Abstract Introduction. Leiomyomas are infrequently localized on the ileum. They are diagnosed accidentally or due to complications from their existence. Case report. We present a case of a 65-year-old patient, with CT angiogram performed due to a pain, swelling and coldness in the lower extremities, which pointed to a well-vascularized tumorous formation on the small intestines. Anamnestic and laboratory findings were negative for the existence of carcinoid. Exploratory laparotomy with partial resection of the ileum was performed, using “no touch” technique and a termino-terminal anastomosis was done. Results. The operative and postoperative period were uneventful. The histopathological finding confirmed leiomyoma of the small bowel. Conclusions. Leiomyomas of the small intestines are rare and their clinical presentation is atypical. The surgical therapy is primary and often indicated to accidentally discovered lesions. Definitive diagnosis is confirmed with histopathological analysis from which the further therapy depends.
{"title":"Leiomyoma of the Ileum: A Case Report and Literature Review","authors":"Ivana Roso, Igor Fildiski, M. Panovski","doi":"10.1515/mmr-2016-0009","DOIUrl":"https://doi.org/10.1515/mmr-2016-0009","url":null,"abstract":"Abstract Introduction. Leiomyomas are infrequently localized on the ileum. They are diagnosed accidentally or due to complications from their existence. Case report. We present a case of a 65-year-old patient, with CT angiogram performed due to a pain, swelling and coldness in the lower extremities, which pointed to a well-vascularized tumorous formation on the small intestines. Anamnestic and laboratory findings were negative for the existence of carcinoid. Exploratory laparotomy with partial resection of the ileum was performed, using “no touch” technique and a termino-terminal anastomosis was done. Results. The operative and postoperative period were uneventful. The histopathological finding confirmed leiomyoma of the small bowel. Conclusions. Leiomyomas of the small intestines are rare and their clinical presentation is atypical. The surgical therapy is primary and often indicated to accidentally discovered lesions. Definitive diagnosis is confirmed with histopathological analysis from which the further therapy depends.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"43 - 46"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036103","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}
V. Koevska, S. Perchinkova-Mishevska, E. Nikolik-Dimitrova, B. Mitrevska
Abstract Introduction. Osteoporosis causes chronic back pain leading to restriction of functional capacity and quality of life. The aim of this study was to examine the influence of physical therapy modalities on pain in patients with osteoporosis. Methods. This is a prospective study of patients with osteoporosis, randomly chosen and followed for three months in the Institute of Physical Medicine and Rehabilitation (IPMR). Physical therapy consisted of physical modalities and therapeutic exercises. Physical therapy modalities included interferential currents and pulsed low-frequency electromagnetic field conducted each day with weekend breaks, 21 in total. Patients had therapeutic exercises 3 times a week during the entire follow-up period. Patients were assigned into two groups. The first group consisted of nine patients who underwent physical procedures and the second group consisted of nine patients who did not receive physical therapy modalities. Two check-ups were made on day 21 and at the end of the third month. Assessment of pain intensity was made by the use of a numeric pain rating scale. Results. No significant difference between the groups was observed regarding mean age of patients (p<0.21). The first check-up showed a significantly higher pain score in the second group of patients (p=0.0003). There was no significant difference in pain intensity between both groups of patients in the three-month period of investigation (p<0.63). Conclusion. Physical therapy modalities influence on pain in patients with osteoporosis. Our investigation included a small number of patients and hence further studies are necessary.
