Donev, LJupcho
Preferred name
Donev, LJupcho
Official Name
Donev, LJupcho
Translated Name
Донев Љупчо
Alternative Name
Donev, LJupcho
Донев Љупчо
Донев Љ
Donev Lj
Ljupcho Donev
Ljupco Donev
Donev Ljupco
Donev. Ljupcho
Ljupcho.Donev
12 results
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Item type:Publication, Spontaneous rectus sheath hematoma– cause of acute abdomen in patients on anticoagulant therapy: two case reports(Scientific Foundation SPIROSKI, 2020-07-16) ;Petreski, Dimitar; ;Todorovic, Lazar ;Kamiloski, Marjan(Spontaneus) Rectus sheath hematoma ((S)RSH) is an accumulation of blood in the sheath of the rectus abdominis muscle, secondary to rupture of an epigastric vessel or muscle tear. It is defined as spontaneous in patients without history of abdominal trauma. It can be located supra- or infraumbilically. Although the exact incidence is unknown, Klingler et al. observed 23 cases (1.8%) of rectus sheath hematoma among 1257 patients evaluated by ultrasound for acute abdominal disorders. Ultrasonography can help in the diagnosis, but CT scan is most accurate in its ability to define the lesion. When diagnosed clinically, a conservative therapeutic program can usually be instituted. Only in cases of supportive management failure, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated. Case presentation: We present two cases of SRSH in patients using oral anticoagulant agent (acenocoumarol). Their chief complaint was sudden onset of acute abdominal pain. On admission they were haemodynamically stable. After thorough clinical evaluation a suspicion for SRSH diagnosis was made and then confirmed by ultrasonography and CT. Both of them were successfully treated conservatively and discharged home in a good general condition. Conclusion: These two cases illustrate the accurate diagnosis of SRSH treated conservatively leading to optimal patient outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IATROGENIC HYPERNATREMIA AFTER HYPERTONIC SALINE IRRIGATION OF SPLENIC HYDATID CYST –(Department of Anaesthesia and Reanimation Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, R.N.Macedonia, 2020-10) ;Michunivikj Derebanova Lj; ; ;Leshi AJovchevski LPediatric hypernatremia is a rare electrolyte abnormality. However, it can be a complication of hypertonic saline irrigation in hydatid disease. In our case report, we present a ten-year-old boy with splenic hydatid cyst who received operation treatment and developed electrolyte disturbances. Our aim is to emphasize the potential dangers of the use of hypertonic saline and the appropriate management of hypernatremia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EPINEPHRINE AND DEXAMETHASONE AS ADJUVANS IN SUPRACLAVICULAR BLOCK IN PEDIATRIC PATIENTS: A CASE SERIES(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University Skopje, R.N.Macedonia, 2021-06) ;Mikjunovikj Derebanova Lj; ; ;Leshi AToleska MSupraclavicular brachial plexus blocks are not common in pediatric patients due to the risk of pneumothorax, but they are considered to be one of the most effective anesthetic procedures for upper extremity surgeries. Ultrasound-guided approaches increase efficacy of blocks and may reduce the risk of complications associated with injection of large volumes of local anesthetic. Adjuvants are often used with local anesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anesthetics. This paper reports three cases of pediatric patients who received ultrasound-guided supraclavicular brachial plexus block for upper limb surgery while applying different adjuvants (epinephrine and dexamethasone). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Approach to one lung ventilation during surgical removal of aspirated light bulb in a child(Department of Anesthesia and reanimation, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, 2018-12) ;Gjorchevska E; ;Dimitrova M; Simeonov R - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of benzodiazepines and opoides as oral premedication in pediatric anesthesia(Македонско лекарско друштво = Macedonian Medical Association, 2017); ; ; ;Albert Leshi - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Two case reports on the effects of sevoflurane exposure duration on serum levels of neuron specific enolase (NSE) and S100 protein in children(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025-03) ;Demjanski, Vasko; ;Mikjunovikj Derebanova, Ljubica; The length of sevoflurane exposure may raise the risk of neuron-specific enolase (NSE) and S100 protein alterations in blood, which might thereafter result in postoperative cognitive dysfunction (POCD). The pathophysiology of POCD caused by the volatile anesthetic sevoflurane has been the subject of extensive research in recent years. This case study looks at preliminary findings about the effects of different sevoflurane anesthetic exposure durations on the levels of S100 protein and NSE in children’s blood. Additionally, it looks into how sevoflurane affects children’s early cognitive performance following surgery. To detect neurological effects during general anesthesia and ascertain the length of sevoflurane exposure, we employ the particular markers such as S100 protein and NSE. In this case study, we present two pediatric patients who underwent general anesthesia with sevoflurane for different durations. The aim was to observe potential postoperative changes in NSE and S100 protein levels, which are biomarkers associated with neuronal injury and cognitive function. After the surgery, we utilize these levels to assess any cognitive problems. The parents or guardians gave their informed consent. