Faculty of Medicine
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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); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Morphological characteristics of circulus arteriosus cerebri - Circle of Willis(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2012); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of pediatric patients with juvenile idiopathic arthritis treated with biological therapy tocilizumab (actemra)(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2021-10-06); ; ; Gjurkova-Angelovska BetiJuvenile idiopathic arthritis (JIA) is the most common chronic disease in childhood. It manifests a heterogenic group of symptoms of arthritis, lasting at least 6 weeks and it appears before the age of 16. Patients who had no good therapeutic response to conventional therapy with Methotrexate were treated with biological therapy. The aim of this paper was to evaluate 9 patients who were receiving Tocilizumab at the Department of Rheumocariology, University Clinic of Pediatric Diseases in Skopje. Materials and methods: Our study included 9 patients treated at our Department with biological therapy with Tocilizumab. Prior to initiation of the biological therapy, all patients underwent laboratory investigations, purified protein derivate (PPD) skin test for tuberculosis, X ray of the lungs and heart, and analysis of hepatitis markers. All patients were treated with amp. Actemra( Tocilizumab) 8mg/kg /tt i.v. Two of the patients had a severe form of the disease (one with severe systemic form and one with severe oligoarticular form of JIA). All presented patients had clinical remission of the disease. Conclusion: Therapy with tocilizumab in patients with juvenile idiopathic arthritis is a good therapeutic choice. The results obtained in our study have shown a significant therapeutic effect of tocilizumab even in severe forms of the disease - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Lung Function Impairment in Construction Workers – Influence of Smoking and Exposure Duration(Scientific Foundation SPIROSKI, 2021-05-08); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anatomy of middle cerebral artery(Macedonian Association of Anatomists and Morphologists, 2012); ; ; Cerebral circulation, especially arterial, in recent decades has attracted the interest of anatomsits and clinicians. The importance of the cerebral arterial system is due to the exceptional importance of the organ that it supplies and the fact that cerebrovascular pathological processes are the leading place primary cause of morbidity and mortality. The aim of this study was to determine the morphological and topographic characteristics of the middle cerebral artery: shape, position, diameter, length; the number, types and distribution of its branches and the correlation of these vessels with adjacent brain structures. The examination was made on 50 specimens of human brain fixed in 10% formalin. The shape, postion, diameter and length of the middle cerebral artery were assessed, as well as the number, types and distribution of branches and correlation with adjacent brain structures. We present the obtained results and the most common variations. The importance of the MCA is a result of the significance of the structures it supplies.
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