Search

The article presents data on the social characteristics of first sexual intercourse (FSI) among secondary school students in Slovenia, collected as part of the research project 'Sexuality of Secondary School Students in Slovenia'. The results show that for most respondents their FSI was a planned event occurring within an intimate partnership. Protective measures are used to a considerable extent. There are statistically significant gender differences in the majority of the results. The data show responsible behaviour during the FSI, although a share of the respondents is exposed to sexually transmitted infections (STIs). The data may be used for policy decision-makers, especially in terms of sex education and addressing the STI issue. V članku so predstavljeni podatki o družbenih značilnostih prvega spolnega odnosa pri dijakih v Sloveniji, zbrani v okviru raziskovalnega projekta "Spolnost srednješolcev v Sloveniji". Rezultati kažejo, da je bil prvi spolni odnos za večino vprašanih načrtovan dogodek, ki se je zgodil v intimnem partnerstvu. Uporaba zaščite je zelo pogosta. Pri skoraj vseh rezultatih obstajajo statistično pomembne razlike po spolu. Podatki razkrivajo odgovorno vedenje ob prvem spolnem odnosu, kljub temu je določen delež anketirancev izpostavljen morebitnim spolno prenosljivim okužbam. Podatki so pomembna podlaga za oblikovanje politik, zlasti v zvezi s spolno vzgojo in načinom reševanja problemov glede spolno prenosljivih okužb.

Chlamydia trachomatis je najpogostejša bakterijska povzročiteljica spolno prenosljivih okužb v svetovnem merilu. Večinoma okužbe potekajo asimptomatsko, ki v odsotnosti zdravljenja vodijo v resne zdravstvene zaplete. Za zdravljenje klamidijske okužbe se priporoča azitromicin ali doksiciklin. Oba antibiotika spadata v skupino bakteriostatičnih antibiotikov, ki z vezavo na 23S rRNK in 16S rRNK blokirajo sintezo beljakovin. Stopnje neuspešnega zdravljenja so dokaj visoke (8–23 %), najpogostejša vzroka sta ponovna okužba po prekinitvi zdravljenja ali razvoj heterotipske odpornosti. Odpornost proti makrolidom je lahko posledica mutacij v genu za 23S rRNK, ki ovirajo vezavo in interakcijo antibiotika s tarčnim mestom delovanja. Za ugotavljanje občutljivosti klamidije za antibiotike in določanje minimalne inhibitorne koncentracije (MIK) se najpogosteje uporablja metoda gojenja v celični kulturi ob prisotnosti antibiotika v različnih koncentracijah, vendar se test zaradi zahtevnosti izvedbe in manjše občutljivosti uporablja le izjemoma. Namen magistrske naloge je vzpostavitev učinkovite metode za preverjanje prisotnosti mutacij v domeni V 23S rRNK, ki posredujejo odpornost proti makrolidom. V raziskavo smo vključili 58 vzorcev DNK kliničnih izolatov z večkrat potrjeno okužbo s C. trachomatis, kljub antibiotični terapiji. 36 vzorcev DNK smo uspešno pomnožili z alelno specifičnimi oligonukleotidi in izvedli sekvenciranje. Na podlagi bioinformacijske analize na pozicijah A2057, A2058, A2059 in T2611 (štetje po E. coli) nismo našli mutacij, ki vodijo v razvoj odpornosti proti makrolidom. V skladu s pričakovanji smo uspešno uvedli molekularno metodo, ki nam omogoča dokazovanje mutacij, ki posredujejo odpornost proti makrolidom. Chlamydia trachomatis is the most common sexually transmitted bacterial infection worldwide. Often, infections occur asymptomatically, leading to serious health complications in the absence of treatment. The use of azithromycin and doxycycline is recommended for the treatment of sexually transmitted chlamydial infections. Both antibiotics belong to the group of bacteriostatic antibiotics that bind to 23S rRNA and 16S rRNA, blocking protein synthesis. Treatment failure rates are high (8-23 %), for which the most common cause is re-infection after discontinuation of treatment or the development of heterotypic resistance. The most commonly used test for antibiotic susceptibility and MIC determination is cultivation in cell culture in the presence of antibiotics in various concentrations. Resistance to macrolides may be due to mutations in the 23S rRNA gene that cause reduction in interaction of antibiotics with target site of action. The aim of this master's thesis is to establish an effective method for determination of mutations in the domain V of 23S rRNA that mediate resistance to macrolides, so we included 58 DNA samples of clinical isolates with confirmed C. trachomatis infection after antibiotic treatment. 36 DNA samples were successfully amplified with allele-specific oligonucleotides and sequencing was performed. Based on bioinformatics analysis at positions A2057, A2058, A2059 and T2611 (E. coli numbering), we did not find mutations that are important for the development of resistance to macrolides. Based on expectations, we have successfully established a molecular method to obtain nucleotide sequences, whereby the presence of important mutations that mediate resistance to macrolides can be determined based on alignments with reference sequences.

