Dimitrov, Goran
Preferred name
Dimitrov, Goran
Official Name
Dimitrov, Goran
Main Affiliation
Email
goran.dimitrov@medf.ukim.edu.mk
50 results
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Item type:Publication, Distribution of HPV types among patients with positive histological findings for cervical precancerous lesions and invasive cancer of the uterine cervix(Македонско лекарско друштво = Macedonian Medical Association, 2018); ; Introduction. The aim of this study was to provide basic data on the prevalence of different HPV types among the female population in R. Macedonia with histologically proven cervical intraepithelial neoplasia or invasive cervical cancer, in order to better plan the vaccination program and screening for cervical cancer. Mеthods. This study retrospectively statistically (using Statistica SPSS for Windows) analyzed histological findings positive for cervical intraepithelial neoplasia or invasive cervical cancer and positive HPV genoty- ping results of564 patients who came to the University Clinic for Gynecology and Obstetrics due to an abnor- mal Pap smear test during the last year (2017). Results. HPV isolation showed the presence of human papillomavirus in78% of the total of 564 subjects. The prevalence of HPV in LSIL, HSIL, invasive squamo- cellular carcinoma of the uterine cervix and adeno- carcinoma of the uterine cervix was 69.2%, 87.2%, 97.6% and 71.4%, respectively. HR HPV types were isolated in 75%of LSIL and 96% of HSIL. Predo- minantly isolated were HPV types 16, 18, 35, 31, 33, 58, 6, 11 and 40. HPV type 16 wasthe most commonisolated genotype among all patients with 48.4%, 30.1% and 19.6% in HSIL, invasive carcinoma and LSIL, respect- tively. HPV type 18 had the highest rate in patients with invasive adenocarcinoma of the cervix (30.1%). Conclusion. Human papillomavirus types 16, 18, 35, 31, 33, 58, 6, 11 and 40were the predominant high risk types in patients with invasive cervical cancer and its precursors in the Republic of Macedonia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Non-invasive Prenatal Determination of Fetal Maturity(Македонско лекарско друштво / Walter de Gruyter GmbH, 2016-12-01); ; Stojceva-Taneva, OliveraThe prenatal prediction of fetal maturity is very important, since neonatal respiratory distress syndrome (RDS) is one of the biggest causes of neonatal mortality. Our aim was to investigate a new non-invasive method for prediction of fetal maturity and to determine in which group according to gestational age of the fetus, the treatment works the best and in which cases it is necessary to be repeated. Methods. We examined 60 patients (30 with impending preterm delivery, divided in 3 groups: 28-30, 30-32, and 32-34 gestational weeks and 30 controls), at the University Clinic for Gynecology and Obstetrics, Medical Faculty, University “Ss. Cyril and Methodius”, Skopje, R. Macedonia. Fetal maturity was examined using ultrasound histogram from fetal lungs and liver, correlated with gestational age and postpartum RDS. Where possible, we performed amniocentesis for lamellar body count (LBC) to correlate our results with the current invasive method for prediction of fetal maturity. Results. Pre-therapy investigation showed a strong fetal immaturity in 28-32 weeks of gestation and less evident fetal immaturity in 32-34 weeks of gestation. Seventy-two hours post-treatment, fetal maturation was low in the first group, higher in the second and the highest in the third group. Amniocentesis for LBC showed correlation with the ultrasound results. Postpartum results were correlated with pre-delivery ultrasound and showed significance of p <0.05. Conclusion. The results obtained in our study were with high significance, and they were in correlation with other similar studies. However, more extensive investigations should be made to replace the current invasive technique. