Faculty of Medicine

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    ADENOID CYSTİC CARCINOMA TREATED WITH ELECTROCAUTERY– 5-YEAR SURVIVAL
    (Македонско лекарско друштво = Macedonian Medical Association, 2020)
    Arben Rexhepi
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    Dejan Todevski
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    Aleksandra Tatabitovska
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    Adenoid cystic carcinoma (ACC) is an uncommon neoplasm which arises from the major and minor salivary glands of the head and neck. Rarely, it can develop from secretory glands originating in the trachea, breast, lacrimal glands or other exocrine glands. We present a case of a fifty-years-old female patient with a polypoid adenoid ACC, growing from the middle of the left main bronchus causing obstruction of the bronchial lumen. Complete resection of the polypoid mass was accomplished using an electrocautery snare through the flexible bronchoscope, cauterizing the stalk in one attempt. The tumor was extracted in the manner of foreign body extraction, attaining complete recanalization and providing patency of the visible bronchial tree with no immediate or late complications. The followup bronchoscopy after 6 months found no signs of persistent or recurrent disease. The patient was followed at 6 and 12 months and every year for 5 years and no signs for local recidive or metastasis was found. We recommend considering endoscopic electrocautery for selected endobronchial or endotracheal cases of ACC, where surgical or oncologic treatment is not possible, in curative or palliative purposes.
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    Consensus statement: RECOMMENDATIONS FOR THE DIAGNOSTIC ALGORITHM IN LUNG CANCER CONSENSUS STATEMENT OF THE MACEDONIAN RESPIRATORY SOCIETY AND THE MACEDONIAN ASSOCIATION OF PATHOLOGY
    (Македонско лекарско друштво = Macedonian Medical Association, 2019)
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    Dejan Todevski
    ;
    Arben Rexhepi
    ;
    Aleksandra Tatabitovska
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    Lung cancer is the “number one cancer killer” in the world. Its prevalence is associated with smoking as the primary cause, although air pollution in general and genetic factors are also important. The mortality especially from advanced stage lung cancer is still high, although there has been a significant improvement in the past 10 years, mostly due to the introduction of novel compounds such as targeted and immunological treatment. The advances in the treatment of NSCLC have imposed updating of the guidelines for the diagnostic procedure and screening of LC, for the indications for molecular testing as well as for targeted selection of patients who shall benefit the most from the novel treatment modalities. These recommendations shall fulfil their purpose only if implemented in the educational curriculum and if incorporated in the healthcare system strategies.
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    Strategy for Developing a Smoking Cessation Program in Macedonia
    (E-Cronicon, 2020)
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    Arben Rexhepi
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    Macedonia has one of the highest smoking rates in Europe and ranks among the top ten globally. Although there is a moderately strict anti-smoking legislation, tobacco free policies are not financially supported and smoking cessation activities are not included in the regular educational process of health workers in the country. Smoking cessation is not considered a medical intervention, there is no consistent access to nicotine replacement therapy or other cessation medications, nor are they covered by health insurance. The goal of the partners from Henry Ford Health System and the University St Cyril and Method in Skopje was to develop and adapt a Certified Tobacco Treatment Specialists program (aCTTS). A team of physician champions was created to facilitate implementing the program and to educate respiratory and internal medicine specialists, as well as general practitioners who proceeded treating patients for tobacco dependence. During the first four months of the intervention 64,668 patients visits were registered, 25,710 (40%) of them for tobacco-related diseases. Of the latter, 18,558 (72%) included smoking cessation counseling, which by itself is a great progress to reaching a striving population of smokers.