{"title":"Influence of Physical Therapy Modalities on Pain in Osteoporosis Patients: initial results of the treatment with physical therapy","authors":"V. Koevska, S. Perchinkova-Mishevska, E. Nikolik-Dimitrova, B. Mitrevska","doi":"10.1515/mmr-2016-0004","DOIUrl":"https://doi.org/10.1515/mmr-2016-0004","url":null,"abstract":"Abstract Introduction. Osteoporosis causes chronic back pain leading to restriction of functional capacity and quality of life. The aim of this study was to examine the influence of physical therapy modalities on pain in patients with osteoporosis. Methods. This is a prospective study of patients with osteoporosis, randomly chosen and followed for three months in the Institute of Physical Medicine and Rehabilitation (IPMR). Physical therapy consisted of physical modalities and therapeutic exercises. Physical therapy modalities included interferential currents and pulsed low-frequency electromagnetic field conducted each day with weekend breaks, 21 in total. Patients had therapeutic exercises 3 times a week during the entire follow-up period. Patients were assigned into two groups. The first group consisted of nine patients who underwent physical procedures and the second group consisted of nine patients who did not receive physical therapy modalities. Two check-ups were made on day 21 and at the end of the third month. Assessment of pain intensity was made by the use of a numeric pain rating scale. Results. No significant difference between the groups was observed regarding mean age of patients (p<0.21). The first check-up showed a significantly higher pain score in the second group of patients (p=0.0003). There was no significant difference in pain intensity between both groups of patients in the three-month period of investigation (p<0.63). Conclusion. Physical therapy modalities influence on pain in patients with osteoporosis. Our investigation included a small number of patients and hence further studies are necessary.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"19 - 23"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036555","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 Cardiovascular disease is responsible for over 75% of deaths in diabetic patients, the majority caused by coronary artery disease (CAD) and heart failure. Cardiovascular morbidity and mortality in diabetic patients might be independently associated with other pathophysiologic mechanisms than coronary artery disease, epicardial and microvascular disease. There is an increasing notion that diabetic patients suffer from an additional cardiac condition named “diabetic cardiomyopathy”. There are several clinical, experimental, pathological and epidemiological researches that support the existence of a specific “diabetic cardiomyopathy”. This is assumed to be influenced by complex interaction of several metabolic changes that leads to both functional and structural alterations of the diabetic myocardium. In this review epidemiological aspects and clinical implications of this condition are presented.
{"title":"Diabetic Cardiomyopathy: Intersection of Macrovascular and Microvascular Disease, or Much More?","authors":"I. Mitevska, M. Bosevski","doi":"10.1515/mmr-2016-0021","DOIUrl":"https://doi.org/10.1515/mmr-2016-0021","url":null,"abstract":"Abstract Cardiovascular disease is responsible for over 75% of deaths in diabetic patients, the majority caused by coronary artery disease (CAD) and heart failure. Cardiovascular morbidity and mortality in diabetic patients might be independently associated with other pathophysiologic mechanisms than coronary artery disease, epicardial and microvascular disease. There is an increasing notion that diabetic patients suffer from an additional cardiac condition named “diabetic cardiomyopathy”. There are several clinical, experimental, pathological and epidemiological researches that support the existence of a specific “diabetic cardiomyopathy”. This is assumed to be influenced by complex interaction of several metabolic changes that leads to both functional and structural alterations of the diabetic myocardium. In this review epidemiological aspects and clinical implications of this condition are presented.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"51 1","pages":"111 - 117"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036989","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. Left ventricular dysfunction is very frequent in asymptomatic diabetic population. Tissue Doppler Imaging (TDI) is a new echocardiographic technique, able to record early changes of left ventricular dysfunction and to identify asymptomatic diabetic patients at high risk of developing heart failure. Aim. To assess the role of TDI in early detection of diastolic dysfunction in asymptomatic diabetic patients. Methods. Cross-sectional study that involved a total number of 48 subjects. The target group consisted of 25 asymptomatic diabetic patients and control group was composed of 23 subjects without diabetes. All subjects underwent echocardiography (conventional 2D and Pulsed-Wave Doppler and contemporary-TDI) to analyze left ventricular function. We compared the results from both echo-techniques and analyzed the relation of echo-cardiographic parameters with risk factors. Results. We found statistically significant difference between TDI and PW Doppler (E/E'vs E/A) in target (Z=−3.17, p<0.001) and control group (Z=−2.4, p<0.003). There was no significant difference in E/A between the groups (Z=0.0, p<1.0). TDI identified significantly lower E' (Z= 2.03, p<0.04) and higher E/E' (Z= −2.12, p<0.03) in target vs control group. LVDD strongly correlated with duration of DM (p<0.00001), age (p<0.00001), female gender (p<0.0001) and obesity indices (BMI, BSA) (p<0.00001, p<0.00001) in both groups. Conclusion. TDI unmasks the presence of subclinical LV dysfunction in asymptomatic diabetic patients and has a valuable prognostic importance.
