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Ljubljana, Slovenia

Cerne J.,Univerzitetni klinicni center Ljubljana | Novakovic S.,Onkoloski Institute Ljubljana | Gersak K.,Univerzitetni klinicni center Ljubljana
Zdravniski Vestnik | Year: 2013

The major known risk factors for breast cancer are associated with a prolonged exposure to increased levels of estrogens and their reactive metabolites. The mechanisms through which estrogens contribute to the carcinogenic process are complex. Evidence suggests the involvement of estrogen-receptor-mediated signalling which increases cell proliferation of mammary tissue. Furthermore, the metabolism of estrogens leads to the production of reactive metabolites, which exert genotoxic effects. Considerable inter-individual variability in the metabolic pathways of estrogens is attributed to polymorphisms in the genes encoding for enzymes involved in estrogen metabolism. These person-to-person differences define subpopulations of women with different lifetime exposure to estrogens and/or estrogen metabolites. Assessing these genetic differences is therefore relevant as it may help to identify postmenopausal women who are particularly susceptible to breast cancer if exposed to exogenous hormones by hormone replacement therapy. Source

Plavc G.,Onkoloski Institute Ljubljana
Zdravniski Vestnik | Year: 2016

Background: Well-educated and highly-trained physicians are an essential part of high-quality health care. Therefore, quality assurance in medical education must be one of the priorities of health systems. We researched and analysed responses to questions regarding preparedness to internship (IS) and IS itself, obtained from physicians after completion of IS and from their mentors. Methods: In this cross-sectional study, electronic surveys were sent to 298 physicians having completed the IS between February 2014 and February 2015, and to their 200 mentors. Ordinal responses of two independent groups were compared by Mann-Whitney-U test, while Kruskal-Wallis test was used for comparing more than two groups. Frequency distributions were compared by χ2-test. Results: We received completed surveys from 58.1 % of interns. Statistically significant differences were found in the reported preparedness for IS between graduates of the two Slovenian medical faculties (p = 0.001); in the volume of practical procedures performed as prescribed by the IS program between different health institutions (general hospitals average (GH) vs. University Medical Centre (UMC) Ljubljana (LJ) vs. UMC Maribor, 52.7 % vs. 42.7 % vs. 41.1 %, respectively, p < 0.001); in agreement with statements about satisfaction with different clinical departments (p < 0.001) and between different institutions (GH vs. UMC MB vs. UMC LJ, p < 0.001); and in the reported active participation in patient care between different clinical departments (p < 0.001). Conclusions: In this study we identified differences in physicians ‘ preparedness for IS between the graduates of the two Slovenian medical faculties, as well as differences in the realization of IS program between health institutions and clinical departments. The results of this study will allow the assessment of quality improvement after the implementation of planned IS program renovation. © 2016, Slovene Medical Society. All rights reserved. Source

Agency: Cordis | Branch: H2020 | Program: RIA | Phase: PHC-06-2014 | Award Amount: 3.00M | Year: 2015

Breast, colorectal and cervical cancer cause 250,000 deaths each year, representing 20% of EU-cancer mortality. Although important progress has been made in both detection and treatment, there is persisting inequity in progress to reduce its burden. Screening programmes vary substantially between countries and in most long-term effectiveness of screening has not yet been assessed. The objective of EU-TOPIA is to systematically evaluate and quantify the harms and benefits of the running programmes for breast, cervical, and colorectal cancer in all European countries, and identify ways to improve health outcomes and equity for citizens. We will first identify significant inequities in screening outcomes by assessing the key set of quality indicators for benefits and harms in each country. Using these indicators, outcomes and cost-effectiveness of existing cancer screening programmes in 2015 will be estimated. For this, state-of-the-art models of the natural history of the cancers will be constructed, using country-specific data with and from country-specific experts. Barriers hindering implementation of optimal screening programs will be assessed, leading to road maps for improved screening. These road maps contain feasible changes, e.g., to extend or reduce the program, to change the screen test used or change key quality indicators, to perform activities that reduce screen-related harm or incorporate new developments in screening, and provide policymakers with evidence for increased, decreased or optimized use of screening. Capacity for self-evaluation of screening will be built using three web-based tools (monitoring, model-quantification and barrier assessment) explained and trained in workshops with country representatives, also from the Associated Countries. The project will lead to reduced inequity, reduced number of cancer deaths and over-diagnosed cases, and increase in life years gained and better cost-effectiveness by 2025. That is why we call it EU-TOPIA.

