Faculty of Medicine
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Item type:Publication, SINUSITIS TREATMENT IN PREGNANCY- PERSONALISED AND INTEGRATED MEDICINE(Македонско лекарско друштво = Macedonian medical association, 2024-12); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Short‐ and long‐term outcome and predictors in an international cohort of patients with neuro‐COVID‐19(Wiley, 2022-03-07) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Pregnancy with fetal brain tumor(Македонско лекарско друштво = Macedonian medical association, 2024-04-25); ; ; Josheva, JasminkaFetal intracranial tumors are exceptionally rare, occurring at an overall incidence of 0.34 per one thousand live births. As per the 2016 classification of central nervous system tumors, primitive neuroectodermal tumors (PNETs) are categorized as highly malignant embryonal tumors in WHO Group IV. This case involves a 29-year-old in her third pregnancy, with two previous uneventful term deliveries. At 27+3 gestational weeks, she sought care at the University clinic due to fetal hydrocephalus. An ultrasound at 28 gestational weeks revealed a heterogenous, tumor-like mass measuring 70x66mm in the right brain hemisphere. The fetal head exhibited a whole dilated right ventricle (26mm posterior horn dimension) with a leftward shift of the cerebral falx. Subsequent fetal MRI demonstrated a partly solid, partly cystic tumor with a heterogenous appearance in T2 pulse sequence, extending in a frontoparietal direction. The differential diagnosis included glioblastoma. Following comprehensive scans, the parents were informed of the potential outcomes. The newborn, unfortunately, did not survive, weighing 1700g and measuring 42 centimeters. Pathological evaluation identified a primitive neuroectodermal tumor in the right parietal lobe, accompanied by internal hydrocephalus and cerebral encephalomalacia. Microscopic examination showcased Homer-Wright rosette formations, consisting of moderately differentiated round to oval cells with eosinophilic to amphophilic cytoplasm and hyperchromatic nuclei surrounding a central core of neurofibrillary material. Immune histochemical staining confirmed the tumor's profile, including Vimentin(+), S100(+), GFAP(+), Actin(-/+), Desmin(-), CD99(-), EMA(-), CKWS(-), Chromogranin(-), NSE(+), WT1(+), and Synaptophysin positivity in single cells with dendrites. The proliferative index stood at 2-3%. In summary, this rare case emphasizes the challenges of antenatal PNET diagnosis, with only 18% identified before or at delivery among tumors presenting in the first year of life. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, VACCINE BREAKTHROUGH INFECTIONS IN COVID-19 PATIENTS - SINGLE CENTER STUDY IN THE REPUBLIC OF NORTH MACEDONIA(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2022); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Assosiation of COVID-19 Infection and Acute Mesenteric Ischemia(The First Faculty of Medicine of Charles University - Karolinum press, 2023-12); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association of CURB-65 (Confusion, Urea, Respiratory Rate, Blood Pressure) with Mortality of Patients with Severe Community-Acquired Pneumonia(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2009); ; ; Background. Severe community-acquired pneumonia (sCAP) is serious, life-thretening condition, with high mortality rate. Scoring systems for disease severity are used for predicting mortality in patients with pneumonia. Objective of this study was to identify the parameters of CURB-65 score that have higher association with mortality in patients with severe CAP. Material and methods. One hundred and two patients with community-acquired pneumonia were enrolled in the study. The study was conducted at the Intensive Care Department of the Clinic for Infectious Diseases and Febrile Conditions-Skopje. Demographic, clinical and biochemical parameters were analyzed and CURB-65 was calculated in each patient at admission. Predictors were identified using logistic regression analysis. Receiver Operating Characteristic Curve (ROC) was constructed for assessing discriminative power of analyzed parameters. Results. CURB-65 identified severe CAP in 32 (31,4%) patients, with overall mortality rate of 62,5%. Confusion, respiratory rate > 30/min and urea > 7mmol/L had significant association with the mortality. Conclusion. CURB-65 is a simple tool that can identify patients with severe CAP and can be used for early prediction of patients mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Phisyological and biochemical factors in predicting outcome in severe community-acquired pneumonia(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2008); ; The aim of our study was to identify physiologic and biochemical parameters of the patients on admission to hospital that will predict the death from severe community-acquired pneumonia. The study is a retrospective evaluation of