Faculty of Philosophy

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Документ за лицата со аутизам
(Филозофски факултет, Скопје, 2000)
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Успешно привремено екстерно стимулирање на срцевата акција кај болен со ексцесивна хиперкалемија
(Македонско лекарско друштво, 1996)
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Ристовска, Весна
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Чакалароски, Кочо
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Тозија, Лиле
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Ивановски, Нинослав
Прикажан e случај (A.P. на возраст од 35 години, телесна тежина 73,5 kg.) со diabetes mellitus (ДМ), инсулино-зависен, со компликации на повеќе системи (дијабетична нефропатија и ретинопатија, хронична бубрежна инсуфициенција, метаболна ацидоза, екцесивна хиперкалемија). Промените на бубрезите, заедно со атеросклерозата и коронарната болест, се водечка причина за смртноста кај болните со ДМ. Се работи за прв случај во нашата интензивна нефролошка прктика на хиперкалемиски синусен арест, кој беше успешно лекуван со поставување привремен „pace maker “до нормализирање на срцевата спонтана ексцитабилност и воспоставување регуларен синусен ритам. Според нашите сознанија, ова е прв случаj во медицинската практика каде што, со привремено екстракардијално стимулираше на срцевата контрактибилност, е овозможено повторно воспоставување на срцевиот автоматизам. Ургентната хемодијализа (ХД) ja препорачуваме како средство на избор во лекувањето на овој вид синусен арест и малигна брадикардија. Привременото екстракорпорално водење на срцевата акција (привремен „pace maker“) овозможува одржување на системската хемодинамика до нормализирање на внатрешното „milier“ и целосно воспоставување на срцевата глобална функција.
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[review] Анастас Лакоски, Психогенетика
(Faculty of Philosophy, UKIM, Skopje, Macedonia, 1999)
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[review] Горан Ајдински, Карактеристики во развојот кај лесно ментално ретардираните ученици
(Faculty of Philosophy, UKIM, Skopje, Macedonia, 2000)
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Болнички леталитет кај пациенти со акутна бубрежна инсуфициенција во периодот 1990-1994 година
(Македонско лекарско друштво, 1999)
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Чакалароски, Кочо
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Василевска, Кристин
The clinical material of patients affected by acute renal failure (ARF) hospitalized in the Department of Nephrology - Skopje, in the period 0.1.01.1990 - 31.12.1994 was used this study. The study is retrospective, descriptive-epidemiological. Hundred and fifteen patients were analyzed and divided in two groups: 27 dead (23.5%) and 88 survived (76.5%). By demographically factors only the older group has a role of a predictor for lethal outcome. It was stated that the duration of the hospitalization has the significance as a factor associated with the condition upon admission of the patient, and better results were reached by the treatment. Out of the etiologic modalities, the medical ARF was distinctive with lethality rate of 25,3%. Main reason for lethal outcome is a cardiogenic shock and heart failure up to 100%. The lethality from surgical reasons is 22,7% and gynecological ARF has 14,3% lethality. A strong positive correlation is established (r=0.93) between multiorgan system failure (MOSF) and lethality. By multivariate analysis, a positiive correlation was established between the lethal outcome and the duration of hospitalization, wound infection and the age of patients. Syndrome of disseminated intravascular coagidation (DIG) affects the lethality. Out of the laboratory parameters the following were found significant: the number of leukocytes, platelets, glycemia and the enzyme GGT. Patients treated with hemodialysis have a significantly higher lethality when compared to the ones treated in conservative manner, which is due to the severiity of the underlying disorder. Undertaking preventive and therapeutic measures to avert the passage from prerenal into intrinsic ARF can be of particular importance for a decrease in the lethality of ARF.
