Faculty of Medicine
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Item type:Publication, Imaging Insights: Computed Tomography presentation of thoracic hydatid cysts in North Macedonian patients(European Society of Thoracic Imaging, 2024-05)This study endeavors to achieve several key objectives to enrich the comprehension and help gain proficiency in identifying and interpreting a spectrum of thoracic hydatid disease manifestations on Computed Tomography, ranging from common to rare presentations. Furthermore, the study aims to enhance practitioners' capability in recognizing potential complications and mastering the intricacies of differential diagnosis in this context. Delving into the complex realm of hydatid cysts, originating from the larval form of Echinococcus, this research addresses a pressing global challenge[1][2]. While traditionally associated with liver parenchyma, the disease's manifestation in atypical thoracic locations, including the mediastinum and pleural space, necessitates a sophisticated diagnostic approach. This article provides a contextual exploration, shedding light on the endemic nature of hydatid disease, particularly prevalent in regions associated with sheep breeding, and underscores the urgency for precise diagnostic tools. CT not only aids in accurate diagnosis but also provides unparalleled insights into the exact size, location, and internal structure of hydatid cysts, crucial for comprehensive patient management[3]. Moreover, it standsas the primary modality for predicting potential complications, such as cyst rupture, by offering a detailed view of cyst morphology[4][5]. Imaging findings OR Procedure detailsIn a meticulous analysis of 55 chest CT scans from patients in North Macedonia with thoracic hydatid cysts, this study unveils compelling imaging findings. Categorizing cysts into uncomplicated parenchymal, extra parenchymal, and complicated or ruptured forms, the research reveals distinct signs, including the air crescent sign, water lily sign, and dry cyst sign. Conclusion: In summary, this research underscores the critical role of computed tomography in unraveling the complexities of thoracic hydatid cysts. Beyond its contribution to identifying common manifestations, CT emerges as an indispensable tool for deciphering rare, atypical, and complicated presentations. The information provided by CT scans not only facilitates accurate diagnosis but also deepens our understanding of cyst morphology, aiding in predicting potential complications or rupture. The knowledge derived from this study stands poised to elevate diagnostic practices and enrich the collective understanding of thoracic hydatid disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, OPTIMIZING RADIATION EXPOSURE IN PEDIATRIC CT EXAMS(Institute of Knowledge Management, 2024-02-15)ABSTRACT: Introduction: The use of computed tomography (CT) scans in pediatric patients has raised concerns regarding radiation exposure and associated long-term health risks. This study explores the strategies and methodologies employed for optimizing radiation doses in pediatric CT examinations while ensuring diagnostic accuracy. Methods: Through a comprehensive literature review, various optimization techniques and protocols were analyzed. This involved investigating the use of lower tube voltage, iterative reconstruction algorithms, shielding, and specialized pediatric protocols. Additionally, the impact of dose-tracking systems and education on radiographers and clinicians was examined to ensure adherence to best practices. Results: The analysis revealed that employing lower tube voltage significantly reduces radiation exposure without compromising image quality, especially in children. Iterative reconstruction algorithms demonstrated promising results in maintaining image quality while reducing doses. Tailored pediatric protocols and dose-tracking systems further contributed to minimizing radiation exposure. Discussion: Balancing diagnostic accuracy with radiation safety is paramount in pediatric CT imaging. While advancements in technology offer promising solutions, interdisciplinary collaboration, continuous education, and strict adherence to optimized protocols are imperative to mitigate radiation risks in children undergoing CT examinations. Conclusion: Optimizing radiation exposure in pediatric CT exams involves a multifaceted approach, integrating technological advancements, protocol enhancements, and continuous education. Implementing these strategies ensures diagnostic efficacy while prioritizing the safety of pediatric patients. Keywords: computed tomography, radiation exposure, optimization, tube voltage. Field: Medical Sciences and Health - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The first verified patient in Macedonia with ischaemic stroke due to MoyaMoya disease.