Faculty of Medicine

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PREMATURE VENTRICULAR CONTRACTIONS IN ATHLETES
(Faculty of Physical Education, Sport and Health in Skopje, Republic of Macedonia, 2022)
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Furnadjiski, Atanas
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Nastevska Grueva, Elena
Premature ventricular contractions (PVC) are one of the most common heart rhythmdisturbances in the overall population. Most of them are benign and do not harm the usual life and everyday activities in the population. The individual feeling and the perception of the sensation they occur is different in every person and varies between no sensation to fluttering, pounding or jumping, skipped beats or missed beats, all of which can increase awareness of the heartbeat. The importance of these premature ventricular beats rises especially among the athlete population and sportsmen because some of them may be the result of underlying heart disease which can be life threatening. Conclusion: Prompt diagnosis and adequate evaluation of these extra heart beats has a pivotal role and is the most important determinant in further sport involvement for the athletes with PVCs.
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Occupational Asthma: The Knowledge Needs for a Better Management
(Oxford University Press (OUP), 2022-01-05)
Rui, Francesca
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Otelea, Marina Ruxandra
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Fell, Anne Kristin Møller
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The management of occupational asthma (OA) may be influenced by several factors and removal from exposure is the main tertiary prevention approach, but it is not always feasible without personal and socioeconomic consequences. Reducing the delay between the onset of suggestive symptoms of OA and the diagnosis of OA is associated with a better prognosis. Workers' education to increase awareness to trigger agents and a medical surveillance program directed especially at at-risk workers could be helpful in reducing this latency time. An early identification of workers who develop rhinitis and conjunctivitis which often precede the onset of asthma symptoms could be important for an early identification of OA. This is particularly important for cases of asthma caused by high-molecular-weight sensitizers and in the early years of employment. The availability of financial support and compensation measures for workers with OA may influence the latency time before diagnosis and, consequently, may influence the OA outcomes. In conclusion, there is a need for high-quality cohort studies that will increase knowledge about risk factor that may influence the timing of diagnosis of OA. This knowledge will be useful for implementation of future surveillance and screening programs in workplaces.
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NEONATAL HYPOGLYCEMIA: A CONTINUING DEBATE IN DEFINITION AND MANAGEMENT
(Macedonian Academy of Sciences and Arts / Sciendo, 2015-12)
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Elizabeta Petkovska
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Snezana Jancevska
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Neonatal hypoglycemia (NH) is one of the most common abnormalities encountered in the newborn. Maintaining glucose homeostasis is one of the important physiological events during fetal-to-neonatal transition. Transient low blood glucose concentrations are frequently encountered in the majority of healthy newborns and are the reflections of normal metabolic adaptation processes. Nevertheless, there is a great concern that prolonged or recurrent low blood glucose levels may result in long-term neurological and developmental consequences. Strikingly, it was demonstrated that the incidence and timing of low glucose concentrations in the groups most at risk for asymptomatic neonatal hypoglycemia, did not find association between repetitive low glucose concentrations and poor neurodevelopmental outcomes. On the contrary, NH due to hyperinsulinism is strongly associated with brain injury. Fundamental issue of great professional controversy is concerning the best manner to manage asymptomatic newborns NH. Both, overtreating NH and undertreating NH are poles with significant potential disadvantages. Therefore, NH is one of the most important issues in the day-to-day practice. This article appraises the critical questions of definition (widely accepted blood glucose concentration: < 2.6 mmol/l or 47 mg/dl), follow-up ad management of NH
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CONGENITAL HYDRONEPHROSIS: DISEASE OR CONDITION?
(Macedonian Academy of Sciences and Arts / Sciendo, 2014)
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SImeonov R
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Chadikovski V
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Abstract The aim of this paper is to address the dilemmas of the paediatric surgeon when facing an isolated, unilateral, congenital hydronephrosis and discuss the strategic options for the management of this condition. Congenital hydronephrosis, the most commonly diagnosed uropathy in children, is usually a benign and self-resolving condition. Nonobstructive hydronephrosis does not require operative treatment, while timely treatment is imperative for obstructive hydronephrosis before significant renal damage ensues. Managing congenital hydronephrosis is a challenging task. Thirty-two children with unilateral, isolated hydronephrosis and nonobstructed renography curves were followed up for 3 years. On the initial evaluation according to the grade of hydronephrosis: 22.6% were grade I, 54.8% grade II and 22.6% grade III. After 12 months of follow-up: 30% were grade I, 51.5% grade II and 18.5% grade III, respectively. After the three-year follow-up, there were no hydroneproses greater than grade II. The mean value of the separate GFR of the affected kidney at initial evaluation was 42.83%, and 40.33% after three years. In three children the treatment was converted from conservative to surgical. Nonobstructive, congenital hydronephrosis is a benign condition not requiring any medical treatment, but aggressive observation is indicated.
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Management of tobacco dependence
(2018-10-27)
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Dejan Todevski
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Suzana Arbutina
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Monika Tushevska Mitkovska
Tobacco is the leading cause of premature death and disability in Europe. Each year, more than 700,000 Europeans die from tobacco-related illness. In Macedonia, 46.6% of the male and 26.8% of the female population are active smokers. These numbers acertain Macedonia to the high place in Europe by smoking rates. There is nothing more important we can do for patients who smoke than help them stop! Doctors and health professionals must take into account that tobacco dependence is a medical condition and not a habit, vice, pleasure, or life-style choice and it must be diagnosed and treated in the same way as other chronic diseases. Most smokers are not able to stop on their own (without help). Nicotine dependence is a chronic relapsing condition and has two components: physical dependence and psychological dependence. The tenacity of nicotine addiction means that many smokers who attempt to quit will relapse. Relapse is most common within the first few weeks of quitting. The ENSP Tobacco Treatment Guidelines recommend five strategies for addressing tobacco use in clinical settings. Known as the “5As” these strategies are: Ask all patients about smoking status and document in medical record; Advise patients who smoke to quit; Assess readiness to quit; Assist with making a quit attempt, including providing behavioral counselling and prescribing first-line smoking cessation medications; and Arrange follow-up. Behavioral support (Motivational interviewing) is the keystone of tobacco dependence treatment. It is generally matched to the patient’s motivation to quit smoking also known as the patients “stage of change”. There are five stages of change. Pre-contemplation, Contemplation. Preparation, Action and Maintenance. Tobacco dependence may need persistent and repeated therapeutic interventions, as well as long- term follow-up until it is cured. In order to give our contribution to the reduction of tobacco consumption in Macedonia, we are implementing a program for education of doctors and health workers for smoking cessation. The project represents partnership between the Medical faculty in Skopje and the Henry Ford Health System from Detroit, Michigan, USA.

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