Georgieva, Daniela

Preferred name

Georgieva, Daniela

Official Name

Georgieva, Daniela

Main Affiliation

daniela.georgieva@medf.ukim.edu.mk

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General anesthesia: Is it safe for newborns, infants and young children?
(Association of medical doctors "Sanamed" Novi Pazar, 2016)
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Nancheva, Andrea
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The exposure of neonates, infants and small children to general anesthesia is becoming a common occurrence. Accumulating preclinical data indicate that exposure to commonly used general anesthetic agents during key periods of brain development in this population(between late gestation and 3 to 4 years of age,) can lead to apoptotic neurodegeneration, synapse loss, and cognitive and neurobehavioral deficits that persist as the organism matures. New work suggests that infants and small children undergoing some types of surgery could have better recovery if they receive regional anesthesia rather than general anesthesia. In response to this concerns, the Food and drug administration (FDA) and the International Research Society in anesthesia (IARS) started an initiative called Smart Tots (Strategies for Mitigating Anesthesia- related neuro Toxicity in Tots) which examine the effects of anesthesia on brain development. Also another two major prospective studies are ongoing in children : PANDA (Pediatric Anesthesia Neurodevelopment assessment Study )project is a large, multi-center study based at the Morgan Stanley Childrens Hospital of New York at Columbia University, and another one is GAS study which is a multisite randomized controlled trial comparing neurodevelopment outcomes in infant receiving general anesthesia compared to spinal and other regional anesthetics to the stress response to surgery. The findings from these studies will help researches to design the safest anesthetic regimens and to develop the new and safer anesthetic drugs for use in pediatric medicine.
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ASSOCIATION OF POLAND SYNDROME AND HYPERTRICHOSIS IN A PUBERTAL GIRL - Case report
(Institute of Public Health of the Republic of North Macedonia = Институт за јавно здравје на Република Северна Македонија, 2021-06-30)
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Hristijan Nestorov
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Poland syndrome (PS) is a rare congenital malformation, most commonly characterized by absence of chest wall muscles on one side of the body. It may be accompanied with other deformities of the extremities. We present the case of a 10-year-old girl with Poland syndrome and hypertrichosis of the back of the trunk and extremities. The clinical examination did not reveal the etiology of the syndrome, such as familial predisposition or some event that led to interrupted blood flow during the early embionic growth. The pregnancy was concieved with in vitro fertilization (IVF); triplets were born and our patient is one of these three girls. The hypertrychosis appeared at 8 years of life, without evidence of previous familial occurance, medications or hormonal disbalance. Other malformations that were found were: a mild form of kyphoscoliosis and mitral valve prolapse. The child was evaluated using a multidisciplinary approach, with further follow-up planned with surgical correction of the chest wall and breast augmentation.
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TALOCRURAL ARTHRODESIS USING THE METHOD OF ILIZAROV
(Faculty of Physical Education, Sport and Health, Skopje, Republic of Macedonia, 2020)
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Background: Talocrural arthrodesis using the method of Ilizarov is a reasonable procedure for patients with secondary ankle degenerative changes and comorbidities, making other surgical treatment impossible. The aim of this study is to evaluate the results of talocrural arthrodesis as union rate, deviations, functional restoration and complications. Patients and Methods: The study has included 26 patients with Ilizarov talocrural compressive arthrodesis at the Clinic for Orthopaedic Surgery in Skopje from 2015 to 2019, of which 3 were with simultaneous gradual distraction. The follow up was from 22 to 64 months. The age varied from 41 to 77 years. All patients were with comorbidities and poor bone and soft tissue condition. The monitoring was performed using native radiography and ultrasonography at the compression/distraction site. Results: A complete bone fusion was achieved in all patients. The median time of wearing the external fixator was 22 weeks. In three cases with simultaneous distraction, the average bone healing index was 47 days/cm. The final maximal length discrepancy was 11 mm. In 16 patients (61.53%) sings of pin tract infections were detected. The mean number of pin site infections was 2.3/patient. No pin infection has required a change of the pin. Once the construct was removed, patients used a cast for 4-6 weeks and a walker boot for next 6-8 weeks. Conclusion: A talocrural arthrodesis performed by the Ilizarov method offers a high union rate, few deviations and a good functional restoration, often with no additional surgical procedures. In cases with numerous comorbidities and a poor limb condition, it can be a method of choice instead of an arthrodesis using internal fixation in the treatment of end-stage ankle arthritis.
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THE MOST COMMON DISORDERS OF THE HAND ASSOCIATED WITH CARPAL TUNNEL SYNDROME IN ADULTS
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2021)
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Ilir Shabani
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Liljana Angeleska
Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies caused by chronic compression of the median nerve in the area of the carpal tunnel and its etiology is multifactorial. Trigger fingers and de Quervain’s disease are common disorders of the hand related to CTS in adults.Theaim of this study was to present the most common disorders of the hand such as stenosing tenosynovitis in adults with surgically treated CTS and to evaluate their demographic data.Material and methods: A total of 116 surgically treated patients with established diagnosis of CTS (clinically and by electrophysiological examination) were included in this prospective study, which was conducted at the University Clinic for Orthopedic Diseases in Skopje. Demographic data, findings of history of the disease and clinical examination were recorded and analyzed.Results: Participants with CTS included in the study were with a mean age of 55.41±10.7 years (age range 29-75). 75% of them were female. 63.8% of participants suffered from one or more comorbid chronic diseases. On admission to hospital, disorders such as trigger fingers and de Quervain’s disease were concomitantly diagnosed in 15.51% on ipsilateral hand with CTS. All disorders were surgically treated following open carpal tunnel release, as “one stage procedure”, under local anesthesia.Conclusion: Our findings have determined concomitant existence of CTS and stenosing tenosynovitis (trigger fingers and de Quervain’s disease) on ipsilateral hand, which suggests common etiological factors. Female gender and age range 40-60 years are major common factors related to these three disorders.
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GIANT CELL TUMOR OF THE PROXIMAL TIBIA TREATED WITH EN BLOC RESECTION AND RECONSTRUCTION WITH SEMI-CONSTRAINED KNEE ENDOPROSTHESIS: А CASE REPORT
(Faculty of Physical Education, Sport and Health, Skopje, Republic of Macedonia, 2021)
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Introduction:Giant cell tumor(osteoclastoma) is benign, locally destructive tumor with low metastatic potential, but it has tendency of recurrence after the treatment. The primary areas of involvement are the ends of long bones, commonly the distal femur and proximal tibia. The most preferred treatment modality of the giant cell tumor is surgery. Case report: A 54-year-old female presented with pain and slight swelling localized over the proximal left tibia and limited range of motion in the left knee. After histological confirmation of the diagnosis with open biopsy, en bloc resection of the lesion wasmade with reconstruction of knee joint with semi-constrained knee endoprosthesis and trabecular metal. Conclusion: Selecting the appropriate treatment method is very important for the recovery of the function of the affected joint and for the whole extremity, as well. There is an advantage of en bloc resection and reconstruction with semi- constrained knee endoprosthesis in combination with trabecular metal in cases with extensive destruction of bone structure, recurrence, pathological fracture or difficulty in reconstruction after intralesional curettage. Advantages in functional aspect of this treatment modality are retaining the stability of the knee joint, substituting the bone defect and fast recovery of the function of the affected joint and limb.
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Osteodensitometric aspects of bone in limb lengthening and deformity correction
(Македонско лекарско друштво = Macedonian medical association, 2020)
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VACCINATION, ANESTHESIA AND SURGERY
(Medical faculty, Ss Cyril and Methodius University in Skopje, 2020)
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Nancheva Bogoevska, A
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Baloski, M
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Acetabular revisions in total hip arthroplasty
(Medical faculty, Ss Cyril and Methodius University in Skopje, 2020)
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Samardziski M
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PEDIATRIC SURGICAL STRESS RESPONSE AND ANESTHESIA
(MIT Univerzitet Skopje, 2021)
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Nancheva-Bogoevska, Andreja
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Surgical trauma disturb the body homeostasis by inducing a combination of local response to tissue injury and generalized activation of systemic metabolic and hormonal pathways via afferent nerve pathways and the central nervous system. The local inflammatory responses and the parallel neurohumoral responses are not isolated but linked through complex signaling networks, some of which remain poorly understood. The stress response to surgical trauma occurs as a protective mechanism, by activating a series of endocrine, metabolic and immune processes which prevent disturbance of homeostasis. The magnitude of the response is broadly related to the site of injury (greater in regions with visceral pain afferents such as abdomen and thorax) and the extent of the trauma. The stress response to surgical trauma is different in premature, newborns, infants, and in children approaching puberty is the more similar as in adults. New anesthetic agents basically do not trigger the endocrine-metabolic response of the body. Endocrine-metabolic, immune and autonomic responses to surgical trauma can be modified using regional anesthetics techniques and the use of analgesics in general anesthesia. It is the duty of each anesthesiologist before the surgery according to the patient and the kind and length of the surgical intervention, to assess which anesthesia technique and which anesthesiological agents is selected for conducting the operation, in order to provide “stress – free” anesthesia.
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Different treatment of the femoral neck fractures
(Faculty of Physical Education, Sport and Health, Skopje, Republic of Macedonia, 2022)
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Trajanovski A
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Karapandzevska S
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Bozinovska B
The incidence of femoral neck fractures is increasing steadily and daily. The main reason for this data both in the literature and our country is the increase in the life expectancy of the population and the sophistication of medical implants. These fractures are one of the most significant causes of mortality and morbidity in elderly population. In almost all cases, these fractures lead to exacerbation of existing chronic diseases and as a result lead to deterioration, i.e. reduced function of the locomotor system and failure of other organ systems, which often leads to death. They are not only a hospital and health problem, but a socio-economic and financial one too, as for their treatment significant financial resources are spent which additionally burden the health funds. A fracture of the femoral neck can be a trigger for a series of health problems that require different levels of care. The options for surgical treatment for this type of fractures include 2 concepts, namely surgical fixation and arthroplasty. A number of surgical techniques are still controversial and are subject of discussion and investigation

Georgieva, Daniela

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