Faculty of Medicine

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    Efficacy and Safety of COVID-19 Convalescent Plasma in Hospitalized Patients-An Open-Label Phase II Clinical Trial
    (MDPI (Multidisciplinary Digital Publishing Institute), 2022-10-09)
    Grubovic Rastvorceva Rada
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    Sedula Useini
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    Background: COVID-19 convalescent plasma (CCP) is an important antiviral option for selected patients with COVID-19. Materials and Methods: In this open-label, phase 2, clinical trial conducted from 30 April 2020 till 10 May 2021 in the Republic of North Macedonia, we evaluated the efficacy and safety of CCP in hospitalized patients. Treatment was with a single unit of CCP having an anti-RBD IgG concentration higher than 5 AU/mL. Results: There were 189 patients that completed the study, of which 65 (34.4%) had WHO 8-point clinical progression scale score of 3 (requiring hospital care but not oxygen support), 65 (34.4%) had a score of 4 (hospitalized and requiring supplemental oxygen by mask or nasal prongs), and 59 (31.2%) had a score of 5 (hospitalized and requiring supplemental oxygen by non-invasive ventilation or high-flow oxygen). Mean age was 57 years (range 22−94), 78.5% were males, 80.4% had elevated body mass index, and 70.9% had comorbidity. Following CCP transfusion, we observed clinical improvement with increase rates in oxygenation-free days of 32.3% and 58.5% at 24 h and seven days after CCP transfusion, a decline in WHO scores, and reduced progression to severe disease (only one patient was admitted to ICU after CCP transfusion). Mortality in the entire cohort was 11.6% (22/189). We recorded 0% mortality in WHO score 3 (0/65) and in patients that received CCP transfusion in the first seven days of disease, 4.6% mortality in WHO score 4 (3/65), and 30.5% mortality in WHO score 5 (18/59). Mortality correlated with WHO score (Chi-square 19.3, p < 0.001) and with stay in the ICU (Chi-square 55.526, p ≤ 0.001). No severe adverse events were reported. Conclusions: This study showed that early administration of CCP to patients with moderate disease was a safe and potentially effective treatment for hospitalized COVID-19 patients. The trial was registered at clinicaltrials.gov (NCT04397523).
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    Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease
    (Lippincott Williams & Wilkins / Wolters Kluwer, 2023-07-14)
    Bergami, Maria
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    Manfrini, Olivia
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    Nava, Stefano
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    Caramori, Gaetano
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    Yoon, Jinsung
    Background Empiric antimicrobial therapy with azithromycin is highly used in patients admitted to the hospital with COVID‐19, despite prior research suggesting that azithromycin may be associated with increased risk of cardiovascular events. Methods and Results This study was conducted using data from the ISACS‐COVID‐19 (International Survey of Acute Coronavirus Syndromes‐COVID‐19) registry. Patients with a confirmed diagnosis of SARS‐CoV‐2 infection were eligible for inclusion. The study included 793 patients exposed to azithromycin within 24 hours from hospital admission and 2141 patients who received only standard care. The primary exposure was cardiovascular disease (CVD). Main outcome measures were 30‐day mortality and acute heart failure (AHF). Among 2934 patients, 1066 (36.4%) had preexisting CVD. A total of 617 (21.0%) died, and 253 (8.6%) had AHF. Azithromycin therapy was consistently associated with an increased risk of AHF in patients with preexisting CVD (risk ratio [RR], 1.48 [95% CI, 1.06–2.06]). Receiving azithromycin versus standard care was not significantly associated with death (RR, 0.94 [95% CI, 0.69–1.28]). By contrast, we found significantly reduced odds of death (RR, 0.57 [95% CI, 0.42–0.79]) and no significant increase in AHF (RR, 1.23 [95% CI, 0.75–2.04]) in patients without prior CVD. The relative risks of death from the 2 subgroups were significantly different from each other ( P interaction=0.01). Statistically significant association was observed between AHF and death (odds ratio, 2.28 [95% CI, 1.34–3.90]). Conclusions These findings suggest that azithromycin use in patients with COVID‐19 and prior history of CVD is significantly associated with an increased risk of AHF and all‐cause 30‐day mortality.
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    PUNCTURE INJURY IN THORACOLUMBAR REGION
    (Faculty of Medicine, Ss Cyril and Methodius University in Skopje, 2022)
    Volcevski, Goce
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    Mihajloski, Vladimir
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    BOUVERT'S SYNDROME: A CASE REPORT
    (University Ss. Cyril and Methodius in Skopje, 2024)
    Hadzi Manchev, Dragan
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    Osmani, Bujar
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    Gjoshev, Stojan
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    RESECTION OF THE LATE RECCURENCE OF PANCREATIC HEAD CARCINOMA AFTER WHIPPLE PROCEDURE IS SAFE, FEASIBLE AND OFFERS LONG-TERM PROGNOSIS IMPROVEMENT
    (Македонско лекарско друштво = Macedonian medical association, 2023)
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    Gjoshev, Stojan
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    Velimir Shumenkovski
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    BEYOND THE LIVER AND LUNGS: AN UNCOMMON CASE OF ISOLATED SPLENIC ECHINOCOCCOSIS
    (Македонско лекарско друштво = Macedonian medical association, 2025)
    Osmani, Bujar
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    Hadzi-manchev Dragan
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    Neziri, Gani
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    Kolari, Arbijon
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    Vladimir Ivanov
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    INITIAL EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY IN NORTH MACEDONIA: CASE SERIES AND LITERATURE REVIEW
    (Македонско лекарско друштво = Macedonian medical association, 2025)
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    Kolari, Arbijon
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    NOVEL HEPATICOJEJUNOSTOMY TECHNIQUE USING THE CYSTIC DUCT CONFLUENCE IN A NARROW COMMON HEPATIC DUCT
    (Македонско лекарско друштво = Macedonian medical association, 2025)
    Kolari, Arbijon
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    Stojan Gjosev
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    Neziri, Gani
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    Hadzi-manchev Dragan
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    EVALUATION OF STANDARD HEPATICOJEJUNOANASTOMIS AS A SEQUENCE OF RECONSTRUCTION IN RADICAL PANCREATODUODENECTOMY - WHIPPLE PROCEDURE PROSPECTIVE RANDOMIZED SINGLE CENTER CLINICAL STUDY
    (Македонско лекарско друштво = Macedonian medical association, 2025)
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    Kolari, Arbijon
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