Now showing 1 - 10 of 34
  • Some of the metrics are blocked by your 
    Item type:Publication,
    TROPONIN – OUR EXPERIENCE IN DETERMINATION OF MYOCARDIAL ISCHEMIC DAMAGE IN POSTOPERATIVE PERIOD OF CARDIAC SURGERY IN PEDIATRIC POPULATION
    (2017)
    ;
    ;
    ;
    Lj. Kojik
    ;
    Radica Muratovska-Delimitova
    Background: Troponin is an important biomarker for early evidence of ischemic damage to the heart tissue after a cardiac surgery conducted in the pediatric and adult populations. Elevated values correlate with perioperative and postoperative procedures and practices and are a significant factor for possible later complications. Methods: The study included 30 operated children divided into two groups, the first group of operated children without a cardiopulmonary bypass (CPB), and the second group of operated children with a cardiopulmonary bypass. The correlation between elevated troponin and perioperative and postoperative parameters was monitored (duration of CPB and aortic crossclamping time, stay in the intensive care and therapy during respiratory support, during inotropic support, the presence of renal or hepatic failure, postoperative complications). Results: In both groups of operated children troponin was elevated. In the first group of children operated without cardiopulmonary bypass, the average value of troponin was 9.5 ng/ml (range 6.5- 16.8 ng/l). In the second group of operated children (27 children) with cardiopulmonary bypass, the mean value of duration was 81.5 minutes (range 18 to 296 minutes), and X-cross time (aortic crossclamping time) in the same group of children was with a mean value of 28.2 minutes (range of 0-86 min.). In the first group of children the mean value of troponin was 9.5 ng/ml and in the second group 23.0 ng/ml. The obtained values of troponin have confirmed a highly significant correlation with perioperative and postoperative procedures. Conclusions: Troponin is a prognostic marker for early evidence of ischemic and necrotic changes of cardiac infarction in the pediatric population in cardiac surgery. Elevated values in the first 24-48 hours are significantly correlated with perioperative and postoperative procedures and are an important indicator of the extent of damage to the heart tissue. But its prognostic significance of myocardial ischemic changes is lost in a period between 2-6 months after cardiac surgery.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    PROCALCITONIN AS A PROMISING BIOCHEMICAL MARKER FOR EARLY DETECTION AND TREATMENT OF SEPSIS IN NEONATES AT INTENSIVE CARE UNIT AND ONCOLOGIC PATIENTS WITH FEBRILE NEUTROPENIA
    (Macedonian Association of Anatomists and Morphologists, 2020)
    ;
    Tankoska Maja
    ;
    Pandovska Bisera
    ;
    ;
    Kimovska, Milica
  • Some of the metrics are blocked by your 
    Item type:Publication,
    EVALUATION OF PROCALCITONIN AND SERUM ALBUIN LEVELS AS EARLY INFLAMMATORY BIOMARKERS IN NEONATAL SEPSIS
    (Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020)
    ;
    ;
    ;
    ;
    Kimovska M
    Prematurity is the leading cause of death globally, and the second largest contributor to all deaths under the age of 5. The aim of this study was to evaluate serum albumin levels and procalcitonin levels for the diagnosis and prognosis of preterm newborns with neonatal sepsis. In this study, we included 100 hospital admitted preterm newborns with the first 24 hours of life, hospitalized at the Intensive Care Unit at the University Children's Hospital-Skopje, for the time period between November 2018 until 30 April 2020. The preterm newborns have been divided into three groups according to albumin levels (>30, 25-30, or <25 g/l). There was a highly significant difference between the discharge diagnosis groups, regarding their serum albumin levels and Procalcitonin (PCT) levels, and there was a significant correlation between serum albumin level and PCT levels in preterm newborns, as well. Lower serum albumin levels might be associated with a poorer prognosis in neonatal sepsis. Serum albumin and procalcitoni levels have been proposed to be an early marker for the diagnosis of neonatal sepsis and a valuable follow-up tool.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    OSTEOMYELITIS OF FEMUR IN A DRUG ADDICTED CHILD
    (Macedonian Association of Anatomists, 2021)
    ;
    ;
    ;
    ;
    One of the serious complicationsrelated to intravenous drug use is osteomyelitis. We report a13-year-old male child with a history of intravenous heroin abuse, who was admitted to the hospital complaining of abdominal pain and pain in the left leg. Anteroposterior roentgenogram and CT scan of the left thigh and femur,confirmed the diagnosis of osteomyelitis. Pus culture was positive for Staphylococcus aureus. Despite extensive antibiotic and anticoagulant therapy,the patient’sclinical status improved very slowly. Surgical procedure was not undertaken. Femoral osteomyelitis due to injection drug use in childhood is an extremely rare and uncommoncondition. Intravenous drug abuse, late-onset treatment, and secondary bacterial infection can lead to complications which occurred in the case presented.Itis an extremely difficult condition to treat and is a real challenge for physicians. The rapid response and participation of a multidisciplinary team of physiciansis of particularimportance
  • Some of the metrics are blocked by your 
    Item type:Publication,
