1. Fecal short-chain fatty acids are associated with obesity in gestational diabetesKatja Molan, Jerneja Ambrožič, Matevž Likar, Draženka Pongrac Barlovič, Darja Žgur-Bertok, Marjanca Starčič Erjavec, 2025, izvirni znanstveni članek Opis: Background: Short-chain fatty acids (SCFAs), which are produced by the microbial fermentation of undigested carbohydrates, play an important role in the metabolism and physiology of the host. SCFAs are involved in the regulation of maternal metabolism during pregnancy and influence weight gain, glucose metabolism, and metabolic hormones. Methods: In 2017, women who were treated for gestational diabetes mellitus (GDM) at the University Medical Centre Ljubljana were invited to participate in a longitudinal study. A total of 45 women were included in this study and comprehensively phenotyped. During the second and third trimester of pregnancy, the women with GDM provided fecal samples for SCFA analysis. The samples were analyzed by high-performance liquid chromatography for the simultaneous determination of acetate, propionate, and butyrate. Results: SCFA concentrations in feces differed between overweight/obese and normal-weight women with GDM. Acetate and propionate concentrations were significantly higher in pregnant women who were overweight or obese before pregnancy compared to normal-weight women but butyrate concentrations were not. Butyrate was elevated in the third trimester in the group with excessive gestational weight gain. Conclusions: The relationship between SCFAs and obesity is complex, and the association between SCFAs and GDM remains to be clarified. Regardless of the conflicting publications on the role of SCFAs, our study showed that higher acetate and propionate levels were associated with the weight categories of overweight or obesity before pregnancy and higher butyrate levels were associated with excessive gestational weight gain.
Ključne besede: fecal SCFA, pregnancy, gestational diabetes mellitus, preconception BMI, gestational weight gain
Objavljeno v ReVIS: 12.02.2025; Ogledov: 239; Prenosov: 2
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7. A mixed-methods study of patient and healthcare professional perceptions of care pathways for knee osteoarthritisPika Krištof Mirt, Karmen Erjavec, Sabina Krsnik, Petra Kotnik, Mohsen Hussein, 2024, izvirni znanstveni članek Opis: Background: This study aimed to address research gap concerning the perception of the care pathway for knee osteoarthritis (KOA) patients, focusing on both the patient and health professional perspectives in countries with inefficient health systems, such as Slovenia, by examining patient satisfaction with conservative treatment, assessing the perceptions of both patients and health professionals regarding the latter's involvement, and justifying the chosen KOA treatment approaches.
Methods: A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews with KOA patients (n = 82) and healthcare professionals (n = 68). Results: The care pathway for conservative KOA treatment in Slovenia begins with general practitioners (GPs), who conduct initial examinations, prescribe analgesics, and refer patients to radiologists and orthopaedic surgeons. GPs received high satisfaction ratings (μ = 4.32). Orthopaedic surgeons, who confirm diagnoses and create treatment plans involving physiotherapy, medication, or joint injections, also received high satisfaction scores (μ = 4.47), despite long waiting times. Consultations with radiologists, mentioned less frequently, again received high satisfaction scores (μ = 4.67). Physiotherapists, consulted later, received high satisfaction scores (μ = 4.16) but long waiting times resurfaced. Referrals to rheumatologists occur for systemic diseases or ineffective conservative treatments. Psychologists, occupational therapists, and dieticians are rarely consulted, indicating limited integration into the treatment pathway. A comparison of health professionals' involvement showed that health professionals consider GP involvement less necessary (μ = 2.47) than patients do (μ = 2.82, p = 0.015). The same applies to radiologists (μ = 2.47 vs. μ = 2.87, p = 0.004), reflecting different views on diagnostic imaging. Our qualitative investigation revealed that, due to long waiting times, an alternative care pathway is developing with orthopaedic surgeons as the initial point of contact, bypassing GPs, and highlighted that patients and healthcare professionals differently perceive the latter's treatment roles.
Conclusions: The current conservative KOA care pathway lacks initial lifestyle change advice from the GP, referrals for conservative treatments, and a multidisciplinary team engaged in regular treatment monitoring and adjustment. Our mixed-methods research approach highlighted significant differences in perceptions of the treatment process and the roles of health professionals; the knowledge supplied of those differences should support experts and policymakers to optimise care pathways in Slovenia.
Ključne besede: conservative treatment, health professional involvement, integrated care pathway, knee osteoarthritis, patient satisfaction, Slovenia
Objavljeno v ReVIS: 24.12.2024; Ogledov: 423; Prenosov: 4
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9. Patient needs, functional requirements, aesthetic preferences and barriers in app-based therapy for knee osteoarthritisKarmen Erjavec, Petra Kotnik, 2024, izvirni znanstveni članek Ključne besede: perceptions, patients, application, physiotherapy, knee osteoarthritis
Objavljeno v ReVIS: 23.09.2024; Ogledov: 484; Prenosov: 2
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