Mandzukovska, Hristina

Preferred name

Official Name

Mandzukovska, Hristina

Alternative Name

Христина Манџуковска

H.Bicevska

H.Mandzukovska

Hristina Bicevska- Mandzukovska

Христина Бицевска

Hristina Bicevska

Hristina Mandzukovska

Mandzukovska Hristina

Mandzukovska H.

Mandjukovska Hristina

Mandjukovska H.

Бицевска Х.

Бицевска Христина

Бицевска-Манџуковска Х.

Х.Бицевска

Христина Бицевска-Манџуковска

Х.Манџуковска

Main Affiliation

hristina.mandzukovska@medf.ukim.edu.mk

Now showing 1 - 10 of 26

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TROPONIN – OUR EXPERIENCE IN DETERMINATION OF MYOCARDIAL ISCHEMIC DAMAGE IN POSTOPERATIVE PERIOD OF CARDIAC SURGERY IN PEDIATRIC POPULATION
(2017)
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Lj. Kojik
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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.
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MOST COMMON FACTORS AFFECTING OCCURRENCE OF NEONATAL SEPSIS - CHALLENGE AND EXPERIENCE FOR TREATMENT AT NEONATAL INTENSIVE CARE UNIT
(Macedonian association of anatomists and morphologists, 2018)
Najdanovska-Aluloska Natasa
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Angelkova N
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Background: Neonatal sepsis remains a serious complication, especially among preterm infants. Neonatal sepsis is divided into early- and late-onset sepsis, based on timing of infection and presumed mode of transmission. Early - onset sepsis is defined by onset with in the first week of life, to infections occurring in the first 72 hours due to maternal intrapartum transmission of invasive organisms. Late - onset sepsis is defined as infection occurring after one week and is attributed to pathogens postnatally acquired. Materials and Methods: We have investigated neonatal sepsis in our NICU from 1 January till 31 December 2017, for one-year period, in order to determine mortality associated with sepsis and to identify the dependent predictors for morbidity and mortality. A total 216 infants were admitted in the NICU. Data were collected regarding the primary reason for NICU, maternal condition, gender, gestational age, length of NICU stay, duration of MV and non-invasive ventilation, using of umbilical catheter, and peripherally vein line. Results: Early - onset sepsis was detected in 15 neonates (12 %) within the first 72 hours. Late - onset sepsis was detected in 18 neonates (3,2 %) after 72 hours. Premature infants 23 (70 % range 26 - 37 gestational age) were more exposed to sepsis than term infants 10 (30 %; range 38-40 gestational age). 15 neonates (45,5%) were exposed to the early - onset sepsis, and 18 neonates (54,5%) were exposed to late-onset sepsis. The most frequent isolates were Staphylococcus aureus 7 ( 21,2 %), followed by Acinetobacter 6 (18,1 %), Meticillin- resistant Staphylococcus aureus 5 (72 % from total 7 Staphylococcus aureus) and Staphylococcus epidermidis 5 (15,1%), followed by Klebsiella pneumoniae 2 ( 6,06 % ), Serratia 2 (6,06 %) and Pseudomonas aureginosa 2 (6,06 %). Late - onset sepsis was significantly more common in premature infants. We confirmed that neonatal sepsis resulted with increase duration of NICU stay and duration of MV. Early diagnosis, followed by appropriate antibiotic treatment, short hospital stay and restricted use of invasive devices should be the aims to reduce the risk of late - onset sepsis during the stay in the NICU. Conclusion: Neonatal sepsis is a major cause of death in infants despite sophisticated neonatal intensive care. Early and adequate antibiotic therapy decreases the risk of morbidity of hospitalized patients.
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Importance of 6 minute walk test in diagnostics of rare metabolic myophaty a case report
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2017-12)
Natalija Angelkova
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Elena Shukarova Angelkova
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Mirjana Kocova
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Vesna Sabolic
