L. Petkovska, Z. Petronijevic, A. Chibishev, Dushan Petkovski, Aleksandra Stevchevska
Abstract A 64-year-old man ingested about 60 ml 2% of topical minoxidil solution in order tomake his hair grow faster. Twelve hours after ingestion he was brought to the University Clinic of Toxicology with severe hypotension, tachycardia, chest pain and subendocardial ischemia. ECG showed diffuse T-wave inversion and depressed ST segments. He was also oligoanuric at admission. In spite of the intensive hydration with crystalloidsolutions and intravenous dopamine administration that resulted in partial hemodynamic improvement and resolution of the ECG changes, kidneyfailure occurred. After two hymodialysis sessions, urea and creatinine levels returned to normal and rebound hypertension appeared. The patient was discharged after 12 days of hospitalization in a good condition. Topical minoxidilsolution is formulation used for treatment of androgenic alopecia. If orally ingested it leads to severe hypotension, acute coronary syndrome, compensatory tachycardia and acute kidneyfailure. Emergency therapeutic approach is a precondition for successful outcome.
{"title":"Minoxidil Overdosage: A Case Report","authors":"L. Petkovska, Z. Petronijevic, A. Chibishev, Dushan Petkovski, Aleksandra Stevchevska","doi":"10.1515/mmr-2016-0020","DOIUrl":"https://doi.org/10.1515/mmr-2016-0020","url":null,"abstract":"Abstract A 64-year-old man ingested about 60 ml 2% of topical minoxidil solution in order tomake his hair grow faster. Twelve hours after ingestion he was brought to the University Clinic of Toxicology with severe hypotension, tachycardia, chest pain and subendocardial ischemia. ECG showed diffuse T-wave inversion and depressed ST segments. He was also oligoanuric at admission. In spite of the intensive hydration with crystalloidsolutions and intravenous dopamine administration that resulted in partial hemodynamic improvement and resolution of the ECG changes, kidneyfailure occurred. After two hymodialysis sessions, urea and creatinine levels returned to normal and rebound hypertension appeared. The patient was discharged after 12 days of hospitalization in a good condition. Topical minoxidilsolution is formulation used for treatment of androgenic alopecia. If orally ingested it leads to severe hypotension, acute coronary syndrome, compensatory tachycardia and acute kidneyfailure. Emergency therapeutic approach is a precondition for successful outcome.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"104 - 107"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Cvetanovska, Zvonko Milenkovik, Irena Kondova Topuzovska, K. Grozdanovski, Valerija Kirova Uroshevik, I. Demiri, K. Spasovska, V. Cvetanovski
Abstract Introduction. The risk factors associated with the progression of a severe clinical form of seasonal influenza are of a particular importance in developing a current and accurate decision in terms of treatment options. Aim. The aim of the study was to identify the specific factors associated with a severe form of seasonal influenza. Method. The study was conducted as a prospective, group comparison at the University Clinic for Infectious Diseases in Skopje, Macedonia, during the period of January 01, 2012, until January 01, 2015. This study analyzed 122 adult patients, who were clinically-confirmed to be infected with seasonal influenza by laboratory analyses and other necessary tests. These patients were grouped into two categories: patients with a mild form of seasonal influenza, and patients with a severe form of seasonal influenza. Furthermore, the demographic, clinical, and biochemical results obtained were analyzed. The variables in the univariable analysis which were significantly associated with a severe form of seasonal influenza were included in the multivariable logistic regression analysis in order to extract and determine the independent predicttors of a severe form of seasonal influenza. Results. The multivariable analysis yielded cardiovascular diseases (p=0.01), dyspnea (p=0.001), tachypneа >20 respiration/ minute (p=0.005), values of LDH greater than 618 U/L (p=0.048) and SAPS 2score (p=0.031) as independent variables which predict the severity of the illness. The area under the ROC curve [0.826 (95% CI)] suggests that the probability of a severe form of influenza was82.6%. The global accuracy for this model to predict a severe form of influenza was 81.1%, with the sensitivity being 88.5%, and the specificity 72.9%. Conclusion. Cardiovascular diseases, dyspnea, tachypnea, elevated levels of LDH and SAPS 2 score are independent predictive indicators for severe influenza. Early identification of these indicators will allow implementation of adequate medical intervention which will in turn reduce mortality rates.
