Faculty of Medicine

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    MARIJUANA-INDUCED ACUTE CORONARY SYNDROME IN A YOUNG PATIENT
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023)
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    Jovanoski, Mario
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    Andov, Mishel
    Introduction: Acute coronary syndrome (ACS) is generally a natural consequence of the progression of coronary atherosclerosis. But in minority of cases, it might be developed due to non-atherosclerotic reasons including recreational marijuana use. Possible pathophysiological mechanisms include inflammation, procoagulant state and vasoconstriction (vasospasm) of the coronary arteries. Marijuana adverse effects on cardiovascular system are various and well documented. Case report: We present a 29-years old male who was referred to our Clinic due to chest pain and morphologic ECG changes. The patient has been previously hospitalized in local hospital due to hematochezia. Because of the chest pain, ECG was performed, and blood sample was taken there to determine the troponin level (hs-Tn I). ST-segment elevation and high level of hsTn I were indication for urgent transfer of the patient to our clinic. After admission, the patient underwent coronary angiography and PCI. Thoroughly taken history revealed that the patient was occasionally smoking marijuana in recreational purposes. He was a cigarette smoker, but he had no additional known risk factors for CAD. Conclusion: Recreational marijuana use may be a trigger factor for an acute coronary syndrome. We should always think and suspect marijuana and other recreational drugs as a potential risk factor for adverse cardiovascular events in young patients.
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    MOST COMMON FACTORS AFFECTING OCCURRENCE OF NEONATAL SEPSIS - CHALLENGE AND EXPERIENCE FOR TREATMENT AT NEONATAL INTENSIVE CARE UNIT
    (Macedonian association of anatomists and morphologists, 2018)
    Najdanovska-Aluloska Natasa
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    Angelkova N
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    Background: Neonatal sepsis remains a serious complication, especially among preterm infants. Neonatal sepsis is divided into early- and late-onset sepsis, based on timing of infection and presumed mode of transmission. Early - onset sepsis is defined by onset with in the first week of life, to infections occurring in the first 72 hours due to maternal intrapartum transmission of invasive organisms. Late - onset sepsis is defined as infection occurring after one week and is attributed to pathogens postnatally acquired. Materials and Methods: We have investigated neonatal sepsis in our NICU from 1 January till 31 December 2017, for one-year period, in order to determine mortality associated with sepsis and to identify the dependent predictors for morbidity and mortality. A total 216 infants were admitted in the NICU. Data were collected regarding the primary reason for NICU, maternal condition, gender, gestational age, length of NICU stay, duration of MV and non-invasive ventilation, using of umbilical catheter, and peripherally vein line. Results: Early - onset sepsis was detected in 15 neonates (12 %) within the first 72 hours. Late - onset sepsis was detected in 18 neonates (3,2 %) after 72 hours. Premature infants 23 (70 % range 26 - 37 gestational age) were more exposed to sepsis than term infants 10 (30 %; range 38-40 gestational age). 15 neonates (45,5%) were exposed to the early - onset sepsis, and 18 neonates (54,5%) were exposed to late-onset sepsis. The most frequent isolates were Staphylococcus aureus 7 ( 21,2 %), followed by Acinetobacter 6 (18,1 %), Meticillin- resistant Staphylococcus aureus 5 (72 % from total 7 Staphylococcus aureus) and Staphylococcus epidermidis 5 (15,1%), followed by Klebsiella pneumoniae 2 ( 6,06 % ), Serratia 2 (6,06 %) and Pseudomonas aureginosa 2 (6,06 %). Late - onset sepsis was significantly more common in premature infants. We confirmed that neonatal sepsis resulted with increase duration of NICU stay and duration of MV. Early diagnosis, followed by appropriate antibiotic treatment, short hospital stay and restricted use of invasive devices should be the aims to reduce the risk of late - onset sepsis during the stay in the NICU. Conclusion: Neonatal sepsis is a major cause of death in infants despite sophisticated neonatal intensive care. Early and adequate antibiotic therapy decreases the risk of morbidity of hospitalized patients.
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    Screening for obstructive sleep apnea as a stroke risk factor with Berlin questionnaire
    (Congress of respiratory medicine of the Republic of Macedonia, 2016-10)
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