Rajer M.,Onkoloski Institute Ljubljana | Duratovic A.,Onkoloski Institute Ljubljana
Zdravniski Vestnik | Year: 2015

Background: Nowadays cancer patients tend to be more involved in the medical decision-making process. Active participation improves health outcomes and patient satisfaction. To participate effectively patients require a huge amount of information, but time limits make it impossible to satisfy all information needs at clinics. We tried to find out which kind of media cancer patients use when searching for information and how often. Lastly, we try to find out how popular the Internet is in this regard. Metods: In this research, we invited cancer patients, who had regular clinic examinations at the Institute of Onoclogy between 21–25 May 2012. We carried out a prospective cross-sectional survey by means of anonymous questionnaires. We were investigating which media were used and how often. We analysed results using descriptive statistics, ANOVA, the χ2-Test and the t-test. Results: 478 of 919 questionnaires distributed among cancer patients were returned. Mean age of the respondents was 59.9 years. 61% of them were female, and the most common level of education was high school (33%). Most common cancer type was breast cancer (33%), followed by gastrointestinal and lung cancers. Most often, patients search for information on television (81.4% respondents), followed by specialized brochures (78%), internet (70.8%) and newspapers (67.6%). Patients who do not use media forinformation search are older than average (62.5 years vs. 59.9 years; p < 0.000). Conclusions: According to our results, patients search for information most often on television, followed by brochures, internet and newspapers. Older patients less often search for information. This data might help doctors in their daily clinical practice. © 2015, Slovene Medical Society. All rights received. Source

Tepes B.,Abakus medico d.o.o. | Stefanovic M.,Diagnosticni center Bled | Bracko M.,Onkoloski Institute Ljubljana | Grazio S.F.,Onkoloski Institute Ljubljana | And 3 more authors.
Zdravniski Vestnik | Year: 2010

Background: Colorectal cancer (CRC) is the third most common cancer in the USA. In Slovenia, CRC is the second most common cancer after skin cancers. Five-year survival depends on the clinical stage at presentation. Patients with-earlier clinical stages can be found only by means of a national screening programme. Results: In the pilot phase of the Slovenian National Screening Programme SVIT we invited 9091 patients aged 64 to 68 years from Ljubljana, Kranj and Celje region; 3807 persons responded to our invitation (41.9 %). Two samples for fecal immune tests were sent to 3117 study subjects who met inclusion criteria, and we received 2829 tests back. Among them 7.5 % of tests were possitive. Untill 11 February 2009, there were 193 colonoscopies performed in DC Bled, DC Lipa and AM DC Rogaška. Histology specimens were taken from 135 patients (70 %). Adenoma detection rate was 53.8 %, with the number of adenomas per patient ranging from 1 to 17 (2.4 on average). Advanced adenomas were detected in 60 (31 %) of patients. Invasive carcinomas were detected in 15 patients (7.6 %), 10 of them (73.3 %) were in clinical stages I and II. Conclusions: We have proved that CRC screening programme can detect patients with CRC in early clinical stages. Adenomas and invasive cancers were detected in 61.7 % of patients. In almost all patients adenomas were removed at screening colonoscopy, thus reducing the possibility of later development of CRC in those patients. We have proved that CRC screening programme SVIT in Slovenia can be very effective. When SVIT will be launched in our country in full scale and compliance rate will exceed 60 %, we can expect to reduce CRC by 300 and CRC dependent deaths by 200 cases yearly. Source

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