Faculty of Medicine

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Author: search.filters.author.Baloski, MarjanHas files: No

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    Bleeding duodenal ulcer in a patient with Hemophilia A: A case report
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2024-12-31)
    Baloska, Ivana
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    Baloski, Marjan
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    <jats:p>Hemophilia A is a hereditary bleeding disorder characterized by excessive musculocutaneous hemorrhage due to a congenital deficiency of factor VIII. While upper gastrointestinal bleeding in patients with hemophilia A has been reported globally, specific literature on this topic remains scarce, emphasizing the need for further research. Case presentation: A 38-year-old male presented at the Univesrity Clinic of Gastroenterhogepatology, reporting a recent episode of black stool three days prior to admission. His digital rectal examination was unremarkable, and levels of blood urea and nitrogen (BUN) were within normal ranges. Apart from Helicobacter pylori infection, the patient lacked significant risk factors for duodenal ulcers. An esophagogastroduodenoscopy (EGD) revealed a duodenal ulcer (classified as Forest Ib), and endoscopic hemostasis was performed using 9ml adrenaline solution. Coagulation factor VIII was administered prior to the procedure. Following the EGD, the patient was treated according to the duodenal ulcer protocol and hospitalized at the University Clinic. Conclusion: Recognizing risk factors, such as Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs, is crucial in managing duodenal bleeding ulcers in patients with Hemophilia A. Screening for Helicobacter pylori infection can significantly reduce the risk of ulcer-related bleeding episodes and enhance overall patient health. Further research and the development of clinical strategies are essential to optimize the management of duodenal ulcers in this patient population.</jats:p>
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    Special Conditions in Venous Thrombembolism - Case Series
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2019-10-01)
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    Klincheva, Milka
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    Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management, and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding, renal insufficiency, disseminated malignancy or pregnant patients) have been under-represented in randomized clinical trials. We still need information from real life data (as example RIETE). The paper presents case series with VTE in special conditions, including cancer associated thrombosis, malignant homeopathies, as well in high risk population.
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    PEDIATRIC SURGICAL STRESS RESPONSE AND ANESTHESIA
    (MIT Univerzitet Skopje, 2021)
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    Nancheva-Bogoevska, Andreja
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    Surgical trauma disturb the body homeostasis by inducing a combination of local response to tissue injury and generalized activation of systemic metabolic and hormonal pathways via afferent nerve pathways and the central nervous system. The local inflammatory responses and the parallel neurohumoral responses are not isolated but linked through complex signaling networks, some of which remain poorly understood. The stress response to surgical trauma occurs as a protective mechanism, by activating a series of endocrine, metabolic and immune processes which prevent disturbance of homeostasis. The magnitude of the response is broadly related to the site of injury (greater in regions with visceral pain afferents such as abdomen and thorax) and the extent of the trauma. The stress response to surgical trauma is different in premature, newborns, infants, and in children approaching puberty is the more similar as in adults. New anesthetic agents basically do not trigger the endocrine-metabolic response of the body. Endocrine-metabolic, immune and autonomic responses to surgical trauma can be modified using regional anesthetics techniques and the use of analgesics in general anesthesia. It is the duty of each anesthesiologist before the surgery according to the patient and the kind and length of the surgical intervention, to assess which anesthesia technique and which anesthesiological agents is selected for conducting the operation, in order to provide “stress – free” anesthesia.