Darko DJambaz
Preferred name
Darko DJambaz
Email
darko.dzambaz@medf.ukim.edu.mk
12 results
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Item type:Publication, Major abdominal surgery for Jehovah's Witnesses: Challenge while practicing bloodless medicine in a middle income country(SAGE Publications Ltd., 2023); ; ; ; We present a 59-year-old female Jehovah's Witness patient transferred from another facility to our tertiary center as an emergency case owing to anemia due to gastrointestinal bleeding. A computed tomography scan and gastroscopy confirmed an invasion of the duodenum by a malignant process. The patient underwent a Whipple procedure and a right hemicolectomy refusing blood transfusion. On the 17th postoperative day, the patient was discharged following a successful surgery. This article's objectives are to first highlight the moral and ethical quandary and then share our surgical experiences with this particular patient population. In conclusion, Jehovah's Witnesses' management of major abdominal surgery poses considerable clinical, moral, and legal difficulties. Despite them, doctors must put the patients' needs first while also honoring their religious convictions. However, urgent situations continue to arise, forcing medical professionals to weigh their religious convictions against the need to save a patient's life. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gastric metastasis from high-grade soft tissue sarcoma: a rare occurrence with literature review(Oxford University Press and JSCR Publishing Ltd, 2025-03-15); ; Todorova, TeodoraMetastasis of high-grade soft tissue sarcoma to the stomach is an extremely rare occurrence. While sarcomas can spread to distant organs,they most commonly metastasize to the lungs,liver,and bones.We report a unique case of gastric metastasis from a high-grade soft tissue sarcoma,occurring 4 years after the initial diagnosis of fibrosarcoma in the right femoral region.The patient did not undergo adjuvant chemotherapy and developed a large soft tissue metastasis in the left gluteal region 2 years later. After 4 years, he presented with a second soft tissue metastasis and suspected metastatic lung nodules. Symptoms of melena and severe anemia prompted a gastroscopic examination, which revealed gastric metastasis from a high-grade soft tissue sarcoma. Due to severe anemia, a palliative gastric resection was performed.A review of the literature indicates that metastatic leiomyosarcomas are the most frequently reported sarcoma subtype metastasizing to the stomach. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Percutaneous Onsite Insertion of Catheter for Peritoneal Dialysis - A New Method Introduction in the Country(Walter de Gruyter GmbH, 2023-07-01); ; ; Peritoneal dialysis (PD) is one of the options for renal replacement therapy (RRT) in the end stage renal disease (ESRD) patients. Compared to hemodialysis (HD), patients on PD experience a greater sense of well-being, an improved steady state in terms of extracellular fluid volume shifts and hemodynamics and it is preferred method for patients with problematic vascular access, bleeding tendencies, heart failure and elderly patients. In order to perform PD, a tunneled catheter should be placed through the abdominal wall and into peritoneal space, with positioning of the catheter within the most dependent portion of pelvis. Currently, there are several techniques available for PD catheter placement: open surgery, laparoscopic and percutaneous. We present for the first time in our country a case of 65 year old male patient to whom percutaneous onsite insertion of peritoneal catheter was performed. The idea is to emphasize that sometimes this should be a method of choice for RRT, especially in patients where general anesthesia should be avoid. Compared to other methods, percutaneous insertion is a simple procedure with no need for general anesthesia, and the benefits of quick recovery, earlier ambulation, and less delay in catheter placement. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HER2 Positive Gastric Carcinomas and Their Clinico-Pathological Characteristics(ID Design 2012/DOOEL Skopje, 2018-07-20); ; ; Hadzi-Manchev, DraganHER2 protein expression in gastric carcinoma, in correlation with existing, acknowledged prognostic factors which include the parameters that determine the TNM stage of the disease, could become the basis for ongoing research in the field of molecular targeted and personalised therapy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EBV Positive Gastric Carcinomas and Their Clinicopathological Characteristics(ID Design 2012/DOOEL Skopje, 2018-10-25); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Desmoid-type fibromatosis in splenic hilum with rupture of lienal artery aneurism in a 17-year-old male(2023-04); ; ; ; Desmoid Fibromatosis (DF) is locally aggressive benign fibroblastic or myofibroblastic tumor with no me- tastatic potential, but has high recurrence rate. The symptoms vary according to tumor location, abdominal or extra-abdominal. In this study we present a case of a 17-year-old male with intraabdominal bleeding due to rupture of lienal artery aneurism in splenic hilum where desmoid fibromatosis was found. From abdo- minal cavity 3L free blood was evacuated. Immunohistochemistry revealed nuclear positivity for β-catenin stain