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Смртноста кај пациенти со акутна бубрежна инсуфициенција (5 годишен клинички материјал)
(Faculty of Medicine, UKIM, Skopje, Macedonia, 1999)
The acute renal failure (ARF) represents a syndrome of multi-etiological origin that can be defined as a rapid impairment of the renal excretory function, with reduction of the glomerular filtration rate (GFR) and retention of the degradation products of nitrogen metabolism (urea, creatinine, indol, scatol, phenol, succinyl guanidine acid…). The aim of this master theses is: to present the mortality rate in ARF patients, to determine the influence of the demographic factors upon the outcome, to get an insight in the etio-pathogenetic factors with lethal outcome, to analyze multiorganic damages in correlation with outcome, to establish relation between laboratory parameters and mortality of the syndrome, to compare therapeutic procedures and to present survival rate of patients with ARF. The clinical material of patients affected by ARF hospitalized in the Department of Nephrology – Skopje, in the period 01.01.1990 – 31.12.1994 was used in this study. The study is retrospective, descriptive - epidemiological. Hundred and fifteen patients were analyzed and divided in two groups: 27 dead and 88 survived. A clinical-epidemiological approach was used in processing the results. The statistic analysis of the data derived by the following methods: dynamic indexes, Pearson’s X2 test, Kolmogorov-Smirnov test was used. Continuing variables were analyzed by Student’s t-test or analysis of variances (ANOVA). Also, a simple and multiple regression analysis was used for selection of most important factors-predictors for higher mortality rate. Conclusion of the analysis was that the mortality rate was 23,5%. By demographically factors only the older group has a role of a predictor for lethal outcome. It was stated that the duration of the hospitalization has the significance as a factor associated with the condition upon admission of the patient, and better results were reached by the treatment. Out of the etiologic modalities, the medical ARF was distinctive with mortality rate of 25,3%. Main reason for lethal outcome is a cardiogenic shock and heart failure up to 100%. The mortality from surgical reasons is 22,7% and gynecological ARF has 14,3% mortality. A strong positive correlation is established (r=0.93) between multiorgan system failure (MOSF) and mortality. By multivariate analysis, a positive correlation was established between the lethal outcome and the duration of hospitalization (p<0.01), wound infection (p<0.04) and the age of patients (p<0.02). Univariate analysis showed association between mortality with ARF and the following variables: comma on admission, the need of assisted mechanical ventilation and existence of abdominal infections. DIC syndrome affects the mortality (p<0.05). Out of the laboratory parameters the following were found significant: the number of leukocytes (p=0.01), platelets (p=0.05), glycemia (p=0.01) and the enzyme GGT (p=0.05). Patients treated with hemodialysis have a significantly higher mortality when compared to the ones treated in conservative manner (p=0.05), which is due to the severity of the underlying disorder. The survival rate is 76.5%. Undertaking preventive and therapeutic measures to avert the passage from prerenal into intrinsic ARF can be of particular importance for a decrease in the mortality of ARF.
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Психијатриски компликации и адаптациони нарушувања кај пациенти лекувани со хронична хемодијализа
(Македонско лекарско друштво, 1997)
Чакалароски, Кочо
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Ристовска, Весна
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Поленаковиќ, Момир
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The psychiatric complications and adaptation disorders observed in patients with chronic renal- failure under maintenance hemodialysis are reviewed. The main psychiatric complications are depressive states, while special adaptation troubles are lack of compliance with food and water restriction and „ relations with their spouses or the medical staff charged with hemodialysis. The mechanisms of some disorders are analysed and emphasise is placed on the usefulness of psychiatric and/or psychological assistance not only for the patient but also to his spouse or the medical staff.