{"title":"Subclinical Diastolic Dysfunction in Diabetic Population","authors":"S. Mitrovska","doi":"10.1515/mmr-2016-0026","DOIUrl":"https://doi.org/10.1515/mmr-2016-0026","url":null,"abstract":"Abstract Introduction. Left ventricular dysfunction is very frequent in asymptomatic diabetic population. Tissue Doppler Imaging (TDI) is a new echocardiographic technique, able to record early changes of left ventricular dysfunction and to identify asymptomatic diabetic patients at high risk of developing heart failure. Aim. To assess the role of TDI in early detection of diastolic dysfunction in asymptomatic diabetic patients. Methods. Cross-sectional study that involved a total number of 48 subjects. The target group consisted of 25 asymptomatic diabetic patients and control group was composed of 23 subjects without diabetes. All subjects underwent echocardiography (conventional 2D and Pulsed-Wave Doppler and contemporary-TDI) to analyze left ventricular function. We compared the results from both echo-techniques and analyzed the relation of echo-cardiographic parameters with risk factors. Results. We found statistically significant difference between TDI and PW Doppler (E/E'vs E/A) in target (Z=−3.17, p<0.001) and control group (Z=−2.4, p<0.003). There was no significant difference in E/A between the groups (Z=0.0, p<1.0). TDI identified significantly lower E' (Z= 2.03, p<0.04) and higher E/E' (Z= −2.12, p<0.03) in target vs control group. LVDD strongly correlated with duration of DM (p<0.00001), age (p<0.00001), female gender (p<0.0001) and obesity indices (BMI, BSA) (p<0.00001, p<0.00001) in both groups. Conclusion. TDI unmasks the presence of subclinical LV dysfunction in asymptomatic diabetic patients and has a valuable prognostic importance.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"140 - 144"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/mmr-2016-0026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67037014","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. Many situations in pregnancy create a thrombophilia, which is believed to have a protective function, which is the result of the hormone influence, primarily by gestagenic hormones. This is a physiological condition and it helps in successful implantation of the embryo and prevention of bleeding. The presence of additional, hereditary or acquired cause of thrombophilia disrupts the natural balance and creates conditions for venous thromboembolism and consequences for pregnancy, such as miscarriage, intrauterine fetal death, delayed intrauterine growth, eclampsia and abruption of the placenta. Methods. The study was designed as a retrospective epidemiological cross-sectional study and was conducted at the Institute of Transfusion Medicine in Skopje in the period from June to October 2016. The study included patients with current pathological pregnancies. The following laboratory analyses were conducted in all patients: hemostasis, D-dimer, antithrombin III, protein C, protein S, antiphospholipid antibodies, lupus anticoagulant, MTHFR, factor V Leiden and prothrombin mutation. Results. The study included 41 patients, of whom 3 were excluded due to an insufficient medical history, 3 who were receiving corticosteroid therapy, 2 due to incomplete laboratory analyses and one patient with proven systemic lupus. Data analysis showed that family history of thrombophilia was present in 25%. The most common MTHFR mutation was recorded in 26 (82%) patients, followed by the factor V mutation present in 18 (55%) of the examined patients. AT III deficiency was detected in only one patient (2%). In 12 patients (35%) a disturbed ratio of DD vs. markedly shortened APTT or inappropriately low levels of DD was registered, which is an indirect indicatorof hypofibrinolysis. Conclusion. Pathologic pregnancy is a condition that is often associated with thrombophilia. Advanced age of a patient, family and personal history of thrombotic conditions indicate a high risk of complications in pregnancy. Due to the current increased frequency of high risk pregnancies associated with circulation problems with the placenta, there is a need for more frequent hemostatic examinations in pregnancy.
