Kamnar, Viktor

Preferred name

Kamnar, Viktor

Official Name

Kamnar, Viktor

Main Affiliation

viktor.kamnar@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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TALOCRURAL ARTHRODESIS USING THE METHOD OF ILIZAROV
(Faculty of Physical Education, Sport and Health, Skopje, Republic of Macedonia, 2020)
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Background: Talocrural arthrodesis using the method of Ilizarov is a reasonable procedure for patients with secondary ankle degenerative changes and comorbidities, making other surgical treatment impossible. The aim of this study is to evaluate the results of talocrural arthrodesis as union rate, deviations, functional restoration and complications. Patients and Methods: The study has included 26 patients with Ilizarov talocrural compressive arthrodesis at the Clinic for Orthopaedic Surgery in Skopje from 2015 to 2019, of which 3 were with simultaneous gradual distraction. The follow up was from 22 to 64 months. The age varied from 41 to 77 years. All patients were with comorbidities and poor bone and soft tissue condition. The monitoring was performed using native radiography and ultrasonography at the compression/distraction site. Results: A complete bone fusion was achieved in all patients. The median time of wearing the external fixator was 22 weeks. In three cases with simultaneous distraction, the average bone healing index was 47 days/cm. The final maximal length discrepancy was 11 mm. In 16 patients (61.53%) sings of pin tract infections were detected. The mean number of pin site infections was 2.3/patient. No pin infection has required a change of the pin. Once the construct was removed, patients used a cast for 4-6 weeks and a walker boot for next 6-8 weeks. Conclusion: A talocrural arthrodesis performed by the Ilizarov method offers a high union rate, few deviations and a good functional restoration, often with no additional surgical procedures. In cases with numerous comorbidities and a poor limb condition, it can be a method of choice instead of an arthrodesis using internal fixation in the treatment of end-stage ankle arthritis.
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GIANT CELL TUMOR OF THE PROXIMAL TIBIA TREATED WITH EN BLOC RESECTION AND RECONSTRUCTION WITH SEMI-CONSTRAINED KNEE ENDOPROSTHESIS: А CASE REPORT
(Faculty of Physical Education, Sport and Health, Skopje, Republic of Macedonia, 2021)
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Introduction:Giant cell tumor(osteoclastoma) is benign, locally destructive tumor with low metastatic potential, but it has tendency of recurrence after the treatment. The primary areas of involvement are the ends of long bones, commonly the distal femur and proximal tibia. The most preferred treatment modality of the giant cell tumor is surgery. Case report: A 54-year-old female presented with pain and slight swelling localized over the proximal left tibia and limited range of motion in the left knee. After histological confirmation of the diagnosis with open biopsy, en bloc resection of the lesion wasmade with reconstruction of knee joint with semi-constrained knee endoprosthesis and trabecular metal. Conclusion: Selecting the appropriate treatment method is very important for the recovery of the function of the affected joint and for the whole extremity, as well. There is an advantage of en bloc resection and reconstruction with semi- constrained knee endoprosthesis in combination with trabecular metal in cases with extensive destruction of bone structure, recurrence, pathological fracture or difficulty in reconstruction after intralesional curettage. Advantages in functional aspect of this treatment modality are retaining the stability of the knee joint, substituting the bone defect and fast recovery of the function of the affected joint and limb.
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Monitoring the reduction and maintenance of periprosthetic bone tissue in cementless primary hip endoprosthesis with alendronate therapy
(Scientific Foundation SPIROSKI, 2021-11-20)
Shabani, Ilir
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Popovski, Neron
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Loss of periprosthetic bone tissue in primary hip endoprostheses is common in clinical practice. This loss can be progressive and in extreme conditions can jeopardize the longevity of the prosthesis. In order to monitor the function of Alendronate therapy for bone maintenance, the study included 50 patients with implanted total cement-free hip endoprosthesis (TPH). The first group of 25 patients received Alendronate, calcium and vitamin D3 orally postoperatively. The second group of 25 patients were examined postoperatively without therapy. Patients were followed by radiographic and dual-energy X-ray absorptiometry (DXA) at 6 and 12 months. The study showed that in patients with TPH there was a difference in the X-ray findings as well as occurrence of osteolysis in certain Gruen zones, which was confirmed by changes in the state of bone mineral density (BMD) and bone mineral content (BMC) in the interval between 6 and 12 months using the DXA method. Alendronate therapy after TPH implantation allows reduction of periprosthetic bone mass loss, maintenance of bone mineralization and implant hardening.
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The importance of HPV vaccination in the prevention of cervical cancer
(SHMSHM - AAMD, 2021)
Dejan Filipovic
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Vladimir Chadikovski
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Kristina Stavridis
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Osteodensitometric aspects of bone in limb lengthening and deformity correction
(Македонско лекарско друштво = Macedonian medical association, 2020)
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Acetabular revisions in total hip arthroplasty
(Medical faculty, Ss Cyril and Methodius University in Skopje, 2020)
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Samardziski M
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PEDIATRIC SURGICAL STRESS RESPONSE AND ANESTHESIA
(MIT Univerzitet Skopje, 2021)
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Nancheva-Bogoevska, Andreja
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Surgical trauma disturb the body homeostasis by inducing a combination of local response to tissue injury and generalized activation of systemic metabolic and hormonal pathways via afferent nerve pathways and the central nervous system. The local inflammatory responses and the parallel neurohumoral responses are not isolated but linked through complex signaling networks, some of which remain poorly understood. The stress response to surgical trauma occurs as a protective mechanism, by activating a series of endocrine, metabolic and immune processes which prevent disturbance of homeostasis. The magnitude of the response is broadly related to the site of injury (greater in regions with visceral pain afferents such as abdomen and thorax) and the extent of the trauma. The stress response to surgical trauma is different in premature, newborns, infants, and in children approaching puberty is the more similar as in adults. New anesthetic agents basically do not trigger the endocrine-metabolic response of the body. Endocrine-metabolic, immune and autonomic responses to surgical trauma can be modified using regional anesthetics techniques and the use of analgesics in general anesthesia. It is the duty of each anesthesiologist before the surgery according to the patient and the kind and length of the surgical intervention, to assess which anesthesia technique and which anesthesiological agents is selected for conducting the operation, in order to provide “stress – free” anesthesia.
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Comparative analysis of radigraphic and ultrasonographyc parameters of new bone formation throughout limb lengthening
(SHMSHM - AAMD, 2014)
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RESPIRATORY FAILURE IN A CHILD WITH ASSOCIATED CONGENITAL HEART DEFECT
(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.N.Macedonia, 2020)
Stojanovic V
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Chadikovski V
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Radoeshki A
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Krmzova M
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Trpkovska V

Kamnar, Viktor

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