Faculty of Medicine
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Item type:Publication, ANEMIA IN PREGNANCY AND RISK FACTORS(Македонско лекарско друштво = Macedonian medical association, 2025-09); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREVALENCE AND IDENTIFICATION OF POTENTIAL PREDICTORS ASSOCIATED WITH GESTATIONAL DIABETES MELLITUS IM MACEDONIA(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025-03-01); ; Ninova, AgavniIntroduction: Peripheral nerve blocks have an increasingly important role as an anesthetic technique for surgical anesthesia, postoperative analgesia, and fast discharge of patients after surgery involving the upper or lower extremities, alone or in combination with spinal or general anesthesia. Ultrasound guidance has become the most popular for performance of peripheral nerve blocks. Methods: In our retrospective study, we included all patients that were admitted in our hospital for orthopedic procedures on lower and upper extremities who received peripheral nerve block, alone or in combination with spinal or general anesthesia in the last 5 years. Ultrasound guidance was used and local anesthetic Bupivacaine 0.5%. Dexamethasone 4 mg was given intravenously as an adjuvant to peripheral nerve blocks. Results: The total number of patients included in our study was 300, the total number of performed peripheral nerve blocks was 302. 144 (48%) patients were male and 156 (52%) – female. The type of performed blocks was: 164 (54%) femoral, adductor canal blocks 22 (7.28%), 26 supraclavicular (8.60%), 77 interscalene (25.49%), 9 axillar (2.98%), 2 popliteal (0.66%), 1 iPACK and 1 TAP block (0.33%). Peripheral nerve blocks were combined with general or spinal anesthesia or performed as a sole technique for intraoperative analgesia in 17 patients (5.67%). Discussion: In our hospital we performed ultrasound guided peripheral nerve blocks last years in combination with a general, spinal anesthesia or as a sole technic for intraoperative and postoperative analgesia. Our patients were very satisfied with good postoperative pain control, and no serious complications were observed. Conclusion: Ultrasound guided peripheral nerve blocks are good choice for intraoperative anesthesia and postoperative analgesia, especially in older patients and patients with a lot of comorbidities. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, РИЗИК ФАКТОРИ ЗА ПАТОЛОШКИ ПРОМЕНИ НА ЕНДОМЕТРИУМОТ И НИВНА АСОЦИЈАЦИЈА СО ЕНДОКРИНИТЕ НАРУШУВАЊА, МЕТАБОЛИЧЕН СИНДРОМ И ОСТЕОПОРОЗА(2022)Introduction: The International Federation of Gynecology and Obstetrics (FIGO) has defined a classification system for abnormal uterine bleeding, called PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory disfunction, endometrial dysfunction, iatrogenic causes, unclassified reasons). Dysfunctional uterine bleeding is often during the menopausal transition as a result of hormonal changes during this period. In postmenopause there should be no uterine bleeding, the thickness of the endometrium should be less than 5 mm, and if it is above 5mm, the presence of polyp, hyperplasia or cancer is possible. Postmenopausal bleeding occurs in approximately 90% of patients with endometrial cancer, but only 9% of women with postmenopausal bleeding have endometrial cancer. Endometrial hyperplasia and endometrial polyps are associated with development of endometrial cancer and therefore these changes can be called premalignant. Atypical endometrial hyperplasia is a preneoplastic condition that precedes the most common malignant tumor of the uterus, endometrioid adenocarcinoma. Risk factors such as obesity, chronic anovulation, nulliparousness, late menopause, unopposed estrogen (without progesterone), hypertension and diabetes, all increase the risk of endometrial hyperplasia and endometrial cancer. Objectives: To determine the histopathological changes of the endometrium that occur during the period of perimenopause and postmenopause; to determine their association with the presence of diabetes, hypertension, metabolic syndrome, thyroid disorders, glycosylated hemoglobin levels, Vitamin D levels, and to determine the dynamics of bone markers in the peri and postmenopausal period. Material and methods: The study was a prospective observational cohort, involving a total of 160 respondents. The study group consisted of 120 patients who underwent fractionated explorative curettage due to a medical indication (abnormal bleeding or ultrasound-diagnosed endometrial abnormality). They were divided into two subgroups: perimenopausal and postmenopausal. The control group consisted of 40 healthy women without fractionated explorative curettage. Anamnestic data were taken from all respondents. Blood pressure, body weight, height, waist circumference, anteroposterior diameter of the uterus and endometrial thickness were measured. This laboratory analyses were performed: Glycemia, glycosylated hemoglobin (HbA1c), Hormonal Status - FSH, LH, Estradiol, Serum insulin, Thyroxine (fT4), Parathormon (PTH), lipid status, ionized calcium, serum iron, bone markers (Osteocalcin, β-Cross Laps), vitamin D (25-Hydroxyvitamin D). Results: The most common pathological change of the endometrium was an endometrial polyp, and it was present in 45% of the respondents. Endometrial hyperplasia without atypia was present in 23.3% of perimenopausal and 15% of postmenopausal women. Endometrial adenocarcinoma was present in 3% of perimenopausal and in 5% of postmenopausal women. Patients with endometrial pathology were older than healthy women