patients with clinically and radiologically diagnosed community-acquired pneumonia, treated in the Intensive Care Unit of the Clinic for Infectious Diseases, Skopje, Macedonia in the period between 2003-2005. Eighty-one patients were included in the study, divided in two groups: group A - survivors and group B - non-survivors. Age, gender, symptoms before admission, co-morbidity, tobacco smoking, body temperature, heart rate, respiratory rate, arterial blood pressure, leukocytes count, haematocrit, glycemia, urea, sodium, serum albumen and arterial oxygen saturation were measured in each patient on admission. Results: Twenty-nine (35,8%) of all analyzed patients died, with mean age 63,1±17,9. From patients who died, 19 (43,2%) were males. Smoking, heart rate > 90/min, tachipnea ≥ 25/min., body temperature > 38, 5°C, leucocytes count > 10x10 9/L, uremia >7,4mmol/L and hypoxemia <90% were significantly associated with death on admission of patients with severe community-acquired pneumonia. In conclusion, severe community-acquired pneumonia is a serious life-threatening infection with high mortality. Identifying factors that predict adverse outcome on admission of the patients will contribute in undertaking appropriate treatment and management of this disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of severity scoring systems in patients with severe community acquired pneumonia("N Gh Lupu" Foundation of Internal Medicine and Romanian Academy, 2021-12); ; ; ; Background. The aim of this study was to evaluate the ability of severity scoring systems to predict 30-day mortality in patients with severe community-acquired pneumonia. Methods. The study included 98 patients aged ≥18 years with community acquired pneumonia hospitalized at the Intensive Care Unit of the University Clinic for Infectious Diseases in Skopje, Republic of North Macedonia, during a 3-year period. We recorded demographic, clinical and common biochemical parameters. Five severity scores were calculated at admission: CURB 65 (Confusion, Urea, Respiratory Rate, Blood pressure, Age ≥65 years), SCAP (Severe Community Acquired Pneumonia score), SAPS II (Simplified Acute Physiology Score), SOFA (Sequential Organ Failure Assessment Score) and MPM (Mortality Prediction Model). Primary outcome variable was 30-day in-hospital mortality. Results. The mean age of the patients was 59.08 ± 15.76 years, predominantly males (68%). The overall 30-day mortality was 52%. Charlson Comorbidity index was increased in non-survivors (3.72 ± 2.33) and was associated with the outcome. All severity indexes had higher values in patients who died, that showed statistical significance between the analysed groups. The areas under curve (AUC) values of the five scores for 30-day mortality were 0.670, 0.732, 0,726, 0.785 and 0.777, respectively. Conclusion. Widely used severity scores accurately detected patients with pneumonia that had increased risk for poor outcome, but none of them individually demonstrated any advantage over the others. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FATAL ACUTE SELF-POISONING WITH ONE PHOSTOXIN TABLET – A CASE REPORT(2023-05); ; Aluminum phosphide (AlP) is well known as an effective pesticide for grain preservation, but also as a suicidal agent due to its high human toxicity. Phosphine gas (PH3), which is released in contact with stomach acid, is responsible for systemic toxicity and high mortality. We report the first case of severe intentional AlP poisoning treated in our clinic with a fatal outcome and review the therapeutic modalities. A 35-year-old woman with a history of epilepsy was admitted to the University Clinic for Toxicology two hours after the intentional ingestion of a phostoxin (AlP) tablet. She presented with vomiting, abdominal pain, leukocytosis, ECG changes (prolonged PT interval, inverted T waves in D3, AVF, and left precordial leads), hypotension (80/40 mmHg, heart rate 120/min) and respiratory failure, after which she was transferred to the ICU. Signs of hepatic lesion, rhabdomyolysis, renal failure and metabolic acidosis (pO2 9.6 kPa, pCO2 4.14 kPa, pH 7.15, bicarbonate 11 mmol/L, BE -15) were noted. Despite the application of mechanical ventilation, fluid supplementation and inotropic support, hemodynamic instability worsened. Cardiopulmonary resuscitation was performed three times, but unfortunately the patient had a fatal outcome on the fourth day of hospitalization. Freshly opened phostoxin tablets (3 g) are very toxic, and the dose of AlP they contain is sufficient to cause progressive life-threatening symptoms and a fatal outcome. In the absence of antidote, consensus on treatment and elucidated mechanisms of toxicity, the key to treatment is rapid decontamination and initiation of resuscitation measures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clinical Characteristics, risk factors and outcome in patients with in tracerebral haemorrhage(Leage against epilepsy of Macedonia, 2015); ;