Ismaili, Irfan

Preferred name

Ismaili, Irfan

Official Name

Ismaili, Irfan

Alternative Name

Irfan Ismaili

Main Affiliation

irfan.ismaili@medf.ukim.edu.mk

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Recommmendations for the diagnostic algorithm in lung cancer. Consensus statement of the Macedonian respiratory society and the Macedonian association of pathology
(Македонско лекарско друштво = Macedonian Medical Association, 2019)
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Todevski Dejan
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Rexhepi Arben
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Tatabitovska Aleksandra
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Lung cancer is the “number one cancer killer” in the world. Its prevalence is associated to smoking as the primary cause, although air pollution in general and genetic factors are also in stake. The mortality especially from advanced stage lung cancer is still high, although there has been a significant improvement in the past 10 years, mostly due to the introduction of novel compounds such as targeted and immunological treatment. The advances in the treatment of NSCLC have imposed updating of the guidelines for the diagnostic procedure and screening of LC, for the indications for molecular testing as well as for targeted selection of patients who shall benefit the most of the novel treatment modalities. These recommendations shall fulfill their purpose only if implemented in the educational curriculum and if incorporated in the healthcare system strategies.
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Consensus statement: RECOMMENDATIONS FOR THE DIAGNOSTIC ALGORITHM IN LUNG CANCER CONSENSUS STATEMENT OF THE MACEDONIAN RESPIRATORY SOCIETY AND THE MACEDONIAN ASSOCIATION OF PATHOLOGY
(Македонско лекарско друштво = Macedonian Medical Association, 2019)
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Dejan Todevski
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Arben Rexhepi
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Aleksandra Tatabitovska
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Lung cancer is the “number one cancer killer” in the world. Its prevalence is associated with smoking as the primary cause, although air pollution in general and genetic factors are also important. The mortality especially from advanced stage lung cancer is still high, although there has been a significant improvement in the past 10 years, mostly due to the introduction of novel compounds such as targeted and immunological treatment. The advances in the treatment of NSCLC have imposed updating of the guidelines for the diagnostic procedure and screening of LC, for the indications for molecular testing as well as for targeted selection of patients who shall benefit the most from the novel treatment modalities. These recommendations shall fulfil their purpose only if implemented in the educational curriculum and if incorporated in the healthcare system strategies.
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Complications associated with acute pulmonary embolism – data from the registry of patients with venous thrombembolism
(Македонско лекарско друштво = Macedonian Medical Association, 2022)
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Dejan Todevski
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Suzana Arbutina
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Correct estimation of the severity, mortality, and complication risk are crucial for effective treatment of pulmonary embolism (PE). A total of 162 patients hospitalized with acute PE, treated either with standard treatment with heparin and vitamin K antagonists (VKA) or heparins, followed by direct oral anticoagulants (DOAC) were followed for a 90-days period. Demography, clinical and radiologic presentation, smoking status and concomitant comorbidities were analyzed. The mortality risk was estimated by calculating PESI and sPESI score. The results showed uneven utilization of both treatment modalities (93.8% treated with VKA versus 6.17% with DOAC). Smoking as an independent factor was detected in 55.56% of patients, and is greater than the overall smoking prevalence in Macedonia. Central propagation of PE was found in 57.79% of cases and together with the presence of pleural effusion was associated with a greater risk for complications. Estimation of 30-day mortality risk with PESI and sPESI showed their high predictive value, with an advantage of sPESI, in terms of better accuracy and simplicity of performance. Correct estimation of risk for complications and mortality is important for improving the overall safety of patients with PE and has a positive „cost-benefit“ effect for organization of the treatment.
