The advent of artificial intelligence has also entered in the field of sport training. Every time we undergo a training session our sport watches collect and save different parameters, which require further analysis in order to improve our next performance. And not to mention all the parameters we are unaware of. Of course, human cognitive functions are of limited value in dealing with large data sets. Our brain might intuitively plan the following training based only on how we felt during the past training and not regarding the actual performance facts which can only be detected with the tools of computational intelligence. There are hidden correlations to be found. Our past work has proven to be more than useful in this area and here you can find our articles regarding this hot topic: Planning the sports training session with the bat algorithm and Computational intelligence in sports: Challenges and opportunities within a new research domain. The advent of a new concept in the form of artificial sport trainer in collaboration with a human trainer is still in the developing phase. Hence we could see it fully in practice in the following years.
One of practical implications of storing data into plants is an insertion of short DNA labels into protected plant varieties. It is a new approach for managing intellectual property rights in the seed industry. By using our online application tool it will become easy to distinguish protected from non-protected varieties. The original scientific article was published in Transgenic Research by Springer and is available at:
Pretekli teden je v Ljubljani potekal 12. svetovno znani kongres posvečen ultrazvoku in širjenju njegove uporabnosti. Edinstvena priložnost, saj gre sicer za kongres, ki je vsako leto organiziran drugje v svetu, medtem ko so posamezni segmenti kongresa organizirani posamično tudi v Sloveniji. A kot rečeno, tokrat celoten WINFOCUS v Ljubljani. Udeležila sem se dvodnevnega programa uporabe ultrazvoka v vsakdanjih urgencah in resnično lahko rečem, da po skupno 12 urah predavanj in 8 urah praktičnega dela z ultrazvokom zapustiš prizorišče samozavestnejši za trenutke, ko ti na vrata urgentne ambulante potrka pacient z dispnejo in bolečino v prsnem košu. Da ne omenjam vsakdanjega kruha urgentnih ambulant – globoke venske tromboze in pljučne embolije. In v infektologiji pogosti vzrok dispneje – pljučnica s pridruženim plevralnim izlivom – vse to in še več je sposoben prepoznati soliden UZ in seveda ultrazvočist za njim. Ni zastonj namera, da bi vsak zdravnik poleg stetoskopa v žepu nosil še dlančni UZ aparat, tudi kot aplikacija s sondo na našem mobilnem telefonu.
Osnovni pristop h kritično bolnemu je naš algoritmični ABCDE. In prav pri vsaki črki protokola nam pomaga ultrazvočni aparat.
Pri pregledu A(irway) si lahko z linearno sondo pomagamo pri vstavitvi endotrahealnega tubusa. Predvsem nas seveda zanima ali smo vstopili v trahejo ali v požiralnik. Druga redkejša indikacija je uporaba za lociranje tiroidnega in krikoidnega hrustanca oziroma krikotiroidne membrane, kadar je zgornja dihalna pot neprehodna. Konikotomije oziroma krikotiroidotomije nihče nerad izvaja na slepo, z UZ pa nam je prihranjena dilema pri lociranju mesta, kjer bomo pičili.
Pri pregledu B(reathing) nas zanima več stvari. Sicer je boljša uporaba linearne sonde in manjše globine, a z abdominalno sondo dobimo širše vidno polje. Zanima nas “lung sliding, lung pulse in B linije (več kot dve na en medrebrni prostor). Če je kateri izmed treh naštetih pojmov viden oziroma najden na UZ pljuč, lahko s 100% verjetnostjo ovržemo pnevmotorax tega pljučnega krila. Dodatno nam najdba “lung point”,kjer je plevra tipično prekinjena, seveda na kazuje pnevmotorax. Na drugi strani pa najden kateri izmed teh znakov ne pomeni, da je krivec pnevmotorax, saj gre lahko tudi za KOPB ali drugo dogajanje v pljučih. B linije so znak spremenjene lomljivosti svetlobe in nam nakazujejo intersticijski sindrom oziroma edem (pljučni edem katerekoli etiologije, pljučnica,…). Na bazi pljuč, kjer je diaframga v stiku z jetri desno ali vranico levo, smo pozorni na t.i. znak zavese oz “curtain sign”. Preprosto rečeno, smo pozorni ali se med mirnim dihanjem diafragma lepo pomika glede na vretenca in ali preko diafragme ne zaznamo hipoehogene tekočinske kolekcije. Sistematičen in koristen UZ prikaz pljuč je na voljo na tej povezavi: https://www.youtube.com/watch?v=uv6zI4QHYss