Uvod: Zaradi spolnih odnosov pri nizki starosti, pomanjkanja ustreznega znanja o varni spolnosti in ustrezni kontracepciji lahko pride do spolno prenosljivih okužb. Pomembno vlogo pri preprečevanju imata preventiva in pravočasna spolna vzgoja. Namen: Želimo predstaviti najpogostejše spolno prenosljive okužbe v Sloveniji ter pomembnost spolne vzgoje pri preprečevanju teh. Cilji so, ugotoviti kakšne posledice pustijo spolno prenosljive okužbe na fizično in psihično zdravje in kakšna je učinkovitost zgodnje spolne vzgoje in uporabe kondomov. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom znanstvene in strokovne literature v slovenskem in angleškem jeziku s področja spolnosti in spolno prenosljivih okužb. Pri iskanju smo uporabili časovni okvir objav od leta 2008 do 2019. Literatura je bila iskana s pomočjo Digitalne knjižnice Univerze v Ljubljani (DiKUL), Digitalne knjižnice Univerze Maribor (DKUM), bibliografskih podatkovnih baz CINAHL, ScienceDirect, Cochraine Library, Medline, Web of Science, COBIB.SI in v revijah Obzornik zdravstvene nege ter Zdravniški vestnik. V analizo smo vključili 35 enot literature. Rezultati: Najpogostejše okužbe v Sloveniji so okužba s humanim papiloma virusom, Chlamydia trahomatis, Treponema pallidum, virusom Herpes simplex tip 2 in z bakterijo Neisseria gonorrhoeae. Velika večina spolno prenosljivih okužb dolgo časa ostane asimptomatskih, ko simptomi nastopijo, pa je lahko stanje že resno. Vplivi na fizično zdravje se lahko kažejo kot kratkoročne ali dolgoročne posledice. Pravočasna spolna vzgoja daje posameznikom ustrezna znanja in veščine, kako se spustiti v svet spolnosti. Razprava in zaključek: Spolnost je neizogibna človeška želja, zato je pomembno, da posamezniki razumejo pomembnost posledic, ki jih spolno prenosljive okužbe pustijo na fizičnem in psihičnem zdravju človeka. Pomembno je, da poudarimo dejstvo, da se določene posledice pojavijo lahko šele nekaj mesecev do nekaj let po dejanski okužbi, vendar lahko močno ogrozijo življenje. Z ustreznim znanjem, nasveti in primerno kontracepcijo lahko mladostniki varno prakticirajo spolnost, hkrati pa s tem vplivajo na zmanjševanje incidence spolno prenosljivih okužb. Introduction: Because of young age adolescents do not have adequate knowledge of safe sex practice, appropriate contraception which increases the chance to contract a sexually transmitted infection. An important role in preventing spreading sexually transmitted infections is early sex education. Purpose: The purpose of the thesis is to present and state which sexually transmitted infections are the most common in Slovenia, and the importance of sex education in preventing them. The goals are to present and answer the following assumptions: what are their consequences on physical and mental health, how effective is early sex education and how effective are condoms. Methods: In the thesis there was used a descriptive method of work with a combination of a systematic review of scientific and professional literature written is slovene or english in the field of sexuality and sexually transmitted infections. The time frame of literature age was from 2008 to 2019. The literature was searched for through the Digital library of the University of Ljubljana (DiKUL), the Digital library of the University of Maribor (DKUM), the CINAHL bibliographic databases, ScienceDirect, the Cochraine Library, Medline, Web of Science, COBIB.SI, and in journals Obzornik zdravstene nege and Zdravniški vestnik. 35 pieces of literature were included in the analysis. Results: Most common infections in Slovenia are infections with human papillomavirus, Chlamydia trahomatis, Treponema pallidum, herpes simplex virus type 2 and the bacteria Neisseria gonorrhoeae. The vast majority of sexually transmitted infections remain asymptomatic for a long time, but when the symptoms are present, the condition can already be serious. The individual can be affected both physically and mentally. In the case of physical health the consequences can be short-term or long-term. Sex education provided early enough gives appropriate knowladge and skills to enter the world of sexuality safely. Discussion and conclusion: Sexually activity is a inevitable human desire, so it is crucial for people to understand the importance of the effects that sexually transimtted infections have on the human health, both physical and mentally. It is important to emphasize the fact that certain consequences can take from a few month to a few years to be seen, but can represent serious risks. With appropriate knowladge, advice and contraception, individuals can safely enter the world of sex and reduce the rise of sexually transmitted infections.

