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Biomedical subjects

Rok Tavcar

Publications and source records attributed to Rok Tavcar.

13 recordsLinked to original sources
PubMed2006

A prospective, randomized comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: five-year follow-up.

BACKGROUND: There are still controversies about graft selection for primary anterior cruciate ligament reconstruction. Prospective randomized long-term studies are needed to determine the differences between the materials. HYPOTHESIS: Five years after anterior cruciate ligament reconstruction, there is a difference between hamstring and patellar tendon grafts in development of degenerative knee joint disease. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: From June 1999 to March 2000, 64 patients were included in this prospective study. A single surgeon performed primary arthroscopically assisted anterior cruciate ligament reconstruction in an alternating sequence. In 32 patients, anterior cruciate ligament reconstruction was performed with hamstring tendon autograft, whereas in the other 32 patients, anterior cruciate ligament reconstruction was performed with patellar tendon autograft. RESULTS: At the 5-year follow-up, no statistically significant differences were seen with respect to the Lysholm score, clinical and KT-2000 arthrometer laxity testing, anterior knee pain, single-legged hop test, or International Knee Documentation Committee classification results; 23 patients (82%) in the hamstring tendon group and 23 patients (88%) in the patellar tendon group returned to their preinjury activity levels. Graft rupture occurred in 2 patients from the hamstring tendon group (7%) and in 2 patients from the patellar tendon group (8%). Grade B abnormal radiographic findings were seen in 50% (13/26) of patients in the patellar tendon group and in 17% (5/28) of patients in the hamstring tendon group (P = .012). CONCLUSION: Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 5 years. No significant differences in the rate of graft failure were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 5 years after surgery.

Adolescent↗
PubMed2005

Increased Th1 and Th2 immune reactivity with relative Th2 dominance in patients with acute exacerbation of schizophrenia.

AIM: To determine concentration of T helper (Th(1)) cytokines and Th(2) cytokines in patients with acute exacerbation of schizophrenia and compare the cytokine profiles between subtypes of schizophrenia. METHOD: One hundred inpatients with acute exacerbation of schizophrenia and 34 matched healthy subjects from the same population without psychiatric history were included in the study. According to predominant symptom complexes the patients were divided into three subgroups: hallucinations and delusions (n=36); disorganized behavior (n=33), and primary, enduring negative or deficit symptoms (n=31). In vitro IFN-gamma and IL-4 secretion by peripheral blood mononuclear cells after stimulation with ionomycin and phorbol 12 myristate 13 acetate was measured by enzyme-linked immunosorbent assay (ELISA) tests. RESULTS: Significant increase in in vitro secretion of IFN-gamma (21,505 vs 14,915 pg/mL; P=0.037; independent samples t test) and IL-4 (32 vs 15 pg/mL; P<0.001) with a shift to the Th(2) (1,022 vs 1,432 pg/mL; P=0.005) immune response was observed in patients with schizophrenia compared to healthy controls. We found pronounced effects of age and age at first hospitalisation on the Th(1)/Th(2) immune balance (R(2)=0.068; P=0.037). There were no significant differences in in vitro secretion of IFN-gamma (P=0.734; one-way analysis of variance), IL-4 (P=0.485) and IFN-gamma/IL-4 ratio (P=0.293) between the subgroups of patients with schizophrenia. CONCLUSION: Our findings indicate a simultaneous increase of in vitro reactivity of both Th(1) and Th(2) arm of cell mediated immunity, with a relative predominance of Th(2) immunity in patients with acute exacerbation of schizophrenia.

Acute Disease↗
PubMed2002

Predictors of noncompliance in males with first-episode schizophrenia, schizophreniform and schizoaffective disorder.