{"title":"Thrombophilia in Pathological Pregnancies","authors":"J. Angelovski","doi":"10.1515/mmr-2016-0024","DOIUrl":"https://doi.org/10.1515/mmr-2016-0024","url":null,"abstract":"Abstract Introduction. Many situations in pregnancy create a thrombophilia, which is believed to have a protective function, which is the result of the hormone influence, primarily by gestagenic hormones. This is a physiological condition and it helps in successful implantation of the embryo and prevention of bleeding. The presence of additional, hereditary or acquired cause of thrombophilia disrupts the natural balance and creates conditions for venous thromboembolism and consequences for pregnancy, such as miscarriage, intrauterine fetal death, delayed intrauterine growth, eclampsia and abruption of the placenta. Methods. The study was designed as a retrospective epidemiological cross-sectional study and was conducted at the Institute of Transfusion Medicine in Skopje in the period from June to October 2016. The study included patients with current pathological pregnancies. The following laboratory analyses were conducted in all patients: hemostasis, D-dimer, antithrombin III, protein C, protein S, antiphospholipid antibodies, lupus anticoagulant, MTHFR, factor V Leiden and prothrombin mutation. Results. The study included 41 patients, of whom 3 were excluded due to an insufficient medical history, 3 who were receiving corticosteroid therapy, 2 due to incomplete laboratory analyses and one patient with proven systemic lupus. Data analysis showed that family history of thrombophilia was present in 25%. The most common MTHFR mutation was recorded in 26 (82%) patients, followed by the factor V mutation present in 18 (55%) of the examined patients. AT III deficiency was detected in only one patient (2%). In 12 patients (35%) a disturbed ratio of DD vs. markedly shortened APTT or inappropriately low levels of DD was registered, which is an indirect indicatorof hypofibrinolysis. Conclusion. Pathologic pregnancy is a condition that is often associated with thrombophilia. Advanced age of a patient, family and personal history of thrombotic conditions indicate a high risk of complications in pregnancy. Due to the current increased frequency of high risk pregnancies associated with circulation problems with the placenta, there is a need for more frequent hemostatic examinations in pregnancy.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"27 1","pages":"129 - 132"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67037005","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}
V. Mirčevska, S. Petrovska, O. Zafirovski, Maja Jovikj
Abstract Introduction. The term biomarkers or biological markers generally refers to proteins measured in the circulation (blood), whose concentration indicates some normal or pathological state or condition. The biomarker is objectively measured and evaluated as an indicator of normal biological processes or pharmacological responses to therapeutic interventions. One of these biological markers is C-reactive protein (CRP). Aim. To evaluate the efficiency of using adequate and appropriate biomarkers for diagnosis, treatment and monitoring of pneumonia in children. Methods. This study included 30 patients with diagnosed pneumonia, who were admitted at our Institute. Blood samples were taken prior to initiation of treatment in patients with pneumonia and 7 and 14 days after the treatment. The control group included physically active and healthy individuals without family history of disease, aged from 1 to 14 years. All the results of the biochemical analyses were within the reference values, and none of the control individuals received therapy. In our country, for serum C-reactive protein, as well as for other parameters that determine the diagnosis of the patient, we use a common method for determining normal values, by choosing a huge representative sample from the screening population, consisting of healthy individuals without any disease, especially with no sign of this disease (the children who should be checked up). Further, normal values obtained in this way are taken as reference values. Results. The average serum CRP protein levels prior to antibiotic therapy were the following: (1-2) x̄±sd =34.94±20.44 mg/L, (3-6) x̄±sd=68.20±10.87 mg/L, (7-11) x̄±sd=65.59±12.01 mg/L, whereas in patients with pneumonia after 7-day antibiotic treatment the values were the following: x̄±sd=24.64 ± 11.57 mg/L/x̄±sd =40.10±6.83 mg/L/x̄±sd=32.09±6.68 mg/L (P<0.05), and after 14-day-therapy x̄±sd=6.80±1.14 mg/L/x̄± sd=7.20±0.82 mg/L/x̄±sd=8.10±0.89 mg/L (P<0.05). Also, CRP in serum correlated with the severity of the clinical condition (P<0.05). Discussion and conclusion. This study is useful for showing the importance of C-reactive protein in serum for early diagnosis and follow-up of the pneumonia. CRP is very important as a biomarker, both from clinical and scientific aspect. It can be used for early rapid diagnosis, monitoring of pneumonia and can successfully be used in a large number of diagnosis. It opens new opportunities for further research in this field.
