Faculty of Medicine

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Author: search.filters.author.Bozinovska Beaka, GordanaHas files: Yes

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    A Case Report of Intraoperatively Diagnosed Cholangiocarcinoma after Unsuccessful Conservative Treatment of ERCP Complicated with Hemorrhage
    (Vilnius University Press, 2018-12-03)
    Bozinovska Beaka, Gordana
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    Zdravkovska, Milka
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    Burova, Blagica
    Cholangiocarcinoma is a malignant tumor arising from the epithelium of the bile ducts. Most of these tumors are adenocarcinomas [1]. Intrahepatic cholangiocarcinoma accounts for 10% of all cholangiocarcinomas, hilar cholangiocarcinoma for 25%, and extrahepatic cholangiocarcinoma for 65% [2, 3]. Cholangiocarcinoma can develop in any part of the extrahepatic duct, occurring in 50–75% of reported cases in the upper third of the duct including the hepatic hilum, in 10–25% in the middle third, and in 10–20% in the lower third [4–6]. Approximately 95% of cases show extrahepatic obstruction at the time of diagnosis [7]. In a meta-analysis of 21 prospective trials, the rate of hemorrhage as a complication of ERCP was 1.3% (95% CI, 1.2%–1.5%) with 70% of the bleeding episodes classified as mild [8]. Hemorrhagic complications may be immediate or delayed, with recognition of occurring up to 2 weeks after the procedure. The risk of severe hemorrhage (ie, requiring >5 units of blood, surgery or angiography) is estimated to occur in fewer than1 per 1 000 sphincterotomies [9]. Despite new and advanced diagnostic methods, sometimes this type of tumor is finally diagnosed from pathological findings on excised tissue.
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    Comparative Study for Application of Polypropylene Monofilament Light Mesh, Polypropylene Monofilament Heavy Mesh and Self Gripping Polypropylene Mesh in Patients with Inguinal Hernia Surgically Treated with Lichtenstein Technique
    (Vilnius University Press, 2020-12-29)
    Bozinovska Beaka, Gordana
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    Zdravkovska, Milka
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    Kalamaras, Patricija
    <jats:p>Background / Objective. In our clinical study we have compared the results of intraoperative and postoperative period in patients with inguinal hernia treated operatively with Lichtenstein technique, where one of three different polypropylene meshes has been applied: polypropylene monofilament light mesh, polypropylene monofilament heavy mesh and self gripping polypropylene mesh. Follow up period have been one year. Methods. This study represents randomized, retrospective-prospective, comparative clinical study where 243 patients have been divided into three groups depends of prosthetic mesh that was applied with Lichtenstein technique. We have evaluated the connection between types of used mesh with some of followed parameters: postoperative pain intensity, postoperative patient mobilization, postoperative surgical site occurrences, duration of hospitalization, chronic pain, filling of foreign body in inguinal area and development of recurrences. Results. Patients with applied self gripping polypropylene mesh have significantly lowest pain, lowest hospital stay and lowest duration of surgical procedure than other two groups of patients. In term of chronic pain, only statistically significance we confirmed between the groups of heavy monofilament mesh and self griping polypropylene mesh, where higher number of patients from group with monofilament polypropylene light mesh reported chronic pain. In our study we confirmed that working status and patient age have significant influence on the intensity of postoperative pain in all three patients group. There is no statistical correlation between type of the mesh and surgical site occurrence rate. Conclusion. Patients with applied self gripping polypropylene mesh have significantly lowest pain, lowest hospital stay, lowest duration of surgical procedure and less number of patients experienced feeling of “foreign body” in their groin than other two groups of patients.</jats:p>
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    METASTATIC CUTANEUS MELANOMA OF THE GALLBLADDER-CASE REPORT
    (Association of medical doctors "Sanamed" Novi Pazar, 2019-08-04)
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    Nancheva Bogoevska, Andrea
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    Bozinovska Beaka, Gordana
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    Gjoreski, Aleksandar
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    Melanoma is an aggressive malignant tumor that originates from melanocytes and most com- monly occurs on the skin. Dominantly metastasize to regional lymph nodes, in the brain and lungs and rarely in the gastrointestinal (GI) system. The aim of this re- port is to present a rare case of metastasis of cutaneous malignant melanoma in the gallbladder, discovered 10 months after excision of the primary melanoma of the skin. A 45-year-old patient was hospitalized in our hos- pital due to abdominal pain in right upper quadrant and nausea lasting for 7 days. An intraluminal substrate was found in the gallbladder with computed tomogra- phy and later a CT guied biopsy was performed on it, thus proving a metastatic deposit of primary malignant melanoma. Metastatic deposits in the gallbladder are extre- mely rare finding, and 238 cases have been described in the literature.