Faculty of Medicine

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Author: search.filters.author.Andon ChibishevLanguage: search.filters.language.(Other)

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    TROPONIN I VISOKE OSETLJIVOSTI I DUŽINA BORAVKA U BOLNICI KOD AKUTNO OTROVANIH PACIJENATA SA RABDOMIOLIZOM
    (2023-05)
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    Niko Bekarovski
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    Andon Chibishev
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    Cardiac troponins (cTn) are regulatory proteins that play a pivotal role in the interaction between actin and myosin, controlling the contraction and relaxation of skeletal and cardiac muscle. The high-sensitivity cardiac troponin I assay is not entirely specific for myocardial injury. The aim is to determine the role of hs–TroponinI on the hospital length of stay in patients with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances. In a clinically controlled prospective study, 140 patients with rhabdomyolysis were divided into two groups depending on the intoxicating substance (psychotropic or chemical). Rhabdomyolysis was defined as a creatine kinase (CK)>250 U/L according to the poisoning severity score (PSS). We analyze hs–TroponinI in both groups upon admission. In patients with rhabdomyolysis in the group of psychotropic intoxications, the level of hs-TnI on admission significantly affected the length of hospitalization in 17.7% (R2 = 0.177). Increasing the value of the hs-TnI level per unit on admission increased the length of hospital stay by an average of 0.016 days. In patients with rhabdomyolysis in the chemical intoxication group, the hs-TnI level on admission has no influence on the hospital length of stay (R2 = 0.000). The increased hs-TnI level on the first day did not affect the hospital length of stay variability. In patients with rhabdomyolysis acutely intoxicated with psychotropic substances, hs-Tn I can be used to predict the length of hospital stay
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    CANNABIS AND AMPHETAMINE USE IN PATIENTS ON BUPRENORPHINE MAINTENANCE TREATMENT
    (2023-05)
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    ;
    Niko Bekarovski
    ;
    Andon Chibishev
    ;
    Polydrug abuse is a known problem among patients on opioid maintenance treatment. Objective is to assess the profile of patients on buprenorphine substitution treatment who use cannabis, amphetamine or cannabis and amphetamine in parallel. This study was conducted in 2021 year at University Clinic for toxicology, Skopje and has a prospective cohort design that included 112 patients with opioid use disorder on buprenorphine maintenance treatment. The data were collected according to a previously designed self-administered questionnaire adapted according to the “treatment demand indicator”. The following variables were analyzed: gender, age, duration of opioid use disorder, route of administration, duration of buprenorphine treatment, buprenorphine dose, cannabis and amphetamine use. The majority of patients were male (88.4%). The mean age of patients was 38.7±4.3 years. The average duration of opioid use disorder was 16.8±6.8 years; the duration of buprenorphine treatment was 6.3±3.3 years; buprenorphine dose was 12.5±4.9mg. Parallel use of buprenorphine with cannabis was declared in 43.7% of the patients and they were significantly younger compared to others (p=0.014). A combination of buprenorphine with amphetamine was used in 14.3% with significantly younger ages compared to others (p=0.003). Buprenorphine with both cannabis and amphetamine was practiced in 15.2% of the patients. No significant correlation was found between other variables of the studied group and the parallel use of cannabis and amphetamine. Almost half of the patients on buprenorphine substitution treatment reported parallel use of cannabis. The patients who declared parallel use of cannabis and amphetamines were of younger age compared to others.