{"title":"Seasonal Influenza- Factors Associated with a Severe Clinical Form of the Illness","authors":"M. Cvetanovska, Zvonko Milenkovik, Irena Kondova Topuzovska, K. Grozdanovski, Valerija Kirova Uroshevik, I. Demiri, K. Spasovska, V. Cvetanovski","doi":"10.1515/mmr-2016-0014","DOIUrl":"https://doi.org/10.1515/mmr-2016-0014","url":null,"abstract":"Abstract Introduction. The risk factors associated with the progression of a severe clinical form of seasonal influenza are of a particular importance in developing a current and accurate decision in terms of treatment options. Aim. The aim of the study was to identify the specific factors associated with a severe form of seasonal influenza. Method. The study was conducted as a prospective, group comparison at the University Clinic for Infectious Diseases in Skopje, Macedonia, during the period of January 01, 2012, until January 01, 2015. This study analyzed 122 adult patients, who were clinically-confirmed to be infected with seasonal influenza by laboratory analyses and other necessary tests. These patients were grouped into two categories: patients with a mild form of seasonal influenza, and patients with a severe form of seasonal influenza. Furthermore, the demographic, clinical, and biochemical results obtained were analyzed. The variables in the univariable analysis which were significantly associated with a severe form of seasonal influenza were included in the multivariable logistic regression analysis in order to extract and determine the independent predicttors of a severe form of seasonal influenza. Results. The multivariable analysis yielded cardiovascular diseases (p=0.01), dyspnea (p=0.001), tachypneа >20 respiration/ minute (p=0.005), values of LDH greater than 618 U/L (p=0.048) and SAPS 2score (p=0.031) as independent variables which predict the severity of the illness. The area under the ROC curve [0.826 (95% CI)] suggests that the probability of a severe form of influenza was82.6%. The global accuracy for this model to predict a severe form of influenza was 81.1%, with the sensitivity being 88.5%, and the specificity 72.9%. Conclusion. Cardiovascular diseases, dyspnea, tachypnea, elevated levels of LDH and SAPS 2 score are independent predictive indicators for severe influenza. Early identification of these indicators will allow implementation of adequate medical intervention which will in turn reduce mortality rates.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"68 - 74"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction. Pelvic malignancy (cervical, rectal and endometrial carcinoma) is a very common and deadly disease. Adjuvant therapy consists of regimens that include both concurrent chemotherapy/radiotherapy (RT) and adjuvant chemotherapy. The aim of the study was to evaluate and analyze renal function through the changes in GFR (Glomerular Filtration Rate), using 3D conformal radiotherapy (3DCRT) techniques in the treatment of patients with pelvic malignancy. Methods. This study was conducted at the Clinical Center of Kosovo, Oncology Department. Several variables were evaluated in 75 patients: sex, age, type of primary malignancy, median tumor dose (TD) evidence over 50 and above 50 Gray (Gy). Time of the appearance of toxicity was followed by GFR changes during3- and 6-month follow-up period. Patients with pretreatment genitourinary morbidity (PGUM) were excluded from the study. Results. Our cohort consisted of 75 patients with pelvic malignancy, of whom 53(70.7%) were female and 22(29.3%) male. The average age of the patients included in the study was 57.5±11.2 years. Thirty (40.0%) of the 75 patients had rectal carcinoma, 28 (37.3%) cervical cancer (CC) and 17 (22.7%) endometrial carcinoma. The average value of GFR in the beginning was 71.7± 23.1ml/min, it was 75.6±25.6ml/min three months after beginning of therapy and 79.1±25.9 ml/min six months after therapy. The test of comparison showed a signifycant statistical difference between the values of GFR at the baseline of treatment vs three months after therapy (P<0.05), baseline of therapy vs six months after therapy (P<0.001), while there was no difference between GFR values three months and six months after therapy. Conclusion. Overall, the kidney function improved at 3 and 6 months in majority of patients.
