Faculty of Medicine
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Item type:Publication, SONOGRAPHIC FEATURES OF TESTICULAR TORSION IN NEONATE(Македонско лекарско друштво = Macedonian medical association, 2025-04); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ehogenicity of thyroid gland on ultrasonography in primary hypothyroidism(Македонско лекарско друштво = Macedonian medical association, 2011); ; Background. The aim of this study was to investigate the association between echogenicity of thyroid gland and low thyroid function. Methods. The study group included 60 patients, with normal and low thyroid function, who visited the Outpatient Department of the Clinic of Endocrinology, Diabetes and Metabolic Disorders in the period from April 2008 to October 2009. Echogenicity of the thyroid gland in all patients was evaluated by ultrasonography as well as serum concentrations of TSH, fT4 and thyroid auto antibody (anti-TPO). To find out the association between thyroid ehogenicity with mean TSH and anti-TPO in different ages, we divided the patients into five subgroups according to age. Results. Patients with decreased echogenicity had a higher mean TSH compared with patients with normal echogenicity (2.77 mIU/l vs. 1.75 mIU/l) (p=0.04). Differences were more significant in patients with markedly decreased echogenicity (6.34 mIU/l vs. 1.75 mIU/l) (p< 0.0001). Patients with reduced echogenicity had a higher risk of having anti-TPO than patients without normal echogenicity (p<0.001). This association was stronger when echogenicity was markedly decreased. According to age, only younger population (19-29 years) with decreeased and markedly decreased echogenicity had significantly higher mean TSH and anti-TPO values. Conclusions. Thyroid ultrasonography changes can be used as an early sign of low thyroid function, especially in younger population. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging(Sciendo, 2017-09); Patrovic, LukasJuvenile spondyloarthropathies are mainly manifested by symptoms of peripheral arthritis and enthesitis. Early involvement of sacroiliac joints and spine is exceptionally rare in children; this usually happens in adulthood. Conventional radiographs visualize late inflammatory lesions. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presented classifications and radiographic presentation of juvenile spondyloarthropathies. This part discusses changes seen on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance also shows subchondral bone marrow edema, which is considered an early sign of inflammation. Ultrasonography and magnetic resonance imaging do not show specific lesions for any rheumatic disease. Nevertheless, they are conducted for early diagnosis, treatment monitoring and identifying complications. This article presents a spectrum of inflammatory changes and discusses the diagnostic value of ultrasonography and magnetic resonance imaging. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Role of Ultrasound in the Diagnosis of Soft Tissue Tumors(Georg Thieme Verlag KG, 2020-04); Fanti, StefanoThe vast majority of soft tissue masses are benign. Benign lesions such as superficial lipomas and ganglia are by far the most common soft tissue masses and can be readily identified and excluded on ultrasound (US). US is an ideal triaging tool for superficial soft tissue masses. Compared with magnetic resonance imaging (MRI), High-resolution US is inexpensive, readily available, well tolerated, and safe. It also allows the radiologist to interact with the patient as a clinician. In this review, we describe and illustrate the lesions with typical (diagnostic) US features. When the appearances of the lesion are not typical as expected for a benign lesion, lesions are deep or large, or malignancy is suspected clinically, MRI and biopsy are needed. The management of suspicious soft tissue tumors has to be carefully planned by a multidisciplinary team involving specialized surgeons and pathologists at a tumor center. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, OUTCOMES OF ULTRASOUND-MONITORED TREATMENT OF DIVELOPMENTAL DYSPLASIA OF THE HIP GRAF TYPE II(Association of medical doctors „Sanamed“ Novi Pazar, Serbia, 2022-09-17); ; ; Abstract: Introduction: The management of developmental dysplasia of the hips (DDH) type Graf IIa is still controversial. This study aims to examine the outcomes of ultrasound-monitored Pavlik harness treatment, as well as the effects of associated factors, such as gender, side of DDH, the age at the treatment start, and laterality on the treatment outcomes in different Graf type II subtypes. Methods: A cohort retrospective investigation was performed on 88 ultrasound-screened infants or 125 hips diagnosed with Graf type II dysplasia during a six-month period at a single institution, the University Clinic for Orthopedic Surgery, Skopje. Subsequently, 47 infants (18 boys, 29 girls) or 73 hips who underwent Pavlik harness treatment with at least one follow-up throughout treatment monitoring were included in this study. Results: The treatment success rate of the right DDH Graf type IIa (-) was higher (70.8%) compared to the rate of success (50%) in the treatment of left Graf type IIa (-) hips. The mean age of the infants at the treatment start in successfully treated Graf type IIa (-) hips was lower (9.12 ± 2.27 weeks) compared to the age of the infants with treatment failure at the last follow-up (11.33 ± 3.06 weeks), P = 0.04. Conclusion: The age of treatment initiation and the side of DDH were the most relevant factors related to the treatment outcome. Infants with maturational deficit hips, Graf type IIa (-), should undergo early initiated, carefully guided, and monitored Pavlik harness treatment. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Predictive values of the ultrasound parameters, CA-125 and risk of malignancy index in patients with ovarian cancer(2011); ; Backgrounds: Assessment of predictive values for CA-125, ultrasound features (US) and risk of malignancy index (RMI) in ovarian malignancy. Material and methods: 115 patients, divided into: 1) group-A (n = 41)--ovarian malignancy; group-B (n = 74)--benign ovarian tumor; 2) subgroup-CA(a) with low CA-125 (< 35 U/mL) (n = 64); subgroup-CA(b) with slightly elevated CA-125 (35-130 U/ml) (n = 26); subgroup-CA(c) with high CA-125 (> 130 U/ml) (n = 25). Results: 1) patients of group-A were older (p < 0.05); CA-125 < 35 U/ml predominated in group-B (p < 0.001); 2) CA-125 < 35 U/ml showed relatively high NPV, sensitivity and specificity (82.8%; 0732; 0.716, respectively). Our proposed graduation of CA-125 into three grades: a) < 35 U/mL; b) 35-130 U/mL; c) > 130 U/mL increased the specificity for both parameters: CA125 = 35-130 U/mL up to 0.811, and for CA-125 > 130 U/mL up to 0.905, and PPV for the latter parameter up to 72.0%; 3) US: a) highest sensitivity, as indicator for best distinguishing of diseased patients, showed: rugged margins and presence of septum/vegetations (0.878; 0.897, respectively); b) highest specificity, as indicator for best distinguishing of healthy patients: clear distinguish ability of tumor from surrounding tissue and absence of ascites (0.811; 0.932, respectively); c) presence of ascites had highest PPP (100%) i.e. it was the best malignancy predictor; 4) RMI showed only relatively high NPV for RMI < or = 200 (76.8%); 4) additional analysis of RMI in correlation with proposed CA-125 gradation increased the predictive values of RMI: a) subgroup-CA(a): NPV and sensitivity for RMI < or = 200 (81.6%; 0.818, respectively) and NPV for RMI > 200 (86.7%); b) subgroup-CA(b): specificity for RMI < or = 200, as good indicator for distinguishing healthy patients (0.929); c) subgroup-CA(c): sensitivity for RMI > 200, as good indicator for distinguishing diseased patients (0.944). Conclusion: CA-125 and US, as single criteria were not accurate. RMI is good indicator only in correlation with CA-125. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Morpho-clinical variations of ectopic thyroid gland(Medical faculty, Ss Cyril and Methodius University in Skopje, 2018); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE ANALGESIC EFFECT OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, Macedonia, 2017-04); ; ; Background: Transversus abdominis plane (TAP) block is a (new) regional anesthetic technique that provides analgesia to the parietal peritoneum, as well as the skin and muscles of the anterior abdominal wall, by introducing local anesthetic into the neuro-fascial plane between the internal oblique and the transversus abdominis muscles. Pain after laparoscopic bilateral inguinal hernia surgery can be moderate to severe and can result in prolonged hospital stay, unanticipated hospital admission and delayed return to normal daily activities. We evaluated the efficacy of TAP block in patients undergoing laparoscopic bilateral inguinal hernia repair in a randomized controlled clinical trial. Material and methods: Sixty patients undergoing laparoscopic bilateral inguinal hernia repair were randomized to undergo standard care (n=30) or to undergo a bilateral TAP block with bupivacaine (n=30). All patients received standard anesthetic, and after induction of anesthesia, the TAP group received an ultrasound-guided bilateral TAP block. Each patient was assessed after operation at 2, 6, 12 and 24 hours after surgery. Results: Bilateral ultrasound-guided TAP block significantly reduced postoperative visual analogue scale (VAS) pain scores at rest and on moving, reduced ketonal and tramadol postoperative consumption and reduced incidence of PONV in the TAP block group after surgery compared to control group. Conclusion: Bilateral ultrasound-guided TAP block provides effective postoperative analgesia during the 24 postoperative hours after laparoscopic bilateral inguinal hernia repair. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Diagnostic performance of human epididymis protein 4 compared to a combination of biophysical and biochemical markers to differentiate ovarian endometriosis from epthelial ovarian cancer in premenopausal women d biochemical markers to differentiate ovarian endometriosis from epithelial ovarian cancer in premenopausal women(Japan Society of Obstetrics and Gynecology, 2017-12); Marko StanojevicAim: This study is a comparison of human epididymis protein 4 (HE4) with cancer antigen 125 (CA125), using the Risk of Ovarian Malignancy Algorithm (ROMA), Copenhagen Index (CPH-I), Risk of Malignancy Index (RMI) and Morphology Index (MI) to differentiate ovarian endometriosis from epithelial ovarian cancer (EOC) in premenopausal women. Methods: The study was performed at the University Clinic of Obstetrics and Gynecology in Skopje. One hundred and sixty-four premenopausal patients were divided into three study groups, including ovarian endometriosis (37), other benign pelvic masses (57) and EOCs (11), and a control group (59). After ultrasonography, all subjects underwent blood sampling. Surgery and histological verification was performed. Pelvic masses were classified based on histological findings. Mann–Whitney, receiver operating characteristicarea under the curve (AUC), sensitivity, specificity and Kruskal–Wallis tests were used for statistical analysis. The level of significance α was set at 5%. Results: For each of the tested markers, sensitivity, specificity and accuracy to distinguish ovarian endometriosis from EOC were as follows: HE4 (81.82%, 100%, 95.83%); CA125 (81.82%, 48.65%, 56.25%); ROMA (90.91%, 83.78%, 85.42%); CPH-I (81.82%, 97.30%, 93.75%); RMI (90.91%, 35.14%, 47.92%); and MI (100%, 75.68%, 81.25%), respectively. The AUC for ovarian endometriosis compared to EOC for tested markers was as follows: HE4 (AUC = 0.934), CA125 (AUC = 0.821), ROMA (AUC = 0.929), CPH-I (AUC = 0.924) and RMI (AUC = 0.880), respectively. Conclusion: HE4 and CPH-I perform best to discriminate ovarian endometriosis from EOC in premenopausal women. MI has maximal sensitivity to detect EOC.