Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Search Results

Now showing 1 - 9 of 9

Some of the metrics are blocked by your
consent settings
PLUCNA EMBOLIJA U BOLESNIKA S LEIDENOVOM TROMBOFILIJOM FAKTORA V I PSORIJAZOL: PRIKAZ SLUCAJ.
(Association of pulmologists from Republika Srpska, 2023-05)
Baloski Marjan
;
;
Bushev Jane
;
Brishkoska-Boshkovski Vesna
;
Hasan Taner
Cilj: Genetski faktori rizika pove!avaju rizik venske tromboembolije. Poremecaji u sintezi ili aktivnosti faktora koagulacije. Faktor V Leiden, protrombin (20210-A), antitrombinski deficit, deficit proteina C i proteina S i hiperhomocisteinemija najcesce su mutacije gena povezanih sa venskim tromboembolijom . Uvod : Psorijaza i prisutvo mutacije trombofilnih gena povecava rizik venske tromboembolije. Prethodna venska tromboembolija je jedan od najjacih faktora rizika, cak i kod pacijenata koji su aktivno leceni antikoagulansom. Psorijaza je kompleksna imuno posredovana bolest, povezana sa kardiovaskularnim rizikom, markerima hiperkoagulabilnosti i povisenim homocisteinom. Mnogo izvjestaja o opservacijama sugerira povecanu ucestalost venskih trombembolickih dogadaja kod pacijenata sa psorijazom. Nalazi: Prikazujemo bolesnika s nasljednom trombofilijom i kronicnom difuznom psorijazom kompliciranom plu!nom embolijom. Analiza DNK ukazuje na prisutnost homozigoze za mutaciju faktora V Leidena. Dermatoloska anamneza je pozitivna na psorijazu. Zaklju!ak: Prikaz ovog slucaja ukazuje na povezanost venske tromboembolije i psorijaze. Pacijenti sa naslednom trombofilijom, psorijazom I plucnim tromboembolizmom, imaju visoki rizik od razvoj venske tromboembolije.
Some of the metrics are blocked by your
consent settings
Alpha-1 antitrypsin deficiency (AATD) in a young female patient
(General Hospital Tešanj, 2022-11-12)
;
Mickovski Ivana
;
Baloski Marjan
;
Bushev Jane
;
Buklioska Adriana
Introduction The alpha-1 antitrypsin deficiency (AATD) is a hereditary autosomal codominant disease. The phenotype Pi ZZ is associated more frequently with pulmonary disease and is responsible for the presence of emphysema early in life, particularly in smokers. Generally, AATD is suspected in young patients with pulmonary emphysema or chronic obstructive pulmonary disease (COPD). Patients often suffer from diagnostic gaps and are misdiagnosed with chronic obstructive pulmonary disease (COPD), asthma, and airway hyper-reactivity (AHR), as AATD may present with nonspecific respiratory symptoms. AATD is most common in white people, and it most frequently affects the lungs and liver. In the lungs, the most common manifestation is early-onset (patients in their 30s and 40s) pan acinar emphysema most pronounced in the lung bases. However, diffuse or upper lobe emphysema can occur, as can bronchiectasis. The most frequently described symptoms include dyspnea, wheezing and cough. Pulmonary function testing shows findings consistent with COPD; however, bronchodilator responsiveness may be seen and may be labelled as asthma. Case presentation We describe a case of a 40-year-old Caucasian female patient, admitted to hospital because of dyspnea, malaise, cough. Symptoms started one year ago, after mild SARS-COV 2 infection. Chest X-ray during the acute illness described emphysema, with flattened diaphragm, and no signs of consolidation. According to history she was a non-smoker, office worker, with negative family history of respiratory or liver illness. She never used any regular therapy before, no comorbid diseases and denied frequent respiratory infections during childhood. Chest computer tomography (CT) presented pan acinar emphysema most pronounced in the lung bases. Post bronchodilator