Faculty of Medicine

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    STUDIJA PRESEKA – KVALITET ZIVOTA PACIJENATA SA HOBP-OM: UPOTREBA SGRQ I HADS
    (2024-01-06)
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    Suzana Arbutina
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    Aleksandra Stefanovska
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    Verce Jovanovska
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    Valentina Smileska
    Hronična opstruktivna bolest pluća (HOBP) je dugotrajna, progresivna bolest pluća koja ometa normalan protok vazduha u plućima.Ova bolest obuhvata dva glavna stanja:hronični bronhitis i emfizem.Glavni uzroci HOBP-a su pušenje, dugotrajna izloženost drugim iritansima pluća, zagađenja vazduha ili hemikalija na radnom mestu. Simptomi HOBP-a uključuju kašalj, prisusvo sputuma, dispneju i umor. Lečenje HOBP-a obično uključuje promene u načinu života, kao što su prestanak pušenja, redovno vežbanje i ishrana, kao i lekove za olakšavanje simptoma i sprečavanje komplikacija. Teže slučajeve HOBP-a može zahtevati dodatne terapije poput kiseonika ili pulmološke rehabilitacije. Rano prepoznavanje i upravljanje HOBP-om ključni su za kontrolu simptoma i očuvanje kvaliteta života.Ova presečna studija imala je cilj da proceni kvalitet života pacijenata sa HOBP-om koji koristi respiratorni upitnik Svetog Đorđa (SGRQ) i bolničku skalu anksioznosti i depresije (HADS). Studija je obuhvatila 62 pacijenta koji su popunjavali upitnike na početku hospitalizacije i ponovo nakon otpuštanja iz bolnice. Rezultati studije su pokazali da je značajan deo pacijenata sa HOBP imao simptome anksioznosti i depresije. Utvrđeno je da su ovi simptomi mentalnog zdravlja snažno povezani sa negativnim ishodima kvaliteta života pacijenata. Studija je takođe otkrila da je anksioznost više zastupljena među pacijentima sa anksioznošću i depresijom u anamnezi, kao i među ženskom populacijom. Pored toga, utvrđeno je da komorbiditeti u HOBP-u doprinose nižem kvalitetu života u smislu simptoma mentalnog zdravlja. Korelacionom analizom otkrivena je jaka povezanost između SGRQ rezultata i prisustvo simptoma anksioznosti i depresije, naglašavajući međusobnu povezanost prirode fizičkog i mentalnog zdravlja kod pacijenata sa HOBP. Zaključak ovih nalaza naglašavaju važnost bavljenja i respiratornim i psihološkim aspektima HOBP u strategijama nege i lečenja pacijenata. Prepoznajući vezu između respiratornih simptoma i psihičkog stresa, zdravstveni radnici mogu da sprovedu ciljane intervencije za poboljšanje kvaliteta života pacijenata sa HOBP. Ova studija preseka pruža uvid u odnosu između respiratornih simptoma i psihološkog blagostanja kod ovih. Nalazi naglašavaju potrebu za integrisanim pristupom koja se bavi fizičkim i psihološkim aspektima HOBP
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    Barriers and factors that facilitate the use of long-term oxygen therapy at home and the quality of life of patients with COPD
    (Association of Traditional Chinese Medicine and Acupuncture Tong Da Tang TCM, Skopje R.N. Macedonia, 2024)
    Suzana Arbutina
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    Aleksandra Stefanovska
    Background: Long-Term Oxygen Therapy (LTOT) is a critical intervention for managing chronic obstructive pulmonary disease (COPD) in patients with severe hypoxemia. Despite its clinical benefits, the effective use of LTOT at home faces numerous barriers and facilitating factors that significantly influence the quality of life (QoL) of COPD patients. Objective: This study aims to explore the barriers and factors that influence the use of LTOT at home, as well as its impact on the quality of life of COPD patients Methods: Through a comprehensive review of the literature, we identify the challenges and facilitators associated with LTOT use, along with the factors that contribute to the quality of life of patients. A mixed-methods approach was utilized in this study, involving qualitative data from semi-structured interviews with patients, caregivers, and healthcare providers. The study included a cohort of COPD patients on LTOT, assessing their experiences and QoL over a specified period. Results: Key barriers to effective LTOT use at home included physical limitations, social stigma, equipment management issues, and insufficient patient education. Facilitating factors identified were robust social support, comprehensive education programs, and regular follow-up with healthcare providers. Conclusion: Understanding the barriers and facilitating factors in the use of LTOT at home is essential for enhancing adherence and improving the QoL of COPD patients. Tailored interventions that address these barriers and leverage facilitating factors can lead to more effective LTOT use and better patient outcomes. This study highlights the importance of a holistic approach in managing COPD, incorporating both medical treatment and supportive measures to optimize patient well-being. The findings provide valuable insights into enhancing the effectiveness of LTOT at home and improving the overall well-being of individuals living with COPD.
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    Pulmonary embolism - Pulmonary thromboembolism in patient with rectal adenocarcinoma
    (Association of Traditional Chinese Medicine and Acupuncture Tong Da Tang TCM, Skopje R.N. Macedonia, 2024)
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    Suzana Arbutina
    ;
    Gabrijela Dimoska
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    Aleksandra Stefanovska
    Pulmonary thromboembolism (PTE) is potentially life-threatening disorder. The pathogenesis of pulmonary thromboembolism isn’t fully understood, but it is believed to involve imbalance between pro-coagulants and anticoagulants, as well as endothelial dysfunction and acute or chronic inflammation. Pulmonary embolism (PE) occurs when there is a disruption to the blood flow in the pulmonary artery or pulmonary branches by a thrombus that originated somewhere else. Risk factors for PE are deficiency of protein S,protein C deficiency, anti-thrombin III deficiency, LA-lupus anticoagulant, factor V Leiden deficiency, antiphospholipid syndrome (APLS), previous surgical treatment, chemotherapy, immunosuppressive drugs, immobility, overweight ,oral contraceptives, pregnancy ,history of vein thrombosis ,thrombophlebitis , varicose veins. There is a relationship between higher body mass index (BMI) and VTE, and patients with severe obesity (BMI ≥ 35) have higher risk of pulmonary thromboembolism compared with those of normal BMI. Patients with pulmonary thromboembolism may present with a spectrum of symptoms, including chest pain, shortness of breath, tachycardia, hemoptysis, asymmetric pitting edema on legs, prominent superficial collateral vessels, tenderness and pain to palpation of the leg, red or purple color, warmth on the affected leg. The diagnostic work-up of suspected pulmonary embolism includes D-dimer testing, ECG, ultrasonography of heart and CT angiography. Direct oral anticoagulants are first-line treatment options for venous thromboembolism because they are associated with a lower risk of bleeding disorders than vitamin K antagonists. Use of thrombolysis should be limited to pulmonary embolism associated with haemodynamic instability. Anticoagulants should be continued for at least 3 to 6 months to prevent early recurrences and relaps of PE. Haematological malignancies, lymphoma, lung cancers and colorectal cancers are the most common cause of PE