Faculty of Medicine
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Item type:Publication, KIDNEY FUNCTION DECLINE AND MORTALITY IN DONORS WITH EXPANDED CRITERIA - FIVE YEARS FOLLOW UP STUDY(Macedonian Association of Anatomists and Morphologists, 2024); ; ; ; Kidney donors are considered healthy, but with a need for continued medical follow up and encouragement for continued healthy lifestyle, especially when expanded criteria for donation are applied. This study aims to analyse the five years follow up of kidney donors after explanation, encountering risks of kidney function decline and donors’ mortality. In a retrospective study we evaluated a donor cohort with 5 years of follow up. Demographic characteristics as age, gender and the presence comorbidities as diabetes, hypertension, hyperlipidemia and Body Mass Index (BMI) >30kg/m2 were analyzed. Estimated glomerular filtration rate (eGFR) by CKD EPI formula was notified prior donation, and annually afterwards. Consultations with nephrologist or other specialists were notified. In a multivariate regression analysis, the reduction ratio (RR) of eGFR was explored as dependent variable. Cox regression analysis exploited mortality; Kaplan Meier survival curve was applied in respect of BMI. Seventy-five donors with average age above 55 years were predominantly women (69%), nearly every nineth patient had diabetes or obesity (9%). Proportion of donors referred to nephrologist at the 12 months, declined up to 58% at the fifth year, ignoring medical checks showed ascending trend to 16% at the end of second and third year and 12% at the end of observational period. The univariate regression analysis found diabetes, hyperlipidemia and hypertension, the presence of multiple comorbidities, gender and age as insignificant predictors of eGFR 12 months reduction ratio. The nephrologist referral showed borderline significance (β = - 0.103, p=0.076). Only BMI over 30kg/m2 worsened the kidney function (β = 0.600, p=0.001). Five years mortality rate was 6.7%. The diseased donors were significantly older, more frequently had diabetes and obesity also they had significantly lower eGFR pre-donation, at the end of the first year but also and more step decline of it after 12 months. In the multivariate analysis BMI>30kg/m2 emerged as most powerful predictor of mortality (HR 40.02; CI: [4.11-389), p=0.0001). Survival of obese patients was significantly shorter when compared with patients with lower body weight (43.28 ± 7.51 vs. 59.33±0.65, Log rank p=0.000), respectively. Our study demonstrates that the mortality and declination of renal function after donation are associated with nephrologist referral and other potentially modifiable factors, especially obesity. Improved protocols for pre-donation information, education and adequate after-donation follow up is mandatory to achieve better longevity and kidney function survival in these frail and precious individuals. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Spontaneous omental infarction in an obese young female patient treated with laparoscopy: a case report(Oxford University Press (OUP), 2024-06); ; ; Argirov, IvanPartial infarction of the great omentum is a rare cause of abdominal pain and may present as a surgical emergency. Omental infarction might occur due to its torsion, but cases without obvious cause are reported. Risk factors related to this condition are overweight, obesity, abdominal trauma, recent abdominal surgery, hypercoagulability, postprandial vascular congestion and an increase in intra-abdominal pressure. Because of the condition's rarity, most patients are treated with surgery and the diagnosis is established intraoperatively. Preoperative diagnosis allows successful conservative treatment with analgesics and anti-inflammatory drugs. This case reports a young female patient with class III obesity presented with spontaneous partial infarction of the great omentum treated with laparoscopy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, OBESITY PARAMETERS IN FEMALE MEDICAL STUDENTS(Faculty of Medicine, University Ss. Cyril and Methodius in Skopje, 2021); ; Abstract Introduction.The behavioral patterns, eating habits and participation in physical activities of university students have important influence on body composition of this young population group. The aim of this study was to determine the level of overweight and obesity in female medical students and level of physical activity. Material and methods. A descriptive cross-sectional study was conducted at Faculty of Medicine, Ss. Cyril and Methodius University in Skopje between December 2019 and April 2020. A total of 308 girls, students of the 1st and 2nd year of study, underwent body composition testing with InBody 720 bioimpedance analyzer. International physical activity questionnaire (IPAQ) was used for determining the level of physical activity. Results. The average age of participants was 19.4 1.1 years, and the mean values for obesity parameters were as followed: BMI = 22.5 4.3 kg/m2 ; BF% = 28.3 8.5; WHR= 0.87 0.07. One third of students had normal body fat percentage (34.5%) and waist-to-hip ratio (33.3%). Two thirds of students showed normal BMI, and 14.6% of girls were overweight while 6% were obese according to BMI. The greatest percentage of students, 60% of girls, showed BF% and WHR higher than normal values. Conclusion. Analysis of obesity parameters derived from bioimpedance analyzer – (BIA) showed that BMI parameter was less sensitive to level of obesity than BF% and WHR. The findings revealed that more than half of the young female medical students were overweight and/or obese. Key words: obesity, body mass index, body fat, waist to hip ratio, students - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Metformin improves menstrual patterns, endocrine and metabolic profile in obese hyperinsulinemic women with a polycystic ovary syndrome(Macedonian Academy of Sciences and Arts, 2006-07); ;