Prgova, Biljana

Preferred name

Prgova, Biljana

Official Name

Prgova, Biljana

Main Affiliation

biljana.prgova@medf.ukim.edu.mk

Now showing 1 - 10 of 29

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THE ROLE OF T2W PULSE SEQUENCE AND DIFFUSION WITH ITS NUMERICAL ADC MAP IN PROSTATE CANCER DIAGNOSIS
(Macedonian Association of Anatomists and Morphologists, 2023)
Kostova, Masha
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In patients with increased PSA (prostate-specific antigen), the next diagnostics tool is transrectal ultrasound-guided biopsy-TRUS. Multiparametric magnetic resonance imaging (mp MRI) as non invasive diagnostic tool is used as a triage test to avoid biopsy, as well as to improve the diagnostics. In our study we want to prove the clinical meaning of T2W pulse sequence and diffusion as a part of mp MRI in prostate malignant lesions detection and their distinction from the benign lesions. This cohort prospective study included 100 patients with increased levels of PSA from 4 ng/ml to 76 ng/ml. The MRI equipment used was Siemens Essenza1,5T with body coil. The results from the T2W pulse sequence and diffusion are correlated with the values of diffusion and ADC map, in which the suspected zones are marked on a template. Patients undergo biopsy depending on the PIRADS (prostate-imaging and reporting data system) classification. The MRI results and the pathohistological findings are then compared. Clinically significant cancer is considered to be a cancer with a Gleason score 6, diameter > 6mm. The values of diffusion with its numerical ADC map are considerably lower for malignant nodules compared to benign ones. Hyposignal of T2W pulse sequence is characterized with score 2 and 3 in benign changes, and 4 and 5 in malignant changes using the PI RADS score system for differentiation. T2W pulse sequence combined with diffusion is a powerful tool for non-invasive differentiation of benign prostatic hyperplastic nodule and prostatitis from a malignant nodule.
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POST-PNEUMONECTOMY SYNDROME IN ADULT PRESENTING WITH RECURRENT SYNCOPE
(Macedonian Association of Anatomists and Morphologists, 2022-12)
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Ristovski, Vladimir
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Eftimovska-Otovic, Natasha
Post-pneumonectomy syndrome is a rare, late complication of pneumonectomy, caused by a mediastinal shift, rotation and deviation of the remaining lung into the contralateral hemithorax, most commonly resulting in symptomatic central airway compression. Case report: Recurrent syncope following a left pneumonectomy was described in a 63 year-old man, forty years after the initial treatment. Four years physician visit including the family doctor, a neurologist, neurosurgeon, physiatrist, radiologist, psychiatrist and finally a cardiologist made the diagnosis hard to establish and the treatment delayed. The post-pneumonectomy syndrome is a complex constellation of symptoms, following previous lung pneumonectomy, with various presentations mimicking different pathologies. Its diagnosis is often misleading, making the treatment and prognosis hard to predict.
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JEJUNAL ADENOCARCINOMA: A CASE REPORT
(2019-06-05)
Bozinovska Beaka, Gordana
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Zdravkovska, Milka
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Eftimovska Rogac, Irena
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Bozinovska, Nadica
<jats:p>Tumors of the small intestine are extremely rare, and clinical signs and symptoms are nonspecific, resulting in prolongation of the diagnosis process and subsequently worsening the outcome of the treatment. In addition to non-specific symptomatology, additional difficulty in diagnosing is the very inaccessibility of the jejunum through endoscopic techniques. The following is a review of the case of a female patient with jejunum carcinoma. CASE REPORT. A 64-year-old patient with nonspecific symptoms of fatigue, weight loss and sore pain in the stomach initially hospitalized due to anemic syndrome. An endoscopic evaluation was performed, and the fining was chronic gastritis. The patient was prescribed with iron supplementation therapy and was sent home. Within a month, the fore mentioned symptoms started to intensify, and the patient was hospitalized at the General Hospital in Skopje, where extensive investigations were conducted. Upper digestive endoscopy was made, and the finding again only showed chronic gastritis. Due to lack of findings, the doctors performed abdominal ultrasonography that indicated only a bolded intestinal