{"title":"C-Reactive Protein –Biological Marker of Inflammation in Patients with Pneumonia","authors":"V. Mirčevska, S. Petrovska, O. Zafirovski, Maja Jovikj","doi":"10.1515/mmr-2016-0005","DOIUrl":"https://doi.org/10.1515/mmr-2016-0005","url":null,"abstract":"Abstract Introduction. The term biomarkers or biological markers generally refers to proteins measured in the circulation (blood), whose concentration indicates some normal or pathological state or condition. The biomarker is objectively measured and evaluated as an indicator of normal biological processes or pharmacological responses to therapeutic interventions. One of these biological markers is C-reactive protein (CRP). Aim. To evaluate the efficiency of using adequate and appropriate biomarkers for diagnosis, treatment and monitoring of pneumonia in children. Methods. This study included 30 patients with diagnosed pneumonia, who were admitted at our Institute. Blood samples were taken prior to initiation of treatment in patients with pneumonia and 7 and 14 days after the treatment. The control group included physically active and healthy individuals without family history of disease, aged from 1 to 14 years. All the results of the biochemical analyses were within the reference values, and none of the control individuals received therapy. In our country, for serum C-reactive protein, as well as for other parameters that determine the diagnosis of the patient, we use a common method for determining normal values, by choosing a huge representative sample from the screening population, consisting of healthy individuals without any disease, especially with no sign of this disease (the children who should be checked up). Further, normal values obtained in this way are taken as reference values. Results. The average serum CRP protein levels prior to antibiotic therapy were the following: (1-2) x̄±sd =34.94±20.44 mg/L, (3-6) x̄±sd=68.20±10.87 mg/L, (7-11) x̄±sd=65.59±12.01 mg/L, whereas in patients with pneumonia after 7-day antibiotic treatment the values were the following: x̄±sd=24.64 ± 11.57 mg/L/x̄±sd =40.10±6.83 mg/L/x̄±sd=32.09±6.68 mg/L (P<0.05), and after 14-day-therapy x̄±sd=6.80±1.14 mg/L/x̄± sd=7.20±0.82 mg/L/x̄±sd=8.10±0.89 mg/L (P<0.05). Also, CRP in serum correlated with the severity of the clinical condition (P<0.05). Discussion and conclusion. This study is useful for showing the importance of C-reactive protein in serum for early diagnosis and follow-up of the pneumonia. CRP is very important as a biomarker, both from clinical and scientific aspect. It can be used for early rapid diagnosis, monitoring of pneumonia and can successfully be used in a large number of diagnosis. It opens new opportunities for further research in this field.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"24 - 29"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036560","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 paper presents the specifics of a laser-assisted labial frenectomy in a pediatric patient, with emphasis on the surgical technique, the laser parameters, patient’s compliance and postoperative outcome. A 9-year-old girl was referred to the University Department of Oral Surgery for labial frenectomy for orthodontic reasons. The clinical examination and evaluation revealed the presence of an aberrant labial frenum (class IV according to Placeket et al.) and a 3 mm wide medial diastema. A penetrating frenum caused a significant problem in the closure of the diastema during the orthodontic treatment, and a frenectomy was indicated. A conventional frenectomy is carried out with a scalpel excision followed by placement of few stitches. Some degree of post-operative discomfort as well as the need for a return visit to remove the stitches can be anticipated. The patient was in good general health but anxious about the surgical intervenetion, and hence Er. YAG laser frenectomy was suggested. The surgery was performed with Er.YAG laser (Fotona Fidelis III) and a non-contact hand piece, working with long pulse mode (LP), energy (E) of 120 mJ, frequency of 15 Hz and power of 1.80 W. The surgery was fast and easy to perform. The cooperation with the patient during treatment was excellent. The bleeding was scarce and the visibility was not compromised. Sutures were not necessary. The postoperative period was uneventful, pain-free, without swelling or signs of infection. No painkillers or antibiotics were used. A fibrin coating was visible the following day. The wound healing process was completed three weeks after surgery, with minimal scar. This laser is suitable to be used in soft-tissue proceduresin pediatric patients.
