Georgiev, Antonio

Preferred name

Georgiev, Antonio

Official Name

Georgiev, Antonio

Main Affiliation

antonio.georgiev@medf.ukim.edu.mk

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General anesthesia: Is it safe for newborns, infants and young children?
(Association of medical doctors "Sanamed" Novi Pazar, 2016)
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Nancheva, Andrea
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The exposure of neonates, infants and small children to general anesthesia is becoming a common occurrence. Accumulating preclinical data indicate that exposure to commonly used general anesthetic agents during key periods of brain development in this population(between late gestation and 3 to 4 years of age,) can lead to apoptotic neurodegeneration, synapse loss, and cognitive and neurobehavioral deficits that persist as the organism matures. New work suggests that infants and small children undergoing some types of surgery could have better recovery if they receive regional anesthesia rather than general anesthesia. In response to this concerns, the Food and drug administration (FDA) and the International Research Society in anesthesia (IARS) started an initiative called Smart Tots (Strategies for Mitigating Anesthesia- related neuro Toxicity in Tots) which examine the effects of anesthesia on brain development. Also another two major prospective studies are ongoing in children : PANDA (Pediatric Anesthesia Neurodevelopment assessment Study )project is a large, multi-center study based at the Morgan Stanley Childrens Hospital of New York at Columbia University, and another one is GAS study which is a multisite randomized controlled trial comparing neurodevelopment outcomes in infant receiving general anesthesia compared to spinal and other regional anesthetics to the stress response to surgery. The findings from these studies will help researches to design the safest anesthetic regimens and to develop the new and safer anesthetic drugs for use in pediatric medicine.
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Do hypertensive patients chronically treated with Renin-Angiotensin system antagonist have risk of hypotension during induction in general anesthesia?
(MIT Univerzitet Skopje, 2021)
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Toleska, M.
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IS REGIONAL POPLITEAL SCIATIC NERVE BLOCK A BETTER OPTION FOR TREATING PEDIATRIC SPORTS INJURIES THAN GENERAL ENDOTRACHEAL ANESTHESIA?
(Faculty of Physical Education, Sport and Health in Skopje, Republic of Macedonia, 2023)
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Ristevski, Toni
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Trifunovski, Aleksandar
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In pediatric anesthesia, the use of ultrasound-guided peripheral nerve blocks has grown in favor. In order to determine the most effective anesthetic technique for pediatric ankle and foot sport procedures, this study evaluated the effectiveness of popliteal sciatic nerve blocks. ASA I or II pediatric patients between the ages of 1 and 14 who had either a localized popliteal sciatic block or general endotracheal anesthesia for surgery due to a sport injury were included in the retrospective analysis. The length of analgesia, the length of recovery, the time until hospital discharge, and any problems that were reported were evaluated. In comparison to general endotracheal anesthesia, popliteal plexus regional anesthesia showed quicker operation times, shorter recovery times, and longer analgesia durations. Additionally, the popliteal plexus anesthetic group's average hospital stay was shorter and there were no problems. Despite several cases of unsuccessful blocks and minor problems in the general anesthetic group, it was clear that popliteal nerve blocks often reduced pain, reduced the need for opioids, increased patient comfort, and sped up recovery. In conclusion, popliteal nerve blocks are a safe, dependable, and effective alternative to conventional anesthetic methods for treating postoperative pain in pediatric ankle and foot procedures.
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THE MOST COMMON DISORDERS OF THE HAND ASSOCIATED WITH CARPAL TUNNEL SYNDROME IN ADULTS
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2021)
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Ilir Shabani
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Liljana Angeleska
Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies caused by chronic compression of the median nerve in the area of the carpal tunnel and its etiology is multifactorial. Trigger fingers and de Quervain’s disease are common disorders of the hand related to CTS in adults.Theaim of this study was to present the most common disorders of the hand such as stenosing tenosynovitis in adults with surgically treated CTS and to evaluate their demographic data.Material and methods: A total of 116 surgically treated patients with established diagnosis of CTS (clinically and by electrophysiological examination) were included in this prospective study, which was conducted at the University Clinic for Orthopedic Diseases in Skopje. Demographic data, findings of history of the disease and clinical examination were recorded and analyzed.Results: Participants with CTS included in the study were with a mean age of 55.41±10.7 years (age range 29-75). 75% of them were female. 63.8% of participants suffered from one or more comorbid chronic diseases. On admission to hospital, disorders such as trigger fingers and de Quervain’s disease were concomitantly diagnosed in 15.51% on ipsilateral hand with CTS. All disorders were surgically treated following open carpal tunnel release, as “one stage procedure”, under local anesthesia.Conclusion: Our findings have determined concomitant existence of CTS and stenosing tenosynovitis (trigger fingers and de Quervain’s disease) on ipsilateral hand, which suggests common etiological factors. Female gender and age range 40-60 years are major common factors related to these three disorders.
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Rare case of super-response to Cardiac Resynchronization Therapy in Macedonian patient with Dilated Left Ventricular Non-Compaction Cardiomyopathy
(Mahendra Patidar, 2024)
Bozhin Shopov
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Planinka Zafirovska
