Faculty of Medicine
Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14
Browse
6 results
Search Results
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, Cognitive impairment in CKD patients: a guidance document by the CONNECT network(Oxford University Press (OUP), 2024-09) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Pathohistomorphometric and Immuno-Histologic Changes in Early Arteriovenous Fistula Failure in Patients with Chronic Kidney Disease(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2024-06-01); ; ; ; Popov, ZhivkoHemodialysis is a prevalent treatment for the end-stage chronic kidney disease (CKD) worldwide. The primary arteriovenous fistula (AVF), widely considered the optimal hemodialysis access method, fails to mature in up to two-thirds of the cases. The etiology of the early AVF failure, defined as thrombosis or inability to use within three months post-creation remains less understood, and is influenced by various factors including patient demographics, surgical techniques, and genetic predispositions. Neointimal hyperplasia is a primary histological finding in stenotic lesions leading to the AVF failure. However, there are insufficient data on the cellular phenotypes and the impact of the preexisting CKD-related factors. This study aims to investigate the histological, morphometric, and immunohistochemical alterations in the fistula vein, pre-, peri-, and post-early failure. Materials and Methods Eighty-nine stage 4-5 CKD patients underwent standard preoperative assessment, including the Doppler ultrasound, before a typical radio-cephalic AVF creation. Post-failure, a new AVF was created proximally. The vein specimens were collected during the surgery, processed, and analyzed for morphometric analyses and various cellular markers, including Vimentin, TGF, and Ki 67. Results The study enrolled 89 CKD patients, analyzing various aspects of their condition and AVF failures. The histomorphometric analysis revealed substantial venous luminal stenosis and varied endothelial changes. The immunohistologic analysis showed differential marker expressions pre- and post-AVF creation. Conclusion This study highlights the complexity of the early AVF failures in CKD patients. The medial hypertrophy emerged as a significant preexisting lesion, while the postoperative analyses indicated a shift towards neointimal hyperplasia. The research underscores the nuanced interplay of vascular remodeling, endothelial damage, and cellular proliferation in the AVF outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Outcomes of digoxin vs. beta blocker in atrial fibrillation: report from ESC–EHRA EORP AF Long-Term General Registry(Oxford University Press (OUP), 2021-10-19) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ENCOURAGING SELF-ADMINISTRATION OF ERYTHROPOIETIN BY CREATING INFORMATION BROCHURE FOR PREDIALYSIS CKD PATIENTS(2024-04-04); Milenkova Bogojevska, MENCOURAGING SELF-ADMINISTRATION OF ERYTHROPOIETIN BY CREATING INFORMATION BROCHURE FOR PREDIALYSIS CKD PATIENTS A. Karanfilovikj, L. Trajcheska, S. Sulejman, A. Canevska Taneska, M. Milenkova Bogojevska, A. Spasovska Vasilova, Z. Shterjova Markovska, J. Usprcov, V. Karanfilovski, A. Stojanoska Severova, Z. Janevski, A. Memeti, S. Filipovski, B. Bedzeti, I. Rambabova Bushljetikj University Department for Nephrology, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, N. Macedonia PP Introduction. Patients with chronic kidney disease have a relatively deficient erythropoietin production, and this is one of the most significant causes of anemia in this group. The disorder starts to develop when the glomerular filtration rate drops below 60 mg/ml. In it’s severe form, anemia decreases quality of life and increases the risk of cardiovascular diseases and mortality in this patients, so the implementation of prevention and control measures is recommended. Methods. In our institution, 54 predialysis CKD patients, with average age 69,44±15, have been regularly followed and treated for anemia with subcutaneous administration of ESA, mostly on weekly basis. Considering the numerous comorbidities of this group of patients, in order to reduce frequent outpatient visits and improving the quality of life, 30 (60%) patients accepted to be educated on self-administration of EPO. Results. We created an information brochure for patients, as an educational training material, with basic information about the medication, how to administer, side effects, contraindications and information about safe storage and disposal. Conclusion. The benefits of education through the information brochure for self-application of EPO among the group of predialysis CKD patients are improved cardiovascular function and a more compliant patient enjoying an improved quality of life. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Psychological impact of chronic kidney disease on children(2018)A large number of children are suffering from chronic diseases. Like most chronic childhood illnesses, chronic kidney disease (CKD) deeply affects child's life, both physically and emotionally, concerning that they experience a lot of stress, have many responsibilities with disease management, face possibility of the shortened life span and questionable quality of life. Moreover, CKD would affect the family and siblings too. Many factors influence on proper psychosocial adjustment. Most often it depends on age of the disease’s onset, clinical features, family structure and functioning, child’s age and personality, supporting system etc. Majority of the children with CKD will easily express physical unease, but many of them will hide how they mentally feel. As well as medical treatment, psychological coping and recovery is an important part of managing CKD too. Fear and anxiety are most common emotions. They address health, future, medical procedures especially dialysis or kidney transplantation, uncertainty in the family, school and social life. Depressive feelings, hopelessness or despair can also seriously interrupt the medical treatment and overall child’s health. Denial is present especially when the trauma is very severe and threatens child’s wellbeing. Anger is also common. Child can be mad about what is happening to him/her, mad at parents and medical community for allowing their health to deteriorate, mad to “higher powers” or destiny. Furthermore, impairment of cognitive functions occurs frequently in CKD too. It can be seen in the areas of attention, cognitive flexibility, executive functioning, memory and learning, which can deeply affect child’s everyday functioning or performance in school. Treating children with CKD needs a multidisciplinary care. Early identification and treatment of psychological conditions is very important, in order to improve child’s quality of life as well as his/her family. Children with CKD live longer, so understanding long-term psychosocial effects becomes increasingly important to clinicians and families. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Quality of Health Care and Mortality - Three Years of Experience(Macedonian Association of Anatomists and Morphologists, 2018); ; ; ;