and had significantly more frequently: greater endometrial thickness, higher blood pressure, body mass index, waist circumference, glycemia, triglycerides, serum insulin and metabolic syndrome. Vitamin D levels were lower in women with explorative curettage than in healthy women, and significantly lower in those with organic changes compared with those with functional pathological changes of the endometrium. Women with organic changes of the endometrium, compared with those with functional changes, had significantly higher: body mass index, waist circumference and endometrial thickness. Perimenopausal women, compared with those in postmenopause, had significantly longer duration and intensity of bleeding, larger anteroposterior diameter of the uterus and thickness of the endometrium. Postmenopausal women had higher body mass index, waist circumference, blood pressure, glucose, HbA1c, serum iron and bone markers (osteocalcin and β Cross Laps), than those in perimenopause. Postmenopausal duration in patients with explorative curettage was significantly positively correlated with serum values of bone markers osteocalcin and β Cross Laps. Conclusions: Fractionated explorative curettage is an effective method for timely and effective diagnosis of pathological changes of the endometrium in women with abnormal uterine bleeding or ultrasound-diagnosed abnormal endometrial findings. In the period of perimenopause and postmenopause, there are changes in the genital organs, but also there are internal disorders (obesity, metabolic syndrome, diabetes, thyroid disorders, cardiovascular disease, osteoporosis), which should be timely prevented, diagnosed and treated. According to our study, some of them are related to the occurrence of changes in the endometrium and the need for fractionated explorative curettage for timely diagnosis, especially of premalignant and malignant changes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation of low-energy vertebral fracture, clinical risk factors and bone densitometry in postmenopausal women(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2020); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Carotid intima media thickness is in a relation to risk factors for coronary artery disease(Geotar-Media Publishing Group, 2020-01); ; Introduction: Carotid intima-media thickness (CIMT) is a double line pattern measured from the lumen-intima to media-adventitia interface. Measuring CIMT with B-mode ultrasound can detect early arterial wall changes. We aimed to measure CIMT in manifested atherosclerotic disease and find a relation to present risk factors. Material and methods: This cross sectional study included a population of 657 patients, with documented coronary artery disease (CAD), 66,1% were men (469 pts), 33,9% were women (241 pts). The mean age of patients was 64,72 years (55,6-73,8). The measurement of CIMT (maximal and mean) was performed with B-mode ultrasound, on longitudinal view, on multiple plaque-free segments at the level of common carotid artery, on the far wall, on both sides. Multivariate regression analysis was done to estimate independent factors for CIMT, when risk factors, age, and sex included in analysis. Results: The mean value of maximal CIMT was 0,96 mm (0,52-1,4), mean value of mean CIMT was 0,88 mm (range 0,61-1,15) and mean systolic blood pressure of 133,21 mm Hg (108,03-158,39) was found. Increased CIMT was found in 75,7% of patients (502 pts). Smoking was found as an independent risk factor for increased CIMT with odds ratio (OR) 4,7 (95% CI; 0,67-5,32) and diabetes mellitus with OR 1,6 (95% CI; 0,47-2,16). Conclusion: Diabetes and smoking are independently related to increased CIMT. These are preliminary results of National survey on 657 pts with coronary artery disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Dyslipidaemia and hypertension in patients with subclinical hypothyroidism(Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RESULTS FROM POST - MARKETING OBSERVATIONAL STUDY FOR THE ASSESSMENT OF SAFETY OF INTRAVENOUS IBANDRONIC ACID IN POSTMENOPAUSAL WOMEN(SHMSHM - AAMD, 2020-12-23); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SMOKING HABIT AS A RISK FACTOR ASSOCIATED WITH OCCURRENCE OF LUNG CANCER(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RISK FACTORS IN HOSPITALIZED PATIENTS WITH STROKE POSITIVE ON SARS-COV-2-INFECTION(Macedonian Association of Anatomists and Morphologists, 2023-11); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, TYPE 2 MYOCARDIAL INFARCTION(MIT University Skopje, 2023); Myocardial injury is when there is elevated cardiac troponin values at least one value above the upper reference limit (URL). Causes of elevated troponin can be sustained bradyarrhythmia, hypotension, shock, respiratory failure, anemia, tachyarrhythmia, hypertension, heart failure, defibrillator shocks, sepsis, chronic kidney disease, stroke, subarachnoid hemorrhage, pulmonary embolism, pulmonary hypertension, infiltrative disease (amyloidosis, sarcoidosis..), chemotherapeutic agents, critically ill patients, strenuous exercise, cardiac ablation, cardiomyopathy, coronary spasm, microvascular dysfunction, atherosclerotic plaque disruption with thrombosis, etc. When it is associated with myocardial ischemia it is designated as myocardial infarction (MI). Type 2 myocardial infarction occurs due to disturbed oxygen supply and/or unbalanced demand. There are no conditions that are characteristic for type 1 MI such as plaque, rupture and thrombosis
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