Ministry of the Interior

The aim of this study was to predict and explain parenting stress at 3 months after the delivery with pregnancy-related features collected in different stages of pregnancy using generalized additive modelling. Pregnant women (n=1138) were recruited for this study. The participants completed multiple questionnaires at gestational weeks 14, 24, 34, and postnatally. The Swedish Parenthood Stress Questionnaire, completed at 3 months postpartum, served as the primary outcome measure. All pregnancy-measured variables were employed as explanatory factors, and a machine learning model underwent training and testing. Initially, the model incorporated variables from gestational week 14, wherein factors associated with the mother's personal well-being-such as quality of life and depressive symptoms-predicted parenting stress. Subsequently, the model expanded to include variables from gestational weeks 14 and 24, and based on that, also factors related to the relationship, such as avoidance and anxiety in close relationships and satisfaction in the relationship, predicted postpartum parenting stress. As the model evolved further, encompassing variables from gestational weeks 14, 24, and 34, it revealed that factors pertaining to both relationship satisfaction and the mother's well-being continued to predict parenting stress. The study underscores the significance of addressing both maternal well-being and relationship issues during maternity care.

Bu çalışma, Türkiye’deki “Cerattepe çevre hareketini” insan hakları ve sivil itaatsizlik perspektifinden ele almaktadır. Cerattepe örneği, sağlıklı bir çevre hakkının yalnızca ekolojik bir mesele olmadığını, aynı zamanda toplumsal farkındalık, demokratik katılım ve kolektif sorumlulukla doğrudan bağlantılı olduğunu göstermektedir. Araştırmada, Artvin halkının, madencilik faaliyetlerinin yol açabileceği çevresel ve toplumsal tehditlere karşı yürüttüğü paneller, toplantılar, protestolar, yürüyüşler ve sosyal medya kampanyaları detaylı biçimde incelenmiştir. Çalışma, çevre hakkının yerel ve ulusal düzeyde toplumsal bir sorumluluk olarak nasıl somutlaştığını ve sivil itaatsizlik araçlarıyla güçlendirilebileceğini ortaya koymaktadır. Sonuç olarak, Cerattepe mücadelesi, çevre hakkının korunmasının yalnızca ekosistemlerin sürdürülebilirliği için değil, aynı zamanda insanlığın ortak geleceğini güvence altına almak için de temel bir unsur olduğunu vurgulamaktadır.

Bezoar is a mass of swallowed foreign material most often composed of hair or fiber. Commonly, bezoars occur in young women with a history of psychiatric disorders, especially trichotillomania and trichophagia. Diagnostically, gastroscopy remains the gold standard. Prevalence is low, affecting up to 0.4% of the general population. Bezoars can lead to ulcer formation and hemorrhagic complications. Literature describes various treatment options, including endoscopic, laparoscopic and open surgical approaches. Psychiatric consultation and follow up are crucial for recurrence prevention. A 73-year old woman with a history of gastric ulcers and depression was urgently admitted to general surgery ward due to fatigue, abdominal pain and a suspicion of gastrointestinal hemorrhage. Outpatient gastroscopy revealed extensive ulceration of the posterior wall of the stomach, a large bezoar and pyloric stenosis. On admission, patient was severely anemic. Endoscopic haemostasis proved unfeasible due to the large bezoar. After initial stabilization, operative treatment was recommended. Laparotomy was performed revealing thickening on the posterior wall of the stomach, stenosis of the duodenum and a large diverticulum on the anterior wall of the descending part of the duodenum. Subtotal gastrectomy and diverticulum resection was performed. Restoration of gastrointestinal continuity was carried out using the Roux-en-Y method. Examination of the specimen confirmed the presence of a four centimeter bezoar and a three centimeter gastric ulcer. Post-surgery period was complicated by pneumonia and peripheral pulmonary embolism. Patient was discharged after treatment in good general and local condition after fifteen days since admission. Despite being rare, bezoars occur and should be taken into consideration during differential diagnosis of gastric symptoms and dyspepsia, even in the elderly population, especially with a history of psychiatric disorders. Bezoars can prevent endoscopic treatment of gastric hemorrhage and force surgeons to perform extensive surgical resections.

One of the most common diseases in general surgery remains cholecystitis. This is related to the prevalence of gallstones, which affects 10 to 15% of the general population. There are various types of treatment like conservative and surgical treatments, with a distinction between laparoscopic and robotic techniques. Numerous studies have been conducted which prove that laparoscopy is a safe method that significantly reduces the time of convalescence and recovery after surgery. The lack of a clear assessment of the effectiveness of treatment techniques is presented in the following paper. Advances in medicine have led to the widespread use of robotic arms in surgery, which has resulted in shorter hospital stays due to faster recovery times after surgery. This is related, among other things, to increased precision when operating instruments, and thus reduced trauma to the tissues in the abdominal cavity compared to laparoscopic surgery. However, robotic surgery has certain limitations related to the availability of equipment in specific hospitals and, above all, the increased costs of surgery compared to the use of a laparoscope. When analyzing the collected material on gallbladder surgery and possible treatment techniques for this pathology, it is not possible to clearly determine which treatment technique should be used as the gold standard in treating patients. However, it is important to remember that complications may occur in both cases, resulting in conversion to open surgery.