Uvod: Spolno prenosljiva klamidijska okužba je ena najpogostejših spolno prenosljivih okužb. V večini primerov poteka asimptomatsko, vendar nezdravljena lahko predvsem pri ženskah pusti dolgotrajne posledice, kot sta vnetna medenična bolezen in neplodnost. V nosečnosti lahko povzroči zaplete, kot so prezgodnji porod, spontani splav in mrtvorojenost. Testiranja v Sloveniji se ne izvajajo rutinsko, le na željo nosečnic. Namen: Namen diplomskega dela je predstaviti prevalenco spolno prenosljive klamidijske okužbe, njen vpliv na zdravje nosečnice in razvoj otroka, raziskati vpliv okužbe na neželene izide nosečnosti s poudarkom na prezgodnjem porodu ter preučiti zdravstvenovzgojno in preventivno vlogo medicinske sestre v obravnavi okužene nosečnice. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom domače in tuje literature, objavljene med letoma 2009 in 2019. Iskanje literature je potekalo v podatkovnih bazah CINAHL, ScienceDirect, COBIB.SI in Medline/PubMed. V analizo smo vključili 14 člankov. Rezultati: V državah razvitega sveta, kamor sodi tudi Slovenija, je prevalenca okuženosti nosečnic s spolno prenosljivo klamidijsko okužbo od 3 do 14 %. Spolno prenosljiva klamidijska okužba v ženskem reproduktivnem traktu povzroči vnetni proces, ki znatno poveča možnosti za spontani prezgodnji porod, spontani splav ter mrtvorojenost. Medicinska sestra se mora nenehno izobraževati o novostih na področju testiranja, da lahko s svojim zdravstvenovzgojnim delom ozavešča nosečnice in njihove partnerje o pomembnosti zgodnjega testiranja in zdravljenja. Razprava in zaključek: Zgodaj odkrita in ozdravljena spolno prenosljiva klamidijska okužba nima vpliva na zdravje matere in razvoj ploda, zato je pomembno hitro prepoznati dejavnike tveganja in simptome okužbe. Medicinska sestra ima poglavitno vlogo v ozaveščanju in izobraževanju nosečnic o okužbi. Obravnavane raziskave so heterogene in pozivajo k nadaljnjim podrobnejšim študijam na tem področju. Introduction: Sexually transmitted chlamydial infection is one of the most common sexually transmitted infections. In most cases they are asymptomatic, but left untreated they can leave long-term effects especially in women, for example pelvic inflammatory disease and infertility. In pregnancy it can affect the incidence of adverse pregnancy outcomes, such as preterm delivery, spontaneous abortion and stillbirth. In Slovenia screening for chlamydial infections isn't done routinely, only when pregnant women ask for it. Purpose: The purpose of this study was to examine the prevalence of sexually transmitted chlamydial infections, it's affect on pregnant women's health and infant development, explore the effect of infection on adverse pregnancy outcomes, specifically preterm delivery, and the health-educational and preventative role of the nurse when she is caring for infected pregnant women. Methods: A descriptive method of work was used with a systematic review of domestic and foreign literature, published between the years of 2009 and 2019. Data was gathered from the following databases: CINAHL, ScienceDirect, COBIB.SI and Medline/PubMed. 14 articles were included in this study. Results: In developed countries, which Slovenia is a part of, is the prevalence of sexually transmitted chlamydial infection between 3 and 14 %. Sexually transmitted chlamydial infection causes an inflammation in female reproductive system, which increases the risk of preterm delivery, spontaneous abortion and stillbirth. The nurse has to continuously educate herself on the subject of testing, so that she can make pregnant women and their partners aware of the importance of early screening and treatment. Discussion and conclusion: Early diagnosed and treated sexually transmitted chlamydial infection leaves no important affect on health of mother and child, therefore it is important to recognise risk factors and symptoms of infection. Nurses have the integral role in educating and making pregnant women aware about the sexually transmitted chlamydial infection. Studies are heterogenous and are appealing for further more detailed studies in this field.