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COMPARISON OF THE EFFECTS OF DESFLURANE AND SEVOFLURANE IN AWAKENING AND COGNITIVE FUNCTION AFTER A GENERAL ANESTHESIA(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ; ; ;Leshi, AlbertAngjusev, DarkoIntroduction: The pharmacokinetics of desflurane and sevoflurane favour improved intraoperative control of anaesthesia and led to faster postoperative recovery. These anaesthetics have a lower blood/gas coefficient than isoflurane and halothane. (1) The low fat/gas coefficient and low brain/blood coefficient of desflurane lead to faster elimination of and faster awakening from anaesthesia. This leads to a quicker return of cognitive functions and speedier discharge from the Post Anaesthesia Care Unit (PACU). Objectives The purpose of this study is to compare the emergence time and time of return of cognitive functions in patients with general inhalation anaesthesia (general anaesthesia) maintained with inhalant anaesthetics desflurane and sevoflurane, respectively, under standardized conditions. Material and methods: This study included ASA I and II patients undergoing colorectal abdominal surgery who were randomly assigned into two groups: the first group received the inhalation anaesthetic desflurane in combination with the analgesic remifentanil for anaesthesia maintenance, while the second group was kept under using sevoflurane in combination with fentanyl. We used standard hemodynamic monitoring, the Train of Four (TOF) and the Bispectral Index System (BIS) to determine the depth of the anaesthesia. We recorded the time required for extubation, the opening of the eyes, verbal response, the modified Aldrete score of 9, the Mini Mental State Examination (ММSE) of 25 and the Short Orientation-Memory-Concentration Test (OMCT). Results: The results, expressed in minutes and obtained in both patient groups, demonstrate a significantly shorter time for regaining cognitive functions in the patients who received a desflurane inhalation anaesthetic with remifentanil compared to the patients who received a sevoflurane inhalation anaesthetic with fentanyl. This is thought to be due to the faster pharmacokinetic profile of desflurane, leading to an accelerated elimination in the patients. Desflurane, in combination with remifentanil, a short-acting opioid, further shortens the recovery time of cognitive functions. Conclusion: This study underscores that the time required for early recovery from anaesthesia is markedly shorter in patients receiving desflurane compared with patients given sevoflurane when administering general anaesthesia. This finding emphasizes the potential benefits of desflurane in optimizing perioperative outcomes, including faster emergence from anaesthesia and cognitive recovery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, AIRWAY MANAGEMENT IN 7-WEEKS-OLD INFANT WITH PIERRE ROBIN SYNDROME AND CONGENITAL PYLORIC STENOSIS(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-05); ;Golubikj, Nichevska Sanja ;Leshi, Albert; Angjusev, DarkoPierre Robin Syndrome (PRS) is characterized by a sequence of events including mandibular hypotrophy (micrognathia), abnormal posterior placement of tongue (glossoptosis), and airway obstruction. Pyloric Stenosis on the other hand is the most common infant surgical condition which presents with episodes of projectile vomiting leading to dehydration and weight loss. Airway management in these patients is a true challenge for every anesthesiologist. The patient was 7 weeks old infant, weighted 3,1 kg, admitted in Intensive Care Department for surgical repair of pyloric stenosis, previously diagnosed with Pierre Robin Syndrome at birth. Preoperative preparation, intravenous rehydration and electrolyte substitution was obtained. Video laryngoscope was used for management of difficult airway. We had many attempts in visualization of the vocal cords, eventually we performed awake intubation with stylet uncuffed endotracheal tube size 3. Pyloromyotomy was performed. Maintenance of anesthesia was with Sevoflurane and bolus doses of Fentanyl as adjunct. Perioperative vital signs were within normal ranges. Awake extubation