Kostova, Elena
Preferred name
Kostova, Elena
Official Name
Kostova, Elena
Main Affiliation
Email
elena.kostova@medf.ukim.edu.mk
30 results
Now showing 1 - 10 of 30
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Item type:Publication, Distribution of CYP2C9 and VKORC1 Gene Polymorphisms in Healthy Macedonian Male Population(ID Design 2012/Scientific Foundation SPIROSKI, 2013-12-15); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of clinical and arthroscopic findings in meniscaltears(Centre for Evaluation in Education and Science (CEON/CEES), 2014); Introduction: This study was conducted to compare the clinical and arthroscopic findings in lateral and medial meniscal tear injuries in order to assess the diagnostic significance of the clinical examinations findings. Patients and methods: All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 40 were diagnosed LM (lateral meniscus) tears and in 45 MM (medial meniscus) tears arthroscopically. In this study meniscal tears were clinically diagnosed by positive McMurray and Apley test. All clinically diagnosed patients underwent diagnostic and therapeutic knee arthroscopy to assess the accuracy of clinical diagnosis. The accuracy, PPV, NPV, sensitivity and specificity were calculated based on clinical examinations and arthroscopic findings. Results: Identification of meniscal tears in our study was presented with 85% accuracy of “McMurray” clinical examination test for LM tears and 80% accuracy for the MM tears, and for “Apley” clinical examination test for LM tears was obtained with 73% accuracy and 63 % accuracy for MM tears. Conclusion: According to our findings we can conclude that McMurry clinical examination test is more accurate for predicting i.e. diagnosing of meniscal tears. Contrary, Apley clinical examination test showed less accuracy for predicting i.e. diagnosing of meniscal tears. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Reliability Assessment of Arthroscopic Findings Versus MRI in ACL Injuries of the Knee(ScopeMed, 2014-04); ; Introduction: This study was conducted to analyze the reliability of clinical diagnosis in ACL tear injuries. Material and methods: All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 73 were arhroscopicaly diagnosed ACL tears. All these patients underwent therapeutic arthroscopic knee surgery. The clinical diagnosis was confirmed during this procedure. The accuracy, sensitivity and specificity were calculated based on these arthroscopic findings. Results: The accuracy of clinical diagnosis in our study was 82.5% for ACL tears. Our study revealed high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an appropriate screening tool for therapeutic arthroscopy, making diagnostic arthroscopy unnecessary in most patients. Conclusion: Magnetic resonance imaging is accurate and non invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation in patients with soft tissue trauma to knee. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FREQUENCY OF SURGICAL SITE INFECTIONS FOLLOWING SURGICAL TREATMENT OF ISOLATED FRACTURES: A RETROSPECTIVE STUDY(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024); ; Kacarska, AleksandraSurgical site infections (SSIs) are a frequent and serious complication that occur after surgical treatment of isolated fractures, leading to increased morbidity, mortality, prolonged hospital stays, and higher healthcare costs. This study aimed to identify the frequency and risk factors associated with SSIs. Methods: This retrospective observational study included 51 patients who underwent open reduction and internal fixation (ORIF) surgery for isolated fractures and later developed bacterial infections. We analyzed factors such as the presence of comorbidity, patient age, gender, body region affected, and duration of the operation. We used multinomial logistic regression and chi-square tests as statistical analyses to examine the relationships between these factors and the types of pathogens as a cause of bacterial infection, classified as Gram-positive bacteria only, Gram-negative bacteria only, or both. Results: Our study found that in 18%, 56% and 26% of patients the cause of infection was Gram-positive, Gram-negative and both groups of bacteria, respectively. The factors that did not significantly predict the type of bacterial infection were: comorbidity presence, although the observed trends suggested further investigation was needed; duration of operation; and patient age. Gender analysis concluded a marginally significant association, with males less likely to have infections caused by Gram-positive bacteria. Additionally, the body region affected showed a marginally significant correlation with infection type, with the thigh region being more sensitive to infections caused by Gram-negatives. Our study highlights trends and marginal associations in SSIs post-ORIF surgery, suggesting the need of personalized infection control strategies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Our Experience with Surgical Treatment of Scaphoid Fractures with Headless Compression Screw(Scientific Foundation SPIROSKI, 2024-10-10); ; ; Gjorikj-Petrushevska, MagdalenaBACKGROUND: Fractures of the scaphoid bone are quite common, and they come with their own set of challenges due to the specific shape of the fractures and the delicate blood supply to the scaphoid bone. Failing to diagnose and treat acute scaphoid