Krstevska, Blagica

Preferred name
Krstevska, Blagica
Official Name
Krstevska, Blagica
Main Affiliation
Email
blagica.krstevska@medf.ukim.edu.mk

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    Item type:Publication,
    Genetic Alteration Profiling in North Macedonian Lung Cancer Patients
    (MDPI AG, 2025-10-10)
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    Background/Objectives: Late diagnosis and inefficient treatment regimens lead to poor prognosis, with a low 5-year survival rate for both non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). New targeted therapeutic agents can be developed and introduced only by first discovering new driver oncogenes and with a thorough investigation of the known driver genes. The aim of the current study is to investigate the prevalence of alterations in the eight most frequently altered genes in lung cancer-BRAF, EGFR, KRAS, ALK, ROS1, HER2, PD-L1 and PIK3CA. Methods: Real-time polymerase chain reaction (RT-PCR) was used to detect KRAS and EGFR mutations, multiplex PCR and microarray hybridization for KRAS/BRAF/PIK3CA mutations. Immunohistochemical analysis was performed for the detection of ALK, HER2/NEU, ROS-1 and PD-L1 alterations. Results: Overall, 221/603 patients (36.65%) had at least one genetic alteration, of which 22 patients (3.65%) had two genetic alterations and two patients had more than two genetic alterations. Additionally, 50 patients were identified with one or more KRAS mutations (8.29%), 45 patients with EGFR mutations (7.46%), and 1.82% with PIK3CA mutations and 0.66% with BRAF mutations. Furthermore, 50% of the co-occurring alterations were either on KRAS and PIK3CA genes (3/6), on KRAS and BRAF genes (2/6, 33.33%) or on EGFR and PIK3CA genes (1/6, 16.67%), and 10.45% of the patients exhibited PD-L1 overexpression, 5.31% ALK rearrangements, and 2.36% HER2/NEU expression, with no ROS-1 rearrangements detected. Conclusions: Comprehensive testing for somatic alterations in EGFR, BRAF, KRAS, and PIK3CA is significant in guiding therapeutic decisions in lung cancer management. Such testing should be routinely conducted to establish a thorough genetic profile of lung cancers in a manner that is both time-efficient and cost-effective.
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    Item type:Publication,
    The suprising stories of the acute abdomen:Tosion of the appendix vermiformis
    (2025-04)
    Srbakovska, Bisera
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    Ognenoska, Biljana
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    Acute appendicitis is the most common cause of acute abdominal pain needing surgical treatment. However, it can be clinically and radiologically mimicked by other conditions, some of them with an extremely rare occurrence. A two year old boy presented to our hospital with a history of abdominal pain and vomiting in the last 48 hours. On physical examination, the patient was found to be dehydrated, with a dry mouth and a white-coated tongue. Tenderness was noted throughout the entire abdomen, with rigidity and guarding, especially in the right lower quadrant. Laboratory results showed an elevated Creactive protein level of 50.2 mg/L and a white blood cell count of 25,800/μL. Under the suspicion of acute complicated appendicitis, emergency McBurney laparotomy was performed. Operative findings revealed an enlarged, dark purple, congested appendix, twisted 720° around its base at the cecum in the anticlockwise direction. There was no evidence of perforation. A typical appendectomy was performed. The postoperative course was uneventful and the patient was discharged home on the fourth post-operative day. Microscopic examination confirmed the hemorrhagic infarction and ischemic necrosis of the appendix, followed by an inflammatory reaction caused by the torsion. To our knowledge only 22 cases of torsion of the vermiform appendix in children have been reported in literature, with our case being the 23rd. Though extremely rare, it should be considered as a potential diagnosis in patients presenting with right lower abdominal pain. Histopathology is crucial in differentiating primary from secondary causes of appendicular torsion.