This is a chapter on fetal nutrition in the first Clinical Nutrition textbook in Slovenia. Clinical nutrition is now being recognized as an independent medical speciality. ONCA initiative (Optimal Nutritional Care for All) was founded based on the Prague Declaration premisses of 2009 that were endorsed by the EU Parliament in 2010. The WHO has joined ONCA in 2012. The goal of ONCA activities are to reduce malnutrition, which costs the EU taxpayers 170 billion euros per year. Clinical nutrition is promoted into the healthcare system through the ONCA activities; these include the education of healthcare professionals, including MDs and nurses.
F.23 Development of new system-wide, normative and programme solutions, and methods
COBISS.SI-ID: 31985625Diabetes type II is often found in aging, especially the obese population. Here we describe a possible use of venlafaxine for the treatment of diabetes as intoxication with this drug leads to hypoglicemia due to insulin independent entry of glucose into the cells. In venlafaxine overdose with prolonged normoinsulinemic hypoglycemia resistant to glucose therapy the increased rate of glucose uptake from the blood by the peripheral tissues (e.g. increased glucose disposal rate) might became clinically important. The increased glucose uptake rate might be associated with increased serotonin since in rats serotonin induces beta endorphin release and stimulates muscle glucose utilization through the activation of mu-opioid receptors by the insulin independent mechanism. In addition, increased glucose utilization (uptake) in peripheral tissues or/and inhibition of hepatic gluconeogenesis in venlafaxine overdose could also be mediated directly through opioid pathways involving the mu-opioid receptors since venlafaxine is structurally very similar to the mu-opioid receptor agonist tramadol, which is a known cause of hypoglycemia. In conclusion, the potential of venlafaxine to increase glucose uptake might influence the therapeutic approach in patients with diabetes and depression which commonly goes together.
F.12 Improvements to an existing service
COBISS.SI-ID: 31706329Centre for Clinical Toxicology and Pharmacology at the University Medical Centre Ljubljana (UMCL) serves as a consulting centre for all medical institutions in Slovenia in case of accidental or suicidal intoxications. Development of "cloud" applications is described and its use for improvement of the consulting service is described.
F.15 Development of a new information system/databases
COBISS.SI-ID: 32220121At the European Congress of Radiology, in March 2015 we presented the successful introduction of ultrasound guided punctures of shoulder joint with posterior approach for application of contrast media for MR arthrography.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 2748076Adverse drug reactions reporting to the national centre for pharmacovigilance at the University Me- dical Centre Ljubljana (UMCL) is mandatory for all health workers. National centre for pharmacovigi- lance collects and assesses reports of suspected adverse drug reactions and forwards them to the Agency of the Republic of Slovenia for Medicines and Medical Devices (JAZMP), which maintains the national database and publishes annual reports on reported adverse drug reactions. 1181 suspected adverse drug reactions were reported in Slovenia in 2014 (7). In 2015, online adverse drug reaction re- porting system was introduced that can be acces- sed at http://kf.kclj.si and JAZMP and UMCL homepages. The introduction of online reporting and its integration with hospital information systems is expected to increase the number of reported ad- verse drug reactions.
F.04 Increase of the technological level
COBISS.SI-ID: 32222425