Faculty of Medicine

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    One-year post-Covid-19 follow up
    (Macedonian Association of Internal Medicine, 2022-05)
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    Eftimova A
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    Trajkova M
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    Bushljetikj O
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    A rare case of renal artery thrombosis and kidney infarction associated with Covid-19 infection
    (Macedonian Association of Internal Medicine, 2022-05)
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    Chelikic A
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    Petrovski Z
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    Janushevski F
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    Parishko E
    COVID-19 is a multisystemic disease associated with a hypercoagulable state and prothrombotic complications, including deep vein thrombosis, pulmonary thromboembolism, as well as arterial ischemic strokes. We present a rare case of renal artery thrombosis with kidney infarction associated with SARS-CoV-2 infection in a 44-years-old male patient. Patient was hospitalized in the Covid department of our clinic and initially presented with fever, cough and dyspnea. The second day of the hospital stay, he complained of flat abdominal pain. CT angiography of the abdomen was performed which showed thrombosis of the right renal artery with the diameter of the thrombi up to 3mm and clearly delimited triangular zone of ischemia of the upper lobe of the right kidney. Selective angiography of the right renal artery was performed which revealed total occlusion of the branch of the right renal artery for the upper pole. An attempt for recanalization was not successful. The patient was discharged in a good clinical condition with recommendation for antibiotic, antiplatelet and anticoagulation therapy with LMWH. After one year follow -up the kidney ultrasound revealed a hypotrophy of the right kidney with reduced parenchyma. The prothrombogenic features of SARS-CoV-2 virus can lead to serious and life- threatening complications during or after the acute onset of the infection. Although rare, renal artery thrombosis with renal infarction has been reported as a complication of COVID-19 infection. This case highlights the importance of vigilance in thrombotic complications and their therapeutic approach in COVID-19.
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    Case report: Cardiomyopathy in a pregnant young woman with hypertension
    (Macedonian Association of Internal Medicine, 2022-05)
    Trajkova M
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    Eftimova A
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    Arnaudova Dezhulovikj F
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    Bushljetikj O
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    Role of optical coherence tomography in complex percutaneous coronary interventions(case report)
    (Македонско здружение по Кардиологија, 2021-10)
    Bushljetikj O
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    Zdravkovski I
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    Subclavian artery stenosis and subclavian steal syndrome
    (2022-05)
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    Bushljetikj O
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    Petrovski Zh
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    Kitanoski D
    Introduction- Atherosclerosis is the most common cause for subclavian artery stenosis. Other etiologies include Takayashi arteritis, thoracic outlet syndrome, compression syndromes, fibromuscular dysplasia and iatrogenic injury. It is estimated that approximately 2% of the population has subclavian artery stenosis, with a predominance of the left a.subclavia. Case report ----A 63 year old patient , with back pain, arm claudication and muscle fatigue, dizzines during working with left arm and tinnitus. Physical examination findings showed diference in both arm and blood pressures-sistolic( 50mmHg) and diastolic (20mmHg), coldness in left arm, diminishedradial pulsations. Arterial color Doppler , coronarography aortography and peripheral angiography were performed. Arterial Color Doppler showed transient systolic retrograde flow and anterograde diastolic flow through a.vertebralis, increased PSV> 340 ms and PSVr>3,0. Coronary finding -intermediate stenosis of the distal part of the right coronary artery. On aortography was seen critical ostial stenosis of the left a. subclavia between 95-99%. Peripheral angiogram of lower limb arteries showed genarilised atheromatosis. The threatment include ballon angioplasty and stentintg to a.subclavia Discussion - Subclavian steal should be considered among patient 50-70 year old , exhibiting vertebrobasilar territory neurological symptoms during arm activity. Blood presure measurement on both arm should be mandatory in patients with that symptomatology. Doppler ultrasound is the first step in differential diagnosis of arteria subclavia stenosis and it is usually confirmed with Ct arteriography and peripheral angiography of the aorta and upper limb. endovascular treatment with antegrade approach is the first choice of treatment in our institution, with high technical succes and safety. Conclusion- Endovascular treatment of a. subclavia stenosis should be consider as a therapeutic modality in all symptomatic patients. It characterizes with high blood procedure succes and excellent long term patency of the stent.
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    Comparison of two-dimenzional and three-dimensional echocardiography in determination od left ventricle volumes and ejection fraction in adult population.
    (Macedonian Academy of Sciences and Arts, 2017-12)
    Bushljetikj O
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    Introduction: Left ventricle (LV) volumes and ejection fraction (EF) determined with two-dimensional echocardiography (2DE) and three-dimensional echocardiography (3DE) show significant differences.The aim of this study is to determine the agreement of the measurements of LV volumes and EF with 2DE and 3DE in the general adult population, with preserved LV systolic function. Material and methods: In 52 subjects, older than 65 years, LV end-diastolic volume index (EDVi), end-systolic volume index (ESVi) and EF were measured with 2DE and 3DE according to the official recommendations, and reproducibility of both methods and their agreement were determined. Results: Intraclass correlation coefficient for intra-observer reproducibility in the measurement of EDVi, ESVi and EF with 2DE was 0.861, 0.891 and 0.917 respectively, whereas with 3DE 0.854, 0.893 and 0.913, respectively. The difference in the measurement of EDVi and ESVi was significant (p<0.001) whereas the measurement of EF was insignificant (p=0.153). The mean difference value EDVi and ESVi determined with 2DE and 3DE was 5.6+/-5.21 and 3.01+/-2.69 ml/m2 (p<0.001), and of EF 0.306+/-1.475%. Spear- man’s correlation coefficient for EDV was 0.693, for ESV 0.763 and for EF 0.97. Conclusion: Larger LV volumes were measured in the adult population using 3DE compared to 2DE, but identical values for EF were obtained. This difference in the measured values could not be attributed to the largeness of the LV volume and EF itself.. 3DE demonstrated better intra-observer reproducibility for LV volumes and EF as a major parameter in many clinical decisions.