{"title":"Influence of Radiation Therapy on Glomerular Filtration Rate after Treating Pelvic Malignancy","authors":"Vildana Goga-Cmega, L. Tozija, G. Spasovski","doi":"10.1515/mmr-2016-0017","DOIUrl":"https://doi.org/10.1515/mmr-2016-0017","url":null,"abstract":"Abstract Introduction. Pelvic malignancy (cervical, rectal and endometrial carcinoma) is a very common and deadly disease. Adjuvant therapy consists of regimens that include both concurrent chemotherapy/radiotherapy (RT) and adjuvant chemotherapy. The aim of the study was to evaluate and analyze renal function through the changes in GFR (Glomerular Filtration Rate), using 3D conformal radiotherapy (3DCRT) techniques in the treatment of patients with pelvic malignancy. Methods. This study was conducted at the Clinical Center of Kosovo, Oncology Department. Several variables were evaluated in 75 patients: sex, age, type of primary malignancy, median tumor dose (TD) evidence over 50 and above 50 Gray (Gy). Time of the appearance of toxicity was followed by GFR changes during3- and 6-month follow-up period. Patients with pretreatment genitourinary morbidity (PGUM) were excluded from the study. Results. Our cohort consisted of 75 patients with pelvic malignancy, of whom 53(70.7%) were female and 22(29.3%) male. The average age of the patients included in the study was 57.5±11.2 years. Thirty (40.0%) of the 75 patients had rectal carcinoma, 28 (37.3%) cervical cancer (CC) and 17 (22.7%) endometrial carcinoma. The average value of GFR in the beginning was 71.7± 23.1ml/min, it was 75.6±25.6ml/min three months after beginning of therapy and 79.1±25.9 ml/min six months after therapy. The test of comparison showed a signifycant statistical difference between the values of GFR at the baseline of treatment vs three months after therapy (P<0.05), baseline of therapy vs six months after therapy (P<0.001), while there was no difference between GFR values three months and six months after therapy. Conclusion. Overall, the kidney function improved at 3 and 6 months in majority of patients.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"88 - 92"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The biological uniqueness of malignant tumors in pregnancy lies in the combination of uncontrolled growth of malignant tumors and controlled growth of fetoplacental complex in the same host. The risk of pregnancy associated with a malignant disease is approximately 0.1% (1 case per 1, 000 deliveries). According to results from one of the largest studies of malignant tumors in pregnancy, which involved almost thousand cases, the most frequent types were breast and cervical cancer, then melanoma, lymphoma and leukemia, gastric and rectal cancer, bone sarcoma and other sarcomas of the soft tissue. According to a Swedish retrospective study on cancer during pregnancy, the incidence rate is 37.4 cases per 100 000 deliveries. Pregnancy-associated malignant disease brings a range of specific problems, such as: difficulties related to diagnosis and staging of the disease; the risk of performing diagnostic and therapeutic procedures during pregnancy; counseling and treatment plan of pregnant women having malignant disease. The treatment plan of a pregnant patient with cancer has three possibilities: termination of pregnancy; postponement of treatment to reach fetal viability; treatment during pregnancy. The management of malignant disease during pregnancy may be highly dangerous or even fatal for the fetus. The treatment includes surgery, radio and chemotherapy. In malignant diseases during pregnancy, the prognosis is the same as in general population cancers of the same stage, localization and type. Termination of pregnancy is indicated in cases of, either high absorbed fetal radiation dose, or high grade, aggressive or metastatic cancer.