Background. Creatine monohydrate is one of the most widely researched and effective ergogenic supplements used to enhance performance and body composition in strength-based sports. Although creatine is known to be effective, researchers are still learning how to use it in the best way, how different people respond to it, and what other benefits it might have. . Aim. This systematic review evaluates the effectiveness of creatine supplementation in improving muscle strength, lean body mass, endurance, recovery, and related functional parameters, based on evidence from 49 scientific publications.. Material and methods. Studies included in this review examined creatine use in both short- and long-term protocols across varied populations, including athletes, recreationally active individuals, and older adults. Outcomes assessed included changes in 1RM strength, lean body mass, power output, quality of life, and biochemical markers. . Results. Creatine consistently improved strength and lean mass when combined with resistance training, regardless of dosing strategy or timing. Younger adults experienced faster and larger gains, while older individuals showed moderate improvements in physical function and well-being. Creatine monohydrate was more effective than alternative forms, and loading phases were not required for results. However, its effects were minimal without concurrent exercise and limited in some clinical populations. Additional benefits, such as enhanced sleep or antioxidant status, were reported in specific groups. Conclusions. Creatine supplementation is a safe, cost-effective, and well-supported strategy for enhancing resistance training outcomes. Its consistent efficacy across populations makes it a valuable tool for both athletic and clinical applications, particularly when paired with structured exercise.

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune complex deposition and multi-organ inflammation. Lupus nephritis (LN), a severe renal manifestation, is a leading cause of morbidity and mortality in SLE patients, with a significant risk of progression to end-stage renal disease (ESRD) if not managed promptly. Aim: This article synthesizes the complex etiology, pathophysiology, and management of LN, with an implicit aim to underscore the necessity of a multidisciplinary, collaborative approach to optimize patient outcomes through early detection, precise diagnosis, and personalized treatment. Methods: The review consolidates current medical literature on LN, detailing its pathogenesis involving genetic predisposition, environmental triggers, and immune dysregulation. It emphasizes the critical role of renal biopsy for histopathological classification (ISN/RPS system) and evaluation of activity/chronicity indices. The management framework is analyzed, outlining evidence-based protocols for induction and maintenance immunosuppressive therapy, risk-factor modification, and the integration of novel biologic agents. Results: LN prognosis is highly dependent on timely intervention guided by histologic class. Proliferative forms (Classes III/IV) carry the poorest renal outcomes without aggressive treatment. Advances in therapy, including mycophenolate mofetil, belimumab, and voclosporin, have improved remission rates and enabled steroid-sparing strategies. However, outcomes are significantly influenced by factors such as ethnicity, access to care, and adherence to long-term maintenance therapy. Conclusion: Effective management of LN requires an interdisciplinary model integrating rheumatology, nephrology, nursing, primary care, and laboratory science. This collaborative framework ensures vigilant surveillance, biopsy-informed treatment decisions, aggressive comorbidity management, and comprehensive patient education, ultimately leading to preserved renal function and improved quality of life.

In order to detect serious crime, the police can use covert investigative measures, when traditional forensic methods do not yield sufficient evidence for prosecution. Such measures may only be conducted on the basis of statutory provisions and upon orders issued by the public prosecutor's office or the court, as they constitute a significant interference with human rights and fundamental freedoms. The present article deals with various investigative measures, such as covert action and surveillance, with a special focus on covert searches, which have been used in some countries, but are not yet part of the legal system of the Republic of Slovenia. It allows law enforcement authorities to conduct a search without the suspect's knowledge. Given that the Constitution of the Republic of Slovenia defines the right to privacy and personal dignity, we will analyze the legal justification of the measure and its impact on the protection of human rights and fundamental freedoms. We will mention a judgment of the European Court of Human Rights which addresses the issue of the legitimacy of these measures and their compliance with fundamental human rights, in particular with regard to the right to privacy, personal dignity and inviolability of the home. We will focus on the need to ensure control over the use of covert investigative measures in order to prevent possible mistreatment, considering both national and international legal norms and the Case- Law of the European Court of Human Rights.

<title>Abstract</title> Purpose Pulmonary arterial hypertension (PAH) is a rare disease with poor prognosis. The same treatment is recommended in patients with PAH associated with connective tissue disease (CTD) and idiopathic PAH (IPAH). However, the effectiveness of PAH-specific treatment in these both groups is inconsistent. Methods The study incorporated data from the prospective, multicentre polish registry (BNP-PL) by comparison of baseline vs. 1-year follow-up clinical, laboratory, echocardiographic and hemodynamic parameters in PAH-CTD vs. IPAH group. The all-cause 1-year mortality was also analyzed. Results 624 patients were included in the study: 176 (28%) PAH-CTD and 448 (72%) IPAH. 48 (8% of the total 624) patients died during 1-year follow up: 32 (7%) with IPAH and 16 (9%) with PAH-CTD (p = 0.4). The effectiveness of treatment was examined in 421 patients: 115 (27%) PAH-CTD and 306 (73%) IPAH. The improvement of treatment was effective in both groups in terms of WHO FC (p &lt; 0.001 in both groups), 4-strata risk model (p &lt; 0.001 in both groups), six minute walking test (6MWT, p &lt; 0.001 in IPAH, p = 0.001 in PAH-CTD), Δ6MWT (p = 0.19 between PAH-CTD and IPAH), tricuspid annular plane systolic excursion (p &lt; 0.001 in both groups), NT- proBNP (p &lt; 0.001 in IPAH and p &lt; 0.01 in PAH-CTD), mean pulmonary arterial pressure (p = 0.043 in IPAH and p = 0.01 in PAH-CTD), pulmonary vascular resistance (p &lt; 0.001 in both groups) and cardiac output (p &lt; 0.001 in IPAH and p = 0.034 in PAH-CTD). Conclusions PAH specific treatment in PAH-CTD patients is as effective as in IPAH patients during 1-year observation. 1-year all-cause mortality was not significantly higher in PAH-CTD patients compared to IPAH patients.