Faculty of Medicine

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Secondary malignant neoplasms in patient with breast carcinoma after radio and chemotherapy
(Македонско друштво на ортопеди и трауматолози = Macedonian Association of Orhopedics and Traumatology, 2017-06)
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Secondary malignant neoplasms (SMN) are cancers caused by treatment with radiotherapy and chemotherapy. They are unrelated to the first cancer that was treated and may occur months or even years after initial treatment. With advances in diagnosis and treatment there is an increasing number of long-term cancer survivors, but also there is growing concern about the risk of radiotherapy and chemotherapy induced malignant neoplasm. In our case report we present a patient that underwent radiotherapy and chemotherapy several times because of recurrence from a well differentiated breast carcinoma with characteristics of cilindroma. After 6 years from the initial treatment a solid renal tumor was found, the histopathological finding from the kidney tissue was “multilocular renal cell carcinoma”. After 11 years skin changes appeared, histopathologically classified as dermatofibrosarcomama.
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Nasal Cavity and Paranasal Sinus Cancer: Diagnosis and Treatment
(Springer Science and Business Media LLC, 2024-06-27)
Jakimovska, Frodita
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The purpose of this review is to analyze the diagnosis and treatments of the sinonasal malignant tumors throw systematic reviewed literature. The systematic review of the literature was performed according to PRISMA guidelines.
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Predictors of active cancer thromboembolic outcomes. RIETE experience of the Khorana score in cancer-associated thrombosis.
(Thieme, 2017)
Tafur AJ,
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Caprini JA,
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Cote L
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Trujillo-Santos J
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Del Toro J,
Even though the Khorana risk score (KRS) has been validated to predict against the development of VTE among patients with cancer, it has a low positive predictive value. It is also unknown whether the score predicts outcomes in patients with cancer with established VTE. We selected a cohort of patients with active cancer from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the prognostic value of the KRS at inception in predicting the likelihood of VTE recurrences, major bleeding and mortality during the course of anticoagulant therapy. We analysed 7948 consecutive patients with cancer-associated VTE. Of these, 2253 (28 %) scored 0 points, 4550 (57 %) 1-2 points and 1145 (14 %) scored ≥3 points. During the course of anticoagulation, amongst patient with low, moderate and high risk KRS, the rate of VTE recurrences was of 6.21 (95 %CI: 4.99-7.63), 11.2 (95 %CI: 9.91-12.7) and 19.4 (95 %CI: 15.4-24.1) events per 100 patient-years; the rate of major bleeding of 5.24 (95 %CI: 4.13-6.56), 10.3 (95 %CI: 9.02-11.7) and 19.4 (95 %CI: 15.4-24.1) bleeds per 100 patient-years and the mortality rate of 25.3 (95 %CI: 22.8-28.0), 58.5 (95 %CI: 55.5-61.7) and 120 (95 %CI: 110-131) deaths per 100 patient-years, respectively. The C-statistic was 0.53 (0.50-0.56) for recurrent VTE, 0.56 (95 %CI: 0.54-0.59) for major bleeding and 0.54 (95 %CI: 0.52-0.56) for death. In conclusion, most VTEs occur in patients with low or moderate risk scores. The KRS did not accurately predict VTE recurrence, major bleeding, or mortality among patients with cancer-associated thrombosis.
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Lung cancer in the Skopje region
(Македонско лекарско друштво = Macedonian Medical Association, 2012-04-26)
Pejchinovski, G
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Brcina, I
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Malinska, P
Goal: Report of the five year analysis of patients treated in the hospital of the Skopje region with malignant neoplasms of the bronchus and lungs. Material and operation method: Individual reports for hospital treated persons (Form No 3-21-61A) with clinical diagnosis (C34.0 - C34.9) according to MKB – 10 Revision. With the statistical operation method of the data base, it has been processed 9140 reports of the hospital patients from 2004 to 2008. Results: In the period from 2004 to 2008 in the hospital of the Skopje region, from the total number of the treated patients, 2,02% had clinical diagnosis lung cancer. In relation to the gender structure, 82.9% were men and 17.1% women. The most frequent age structure are the patients between 50 and 59 years with 39,5%. Treated patients at the age of 60-69 years are represented with 33,3%. The five-year analysis shows that 85,1% are patients with clinical diagnosis of lung cancer at the age of 50-79 years. According to MKB 10 Revision the localization are according to code C34.9 represented with 73,9%, and with the code C34.1 or the malignant upper lobe lung is represented with 11,8% Conclusion: In 2008, the number of patients with clinical diagnosis: malignant bronchus and lung were increased for three times compared to 2004. The male patients, almost 5 times more frequently get ill with malignant tumors of the bronchus and lungs compared to female patients. The most common localizations were diagnosed in patients with the following clinical diagnoses: malignant upper lobe lung, then the malignant main bronchus, malignant lower and middle lobe.
