Faculty of Medicine
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Item type:Publication, CD30-Positive Diffuse Large B-Cell Lymphoma of the Breast in a Patient with Lymphocytic Mastitis: Evidence Suggestive of High-Grade Transformation from Extranodal Marginal Zone Lymphoma(EA4HP-SH 2026, 2026); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Beyond Sodium: Inflammation as the Strongest Predictor of Mortality Among Non-Diabetic Hemodialysis Patients(Macedonian Academy of Sciences and Arts, 2026-06-01); : Standard dialysate sodium concentration (sDNa) may not adequately reflect individual sodium requirements in each hemodialysis patient, potentially contributing to interdialytic weight gain (IDWG), hypertension and inflammation. The aim of this study was to compare clinical and biochemical outcomes between individualized and standard dialysate sodium prescriptions and to assess factors associated with mortality. : This was a prospective interventional study conducted in two phases. In the first phase, patients were treated with standard hemodialysis (HD) using a fixed dialysate sodium concentration of 138 mmol/L. In the second phase, dialysate sodium was individualized based on each patient's pre-dialysis serum sodium concentration. Each patient served as their own control. Outcomes included IDWG, blood pressure, thirst score, dialysis adequacy (Kt/V, URR), nutritional markers, C-reactive protein (CRP), electrolytes, and mortality. : Individualized dialysate sodium prescription was associated with a significant reduction in IDWG (1.93 ± 0.64 vs 2.17 ± 0.79 kg; p = 0.001) and improved dialysis adequacy (Kt/V: 1.50 ± 0.24 vs 1.36 ± 0.22; p < 0.001). Survivors had higher serum albumin levels and lower CRP values compared to non-survivors. Serum and dialysate sodium concentrations were not independently associated with mortality. In logistic regression analysis, CRP >10 mg/L showed the strongest observed association with mortality (OR 10.278; 95% CI 1.709-61.826; p = 0.011). : Individualized dialysate sodium prescription may improve fluid control and dialysis adequacy in selected patients. Inflammation was significantly associated with mortality in this cohort; however, results should be interpreted with caution due to the limited number of events. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, From diagnosis to disease-specific treatment: first experience with enzyme replacement therapy for Fabry disease in North Macedonia-a case series(Frontiers Media S.A., 2026); ; ; ; BACKGROUND: Fabry disease is a rare X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A, leading to progressive accumulation of globotriaosylceramide and Lyso-Gb3 across multiple organ systems. Timely initiation of enzyme replacement therapy (ERT) is critical to prevent irreversible organ damage; however, access to disease-specific treatment remains limited in many regions. METHODS: We describe a prospective observational case series representing the first national experience with ERT in North Macedonia in two male patients with advanced Fabry disease following kidney transplantation. Clinical, biochemical, cardiac, neurological, and patient-reported outcomes were prospectively evaluated after initiation of agalsidase beta (1 mg/kg) and agalsidase alfa (0.2 mg/kg), respectively. RESULTS: Both patients demonstrated substantial and sustained reductions in Lyso-Gb3 levels, confirming a robust biochemical response. Renal graft function remained stable without proteinuria, and no progression of cardiac involvement was observed. Clinical response varied between patients: the first patient experienced marked and sustained improvement in neuropathic pain and quality of life, whereas the second patient demonstrated persistent fluctuating neurological manifestations despite significant biochemical response. Persistent neurological impairment in the second patient was associated with combined central and peripheral nervous system involvement, including Fabry-related ischemic encephalopathy. CONCLUSION: In this two-patient case series, ERT was well-tolerated and associated with substantial reduction of biochemical disease burden and stabilization of renal graft and cardiac function. However, persistent neurological impairment despite marked Lyso-Gb3 reduction suggests limited reversibility of advanced central nervous system involvement, highlighting the importance of early diagnosis, family screening, and timely initiation of disease-specific therapy in Fabry disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Global Perspective on Kidney Biopsy and Glomerular Disease in North Macedonia.