was performed. The facial malformation that appears in patients with Pierre Robin Syndrome makes visualization of the glottis extremely difficult to impossible. In cases where tracheal intubation is needed, awake fiberoptic intubation is recommended, but it can have many limitations. These two conjoined conditions present the quandary of safely managing an expected difficult airway in an uncooperative patient. With this case we can conclude that for children with Pierre Robin syndrome, video laryngoscopy should be considered as a first attempt intubation device both in the operating room and for emergent situations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DELAYED COMPLICATIONS FOLLOWING LONG-TERM CENTRAL VENOUS CATHETER PLACEMENT IN PEDIATRIC ONCOLOGY CASES(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ;Litajkovska, Slavica; ;Aleksovski, ZlatkoIntroduction: Modern chemotherapy protocols in pediatric oncology necessitate the deployment of central venous catheters. The duration of catheter usage ranges from several months to a year. Typically, long-term central venous catheters (LCVC), including external tunneling (ETLCVC) and totally implanted (TILCVC) variations, are employed for this purpose. Aim: This study aims to assess the superiority of ETLCVC over TILCVC and to evaluate the occurrence of delayed complications, specifically focusing on catheter occlusion, dislocation of the catheter and catheter – related thrombosis, following the placement of central venous catheters. Material and Methods: This prospective interventional clinical study encompassed 120 pediatric patients, aged 2-14 years, diagnosed with leukemia, lymphomas and solid tumors. The participants were stratified into two groups (n=60). Group 1 received ETLCVC, whereas Group 2 underwent TILCVC placement. An informative interview was conducted with the eligible patients' parents, and written consent for study participation was obtained. Results: In the group of patients with an implanted ETLCVC, four patients had a dislocation of the catheter, three patients had a catheter occlusion, two patients had a catheter – related thrombosis. In the group of patients in whom a TILCVC was implanted, one patient had an dislocation of the catheter, one patient had catheter occlusion, and there wasn’t any patient with catheter – related thrombosis. Conclusion: Incidence of delayed complications (catheter occlusion, dislocation of the catheter, and catheter –related thrombosis) in our study were more frequent in patients in whom ETLCVC was applied, but this difference did not have statistical significance. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BEDSIDE ECHOCARDIOGRAPHY IN A HEMODYNAMICALLY UNSTABLE CHILD(Department of Anesthesia and reanimation, Faculty of Medicine, "Ss.Cyril and Methodius", University Skopje Macedonia, 2019-12); ;Toleska M.; ; Trposka A.Introduction:Echocardiography may be considered as an important tool due to hemodynamic assessment of a hemodynamically unstable child in a Pediatric Intensive Care Units (PICU), which could provide identification of the etiology and pathophysiology of hemodynamic instability but also to help due to guiding therapy. Objectives: The aim of our cohort study is to determine the impact of usage of fast focused echocardiography examination in the Surgical PICU done by Anesthesiologist/Intensivist. Material and Methods: We’ve made a fast focused bedside transthoracic echocardiographic examination of 11 hemodynamically unstable children using the regular parasternal long and short axis view and four chamber subcostal view of the heart, LVOT, aorta, truncus pulmonalis and Inferior vena cava (IVC) for qualitative assessment. Dimensions and collapsibility of IVC were measured. The youngest patient was premature neonate born in 28th gestation week and the oldest was 12 years old child. Results: In 9 out of 11 children we’ve identified abnormality by the qualitative assessment of the heart due to performing focused echocardiography. In 4 children we found global myocardial hypokinesia, one child with insignificant pericardial effusion (2 mm) and 4 children with Inferior vena cava collapsibility greater than 50%. In the children with hypokinesia inotropic support was established while the children with IVC collapsibility greater than 50% were treated with fluid boluses. Persistence of foramen ovale as a random finding was seen in 5 neonates, insignificant for the hemodynamic instability. Conclusion: Several studies have shown the positive effect of the echocardiography usage in the management of critically ill children, changing their treatment in 30%–60% of cases after the test is performed (2). From our study we can conclude that performing focused echocardiography is feasible and provides valuable data which could lead to improved care of severely ill children and thus should be encouraged in daily ICU practice.
