Faculty of Medicine
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Item type:Publication, Emerging opportunistic yeast infections – literature review(Institute of public health of Republic of Macedonia, 2025-12-30)The growing threat of fungal infections demands immediate attention from healthcare systems in all countries. With the advancement of modern medicine and a growing population of immunosuppressed and immunocompromised patients, as well as critically ill patients, increasingly frequent diagnoses of invasive yeast infections have become an important cause of morbidity and mortality. In the last decade, increased incidence of non-albicans Candida species infection compared to C. albicans has been registered worldwide. Several non-albicans Candida species, such as C. glabrata and C. krusei, may be resistant to azole antifungal therapy The emergence of multidrug-resistant C. auris is the latest threat in many countries, since this fungus can cause intrahospital infections. Trichosporon species are the second most common cause of invasive yeast infections in patients with haematological malignancies, and can be resistant to amphotericin and echinocandins. Despite diagnostic and therapeutic advances, cryptococcosis continues to be a disease with unacceptably high incidence and mortality, particularly in resource-limited settings. Rhodotorula species can be a significant cause of catheter-related fungaemia, sepsis, and invasive disease in severely immunosuppressed patients. Other uncommon yeasts that can cause invasive disease in severely immunosuppressed patients include Magnusiomyces capitatus, Geotrichum candidum, Kodamaea ohmeri, Saccharomyces cerevisiae, Malassezia furfur and Sporobolomyces species. Although rare yeasts are emerging as opportunistic human pathogens, diagnosis remains challenging and treatment suboptimal. Therefore, enhanced awareness of fungal infections is crucial among healthcare providers, and this requires great knowledge and understanding, and appropriate diagnostic testing, so every segment of the healthcare system can contribute to address the challenges posed by fungal infections. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EVALUATION OF (1,3)-B-D-GLUCAN ASSAY IN RESPIRATORY SAMPLES FOR DIAGNOSIS OF ASPERGILLOSIS(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-12-16)Introduction: Aspergillosis is significant problem in immunocompromised and critically ill patients. Early diagnosis is still challenging, and therefore there is a need for rapid and more sensitive diagnostic methods. Aim: the aim was to evaluate the performance, sensitivity and specificity of the panfungal (1,3)-b-D-glucan marker in respiratory samples, compared to conventional method, for early diagnosis of aspergillosis. Material and methods: Samples of 125 patients divided into 4 groups, classified according to clinical diagnosis and EORTC/MSG criteria, were analysed at the Institute of Microbiology and Parasitology, with conventional methods and (1,3)-b-D-glucan marker in respiratory samples, during a period of two years. Results: A total of 71 isolates of Aspergillus were confirmed in this study. Four isolates originated from bloodcultures. Culture of respiratory samples revealed Aspergillus in the group of chronic aspergillosis (63.33%), followed by groups of cystic fibrosis (56.67%), primary immune deficiency (51.43%), and the group with prolonged ICU stay (43.33%). Sensitivity and specificity of respiratory samples’ culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in all four groups, respectively. Sensitivity and specificity of panfungal (1,3)-b-D-glucan marker in respiratory samples, were: 71.43% and 85.71%, 72.73% and 62.5%, 68.18% and 0%, 50% and 50%, in all 4 groups, respectively. Conclusion: Results of this study demonstrate that a positive (1,3)-b-D-glucan marker in respiratory samples highlights the value of this test as a diagnostic adjunct in diagnosis of aspergillosis, along with results from conventional mycological analyses, so timely antifungal treatment with a favorable clinical outcome, is achieved. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CHRONIC RESPIRATORY SYMPTOMS AND SPIROMETRIC PARAMETERS AMONG PROFESSIONAL DRIVERS - THE IMPACT OF OCCUPATIONAL EXPOSURE AND WORK TENURE(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-06-18) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DERMATOGLYPHIC PATTERNS AMONG STUDENTS IN NORTH MACEDONIA(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-03-24); ; ; ; Introduction: Dermatoglyphics is a scientific discipline that studies the epidermal ridge patterns present on the palmar surfaces of the hands, the toes and the plantar surfaces of the feet. Aim. An analysis of individual dermatoglyphic characteristics in healthy medical students of Macedonian and Albanian ethnicity was conducted. Material and methods: The study included 234 healthy students; palm prints were obtained and dermatoglyphic parameters were read, classified and compared with data reported in the dermatoglyphic literature. Imprinting was done by the Cummins and Midlo ink method. The reading and classification of dermatoglyphic patterns were performed according to Henry's system. Results: Ulnar loops were the most prevalent patterns, followed by circular, arcuate and complex patterns, which were present in a small percentage in both genders; radial loop was present only on the second finger in both genders. There were differences on the right hand for the second, fourth and fifth finger, and on the left hand for the third, fourth and fifth finger between males and females. Also, significant differences were found in the third and fourth interdigital spaces and hypothenar area. The triradii distribution formula in females was: a > b > d > c > t; whereas in males it was: a > t > b > c = d. Additional triradii were rare in both genders. The atd angle was within the range of 32ᵒ -55ᵒ in females and 33ᵒ -50ᵒ in males, most often 40ᵒ in both groups. Conclusion: This population-based study have shown similarities and differences in the prevalence of some dermatoglyphic features in males and females among healthy students. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparative analysis of effect of metoprolol and remifentanyl on mean arterial pressure in general anaesthesia(Medical faculty, Ss Cyril and Methodius University in Skopje, 2017) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of adductor canal block with femoral nerve block in anterior cruciate ligament reconstruction(Association of Physiologists of Macedonia, 2018) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Safety and Feasibility of Retrograde Recanalization of Radial Artery Occlusion in Patients with Need for Repeated Wrist Procedures(Scientific Foundation SPIROSKI, 2022-11-25); ; ; ; AIM: The purpose of the study was to present a new technique of retrograde recanalization of radial artery (RA) occlusion (RAO) in patients with need for repeated wrist access percutaneous angiographic procedures. MATERIALS AND METHODS: During a 10-year period from March 2011–May 2021, 53 000 patients were referred for percutaneous coronary intervention (PCI) in a high-volume transradial center. RAO on angiography was documented in 1165 patients. Retrograde recanalization of RAO was attempted in 70 patients. The selected patients were with multiple previous bilateral wrist interventions (n = 3–9). Ipsilateral ulnar artery was usually rudimented or occluded and contralateral wrist approach could not be used. We examined clinical and procedure characteristics, access site bleeding and ischemic complications and procedural success of retrograde recanalization of RAO. Visual analog scale (VAS) score forearm pain assessment was performed after procedure. Technique: All patients had palpable pulse distal of previous puncture site due to collaterals from ipsilateral ulnar and interosseous artery. The RA was punctured with an inner metallic needle with a plastic cannula. Using retrograde radial angiography performed by injecting contrast through the plastic cannula, the occluded segment was visualized and crossed with different types of hydrophilic chronic total occlusion guide wires. After sheath insertion, balloon dilatation of the occluded RA segment, successful catheterization, and/or percutaneous coronary intervention was performed. Final RA angiography was performed on all patients. RESULTS: Successful retrograde opening of RAO was achieved in 65 out of 70 patients (92%). PCI was performed in 56% of patients through the opened RAO and 5 patients underwent CAS. Procedural success through opened RA was achieved in all 65 patients. Forearm pain during procedure was present in all cases (VAS score 3 ± 2.1). Access site bleeding EASY score 3 and 4 occurred in 6 patients (8.5%). One patient had discharge of embolic material up the arm without clinical consequences. In one patient, we observed dissection of the interosseous artery. Clinical and duplex long-term follow-up with a median of 4.1 years showed patent RA in only 20 patients. There were no registered cases of hand ischemia. About 61% of patients underwent subsequent PCIs, through other alternative access sites. CONCLUSION: Retrograde recanalization of RAO is successful and safe in patients with need of repeated coronary angiography procedures and inability to use other wrist access sites. Puncturing the collateral and performing retrograde radial angiography through the cannula is a key factor in successful opening of the RAO. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SUBCLAVIAN CRUSH SYNDROME AND INAPPROPRIATE SHOCKS IN PATIENT WITH IMPLANTABLE CARDIOVERTER DEFIBRILATOR(Macedonian Association of Anatomists, 2022); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Stereological study of the Wistar rats` thymus after application of high therapeutic doses of dexamethasone and medroxyprogesterone acetate(Macedonian Association of Anatomists and Morphologists, 2017); Aim: The aim of our study was to evaluate the eventual immunosuppressive effect of high therapeutic dose of medroxyprogesterone acetate (MPA), to determine morphological and stereological thymic tissue characteristics and to compare them with the morphological characteristics induced by the high therapeutic dexamethasone (Dex) dose. Material and Methods: A total of 36 female Wistar rats were divided into three groups. The control group of rats were administered physiological solution, whereas the experimental groups received Dex at a dose of 3 mg/kg bw and MPA at a dose of 150 mg/kg bw. Drugs were administered intramuscularly every day, in a period of 7 days. Thymus paraffin sections were stained according to the following methods: hematoxylin-eosin, periodic acid-Schiff and elastica-van Gieson. The stereological measurements were performed by using the Weibel’s multipurpose test system (M-42). Results: Histological analysis in the drug-treated rats showed disrupted thymic cytoarchitecture, lymphocyte density reduction which in some areas was to a degree of lymphocyte depletion, presence of Hassal’s corpuscles in thymic lobules medulla and abundant presence of interstitial connective tissue. Stereological analysis showed a significant reduction in the thymic parenchyma volume density, which was due to the more pronounced decrease in the thymic lobules cortex volume density and a significant increase of the interstitial connective tissue volume density. Conclusion: Our results showed that the high therapeutic dose of MPA provoked a marked reduction in immunocompetent lymphoid tissue, which led in changing the proportion of thymic structural components. These resulted in an immunosuppressive effect. Almost identical changes were caused by the high therapeutic dose of Dex, but thymic parenchyma was significantly more sensitive substrate for Dex than for MPA. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Hypoplasiа of polygon of Willis(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2012);
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