spirometry revealed forced expiratory volume in 1st second (FEV1) 54%, and forced vital capacity (FVC) 84%, with FEV1/FVC=0.64. Routine biochemistry laboratory was normal. Gas analyses noted respiratory failure type 1 (partial) with hypoxemia partial oxygen pressure 8.1kPa, hypocapnia because of hyperventilation with partial carbo dioxide pressure 4.1kPa, and oxygen saturation 92%. Echocardiography without any findings of right heart failure, normal systolic pulmonary arterial pressure (sPAP). Abdominal ultrasound without pathological findings, no liver disease detected. According to CT finding the patient was sent to the Institute for clinical immunology and genetic disorders where the serum value of alpha-1 antitrypsin was measured. The value was 0,2 micromoles /L (reference value 5-6 micromole /L). The patient was prescribed inhaled therapy of long acting anticholinergic, short acting beta-2 agonist. She was also suggested therapy with intravenous human alpha 1-proteinase inhibitor (AAT augmentation therapy). Conclusion It is never too late to suspect AATD, especially in a patient with an unusual medical history. In recent years, evidence is beginning to emerge that there may be value in identifying and treating patients who do not already have deterioration of functional parameters. The Alpha-1 Foundation recommendations for the diagnosis and management of AATD in adult patients indicate that treatment should be provided for patients with FEV1 between 30 and 65%. It may be useful to evaluate and treat patients based on clinical symptoms, even outside the established parameters, in particular cases.
Some of the metrics are blocked by your
consent settings
COPD as a risk factor for Coronary Artery Disease (CAD): Overview of 10-year atherosclerotic cardiovascular disease (ASCVD) risk assessment
(2022-12-01)
;
Mickovski Ivana
;
Baloski Marjan
;
Doneva Daniela
;
Neshovska Radmila
We aimed to investigate the association between COPD and CAD (overview of 10-year risk of fatal cardiovascularevent), and the relation to the severity of airflow limitation.Cross-sectional study including 220 patients with stable COPD as investigated group (IG), aged 40 to 75 yearsand 58 non-COPD subjects, matched by gender, age, BMI, smoking status, as control group (CG). All studysubjects underwent pulmonary, cardiological evaluation, lipid and glycemic status.The analysis compared the 10-year established ASCVD risk between COPD stages (according to GOLDclassification 1, 2, 3, 4) and between IG vs. CG. ASCVD score was classified as low (score <5%), borderline (5 to<7.5%), moderate (≥7.5 to <20) and high risk (score ≥20%). Results presented statistically significant differencebetween mean ASCVD value in IG 21,69±13,86% vs. CG 15,83±9,92% (p=0.0028). The median risk of ASCVDfor fatal cardiovascular events was high in IG and moderate in CG. The mean and median values of 10-yearASCVD risk in the IG subgroups were: GOLD1 16,79±8,04% (50% of the subjects with risk >15,7%), GOLD222,67±16,49% (50% of the subjects with risk >20,6%), GOLD3 26,81±14,15% (50% of the subjects with risk >27,6%) and GOLD4 20,70±13,52% (50% of the subjects with risk > 18,4%). The average ASCVD risk of fatalcardiovascular event was moderate in GOLD1 and GOLD4, and high in GOLD2 and GOLD3.We found higher risk for fatal cardiovascular outcome in patients with COPD, even in the early COPD stages(GOLD2), compared to non-COPD group. Our findings suggest that an urgent need to develop comprehensivestrategies for prevention, screening and early treatment are needed.
Some of the metrics are blocked by your
consent settings
Outcomes of transbronchial and transthoracic biopsy in pulmonary diseases