Pri pregledu C(irculation) je UZ izjemnega pomena. Pregledamo lahko vse tri pomembne komponente, torej vene, srce in arterije. Za oceno šokiranega bolnika po poškodbi ali mlade ženske, v šokovnem stanju, s sumom na rupturirano ektopično nosečnost, je FAST UZ pregled trebuha nepogrešljivega pomena. Pregledamo 3 (vključno s perikardialnim prostorom 4) področja v telesu, kamor bi se lahko izgubljala tekočina. In sicer desno hepatorenalno področje vključno z desnim plevralnim prostorom, levi splenorenalni žepek z levim hepatorenalnim prostorom, substernalni pogled na perikardialni ovojček in preko mehurja pogled v rektovesikalni žepek pri moškem oziroma rektovaginalni žepek pri ženski. Prosta tekočina v teh predelih nam nakaže, da je vzrok šoka lahko hipovolemija. Nazoren prikaz pa v tem videu: https://www.youtube.com/watch?v=6qWNmMvAfdQ
Dodatno lahko pregledamo tudi aorto, če sumimo na rupturo anevrizme ter za oceno volemije še polnjenost spodnje vene cave. Pregled srca sestoji iz treh pogledov, najbolje je seveda uporabljati kardiološko sondo, čeprav se da tudi z abdominalno sondo kar precej videti. Pogledamo substernalno, parasternalno in apikalno. Najboljši je parasternalni pregled. Ocenjujemo 3 E-je, in sicer “equality, ejection, effusion”. Pod prvo točko nas zanima ali je desni prekat manjši od levega, ali je septum raven. Kakršnekoli anomalije normalnih razmerij bi nam lahko nakazovale povečane polnilne tlake v desnem srcu, ki bi nastopili recimo ob pljučni emboliji, pljučni hipertenziji, ipd. Drugi pojem nam nakazuje ustreznost sistolne funkcije in kaže na možno hipotonijo srca recimo ob infarktu. Tretji pojem pa se navezuje na perikardilani izliv oziroma na morebiten hipoehogeni pas tekočine v perikardu. Prikaz pa tukaj: https://www.youtube.com/watch?v=H_3V9xlDMA0
Na koncu pregledamo še vene, katere pa sem že opisovala v enem izmed prejšnjih postov. Dvotočkovni pregled ob sumu na GVT je po raziskavah dovolj za izključitev potencialno nevarne GVT, katere ne moremo poslati domov z napotnico za UZ čez dva dneva. Prva točka pregelda je predel v. femoris communis z vtočiščem v. saphene magne. Druga točka pa je pregled poplitealne vene z v. sapheno parvo. V obeh naštetih točkah iščemo znake tromboze in skušamo stisniti vene z ultrazvočno sondo. Izvedemo lahko tudi augmentacijo, pozorni pa smo lahko tudi na respiratorni alterans z dihanjem. Vsekakor izjemnega pomena, ko se odločamo ali je oteklina na račun limfedema, površinskega tromboflebitisa ali resnično GVT.
WINFOCUS zelo priporočam v udeležbo. Ko je pred tabo resnična situacija z adrenalinom na vrhuncu in pacientom v akutni stiski, je vsako čakanje na dodatne slikovne preiskave (RTG pc. CT, ipd.) lahko preveč zamudno in je tista neškodljiva naprava v kotu sobe lahko diagnostičnega pomena.
On 21. of August we took part in an inagural Challenge Samorin, Slovakia. It was a 1,9 km swim, 90 km bike and a half-marathon run… Swimming took part in the Donau river, which had pleasant 19 degrees. Though it was only an up and down route with no obvious turns to the left or right, it was a particulary special swim because of the current. Anyway, on the bike it started raining like a shower. I was kind of a “deja vu”…like Iceland… again cold and wet bike ride.
Well, once we managed to get to the running part it was all OK. It was a really lovely run on the banks of the Donau river, the rain stopped and we started enjoying the countdown to the finish line. Through the rice I have been feeling rather tired and sleepy, a long season behind has started to take its toll. But still, we had a really nice time in Slovakia and the race was just a relaxation during the weekend.
Now, that is it for this season. 1 Ironman and 4 half-Ironman distances this year. I am really satisfied with the 2016 season. 🙂 Now it is time for autumn and winter… and indulging into activities other than triathlon.
