Faculty of Medicine
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Item type:Publication, Complications associated with acute pulmonary embolism – data from the registry of patients with venous thrombembolism(Македонско лекарско друштво = Macedonian Medical Association, 2022); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EVALUATION OF RESPIRATORY FAILURE FOLLOWING PEDIATRIC CARDIAC SURGERY(Macedonian Association of Anatomists and Morphologists, 2021-08)Background: This study evaluated the respiratory failure (postoperative reintubation, respiratory acidosis, deterioration of gas blood, respiratory disfunctions, hypoxia) after congenital heart surgery. Material and methods: To evaluate the impact of respiratory failure (within 48 hours postoperatively) in patients undergoing congenital heart surgery. This retrospective study included 45 operated patients (male and female aged 3 to 9 months) who had undergone cardiac surgery at the University Clinic for Pediatric Surgery in a period of two years. Type of congenital heart diseases, perioperative and postoperative parameters (duration of cardiopulmonary bypass - CPB, cross-clamping of aorta, duration of stay in ICU and complications) were analyzed. Results: Of a total of 45 operated patients, five required reintubation, and their average age was 7.5 months, and median body weight 7.8 kg. Perioperative procedures were prolonged (duration of CPB - 97 minutes, aortic cross-clamping time - 59 min. and duration stay in ICU -7.2 days), caused postoperative complications (chylothorax, respiratory infection and thoracic bleeding) and worsening of respiratory failure. We evaluated postoperative respiratory failure in five reintubated patients. Conclusion: Prolongated perioperative and postoperative procedures were significantly associated with postoperative complications, worsening of the general condition and prolonged postoperative treatment. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prevalence of Rotaviruses in the Etiology of Acute Diarrhea in Young Children, Clinical forms, Extraintestinal Manifestations and Complications(Macedonian Academy of Sciences and Arts/Sciendo, 2020-12-08); ; ; ; Rotavirus is highly contagious factor with dominant feces-oral transmission. Because it is stable in external environment, transmission clusters are possible by close contact, ingestion of contaminated water or food or contact with contaminated surfaces. It survives within hours and days on hands and contaminated surfaces. This makes it the most common enteric and nosocomial pathogen in the world, especially in early childhood. In addition to the rapid dehydration with pronounced electrolyte disturbances, numerous extraintestinal possibilities have been recorded in the clinical picture, which emphasizes the need for prevention of this disease.In the period from 1.02.2018 to 31.01.2020 at the Clinic for Infectious diseases were treated 1060 patients with diarrheal disease, of which 502 children (47.36%). Rotavirus etiology was confirmed in 23.30% of the children. According to the protocols, laboratory and biochemical investigations were done to all 117 children, with tracking parameters and their dynamics of admission and discharge from the hospital. Most of the children, 84 (82.0 6%) are from urban areas, with a more confirmed epidemiological survey of 59 (42.00%). The average age of the children was 8 months, with a small percentage of children on maternal food (breastfed 25, i.e. 21.37%), with high febrile admission in 99% of children with an average temperature of 38.5oC and an average febrile duration of 4 days, with an average of 7 (+ 2.49) of stools and 5 (+ 2.12) of vomiting. There was a significant difference in hematocrit, leukocyte, electrolyte, glycaemia, and CRP values on admission and discharge. There was predominant isonatremic dehydration, and the compensatory mechanisms followed by the values of the electrolytes ABS, Ph, BE showed a tendency to maintain within the physiological limits. The clinical picture of extraintestinal manifestations included bronchitis, mesenteric lymphadenitis, upper respiratory infections and rash.Rotavirus infection is a serious health and economic problem in our country, so it needs continuous prevention and monitoring in order to reduce the incidence, and thus the need for hospitalization and cure of rotavirus disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Impact of Pneumonia on the Course and Outcome in Patients with Seasonal Influzenza(Macedonian Academy of Sciences and Arts/Sciendo, 2020-09-01); ; ; ; Introduction: Seasonal influenza, although often presented as a mild, self-limiting disease, is frequently accompanied by complications that lead to the development of a severe clinical presentation and a fatal outcome. The most common are respiratory complications, with secondary bacterial pneumonia being the leading cause. Aim: The aim of this study is to determine the impact of pneumonia on the severity of the clinical presentation and outcome in patients with seasonal influenza. Materials and methods: This research is comparatively group-based and has been conducted at the University Clinic for Infectious Diseases and Febrile Conditions during a three-year period. The