Zvonka Zupanič Slavec

The development of nuclear medicine in Slovenia and Ljubljana; half a century of nuclear medicine in Slovenia

The development of nuclear medicine in Slovenia and Ljubljana; half a century of nuclear medicine in Slovenia Background. Nuclear medicine began to be developed in the USA after 1938 when radionuclides were introduced into medicine and in Europe after radionuclides began to be produced at the Harwell reactor (England, 1947). Slovenia began its first investigations in the 1950s. This article describes the development of nuclear medicine in Slovenia and Ljubljana. The first nuclear medicine interventions were performed in Slovenia at the Internal Clinic in Ljubljana in the period 1954-1959. In 1954, Dr Jože Satler started using radioactive iodine for thyroid investigations. In the same year, Dr Bojan Varl, who is considered the pioneer of nuclear medicine in Slovenia, began systematically introducing nuclear medicine. The first radioisotope laboratories were established in January 1960 at the Institute of Oncology and at the Internal Clinic. Under the direction of Dr. Varl, the laboratory at the Internal Clinic developed gradually and in 1973 became the Clinic for Nuclear Medicine with departments for in vivo and in vitro diagnostics and for the treatment of inpatients and outpatients at the thyroid department. The Clinic for Nuclear Medicine became a teaching unit of the Medical Faculty and developed its own post-graduate programme - the first student enrolled in 1972. In the 1960s, radioisotope laboratories opened in the general hospitals of Slovenj Gradec and Celje, and in the 1970s also in Maribor, Izola and Šempeter pri Novi Gorici. Conclusions. Nowadays, nuclear medicine units are modernly equipped and the staff is trained in morphological, functional and laboratory diagnostics in clinical medicine. They also work on the treatment of cancer, increased thyroid function and other diseases.

Državna zaščita vojnih invalidov na slovenskem po 1. svetovni vojni

War invalids, war widows and their dependent family members were permanent victims of war. The First World War brought great changes in organized care and treatment of war invalids. At the first post-war census of the Yugoslav population in 1921, Slovenia recorded around 11,500 people with disabilities and about 31,000 war widows with about 50,000 dependent family members. The census was conducted by a professional service within the Ministry for Social Policy. The large increase of the number of war invalids demanded more effective care for them, as they represented not only a material but also a moral and political problem for the country. A more recent disability legislation expanded the rights of war invalids and significantly improved their economic and social status and provided them with various benefits. Above all, the country expanded the rehabilitation of persons with disabilities, implemented occupational therapy and trained them for different work, including work in production among other areas. An increasing number of institutions were built that had adopted the disabled into permanent care.

Process of establishing Slovenija Transplant (Institute of the Republic of Slovenia for the Transplantation of Organs and Tissues)

Transplantation medicine is a rather young medical field. As a method of treatment human organs are used. These organs are donated with the aim to help fellow humans plagued by disease or in desperate situation. First condition for a successful treatment is developing a program that will take care of procuring the necessary organs. This should be an independent activity which requires appropriate addressing of professional, juridical, organizational and ethical aspects. In 1970, Slovenia started kidney transplantation from living related donors. As long as the transplantation activity covered only kidney transplants of the living donors, all the activities were conducted by nephrologists. Act on removal and transplantation of human body parts for medical purposes issued in 1985, and Rules on detailed medical criteria and the methods for determining occurrence of brain death of the person from whom it is permitted to take body parts for transplantation for treatment in 1986, made it possible to transplant organs from deceased donors. With the transition to deceased donor organs and the possibility of transplanting other organs (heart, liver, lungs, pancreas), it became necessary to organize these activities on national level. In 1992 Extended expert council for transplantation was established. The council planned all the necessary procedures for the construction of National transplantation network, the establishment of 24-hour coordination and the fastest way of passing of a transplantation law which enabled the establishment of Slovenia-transplant in 2000. After the establishment of 24-hour central coordination the number of organs procured from deceased donors has increased substantially. Slovenia has reached a similar number of organs obtained from deceased donors per million inhabitants, as member countries of the Eurotransplant association. At the same time the system was safe, reliable, transparent and properly regulated. Slovenia could therefore start negotiations for joining Eurotransplant. Even before the formal establishment of Slovenija Transplant, Slovenia became full member of the association.