On Saturday, 23.7. 2016, we were a part of an amazing, inaugural Challenge Iceland, half Iron distance triathlon. The name says it all and all three of us agree that this was the most fascinating, adventurous triathlon we have ever done. An unforgettable experience in the land of the Vikings.
The swim start took place on Saturday morning in a 10.000 years old glacier lake situated 40 km from Reykjavik. It was a rainy morning with outside temperatures approximately 12°C. The water in the lake was said to have 15°C but in fact this was only true for the shallow part on the entry into the lake… as you went further, the water became colder and colder. We dressed up our swim suits in a nearby tent because the rain was pouring from the sky. The tent was already crowded with athletes and it seemed like we all knew that going into that lake will take some craziness. The scenery behind the lake was a picturesque mountain and hills covered with snowy patches and we also noticed a waterfall which was probably providing all this cold water into our lake. It was time to get in. We did not think much; we got wet as fast as possible and once you swam a few metres the water temperature seemed bearable. We were laughing and shaking, waiting for the start signal.
Swimming started and the first few hundred meters were actually OK, like swimming in a »normal« lake. The water was crystally clear and the first problem we have encountered was its unequal depth. Therefore, we had to walk for a few meters in the middle of the lake until we could swim again. The time went by, I could feel my finger tips freezing and after swimming for 40 minutes the coordination of limbs was awfully bad…I got the feeling that I came into the coldest part of the lake. It took another 5 minutes to swim to the exit on the shore and a few minutes to get out into the transition zone. The conditions really prolonged our swimming times.
Iztok and Dušan were already starting the bike ride, when I entered the transition zone and dressed up my bike gear in a whole-body-shaking condition. As a doctor, I would of course totally disencourage anyone to perform swimming in a cold, glacier lake… I was thinking of our kidneys, our heart pumps and all the organs who had to perform their functions despite our morning glacier bathing. But on the other hand, we will never walk this road again and I knew we were well prepared and fit enough to do this without consequences. The cold water took its toll, some of the athletes had to finish their race during or after the swim…medical professionals had much work to do; from mild hypothermia to cramps. Luckily, nothing serious.
I took my bike and ran to the bike start area. I almost dropped it as I was getting on it. In the second attempt I managed to start biking, rain was still pouring from the sky. »Nice and easy« said someone from the surrounding crowd… and we took his advice, we did the 90 km bike ride considering all the safety precautions; careful use of brakes, slow turning. I was afraid to speed up since the road was slippery and I do not have a lot of experience with racing in the rain. All the events so far were in tropical conditions in comparison to this event. I was happy with the scenery I was able to see during the bike course. Astonishing. The road was actually traffic-free and as you were riding in the middle of the road with cliffs and shore on one side, mighty hills on another side it felt like living on another planet. The hills seemed like being there forever, long before the human invasion of this planet and they were the silent witness of our bike ride on that vintage day. From Vikings to Challenge Iceland, those hills can manage all as long as you leave nothing but footprints and take nothing but memories.
The bike course was going up and down with app. 1000 m of ascent. This warmed my fingertips, the rain stopped pouring and after 90 km it was time to do the 21 km run-a half marathon. The run took its place around the lake, two 10,5 km laps. I was so hungry when getting off the bike, I could not wait for that chocolate bar in the transition zone. I must have underestimated the conditions on the bike and took only one small bar with me on the bike… obviously not enough. I changed my clothes and started running. The run was sitauted in a lovely scenery beside the lake, there were some aid stations with chocolate and bananas. The sun was already shinning and it was time to get to the finish line. Passing the line I stopped and took a few deep breaths.
There was a hot, spicy pumpkin soup in the finish area. We ate several cups of it, and a lot of fruit, it was delicious! And all the volunteers with cool, big Icelandic hearts were there to help us through the day. We did well in competition and our highest rankings in our age groups brought us entry slots for the Challenge World Championship 2017 in Šamorin. For all the rest, I will let the pictures do the talking…
It was a sunny Thursday afernoon when we packed our things and hit the road to Czech Republic, more accurately to Otrokovice town. Moraviaman triathlon is a part of Czech national triathlon championship but it is also open for foreign athletes. We arrived in the late evening and of course all the restaurants were closed. So we took a look into the nearest restaurant with lights on (later we foud out that it was actually a Texas country style bar) which served us heated deep-frozen pizzas and, of course, Staropramen beer. It looked like we were the most complex guests in the last few years since they had to brush the dust from the menu. Well, we were satisfied anyway.