{"title":"Malignant Diseases in Pregnancy - Ethical, Diagnostic and Treatment Challenge","authors":"V. Kesic, G. Dimitrov","doi":"10.1515/mmr-2016-0011","DOIUrl":"https://doi.org/10.1515/mmr-2016-0011","url":null,"abstract":"Abstract The biological uniqueness of malignant tumors in pregnancy lies in the combination of uncontrolled growth of malignant tumors and controlled growth of fetoplacental complex in the same host. The risk of pregnancy associated with a malignant disease is approximately 0.1% (1 case per 1, 000 deliveries). According to results from one of the largest studies of malignant tumors in pregnancy, which involved almost thousand cases, the most frequent types were breast and cervical cancer, then melanoma, lymphoma and leukemia, gastric and rectal cancer, bone sarcoma and other sarcomas of the soft tissue. According to a Swedish retrospective study on cancer during pregnancy, the incidence rate is 37.4 cases per 100 000 deliveries. Pregnancy-associated malignant disease brings a range of specific problems, such as: difficulties related to diagnosis and staging of the disease; the risk of performing diagnostic and therapeutic procedures during pregnancy; counseling and treatment plan of pregnant women having malignant disease. The treatment plan of a pregnant patient with cancer has three possibilities: termination of pregnancy; postponement of treatment to reach fetal viability; treatment during pregnancy. The management of malignant disease during pregnancy may be highly dangerous or even fatal for the fetus. The treatment includes surgery, radio and chemotherapy. In malignant diseases during pregnancy, the prognosis is the same as in general population cancers of the same stage, localization and type. Termination of pregnancy is indicated in cases of, either high absorbed fetal radiation dose, or high grade, aggressive or metastatic cancer.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"21 1","pages":"53 - 56"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gordana Mirchevska, Z. Cekovska, E. Trajkovska-Dokic, M. Petrovska, N. Panovski
Abstract Introduction. Although blood culture is considered a gold standard in diagnosis of invasive infections, it is still not reliable and fast enough for diagnosis of candidemia. Determination of serum (1,3)-⃞-D-glucan is a highly sensitive and specific test for invasive mycosis, and could probably be of benefit to patients with high risk for invasive infections with Candida species. Aim. The aim of this study was to prospectively evaluate the diagnostic performance of serum (1.3)-⃞-Dglucan BDG (Fungitell) assay, in comparison with blood culture, for diagnosis of invasive infections with Candida species. Methods. Blood and sera from 120 patients divided in 4 groups, hospitalized at the University clinics in Skopje, during a 2-year period, were investigated for invasive Candida infections. Blood was examined with conventional methods (automated BacT/Alert system, Gram stain and culture on fungal media). Identification of Candida species was performed with VITEK-2 system. Serum (1,3)-⃞-D-glucan was determined by means of Fungitell assay. Results. Positive blood culture was registered in 23.33%, 43.33%, 23.8% and in 3.33% of samples only in groups I, II, III and IV, respectively. Positive findings with (1,3)-⃞-D-glucan Fungitell assay at the same time with blood culture were detected in 83.33%, 76.67%, 30% and 26.67% in groups I, II, III and IV, respectively. The average concentration of BDG was highest in group I, followed by group II, group IV and group III. Conclusion. Our results suggest that a positive (1,3)-⃞-D-glucan assay could be a superior test in addition to the blood culture for diagnosis of candidemia and highlights the value of this test as a diagnostic adjunct in the serodiagnosis of an invasive candidiasis.