PURPOSE: Many factors influencing compliance in schizophrenia have been reported in the literature. Our aim was to assess predictors of noncompliance in male patients with first-episode schizophrenia, schizophreniform and schizoaffective disorder in a naturalistic setting. SUBJECTS AND METHODS: Fifty-six male patients, discharged from hospital, were included in a 1-year follow-up study. Psychopathological symptoms were assessed with positive and negative syndrome scale at admission and discharge, while extrapyramidal side effects were recorded weekly during hospitalisation using the Simpson-Angus and Barnes akathisia scales. Socio-demographic and some other variables were also recorded. RESULTS: Thirty patients (53.6%) dropped out of treatment in the first year and 21 of them relapsed. With the Cox survival analysis three predictors of noncompliance were found: diagnosis of schizophrenia versus the other two diagnoses, positive symptoms at admission, and lack of insight at discharge. Discussion. In spite of a specific methodology and selection of only first-episode male patients, the results are in accordance with the findings of other authors. This confirms the universality of noncompliance in psychotic patients. CONCLUSIONS: First-episode patients have a high dropout rate. However, in compliant patients, the relapse rate was low, and therefore special attention and compliance-promoting interventions in first-episode patients are needed.

Adult↗
PubMed2002

Evidence-based prevention strategies of suicide behavior in the world: implications for Slovenia.

In this review we consider how Slovenia could consider tackling its high rate of suicide (overall 29 per 100,000, 46 in males, 13 in females). First, we consider the evidence for risk factors that may contribute to Slovenia's high rate of suicide. Second, we describe the interventions to try to reduce the impact of these factors and the evidence for such interventions. We categorize interventions in terms of their operation at either the population level or that of high-risk groups. However, it should be borne in mind that settings often assumed to provide access to population groups, such as general practice and schools, do not reach some people who are likely to be at high risk; for example those who have dropped out of school or who have been excluded from a GP's list. We focus particularly on those for high-risk groups, as a number of East-European countries with high suicide rates such as Slovenia, Hungary, and the Baltic republics are currently considering a shift toward more community-based mental health services. The provision of community mental health services in Slovenia would provide an opportunity to study their impact on the suicide rate. However, we conclude that their development should be accompanied by other initiatives operating at population levels. This multilevel approach acknowledges the complexity of the etiology of suicide, the impossibility of reaching all those at risk through services and the lack of strong evidence for any one intervention.

Evidence-Based Medicine↗
PubMed2002

Comparison of psychiatric inpatient suicides with suicides completed in the surrounding community.

We compared main characteristics of 58 (22 male and 36 female) psychiatric inpatients that committed suicide in the psychiatric hospital with all 1261 suicides (956 male and 305 female) that occurred outside hospitals in the same health district of Slovenia, all these in the period between 1985 and 1993. The independent t-test and cross-tabulation were used to compare the two groups on age, sex, marital status and suicide method profile. It appeared that female suicide is much more frequent in the psychiatric inpatients' group than in others. Only male psychiatric inpatients' suicides are younger than other suicide victims. Psychiatric inpatients use methods like jumping from high places and drowning more often than do others, which goes in line with the availability of methods of suicide. Apparently, the studied hospital has some wards on the third floor and majority of acute wards are located by the river. However, psychiatric inpatients do not differ from other suicide victims on marital status. Higher suicide rates in men compared with women in the population, but not in psychiatric inpatients, could be explained by the presence of so-called atypical, clinically unrecognized depression in the male population.

Age Factors↗
PubMed2002

Community rehabilitation service for patients with severe psychotic disorders: the Slovene experience.

BACKGROUND: Rehabilitation can be carried out at various sites. METHOD: Two groups of patients with severe mental disorders were compared: those included in community rehabilitation service and those only attending an outpatient clinic regarding their clinical status, social functioning, standard of living and quality of life. RESULTS: We found no significant global differences in group characteristics, social functioning and clinical status, but we did prove the lower social status of the group included in the rehabilitation service and their satisfaction with the services they use. CONCLUSIONS: The community rehabilitation services in Slovenia are coping with existential social needs of their users but this study failed to demonstrate their success in improving health or social functioning.

Adaptation, Psychological↗