{"title":"Laser Labial Frenectomy in Pediatric Patients","authors":"M. Kacarska, Maja Gjorovska, B. Džipunova","doi":"10.1515/mmr-2016-0023","DOIUrl":"https://doi.org/10.1515/mmr-2016-0023","url":null,"abstract":"Abstract The paper presents the specifics of a laser-assisted labial frenectomy in a pediatric patient, with emphasis on the surgical technique, the laser parameters, patient’s compliance and postoperative outcome. A 9-year-old girl was referred to the University Department of Oral Surgery for labial frenectomy for orthodontic reasons. The clinical examination and evaluation revealed the presence of an aberrant labial frenum (class IV according to Placeket et al.) and a 3 mm wide medial diastema. A penetrating frenum caused a significant problem in the closure of the diastema during the orthodontic treatment, and a frenectomy was indicated. A conventional frenectomy is carried out with a scalpel excision followed by placement of few stitches. Some degree of post-operative discomfort as well as the need for a return visit to remove the stitches can be anticipated. The patient was in good general health but anxious about the surgical intervenetion, and hence Er. YAG laser frenectomy was suggested. The surgery was performed with Er.YAG laser (Fotona Fidelis III) and a non-contact hand piece, working with long pulse mode (LP), energy (E) of 120 mJ, frequency of 15 Hz and power of 1.80 W. The surgery was fast and easy to perform. The cooperation with the patient during treatment was excellent. The bleeding was scarce and the visibility was not compromised. Sutures were not necessary. The postoperative period was uneventful, pain-free, without swelling or signs of infection. No painkillers or antibiotics were used. A fibrin coating was visible the following day. The wound healing process was completed three weeks after surgery, with minimal scar. This laser is suitable to be used in soft-tissue proceduresin pediatric patients.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"125 - 128"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67037001","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}
S. Petrovski, E. Arabadzhieva, S. Bonev, D. Bulanov, V. Popov, V. Dimitrova
Abstract Introduction. Colorectal liver metastases have a poor prognosis and only 2% have an average 5-year survival if left untreated. In recent decades there has been a development in the diagnosis, treatment and palliative treatment of patients with colorectal liver metastases, and despite radical resection the average five-year survival is between 25% and 44%. Aim. To explore the experience of the Clinic in the treatment of colorectal liver metastases, comparing it with data from the literature and based on the comparison to determine the prognostic factors that affect survival after radical surgical treatment of patients. Methods. A retrospective study was conducted at the Clinic of General and Hepato-pancreatic Surgery at the University Hospital “Aleksandrovska”-Sofia. The study comprised the period between 01.01.2006 to 31.12.2015. It included a total of 239 cases, of whom: 179 patients underwent radical interventions, 5 palliative and 55 patients underwent explorative interventions due to liver metastases. Clinical and pathological materials were analyzed using SPSS-19 to determine the prognostic significance of a number of factors in relation to the survival: gender, age, type and localization of metastases, postoperative stage of the primary tumor, type and volume of liver resection, extrahepatic metastases, preoperative values of CEA, postoperative values (AST, ALT). Results. Factors that correlated with lower survival type: metastases (synchronous or metachronus), localization of metastases (uni-or bilobar), presence of the regional lymph node metastases and metastases to other distant organs and the impossibility of radical resection of liver were statistically significant with multivariant analysis. Elevated preoperative value of CEA, the value of hemoglobin and stage IV disease also affected the survival of patients. Conclusion. In patients with colorectal liver metastases only resection has potentially curative character. The surgical strategy for resection in context of increasing the percentage of patients with resectable potential is the only possible factor for long-term survival.
