Faculty of Medicine

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    VERRUCOUS MALFORMATIONS AS A RARE CASE IN THE GROUP OF VASCULAR ANOMALIES WITH SLOW BLOOD FLOW IN CHILDREN
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2025-04-04)
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    Kamiloski, Marijan
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    Lumani Bakiji, Njomza
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    Racaj, Anila
    Verrucous venous malformations belong to the group of vascular anomalies. The International Society for the Study of Vascular Anomalies (ISSVA) classifies these changes into two major groups: vascular tumors and vascular malformations. The vascular malformations group includes lymphatic malformations, venous malformations, and their combinations (malformations with slow blood flow), as well as arteriovenous malformations (malformations with fast blood flow). Verrucous venous malformations (VVM) are a rare congenital vascular anomaly first described by Helwig in 1967. They are characterized by varying degrees of hyperkeratosis of the skin and subcutaneous tissue. Clinically, they manifest as dark red solitary or multiple hyperkeratotic plaques, most commonly localized on the extremities. Treatment is combined and includes surgical intervention, electrocoagulation, laser therapy, topical agents, and systemic medications. Materials and Methods: Between 2019 and 2024, two children with suspected verrucous venous malformations were admitted to the Public Healthcare Institution – University Clinic for Pediatric Surgery. The lesions were unilaterally located on the lower extremities. The gender distribution was 1:1 (male to female), with an average age of 10 years. The changes had been present since birth. There was no positive family history in either patient. Clinically, one of the patients presented with inflammation of the lesion, accompanied by pain and serous secretion. Results: Following appropriate preoperative preparation, both patients underwent surgical excision and autologous skin transplantation. The postoperative course was uneventful. Histopathological examination confirmed the diagnosis. After excision, electrocoagulation was applied to residual lesions. A reduction of approximately 90% in lesion size was recorded. Conclusion: Verrucous venous malformations are a rare type of malformation within the group of vascular anomalies, requiring a multidisciplinary treatment approach.
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    Our Experience with Surgical Treatment of Scaphoid Fractures with Headless Compression Screw
    (Scientific Foundation SPIROSKI, 2024-10-10)
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    Merdjanoski, Igor
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    Gjorikj-Petrushevska, Magdalena
    BACKGROUND: Fractures of the scaphoid bone are quite common, and they come with their own set of challenges due to the specific shape of the fractures and the delicate blood supply to the scaphoid bone. Failing to diagnose and treat acute scaphoid fractures promptly can result in failure of the bone to heal and subsequent development of wrist arthritis. Advances in diagnosis, surgery, and implant materials have led to a growing inclination towards early surgical fixation, even for non-displaced scaphoid fractures that could potentially be treated without surgery. AIM: The study's goal was to assess the effectiveness of headless compression screws for treating acute scaphoid fractures and, in two cases, nonunion following previous conservative therapy. METHODS: Between January 2022 and March 2024 ten patients with scaphoid fractures were surgically treated at the University Clinic of Traumatology Skopje, within twelve months follow-up. All of them were male with mean age of 27,3 years. All were diagnosed with X-rays and CT scans. Six of the fractures were on the right hand and four on the left. RESULTS: All the patients were surgically treated with open reduction and internal fixation with headless compression screw. Volar approach was used in 9 cases and dorsal approach in only one of them. Six of the patients were surgically treated within 4-14 days after injury and four of them were surgically treated due to non union after previous conservative treatment, two of them after three and two of them after seven months of injury. All fractures united after a mean time of 9,5 weeks, without secondary displacement. Throughout the follow-up period, there were no incidences of developing osteoarthritis of the wrist. CONCLUSIONS: It is crucial to understand that achieving a positive result is not guaranteed for every patient and relies on selecting the right patients and fractures. However, our study shows favorable results in sooner surgical treatment with the headless compression screw, rather than delayed treatment of scaphoid fractures. Surgical treatment with headless compression screw showed both functional and radiographic results. While it is beneficial for the screw to be positioned in the subchondral area, it is important to be cautious to avoid cortical penetration, as this will require the screw to be removed later.
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    FACTORS INFLUENCING THE EARLY POSTOPERATIVE QUALITY OF LIFE IN PATIENTS TREATED SURGICALLY FOR GYNECOLOGICAL MALIGNANCIES
    (Macedonian association of anatomists and morphologists, 2019)
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    Jovanovska V
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    Tanturovski D
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    Stojchevski S
    ABSTRACT Aim: To evaluate the influence of inherent patient characteristics on early postoperative QoL in patients treated surgically for gynecological malignancies Materials and methods: The study was designed as a prospective cohort study. Patients scheduled for surgical treatment of a gynecological malignancy at the Department of gynecological oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2018. Quality of life was quantified using a standardized and validated questionnaire (FACT-G) preoperatively and 1 month after surgical treatment. We explored the effect of the following variables: age, BMI, nationality, education, marital status, place of residence, employment, primary location of the neoplasm, disease stage, extent of surgical resection, comorbidities and smoking. Results: Data from 123 patients were included in the final analysis. The average age of patients at the time of recruitment was 58±10 years (range 23-79 years). Eighty-four patients (68.29%) had endometrial cancer, 22 (17.89%) patients had cervical cancer, while 17 (13.82%) patients had ovarian cancer. Postoperative FACT-G scores were significantly lower (p=0.015). A clinically relevant postoperative decrease in quality of life was identified in 51 patients (41.5%). Independent predictors of deteriorated postoperative QoL in this study were: advanced disease stage, extensive surgical resection, comorbidities and higher education. Conclusion: The results illustrate the physical, psychological, and social effects of the surgical treatment on the early postoperative QoL, thereby emphasizing the need for a comprehensive, multidisciplinary approach to the pre and postoperative care of these patients.
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    Giant mediastinal thymic cyst
    (Macedonian Academy of Sciences and Arts, 2017)
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    Goge Damjanovski
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    Imran Ferati
    The authors present a rare case of giant mediastinal cyst which arises from the thymus gland, and goes down in both pleural spaces, especially in the right chest cavity where a dominant part of the cyst was present. The cyst was full with 2.5 liters of transparent fluid, and compressed surrounding structures – heart and both lungs, especially the right one which was partially collapsed. The patient was a 52 years old woman, without any clinical symptoms. Accidentally, on the screened chest X-ray a shading in the distal third of the right chest was detected. The case was well documented with a CT of the chest, and an indication for surgical treatment was made. The surgery was done successfully in general anesthesia according to the small right anterior thoracotomy from which a giant part of the cyst was mobilized, which was in the right pleural cavity, but, also, the thymus with the origin of the cyst in the anterior and superior mediastinum was completely removed. In the end, a part of the cyst which was in the left pleural cavity was removed.