Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Access type: UnknownAuthor: search.filters.author.Kamiloski, Marijan

Search Results

Now showing 1 - 2 of 2
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    COMPARISON OF ENDOSCOPIC AND CONSERVATIVE MANAGEMENT IN PEDIATRIC VESICOURETERAL REFLUX: A RETROSPECTIVE STUDY
    (Macedonian Association of Anatomists and Morphologists, 2025-11)
    ;
    Kamiloski, Marijan
    ;
    Ceku, Gani
    ;
    Cvetanovska, Vesna
    ;
    Lumani Bakjii, Njomza
    AbstractBackground:Vesicoureteral reflux (VUR) is a prevalent congenital urinary tract anomaly in children, often associated with recurrent urinary tract infections (UTIs), renal scarring, and long-term complications such as hypertension and chronic kidney disease. The optimal management of primary VUR—particularly in intermediate grades—remains debated, with both conservative and endoscopic treatments widely used.Objective:To compare clinical and functional outcomes of endoscopic injection therapy versus conservative management in pediatric patients with primary VUR, focusing on reflux resolution, UTI recurrence, renal scarring, and renal function.Methods:This retrospective study included 70 pediatric patients with primary VUR treated at a tertiary center between 2015 and 2018. Thirty-five patients underwent endoscopic subureteric injection with dextranomer/hyaluronic acid copolymer, and 35 received conservative management with antibiotic prophylaxis. Comparative analysis assessed changes in VUR grade, recurrence of UTIs, renal scarring (via technetium-99m dimercaptosuccinic acid [DMSA] scintigraphy), renal function by kidney side, and serum creatinine levels.Results:Endoscopic treatment achieved complete reflux resolution in 74.3% of cases. A significant reduction in reflux grade and improvement in right kidney function were observed in the intervention group (p < 0.001). The conservative group showed higher rates of recurrent febrile UTIs and no significant improvement in renal function. Renal scarring was present in both groups but slightly less frequent following endoscopic therapy. Post-treatment left kidney function was significantly higher in the conservative group (p = 0.020), likely reflecting baseline differences.Conclusions:Endoscopic injection therapy is a safe and effective treatment for moderate-to-high-grade VUR in children, associated with superior reflux resolution and better infection control compared to conservative management. Conservative therapy remains appropriate for select low-grade cases but may confer higher risk for recurrent infections and limited renal recovery. Individualized treatment selection is essential to optimize pediatric VUR outcomes
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    VERRUCOUS MALFORMATIONS AS A RARE CASE IN THE GROUP OF VASCULAR ANOMALIES WITH SLOW BLOOD FLOW IN CHILDREN
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2025-04-04)
    ;
    Kamiloski, Marijan
    ;
    ;
    Lumani Bakiji, Njomza
    ;
    Racaj, Anila
    Verrucous venous malformations belong to the group of vascular anomalies. The International Society for the Study of Vascular Anomalies (ISSVA) classifies these changes into two major groups: vascular tumors and vascular malformations. The vascular malformations group includes lymphatic malformations, venous malformations, and their combinations (malformations with slow blood flow), as well as arteriovenous malformations (malformations with fast blood flow). Verrucous venous malformations (VVM) are a rare congenital vascular anomaly first described by Helwig in 1967. They are characterized by varying degrees of hyperkeratosis of the skin and subcutaneous tissue. Clinically, they manifest as dark red solitary or multiple hyperkeratotic plaques, most commonly localized on the extremities. Treatment is combined and includes surgical intervention, electrocoagulation, laser therapy, topical agents, and systemic medications. Materials and Methods: Between 2019 and 2024, two children with suspected verrucous venous malformations were admitted to the Public Healthcare Institution – University Clinic for Pediatric Surgery. The lesions were unilaterally located on the lower extremities. The gender distribution was 1:1 (male to female), with an average age of 10 years. The changes had been present since birth. There was no positive family history in either patient. Clinically, one of the patients presented with inflammation of the lesion, accompanied by pain and serous secretion. Results: Following appropriate preoperative preparation, both patients underwent surgical excision and autologous skin transplantation. The postoperative course was uneventful. Histopathological examination confirmed the diagnosis. After excision, electrocoagulation was applied to residual lesions. A reduction of approximately 90% in lesion size was recorded. Conclusion: Verrucous venous malformations are a rare type of malformation within the group of vascular anomalies, requiring a multidisciplinary treatment approach.