Faculty of Medicine
Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14
Browse
8 results
Search Results
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, Surgical complications in COVID-19 patients in the setting of moderate to severe disease(Baishideng Publishing Group Inc., 2021-08-27); Velikova, TsvetelinaThe coronavirus disease 2019 (COVID-19) pandemic has had a considerable impact on the work of physicians and surgeons. The connection between the patient and the surgeon cannot be replaced by telemedicine. For example, the surgical staff faces more serious difficulties compared to non-surgical specialists during the COVID-19 pandemic. The primary concerns include the safest solutions for protecting healthcare staff and patients and the ability to provide adequate surgical care. Additionally, the adverse effects of any surgery delays and the financial consequences complicate the picture. Therefore, patients' admission during the COVID-19 pandemic should be taken into consideration, as well as preoperative measures. The COVID-19 situation brings particular risk to patients during surgery, where preoperative morbidity and mortality rise in either asymptomatic or symptomatic COVID-19 patients. This review discusses the recent factors associated with surgical complications, mortality rates, outcomes, and experience in COVID-19 surgical patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COVID-19 in the endoscopy unit: How likely is transmission of infection? Results from an international, multicenter study(Baishideng Publishing Group Inc., 2021-09) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A rare presentation of an elderly patient with acute lymphocytic leukemia and platelet count of zero associated with ST-elevation myocardial infarction, pulmonary thromboembolism in the setting of SARS-CoV 2: a case report(Springer Science and Business Media LLC, 2021-05-01); Moscatelli, SaraNovel coronavirus disease 2019 (COVID-19) is known to lead not only to severe acute respiratory syndrome, but also can result in thromboembolic events in both the venous and the arterial circulation by inducing coagulation disorders. The potential causes of coagulopathy are inflammation, platelet activation, endothelial dysfunction, and stasis. The thrombotic events including pulmonary embolism, deep venous thrombosis as well as intracatheter thrombosis are more likely to develop in patients infected with severe form of SARS-CoV-2 who are admitted to ICU. Furthermore, these events contribute to multi-organ failure. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE EFFECT OF METHYLPREDNISOLONE VERSUS DEXAMETHASONE IN INCREASING THE DIABETOGENIC EFFECT OF SARS-CoV-2 INFECTION AND THE DEVELOPMENT OF A NEW-ONSET DIABETES MELLITUS(Macedonian Association of Anatomists, 2022); ; ; Milenkovski, MarijanSARS-CoV-2 causes predominantly lung disease, but by way of binding to the angiotensinconverting enzyme 2 (ACE2) receptors, it can attack key metabolic organs and may lead to alterations of glucose metabolism. The aim of the study was to examine the effect of methylprednisolone compared with dexamethasone on the glycaemic control as well as the development of new-onset diabetes in patients who were hospitalized due toCOVID-19 pneumonia. We reviewed the records of 203 consecutive patients who were hospitalized with a clinical presentation of COVID-19 pneumonia in the modular hospital at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, from December 2020until May 2021. We identified 65 patients with diabetes (32,0%), 49 patients (75%) of whichwith pre-existing diabetes, and 16 (25%) with newly diagnosed diabetes. Impaired glycoregulation was recorded in 19,2% of patients, of whom 5,5% did not receive any corticosteroid-therapy, 22,4% were treated with methylprednisolone – pulse doses,and 21,4% were treated with dexamethasone. Patients with diabetes had a 1,9 times (CI 0,9-3,9) higher mortality rate than nondiabetic patients. We suggest that, if corticosteroid therapy is necessary during the treatment of COVID-19 pneumonia, it is safer to administer dexamethasone than methylprednisolone, especially in patients who have pre-existingdiabetes or are at risk ofdeveloping diabetes. Deterioration of glycoregulation and the need to replace oral antidiabetic therapy with insulin are common. New-onset diabetes often persists even after recovering from Covid-19 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Insight in the Current Progress in the Largest Clinical Trials for Covid-19 Drug Management (As of January 2021)(Macedonian Academy of Sciences and Arts/Sciendo, 2021-04-23); ; Abstract The outbreak of the COVID-19 pandemic has generated the largest global health crisis of the 21st century, evolving into accelerating socioeconomic disruption. In spite of all rapidly and widely emerging scientific data on epidemiology, diagnosis, prevention and treatment of the COVID-19 disease, severe acute respiratory coronavirus 2 (SARS-CoV-2) is continuing to propagate in lack of definitive and specific therapeutic agents. Current therapeutic strategies are mainly focused on viral inhibition by antiviral drugs and hampering the exuberant immune response of the host by immunomodulatory drugs. In this review, we have studied the reports of the largest clinical trials intended to COVID-19 treatment published during the first year of the pandemics. In general, these results concentrate on seven therapeutic options: remdesivir, chloroguine/hydroxychloroquine, lopinavir-ritonavir combination, corticosteroids, tocilizumab, convalescent plasma and monoclonal antibodies. In line with the reviewed data, as of January 2021, most of the evidence support the use of remdesivir in hospitalized patients with moderate and severe forms of the disease and provide reliable data on the substantial beneficial effect of corticosteroids in patients requiring supplemental oxygen. Moreover, preliminary RECOVERY trial results have demonstrated the efficacy of tociluzumab in the treatment of critically ill patients. The reports presenting the outcomes of the other immune-based therapies under investigation are enthusiastically awaited. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study(Wiley-Blackwell, 2021-11); ; We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or ≥ 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Back to the basics: Propolis and COVID-19(Wiley Online Library, 2020-07); ; The epidemiological burden of COVID-19 is a healthcare challenge throughout the world, not only in terms of testing the limits of medical capacities, but also as an enigma considering preventive strategies and methods. The upper respiratory tract mucosa is the first line of defense, as a physical barrier, as well as through multiple innate and adaptive immune mechanisms which are crucial for efficient antiviral responses. Identifying methods able to reduce or prevent colonization, viral adhesion, and promote virus shedding on mucous membranes or have the ability to inactivate pathogens and thus reduce virus dose and/or increase immune response would be essential in the management of COVID-19 outbreak and help in flattening the curve. We review the effects of propolis, an old remedy with proven antiviral properties, as a possible low-cost inhibitor of SARS-CoV-2 in the oropharyngeal niche, prophylaxis, or adjuvant therapy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CANDIDA INTERTRIGO IN A PATIENT ON ICU POSITIVE TO COVID19(Association of the Albanian Doctors from Macedonia, 2021);