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Correlation between detected respiratory pathogens and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease
(Македонско лекарско друштво = Macedonian medical association, 2021)
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Correlation of Clinical and Inflammatory Parameters in Chronic Obstructive Pulmonary Disease
(SHMSHM - AAMD, 2023-04)
Angjela, Debreshlioska
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Vuinov, Venco
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Karakostova, Marija
Aim: The aim of this study was to determine the values of systemic inflammatory parameters in patients with COPD and to determine their correlation with selected clinical parameters. Material and methods. We conducted a cross-sectional analytical study at PHI University Clinic for Pulmonology and Allergy, on 59 patients diagnosed with COPD. All patients underwent anamnesis with review of medical records for demographic and clinical data, history of allergies, cigarette smoking, and history of exacerbations. Patients completed a COPD assessment questionnaire (CAT) and a modified dyspnea scale (mMRC) and the BODE (Body mass index, Obstruction, Dyspnea, Exercise capacity) index was calculated. Spirometry and lung X-ray were performed. Peripheral blood was taken for analysis of inflammatory parameters. Results: A total of 59 patients were included, of which 14 (23.72%) were women and 45 (76.27%) were men. The mean age was 65.23 years. Statistical analysis showed a significant positive correlation between CRP and GOLD, CAT, mMRC and the existence of chronic bronchitis, as well as a significant linear moderate negative correlation between CRP and CAT. A significant linear positive correlation between Le and GOLD, CAT, mMRC and BODE, a significant linear positive correlation between Ne and GOLD, mMRC and BODE, as well as a significant linear moderate negative correlation between Ne and FEV1 were also determined. Of the cytokines Il-4 showed a significant linear moderate positive correlation with chronic bronchitis, and Il-18 a significant linear strong positive correlation with the presence of emphysema. Conclusion: The existence of a correlation between selected inflammatory and clinical parameters provides additional data that may help elucidate pathogenetic mechanisms and determine potential therapeutic targets that would personalize the approach to the patient with COPD.
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ADENOID CYSTİC CARCINOMA TREATED WITH ELECTROCAUTERY– 5-YEAR SURVIVAL
(Македонско лекарско друштво = Macedonian Medical Association, 2020)
Arben Rexhepi
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Dejan Todevski
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Aleksandra Tatabitovska
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Adenoid cystic carcinoma (ACC) is an uncommon neoplasm which arises from the major and minor salivary glands of the head and neck. Rarely, it can develop from secretory glands originating in the trachea, breast, lacrimal glands or other exocrine glands. We present a case of a fifty-years-old female patient with a polypoid adenoid ACC, growing from the middle of the left main bronchus causing obstruction of the bronchial lumen. Complete resection of the polypoid mass was accomplished using an electrocautery snare through the flexible bronchoscope, cauterizing the stalk in one attempt. The tumor was extracted in the manner of foreign body extraction, attaining complete recanalization and providing patency of the visible bronchial tree with no immediate or late complications. The followup bronchoscopy after 6 months found no signs of persistent or recurrent disease. The patient was followed at 6 and 12 months and every year for 5 years and no signs for local recidive or metastasis was found. We recommend considering endoscopic electrocautery for selected endobronchial or endotracheal cases of ACC, where surgical or oncologic treatment is not possible, in curative or palliative purposes.
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Excellent Response to Alectinib in ALK Positive NSLC Adenocarcinoma, Case Report and Literature Review
(Macedonian Association of Anatomists and Morphologists, 2023)
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Pachoska Stojchevska, Vesna
