Faculty of Medicine

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Author: search.filters.author.Petrushevska, GordanaStart date: 2010

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    PREVALENCE AND CO-EXPRESSION OF HPV, EBV AND CMV IN LARYNGEAL SQUAMOUS CELL CARCINOMA IN NORTH MACEDONIA
    (Здружение на микробиолозите на Македонија = Macedonian Microbiological Society, 2026-04-17)
    Baneva, Evgenija
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    Ognenoska, Biljana
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    Kostadinovska, Lenche
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    Kamshikoski, Igor
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    Micevski, Goran
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    Pathohistomorphometric and Immuno-Histologic Changes in Early Arteriovenous Fistula Failure in Patients with Chronic Kidney Disease
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2024-07-15)
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    Popov, Zivko
    Background Hemodialysis is a prevalent treatment for the end-stage chronic kidney disease (CKD) worldwide. The primary arteriovenous fistula (AVF), widely considered the optimal hemodialysis access method, fails to mature in up to two-thirds of the cases. The etiology of the early AVF failure, defined as thrombosis or inability to use within three months post-creation remains less understood, and is influenced by various factors including patient demographics, surgical techniques, and genetic predispositions. Neointimal hyperplasia is a primary histological finding in stenotic lesions leading to the AVF failure. However, there are insufficient data on the cellular phenotypes and the impact of the preexisting CKD-related factors. This study aims to investigate the histological, morphometric, and immunohistochemical alterations in the fistula vein, pre-, peri-, and post-early failure. Materials and Methods Eighty-nine stage 4-5 CKD patients underwent standard preoperative assessment, including the Doppler ultrasound, before a typical radio-cephalic AVF creation. Post-failure, a new AVF was created proximally. The vein specimens were collected during the surgery, processed, and analyzed for morphometric analyses and various cellular markers, including Vimentin, TGF, and Ki 67. Results The study enrolled 89 CKD patients, analyzing various aspects of their condition and AVF failures. The histomorphometric analysis revealed substantial venous luminal stenosis and varied endothelial changes. The immunohistologic analysis showed differential marker expressions pre- and post-AVF creation. Conclusion This study highlights the complexity of the early AVF failures in CKD patients. The medial hypertrophy emerged as a significant preexisting lesion, while the postoperative analyses indicated a shift towards neointimal hyperplasia. The research underscores the nuanced interplay of vascular remodeling, endothelial damage, and cellular proliferation in the AVF outcomes.
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    Genetic Alteration Profiling in North Macedonian Lung Cancer Patients
    (MDPI AG, 2025-10-10)
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    Background/Objectives: Late diagnosis and inefficient treatment regimens lead to poor prognosis, with a low 5-year survival rate for both non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). New targeted therapeutic agents can be developed and introduced only by first discovering new driver oncogenes and with a thorough investigation of the known driver genes. The aim of the current study is to investigate the prevalence of alterations in the eight most frequently altered genes in lung cancer-BRAF, EGFR, KRAS, ALK, ROS1, HER2, PD-L1 and PIK3CA. Methods: Real-time polymerase chain reaction (RT-PCR) was used to detect KRAS and EGFR mutations, multiplex PCR and microarray hybridization for KRAS/BRAF/PIK3CA mutations. Immunohistochemical analysis was performed for the detection of ALK, HER2/NEU, ROS-1 and PD-L1 alterations. Results: Overall, 221/603 patients (36.65%) had at least one genetic alteration, of which 22 patients (3.65%) had two genetic alterations and two patients had more than two genetic alterations. Additionally, 50 patients were identified with one or more KRAS mutations (8.29%), 45 patients with EGFR mutations (7.46%), and 1.82% with PIK3CA mutations and 0.66% with BRAF mutations. Furthermore, 50% of the co-occurring alterations were either on KRAS and PIK3CA genes (3/6), on KRAS and BRAF genes (2/6, 33.33%) or on EGFR and PIK3CA genes (1/6, 16.67%), and 10.45% of the patients exhibited PD-L1 overexpression, 5.31% ALK rearrangements, and 2.36% HER2/NEU expression, with no ROS-1 rearrangements detected. Conclusions: Comprehensive testing for somatic alterations in EGFR, BRAF, KRAS, and PIK3CA is significant in guiding therapeutic decisions in lung cancer management. Such testing should be routinely conducted to establish a thorough genetic profile of lung cancers in a manner that is both time-efficient and cost-effective.
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    Finding of a mass on the mitral valve in a patient on chronic dialysis
    (Elsevier BV, 2025-04)
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    Lazovski, Nikola
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    Mehmedovic, Nadica
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    Myxomas are cardiac neoplasms that are most commonly located in the left atrium, usually arising from the vicinity of the fossa ovalis. However, there have been cases, although very rarely, of valvular myxoma. A cardiac mass found incidentally on echocardiography can present a challenge in particular if asymptomatic or found in an unusual location. We present the case of a 58-year-old male with kidney disease treated with chronic dialysis, referred to the cardiology clinic because of an incidental finding of a mitral valvular mass on routine transthoracic echocardiography. Although this lesion was initially misdiagnosed as native valvular endocarditis with vegetation, a series of clinical and radiological investigations led to the preoperative diagnosis of possible papillary fibroelastoma or calcified thrombotic mass. Given the increased risk of embolization due to the mass being mobile and greater than 1 cm in size, the patient was referred to cardiac surgery. Excision of the mass without mitral valve replacement was performed. Histopathological findings of the mass revealed the existence of a cardiac myxoma. In such cases of a mitral valve mass, multimodality imaging should have of high priority to achieve an accurate diagnosis. Although a definitive diagnosis can only be established after surgical excision of the mass and histopathological confirmation, it is very important to consider a differential diagnosis of mitral valve myxoma in any patient with an unexplained mitral valve mass.
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    Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report
    (Vilnius University Press, 2022-12-30)
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    Dukovski, Dushko
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    Diffuse large B cell lymphoma is the most common extranodal non-Hodgkin lymphoma of the small intestine accounting for more than 50% of cases. Forty percent of these cases initially present with small bowel obstruction. Therefore, the diagnosis is usually established after surgery for bowel obstruction. The treatment is then continued with a certain chemotherapy regimens. We present a case of a 46-years-old female patient with signs of small bowel obstruction due to previously undiagnosed diffuse large B-cell lymphoma. Postoperatively, the patient was treated with 7 cycles of R-CHOP protocol and complete response was achieved in the short follow-up period.</jats:p>