(Turkish Respiratory Society; Respiratory Society of Serbia, 2017-04)
Bushev Jane
;
Kochovska Kamchevska Nade
;
Smileska Snezana
;
Baloski Marjan
;
AIM: contribution of invasive methods- transbronchial (TBLB) and transthoracic biopsy (TTNA) in the diagnostics of certain chest X- ray infiltrations. MATERIAL-METHODS: 76 - aged 41 to 83 years, out/ inpatient 14/ 62, male/ female 64/12 with lung and/or mediastinal changes, were analyzed since January 2015 to 2017. Bronhoscopic examination (before TTNA) excluded abnormalities. RESULTS: 92 biopsies were made (30 TBLB, 62 TTNA, in 16 patients both methods). TBLB- 14 patients, TTNA- 46 patients, both- 16 patients. TBLB with histological confirmation was obtained in 8 (57%) of 14 cases (4 in the first and 4 in the repeated TBLB), and in 42 (91%) of 46 made of TTNA. In 16 patients in which both methods (TBLB and TTNA) were performed, defined histological diagnosis was obtained in 4 samples of TBLB (also confirmed with TTNA), and in 12 samples of the TTNA. Defined histological diagnosis was not obtained in 18 of 30 TBLB (12 of them clarified by TTNA) and in 8 of 62 TTNA. 62 patients (81.5%) had a histopathological confirmation: 34 Carcinoma planocellulare bronchogenes; 10 Carcinoma microcellulare bronchogenes; 14 Adenocarcinoma; 4 Sarcoidosis. CONCLUSION: TBLB and TTNA are safe and cost effective diagnostic methods for definitive diagnosis of the changes in chest wall, lung parenchyma and mediastinum. Strategy of treating bronchial carcinoma requires clear histopathological classification, and therefore at sufficiently defined histological forms indicated repeating both methods. Usage of both TBLB and TTNA, even though with congruent histopathologic findings, has strengthened definitive diagnosis, which was confirmed with our results.
Some of the metrics are blocked by your
consent settings
Solitary lung metastasis of malignant melanoma - Case report
(Turkish Respiratory Society; Respiratory Society of Serbia, 2017-04)
;
Kochovska Kamchevska Nade
;
Bushev Jane
;
Smileska Snezana
;
Baloski Marjan
Malignant melanoma is increasing last thirty years, one of the most common cancers in young adults (especially women). Primary localization on skin, mouth, intestines, eye. Survival in malignant melanoma stage IV is 10-15%, better prognosis have patients with normal lactate dehydrogenase (LDH). Lung metastases are usually asymptomatic, multiple, nodular. Desmoplastic (neurotropic, spindle cell) melanoma is rare form of infiltrating carcinoma, with diificult diagnosis due to similarity to un-melanocytic lesion as scar, fibroma, cyst. Female patient, 69 years of age, hospitalized for changes seen on chest X-ray. Symptoms: intermittent pain in left shoulder, dyspnea. Profession: housewife, non-smoker, comorbidity: arterial hypertension. Normal lung auscultatory finding. Laboratory: sedimentation 20, hemoglobin 11,9, LDH and tumor markers (CA19-9, CEA, CA 125, CA 15-3) normal. Chest X-ray: left apical, oval, soft-tissue shadowing. Bronchoscopy – without pathological findings. A computed tomographic chest scan showed: in left apicoposterior segment, solid formation with dimensions 18x13,6mm, close to the pleura, that accumulated contrast, two mediastinal lymph nodes 5,7mm and 8,5mm. CT guided transthoracic lung core biopsy was performed. Histopathological diagnosis - Metastatic process of Spindle cell melanoma malignum. Microscopic examination with accumulation of large, pleomorphic cells with deposits of melanin irregularly arranged. The origin and systemic dissemination of the melanoma was investigated. Abdominal ultrasound without abnormalities. Dermatological, ophthalomological, gastroenterohepatological examinationas were performed, but the primary lesion remained unknown. The patient denied to receive proposed oncological and surgical therapy. Two years after, control CT scan, the tumor was 47x43mm, in right lung secondary deposite 11x8mm, increased mediastinal lymph nodes to 18mm.