segment with a thick wall of 9mm in the projection of the left flexure to the descending colon. The need for additional investigations grew and computed tomography with contrast of the abdomen and small pelvis was performed. The finding of the computed tomography was in favor of an irregular intestinal segment in the projections of the jejunal convolutions, with a thickened heterogenic wall and pathological post-contrast coloring. Due to the need for correlation with other trials, MRI was performed, and its finding was highly suspected of a tumor change in the jejunum, but an inflammatory disease was not excluded. Because of this finding, the patient was sent to the Department of Digestive Surgery at the same facility. From a surgical point of view, the patient was treated with an upper medial laparotomy, which made it possible for the tumor to be released from its surroundings. The surgery and after surgery course and the patient’s condition were all as expected. The patient was in a stable general condition after the surgery, and she was sent home. The pathophysiological finding resulted in jejunal adenocarcinoma (Latin adenocarcinoma intestinijejuni). After the pathophysiological finding was obtained, the patient was referred to an oncologist for eventual adjuvant therapy. DISCUSSION. Small intestine carcinoma is a specific clinical and surgical entity, which is often diagnosed in an already overdue phase. This is due in part to the non-cohesive symptomatology, but largely due to the still insufficiently sophisticated detection methods. Because of this enigmatic nature of these carcinomas, it may be necessary to think of a special team in the digestive surgery departments, which would solely work on this pathology, in order to speed up diagnosis and improve the outcome of the treatment for the patient.</jats:p>
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MAGNETIC RESONANCE IMAGING IN SPORT MEDICINE
(University Ss. Cyril and Methodius in Skopje, 2022)
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The use of appropriate imaging methods in sport medicine is very important in order to diagnose and evaluate the sport injuries. The aim of the study was to present the most frequent sport injuries, for the last 6 month period, using diagnostic modality as MRI, for better patient’s outcome. A number of 45 patients with sport injuries were diagnosed, regarding knee injury (n=28), shoulder injury (n=10), ankle injury (n=5) and hip injury (n=2). Out of all patients, 39 were male, and 6 were female. Regarding sport type, ball sports (n=40), bodybuilding (n=2), skiing (3) were included. In the study, the imaging device Magnetom Essenca 1.5T by Siemens, Erlangen, Germany was used. Most of the sport injuries were related to knee joint (62%), mostly involving the meniscus, common for ball sports, skiing, and gymnastics. The other injuries were related to the following body parts: shoulder joint (22%), ankle joint (11%) and hip (5%). MRI was found to be sensitive in diagnosis of soft tissue injuries, providing a good visualization in the musculoskeletal system, and may be clarified as a golden standard to diagnose and evaluate sport injuries.
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Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica
(Walter de Gruyter GmbH, 2023-07-01)
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Kostova, Masha
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Ristikj-Stomnaroska, Daniela
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Stoshevska, Tatjana Deleva
Periradicular therapy (PRT) is a minimally invasive radiological procedurein patients with chronic lumbar pain.The aim of the study is to identify clinical and radiological predictive factors for treatment success after a single PRT treatment in patients with sciatica.The study includes a prospective follow-up of 166 patients treated with PRT. The pain intensity is determined according to the VAS scale and the degree of improvement is presented as excellent (over 75%), good (50-70%), moderate (25-49%), and weak (less than 25%). The follow up of the treated patients was done at 2 weeks, 3 and 6 months. In patients with pain duration up to 3 months, the improvement was excellent in n=32 (58.18%) after 2 weeks, after 3 months n=41 (74.55%) and after 6 months n=41 (74.55%). This stands in contrast to patients with pain over 1 year. The percentage of improvement after 6 months, post-intervention, was highest in patients without nerve root compression (86.25±19.2),and the highest improvement after 6 months was in patients with localization of pain at the L4-L5 level (69.69±29.7), the greatest improvement after six months was in patients with extraforaminal hernia (62.82±34.3), and the lowest in patients with central stenosis (40.21±30.7).Our study results suggest that the shorter a pain duration, low-grade root compression, injection level and type of herniation area predictor the more favourable response patients have to transforaminal epidural steroid injection in patients with sciatica.