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Non small cell lung carcinoma (NSCLC) is a type of lung carcinoma that slowly grows within the lung tissue. Hence, it is often diagnosed late when the disease has already progressed and passed to other body organs and/or lymph nodes. In most cases, this makes NSCL inoperable at the exact moment of diagnosing, which leads to the necessity of using chemotherapy that has the purpose of narrowing the extended masses in the lungs and/or any near/further metastases. Alectinib is a tyrosine k inase inhibitor (TKI) that is currently being used as a first line target therapy in treating the inoperable ALK rearranged NSCLC, but still the effectiveness of the treatment is not definitely known and examined. Herein, we present the case of a 51 year old male patient admitted to our hospital with hemoptysis for 2 weeks. Contrast enhanced computerized tomography (CT) of the chest showed an approximately 28x23 mm soft tissue mass infiltrating the lumen of the right bronchus and causing obstruction. On the same side at the base, a hypodense nodule of 19 mm with some surrounding pneumonic reaction and irregular contours was detected. Several significant lymph nodes were detected in the hilar and mediastinal regions. Bronchial biopsy of the mass showed pulmonary adenocarcinoma and the immunohistochemical testing results confirmed ALK rearrangements. TKI Alectinib was given at a dosage of 600mg twice per day for 13 cycles, achieving a complete response of the disease with complete regression of the mass in the right bronchus, complete regression of the right nodule and hilar and mediastinal lymph nodes were not detected following the treatment. The patient continued to receive Alectinib and did not report any specific discomfort at his 13th month follow up.
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Плеврален излив кај болни со малигна болест - ретроспективна студија на пресек
(SHMSHM - AAMD, 2023)
Todevski, Dejan
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Arbutina, Suzana
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Вовед: Oсновна процедура за дијагностика на малигните изливи е цитопатолошката анализа на плевралниот пунктатот добиен со дијагностичка парацентеза. Цел на студијата е да се одреди фреквенцијата на плевралните изливи кај малигни заболувања, како и на цито-патолошки потврдените малигни изливи во зависност од патохистопатолошкиот наод на примарната болест. Материјал и методи : Направена е студија на пресек која анализира пациенти лекувани на Клиниката за пулмологија и алергологија, Скопје поради малигно заболување и придружен плеврален излив. Aнализирана е медицинската историја на болните, резултатите од патохистологијата на примарната неоплазма и цитопатолошките резултати од плевралниот излив. Резултати: Кај 57 пациенти вклучени во студијата, белодробниот аденокарцином кај мажи и карциномот на дојка кај жени се најчестите малигни заболувања асоцирани со плеврален излив, со застапеност од 21(36,8%). Следуваат лимфомите и гастроинтестиналните малигноми со по 5 (8,8%) и планоцелуларниот карцином на бели дробови со 4 пациенти (7,7%). Цитопатолошка потврда на малигната природа на изливот е најдена кај 16 (28,1%) од пациентите. Најголем процент на позитивен цитопатолошки наод во плевралниот излив беше најден кај белодробниот аденокарцином 5 (31.3%), карциномот на дојка 3 (18.7%), додека мезотелиомот, оваријалниот карцином, лимфомот, карцином на панкреас, ситноклеточниот и недефинираниот неситноклеточен карцином беа застапени со по 1 пациент (6,3%). Заклучок: Детекцијата на малигниот плеврален излив со позивната цитопатологија зависи од типот на туморот што го предизвикал. Кај аденокарциномот на бели дробови и дојка сензитивноста на цитологијата е многу висока; кај други малигноми понекогаш има потреба таа да се комбинира со други дијагностички процедури.
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ADULT PATIENT WITH BRONCHOGENIC CYST - A RARE PULMONARY DEVELOPMENTAL ANOMALY
(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2022)
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Jovanoski, Smilko
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Debreshlioska, Angela
Bronchogenic cysts are anomalies in the prenatal development of the lungs that we encounter extremely rarely in the adult population because they are diagnosed in childhood, usually after birth. So far, there is no published case in the Republic of Macedonia with a diagnosed bronchogenic cyst in the lung parenchyma. Such cases need to be solved with surgical intervention in order to avoid possible complications.
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Употреба на Multiplex Real Time Polymerase Chain Reaction методата во детекција на респираторни патогени кај пациенти со акутна егзацербација на астма
(Македонско лекарско друштво, Македонско здружение за алергологија и клиничка имунологија, 2018-09)
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Goseva, Zlatica
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Ismaili, Irfan

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