摘要介绍。虽然血培养被认为是诊断侵袭性感染的金标准，但它对念珠菌的诊断仍然不够可靠和快速。血清(1,3)-⃞- d -葡聚糖的测定是一种高度敏感和特异性的侵袭性真菌病检测方法，可能对念珠菌侵袭性感染的高风险患者有益。的目标。本研究的目的是前瞻性评价血清(1.3)-⃞-葡聚糖BDG (Fungitell)检测与血培养对假丝酵母菌侵袭性感染的诊断效果。方法。对2年期间在斯科普里大学诊所住院的120名分为4组的患者的血液和血清进行侵袭性念珠菌感染调查。采用常规方法(自动BacT/Alert系统、革兰氏染色和真菌培养基培养)检测血液。采用VITEK-2系统对念珠菌进行菌种鉴定。血清(1,3)-⃞- d -葡聚糖采用真菌细胞法测定。结果。仅I、II、III、IV组血培养阳性率分别为23.33%、43.33%、23.8%和3.33%。与血培养同时进行(1,3)-⃞- d -葡聚糖真菌试验的阳性检出率分别为83.33%、76.67%、30%和26.67%。BDG平均浓度以ⅰ组最高，其次为ⅱ组、ⅳ组和ⅲ组。结论。我们的研究结果表明，阳性(1,3)-⃞- d -葡聚糖检测可能是除血培养外诊断念珠菌病的一种更好的检测方法，并突出了该检测作为侵袭性念珠菌病血清诊断辅助诊断的价值。
{"title":"Evaluation of Panfungal Marker (1,3)-⃞-D-Glucanin Diagnosis of Invasive Infections with Candida Species","authors":"Gordana Mirchevska, Z. Cekovska, E. Trajkovska-Dokic, M. Petrovska, N. Panovski","doi":"10.1515/mmr-2016-0015","DOIUrl":"https://doi.org/10.1515/mmr-2016-0015","url":null,"abstract":"Abstract Introduction. Although blood culture is considered a gold standard in diagnosis of invasive infections, it is still not reliable and fast enough for diagnosis of candidemia. Determination of serum (1,3)-⃞-D-glucan is a highly sensitive and specific test for invasive mycosis, and could probably be of benefit to patients with high risk for invasive infections with Candida species. Aim. The aim of this study was to prospectively evaluate the diagnostic performance of serum (1.3)-⃞-Dglucan BDG (Fungitell) assay, in comparison with blood culture, for diagnosis of invasive infections with Candida species. Methods. Blood and sera from 120 patients divided in 4 groups, hospitalized at the University clinics in Skopje, during a 2-year period, were investigated for invasive Candida infections. Blood was examined with conventional methods (automated BacT/Alert system, Gram stain and culture on fungal media). Identification of Candida species was performed with VITEK-2 system. Serum (1,3)-⃞-D-glucan was determined by means of Fungitell assay. Results. Positive blood culture was registered in 23.33%, 43.33%, 23.8% and in 3.33% of samples only in groups I, II, III and IV, respectively. Positive findings with (1,3)-⃞-D-glucan Fungitell assay at the same time with blood culture were detected in 83.33%, 76.67%, 30% and 26.67% in groups I, II, III and IV, respectively. The average concentration of BDG was highest in group I, followed by group II, group IV and group III. Conclusion. Our results suggest that a positive (1,3)-⃞-D-glucan assay could be a superior test in addition to the blood culture for diagnosis of candidemia and highlights the value of this test as a diagnostic adjunct in the serodiagnosis of an invasive candidiasis.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"75 - 81"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction. The aim of the study was to analyze effusion, bone edema, joint/articular cartilage, menisci and ligaments in correlation with pain intensity, sport activity and BMI. Methods. In our prospective study, 261 knee MRIs of patients with acute knee trauma were analyzed, who had a negative x-ray of the knee for fracture, and pain lasting for 1 month despite conservative therapy. Results. Gender distribution: 65.1% male and 34.87% female patients. Majority of subjects had body mass index from 18.5-24.9 (41.76%) The presence of an edema in the medial condyle of the femur was detected in 12.64% of patients. The most common lesion was lesion on the cartilage of the medial condyle on the femur (33.72%). We found lesions of the ACL in 40% of the cases. All patients with a combined trauma to the anterior cruciate ligament and the posterior horn of the medial meniscus had also a bone edema type 1 and type 2. Conclusion. Age and body weight do not have an impact on the cause of trauma and the type and grade of the knee lesions. Athletes and not athletes have signifycantly different causes of trauma to the knee. Patients with lesions in the posterior horn of the medial meniscus grade 3 had significantly more bone edemas (p=0.013). Localization of the pain is not linked to the cause of injury, but it depends on the developed lesions on the knee.