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COVID -19 INDUCED AORTIC THROMBUS AND CRITICAL LIMBISHAEMIA
(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2023-04-07)
Nancheva Bogoevska, Andrea
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Risteski, Filip
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Gjoreski, Aleksandar
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Jovanoska, Ivona
50 years old male presented with livid redness on both feet, predominantly left, accompanied with severe pain and coldness. Two weeks before, he admitted to hospital due to COVID-19 bronchopneumonia. Urgent abdominal and lower extremities contrast enhanced CT was performed, which showed mural thrombus of the abdominal aorta (AA) extending from below the left renal artery to the iliac bifurcation and total occlusion of the left and partial occlusion of the right crural arteries. Interventional procedures are the first choice for initial emergency management, leaving surgery as a second and anticoagulant therapy as third option for treatment. Endovascular treatment is based on stent grafting. Covered stent graft was used to repair the AA and kissing stenting technique was used in the aortoilical part. The result was complete patency of AA and both iliacal arteries, with improved clinical status. Mural thrombi are likely to occur in large vessels as the heart and descending aorta, and less commonly in the aortic arch or the AA, causing flow reduction. Their occurrence is a rare in the absence of hypercoagulative state or inflammatory, infectious, or familial aortic ailments. In our case, Covid -19 is associate occurrence of thrombus in the AA, which throws out smaller thrombi in the peripheral circulation that causes critical limb ischemia (CLI).CT is the best modality for early diagnosis and endovascular treatment the least invasive treatment. Mural aortic thrombus accompanied by CLI is an urgent medical condition which, if not diagnosed and treated on time, can result in limb amputation or death. Endovascular stenting is first choice of treatment in patients without previous vascular disease.
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Differential Diagnosis of Diffuse Cystic Lung Disease at HRCT - An Overview
(Biomedical & Clinical Research (Biores Scientia), 2024)
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Introduction: The diffuse cystic lung diseases (DCLDs) are a diverse group of lung disorders characterized by the presence of multiple regular or irregular spherical parenchymal lucencies bordered by a thin wall and having a well-defined interface with normal lung. Other lucent lung lesions like centrilobular emphysema, cavity, cystic bronchiectasis, honeycomb cyst, and pneumatoceles are close mimics of a lung cyst on high-resolution computed tomography (HRCT) HRCT is an important modality in the evaluation of interstitial lung disease to include cystic lung disease. This review describes a simple algorithmic approach for DCLDs on HRCT based on cyst’s distribution, size, and shape, as well as background parenchymal changes and it helps also in differentiation of common and uncommon diffuse cystic lung disease. Aim: The aim of the study is to present, describe and make differential diagnosis of this spectrum of diseases associated with air cysts at high-resolution CT. Conclusion: Diffuse cystic lung diseases are a group of complex disorders that often have an overlapping clinical presentation, but different underlying pathological processes. HRCT still remains the imaging of choice for the diagnosis of common diffuse cystic lung diseases.
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OSMOTIC DEMYELINATION SYNDROME
(Македонско лекарско друштво = Macedonian medical association, 2023-04-07)
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Risteski, Filip
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Chalcheska, Slavica