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Background: Left ventricular non-compaction (LVNC) is rare cardiomyopathy with increased and prominent endomyocardial trabeculations also known as spongy myocardium. It is often found in association with a dilated cardiomyopathy (DCM) and has high incidence of Heart failure (HF). Cardiac resynchronization therapy (CRT) is currently recommended by the available guidelines for selected patients with Heart failure with reduced ejection fraction (HFrEF). Aim: Our case report aims to highlight the therapeutic benefits and superresponse to CRT in a patient with Left ventricular non-compaction cardiomyopathy and HFrEF. Case report: 55-year-old Macedonian male patient with HFrEF, Left bundle branch block (LBBB) remained symptomatic (NYHA III) despite optimal medical treatment (OMT). Echocardiography and CMR findings were in addition to dilated and left ventricular non-compaction cardiomyopathy. Cardiac resynchronization therapy was indicated and 18 months after implantation of CRT-P device we have achieved complete and utter reversibility of systolic myocardial function (EF from 23% to 53%), left ventricular internal diameter was reduced from 90mm to 64mm, left ventricular end systolic volume (LVESV) was reduced from 319ml to 98ml and patient quality of life significantly improved. Conclusion: Cardiac resynchronization therapy is a safe and valuable method of treatment for patients with HFrEF due to dilated left ventricular non-compaction cardiomyopathy.
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EVALUATING A TRANSITORY RIGHT BUNDLE BRANCH BLOCK IN FOOTBALL PLAYER
(Faculty of Physical Education, Sport and Health in Skopje, Republic of Macedonia, 2022)
Janushevski, Filip
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Background: Athletic heart is a non-pathological condition. The occurrence of arrhythmias or branch block in athletes should be taken seriously. Cardiac examinations performed by an experienced cardiologist are crucial for defining the true condition of the athlete's heart and the eventual prevention of sudden cardiac death. Case report A professional football player at the age of 22 years with no personal or familial history of cardiovascular disease is referred to a cardiologist for abnormal treadmill test results. The treadmill test was impressive for the RBBB pattern on the electrocardiogram (ECG) that was not revealed on his basic and native ECG. As mentioned before he had no history of cardiovascular disease and he had been playing football skillfully for 10 years. This case report represents the importance of the electrocardiogram as a diagnostic tool in the evaluation of the athlete’s heart. Conclusion Despite consensus documents, recommendations and guidelines for electrocardiogram interpretation in athletes this method lacks specificity and sensitivity and sometimes further evaluation is needed for proper diagnosis and treatment.
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Genetically Associated Hypertrophic Cardiomyopathy Combined with Persistent Left Superior Vena Cava
(Valley International, 2023-01-24)
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Grueva, Elena
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Mitevski, Goran
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Nikolovski, Robert
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Janushevski, Filip
Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy. An implantable cardioverter defibrillator (ICD) is an efficient way of preventing sudden cardiac death in these patients. Aim: Diagnosis and treatment of genetically associated hypertrophic cardiomyopathy. Case Report: We present a 28-year patient with a history of tachycardia, dizziness, transient chest pains, and anamnestic information on episodes of short-term loss of consciousness and fatigue. She has a positive family history of HCM and her uncle died young from sudden cardiac death (SCD). The electrocardiogram showed hypertrophy, which was confirmed with echocardiography and MRI. Genetic testing confirms PRKAG2 gene mutation. Holter24-hour ECG monitoring showed domination of sinus bradycardia after which it was recommended implantation of ICD. On implantation, persistent left superior vena cava (PLSVC) was discovered and the implantation side was changed. A bipolar Implantable Cardioverter Defibrillator was implanted. Conclusion: When HCM is confirmed at a young age, genetically associated HCM should always be considered. Early recognition of hereditary hypertrophic cardiomyopathy can facilitate better disease management and follow-up even before symptoms appear.
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Flecainide induced wide QRS Tachycardia
(MIT Univerzitet Skopje, 2021)
Gjoko Spasevski
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Elena Kikirkovska
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In this case report we present a 54-year-old patient hospitalized in the rhythmology department, who complains of fatigue and shortness of breath. The electrocardiogram showed atrial flatter with a frequency of 140 / min. After treatment with flecainide, the patient is converted to a sinus rhythm with a frequency of 75 / min. A coronary load stress test was then performed, in which in the recovery phase, the patient switched from a sinus rhythm to a wide QRS atrial flutter with a 1:1 conduction. Echocardiography subsequently revealed dilated left ventricle with global hypokinesia and an ejection fraction of 41%.
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Brugada syndrome: A case report
(Association of Medical Doctors "Sanamed" Novi Pazar, 2016)
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Gjurkova-Angelovska, Beti
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VENTRICULAR ARRHYTHMIAS AS A CAUSE OF A SUDDEN CARDIAC DEATH IN ATHLETES
(Faculty of Physical Education, Sport and Health in Skopje, Republic of Macedonia, 2022)
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Nikolovski, Robert
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Lazovska, Marija
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Janushevski, Filip
We live in a decadewhen the necessity for a healthy life with the prevention of cardiovascular disease is progressively emphasized. Physical activity is one of the basic medical recommendations by the cardiologists in the prevention and improvement of heart health. But what is the edge between the physiological and the possibility of pathological incidents? What are the dangers which are caused by the pro-arrhythmogenic heart in some athletes? Ventricular arrhythmias are a real risk of sudden cardiac death in some athletes. The case with the football player Eriksen at the European Football Championship reopened this question, whether we are doing enough to protect the health of our athletes.

Georgiev, Antonio

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