Some of the metrics are blocked by your
consent settings
Hodgkin lymphoma – lung metastasis - Case report
(Turkish Respiratory Society; Respiratory Society of Serbia, 2017-04)
Baloski Marjan
;
Kochovska Kamchevska Nade
;
Bushev Jane
;
Smileska Snezana
;
Lymphoma is the most common blood cancer. Occurs when lymphocytes grow and multiply uncontrollably in the lymph nodes, spleen, bone marrow, or other organs. Approximately 9,000 new cases of Hodgkin Lyphoma are projected each year, commonly diagnosed in young adults between the ages of 20 and 34 years. Female patient, 33 years old, diagnosed with Hodgkin Lymphoma in 2010. Treated with several cycles of chemotherapy. 2-3 months before hospital admission, she felt shortness of breath, prolonged, dry cough, haemoptysis. On physical examination – swallen lymph nodes in right axilla and neck. Auscultatory normal finding. Other systems without pathological findings. Chest X-ray - right infraclavicular, massive, heterogenous shadowing, separated and connected to right hylus. CT lung scan – in right upper medial segment, stellate, 6sm, cavernous consolidaton. Mediastinal and hilar lymphaednopathy In right axilla enlarged lymph nodes. Bronchoscopy – edematous mucosa. Abdominal and pelvic CT scan – normal. Transthoracic CT guided lung biopsy with histopathological finding - MORBUS HODGKIN PULMONUM. Microscope finding of fragments showed accumulations of mature lymphocytes mixed with macrophages, plasma cells and eosinophilic leukocytes, rare cells with basophilic cytoplasm and hyperchromatic large cores. In several cells binuclearity, in a larger cell multinuclearity. The immunohistochemical analysis conducted further, obtained the following RESULTS: CD-15 (cell marker for Reed-Sternberg cells) positive +, CD-30 (a marker for cell mitosis in cells) is positive focal +, CD-20 (B-grade. marker) positive +, CD-3 (T marker) positive focal +. For further treatment the patient was referred to the Department of Hematology.
Some of the metrics are blocked by your
consent settings
ПОВРЗАНОСТ НА ПОЛИМОРФИЗМОТ C677T ВО ГЕНОТ MTHFR СО БЕЛОДРОБНАТА ЕМБОЛИЈА
(SHMSHM - AAMD, 2020-04)
Baloski Marjan
;
;
Hasan Taner
;
Nedeska Minova Natasha
;
Petkovikj Natasha
Белодробната емболија е релативно чест клинички ентитет проследен е со висок морталитет, па претставува дијагностички и тераписки предизвик. Досегашните студии укажуваат на постоење на генетска поврзаност на определени тромбофилии со појавата на белодробна емболија ,вклучувајќи ги полиморфизмите во генот за метилен-тетрахидрофолатредуктазата (MTHFR). Генетските анализи покажаа дека постои статистички сигнификантна поврзаност на хомозиготниот генотип ТТ, односно на алелот Т, со белодробната емболија. Носителите на овој генотип, односно алел, имаат 4,4 пати, односно, приближно 2,5 пати, соодветно, повисока веројатност од белодробна емболија во однос на носителите на хомозиготниот генотип CC или хетерозиготниот CT, односно на алелот C. Ваквите резултати се конкордантни со дел од објавените клиничко-генетски студии со сличен дизајн и укажуваат на потенцијалната употребливост на овој генски маркер во предикцијата на ризикот од белодробна емболија и текот на болеста.
Some of the metrics are blocked by your
consent settings
REZULTATI TRANSBRONHIJALNE I TRANSTORAKALNE BIOPSIJE U DIJAGNOSTICI PLUCNIH OBOLJENJA.