The following day was dedicated to “carbo-loading”…it is that sweet part of the preparations when you have to do “all you can eat” thing. Boiled potatoes, lots of bread, pizza (from the night before), pasta (in the days before) and some muffins. I must say that the last year I was actually tired of eating so much, but this year I ate smarter: less, but with more complex carbohydrates. I was really satisfied with how I felt: strong and full of OH. In another words, ready to make a lot of ATP molecules on the Ironman day.
Dušan and I went to do the registration on Friday. Iztok was our indispensable companion since he had to skip this Ironman because of some unpredictable health issues. Luckily, he shall be ready for Challenge Iceland since it was not easy for him to skip this emotional, amazing racing day.
Saturday. The swim start was at 7 AM, so we set our clocks at 5 AM. It was a sunny, promising morning. The sun was already up and we had to prepare our things and check in the bikes. I had prepared all the accessories on the desk the night before: swimming googles, swim suit, clothes, helmet, cycling shoes, running shoes, … For breakfast we had some croissants with no filling: this always works for the first hours.
And there it was…a swim start in the nearby lake. Dušan was already dressed up in his swimming suit, I had to dress up too. My thoughts were already in the evening, I had that weird dumpling in my stomach, I was trying to look calm but inside I was really tense …it was that exciting fear of the unknown, that feeling you get when you are coping with a challenge far greater that yourself. I was trying to visualize the finish line, the adrenaline that will flush me in the last kilometres of running and that deep pride inside.
As they say, the swim start in the Ironman can not be felt, it can only be lived. When the gun goes off, it is a war. A 3,8 km swim started violently, people were trying to swim over each other. I managed to make my way through the crowds. There were approximately 400 athletes and it was hard to swim for the first few minutes. The water was dark but it somehow did not bother me too much… I fell into my swimming speed and the time was flying by. We had to do three laps and in between I could see the dark clouds gathering above the lake… After approximately 1h 20 min I was getting out of the lake, the sun was shinning again and I was encouraged for the next distance: 180 km cycling.
I changed my clothes in the transition zone, that took me approximately 3 minutes. I put a banana in my pocket, took my bike and ran to the start of a long, challenging bike ride. We had to do 4 laps, each lap 45 km long. The first part of a lap was somehow boring, heading up the main road, but the second part was abundant with green scenery, with ascents and descents… altogether 800m of ascent. The winds were not helpful and so I can say that the bike course was challenging. I was cycling in a steady pace and I let my mind wander off… in the future, in the past, in imaginary worlds and then back to reality. One moment I felt so happy and fulfilled… indescribable thing. I was doing good until a weird cramp in my gastrocnemicus muscle spoiled that mental harmony… I poured some cold water on it from the bottle on the bike. It was ok then and I ignored the pain since I knew that some salt from the iso drink in the transition zone after the bike ride will save this problem. I was such a relief to get off the bike after more than six hours…
I was really relieved when the run started. 42,2 km, a marathon under the hot sun. We really tried to wash off all the salt that was left on the skin. During the run I reset my watch because I was somehow interested in the distance… and it is mentally encouraging to count down the kilometres. The runnig course was really beautiful, but not flat. There were many ups and downs and in that steep parts my running pace was slower. I tried to drink as much as I could… iso every 20 minutes. After three hours of running the tiredness was coming to the surface. The sun was already going down, loosing its power and when I took my last 10 km lap it was all so full of nostalgie, running in the middle of the wheat fields swaying in the evening breeze. I could easily cry of happiness and relief because the finish line was in the reach.
And there was the finish line in the evening after 13h and 12 min…. A gift for all evenings in the last months spent in preparations for this day. I took a glass of champaign in the finisher arena. It was again an amazing day, like in the last year”s Ironman. There are many priceless moments in life, those are one of them… We achieved two third places and this was a memorable award for all of us.
Prispevek v sobotni prilogi Dnevnika z naslovom Podatke bomo shranjevali v rastline in semena:
On 28. 5. 2016 we were racing the only half iron distance (1,9-90-21) triathlon in Slovenia. This year it was included into the Ocean Lava Series but it has already existed since 2013.
The weather this year and general conditions were excellent. The swim start was in Šmartinsko lake near Celje. The water was surprisingly not cold, but this lake is known for its large inhabitants (catfish 2 metres long etc.). Therefore we had an additional motivation to swim fast and near the group of other swimmers. It is not a lovely feeling to stay behind knowing that you might be a tempting stranger for those creatures below. Luckily, I did not see a thing.
