Faculty of Medicine

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Author: search.filters.author.Ivkovska, SanjaStart date: 2024

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    Gallbladder and gastric metastasis as initial presentation of an undiagnosed primary lobular breast carcinoma
    (Oxford University Press (OUP), 2026-02-24)
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    Ivkovska, Sanja
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    Filipovski, Vanja
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    Kubelka Sabit, Katerina
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    Jasar, Dzengis
    The most common sites for breast cancer metastases include the bones, lungs, liver, and brain. Metastases in the GI tract are rare and predominantly originate from lobular breast cancer. Gastric involvement by invasive lobular carcinoma (ILC) is rare and can mimic primary gastric malignancies, leading to diagnostic challenges. Metastasis of ILC to the gallbladder is exceedingly rare and often identified incidentally during cholecystectomy performed for presumed benign conditions. We present a case of a 62-year-old female patient with symptoms of weight loss and dysphagia. After CT and gastroscopy, gastrectomy and cholecystectomy were performed due to suspicion of gastric carcinoma. Histology and immunohistochemical profiling, with estrogen receptor (ER), progesterone receptor (PR), E-cadherin, GATA3, Mammaglobin, and GCDFP-15, favored the diagnosis of lobular breast carcinoma metastasis over primary gastric adenocarcinoma. Awareness of these atypical presentations is crucial for accurate diagnosis and effective management, as misdiagnosis can result in suboptimal treatment strategies.
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    Knowledge, attitudes and practices towards the influenza vaccine among the adult population in North Macedonia
    (Royal Academy of Medicine of the Balearic Islands, 2024-01-22)
    Gacova, Ivana
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    Radevska, Ana Marija
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    Ivkovska, Sanja
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    Brava, Edmond
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    Skeparovska, Keti
    Introduction: Vaccination against seasonal influenza is the most effective way to prevent infections, hospitalization, morbidity, and mortality. The objective of the study was to assess the knowledge, attitude, and practices of the North Macedonia adult population towards seasonal influenza vaccine. Materials and methods: A prospective cross-sectional study in November-December 2022 among the adult population of North Macedonia was conducted. A total of 1012 respondents filled in the 4-item semi-structured questionnaire. The questionnaire collected information on demographics, knowledge, attitudes, and practices towards the influenza vaccine. The chi-square test was used to test for associations and logistic regression was used to determine the effect of variables on the possibility of vaccination. Results and discussion: The median age of the respondents was 36 years, predominantly female (73.5%). Only 7.8% of respondents received the influenza vaccine in the previous season (2021/2022) and 12.4% planned to vaccinate in the current season. A statistically significant difference between the vaccinated and non-vaccinated individuals was established in terms of age groups and the presence of comorbidity (χ2=11.246, p=0.004). The vaccinated respondents significantly more often tend to consider the influenza vaccine as safe (χ2=5.026, p=0.025) and effective (χ2=11.247, p=0.001). Respondents who had comorbidities, who considered the vaccine as effective, and were not afraid of possible side effects were 3 times, 2.0 times, and 1.8 times more likely respectively to have received an influenza vaccine. Additionally, the respondents who tend to rely more on social media and internet as the main source of information regarding the flu vaccine were 0.5 times more likely to have rejected the vaccine. Conclusion: Addressing influenza vaccine safety, efficacy, patient-specific recommendations and encouraging effective physician communication and counselling are some of the key areas for increasing knowledge and awareness.