Temelkovska Stevanovska, Marina
Preferred name
Temelkovska Stevanovska, Marina
Official Name
Temelkovska Stevanovska, Marina
Translated Name
Temelkovska Marina
27 results
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Item type:Publication, POSTOPERATIVE SERUM CREATININ LEVEL IN TWO DIFERENT HYDRATION REGIMES IN LIVING DONOR KYDNEY TRANSPLANATATION(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2017-04); ; ; Introduction: Early graft function is very important and can be achieved with adequate intraopeartive perfusion characteristics of the graft and urine output. The goal of this study was to examine the influence of targeting central venous pressure (CVP) on early graft function. Material and methods: After approval of Ethical committee of the Medical Faculty-Skopje, we obtained inform consent of 60 patients, ASA 2-3 undergoing renal transplantation of livingrelated person in the Clinic of Urology – Skopje. A prospective clinical study was performed in the period of 2 years. Patients were divided into 2 groups of thirty patients : group A receiving normal saline intraoperatively targeting for CVP to 15 mmHg until vascular clamps were off and group B receiving normal saline 10ml/kg/h. We recorded lactate at the end of the surgery, onset of diuresis and total urine output from unclamping the renal vessels to the end of the surgery in both groups and postoperative serum creatinine in 3times (3, 12, 36 hours). Results: The onset of diuresis in seconds was insignificantly longer in group B p>0,05 (p=o,31). The average value of postoperative levels of the lactate showed that in group B the levels of the lactate were significantly higher for Z=-5,79 and p<0,001 (p=0,000). We didn’t find any statistical differences in postoperative serum creatinine in both groups. Conclusion: Our study didn’t show any benefit from targeting CVP to 15 mmHg. We couldn’t find any significant difference on onset of diuresis and urine output after the unclamping the vessels. However, in the constant infusion group (group B) the level of the lactate was higher CVP. In postoperative biochemical parameters we had no statistical difference between the average values of serum cratinine. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Hypoxia during one lung ventilation in thoracic surgery(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2011); ; Mojsova Mijovska, Maja - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MANAGING DUAL PATHOLOGIES: NEPHRECTOMY FOR RENAL CELL CARCINOMA IN A PATIENT WITH SEVERE TRICUSPID VALVE REGURGITATION(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025); ; ; Chavkoska, MarinaRenal cell carcinoma (RCC) is the most prevalent form of kidney cancer.Tricuspid regurgitation is a condition marked by the reverse flow of blood from the right ventricle into the right atrium and necessitates thorough assessment to ascertain its severity and effect on heart function. In this case, we present a 57-years-old male patient with symptomatic renal cell carcinoma and a severe tricuspid valve regurgitation. The performed open nephrectomy went uneventfully. While the patient was successfully and safely managed from an anesthesiology standpoint despite his comorbidities, performing the procedure in a resource-limited setting posed significant challenges. In such environments, the lack of immediate access to advanced hemodynamic monitoring, cardiothoracic surgical support and perioperative cardiac interventions increases the complexity of managing patients with dual pathologies. Ideally, conducting nephrectomy in an operating theater equipped for simultaneous surgical interventions, addressing both the renal pathology and potential worsening of tricuspid valve regurgitation, with a cardiothoracic team on standby, would have provided a safer approach. However, in settings with constrained resources, optimizing intraoperative management, ensuring rigorous hemodynamic monitoring, and coordinating multidisciplinary teams within the available infrastructure become critical for achieving favorable outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ULTRASOUND GUIDED SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERY IN CARDIOVASCULAR COMPROMISED PATIENT(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025); ; Introduction: We can use the supraclavicular block as a postoperative pain management approach, as an addition to general anesthesia, or as the sole form of anesthesia for upper limb surgery. For upper limb surgery, this block is a fantastic substitute for general anesthesia in patients with pulmonary and cardiac comorbidities. Case Presentation: In order to undergo surgery for a fracture of the proximal portion of his upper arm, a 66-years-old male AA was brought to the Clinic for Orthopedic Diseases in Skopje. The anesthesiologic examination revealed that the