analysis consists of 122 adult patients with clinically and laboratory-confirmed influenza. Based on the severity of the clinical picture, the patients are divided into two groups, severe (n=87) and mild (n=35) forms of the disease. The study included demographic, general data, clinical symptoms, and signs as well as complications. Results: Of 122 patients with seasonal influenza, complications were registered among 108(88.52%), with a significantly more frequent emergence among the group with severe influenza 93.1% vs 77.14% (p=0.012). Pneumonia was the most common 98(80.33%) and had a significant effect on disease severity (p=0.002). Complications from the types of ABI 8(6.56%), ARDS 7(5.74%), sepsis 5(4.1%), DIC 4 (3.28%) and otitis 2(1.64%) were reported only in the group with severe influenza. Acute meningoencephalitis was registered among 5(4.1%), gastroenterocolitis among 3(2.46%), and hepatic damage among 14(11.47%) of patients. Conclusion: Pneumonia as the most common complication among patients with seasonal influenza significantly impacts the clinical course and outcome of the illness. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Complications and Risks of Percutaneous Renal Biopsy(Scientific Foundation SPIROSKI, 2019-03-30); ; ; ; Renal biopsy performed in native and transplant kidneys is generally considered a safe procedure. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ultrasound - Guided Percutaneous Sclerotherapy of Simple Renal Cysts - Five Years Report(Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs, 2020); ; ; ; Introduction. The sclerotherapy is considered a safe and effective treatment of simple renal cysts, usually per- formed by urologists. It was a five-year retrospective report on our tertiary clinical experience with simple renal cysts sclerotherapy performed by nephrologists. Methods. We analyzed the medical histories of patients who underwent sclerotherapy from January 2015 until the end of December 2019 counting overall 23 sessions of sclerotherapy. The method (aspiration or drainage) was chosen according to cyst size and depth. Sclerothe- rapy with 96% alcohol was performed. The cyst size was recorded, and the curative effect was evaluated by the residual cyst volume; over 20% residua in the cyst size was considered as a failed treatment. Patients we- re reexamined by ultrasound at 12-month follow-up, or earlier if symptomatic. Results. The mean age of patients was 58.68±11.08 years and majority of them were females. Most of the cysts [17] induced flank pain, dysregulated hypertension was present in 22% of patients and one have obstructted the urine flow. The mean cyst volume was 540±307.51 ml. All cysts were successfully treated. The mean cyst volume decreased significantly. Concerning the compli- cations, sporadic cases of pain and vomitus occurred du- ring only three treatment procedures. At the follow-up, all patients who suffered from unsatisfactory blood pre- ssure control improved and the hydronephrosis resolved. In five cases there was reoccurrence of a symptomatic cyst, with a need of re-treatment in the follow-up period. Conclusion. Ultrasound-guided aspiration and sclerothe- rapy of simple renal cysts is a safe and effective proce- dure that may be carried out by nephrologists. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Diagnostic and complications of Covid 19 surgical patients(MedCrave, 2021-07-08); Otljanski, M - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The most common complications in intensive care unit department after cardiac surgery in children(Macedonian association of anatomists and morphologists, 2018)Introduction: Having regard all the progress in the field of pediatrics, nowadays heart surgery can be performed with excellent outcomes. Serious complications can cause high morbidity and mortality rates. This study has been performed in order to determine the incidence of morbidity and mortality. Methods: During 2013-2015, the retrospective study was performed with 65 patients undergoing surgery for congenital heart disease which was reviewed for incidence of complications. We used the database of University Clinic for Children's Diseases and University Clinic of Pediatric Surgery in Skopje. Results: 33 children with complications, have been divided into 2 groups cardiac and extra cardiac complications with mean age of 6,5 ± 0,35 (rang 0,5 - 108 months). The first group included SVT (6,25 %), AV-block (6,25 %), pacing (6,25 %) and pericarditis (9,3 %). In the extra cardiac complications, the most common was bleeding (12,5 %), renal failure (9,3 %), chylothorax (9,3 %), seizures (9,3 %), reintubation after surgery (15.6 %), sepsis (12,5 %) and severe pneumonia (6,25 %). The duration of CPB was 68,32 ± 31,9 minutes, the duration of MV was 2,04 ± 2,42 days, and ICU stay was 3,90 ± 3,45. The incidence of mortality was 9,2 % whereby the most common was sepsis, reoperations for previous lung chronic diseases and renal failure. Conclusion: Prolonged duration of CPB, duration of MV and ICU stay, are significant risk factors for the increased number of cardiac and extra cardiac complications. It is necessary to apply the measures and careful monitoring of patients to minimize these effects.