favoring the diagnosis of desmoid type fibromatosis. Some of the cells showed SMA positivity, while CD34, S100 and CD117 were negative. Additional molecular analysis from 3 ml peripheral blood was made by NGS showing intergenic variant on position 51549496 with frequency of 46,4% which is highly pathoge- nic. Intraabdominal fibromatosis has very unpredictable outcome when diagnosed incidentally. Molecular analysis should reveal more genetic alterations in publishing these case presentations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DEMOGRAPHIC AND PATHOLOGICAL CHARACTERISTICS OF GASTRIC CARCINOMAS – A Three-Year Single Center Experience(Macedonian Association of Anatomists, 2020); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CORRELATION BETWEEN HER2 AND EBV EXPRESSION IN GASTRIC CARCINOMA(Macedonian Association of Anatomists, 2020); ; ; Hadzi-Mancev DIntroduction: The understanding of the etiopathogenesis and the molecular basis of gastric carcinoma will facilitate the development of novel molecular target therapies, which interfere with different signal cascades involved in cellular proliferation, differentiation and survival. The aim of this paper was to determine the correlation between HER2 and EBV expression in patients with gastric carcinomas. Material and methods: Eighty patients with gastric carcinoma surgically treated were included in the study. Data of HER2 protein expression were obtained from the archived histopathological reports of the Institute of Pathology in Skopje. For detection of EBV, immunostainings were performed on tumor tissue and the peripheral nontumor gastric mucosa. Results: The results of this study confirmed a significant association between HER2 and EBV expression (p=0.041). The value of the Spearman correlation coefficient (R = - 0.258) indicated a negative, indirect connection of HER2 and EBV expression, which was confirmed as statistically significant (p = 0.02). The HER2 expression in gastric carcinomas was significantly associated with EBV expression, and the expression of HER2 was significantly more common in EBV negative cancers. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Tumor Budding as a Prognostic Marker in Primary Colon Cancer - A Single Center Experience(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH, 2024-06-01); ; Introduction: Tumor budding (TB) is considered to be a morphological and prognostic factor relevant to colon cancer (CC). The aim of our study is to assess the TB and to evaluate its relationship to clinicopathological findings within stage II and III CC patients as a single center experience. Materials and methods: A total of 120 CC patients operated between 2018 and 2021 at the University Clinic of Digestive Surgery in Skopje, the Republic of North Macedonia were included in this retrospective, single center study. TB was evaluated by the magnification of 200x along the invasive front of the primary tumor on H&E and CKAE1/AE3 immunohistochemically stained sections. Two grades were used: low grade (TB1, 0-4 TBs) and high-grade, which includes intermediate (TB2, 5-9 TBs) and high grade (TB3 ≥10TBs) of TBs. Results: A statistically significant correlation has been identified between high-grade TB and age (p=0.05) of the patients. There was also a significantly higher occurrence of high-grade TB in patients within stage III CC. Statistically significant correlations were also found in lymph node status (p<0.01), vascular invasion (p<0.05), lymphatic invasion (p<0.01), postoperative relapse (p<0.01), and death (p<0.01). Tumor relapse and death were significantly more frequent in patients with high-grade TB than those with low-grade TB. Patients with registered high-grade TB demonstrated significantly lower relapse-free survival (RFS) and overall survival (OS) rates than patients with low-grade TB over the observation period (RFS: 53.8% vs. 98.5%, p<0.001; OS: 65.4% vs. 97.1%, p<0.001, respectively). Patients with lung and liver postoperative relapses had higher percentage of cases with high-grade TB (94.1%). Conclusion: Our results are highly suggestive that TB should be included as a histological biomarker in the pathology report of patients with stage II and stage III CC, because of its prognostic value. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RUPTURED HEPATIC ARTERY ANEURYSM SUCCESSFULLY TREATED WITH DUAL-LAYER STENT ENDOVASCULAR TREATMENT: CASE REPORT AND LITERATURE REVIEW(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024); ; ; ; Spontaneous rupture of a hepatic artery aneurysm into the peritoneal cavity is a serious life-threatening complication related to hemodynamic instability and high mortality rate. We present a case of a hepatic artery aneurysm complicated with intraperitoneal bleeding and successfully treated with endovascular stent insertion. A 78-year-old male patient was admitted to a tertiary care center due to an abdominal pain and a large amount of free fluid in the peritoneal cavity. The diagnostic paracentesis confirmed hemoperitoneum. The CT scan revealed an aneurysm of the common hepatic artery that was successfully treated with an insertion of a dual-layered carotid stent. Endovascular stent insertion of a ruptured aneurysm of the common hepatic artery is an effective therapeutic procedure that can provide a definitive curative treatment in some patients.