    HYDROCEPHALUS WITH VENTRICULOPERITONEAL SHUNT IN INFANTS: OUR EXPERIENCES AND CLINICAL OUTCOMES
    (Macedonian Association of Anatomists, 2022-12)
    ;
    ;
    Tamara Voinovska
    ;
    ;
    Mica Kimovska-Hristov
    AbstractHydrocephalus is a condition resulting from disorder in absorption and circulation of the cerebrospinal fluid (CSF). It leads toaprogressive ventricular dilatation and need of ventriculoperitoneal shunt (VP)placement. The aim of our study wasto present our experience withinfantswith hydrocephalus,ventriculoperitoneal shunt placement, and earlypostoperative follow-up.A retrospective study was conducted comprising infantswith hydrocephalus born between January 2019-January 2022with ventriculoperitoneal shunt placement performedatthe University Clinic for Neurosurgery in Skopje,Macedonia. Demographic and clinical characteristics, complications and the need for ventriculoperitoneal shunt were documented.Of twenty-three infantswith hydrocephalus,14 (60.8%) were preterm infants (median birth weight 2120g; mean gestational age 33.1weeks), 9(39.1%) were term infants(mean birth weight 3600g; mean gestational age 38.4 weeks). The etiology of hydrocephalus was:congenital hydrocephalusin 5infants(21.7%),prematurityin 6 infants(26.08%), spina bifida in 2 infants(8.7%),systemic infection in 4 infants(17.3%), and intraventricular hemorrhage in 6 infants(26.08%).Ventriculoperitoneal shunt was placed inall 23infants, at the mean age of 33.5(30-43) days.Postoperative complicationsas a result of ventriculoperitoneal shuntplacement were:ventriculitismanifested in3 preterm (13%) infants,of which 2(8.6%) died;fiveterm infants(21.7%) had postoperativeseizures, of which2 infants(8.6%) died. Nineteeninfants(82.6%) were discharged and transferredto the neonatology department. Ventriculoperitoneal shunt placementis atreatment of choice for infantswith hydrocephalus, although postoperative complications in preterm infantsincrease the percentageof morbidity and mortality.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Semilobar Holoprosencephaly Caused by a Novel and De Novo ZIC2 Pathogenic Variant
    (Walter de Gruyter GmbH, 2023-05)
    ;
    ;
    Spasovska, T
    ;
    ;
    Muaremoska-Kanzoska, Ljelja
    Holoprosencephaly (HPE) is the most common embryonic forebrain developmental anomaly. It involves incomplete or absent division of the prosencephalon into two distinct cerebral hemispheres during the early stages of organogenesis. HPE is etiologically heterogeneous, and its clinical presentation is very variable. We report a case of a 7 month old female infant, diagnosed with non-syndromic semilobar holoprosencephaly, caused by a novel, de novo pathogenic variant in ZIC2 - one of the most commonly mutated genes in non-syndromic HPE coding for the ZIC2 transcription factor. The patient presented with microcephaly, mild facial dysmorphic features, central hypotonia and spasticity on all four extremities. Ultrasound imaging demonstrated the absence of septum pellucidum, semilobar fusion of the hemispheres and mega cisterna magna and brain MRI with confirmed the diagnosis of HPE. Early diagnosis and management are important for the prevention and treatment of complications associated with this condition.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Neonatal lupus erythematosus-a rare syndrome of transient autoimmunity
    (Wiley, 2022-06)
    ;
    ;
    ;
    Janchevska, Snezhana
    ;
    Jovanovska, Jana
    Neonatal lupus erythematosus (NLE) is a rare autoimmune disease due to a passive transfer of maternal autoantibodies to the fetus. The clinical spectrum is variable and includes skin lesions, cardiac, hematological, or hepatobiliary disorders. We report an NLE case presenting with skin eruption that was initially considered as tinea.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    NEONATAL ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT
    (2017)
    ;
    M Kimovska Hristova
    ;
    ;
    R. Muratovska
    ;
    T. Voinovska
    Objective: Acute kidney injury (AKI) is serious clinical problem in newborns in the neonatal intensive care unit (NICU). Predisposing factors for AKI in neonatal age are: certain clinical conditions (asphyxia, prematurity, sepsis, and meconium plug syndrome), therapeutic interventions and other nephrotoxic drugs.The aim of the study were to present the epidemiological and clinical characteristics of neonatal acute kidney injury in intensive care unit. Subjects and Methods: The study was designed as a prospective, clinical, epidemiological investigation conducted in the period of 3 years, which included 100 newborns hospitalized in NICU of University Children’s Hospital. (50 with AKI and 50 without AKI). Мedical data records of admitted neonates with AKI were analyzed. The material was statistically processed using methods of descriptive statistics. Results: The estimated prevalence of AKI in neonates was 6.4%, according to the standard definition, while the prevalence of neonatal AKI according to RIFLE classification was 8.7%. According to pathogenetic mechanisms that lead to kidney injury, prerenal AKI prevailed and it was registered in 78% of male newborns with neoliguric type of AKI. Perinatal asphyxia was a common predisposing factor associated to neonatal kidney injury and it was found in 30% of the examined newborns, being predominant in male infants and born with a low Apgar score in the fifth minute of their life. There was a significant association between the occurrence of AKI and mechanical ventilation and aminoglycoside therapy. The mortality rate was 32% and was significantly higher in the group of newborns with congenital heart diseases. Conclusion: Acute kidney injury is a life threatening condition. It is an independent contributor to mortality. Early diagnosis and appropriate treatment of acute kidney injury in critically ill newborns, improves the outcome and prognosis.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    DIAGNOSTIC VALUES OF BIOCHEMICAL MARKERSIN ASPHYXED NEWBORNS WITH PROVEN SEPSIS