(Lippincott Williams & Wilkins (LWW), 2026-08-01); ; ; ; Suleyman, Sabir - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Beyond Living Donor Kidney Transplantation in COL4 Nephropathy - A Real-World Clinical Dilemma in Light of Current Guidelines(Macedonian Academy of Sciences and Arts, 2025-12); ; ; ; Kidney transplantation is the best choose of modality for treatment of the patients with end-stage kidney disease (ESKD). However, hereditary conditions like COL4 nephropathy introduce significant obstacles in living kidney donor selection. This review presents a real-world clinical dilemma involving a 24-year-old male with autosomal recessive COL4 nephropathy (Alport syndrome) and his 51-year-old mother, a heterozygous carrier. We analyzed the clinical spectrum of COL4 nephropathy in North Macedonia, where 92 patients have been identified via next-generation sequencing (NGS), and COL4A5 mutations were the most prevalent at 67.4%. Because current the kidney disease improving global outcomes (KDIGO) recommendations for living kidney donor evaluation are general and offer scarce guidance for hereditary conditions, we evaluated the recent 2025 ERK Net/ERA/ESPN criteria. These updated guidelines suggest that while donation is generally avoided in carriers, it may be considered in highly selected individuals over 40 years of age with preserved kidney function and no subclinical kidney damage on biopsy. Careful and individualized evaluation of potential living donors from affected families is essential. This approach is particularly important in settings with persistent organ shortages and limited access to deceased-donor transplantation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Nephrotic Syndrome Induced by Tiopronin in a Male Patient with Cystinuria.(Macedonian Academy of Sciences and Arts, 2025-06); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Nasal carriage of Staphylococcus aureus and hygiene practices among food handlers in Skopje, North Macedonia(Walter de Gruyter GmbH, 2026-06-01); Nasal carriage plays a key role in Staphylococcus aureus transmission, particularly among individuals working in the food sector. The aim of this cross-sectional study was to investigate the relationship between personal hygiene and nasal carriage of S. aureus among workers in food production, distribution, and trade. It was conducted in Skopje from November 2021 to March 2022 and included 289 workers undergoing mandatory health and hygiene examinations. Data were collected through a structured questionnaire and microbiological testing of nasal swabs. The overall prevalence of S. aureus nasal carriage was 12.5 % (95 % CI: 8.7–16.3 %). Methicillin-susceptible S. aureus (MSSA) prevailed in 11.8 % (95 % CI: 8.1–15.5 %) and the methicillin-resistant variety (MRSA) in only 0.7 % (95 % CI: 0–1.7 %). We found no significant associations between nasal carriage and demographic or hygiene variables (assessed using the chi-squared test) but did observe higher carriage rates among men (15.7 %), cooks (28.6 %), and individuals with untidy nails (17 %). However, our findings should be interpreted with caution, and future studies should address the limitations of the present study. Targeted training, routine screening, and consistent adherence to good hygiene practices remain important for minimising colonisation and reducing the risk of S. aureus transmission. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Granulomatosis with Polyangiitis (Wegener’s Granulomatosis), Diagnosis, Clinical Approach, Initial Treatment and 1 Year Follow Up (Case Report)(SASPR Edu International Pvt. Ltd, 2026-08-17); ; ; Introduction: Wegener's granulomatosis (WG) is a rare long-term systemic disorder that involves the formation of granulomas and inflammation of blood vessels. Aim: of this study was to present a case of (WG) that was diagnosed with kidney biopsy while the lung infiltrates were not reachable. Materials and methods: 57-year-old male patient admitted for invasive diagnostics due to lung infiltrates. Results: The patient had positive C-ANCA on bloodwork, CT scan showing multiple bilateral lung infiltrates and an inconclusive result from a nasal mucosa biopsy. The lung infiltrates being difficult to reach for biopsy and having confirmed kidney involvement with high creatinine and albuminuria enabled us to do kidney biopsy. The biopsy showed a vasculitis with positive C-ANCA confirming (WG). A high dose of Methylprednisolone (500mg for 3day, then 250 for 3 day and finally 125mg for 3 days) A cyclophosphamide and maintenance dose steroids therapy was initiated by a consulting rheumatologist after discharge. A complete remission of the lung involvement was seen on a CT 2 months after. Discussion: The least invasive site for biopsy being the nasal mucosa is always the best site for biopsy. Having received an inconclusive result leaves the kidney and the lung as secondary options. In our case the kidney was considered due to a better possible yield of viable material Conclusion: Present kidney involvement is always a site for biopsy with a high yield for confirming (WG) despite the risk of bleeding complications who were absent in our case. Keywords: Wegener's granulomatosis, lung infiltrates, kidney vasculitis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Минимална остеосинтеза во третманот на дво- и тропартните фрактури на проксималниот хумерус(2003); ; ; Zhemojtel Adam - Some of the metrics are blocked by yourconsent settings
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