Bike course was 90 km long, with the last 30 km ascent to the valley. Winds were upfront, so all this together made it a quite difficult ride to T2 location. But it went fast since the nature was so astonishing you could easily forget the conditions you were in.
The run was actually one of the most beautiful ones. There were two 10, 5 km laps and the course was going up and down in the forest. The last part, and the most memorable part, was headed to the meadow and then turning onto the soft grass with the mountain scenery in the back. Since the sun was really strong, we all got sunburned (in up-to-the knee-fashion). Anyway, it was a nice saturday and a really beautiful triathlon in the nature.
It was a 1,9k/90k/21k half Iron distance triathlon in Mureck, Austria on 7.5. 2016. In the morning it looked like it was going to be a beautiful day, not like a week before when we had snow in the last days of April. Therefore we had a reason to expect that the water in the Rocksee lake is about to be cold. The start for the women was at 9.15 AM and at 10 AM for the men and the sun had just began to warmen the atmosphere. When I first put my soles into the lake, I was positively surprised… it was not so cold afterall. The water had 18°C but I was ok with it for that 40 min swim.
There was one slight problem in transition 1, getting out of the water and on the bike, because I had some problems with taking off my swim suit. It just did not want to go off! And it took me more than three minutes to get out out T1 zone with my bike. I was already on the bike for 15 minutes when Iztok and Dušan started their race in the second wave-men start.
There were two 45km bike laps and it took me 2h and 53 min for both laps, taking into account the two hilly passages in the middle of the lap. The bike course was windy most of the time and it took a lot of effort to cycle against it. Transition 2, from bike to the run, was much faster, taking a little bit more than one minute.
The run was very beautiful, two laps around the lake and into the forest. On the run the sun was already hot and many of us took some seconds to drink cola in between running. It really felt good. Rushing against the 21st kilometer of running I was already seeing the finish line and passed it after 5h 16 minutes and 51 seconds. And that is my recors for this distance. Not to mention, I achieved the firts place and a voucher for shopping in Giga Sport. It was worth sweating for. 🙂 After the race, there was an award ceremony and we took the chance to meet and make a photo with Marino Wanhoenacker, a Belgian triathlete who broke the world record for the full Ironman triathlon at Klagenfurt in Austria, finishing after 7 hours, 45 minutes and 58 seconds.
At the end of the day, we went for a tasty dinner and this was the best possible ending of that perfect day. Anyway, the trainings contiune, there is 5 weeks until the full Ironman distance.
Zgodba iz vsakdanjika. Nekaj, kar se pri nas diagnosticira vsakih nekaj let.
Moški v srednjih let sprejet zaradi enostranske pljučnice in pnevmotoraksa. Vse skupaj se je začelo z epizodo kašlja, ob katerem je za kratek čas izgubil zavest. Na CT-ju prsnega koša pa presenečenje… slika, identična spodnji.
Torej, na prvi pogled izgleda kot klobčič parazitov v levem pljučnem krilu…in tako je tudi v resnici. Kasneje je bilo z analizo dreniranega materiala iz ciste ugotovljeno, da gre za ehinokoka. Bolezen, katero povzroča, pa se imenuje hidatidoza ali ehinokokoza. Pogosto se bolezen začne popolnoma brez simptomov in traja leta in leta. Najpogostejša je alveolarna oblika bolezni, kakor zgornja, ki se najprej začne v jetrih (in v resnici je bila na ct-ju vidna tudi zgostitev v jetrih) in se nato širi v možgane ter pljuča. Ko bolezen prizadene pljuča, pride do zgoraj opisanih simptomov.
In kje v naravi se lahko okužimo s trdovratnimi jajčeci tega parazita? Najpogosteje so s paraziti okuženi psi, lisice, volkovi. Jajčeca se nato v naravo izločajo z njihovim blatom, človek pa se okuži preko tesnega stika z okuženo živaljo ali njenim blatom. Psi, lisice, volkovi pa parazita dobijo s prehranjevanjem s surovimi organi recimo ovc ali glodalcev. Seveda se lahko tudi mi okužimo s tem, ko jemo recimo premalo pečeno ovčetino ali drugo meso.
Zdravilo, ki se uporablja za zdravljenje je albendazol – širokospektralni antihelmintik. Včasih ga je potrebno jemati tudi več let. Seveda pa je ob formirani cisti indicirana kirurška odstranitev le-te.