SHuntov, Blagoj
Preferred name
SHuntov, Blagoj
Official Name
SHuntov, Blagoj
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Item type:Publication, SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study(Wiley, 2022-01); ; ; Chokleska, NSARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3-6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of the radiological variables, clinical picture and values of C-reactive protein (CRP) and leukocytes in the brain edema development and eary intrahospital mortality in patients with hemorrhagic cerebrovascular insult(Macedonian Association of Physiologists and Antropologists, 2020); - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, CARPENTER SYNDROME - CASE REPORT AND TREATMENT(Македонско лекарско друштво = Macedonian Medical Association, 2016); ; ; Agai LjIntroduction. Carpenter syndrome is a polymorphic disorder transmitted by autosomal recessive inheritance, caused by mutations in the RAB23 gene [1]. These gene- tic disorders are reflected on the biogenesis of intracra- nial structures. This syndrome was described for the first time in 1900 by the British doctor George Carpenter. It may include congenital heart diseases, mental retarda- tion, hypogonadism, obesity, umbilical hernia, develop- mental disorder, bone anomalies and frequent respiratory infections. Carpenter syndrome has two main features: craniosynostosis and more than five fingers or toes (2-4]. Aim. To present our experience in treatment of an in- fant with Carpenter syndrome including trigonocephaly and polydactyly. Case report. In May 2003, an eleven-month-old male infant with Carpenter syndrome was hospitalized in the Pediatric Department of the University Clinic of Neuro- surgery in Skopje, Republic of Macedonia. The infant was referred to our Department from the University Pediatric Clinic because of trigonocephaly and poly- dactyly with two thumbs on his right hand. The infant had already been twice hospitalized at the University Pediatric Clinic for two recurrent lung infections su- ggestive of Carpenter syndrome. The diagnosis of tri- gonocephaly and polydactyly with two thumbs on the right hand was made by physical examination, X-ray of the right infant's hand and computed tomography of the head. According to Oi and Matsumoto classification from 1986 [5], the infant had a severe form of trigonocephaly. Surgical procedure. Under general endotracheal anesthe- sia, the infant was placed supine on the operating table, a bifrontal skin incision was made and the scalp flap was created. The bifrontal craniotomy was realized into one bony piece succeeded by a modified Di Rocco's "shell" procedure including frontal translation and trans- Correspondence to: Vladimir Mirchevski, University Clinic for Neurosurgery, Clinical Center "Mother Teresa" Skopje, Macedonia, E- mail: neurosurgery skopje @yahoo. position rotating the flap for 180 degrees without /touching the orbital rims. Results. The postoperative period was uneventful ex- cept for the expected forehead swelling. The infant was discharged from the hospital on the 7 postoperative day, neurologically intact. Three months after surgery, the head had excellent esthetic appearance, with regular psychomotor development in line with the age of the patient. Six months after the first surgery the patient underwent a second plastic and reconstructive surgery in order to reduce the number of fingers. Conclusion. The early recognition and multidisciplinary approach could prevent new disabled individuals in the society. Our technique shortens the entire surgical procedure, diminishes the time under anesthesia and its complications, especially in departments where blood saving devices are not available - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Craniopharyngiomas: A 20-Year-Period Evaluative Single Center Study(Scholars.Direct, 2021-06-21); ; ; ; Cvetkovski, PetarIntroduction: Craniopharyngioma is a rare histologically benign brain tumor with potential malignant clinical course because of the high propensity of recurrence, deriving from the remnants of Ratkhe’s pouch, presenting as solid mass and partly as fluid-filled cyst. There are two main histological subtypes: adamantinomatous and papillary. The aim of this study is to evaluate statistical features of this tumor in the Republic of North Macedonia. Materials and Methods: This is a 20-year-period retrospective, single center evaluative study (1998-2018) of 40 craniopharyngioma cases operated in the University Clinic of Neurosurgery, diagnosed at the Institute of Pathology, Medical Faculty, University ‘’Ss. Cyril and Methodius’’ in Skopje, Republic of North Macedonia on paraffin section slides routinely stained with H&E. Statistica for Windows 7 was used. Results: From total 4929 cases of benign and malignant brain tumors, craniopharyngioma comprise 40 cases (0.81%); 25 (62.5%) males (37.9 ± 17.8 years), 15 (37.5%) females (34.0 ± 25.4 years), age 3 to 68 years; Most prevalent localization: Sellar region - 11 (27.5%), cerebrum - 8 (20%). Adamantinomatous - 27 (67.5%) cases, papillary 13 (32.5%) cases. Age group distribution: the most cases - 7 (17.5%) in 0-9, 40-49, 60-69 years groups; least cases - 3 (7.5%) in 20-29 years group. Nine (22.5%) of 40 patients have had recurrent tumor (first 1-3 years). Adamantinomatous was diagnosed in 14 (51.85%) males and 13 (48.15%) females; Papillary in 11 (84.62%) males and 2 (15.38%) females. There is significant statistical difference between age groups and craniopharyngioma subtypes (Kruskal-Wallis ANOVA: H = 14.86; p = 0.0274). Conclusion: We found association/correlation between gender, age and histological subtype. Papillary craniopharyngioma appears more frequently in males and adamantinomatous was most prevalent in younger patients. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Mixed ganglioglioma and cavernous angioma in the temporal lobe - case report(International Academy of Pathology, 2018-10); ; ; ; Objective: Gangliogliomas are rare CNS tumors defined by the presence of both neoplastic ganglion and glial cells. They are recognized by the WHO classification mostly as Grade I, although some examples showing atypia have been observed, originating from the glial component. They occur mostly in the pediatric population and young adults. Association of ganglioglioma with cavernoma is extremely rare and it could be considered as an angioganglioglioma. We present a case of synchronous ganglioglioma and cavernous angioma in 57-year-old-man with epilepsy. Methods: The patient was admitted to the Department of Neurosurgery with a left side paresis, somnolent and vomiting. He acknowledges the presence of vascular mass discovered more than 30 years ago, when he got the first seizure and denied operation. CT and MRI showed an increased lesion with recent bleeding at right temporal lobe followed by edema. Craniotomy disclosed a hemorrhagic poorly demarcated tumor which was partially removed. Grossly, the tumor tissue had solid consistency and dark brown color. Standard procedure of paraffin embedded section routinely stained with H&E was performed. Results: Histological examination revealed cavernous angioma with low grade gangliglioma located at the periphery of the angioma. The vascular component was admixed and observed in some regions of the ganglioglial mass, presenting with hyalinized ectatic vascular channels, perivascular hemosiderin deposits, gliosis and vascular calcifications. Glial cells were identified by immunopositivity for GFAP, ganglion cells for Synaptophysin and Chromogranin, cavernous vessels for SMA and CD34. The proliferative index for Ki-67 was lower than 1%. Conclusion: We present an extremely rare case of mixed ganglioglioma and cavernous angioma. The term “angioganglioglioma” was proposed to define a transitional form between angioglioma and ganglioglioma. Several other cases of mixed tumor and vascular malformation have been described in the literature. Further, it may constitute a new distinct clinicopathological entity with neoplastic and hamartomatous features. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of the radiological variables, clinical picture and values of CRP and leukocytes in the brain edema development and early intrahospital mortality in patients with hemorrhagic cerebrovascular insult(2020); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries(Elsevier Ltd., 2022-11-05)
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