{"title":"Influence of Trauma, Sport Activity and Body Mass Index on Knee Lesions Evaluated by Magnetic Resonance","authors":"T. Petrovska, A. Novotni","doi":"10.1515/mmr-2016-0016","DOIUrl":"https://doi.org/10.1515/mmr-2016-0016","url":null,"abstract":"Abstract Introduction. The aim of the study was to analyze effusion, bone edema, joint/articular cartilage, menisci and ligaments in correlation with pain intensity, sport activity and BMI. Methods. In our prospective study, 261 knee MRIs of patients with acute knee trauma were analyzed, who had a negative x-ray of the knee for fracture, and pain lasting for 1 month despite conservative therapy. Results. Gender distribution: 65.1% male and 34.87% female patients. Majority of subjects had body mass index from 18.5-24.9 (41.76%) The presence of an edema in the medial condyle of the femur was detected in 12.64% of patients. The most common lesion was lesion on the cartilage of the medial condyle on the femur (33.72%). We found lesions of the ACL in 40% of the cases. All patients with a combined trauma to the anterior cruciate ligament and the posterior horn of the medial meniscus had also a bone edema type 1 and type 2. Conclusion. Age and body weight do not have an impact on the cause of trauma and the type and grade of the knee lesions. Athletes and not athletes have signifycantly different causes of trauma to the knee. Patients with lesions in the posterior horn of the medial meniscus grade 3 had significantly more bone edemas (p=0.013). Localization of the pain is not linked to the cause of injury, but it depends on the developed lesions on the knee.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"82 - 87"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vanja Dzambazovska-Trajkovska, J. Nojkov, Adrijan Kartalov, B. Kuzmanovska, Tatjana Spiroska, Gjorgji Trajkovski, Nadica Geshkovska-Matevska, A. Dimovski
Abstract The safe and effective analgesia during and after surgery is an important clinical, social and economic problem. The goal of good analgesia is an individual balancing that patient's pain is reduced to a low level, and side effects are minimized. Data from the literature suggest genetic differences between patients in their ability to metabolize a particular drug. The effect of the drug is determined by interreaction of several genetic polymerphisms that affect the pharmacokinetics and pharmacodynamics of the drug, including differences in potency of binding to receptors and activity of drug enzymes and transportters. There is evidence suggesting that mutations of the mu-opioid receptor gene affects interindividual differences in opioid sensitivity. This review of the literature aims to analyze the current knowledge on the impact of genetic polymorphisms of CYP3A4, ABCB1 C3435, ABCB1 2677 and OPRM1 A118G gene on analgesic effect and side effects of opioids in the treatment of postoperative pain.
{"title":"Pharmacogenetics of Opioid Therapy in Treatment of Postoperative Pain: A Review","authors":"Vanja Dzambazovska-Trajkovska, J. Nojkov, Adrijan Kartalov, B. Kuzmanovska, Tatjana Spiroska, Gjorgji Trajkovski, Nadica Geshkovska-Matevska, A. Dimovski","doi":"10.1515/mmr-2016-0012","DOIUrl":"https://doi.org/10.1515/mmr-2016-0012","url":null,"abstract":"Abstract The safe and effective analgesia during and after surgery is an important clinical, social and economic problem. The goal of good analgesia is an individual balancing that patient's pain is reduced to a low level, and side effects are minimized. Data from the literature suggest genetic differences between patients in their ability to metabolize a particular drug. The effect of the drug is determined by interreaction of several genetic polymerphisms that affect the pharmacokinetics and pharmacodynamics of the drug, including differences in potency of binding to receptors and activity of drug enzymes and transportters. There is evidence suggesting that mutations of the mu-opioid receptor gene affects interindividual differences in opioid sensitivity. This review of the literature aims to analyze the current knowledge on the impact of genetic polymorphisms of CYP3A4, ABCB1 C3435, ABCB1 2677 and OPRM1 A118G gene on analgesic effect and side effects of opioids in the treatment of postoperative pain.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"1 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Dabeski, D. Danilovski, V. Antovska, N. Basheska, M. Stojovski, Zora Popovska, Adriana Buklioska, M. Avramovska
Abstract Introduction. Bacterial vaginosis is polymicrobial, primarily anaerobic infection, previously called non-specific vaginitis or vaginitis accompanied by Gardne-rella vaginallis. It is a result of an imbalance between different types of bacteria in the vagina. The aim of the study was to determine the association between bacterial vaginosis and squamous intraepithelial lesions of the uterine cervix. Methods. This cross-sectional study was conducted in a series of 338 sexually active women with cytologicallly diagnosed squamous intraepithelial lesion of the uterine cervix at the University Clinic of Gynecology and Obstetrics in Skopje in the period from October 2014 to October 2015. The age of the patients ranged from 20 to 59 years (35±10.49). All women underwent cervical biopsy with endocervical curettage for histopathological analysis and cervical biopsy for detection and HPV typing. Criteria for diagnosis of bacterial vaginosis was the presence of ≥20% clue cells of ePapanicolaou smear. Results. Bacterial vaginosis was detected in 19.5% (66/338) of the examined women. The most affected was the young population under the age of 30 years. The results showed an association between bacterial vaginosis and squamous intraepithelial lesions of the uterine cervix (p=0.032). There was no association between bacterial vaginosis and the grade of lesion of the uterine cervix (p=0.118), nor with HPV infection (p=0.570). But, however an association was found between HPV infection and squamous intraepithelial lesions of the uterine cervix (p=0.001). Conclusion. The most common risk factor for squamous intraepithelial lesions of the uterine cervix are persistent high-risk HPV infections. Bacterial vaginosis is the most common co-infection.
