Faculty of Medicine

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    Trend of Kidney Replacement Therapy in North Macedonia from the Years 2015 Through 2020
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2024-11-01)
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    Simjanovska, Simona
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    Rushiti, Emine
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    Cibrev, Dragan
    Kidney replacement therapy (KRT) by dialysis or kidney transplantation represents the main treatment modalities for patients with kidney failure. Here we evaluate the trends in taking care of such patients in North Macedonia from 2015 through 2020.
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    Echocardiographic Heart Changes in Pregnancies Complicated with Gestation Hypertension and Preeclampsia
    (International Scientific Invention Journals, 2019-02-13)
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    Milkovski, Daniel
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    Introduction: Echocardiography as an imaging method is increasingly being used in obstetrics in the management of hemodynamic changes which occur in normal but also in pregnancies with gestational hypertension/preeclampsia. Aim: The aim of the study is to show that some of the heart changes in pregnancies complicated with gestational hypertension and preeclampsia are abnormal and further follow up of these patients is needed. Methods: A total of 81 patients were enrolled in the study. The patients were further divided in two groups. Pregnant women with gestational hypertension or preeclampsia (51) and a control group of normotensive pregnancies (30). A total of 3 echocardiograph exam were made, the first upon entry in the study (28 -34 g.w), the second 2 weeks after delivery and the last 6 months after delivery. Results and discussion: We found several statistically significant results that involve the IVS, PWLV, LKM, left chamber hypertrophy and diastolic function. Diastolic dysfunction usually shows up before systolic dysfunction in the evolution of ischemic/hypertensive cardiovascular disease and is of prognostic value in predicting long term cardiovascular morbidity. The changes seen 6 months after delivery on our last control mean that those changes are permanent and need further prevention strategies. Conclusion: From the noninvasive methods echocardiography is the most favorable method in identifying structural changes and functional changes in pregnancies with hypertension. Echocardiography allows fast, reproducible information and is both safe for mother and fetus.
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    Pregnancy in End-stage Renal Disease Patients on Long-term Hemodialysis: Two Case Reports
    (Macedonian Society of Nephrology, Dialysis, Transplantation and Artifical Organs, Department of Nephrology, 2010)
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    Tozija, Liljana
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    Gelev, Saso
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    Adamova, Gordana
    Although still uncommon, pregnancy in haemodialysis (HD) patients does occur and frequency has been increased in the past 20 years. But unfortunately, the rates for premature delivery, neonatal death, maternal hypertension, and preeclampsia in the pregnant HD patient are much higher than in the general population. Infants are often born both prematurely and small for gestational age. We report here two cases of pregnancy in women on long-term HD, one successfully and the other unsuccessfully managed, despite the same treatment strategy. Case 1 was a 43-year-old female patient, 10th gravida, after six years of maintenance HD whose pregnancy was successfully managed up to the 33rd week of gestation with a delivery of a healthy boy weighing 2,100 g. Case 2 was a 32-year-old female patient, 2nd gravida, after five years of maintenance HD, whose pregnancy ended in spontaneous abortion with intrauterine death at week 19 of gestation. Maternal hypertension and anemia contributed partly to the unsuccessful outcome. A successful pregnancy in HD patients requires multidisciplinary management, but considering the previous nephrological/ prenatal/gynaecological/obstetric recommendations, many open questions remain when it comes to the best treatment and management of pregnancy in these women.
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    Renal Lymphangiectasia. An Unusual Mimicker of Hydronephrosis - A Case Report
    (Sciendo, 2020)
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    Renal lymphangiectasia is very rare benign lymphatic malformation of renal lymphatics, characterized by cystic dilatation of perirenal, peripelvic, or intrarenal lymphatic vessels. One of the rare mimickers of hyd- ronephrosis and cystic renal lesions on the imaging findings. We report a case-patient with unilateral right renal lymphangiectasia with flank pain and arterial hy- pertension. The ultrasound examination revealed right kidney hydronephorosis. The renal lymphangiectasia was identified on contrast-enhanced computed tomogra- phy scan. The patient was managed conservatively with antihypertensive drugs. The report also contains a re- view of the literature on the pathophysiology of renal lymphangiectasia, clinical presentation, imaging findings, differentials, complications and treatment.
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    Phaeochromocytoma associated with reversible renal artery stenosis
    (Oxford Academic, 2001-10)
    Kuzmanovska, D
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    Sahpazova, E
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    Damjanovski, G
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    Popov, Z