(Association of pulmologists from Republika Srpska, 2019-05)
Bushev Jane
;
;
Kochovska Kamchevska Nade
;
Smileska Snezana
;
Baloski Marjan
Sazetak: transbronhijalna (TBB) i transtorakalna tenkoiglena aspiraciona (TTPA) biopsija pluca su invazivni dijagnosticki postupci u razjasnjavanju i postavljanju definitivne cito/histoloske dijagnoze kod fokalnih i difuznih promena plucnog parenhima, kao i promena u zidu grudnog kosa i medijastinumu. TBB i TTPA se izvode u lokalnu anesteziju kod bolnickih i ambulantnih pacijenata. Njihova osetljivost i specificnost rastu sa napredovanjem rentgenskih promena i u odmaklom stadijumu bolesti. Cilj rada: uporediti doprinos i znacaj histoloskih opisa i definitivnih dijagnoza, procena kost/benefita kod primene pojedinacnog ili oba postupka biopsije. Metod: Retrospektivna analza 80 pacijenata sa radiografskim plucnim i/ili medijastinalnim promjenama kojima su uradjena dva dijagnosti;ka postupka (TBB pod fluoroskopskom i TTPA pod KT kontrolom). Rezultati: u 80 pacijenata uradjeno je 96 biopsija (34 TBB i 62 TTPA). Histolosku potvrdu dijagnoze dobijeno je u 18 (53%) od 34 pacijenata sa uradjenom TBB i u 54 (87%) od 62 pacijenata sa TTPA. Od svih 80 pacijenata, 66 (82.5%) su imali definitivnu histopatolosku potvrdu i to: Carcinoma planocellulare – 35 (44%), Carcinoma microcellulare (ukljucivsi histopatoloske nalaze Oat cell carcinoma i metastatske depozite u medijastinalnim Lgl) – 11 (14%), Adenocarcinoma (ukljucivsi bronchioloalveolare) – 15 (19%), Sarcoidosis (ukljucivsi nalaze nedovoljno definisanog granulomatoznog procesa) - 5 (6%). Nerazjasnjeno 14 (17.5%) pacijenata. Zakljucak: TBB i TTPA su bezbedne i jeftine invazivne dijagnosticke metode za histolosku i/ili citolosku potvrdu promena u plucima i medijastinumu. Strategija lecenja bronhijalnog karcinoma zahteva jasnu histopatolosku kategorizaciju (nedovoljno definisani histoloski entiteti zahtevaju rebiopsiju primenom obe metode). Fluoroskopski vođena transbronhijalna biopsija je vremenski efektivna, sigurna i efikasna metoda kod fokalnih i difuznih plućnih lezija.
Some of the metrics are blocked by your
consent settings
DESCRIPTIVE ANALYSIS OF CLINICAL AND DEMOGRAPHIC DATA OF SELECTED GROUP OF PATIENTS WITH PULMONARY EMBOLISM
(Macedonian Association of Anatomists and Morphologists, 2020)
Baloski Marjan
;
;
Hasan Taner
;
Nedeska Minova Natasa
;
Pulmonary embolism is a relatively common clinical entity accompanied with a high mortality and is a perplexing diagnostic and therapeutic problem. Current research indicates that pulmonary embolism has a multifactorial and complex pathogenesis. Genetic factors have been under extensive research during the past two decades. The aim of this study was to present a descriptive analysis of demographic and clinical data obtained thus far from 31 patients with documented pulmonary embolism. In our patient group, almost half of the patients were non-smokers and all denied alcohol consumption. More than 80% of the patients had no history of previous pulmonary embolism and no thrombophlebitis, but nearly two thirds of all patients had deep vein thrombosis. A history of acute myocardial infarction existed in about 6.5% of patients, as well as ischemic stroke. Arterial hypertension was present in about one-third of patients, dyslipidemia in 42%, and type 2 diabetes in approximately 13%. Only one patient had an anamnestic data for chronic renal disease, while none had a history of hepatic disease. The results of the analysis of demographic-clinical data of patients are concordant with the results of the previously published studies.

Faculty of Medicine

Browse

Filters

Settings

Sort By

Results per page

Search Results