{"title":"Association Between Bacterial Vaginosis and Squamous Intraepithelial Lesions of the Uterine Cervix","authors":"D. Dabeski, D. Danilovski, V. Antovska, N. Basheska, M. Stojovski, Zora Popovska, Adriana Buklioska, M. Avramovska","doi":"10.1515/mmr-2016-0003","DOIUrl":"https://doi.org/10.1515/mmr-2016-0003","url":null,"abstract":"Abstract Introduction. Bacterial vaginosis is polymicrobial, primarily anaerobic infection, previously called non-specific vaginitis or vaginitis accompanied by Gardne-rella vaginallis. It is a result of an imbalance between different types of bacteria in the vagina. The aim of the study was to determine the association between bacterial vaginosis and squamous intraepithelial lesions of the uterine cervix. Methods. This cross-sectional study was conducted in a series of 338 sexually active women with cytologicallly diagnosed squamous intraepithelial lesion of the uterine cervix at the University Clinic of Gynecology and Obstetrics in Skopje in the period from October 2014 to October 2015. The age of the patients ranged from 20 to 59 years (35±10.49). All women underwent cervical biopsy with endocervical curettage for histopathological analysis and cervical biopsy for detection and HPV typing. Criteria for diagnosis of bacterial vaginosis was the presence of ≥20% clue cells of ePapanicolaou smear. Results. Bacterial vaginosis was detected in 19.5% (66/338) of the examined women. The most affected was the young population under the age of 30 years. The results showed an association between bacterial vaginosis and squamous intraepithelial lesions of the uterine cervix (p=0.032). There was no association between bacterial vaginosis and the grade of lesion of the uterine cervix (p=0.118), nor with HPV infection (p=0.570). But, however an association was found between HPV infection and squamous intraepithelial lesions of the uterine cervix (p=0.001). Conclusion. The most common risk factor for squamous intraepithelial lesions of the uterine cervix are persistent high-risk HPV infections. Bacterial vaginosis is the most common co-infection.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"12 - 18"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Aims. The prenatal prediction of fetal maturity is very important, since neonatal respiratory distress syndrome (RDS) is one of the biggest causes of neonatal mortality. Our aim was to investigate a new non-invasive method for prediction of fetal maturity and to determine in which group according to gestational age of the fetus, the treatment works the best and in which cases it is necessary to be repeated. Methods. We examined 60 patients (30 with impending preterm delivery, divided in 3 groups: 28-30, 30-32, and 32-34 gestational weeks and 30 controls), at the University Clinic for Gynecology and Obstetrics, Medical Faculty, University “Ss. Cyril and Methodius”, Skopje, R. Macedonia. Fetal maturity was examined using ultrasound histogram from fetal lungs and liver, correlated with gestational age and postpartum RDS. Where possible, we performed amniocentesis for lamellar body count (LBC) to correlate our results with the current invasive method for prediction of fetal maturity. Results. Pre-therapy investigation showed a strong fetal immaturity in 28-32 weeks of gestation and less evident fetal immaturity in 32-34 weeks of gestation. Seventy-two hours post-treatment, fetal maturation was low in the first group, higher in the second and the highest in the third group. Amniocentesis for LBC showed correlation with the ultrasound results. Postpartum results were correlated with pre-delivery ultrasound and showed significance of p <0.05. Conclusion. The results obtained in our study were with high significance, and they were in correlation with other similar studies. However, more extensive investigations should be made to replace the current invasive technique.