fractures promptly can result in failure of the bone to heal and subsequent development of wrist arthritis. Advances in diagnosis, surgery, and implant materials have led to a growing inclination towards early surgical fixation, even for non-displaced scaphoid fractures that could potentially be treated without surgery. AIM: The study's goal was to assess the effectiveness of headless compression screws for treating acute scaphoid fractures and, in two cases, nonunion following previous conservative therapy. METHODS: Between January 2022 and March 2024 ten patients with scaphoid fractures were surgically treated at the University Clinic of Traumatology Skopje, within twelve months follow-up. All of them were male with mean age of 27,3 years. All were diagnosed with X-rays and CT scans. Six of the fractures were on the right hand and four on the left. RESULTS: All the patients were surgically treated with open reduction and internal fixation with headless compression screw. Volar approach was used in 9 cases and dorsal approach in only one of them. Six of the patients were surgically treated within 4-14 days after injury and four of them were surgically treated due to non union after previous conservative treatment, two of them after three and two of them after seven months of injury. All fractures united after a mean time of 9,5 weeks, without secondary displacement. Throughout the follow-up period, there were no incidences of developing osteoarthritis of the wrist. CONCLUSIONS: It is crucial to understand that achieving a positive result is not guaranteed for every patient and relies on selecting the right patients and fractures. However, our study shows favorable results in sooner surgical treatment with the headless compression screw, rather than delayed treatment of scaphoid fractures. Surgical treatment with headless compression screw showed both functional and radiographic results. While it is beneficial for the screw to be positioned in the subchondral area, it is important to be cautious to avoid cortical penetration, as this will require the screw to be removed later. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Electrodiagnostic Findings of Median Nerve Motor and Sensory Conduction in Neurological Asymptomatic Newly Diagnosed Patients with Hypothyroidism(Scientific Foundation SPIROSKI, 2024-09-15); BACKGROUND: The influence/impact of thyroid hormones on peripheral nervous system has still not been thoroughly/substantially studied/examined. Neurographic studies, which measure motor and sensory nerve conduction along with F-wave, have an important role in diagnosing diseases of the peripheral nerves since electrophysiological sings of neuropathy can be detected even in subclinical state/cases. AIM: The aims of this study were to assess the neurophysiological parameters of the median nerve by electrodiagnostic measurements using electromyoneurogaphy (EMNG) in the region of radiocarpal joint in patients with newly diagnosed and medically untreated primary hypothyroidism who had no symptoms and signs of peripheral nerve damage/injury/lesion. Furthermore, it was our aim to make an insight of the possible early detection of the latent damage of peripheral nervous system in untreated hypothyroidism. MATERIAL AND METHODS: This was a prospective clinical study that comprised 78 subjects/patients according to inclusion criteria, divided into two groups: one with primary hypothyroidism and the other group involving euthyroid subjects. Thyroid status was examined in each subject; anthropometric parameters were analyzed, and electromyoneurographic imaging (EMNG) of hand median nerve was realized. RESULTS: Of the total number of 78 subjects included in the study, 58 (74.36%) had hypothyroidism and 20 were euthyroid subjects (25.64%). The calculated mean levels of thyroid status parameters in hypothyroid patients, TSH, aTPO and FT4, were 6.19±1.85 mIU/L, 872.22±296.66 U/mL and 0.78±0.11 ng/dL, respectively. In euthyroid patients, the mean levels of TSH, aTPO and FT4 were 0.27±0.08 mIU/L, 31.2071±5.65 U/mL and 1.31±0.25 ng/dL, respectively. Statistically significant differences were obtained between hypothyroid and euthyroid subjects regarding: age (p=0.0147, r=0.3239), body weight (p=0.0441, r= -0.531), body mass index (p=0.0050, r= -0.301), WHO classification for BMI (p=0.0032, r= -0.250), TSH (p<0.0001, r=-0.309), aTPO (p<0.0001, r=0.5554) and FT4 (p<0.0001, r= -0.317). In the group of 58 hypothyroid subjects, 38 (65.52%) were women and 20 (34.48%) were men. A strong correlation and significant statistical difference were registered in EMNG pathological findings in patients with pathologic BMI and with mild predilection for the sensory part of the median nerve. Of the 58 hypothyroid patients, EMNG pathologic findings were present in 18 that, in terms of their features, indicated a distal lesion of the median nerve. These 18 subjects had an increased body mass index (30.83±5.65 kg/m2). CONCLUSIONS: Discovery, definition and explanation of etiopathogenic nodes in peripheral nervous system diseases will require extensive and multidisciplinary strategies in the next decades. These complex conditions, in our opinion, will claim a steady/a step-by-step/ approach to the problems, as well as consistency and symmetry in the design and methodology of the research procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clinical Outcomes of Three Different