Faculty of Medicine
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Item type:Publication, 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); ; ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Factors Affecting In-Hospital Mortality in Patients with Hip Fracture(Albanian Society for Trauma and Emergency Surgery, 2022-01-20); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gastric metastasis from high-grade soft tissue sarcoma: a rare occurrence with literature review(Oxford University Press and JSCR Publishing Ltd, 2025-03-15); ; Todorova, TeodoraMetastasis of high-grade soft tissue sarcoma to the stomach is an extremely rare occurrence. While sarcomas can spread to distant organs,they most commonly metastasize to the lungs,liver,and bones.We report a unique case of gastric metastasis from a high-grade soft tissue sarcoma,occurring 4 years after the initial diagnosis of fibrosarcoma in the right femoral region.The patient did not undergo adjuvant chemotherapy and developed a large soft tissue metastasis in the left gluteal region 2 years later. After 4 years, he presented with a second soft tissue metastasis and suspected metastatic lung nodules. Symptoms of melena and severe anemia prompted a gastroscopic examination, which revealed gastric metastasis from a high-grade soft tissue sarcoma. Due to severe anemia, a palliative gastric resection was performed.A review of the literature indicates that metastatic leiomyosarcomas are the most frequently reported sarcoma subtype metastasizing to the stomach. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RARE TENDON SHEATH GIANT CELL TUMOR OF THE THUMB – CASE REPORT(Македонско друштво на ортопеди и трауматолози = Macedonian Association of Orthopedics and Traumatology, 2022); ; ; Dalipi, RezeartGiant cell tumor of the tendon sheath is benign soft tissue tumor. The literature shows it affects people between age of 30 to 50 years with no gender predominance. Giant cell tumor is benign tumor which sometimes has potential to reappear. After radical surgical removal, according to the literature, 15%44% of the patients have recurrence of the tumor on the same location. This type of tumor is usually located on the fingers, and resembles the second most common benign tumor of the hand. In this report we present a surgically treated patient with giant cell tumor of the tendon sheath in the palmar part of the distal phalanx of the right thumb. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE IMPORTANCE OF FOLLOWING THE ORIGINAL PONSETI METHOD IN TREATMENT OF CLUBFOOT: THE IOWA EXPERIENCE(Македонско друштво на ортопеди и трауматолози = Macedonian Association of Orthopedics and Traumatology, 2022); ; ; Dr. Ignacio Vives Ponseti, an American orthopaedic surgeon with Spanish origin, was born on June the 3rd, 1914 and died at the age 95 in Iowa, USA, on October 18th 2009. He was a brilliant pediatric orhopaedic surgeon, best known for his method of nonoperative treatment of clubfoot, that has become a gold standard of clubfoot treatment. His iconic paper on clubfoot management (1963) is one of the few manuscripts in orthopaedic literature which has radically changed the practice as we know it now. The Ponseti method is easy to learn but, unfortunately easy to modify because modification negatively affects the treatment outcome. That emphasizes the need to learn and follow the exact steps explained by Dr. Ponseti. The first author of this article had the opportunity to learn this method in the place where it all started, guided by Dr. Jose Morcuende, the successor of Dr. Ponseti who continues his legacy in the brightest way possible. After return from the stay at Iowa Stead Family Children’s Hospital 16 patients and 23 feet were treated with best possible adherence to the Ponseti Method. We began using the original Ponseti method in October 2019. Since then, 16 patients, 7 bilateral, 9 unilateral (23 feet in total) have been treated and evaluated. We strove as much as possible to reproduce Ponseti’s strict casting protocol faithfully, as explained in the paper. Usually, for correction of the first three components 4 to 10 casts are necessary, changed on a weekly basis. Equinus is the last deformity to be corrected. In order to avoid prolonged casting and concomitant appearance of rocker bottom deformity, the correction of equinus is facilitated by a simple operative procedure in local anesthesia. Sixty five percent of the patients had good results, 31% had acceptable results, in one patient there was poor result. Compared to the original Ponseti paper from 1963, there is not any significant difference in the results, except the bigger percent of poor results that involves only one patient in our series. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; Todorova, TeodoraIntroduction: 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Conoccurence of extraskeletal osteosarcoma and undiagnosed Paget disease in a 49-year-old female(Oxford University Press (OUP), 2025-01); ; Angelovska, TamaraExtraskeletal osteosarcoma (ESOS) represents a rare soft tissue entity, accounting for ⁓1% of all soft tissue malignancies. It is generally considered to have an even worse prognosis than bone osteosarcoma, therefore detailed investigations and proper treatment are required. ESOSs arising in the subcutaneous tissue are even rarer than the ones positioned in deep tissues, and they are considered to have far better outcomes. We present a case of a 49-year-old patient diagnosed with subcutaneous ESOS and Paget disease of the bone, which is not typical for the patient's age, considering that Paget disease of the bone tends to affect a population above 50 years. The coexistence of these two entities in a single patient and all their features make this case unique, and to the best of our knowledge, this is the first case reported. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Autologous vascular proximal fibular graft in the treatment of giant cell tumor of the distal radius-a case report(Oxford University Press and JSCR Publishing Ltd., 2024-08); ; Giant cell tumor of bone (GCTB) represents an intermediate, locally aggressive tumor, with a peak of incidence in the third decade of life with female predominance (2:1). The distal radius is the third most common localization and especially challenging in the treatment is saving the wrist joint function. In this report, we present a case of a 32-year-old patient diagnosed with a giant cell tumor of the distal radius, primarily treated with curettage of the bone. Due to aggressive tumor recurrence, considering local control of the tumor, we decided to perform a resection of the distal radius and reconstruction with an autologous proximal vascular fibular graft. We performed a SPECT/CT scan to confirm the functionality of the graft. We find this procedure a safe technique for local control of tumor recurrence and an ideal substitute for a limb salvage procedure. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparative analysis of hidden blood loss in total knee arthroplasty(Scientific Foundation SPIROSKI, 2021-11-20); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PERCUTANEOUS AS A MINIMALLY INVASIVE TECHNIQUE FOR ACHILLES TENDON RUPTURE(University Ss. Cyril and Methodius in Skopje, 2022); ; Trajanovski, AleksandarThe 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