{"title":"Non-invasive Prenatal Determination of Fetal Maturity","authors":"E. Dzikova, G. Dimitrov, O. Stojceva-Taneva","doi":"10.1515/mmr-2016-0029","DOIUrl":"https://doi.org/10.1515/mmr-2016-0029","url":null,"abstract":"Abstract Aims. The prenatal prediction of fetal maturity is very important, since neonatal respiratory distress syndrome (RDS) is one of the biggest causes of neonatal mortality. Our aim was to investigate a new non-invasive method for prediction of fetal maturity and to determine in which group according to gestational age of the fetus, the treatment works the best and in which cases it is necessary to be repeated. Methods. We examined 60 patients (30 with impending preterm delivery, divided in 3 groups: 28-30, 30-32, and 32-34 gestational weeks and 30 controls), at the University Clinic for Gynecology and Obstetrics, Medical Faculty, University “Ss. Cyril and Methodius”, Skopje, R. Macedonia. Fetal maturity was examined using ultrasound histogram from fetal lungs and liver, correlated with gestational age and postpartum RDS. Where possible, we performed amniocentesis for lamellar body count (LBC) to correlate our results with the current invasive method for prediction of fetal maturity. Results. Pre-therapy investigation showed a strong fetal immaturity in 28-32 weeks of gestation and less evident fetal immaturity in 32-34 weeks of gestation. Seventy-two hours post-treatment, fetal maturation was low in the first group, higher in the second and the highest in the third group. Amniocentesis for LBC showed correlation with the ultrasound results. Postpartum results were correlated with pre-delivery ultrasound and showed significance of p <0.05. Conclusion. The results obtained in our study were with high significance, and they were in correlation with other similar studies. However, more extensive investigations should be made to replace the current invasive technique.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"153 - 157"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction. The standardized echography is a non-invasive, simple, efficient and painless diagnostic method, which allows visualization and evaluation of posterior eye segment through non-transparent media, such as blurring lens or cataract. The aim of the study was to emphasize the role and importance of standardized echography in preoperative preparation of patients and evaluation of posterior eye segment in patients with senile cataracts. Methods. During a 6 month-period, from 05.05.2015 to 11.05.2015, a total of 718 ultrasound examinations were made in patients with previously diagnosed senile cataracts at the University Clinic for Eye Diseases in Skopje, in the Echography cabinet. Examinations were made by using the apparatus Sonomed E-Z Scan-AB 5500+. Results. Out of the total number of 718 patients with senile cataracts examined by echography-in 295 (24.30%) opacities in the vitreous body were diagnosed, in 128 (18.08%)-posterior vitreous detachment, in 8 (1.11%) synchysis scintillans, in 5 (0.70%) hemophthalmus and in 3(0.42%) detachment of the retina. A total of 302 (42.06%) patients were with normal echographic findings. Conclusion. The results obtained indicate the necessity of preoperatively echographic examination in patients with senile mature and hypermature cataracts.
{"title":"The Role of Standardized Echography in Preoperative Preparations of Patients with Senile Cataract","authors":"Gordana Ivanova, Emilija Gjosevska Dastevska","doi":"10.1515/MMR-2016-0002","DOIUrl":"https://doi.org/10.1515/MMR-2016-0002","url":null,"abstract":"Abstract Introduction. The standardized echography is a non-invasive, simple, efficient and painless diagnostic method, which allows visualization and evaluation of posterior eye segment through non-transparent media, such as blurring lens or cataract. The aim of the study was to emphasize the role and importance of standardized echography in preoperative preparation of patients and evaluation of posterior eye segment in patients with senile cataracts. Methods. During a 6 month-period, from 05.05.2015 to 11.05.2015, a total of 718 ultrasound examinations were made in patients with previously diagnosed senile cataracts at the University Clinic for Eye Diseases in Skopje, in the Echography cabinet. Examinations were made by using the apparatus Sonomed E-Z Scan-AB 5500+. Results. Out of the total number of 718 patients with senile cataracts examined by echography-in 295 (24.30%) opacities in the vitreous body were diagnosed, in 128 (18.08%)-posterior vitreous detachment, in 8 (1.11%) synchysis scintillans, in 5 (0.70%) hemophthalmus and in 3(0.42%) detachment of the retina. A total of 302 (42.06%) patients were with normal echographic findings. Conclusion. The results obtained indicate the necessity of preoperatively echographic examination in patients with senile mature and hypermature cataracts.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"11 - 8"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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