Uvod: Dandanes imajo ljudje do 50 % možnosti, da se bodo skozi življenje okužili s spolno prenosljivimi okužbami, med katerimi je vse več okužb s humanimi papilomavirusi. Število okuženih narašča, posledica okužbe pa je lahko tudi diagnosticiran rak, ki bi lahko bil preprečen s cepivom. Namen: Namen diplomskega dela je ugotoviti osveščenost in znanje študentov zdravstvene nege Zdravstvene fakultete o humanih papilomavirusih. Metode dela: Presečna raziskava je temeljila na anonimnem anketnem vprašalniku, katerega je izpolnilo 175 študentov. Izračunana je bila zanesljivost na podlagi koeficienta Cronbach alfa (0,614), deskriptivna statistika, t-test za ugotavljanje razlik glede na spol ter koeficient kontingence za ugotavljanje razlik v spremenljivkah glede na ostale socialno demografske podatke. Za analizo smo uporabili statistični program SPSS v. 23 (SPSS Inc., Chicago, Ill., USA). Rezultati: Ugotovitve raziskave kažejo, da se študentje delno ne strinjajo, da so humani papilomavirusi močan dejavnik tveganja za nastanek raka glave in vratu (M = 3,00) ter da je kajenje močan dejavnik tveganja pri okužbi s humanimi papilomavirusi (M = 3,21). Glede na spol se študentke statistično značilno delno strinjajo, da se lahko s humanimi papilomavirusi okužijo tudi moški (p = 0,012). Študentje se delno strinjajo s trditvijo, da o cepivu in cepljenju proti humanim papilomavirusom ne vedo dovolj (M = 1,75). Študentje tretjega letnika se statistično značilno popolnoma strinjajo, da se proti humanim papilomavirusom lahko cepijo tudi moški (p = 0,001). Študentje se delno strinjajo, da zdravstveni delavci premalo ozaveščajo mlado populacijo o okužbi s humanimi papilomavirusi in dejavnikih tveganja (M = 1,57), študentje, starejši od 27. leta starosti, se statistično značilno sploh ne strinjajo, da so bili o zaščiti pred okužbami s humanimi papilomavirusi poučeni na sistematskih pregledih (p = 0,000). Razprava in zaključek: Da bi preprečili povečanje števila zbolelih za rakom, ki jih povzroča okužba s humanimi papilomavirusi, potrebujemo primerno zdravstveno vzgojo, dobro osveščeno in precepljeno populacijo, s katero bi posledično začeli zmanjševati obremenjenost z rakotvornimi spremembami, ki so vse pogostejše. Da bomo pri preventivnem osveščanju uspešni, moramo imeti izobražene zdravstvene delavce, ki bodo tovrstno problematiko dobro poznali in bodo pripravljeni na zdravstveno vzgojo naslednjih generacij. Introduction: Today people have up to a 50% chance to get infected with sexually transmitted diseases during their lifetime, among which the infections with the human papillomaviruses are on the rise. The number of infected people is growing, and the consequence of the infection can also be a cancer diagnosis, which could be prevented with vaccine. Purpose: The purpose of this diploma thesis is to determine the level of awareness and knowledge of the nursing students of the Faculty of Health Sciences about the human papillomaviruses. Methods: The cross sectional study was based on an anonymous survey questionnaire, which was filled out by 175 students. Reliability was calculated based on the Cronbach alpha coefficient (0.614), descriptive statistics, the t-test used for determining the differences based on gender, and the contingency coefficient used for determining the differences in the variables, based on other social demographic information. We used the statistical program SPSS v. 23 (SPSS Inc., Chicago, Ill., USA) for the analysis. Results: The findings show that the students partly disagree on the human papillomaviruses being a strong risk factor for the emergence of head and neck cancer (M = 3.00) and that smoking is a strong risk