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RADIATION-INDUCED MUCOSITIS IN PATIENTS WITH OROPHARINGEAL CANCER TREATED WITH MODERATE ACCELERATION OF INTENSITY-MODULATED RADIATION THERAPY AND SIMULTANEOUS INTEGRATED BOOST CONCOMITANT WITH WEEKLY CISPLATIN
(Scientific foundation Spiroski, 2021)
Kostadinova, Lenche
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Stoleska Marina
Radiation-induced mucositis is one of the limiting factors during radiotherapy, disturbing the quality of life and in some cases leading to discontinuation of therapy. Intensity-modulated radiation therapy (IMRT) with simultaneous integrated boost (SIB) represents advanced form of radiotherapy technique in treatment of oropharyngeal carcinoma enabling precision cancer targeting with reducing dose to healthy normal tissues.
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Colon Screening: Colonoscopy vs Virtual Colonoscopy
(2013-03)
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K. Nikolov
Virtual colonoscopy or appropriately named CT Colonography(CTC) is a new radiologic method of screening the colon for precancerous polyps with an ongoing tendention to supplement the regular endoscopic colonoscopy. We are trying to show how this method with the abbility to reconstruct and render the images can better depict the colon and any suspicious lesion thus avoiding the invasivness of the old method and sedation of the patient. We suggest this method for any patient with: * known familial polyposis * blood in the stool * with known Ulcerative colitis or Crohn's disease.
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Surgical treatment of cancer on the eyelids and periorbital skin
(Macedonian Surgical Association, 2003)
Mostrov I
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Naceska, A
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Skin cancer of the eyelids and periorbital area produce cosmetical defects, and unlike other skin cancers they also have tendency to damage ocular and adnexal structures by direct invasion or as a result of the therapy. No matter which treatment is used the cancer should be eradicated in toto, without damaging structures and function of the eye, and as the final goal to achieve normal functional and cosmetical result.
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Vitamin K Antagonists After 6 Months of Low-Molecular-Weight Heparin in Cancer Patients with Venous Thromboembolism
(Elsevier, 2018-04)
Chai-Adisaksopha C
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Iorio A
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Crowther MA
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de Miguel J
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Salgado E
Background: Low-molecular-weight heparin (LMWH) is the treatment of choice in cancer patients with venous thromboembolism. However, data on continuing LMWH treatment beyond 6 months remain scanty. Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to compare the rate of venous thromboembolism recurrences and major bleeding appearing beyond the first 6 months of anticoagulant therapy in cancer patients with venous thromboembolism, according to therapy with LMWH or vitamin K antagonists (VKA). We performed a propensity score-matched cohort study. Results: After propensity matching, 482 cancer patients continued to receive LMWH and 482 switched to VKA. During the course of anticoagulant therapy (mean 275.5 days), 57 patients developed venous thrombosis recurrences (recurrent pulmonary embolism 26, recurrent deep vein thrombosis 29, both 2), 28 had major bleeding, 38 had nonmajor bleeding, and 129 died. No patient died of recurrent venous thrombosis, and 5 patients died of bleeding (2 were on LMWH, 3 on VKA). Patients who continued with LMWH had a similar rate of deep vein thrombosis recurrences (relative risk [RR] 1.41; 95% confidence interval [CI], 0.68-2.93), pulmonary embolism recurrences (RR 0.73; 95% CI, 0.34-1.58), major bleeding (RR 0.96; 95% CI, 0.51-1.79), or nonmajor bleeding (RR 1.15; 95% CI, 0.55-2.40), compared with those who switched to VKA, but a higher mortality rate (RR 1.58; 95% CI, 1.13-2.20). Conclusions: In cancer patients with venous thromboembolism who completed 6 months of LMWH therapy, switching to VKA was associated with a similar risk of venous thrombosis recurrences or bleeding when compared with patients who continued LMWH.

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