{"title":"Prognostic Factors Affecting Survival of Patients after Liver Resection Due to Colorectal Liver Metastases","authors":"S. Petrovski, E. Arabadzhieva, S. Bonev, D. Bulanov, V. Popov, V. Dimitrova","doi":"10.1515/mmr-2016-0025","DOIUrl":"https://doi.org/10.1515/mmr-2016-0025","url":null,"abstract":"Abstract Introduction. Colorectal liver metastases have a poor prognosis and only 2% have an average 5-year survival if left untreated. In recent decades there has been a development in the diagnosis, treatment and palliative treatment of patients with colorectal liver metastases, and despite radical resection the average five-year survival is between 25% and 44%. Aim. To explore the experience of the Clinic in the treatment of colorectal liver metastases, comparing it with data from the literature and based on the comparison to determine the prognostic factors that affect survival after radical surgical treatment of patients. Methods. A retrospective study was conducted at the Clinic of General and Hepato-pancreatic Surgery at the University Hospital “Aleksandrovska”-Sofia. The study comprised the period between 01.01.2006 to 31.12.2015. It included a total of 239 cases, of whom: 179 patients underwent radical interventions, 5 palliative and 55 patients underwent explorative interventions due to liver metastases. Clinical and pathological materials were analyzed using SPSS-19 to determine the prognostic significance of a number of factors in relation to the survival: gender, age, type and localization of metastases, postoperative stage of the primary tumor, type and volume of liver resection, extrahepatic metastases, preoperative values of CEA, postoperative values (AST, ALT). Results. Factors that correlated with lower survival type: metastases (synchronous or metachronus), localization of metastases (uni-or bilobar), presence of the regional lymph node metastases and metastases to other distant organs and the impossibility of radical resection of liver were statistically significant with multivariant analysis. Elevated preoperative value of CEA, the value of hemoglobin and stage IV disease also affected the survival of patients. Conclusion. In patients with colorectal liver metastases only resection has potentially curative character. The surgical strategy for resection in context of increasing the percentage of patients with resectable potential is the only possible factor for long-term survival.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"70 1","pages":"133 - 139"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67037010","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}
G. Spasovski, P. Cochat, Frans Hj Claas, U. Heemann, J. Pascual, Chris Dudley, P. Harden, M. Hourmant, U. Maggiore, M. Salvadori, J. Squifflet, J. Steiger, Armando Torres, O. Viklicky, M. Zeier, R. Vanholder, W. van Biesen, E. Nagler, D. Abramowicz
Abstract The Clinical Practice Guideline on evaluation of the kidney donor and transplant recipient was developed following a rigorous methodological approach aiming to provide information and aid decision-making to the transplant professionals. Thus, this document should help caregivers to improve the quality of care they deliver to patients with no intention it is defined as a standard of care. In this short version of the guidelines we present 112 statements about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. The extended version of the guidelines with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our_journals/ndt/era_edta.html.
{"title":"European Renal Best Practice Guideline on Kidney Donor and Recipient Evaluation and Perioperative Care","authors":"G. Spasovski, P. Cochat, Frans Hj Claas, U. Heemann, J. Pascual, Chris Dudley, P. Harden, M. Hourmant, U. Maggiore, M. Salvadori, J. Squifflet, J. Steiger, Armando Torres, O. Viklicky, M. Zeier, R. Vanholder, W. van Biesen, E. Nagler, D. Abramowicz","doi":"10.2478/mmr-2014-0001","DOIUrl":"https://doi.org/10.2478/mmr-2014-0001","url":null,"abstract":"Abstract The Clinical Practice Guideline on evaluation of the kidney donor and transplant recipient was developed following a rigorous methodological approach aiming to provide information and aid decision-making to the transplant professionals. Thus, this document should help caregivers to improve the quality of care they deliver to patients with no intention it is defined as a standard of care. In this short version of the guidelines we present 112 statements about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. The extended version of the guidelines with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our_journals/ndt/era_edta.html.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"25 1","pages":"1 - 7"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/mmr-2014-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233881","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 Cardiovascular disease affects most men and women as they move through their last several decades of life. Vessels become stiffer, smooth muscle cells migrate, vasomotor functions decline, and the biology of their circulatory system is transformed. Changes in cardiovascular physiology with normal aging and prevalent comorbidities result in differences in the effects of common cardiac problems as well as in the response to their treatment. Patient-centered goals of care such as maintenance of independence and reduction of symptoms may be preferred over increased longevity. New less-invasive treatments are likely to improve outcomes in elderly patients who previously have been considered at prohibitive risk for traditional procedures.
{"title":"Geriatric Cardiology-Therapeutic Strategies","authors":"B. Taneva","doi":"10.1515/mmr-2015-0011","DOIUrl":"https://doi.org/10.1515/mmr-2015-0011","url":null,"abstract":"Abstract Cardiovascular disease affects most men and women as they move through their last several decades of life. Vessels become stiffer, smooth muscle cells migrate, vasomotor functions decline, and the biology of their circulatory system is transformed. Changes in cardiovascular physiology with normal aging and prevalent comorbidities result in differences in the effects of common cardiac problems as well as in the response to their treatment. Patient-centered goals of care such as maintenance of independence and reduction of symptoms may be preferred over increased longevity. New less-invasive treatments are likely to improve outcomes in elderly patients who previously have been considered at prohibitive risk for traditional procedures.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"51 - 54"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036460","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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