Diagnosisi of rare inherited neuromuscular disorders is sometimes delayed due to variations in time of onset, different clinical appearance and limited diagnostic possibilites. The manegement of patients starts with neurological examinations followed by specific laboratory tests and neurological assesement. In the era of molecular medicine, molecular biology tools are useful in avoding some of the the invasive investigation such as muscle biopsy.We present a boy with a mild form of metabolic myopathy due to carnitine palmitoyltransferase 2 deficiency diagnosed upon timed functional assesment.A child had delayed developmental milestones,associated with fatigue and muscle pain during exercising and longer walks.There were no episodes of myoglobrinuira during exercise or during febrile illnesses.Neurological examination reveed proximal muscle weakness.Serum creatine kinase (CK) and serum lactate were above normal limits.Serum acylcarnitine profile was normal.Short timed functional tests such as 10 meters walk/run test showed normal results.Nord Star Amublatory Assesment showed difficulties in balance and jumping.Diagnosis of myopathy was suspected after performance of 6-minute walk test, when the passed distance was 327 meters with slowing and fatigue.EMG and echocardiography were within normal range.Diagnosis was established by equencing of the CPT II gene which revealed c.338C>T (p.Ser113Leu) mutation in homozygous form as characteristic CPT II deficiency profile.
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The most common complications in intensive care unit department after cardiac surgery in children
(Macedonian association of anatomists and morphologists, 2018)
Introduction: Having regard all the progress in the field of pediatrics, nowadays heart surgery can be performed with excellent outcomes. Serious complications can cause high morbidity and mortality rates. This study has been performed in order to determine the incidence of morbidity and mortality. Methods: During 2013-2015, the retrospective study was performed with 65 patients undergoing surgery for congenital heart disease which was reviewed for incidence of complications. We used the database of University Clinic for Children's Diseases and University Clinic of Pediatric Surgery in Skopje. Results: 33 children with complications, have been divided into 2 groups cardiac and extra cardiac complications with mean age of 6,5 ± 0,35 (rang 0,5 - 108 months). The first group included SVT (6,25 %), AV-block (6,25 %), pacing (6,25 %) and pericarditis (9,3 %). In the extra cardiac complications, the most common was bleeding (12,5 %), renal failure (9,3 %), chylothorax (9,3 %), seizures (9,3 %), reintubation after surgery (15.6 %), sepsis (12,5 %) and severe pneumonia (6,25 %). The duration of CPB was 68,32 ± 31,9 minutes, the duration of MV was 2,04 ± 2,42 days, and ICU stay was 3,90 ± 3,45. The incidence of mortality was 9,2 % whereby the most common was sepsis, reoperations for previous lung chronic diseases and renal failure. Conclusion: Prolonged duration of CPB, duration of MV and ICU stay, are significant risk factors for the increased number of cardiac and extra cardiac complications. It is necessary to apply the measures and careful monitoring of patients to minimize these effects.
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SEIZURES – DIAGNOSIS AND TREATMENT AFTER CARDIAC SURGERY IN THE PEDIATRIC POPULATION
(Македонско лекарско друштво = Macedonian medical association, 2018)
Introduction. Seizures are complications that can occur after cardiac surgery of congenital heart disease. Seizures are a symptom of disorders that happened in the brain and can be registerted with neurophysiology diagnostic procedures. A long-term neurodevelopmental follow up and electroencephalographic follow up is needed in purpose to minimize the occurrence of neurological disorders that can happen in the years later. Methods. If the seizures manifested the clinical status and vital parameters of the operated children in the postoperative period are followed-up (breathing, heart rate, blood pressure, neurological condition). Diagnostic examinations are carried out, EEG monitoring, head computed tomography. Anticonvulsant therapy is initiated. Results. From 57 operated patients, seizures appeared in four patients 3/57 (5.3%) in the first 24 hours. Seizures were classified as generalized tonic-clonic in one child (1.8%) and simple/complex partial also in 2 children (3.5%). The main risk factors for development are intracranial bleeding during cardiac surgery, prolonged duration of CPB of 81.5 min (range 11-196 minutes), and 29.2 min ( range 15 - 65 min) of x-clamp of aorta. Hypothermia implemented during the cardiac surgery was 32 C. Due to the prolonged cardiac surgery and deterioration of general condition, the following of postoperative period was also prolonged. Conclusions. The seizures are a rare complication that occurs in the early postoperative period. They are the first marker of brain dysfunction which requires a long-term monitoring of the condition. Seizures increase the risk factors for occurrence of dysfunctional and cognitive disturbances.