Modes of Femoral Hamstring Graft Fixation in Anterior Cruciate Ligament Reconstruction(Македонско лекарско друштво = Macedonian Medical Association/Walter de Gruyter GmbH, 2014-04-01); ; ; Introduction. There are various methods of anterior cruciate ligament (ACL) reconstruction of which the two main choices in autograft reconstruction involve the use of the bone-patella tendon-bone or hamstring graft. Femoral fixation can be divided into three main types: cortical suspensory devices such as Endobutton (Smith & Nephew, Arthrex), interference screws, and femoral transfixation devices such as Transfix (Arthrex) and Rigidfix (Depuy-Mitek). The aim of this study was to compare the clinical outcome between Rigidfix, Transfix and Endobutton devices for soft tissue femoral fixation in primary ACL reconstruction using the autogenous hamstring graft.</jats:p> <jats:p>Methods. We conducted our study in 48 patients admitted to our clinic, University Traumatology Clinic, Clinical Center "Mother Teresa", Skopje for ACL reconstruction from September 2009 to May 2013. The patients with ACL reconstruction were assigned as Rigidfix group (n=28), the second patients to Transfix group (n=13) and the third to Endobutton group (n=7). MRI of the knee joint was done prior to surgery. A data sheet, containing demographic data, examination findings and Tegner & Lysholm score, was completed for each patient.</jats:p> <jats:p>Results. Tegner & Lysholm the average scores before surgery were 2.52 and 34.75 (p>0.05). Six month after arthroscopy, the average value of Tegner and Lysholm scores in patients with ACL reconstruction was 8.37 and 89.08. Comparison among them showed that the operative mode of Endobutton femoral fixation had the highest level of the Lysholm score.</jats:p> <jats:p>Conclusions. Endobutton (Tight rope-RT) yielded a better outcome compared to the other two modes of femoral fixation in terms of instant stability of the graft and the general results.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prognostic significance of serum levels of tumor markers CEA and CA19-9 in patients with colorectal cancer(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2012); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Serum Matrix Metalloproteinase-2, -7 and -9 (MMP-2, MMP-7, MMP-9) levels as Prognostic Markers in Patients with Colorectal Cancer(University of Sarajevo Faculty of Health Sciences, 2012-12-15); ; ; ; <jats:p>Introduction: Matrix metalloproteinases are produced by tumour cells, hence, they may be associated with tumour progression including invasion, migration, angiogenesis and metastasis. Finding prognostic markers to better identify patients with higher risk for poor survival would be valuable in order to customize pre- and postoperative treatment as well as to enable closer follow-up of these patients. Aim of our study was to examineMMP-2, MMP-7 and MMP-9 serum levels and correlated them with pathological data such as stage of the colorectal cancer (CRC) and outcome.Methods: The investigation included 82 patients with operable CRC without distant metastases, who had underwent blood tests in order to determine the MMP-2, MMP-7 and MMP-9 serum levels in the following time periods: preoperatively, 3, 6, 9 and 12 months postoperatively.Results: The values of the investigated MMPs decrease postoperatively and start to increase 6 month later in patients of all stages of the disease, reaching the highest value 12 month postoperatively with statistically important differences of MMP-2, MMP-7 and MMP-7 serum levels in terms of disease staging and defined points of time. Analysis of the results showed that the MMP-2 serum levels obtained 3 and 12 months postoperatively,than MMP-7 serum levels 12 months postoperatively and the MMP-9 serum levels in all analyzed points in time were in significant association with the CRC patients’outcome.Conclusion: The MMP-2, MMP-7 and especially MMP-9 serum values could be important indicators for diagnosis of the patients with CRC and for monitoring of disease progression.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparative analysis of clinical and arthroscopic findings in ACL injury of the knee(2014-01); ; ; ; Background: This study was conducted to compare accuracy of MRI findings taking arthroscopy as standard in knee injuries. Methods: All patients attending our hospital with knee injury underwent clinical examination. Out of them 100 patients with knee injury were subjected to clinical examination, MRI and then Arthroscopy. The results were compared and analyzed using various statistical tests. The accuracy, sensitivity and specificity were calculated based on these arthroscopic and MRI findings. Results: The accuracy of clinical diagnosis in our study was 88% for ACL tears and 85% for meniscal tears. Our study proved high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an excellent screening tool for therapeutic arthroscopy. We can avoid diagnostic arthroscopy in patients with knee injuries having equivocal clinical and MRI examination and go on for therapeutic modality. Conclusions: For the assessment of ligamentous and meniscal injuries magnetic resonance imaging (MRI) is accurate and noninvasive modality. It can be used as a first line investigation but arthroscopy still remains gold standard in diagnosing ACL and meniscal injuries.
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