Papers by Antonina Smetnik
Maturitas, 2022
The menopause, or the cessation of menstruation, is a stage of the life cycle which will occur in... more The menopause, or the cessation of menstruation, is a stage of the life cycle which will occur in all women. Managing perimenopausal and postmenopausal health is a key issue for all areas of healthcare, not just gynecology. Aim: To provide recommendations for the curriculum of education programs for healthcare professionals worldwide, so that all can receive high quality training on menopause. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: Training programs for healthcare professionals worldwide should include menopause and postmenopausal health in their curriculum. It should include assessment, diagnosis and evidence-based management strategies.
Thyroid Ultrasound, 2019
Thyroid diseases are more typical for fertile women than for any other population. Thyroid functi... more Thyroid diseases are more typical for fertile women than for any other population. Thyroid function influences all stages of development and function of the female reproductive system, inclusive of menstrual cycle regulation, fertility, gestation, and postpartum period. All types of thyroid pathology in regard to female reproduction system may be divided into the following two groups: dysfunction of the gland (hypothyroidism and thyrotoxicosis) and abnormalities of thyroid structure (increase in volume and thyroid lesions). Hypothyroidism is easily detected and, unlike autoimmune status, is well managed with drug therapy. Thyrotoxicosis, regardless of the cause, can lead to menstrual cycle disorders. However, thyrotoxicosis is not a cause of infertility. The most common cause of hyperthyroidism in women of childbearing age is Graves’ disease. Thyrotoxicosis due to toxic adenoma proceeds more favorably during pregnancy, since antibodies to the TSH receptors are not produced in the mother’s body. The enlargement of the thyroid gland in the case of normal thyroid function does not affect the female reproductive system. If a pregnant woman is diagnosed of a thyroid nodule, two aspects need to be discussed concerning the thyroid hormonal disorders and benign/malignant nature of the lesion. Malignant thyroid nodules diagnosed with fine needle aspiration cytology in pregnant women demand a different management.
Maturitas, 2015
The ability of microbes to accelerate chloramine decay to the same degree as under severe nitrifi... more The ability of microbes to accelerate chloramine decay to the same degree as under severe nitrification, but without the signs of severe nitrification is reported. Traditionally, only nitrification is believed to microbiologically challenge the stability of chloramine. Chloraminated water containing high amount of natural organic matter (10e12 mg L À1 of dissolved organic carbon (DOC)) was fed to four lab scale reactors connected in series. Each reactor had one day retention time with a total of four days in total. The decay coefficient was observed to be a maximum of 0.06 h À1 without substantial changes in ammonia, nitrite or nitrate levels. Despite very low chloramine residuals, nitrite only increased to less than 0.012 mg-N L À1 , indicating a mildly nitrifying condition. Previously reported decay coefficient (0.001e0.006 h À1) for the condition was an order less. Changing of the feed to a new water from the same source, but with a low DOC (of 4 mg L À1) led to the onset of nitrification complying biostability. The maximum observed chloramine decay coefficient with severe nitrification was 0.085 h À1. Therefore, microbes present under mildly nitrifying condition can be as destructive as that in severely nitrifying condition. For better control of chloramine, attention on microbes present under mild nitrification is needed.
Maturitas
This care pathway from the European Menopause and Andropause Society (EMAS) provides an updated p... more This care pathway from the European Menopause and Andropause Society (EMAS) provides an updated pathway for monitoring and guidance of women at midlife, focusing on those approaching the end of the reproductive lifecycle, going through the menopausal transition and beyond. The care pathway is written by professionals involved in women's health and provides a stepwise individualized approach, stratified according to needs, symptoms and reproductive stage. Furthermore, the pathway provides details on screening for chronic diseases related to menopause and ageing. Treatment options for climacteric symptoms range from menopausal hormone therapy to non-hormonal alternatives and lifestyle modifications. Therapy should be tailored to personal needs and wishes. The pathway aims to offer a holistic, balanced approach for monitoring middle-aged women, aiming to control health problems effectively and ensure healthy ageing.
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Papers by Antonina Smetnik