Kiprijanovska, Biljana
Preferred name
Kiprijanovska, Biljana
Official Name
Kiprijanovska, Biljana
Translated Name
Кипријановска, Билјана
Main Affiliation
8 results
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Item type:Publication, Does the Apolipoprotein E Genotype Increased the Risk of Postoperative Delirium in Adult Patients?(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023-12); ; ; ; Toleska, MarijaBackground: The relationship between genetic predisposition and the development of postoperative delirium has not yet been established. The e4 allele of the apolipoprotein E gene has been reported as a genetic risk factor for delirium. Objective: This paper analyzed the relationship between the frequency of genotypes of the APOE rs7412/rs429358 polymorphism, which contains the minor allele e4, and the occurrence of postoperative delirium. Material and Methods: The study included patients aged 65 years and older without pre-existing cognitive impairment admitted to the University Clinic for Traumatology and Orthopedics for operative treatment of a fracture of the upper end of the thighbone. The Confusion Assessment Method (CAM) confirmed the delirium diagnosis. APOE rs7412/rs429358 polymorphism genotypes were determined by molecular genetic analysis using the quantitative real-time amplification method (qRT-PCR) on DNA samples extracted from venous blood leukocytes. Results: The presented results are from analyzed samples and data from 51 patients. Out of these, postoperative delirium was diagnosed in 12 patients, while in 39 patients weren’t registered, and they are the control group in the trial. Conclusion: This study results indicate the association of the studied polymorphism in the apolipoprotein E gene, which contains the minor allele e4, with the occurrence of postoperative delirium in this group of adult patients. A larger group is necessary to reach more valid conclusions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ADVANTAGES OF TARGET CONTROL INFUSION - TOTAL INTRAVENOUS ANESTHESIA VS SEVOFLURANE INHALATION ANESTHESIA IN CONTROLLING SURGERY - RELATED STRESS RESPONSE(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ; ; Trposka, AngelaIntroduction: The stress response to surgery, a sequence of pathological and physiological alterations brought on by the stimulation of surgery, can be divided into two main categories: the inflammatory-immune response and the neuroendocrine-metabolic response. It depends on the anesthesia technique and surgical approach. Material and Methods: The patients were divided into two groups: Sevoflurane inhalational anesthesia (SIA) and Target control infusion-Total intravenous anesthesia (TCI-TIVA). The TCI-TIVA group has used the Marsh model for the propofol and the Minto model for the remifentanil, using target plasma concentration. The SIA group has induction in general anesthesia with Propofol plus Fentanyl, and the maintenance of anesthesia has been achieved with Sevoflurane on MAC 0.7-1.0. We compared the effect of different anesthetic techniques on the surgical stress response through measuring the blood levels of proinflammatory cytokines Interleukin-6, Cortisol and blood glucose, as well as the hemodynamic response. Results: Interleukin-6 (IL-6) levels rise sharply from T0 (4.78εg/mL) to T2 (10.06εg/mL) and then again at T3 (36.34εg/mL), showing a strong inflammatory response after surgery in the SIA group. IL-6 levels in the TCI-TIVA Group exhibit a comparable pattern, however with a significantly smaller increase at T3 (14.56). When comparing the cortisol levels at T0, both groups show a comparable range of variability. There is a highly significant difference in cortisol levels between TIVA and SIA after extubating and 24 hours postoperatively, as indicated by the T2 p-value of less than 0.001. Glucose levels in the SIA group are comparatively constant from T0 (5.29) to T1 (5.25), then they significantly rise at T2 (6.56) and stay high at T3 (5.71). Glucose levels in the TCI-TIVA Group exhibit less variability, increasing slightly from T0 (5.17) to T2 (5.21) and then staying constant at T3 (5.28). Hemodynamic stability was better with TCI-TIVA than with SIA. Conclusion: Our findings indicate that TCI-TIVA consistently demonstrates advantages regarding controlling the stress response, inflammation, and metabolic response both during and after surgery as compared to the SIA group. These results provide credence to the prospective advantages of TCI-TIVA over SIA in surgical settings where patient’s outcomes depend critically on reducing stress, inflammation, and metabolic disturbances - 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); ; 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, Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries(Elsevier Ltd., 2022-11-05) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, "DEVELOPMENTAL HEMOSTASIS" AND PEDIATRIC SURGERY(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023-12); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BILATERAL TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR TREATMENT OF CHRONIC ABDOMINAL WALL PAIN: A CASE REPORT(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2022-11); ; Transversus abdominis plane (TAP) block is a regional anesthesia technique where the local anesthetic is injected into the interfascial plane between the internal oblique and transversus abdominis muscle. This block is mainly used for treatment of acute pain following abdominal surgery. Persistent postsurgical pain (PPSP) or chronic postsurgical pain (CPSP) is pain that persists at least three months after surgery, which was not present before surgery, or which had different characteristics or increased intensity from preoperative pain. It is localized near the surgical site or a referred area, and other possible causes for the pain had been excluded (cancer recurrence or infection). This pain can lead to functional limitation and psychological trauma in patients. By presenting our case report we would like to describe the effect of TAP block on CPSP in a female patient who had previously undergone many abdominal surgeries. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anesthetic Challenges for Major Hepatectomy(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2022-03); ; Rushiti, KjemalHepatic resection is the treatment of choice for many liver diseases. However, it is a large and complex operation with a high risk of side effects in the patients, and it is a challenge for both surgeons and anesthesiologists. This paper presents a case of successfully performed right hepatectomy in a 45-years-old woman with the finding of a giant liver hemangioma, larger than 10cm, placed near the inferior vena cava and the challenges faced by the anesthesiologists when guiding such a patient during the entire perioperative period. The main concern was the risk of massive blood loss, which might significantly increase the rate of morbidity and mortality. During liver resection, central venous pressure (CVP) was optimally maintained below 5cmH2O to reduce blood loss. The cell salvage technique was used to minimize heterologous blood transfusion. Epidural anesthesia can be safely applied in patients undergoing major hepatic resection, provided that they have corrected perioperative hemostasis. The surgical approach after Belghiti “liver hanging maneuver” performed by the surgeons in our case may involve transient compression of the inferior vena cava that cause profound hypotension. Therefore, a successful outcome requires close collaboration between the anesthesiology and surgical team by sharing decisions throughout the operation and following and implementing the latest evidence-based recommendations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Intrafetal Interventional Procedures and Anesthetic Implications(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-05); ;