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Factors Related to Multiple Organ System Failure in Patients with Acute Renal Failure
(Faculty of Medicine, UKIM, Skopje, Macedonia, 1998)
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Chakalaroski, Kocho
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Vasilevska, Kristin
Multiple organ system failure (MOSF) is a frequent occurrence and the most important cause of death in the intensive care unit. In the pathogenesis of MOSF syndrome many factors participate: systemic inflammation caused by activation of immunoinflammatory cells with excessive release of mediators, hypovolemia, vascular endothelial damage, and ischaemic- induced gut mucosal injury with subsequent disruption of intestinal barrier function. The aim of this study is to analyze variables in relation with MOSF, and to determine correlation between multiple organ system failure and outcome of the acute renal failure (ARF). The clinical material of patients affected by ARF hospitalized in the Department of Nephrology, in the five- year period was used in this study. The study is retrospective, clinic-epidemiological, with 115 analyzed patients. Data analysis showed that 30.4% of patients had MOSF (MOSF score3 5). Multiple linear regression analysis selected: bacteremia, wound infection, coma on admission, number of blood transfusions as independent factors related to the high MOSF score. A strong positive correlation is established between MOSF and mortality (r = 0.93; p < 0.001). MOSF mortality is 65% and is the major cause of death in patients with ARF. Infections were maintained in 49.5% of patients, most frequent of them are urinary tract infection. Sepsis was present in 17.4% of patients with ARF. Patients with MOSF > 7 have significantly higher requirement of antibiotics and blood transfusions (p<0.005). Our results may be useful in strategies to prevent or limit the evolution of MOSF and to improve survival in patients with ARF.
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Имунна недостатъчност и супресия на имунната система у деца с аутизъм
(2002)
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Etiology and pathogenesis of autism are still unknown. The disorder may be a constellation of multiple factors: neural, genetic, immune, environmental, and biochemical. The critically important job of fighting off infections falls to our immune system. Recent research by several scientists has shown that children with autism have serious abnormalities in this all- important system. Defects in the immune system may lead to overgrowth of the intestinal tract with organisms like yeast. The role of immunizations in causing immune deficiencies is very important. The aim of this article is to shown immunodeficient conditions in children with autism and possibility to their therapeutically solution. Autism is characterized with different types of immunodeficiency: myeloperoxidase deficiency, severe combined immunodeficiency disease, selective IgA deficiency, IgG subclass deficiency, and complement deficiency. Here are presented several types of immunotherapeutic methods such as: gamma globulin therapy, transfer factor therapy, treatment with IL-2, enzyme-potentiated desensitization, and two other kinds of pharmacotherapy of autism.
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Страбизам кај Down синдром
(Лекарска комора на Македонија, 2009)
Љубиќ, Антонела
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Тојтовска, Билјана
Цел: Langdon-Down синдромот (ДС) или трисомија 21, претставува најчеста аберација на автозомните хромозоми, поточно на хромозомот број 21. Нарушувањето на окуларниот мотилитет во популацијата со ДС се јавува во повисок процент во однос на општата популација (20-57%). Целта на нашата студија беше да се спореди превал енциј ата на страбизмот и одделните негови типови, во македонската и хрватската популација со ДС, како и со светските вредности на кав- каската и азијатската популација со ДС. Методи: Во епидемиолошката, популациски базирана (population- based), пресечна (cross- sectional) студија беа вклучени испитувана група со 108 испитанци со ДС од Република Македонија и контролна група со 64 испитаници со ДС од Република Хрватска. Испитаниците беа на возраст од 1,9 до 41 година. Кај секој испитаник беше направен комплетен офталмолошки преглед кој вклучуваше: преглед на предниот, среден и заден очен сегмент, процена на окуломоторната рамнотежа, како и преглед на рефрактивниот статус во краткотрајна циклоплегија. Резултати: Возраста на испитаниците од испитуваната група изнесуваше1б.72+/-7.79 години, возраста на испитаниците од контролната група изнесуваше 9-63+/-7-15 години. Дистрибуцијата по пол во испитуваната група покажа застапеност на машкиот пол со 66.7%, додека контролната група покажа застапеност на машкиот пол со 53.0 %. За х2 = 3.34 и р= 0.05, кога се во прашање дистрибуцијата на страбизмот во испитуваната и контролната група, не постоеше значајна разлика. Заклучок: Разликата во преваленцијата помеѓу македонската и хрватската популација со ДС не покажа статистичка значајност. Добивните вредности во македонската и хрватската популација со ДС беа во рамките на преваленциј ата од светските студии од 20% до 40%. Haj честа форма на езотропии беше алтернантната езотропија, додека од езотро- пиите алтернантната егзотропија.

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