Faculty of Medicine

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Author: search.filters.author.Bojadzioska, Maja

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    HYPERTENSION IN PRIMARY HYPERPARATHYROIDISM: A CASE REPORT OF ECTOPIC PARATHYROID ADENOMA
    (Македонско лекарско друштво = Macedonian medical association, 2024)
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    Vejseli, Ron
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    Arbutina, Suzana
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    Trajkovska, Tina
    Primary hyperparathyroidism is a condition characteri- zed by excessive production of parathyroid hormone, often caused by an adenoma or hyperplasia of the parathyroid gland. One of the rare presentations of primary hyperparathyroidism is the development of an ectopic parathyroid adenoma, which can be challen- ging to diagnose and localize. Hypertension is observed seen in many cases of primary hyperparathyroidism (PHPT), although the exact mechanism is yet unclear. This paper aims to provide a comprehensive review of the current understanding of primary hyperparathy- roidism, with a focus on the presentation of ectopic adenomas and the relationship between primary hyper- parathyroidism and resistant hypertension. While most parathyroid adenomas are located in the normal ana- tomical position of the parathyroid glands, a small percentage (approximately 2-5%) can occur in ectopic locations, such as the thyroid gland, carotid sheath, or mediastinum. The atypical location of ectopic parathy- roid adenomas can make them more difficult to iden- tify and remove surgically, which can be difficult diag- nostic challenge. The prevalence of primary hyperpa- rathyroidism has been estimated to be around 0.1-0.4% in the general population, with a higher incidence in postmenopausal women. The imaging tests consist mainly of an initial 99mTc- sestamibi SPECT/CT. Sensitivity and specificity of sestamibi scans are between 73%-80%, respectively. Clinical sensitivity is increased to 96% when sestamibi scans are combined with ultrasound
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    RITUXIMAB IN TREATMENT OF A PATIENT WITH GRANULOMATOSIS WITH POLYANGIITIS – A CASE REPORT
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2024-12-15)
    Bojadzioska, Maja
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    Guchev, Filip
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    Antova, Dubravka
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    Karadzova-Stojanoska, Anzhelika
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    Vidinikj, Sonja
    ANCA-associated vasculitis (AAV) is a necrotizing vasculitis with few or no immune deposits that can affect predominantly small vessels. It can affect ve-ssels in every organ and tissue of the body; the clinical manifestations of the disease are extremely variable. B-cells are of major importance in the disease patho¬ge¬nesis as precursors of ANCA-producing plasma cells and, possibly, also as antigen-presenting and cytokine-producing cells. Therefore, rituximab, a monoclonal anti¬body drug causing partial B-cell depletion, has emerged as a powerful option in the treatment of AAV such as granulomatosis with polyangiitis. We present the case of a 25-year-old female diagnosed with granu-lomatosis with polyangiitis and treated with rituximab and high-dose corticosteroids.
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    The Role of Endothelial Dysfunction in the Pathogenesis of Pregnancy-Related Pathological Conditions: A Review
    (Walter de Gruyter GmbH, 2023-07)
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    Milivojevic, Vladimir
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    Rankovic, Ivan
    In the recent decades, endothelial dysfunction (ED) has been recognized as a significant contributing factor in the pathogenesis of many pathological conditions. In interaction with atherosclerosis, hypercholesterolemia, and hypertension, ED plays a crucial role in the pathogenesis of coronary artery disease, chronic renal disease, and microvascular complications in diabetes mellitus. Although ED plays a significant role in the pathogenesis of several pregnancy-related disorders such as preeclampsia, HELLP syndrome, fetal growth restriction, and gestational diabetes mellitus, the exact pathogenetic mechanisms are still a matter of debate. The increased prevalence of these entities in patients with preexisting vascular diseases highlights the essential pathological role of the preexisting ED in these patients. The abnormal uteroplacental circulation and the release of soluble factors from the ischemic placenta into the maternal bloodstream are the main causes of the maternal ED underlying the characteristic preeclamptic phenotype. Besides the increased risk for maternal and fetal poor outcomes, the preexisting ED also increases the risk of development of future cardiovascular diseases in these patients. This study aimed to look deeper into the role of ED in the pathogenesis of several pregnancy-related hypertensive and liver diseases. Hopefully, it could contribute to improvement of the awareness, knowledge, and management of these conditions and also to the reduction of the adverse outcomes and additional long-term cardiovascular complications.