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SEIZURES AFTER PEDIATRIC CARDIAC SURGERY(REPORT OF THREE CASES) - WHAT CAN WE CONCLUDE?
(Ss. Cyril and Methodius University, Faculty of Medicine, Department of Anaesthesia and Reanimation, 2019)
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Stevic M.
ABSTRACT Seizures are complications that can occur after cardiac surgery of congenital heart disease. Their incidence is overall low. Enthought poorly reported in the literature their notification, early treatment and follow up is essential for further child neurological development. Furthermore, factors that lead to seizures after cardiac surgeries are additionally reported with controversies. While some authors discuss that the diagnosis and the type of surgery are essential for their occurrence other corelate them to prolonged duration of cardiopulmonary bypass (CPB), x-cross of aorta, prolonged hypothermia or duration of mechanical ventilation and intensive care unit (ICU) stay. In this article, we present series of cases of children who had seizures after cardiac surgery, where we made a comparation of several factors like diagnoses, duration of cardiopulmonary bypass and age, as possible factors for seizure occurrence.
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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)
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Tankoska Maja
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Pandovska Bisera
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Kimovska, Milica
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EVALUATION OF PROCALCITONIN AND SERUM ALBUIN LEVELS AS EARLY INFLAMMATORY BIOMARKERS IN NEONATAL SEPSIS
(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020)
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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.
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HYDROCEPHALUS WITH VENTRICULOPERITONEAL SHUNT IN INFANTS: OUR EXPERIENCES AND CLINICAL OUTCOMES
(Macedonian Association of Anatomists, 2022-12)
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Tamara Voinovska
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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.
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THE RISK FACTORS FOR POSTOPERATIVE OUTCOMES IN NEONATAL CARDIAC SURGERY
(Macedonian Association of Anatomists and Morphologists, 2020-12)
ABSTRACT Background: In the last three decades a neonatal cardiac surgery has improved the approach and methods for adequate treatment of complex congenital heart defects. Although we have advances in fetal cardiac imaging and improved perioperative cardiac procedures, the postoperative outcomes in neonatal care (neonates) are still present. Objective: To present our experience of operated neonates with congenital heart defects in a tertiary referral center, Neonatal Intensive Care Unit (NICU) in Skopje N. Macedonia. Materials and methods: We conducted a retrospective study including neonates who underwent surgical intervention between January 2013 and December 2015 at the University Clinic for Pediatric Diseases in Skopje. We analyzed perioperative and postoperative variables. The main outcomes were duration of cardiopulmonaly bypass (CPB), and x-cross of aorta, duration of mechanical ventilation, intensive care unit stay and postoperative complications. Fourteen (14) neonates were discharged from our Clinic. Results: Out of a total of 85 children, 15/85 (17.6 %) were neonates; males 12/15(80%) females 3/15 (20 %). The overall mortality was 1/15% (6.6%). There were 13/15 (86.6%) corrective procedures and 2/15 (13.3%) palliative ones. The mean duration of CPB was 46.6 min. (18±296 min.), the mean duration of x-cross of aorta was 17.5 min. (10±65 min.). The mean duration of mechanical ventilation was 3.4 days (1±15 days), duration of inotropic support was 4.2 days (1± 16 days) and ICU stay was 5.8 days (7.9 ± 14days). After the operation, 2/15 (13.3%) neonates required reintubation in the ICU. Postoperative complications were confirmed in 3 neonates (intracranial bleeding with seizures, block nodes AV and pneumonia). The incidence of all postoperative complications was 6.6%. Fourteen (14) patients were discharged from the Clinic. Conclusion: Due to adequate cardiac surgery, significant technological advances, devices and increasing experience in neonatal cardiac surgery we have improved postoperative outcomes.

Mandzukovska, Hristina

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