factor for the infection with the human papillomaviruses (M = 3.21). Based on gender, the female students statistically typically partly agree that men can infect with the human papillomaviruses as well (p = 0.012). The students partly agree with the claim that they do not know enough about the vaccine and the vaccination against the human papillomavirus (M = 1.75). Third year student statistically completely agree that men can vaccinate themselves against the human papillomaviruses as well (p = 0.001). The students partly agree that the healthcare workers do not make the young population aware enough about the infections with the human papillomaviruses and the risk factors (M = 1.57), students older than 27, on the other hand, statistically typically completely disagree on whether or not they were thought about protection against the infections with the human papillomaviruses at their annual medical check-up (p = 0.000). Discussion and conclusion: In order to prevent the growing number of people getting cancer caused by the human papillomaviruses, we need proper medical education, a well-aware and vaccinated population, with which we could begin to decrease the strain of cancerous changes which are more and more frequent. In order to be successful at raising preventive awareness, we must have educated healthcare workers that will be well aware of this problem and prepared for the medical education of future generations.

Uvod: Spolno prenosljive okužbe po vsem svetu naraščajo in so velik zdravstveni problem. Po ocenah Svetovne zdravstvene organizacije za njimi vsako leto na novo zboli vsaj 125 milijonov ljudi, najbolj pa so jim izpostavljeni mladi. Namen: Namen diplomskega dela je zbrati literaturo na to temo ter z epidemiološkim pregledom opozoriti na problematiko naraščanja okužb v Sloveniji. Metode dela: Teoretični del temelji na pregledu strokovne tuje in slovenske literature. Pri empiričnem delu pa gre za retrospektivno kohortno študijo, zasnovano na podatkih Nacionalnega inštituta za javno zdravje. Rezultati: Epidemiološki pregled prikazuje trend naraščanja spolno prenosljivih okužb v Sloveniji v letih 2005–2014. Leta 2011 je prvič število novih primerov okužb preseglo število 1000. V manjšem upadanju je le zgodnji sifilis ter akutni hepatitis B. Največje breme predstavljajo moški, ki imajo spolne odnose z moškimi, saj pri njih število novih primerov spolno prenosljivih okužb najbolj narašča. Razprava in zaključek: Pomembno je ciljno ozaveščanje skupin prebivalcev s povečanim tveganjem za spolno prenosljivo okužbo ter prizadevanja za zgodnejše odkrivanje le teh. Z zgodnjo diagnozo ne le izboljšamo učinkovitost zdravljenja, ampak tudi preprečimo nadaljnje širjenje okužbe med zdrave ljudi. Introduction: Sexually transmitted infections are increasing worldwide and are a huge health problem. According to estimations of the World Health Organization, each year at least 125 million of people become sick, and the most exposed group are young people. Purpose: The purpose of the graduation thesis is to collect literature on this topic, and to point out the problem of increasing number of infections in Slovenia using an epidemiological survey. Methods: The theoretical part is based on the review of the foreign and Slovenian literature. In the empirical part, retrospective cohort study is used, which is based on the data of the National Institute for Public Health. Results: Epidemiological survey reveals the increasing trend of sexually transmitted infections in Slovenia from 2005 to 2014. In 2011, the number of new infections exceeded 1000 cases for the first time. Only early stage of syphilis and acute hepatitis B are in a minor decline. The greatest burden represent men having sex with men, since the number of new cases of sexually transmitted infections is the most rapidly increasing in them. Discussion and conclusion: Target informing of the population groups with increased risk for sexually transmitted infection is important, as well as efforts for their early detection. Early diagnosis not only improves treatment effectiveness, but also prevents further spread of infection among healthy people.