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MATERNAL OBESITY, АGE AND MATERNAL THYROID STATUS - AN INTRIGUING CONNECTION TO THE NEONATAL OUTCOME(Македонско лекарско друштво /Macedonian Medical Association, 2020); ; Introduction. Thyroid dysfunction is the second most common endocrine disorder affecting women of reproductive age. Higher body mass index (BMI>30 kg/m2) is linked with many endocrine abnormalities, including thyroid dysfunction. Gestational age at birth (GAB) and birth weight (BW) are important predictors of neonatal mortality and morbidity. The objective of this prospective study was to determine the adverse neonatal outcomes of women [small for gestational age (SGA), intrauterine growth restriction (IUGR) and others] complicated with impaired thyroid function and obesity, when compared with those with normal function. Methods. Dried blood spot and urine samples were analyzed for thyroid and iodine status in 358 pregnant women in any gestational week, without known thyroid disorders. They gave birth at the University Clinic of Gynecology and Obstetrics-Skopje. The blood samples were analyzed with time-resolved fluoroimmunoassay in Zurich, and UIC was analyzed by mass spectrometry in Helsinki. Results. We found a significant positive correlation between total thyroxine (TT4) and GAB (p=0.045) and UIE and mother age (p=0.007), but a significant negative correlation between GAB and UIE (p=0.051), GAB and mother’s age (p=0.01), GAB and BMI (p=0.02). There was an inverse correlation between BW and maternal age (βst=-0.0641, P=0.010) and between BW and maternal TT4 (βst=-3.3640, P=0.0016). We found a positive correlation between BW and maternal BMI (βst = 21.847, P = 0.006). Conclusion. Overweight, obese and older women are at increased risk of thyroid dysfunction during pregnancy considered as high-risk pregnancies for adverse neonatal outcomes. We can use maternal TT4, BMI and age for predicting the BW. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ПЕРИУРЕТЕРАЛНА ЕНДОМЕТРИОЗА – ПРИКАЗ НА СЛУЧАЈ(SHMSHM - AAMD, 2022-09-01); ; ; ; Целта на овој труд е да се прикаже редок случај на периуретерална ендометриоза кај возрасен пациент и да се нагласи важноста на сомнителната уринарна ендометриоза и важната улога на компјутер на мала карлица во поставувањето на точна дијагноза на оваа ретка болест. Презентираме редок случај на периуретерална ендометриоза со симптоми кои првенствено произлегуваат од ендометриоза на јајниците. Дијагнозата на периуретерална ендометриоза беше поставена врз основа на компјутеризирана томографија на малата карлица и абдоменот. Клучни зборови: ендометриоза, компјутер на мала карлица, периуретерална ендометриоза. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison Between HPV DNA Testing and HPV E6/E7 MRNA Testing in Women with Squamous Cell Abnormalities of the Uterine Cervix(Walter de Gruyter GmbH / MANU, 2019-05-01); ; ; The aim of the study was to compare the results of two human papillomavirus (HPV) diagnostic techniques: human papillomavirus deoxyribonucleic acid (HPV DNA) testing and human papillomavirus E6/E7 messenger ribonucleic acid (HPV E6/E7 mRNA) testing in women with squamous cell abnormalities of the uterine cervix. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HYDROSALPINX AND DISTRIBUTION OF PREGNANCIES AMONG LAPAROSCOPICALLY TREATED PАTIENTS(Македонско лекарско друштво = Macedonian Medical Association, 2020); ; Introduction. Hydrosalpinx is a common medical condition encountered among female population with infertility issues. One or both fallopian tubes can be filled with a substantial amount of fluid, making them dilated and dysfunctional, usually as a result of an injury or infection. Damages of different degrees can be seen on the mucosal lining, which compromise the processes of normal fertilization and zygote passage. Methods. We retrospectively analyzed clinical records from a period of five years (2013-2017), selecting pa- tients diagnosed as having unilateral or bilateral hydrosalpinx. Clinical files were divided by years and according to the treatment protocol used. Our scope of interest was focused on patients who were treated surgically, with different types of laparoscopic interventions. A total of 74 patients met our criteria for selection. Results. Two groups were related to conservative la- paroscopic approaches and one to complete radical surgical treatment, unilateral or bilateral salpingectomy. Patients in the first group, 9(16.36%), were treated with a laparoscopically-guided creation of salpingostomy. The second group comprised patients treated only with bi- lateral chromopertubation and consisted of 17 (30.91%) patients. The third, and the most numerous group com- prised 29(52.7%) patients treated with salpingectomy. Bilateral salpingectomy was performed in 9(31.03%) and unilateral in 20(68.97%) patients, showing that majority of patients were treated with unilateral salpingectomy, after intraoperative evaluation of tubal patency of the contralateral uterine tube. A total number of 30 patients (54.5%) had successful pregnancies, which ended up with a desired outcome, healthy live birth. Procedures for artificial reproduction and successful pregnancies achieved with IVF were recorded in 11(36.67%) patients and in the remaining 19(63.33%) patients pregnancies were achieved via spontaneous conception. Conclusion. Hydrosalpinx management is mainly influenced by the local tubal changes evaluated laparoscopically and can be surgically treated, either conservative or radical. Conservative approaches lead to fair chances of spontaneous conception and successful pregnancies. An integrated management of hydrosalpinx with bilateral salpingectomy and postsurgical usage of artificial reproduction techniques also leads to a substantial cumulative pregnancy rate. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Patient-Controlled Analgesia (PCA) with Remifentanil Versus Intermittent Epidural Boluses for Labor Analgesia(Македонско лекарско друштво / Walter de Gruyter GmbH, 2017-06-01); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ISOLATED MATERNAL HYPOTHYROXINEMIA AND ITS PERINATAL OUTCOME IN NORTH MACEDONIA(Sestre Milosrdnice University Hospital Center (KBC Sestre milosrdnice), 2021-06); ; Isolated maternal hypothyroxinemia (IMH) is defined as the presence of low maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating hormone (TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR) (p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion (p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis, TSH was a significant variable predicting Apgar score (βst=0.05597, p=0.047), body mass index predicting birth weight (βst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR (βst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (βst=-0.004778, p=0.003) and premature delivery (βst=0.028112, p=0.004) in NTF group. The impact of IMH in pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2021-10) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Коронавирусот кај бремени пациентки и нивните клинички исходи – резултати од студија на случај-контрола(Scientific Foundation SPIROSKI, 2023-11-18); ; ОСНОВА: Избувнувањето на КОВИД-19, предизвикано од новиот коронавирус САРС-КоВ-2, поттикна обемни истражувачки напори за разбирање на неговите разновидни клинички презентации и влијанија врз различни популации на пациенти. Меѓу овие популации, бремените жени привлекоа значително внимание поради загриженоста за потенцијалните последици од КОВИД-19 за време на бременоста. ЦЕЛ: Примарната цел на оваа студија е да одреди дали бремените пациентки со САРС-КоВ-2 искусиле различни исходи од небремени пациентки на иста возраст, во однос на исходите од акутната епизода, како потреба од кислородна терапија и исход од лекувањето.Секундарна цел на студијата е да се одреди присуството на ризик факторите за исход од инфекција со САРС-КоВ-2, како присуството на коморбидитети, но и нивото на различни лабораториски маркери за време на хоспиталниот престој, и нивните разлики помеѓу случаите и контролите. МЕТОДИ: Како случаи беа дефинирани пациентките кои имаа 1) наод кој ја потврдува нивната бременост (ултразвучен наод) достапен во нивната документација или електронски картон, 2) позитивен тест за САРС-КоВ-2, базиран на PCR-метода, како и 3) симптоматологија од горниот респираторен систем или системски знаци. Како контролни пациентки беа дефинирани исто како случаите, но со податок дека не се бремени. За време на болничкиот престој, кај сите пациенти беа рутински одредувани повеќекратни лабораториски мерења на параметри од периферна крв, вклучувајќи комплетна крвна слика (еритроцити, леукоцити, тромбоцити и диференцијална крвна слика), ц-реактивен протеин, активност на лактатна дехидрогеназа и ниво на д-димери. Статистичката анализа беше спроведена со користење на соодветен софтвер (SPSS). За да се сумираат карактеристиките на испитуваната популација се користеа описни статистички податоци, вклучувајќи средини, стандардни отстапувања и проценти. РЕЗУЛТАТИ: Најдени се статистички значајно помали вредности кај бремените жени за заситување со кислород и бројот на тромбоцити, додека е најдено статистички значајно зголемување на бројот на леукоцити, Д-димери, уреа и глукоза. Постојат статистички значајни разлики анализирани со Хи-квадрат тест кај варијаблите неинвазивна вентилација, специфична терапија за корона (remdesivir, tocilizumab, favipiravir), шеќерна болест и друга дијагноза која може да влијае на исходот од САРС-КоВ-2. ЗАКЛУЧОЦИ: Овие наоди покажуваат дека бремените жени може да имаат различни клинички профили кога се погодени од КОВИД-19, нагласувајќи ја важноста на приспособените стратегии за здравствена заштита за оваа популација.