patient had diabetes mellitus type II, cardiomyopathy, untreated ischemic heart disease and wheezing and crepitations in the distal portions of his lungs. We planned the open fixation of the fracture for the patient. A supraclavicular brachial plexus block was performed as the most non-invasive procedure for perioperative treatment, taking into consideration the patient’s health. The patient’s vital indicators were normal and stable during the procedure. After receiving therapy for two days, the postoperative course was uneventful, leading to the patient’s discharge. Conclusion: If not addressed earlier, preoperative pulmonary and cardiac comorbidity increases the risk of perioperative and postoperative problems. With no postoperative problems, peripheral nerve block – in our case, supraclavicular brachial plexus block – proved to be a safe option for anesthesia management used for upper limb surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The impact of intraoperative targeting of the central venous pressure on the onset of diuresis in living donor kidney transplantation(Macedonian Association of Anatomists and Morphologists, 2016); ; ; Introduction: Early graft function is very important and can be achieved with an adequate intraoperative perfusion characteristics of the graft and urine output. The goal of this study was to examine the influence of targeting CVP on the onset of diuresis in kidney transplantation. Material and methods: The patients were divided in 2 groups of thirty patients: group A receiving normal saline intraoperatively, targeting for CVP 15 mmHg until vascular clamps were off and group B receiving normal saline 10ml/kg/h. The hemodynamic changes were recorded as systolic, diastolic and mean arterial pressure in 4 times: T0 before the induction, T1 after induction, T2 before the clamping the vessels and T3 after unclamping. We also recorded the duration of surgery, the duration of cold and warm ischemia, and the amount of normal saline until the unclamping of the vessels, lactates at the end of the surgery and total urine output from unclamping the renal vessels to the end of the surgery in both groups. We were monitoring the administration of plasma expander, dopamine and furosemide (if higher than 40mg) and we were inspecting if any tissue edema occurred. Results: There were no statistically significant differences in intraoperative hemodynamic parameters between both groups. The onset of diuresis in seconds was insignificantly longer in group B p>0.05 (p=0.31). The average value of postoperative levels of the lactate showed that in group B the level of the lactate were significantly higher for Z=-5.79 and p<0.001 (p=0.000). Conclusion: CVP as a guide for volume substitution is still highly recommended in kidney transplantation. The fact that in group B (the constant infusion group) we had 5 (16.7%) patients in whom we didn’t achieved urine output at the end of the surgery and the level of lactate was higher in group B gives us the right to conclude that targeting higher CVP, promotes diuresis and better urine output at the end of the surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Influence of Targeting Central Venous Pressure (CVP) on Early Graft Function after Living Donor Kidney Transplantation(Ommega Online Publishers, 2017-03-30); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Аналгезија со примена на континуиран fascia iliaca compartment блок наспроти континуиран блок на феморалниот нерв кај пациенти со скршеница на колк(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2011); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Myasthenia gravis and general anesthesia(Department of Anesthesia and reanimation, Faculty of Medicine, Ss.Cyril and Methodius University, Skopje, Macedonia, 2017-04); ; ; Myasthenia gravis patients undergoing general anesthesia are real challenge. Several contemporary issues of the disease, as well as the therapy and additional contributing factors interfere with the anesthetics on several levels. Up to day, literature has not proved which type of anesthesia or anesthetics are superior in such patients. The aim of this article is to elaborate and review some of the possible aspects of this disease and their interference with anesthesia that have direct influence on these patients outcome. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The impact of continuous epidural analgesia and continuous femoral nerve block on postoperative cardiac complications in elderly patients with hip fracture(Journal of the Macedonian Medical Association, 2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CEREBRAL OXYGENATION NON INVASIVE MONITORING IN TRAUMATIC BRAIN INJURY – А PILOT STUDY(Macedonian Medical Association = Македонско лекарско друштво, 2017); ; ;
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