Abstract. Osmotic demyelination syndrome (ODS) may be observed as a result of a rapid change in serum osmolarity, such as that induced by an overly rapid correction of serum sodium levels in hyponatraemic patients. Case presentation. We report a case of a 40-year-old male, first hospitalization through Emergency center (glucose 6.4 mmol/l. ECG: sinus rhythm, normal axis with SF 70/min.). Patient has electrolyte imbalance ,elevated liver enzymes, high enzyme activity predominantly of CK (6664) in relation to transaminase activity (AST 288, ALT 127), elevated CK, hyponatremia, hypokalemia and extremely low sodium = 95.Main complaints were muscle pain, muscle weakness, slurred speech, weakness, walk inability. Diagnostic findings. The diagnosis was confirmed by MRI 1,5T Simens Magnetom Essenca (brain) that showed large tipical inhomogeneous hypersignal lesion in the central pontine region on T2 weighted and FLER images with restriction of DWI. There is signal intensity of the basal ganglia nucleus lentiformis and and caudate cerebral nuclei on axial T2 weighted images and FLAIR images which were suggestive of CPM. Teaching points. Central pontine myelinolysis is an acute non-inflammatory demyelinating disorder.It is precipitated by the rapid correction of severe chronic hyponatraemia.Electrolyte abnormalities other than sodium should be investigated and rectified.An in-depth neurological examination is mandated to assess the severity and progression of ODS.MRI is the radiological modality of choice for earlier detection of ODS lesions.
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METASTATIC CUTANEUS MELANOMA OF THE GALLBLADDER-CASE REPORT
(Association of medical doctors "Sanamed" Novi Pazar, 2019-08-04)
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Nancheva Bogoevska, Andrea
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Bozinovska Beaka, Gordana
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Gjoreski, Aleksandar
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Melanoma is an aggressive malignant tumor that originates from melanocytes and most com- monly occurs on the skin. Dominantly metastasize to regional lymph nodes, in the brain and lungs and rarely in the gastrointestinal (GI) system. The aim of this re- port is to present a rare case of metastasis of cutaneous malignant melanoma in the gallbladder, discovered 10 months after excision of the primary melanoma of the skin. A 45-year-old patient was hospitalized in our hos- pital due to abdominal pain in right upper quadrant and nausea lasting for 7 days. An intraluminal substrate was found in the gallbladder with computed tomogra- phy and later a CT guied biopsy was performed on it, thus proving a metastatic deposit of primary malignant melanoma. Metastatic deposits in the gallbladder are extre- mely rare finding, and 238 cases have been described in the literature.
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Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: echocardiography changes and their relation to the level of airflow limitation
(Scientific Foundation SPIROSKI, 2019-10-14)
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Kochovska Kamchevska, Nade
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Petkovikj, Natasha
<jats:p>Objective. To compare frequency of echocardiographic changes in patients with chronic obstructive pulmonary disease (COPD) and non-COPD controls and to assess their relation to the level of airflow limitation. Methods. Study population included 120 subjects divided in two groups. Group 1 included 60 patients with COPD (52 male and 8 female, aged 40 to 80 years) initially diagnosed according to the actual recommendations. Group 2 included 60 subjects in whom COPD was excluded serving as a control. The study protocol consisted of completion of a questionnaire , pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray) and two dimensional (2D) Doppler echocardiography. Results. We found significantly higher mean right ventricle end-diastolic dimension (RVEDd) in COPD patients as compared to its dimension in controls (28.0 Â± 4.8 vs. 24.4 Â± 4.3; P = 0.0000). Pulmonary hypertension (PH) was more frequent in COPD patients than in controls (28.0 Â± 4.8 vs. 24.4 Â± 4.3; P = 0.0000) showing linear relationship with severity of airflow limitation. The mean value of left ventricular ejection fraction (LVEF%) was significantly lower in COPD patients than its mean value in controls (57.4 Â± 6.9% vs. 64.8 Â± 2.7; P = 0.0000) with no correlation with severity of airflow limitation. Conclusion. Frequency of echocardiographic changes in COPD patients was significantly higher as compared to their frequency in controls in the most cases being significantly associated with severity of airflow limitation. Echocardiography enables early, noninvasive, and accurate diagnosis of cardiac changes in COPD patients giving time for early intervention. Key words: airflow limitation, chronic obstructive pulmonary disease, Doppler echocardiography, pulmonary hypertension, ventricular dysfunction. </jats:p>

Prgova, Biljana

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