Faculty of Medicine

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Author: search.filters.author.Todorova, TeodoraHas files: No

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    METASTATIC EXTRAOSSEOUS ACCUMULATION OF 99MTC-MDP IN A PATIENT WITH GIANT CELL TUMOR OF THE HUMERUS – A CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024)
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    Todorova, Teodora
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    Proposed mechanisms for extraosseous 99mTc - MDP uptake are extracellular fluid expansion, enhanced regional vascularity and permeability, and elevated tissue calcium concentration. It can be due to nonmalignant causes, such as parathyroid adenoma, vitamin D intoxication or Paget disease or can be of malignant origin. Malignant conditions are sometimes associated with a life-threatening hypercalcemia and metastatic calcifications.
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    Factors Affecting In-Hospital Mortality in Patients with Hip Fracture
    (Albanian Society for Trauma and Emergency Surgery, 2022-01-20)
    Popovska, Danica
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    Dalipi, Rezeart
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    Todorova, Teodora
    Background. The prevalence of hip fractures is steadily increasing, as the population ages. These fractures are associated with significant morbidity and mortality. Most of these fractures are treated surgically. Factors related to surgical intervention can play a significant role in the outcome. This study examines the association of in-hospital mortality with the timing of surgery, sex, and age of patients treated surgically due to a hip fracture at Clinical Hospital Shtip in a 2-year long period. Material and Methods. A total of 348 patients admitted with a diagnosis of hip fracture who were treated surgically were identified. Data about sex and age were collected. The outcome was assessed for groups treated within 24, 48, 72, and more than 72 hours after admission. Descriptive statistical methods, chi-square test, t-test for independent samples, and odds - ratio with 95% confidence interval (CI) were used in statistical analysis. Results. The delay of surgical treatment beyond 24 hours did not increase the risk of death (OR=0.65, 95%CI=0.23-1.73). Delays beyond 48h and 72h increased the risk of death progressively (OR=1.17, 95%CI=0.50-2.75, and OR=1.65, 95%CI=0.69-3.95 respectively). Mortality was significantly higher in the 76-85-years age group. Conclusions. Association between surgical delay and in-hospital mortality in hip fracture patients is disputed. Confounding factors such as age, sex, comorbidities, and type of treatment determine the outcome. Patients with hip fractures, without any additional disease, should be operated on as soon as possible after admission to the hospital. Delay beyond 48 hours may increase the risk for in-hospital mortality.
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    REGIONAL ANESTHETIC MANAGEMENT OF A PATIENT WITH CHARCOT MARIE TOOTH DISEASE WITH HIP FRACTURE
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024)
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    Dimitrovski, Aleksandar
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    Todorova, Teodora
    Introduction: Charcot-Marie-Tooth disease (CMT) is a hereditary peripheral neuropathy characterized by progressive peripheral muscular atrophy and muscle-sensitive disorders, especially in extremities. The choice of anesthesia in these patients is a great challenge, as the neurological symptoms may worsen. Case presentation: Female S.G., 53 years old, with a previously diagnosed Charcot Marie Tooth disease, was admitted to the Clinic for Orthopedic Diseases in Skopje for the treatment of a basicervical fracture of the femur. Apart from the existing neurological disease, the patient had no other comorbidities. An indication for surgery was set, and regional, i.e. spinal anesthesia was the choice for the surgical management of the patient. In the postoperative period, the patient was treated with analgesic therapy. After 9 days of treatment at the Clinic for Orthopedic Diseases, the patient was discharged in good general condition, without worsening of the neurological symptoms. Conclusion: Regional anesthesia has been shown to be a safe type of anesthesia in surgical treatment of the lower limb.
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    Comparative analysis of hidden blood loss in total knee arthroplasty
    (Scientific Foundation SPIROSKI, 2021-11-20)
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    Shabani, Ilir
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    Velkovski, Vilijam
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    Todorova, Teodora
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    The aim of the study was to investigate the influential factors for hidden blood loss after a total knee arthroplasty and their relationship with the total blood loss. Total knee arthroplasty (TKA) is a crucial treatment of late-stage knee osteoarthritis. Measured blood loss is significantly inconsistent with the hemoglobin (HB) drop postoperatively. Fifty-four patients, 20 males and 34 females, were retrospectively analyzed. The preoperative blood loss and therefore the hidden blood loss following TKA were calculated by the Gross formula. The typical perioperative blood loss was found to be 780±220 ml and therefore the average hidden blood loss was 280±180 ml. No significant differences were found in hidden blood loss for males compared to females. Hidden blood loss may not be reduced by hemostasis during operation with a deflated tourniquet.
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    PERCUTANEOUS AS A MINIMALLY INVASIVE TECHNIQUE FOR ACHILLES TENDON RUPTURE
    (University Ss. Cyril and Methodius in Skopje, 2022)
    Gjorgjieska, Kornelija
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    Dalipi, Rezeart
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    Trajanovski, Aleksandar
    The Achilles tendon is the strongest tendon in the human body. When the applied force exceeds the tensile capacity of this tendon, which occurs when the ankle bends abruptly under the action of a compressive force, the tendon is at risk of rupture. The incidence of rupture ranges from 18 per 100,000. Certain antibiotics, long-term steroid use, tendinopathy, and other degenerative disorders are known to increase the risk of rupture, yet the leading cause remains traumatic injury, with predominance in men aged 30 to 50 years. There are two types of treatment: conservative and surgical. Recent studies have shown a difference in outcome between non-surgical and surgical treatment. Meta-analyses have shown that non-surgical treatment increases the risk of re-rupture, while open surgery has a risk of early complications and infection. It is necessary to find a solution to minimize the postoperative complications of open surgery, and possible relapses after the application of conservative treatment, treated with plaster immobilization. Therefore, there is a need for the use of minimally invasive surgery, which has been adopted as a smart way to reduce the rate of postoperative infections. It is also clear that the treatment must be tailored to the needs of each patient individually