V diplomski nalogi je opisano širjenje okužbe s HIV ter načini preprečevanja v Sloveniji. Namen diplomskega dela je bilo ugotoviti razširjenost okužbe s HIV od prve pojave pa vse do danes ter kako se v Republiki Sloveniji preprečuje nadaljnje širjenje. Pri pisanju diplomskega dela smo uporabili deskriptivno metodo dela. V strukturni obliki smo s pomočjo literature prikazali najnovejša spoznanja. Predstavili smo virus humane imunske pomanjkljivosti, načine širjenja ter razmnoževanja virusa, simptome, diagnosticiranje, testiranje ter zdravljenje okužbe s HIV. Predvsem smo se osredotočili na načine preprečevanja same okužbe s HIV v Sloveniji. Opisali smo postopke in načine preprečevanja okužbe preko spolnega stika, krvi in krvnih izdelkov ter iz matere na otroka. Spoznali smo, da okužba z virusom HIV še zmeraj predstavlja javnozdravstveno težavo, tako po svetu kot v Sloveniji. Čeprav je število okuženih s HIV v Sloveniji v primerjavi z drugimi državami relativno majhno, število okuženi še naprej raste. Tako kot po svetu predstavljajo tudi v Sloveniji moški, ki imajo spolne odnose z moškimi glavno rizično skupino. Leta 2009 je Republika Slovenija sprejela Strategijo preprečevanja in obvladovanja okužbe s HIV/AIDS 2010-2015, v kateri so opisani postopki ter priporočila o tem, kako preprečiti okužbe s HIV. Pomembno vlogo pri izvajanju teh postopkov in priporočil imajo pri nas vladne in nevladne organizacije. Diploma thesis discusses the spread of HIV and prevention methods used in Slovenia. The purpose of the diploma thesis was to determine the prevalence of HIV from the first detection of HIV to present day and how the Republic of Slovenia is preventing further spread of the virus. We used descriptive method to write the thesis. The latest findings were obtained while analysing the literature and are presented in structured form. We presented the human immunodeficiency virus, method of dissemination and propagation of the virus, symptoms, diagnosis, testing and treatment of HIV infections. In particular, we have focused on ways of preventing the HIV infection in Slovenia. We described the methods and procedures to prevent infection through sexual contact, blood and blood products and from mother to child. We have learned that HIV infection still represents a public health problem, both worldwide and in Slovenia. Compared to other countries the number of HIV infections in Slovenia is relatively small, but still rising. Worldwide as in Slovenia the main group at risk are men who have sexual contact with other men. In 2009, the Republic of Slovenia adopted the HIV Infection Prevention and Control Strategy for 2010-2015, which describes the procedures and recommendations on how to prevent HIV infection. Our governmental and non-governmental organizations play an important role in the implementation of these procedures and recommendations.