Tick-borne encephalitis in Slovenia (1953-2013): the 60th anniversary

Izvleček Uvod: Leta 2013 mineva 60 let od izolacije virusa klopnega meningoencefalitisa (KME) v Sloveniji. Od takrat se slovenski infektologi, epidemiologi, virologi in drugi strokovnjaki strokovno in znanstvenoraziskovalno ukvarjajo s proučevanjem KME. Metode: Ob jubileju so s historiografskimi metodami analizirali objave skozi ta čas in pripravili retrospektivno študijo pojavljanja te bolezni pri nas. Rezultati: V nekaterih delih Slovenije se je v letih po drugi svetovni vojni začela pojavljati bolezen osrednjega živčevja, ki je do tedaj niso poznali. Leta 1953 so Milko Bedjanič in Slava Rus, oba infektologa, ter virologinja Jelka Vesenjak Zmijanac z osamitvijo virusa iz krvi bolnice dokazali, da je ta bolezen KME. Virologi so v naslednjih letih proučevali povzročitelja KME; številni epidemiologi so raziskovali njegove epidemiološke značilnost, entomologi in ornitologi ekosisteme arbovirusnih okužb, infektologi klinične in laboratorijske značilnosti okužb in potek okužb ter morebitne posledice bolezni. Mikrobiologi so izpopolnjevali možnosti diagnostike te okužbe. Razvili so tudi uspešno cepivo in zakonsko so določene skupine, ki se morajo obvezno cepiti. Zaključki: Bolezen se je pri Slovencih ustalila kot endemski tip KME, ki jo kliniki sicer dobro obvladujejo, a je skupen trud epidemiologov in javnega zdravja usmerjen v zvišanje precepljenosti proti KME, saj je v Sloveniji ta odstotek zelo nizek in se bolezen še vedno prekomerno pojavlja. Abstract Introduction: In the year 2013, we are celebrating the 60th anniversary of the isolation of the tick-borne encephalitis virus (TBE) in Slovenia. Ever since its isolation, Slovenian infectologists, epidemiologists, virologists and other experts have been researching this disease. Methods: For this anniversary, we have historiographically analysed all qualified articles from this period and prepared a retrospective study of the appearance of the disease in Slovenia. Results: In certain parts of Slovenia, in the years following the Second World War, there was an increased presence of previously unknown diseases of the central nervous system. In 1953, Milko Bedjanič, Slava Rus and Jelka Vesenjak Zmijanac isolated a virus in the blood and thereby proved that the disease was indeed TBE. In the years that followed, virologists studied the cause of TBE, many epidemiologists researched its epidemic characteristics, entomologists and ornithologists studied the ecosystems of arboviral infections and infectologists studied the clinical and laboratory features of infections and the course of the disease as well as its possible consequences. Microbiologists perfected the technique of diagnosing this infection. They developed a vaccine and selected the groups that were legally obliged to be vaccinated. Conclusion: the disease has stabilised as an endemic type of TBE that clinicians can control, but the common effort of epidemiologists and the public health service directed towards vaccinating people against this disease has not been very successful and the disease is still too common.

Development of rehabilitation medicine in Slovenia and in Ljubljana.

Even in ancient times, people found empirically that natural hot springs had a healing effect on ill or injured people. This knowledge was passed on through Antiquity and the Middle Ages to the present, when these discoveries have gained a scientific basis. This knowledge was further enhanced by the recognition that successful treatment and rehabilitation require patients to be physically active. In modern times, this led to the development of a new healthcare profession: physiotherapy. At the beginning of the twentieth century, physicians realized that long-term immobilization of patients in beds was harmful and that they needed to get up and start moving as soon as possible. This task was performed by physiotherapists. In Slovenia, certain spas have been known since Antiquity, and in the nineteenth century some of these were developed into health spas (Lasko, Rimske Toplice, Dobrna, and others), where centuries of experience were put to use. The first institution in Slovenia to introduce physiotherapy for the hospital treatment of patients was the Slajmer Sanatorium in Ljubljana in 1940. After the Second World War, many disabled people of all ages needed a new kind of hospital to address their physical, psychological, and social reintegration into everyday life and work. Following an initiative from orthopedists, the Soca Rehabilitation Institute for the Disabled was founded in 1954 in Ljubljana. Prior to this, it had already functioned as a section of the University Hospital of Orthopedics. It became the central institution for rehabilitation of sick and injured patients, and also a teaching base for related healthcare professions, training physiotherapists, occupational therapists, and doctors specializing in physical and rehabilitation medicine. The article further presents the development of hospital-based rehabilitation at the University Medical Centre in Ljubljana.

