The survey results showed that patients were already significantly satisfied with the eBOL system when it was first introduced and that their satisfaction increased with continued use. A broader survey including a larger number of Slovenian outpatient clinics and capturing both patients' and doctors' opinions would provide more precise and broader insights into the newly introduced IT system's advantages and disadvantages and its users' satisfaction.

Hybrid fixation for repair of dual forearm fractures of adolescent patients: A case report and literature review

Igor Movrin (Author) — Fri, 12 Jul 2024 07:11:18 +0200

Purpose: To assess hybrid fixation as an alternative option for repair of dual forearm fractures of adolescent patients.

Case presentation: An 11-year-old boy presented with trauma to his right forearm resulting from playing on a trampoline. X-ray examinations confirmed fractures of both the right ulna and radius. Closed reduction and internal ESIN (elastic stable intramedullary nailing) fixation was selected for repair of the radius. Closed reduction of the ulnar fracture was unsuccessful, thus open reduction was performed. However, due to instability of the ulnar fracture after open reduction, internal plate fixation of the ulna was selected. At 3 months after surgery, the patient demonstrated full range of motion with no pain.

Acute pancreatitis in a patient with normal lipase: a case report

Tjaša Kitanovski, Andrej Grahek, Žan Garvas (Author) — Fri, 12 Jul 2024 07:10:15 +0200

This case report highlights the rare occurrence of acute pancreatitis in a patient exhibiting normal lipase levels. The patient presented to the emergency department with abdominal pain and fever. Laboratory tests indicated an acute inflammatory process but a negative lipase value. The diagnosis was established by a CT scan showing necrotizing pancreatic changes with elevated carbohydrate-deficient transferrin (CDT) levels, suggesting alcohol as the etiology. Management involved supportive care, aggressive fluid resuscitation, nutritional support, and empirical antibiotic therapy, which led to clinical improvement. This case emphasizes the importance of a comprehensive clinical assessment beyond standard biochemical markers in diagnosing and managing pancreatitis.

Ventricular arrhythmias and cardiac arrest in aconitine poisoning: a case report

Nino Cmor, Gašper Razinger, Jure Fluher, Andrej Markota (Author) — Fri, 12 Jul 2024 07:09:38 +0200

In traditional Chinese medicine, aconitum plants and roots are frequently used after extensive processing to treat various ailments in humans. However, use of a larger than recommended dose and inadequate processing increase the risk of aconitine poisoning. As a result of its particular mechanism of toxicity, aconitine poisoning can present with a variety of arrhythmias, including ventricular ectopy, ventricular tachycardia, ventricular fibrillation, and torsades de pointes. Meticulous arrythmia treatment is needed to restore sinus rhythm. We report a case of ventricular arrhythmias (VAs) induced by accidental aconitine poisoning. Our case highlights the efficacy of amiodarone in treating aconitine-induced VAs. To the best of our knowledge, this is one of the first described cases of aconitine-induced VAs in Europe. Clinicians should be aware of potential rare toxicological causes of malignant arrhythmias and consider toxicological screening in otherwise etiologically unexplained sudden cardiac arrest.

Severe Varicella-Zoster virus pneumonia in a healthy young adult treated with acyclovir and extracorporeal membrane oxygenation: a case report

Thu, 11 Jul 2024 15:17:40 +0200

Purpose: Varicella-zoster virus (VZV) infection is common in children and is usually benign. In adults VZV infection can present as a severe primary viral pneumonia with acute respiratory failure. VZV infections in adult have a high mortality rate.
Case report: A 32-year-old previously healthy male first presented to the emergency department with flulike
symptoms and no rash. Three days later he returned to the emergency department with a disseminated
skin rash and severe acute respiratory distress syndrome that required intubation and mechanical ventilation. A VZV infection was confirmed. Mechanical ventilation was insufficient and venovenous extracorporeal membrane oxygenation was introduced. In addition to supportive measures, he was treated with intravenous
acyclovir. During hospitalisation he developed several complications, including severe cor pulmonale necessitating treatment with nitrous oxide and milrinone, disseminated intravascular coagulation necessitating an extracorporeal membrane change, and ventilator-associated pneumonia. He was discharged home in stable condition on hospital day 27.
Conclusion: Primary VZV infection in adulthood is associated with several complications. Early recognition of
acute respiratory failure, ventilatory support, and early administration of acyclovir are crucial elements of VZV
pneumonia treatment.