    (Macedonian Association of Anatomists, 2020)
    ;
    ;
    ;
    Elizabeta Shuperliska
    ;
    Olivera Jordanova
    Introduction: The aim of this study was to investigate the predictive values of biochemical parameters, including Procalcitonin (PCT), as an early diagnostic and prognostic marker for sepsis in asphyxed newborns with proven sepsis. Materials and Methods: This study was designed as a prospective study, where we included 110 (M:F=67:43) newborns with proven sepsis hospitalized in the Intensive Care Unit at the PHI University Children’s Hospital – Skopje.PCT and CRP,WBC one serum blood sample was obtained from each patient at the 24h at admission, as well asday 3 and day 7. Procalcitoninlevels were measured by using an immunoassay system Vidas, based on the Enzyme Linked Fluorescent Assay (ELFA) principles. Results: The newborns with proven sepsis have been divided into two groups. The first group included 50 proven septicpreterm newborns with a positive blood culture and the second group included 50 proven sepsis full-term newborns.We isolated forty two that had two or three bacteria at the same time. The identified bacteria included Staphylococcus aureus (n=56) mecA,Streptococcus (n=6), Acinetobacter baumannii (n=18), Serratia marcescens (n=9) and Entrobacteriaceae (n=31), Candida albicans(n= 1), Candida parapsilosis(n=1).Statistical analysis confirmed significantly different values of PCT in the analyzed time period in preterm newborns with proven sepsis p<0.001.Statistical analysis confirmed significantly different values of PCT in the analyzed time period in newborns with proven sepsis with asphyxia p<0.001. Conclusion: The levels of PCT have important clinical significance in predicting the prognosis of asphyxed newborns with sepsis, to prevent the development of severe sepsis and septic shock.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    ACUTE KIDNEY INJURY IN NEONATES AND NEUTOPHILIC GELATINOUS ASSOCIATED LIPOCALIN AS EARLY BIOMARKER
    (Macedonian Association of Anatomists, 2019)
    ;
    ;
    Olivera Jordanova
    ;
    Objective: Acute kidney injury (AKI) is a serious problem in neonates in intensive care units. It is defined as a rapid decrease in glomerular filtration that leads to retention of creatinine and nitrogenous waste products and usually with a decrease in urine output. NGAL represents the most promising biomarker for early detection of kidney injury. It can detect the kidney injury in the first 2 to 3 hours of its occurrence, even before there is a decrease in urine output and an increase in sCr. The aim of the study was to determine the role of biomarker NGAL in early detection of kidney injury in neonates. Methods. The study evaluated the neonates suffering kidney injury who at the period of three years were treated at the University Children's Hospital in Skopje. All cases of neonates with kidney injury were analyzed according to gender, gestational age, birth weight and risk factors such as asphyxia, sepsis, prematurity, meconium plug syndrome and congenital heart diseases. NGAL was analyzed in urine samples collected on two occasions (day of admission and 2 days later) and the concentration of NGAL was determined using NGAL ELISA KIT (Bioporto). Medical data records of admitted neonates with AKI were analyzed. The material was statistically processed using methods of descriptive statistics. Results. The study was carried out at the neonatal intensive care unit at the University Children's Hospital Skopje in which neonates with documented acute kidney injury were evaluated. The whole study has been performed during the 3 year period. The estimated prevalence of AKI in neonates was 6.4%. Most of the involved neonates in the study were born at term (68%) with predominance of male neonates (64%). The analyzed results showed a higher values of urinary NGAL on the day of admission (373.8 ± 194.9) and a slight upward trend, with further increase in the third day after admission (439.4 ± 254, 7). There was a significant difference between the uNGAL values and sCr values on the day of admission of neonates in NICU, p<0,001. The mean urinary NGAL values in neonates with AKI with lethal outcome were 586.39 ± 182.3 while the mean values in neonates without lethal outcome was 254.22 ± 28.5. This difference was statistically significant (p<0,001). Conclusion: Early, biomarker based identification of neonates at risk of kidney injury is a fundamental step toward AKI prevention. NGAL has ability to predict AKI before clinical signs are evident and can facilitate implementation of appropriate preventive measures and improve resource utilization. Its use allows us to make the right clinical decisions at the right time, before the illness is clinically manifest and take appropriate measures to prevent renal function decline.