(2005); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COMMON COMPUTED TOMOGRAPHY FINDINGS AND ASSOCIATION OF THEIR EXTENT TO THE DEMOGRAPHIC FEATURES OF 47 COVID-19 PATIENTS IN NORTH MACEDONIA("Ss Cyril and Methodius"University, Faculty of Medicine, Skopje, R. N. Macedonia, Department of Anesthesia and Reanimation, 2021-03); ; ; Tochko, AleksandraIntroduction and Purpose: There was an unprecedentedly rapid and worldwide spread of the coronavirus after the acknowledgement of several cases of unusual pneumonia that were defined as coronavirus disease 19 (COVID-19) and reported in December 2019 in Wuhan, China. As of March 12th, 2021, there are more than 119 million confirmed cases, 2.63 million deaths due to the disease, and 67.1 million recovered. In the Republic of North Macedonia as of March 11th, 2021, we have 110.209 confirmed cases, 3.265 deaths and 96.570 recovered. The purpose of this study was to perform a thorough evaluation of the CTs in COVID-19 patients with the focus on the type, extent and common distribution of the parenchymal findings, as well as to make an assessment of the relationship between the extent of the parenchymal findings and different demographic features of the patients by using a visual volumetric grading of the parenchymal involvement and administering an appropriate CT score. Material and Methods: CT radiological findings of 47 patients from North Macedonia, enrolled in the study, were analyzed and summarized, and all of whom had positive RT – PCR tests for 2019 – nCoV. The CTs in all patients were performed with 1.25 mm and 5 mm slice thickness on 16-slice Somatom Definition AS+ computed tomography (Siemens Healthineers, USA). The main focus was put on identifying the lesions, evaluating their most common type, distribution and scoring their extent in the lung parenchyma. While applying an appropriate CT score, we made a correlation with the demographic characteristics, such as age, gender and body weight. Results and Discussion: The most common CT finding in almost all 47 patients was the ground glass opacities (GGO) diffusely scattered in both lungs with a dominant peripheral and posterior distribution. We found that age and weight are significant risk factors for predicting the severity and outcome of COVID-19 disease. Conclusion: Chest CT is an important diagnostic and predictive tool in patients with COVID-19. There should be a consensus in the definite diagnosis of COVID-19 based on clinical findings, positive nCov PCR tests and radiological findings. Demographic features can aid in the prediction of severity and outcome of the disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ATYPICAL RADIOLOGICAL MANIFESTATIONS OF ACTIVE PULMONARY TUBERCULOSIS IN SERIES OF PATIENTS FROM NORTH MACEDONIA ON COMPUTED TOMOGRAPHY(Institute of Knowledge Management, International Journal, 2022-03-30)Immunocompromised and patients with chronic diseases worldwide, as well as from North Macedonia, have a greater probability of acquiring tuberculosis (TB) in their lifetime, which is caused by the mycobacterial species and still represents one of the major burdens of the public health systems, as well as one of the most frequent causes of death. The disease itself can manifest in two forms, active and dormant. The active form of the disease manifests shortly after acquiring the infection, whilst the dormant one can occur after years of latency as a postprimary form. Negative microbiology results in tuberculous patients can delay and complicate the accurate diagnosis, so the diverse diagnostic imaging modules, especially the computed tomography (CT), have a supreme role in diagnosing, and following patients with pulmonary tuberculosis (PTB) after treatment. Purpose: Our aim was to illustrate and analyze some atypical appearances of active pulmonary tuberculosis (PTB) in series of 30 patients from North Macedonia on computed tomography (CT). Methodology: 30 consecutive chest CT scans of patients with microbiologically proven tuberculosis from North Macedonia were thoroughly analyzed. All patients underwent a non- contrast and then a contrast enhanced chest CT according to appropriate diagnostic protocol on a 64-slice Somatom Definition AS + computed tomograph (Siemens Healthineers, USA). We reviewed 30 CT scans and all the available information from the medical history of the patients, including their microbiology results. Results: Some of the uncommon signs of PTB we observed on the CTs included: (1) various clusters of micronodules; (2) cystic patterns in PTB patients; (3) PTB with diffusely scattered non miliary nodules, (4) PTB in the setting of COVID 19 pneumonia, (5) organizing pneumonia. Conclusion: Aside from the obvious decrease of the PTB incidence globally, there is an evident rise of atypical manifestations, clinically and on imaging. Mastering the knowledge of atypical CT imaging signs in active PTP will help in reaching diagnosis, following treatment response or residual activity of PTP in clinical practice. Diagnostic imaging also aids the detection of complications or sequels from the disease.