Academician Bogdan Brecelj and his contribution to the development of medical rehabilitation in Slovenia

The modern concept of rehabilitation, which deals with the patient as a whole, was developed after the Second World War. A key role was played by Bogdan Brecelj, who established a rehabilitation service and trained professional staff – physiotherapists and physiatrists. The first part of the article deals with the main factors behind the development of rehabilitation medicine, which was not influenced solely by developments in medicine but also by global circumstances – first the war and later on the consequences of industrialization. The combination of developments in industrial pathology (treatment of occupational injuries) and a more philanthropically minded society after the Second World War created demands for fair and equitable care for the disabled and an organised and specialized rehabilitation service as established in Slovenia by Brecelj. His all-embracing approach, which provided rehabilitation for all disabled persons (children, soldiers and workers), created conditions, which enabled rehabilitation medicine to become the third integral part of the healthcare system, alongside the curative and preventive healthcare.

In vitro fertilization – from concept to first child Commemorating the 2010 Nobel Prize in Medicine

Since the birth of the world’s first test-tube baby in 1978, more than 4 million babies have been born worldwide with the help of in vitro fertilization (IVF). In Slovenia, the first babies were born in 1984. In 2005, the percentage of babies born with biomedically assisted reproduction was 3.9 % and was the highest in Europe. IVF is nowadays a widely available and accepted method for helping infertile couples. However, the path to success was long and difficult. In this article, we present the development of IVF from the first ideas about fertilizing eggs outside the body from the end of the 19th century, followed by experiments on different animal species, the first human pregnancy and finally the birth of the first child in the United Kingdom. Many pioneers from other countries, particularly Australia and the United States of America, were instrumental in developing IVF as we know it today. Unfortunately, covering the history of IVF would greatly exceed the purpose of this article. During its history, the method was modified with innovative improvements. In its beginnings, there was a great deal of scepticism and opposition from certain public as well as scientific circles, an attitude that changed radically. The fact that the pioneer Robert Edwards received the Nobel Prize for Medicine in 2010 is proof of the growing acceptance of the method. Surely, IVF is a complex medical field, which raised and still raises ethical and legal questions. But from a merely human perspective, it is simply a method which gave infertile couples the opportunity to fulfill their lifetime dream.

The First Class of Students at the Full Medical Faculty in Ljubljana in 1945: The 65th Anniversary of Their Enrollment

In 1945, a class of 302 students enrolled at the newly established full Faculty of Medicine in Ljubljana with ten semesters of courses. Approximately 200 of them graduated five years later notwithstanding the faculty’s deficiencies in staffing and funding. By the end of 2009, the Ljubljana Faculty of Medicine had trained over 8,500 doctors and dentists. The first class of teachers and students faced many problems, but solved them over time. The spatial situation was solved by government decrees that temporarily assigned the Sempeter barracks, the clinics and health centers of the Ljubljana Hospital to the Faculty of Medicine. Staffing difficulties were solved by awarding professorships to experts in various areas. The problem of textbooks was overcome by students taking notes during lectures and copying them. Initial over-enrollment was solved by academic selection with strict criteria. The student youth organization directed cultivation of the body and mind with political overtones, and led compulsory “volunteer” labor campaigns throughout Yugoslavia. With great effort, despite all the postwar deficiencies, and at the same time enthusiasm for success and the zeal of all involved, the school was formed. It was further developed, year after year, producing ever better doctors with increasingly greater knowledge, comparable to global standards.

The development of Slovenian Heart Surgery: celebrating 50 years (1958-2008).

BACKGROUND The beginnings of Slovenian cardiac surgery reach back to 1958, when the first heart surgery using extracorporeal circulation (ECC) was performed. The 50th anniversary of this event was the impetus for reviewing its developmental path. METHODS History of medicine methodology, including analysis of archival materials, documents, and various publications of the Department of Cardiovascular Surgery, Ljubljana University Medical Center, Slovenia. RESULTS Presentation of the development of Slovenian cardiac surgery from 1958 to 2008. CONCLUSION Small countries may not be able to contribute great developmental steps to world cardiac surgery, but the work of individuals from these countries can represent a contribution to the development of the discipline.

Methodology Of Work

Historiography provides the framework for this study: it presents the personal features of the family of the Counts of Celje, and records the available biographical and genealogical information. In addition, it deals with the question of interment in the family vault at the Celeian Minorite church. An examination was made of all the registers, transcriptions and extracts from the documents of the Celeian Counts in Latin and Old German, all the secondary sources, all domestic and foreign books, and important articles which had been published about them.