Abstract Introduction. The main attribute of asthma is inflammation, which leads to airway remodeling, bronchial hyperreactivity and reversible or partly reversible airway obstruction. According to GINA, asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils (Eo), and T lymphocytes. Many cells and mediators take part in creating the asthmatic inflammatory reaction, but eosinophils play a central role. The aim of this study was to show the values of biological inflammatory markers (IL-5 and Eo). Methods. Patients with severe asthma, 22 (73.33%) female and 8 (26.66%) male, aged 18-65 years were included in the study. The mean age was 35.30 ±9.65 years. Patients were treated with spray Beclomethasone dipropionate of 250 μg at doses from 1000 to 2000 μg/per day. Results. This study included 30 patients of the University Clinic of Pulmology and Allergology, Skopje, with confirmed bronchial asthma, treated with ICS. In all of the patients we monitored Eo count, ECP and IL-5 in peripheral blood at the beginning of the study, after 2 and 6 months treatment. During treatment with ICS we registered changes in all of the tested parameters. Conclusion. ICS objectively suppress the inflammatory reaction in asthma and the biological markers (IL-5, Eo and ECP), which we have monitored, can measure the accomplished effect. They could be used in everyday practice, not only as diagnostic parameters but also as valid therapeutic guides in treatment of asthma.
{"title":"Total Eosinophils, Ecp And IL-5 In Peripheral Blood During Treatment with Inhaled Corticosteroids in Patients with Asthma","authors":"Deska Dimitrievska, M. Zdraveska, Dejan Todevski","doi":"10.1515/mmr-2015-0012","DOIUrl":"https://doi.org/10.1515/mmr-2015-0012","url":null,"abstract":"Abstract Introduction. The main attribute of asthma is inflammation, which leads to airway remodeling, bronchial hyperreactivity and reversible or partly reversible airway obstruction. According to GINA, asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils (Eo), and T lymphocytes. Many cells and mediators take part in creating the asthmatic inflammatory reaction, but eosinophils play a central role. The aim of this study was to show the values of biological inflammatory markers (IL-5 and Eo). Methods. Patients with severe asthma, 22 (73.33%) female and 8 (26.66%) male, aged 18-65 years were included in the study. The mean age was 35.30 ±9.65 years. Patients were treated with spray Beclomethasone dipropionate of 250 μg at doses from 1000 to 2000 μg/per day. Results. This study included 30 patients of the University Clinic of Pulmology and Allergology, Skopje, with confirmed bronchial asthma, treated with ICS. In all of the patients we monitored Eo count, ECP and IL-5 in peripheral blood at the beginning of the study, after 2 and 6 months treatment. During treatment with ICS we registered changes in all of the tested parameters. Conclusion. ICS objectively suppress the inflammatory reaction in asthma and the biological markers (IL-5, Eo and ECP), which we have monitored, can measure the accomplished effect. They could be used in everyday practice, not only as diagnostic parameters but also as valid therapeutic guides in treatment of asthma.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"55 - 58"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036465","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 Anomalies of the venous system may impose serious limitations to the treatment of arrhythmias by means of ablation therapy. We describe a patient who had WPW syndrome with frequent supraventricular tachycardias in whom an ablation was performed. The patient was found to have a persistent left superior vena cava and a left-sided manifest accessory pathway. Persistent left superior vena cava is the most common congenital thoracic venous anomaly with a prevalence of 0.3-0.5% in the general population and is found more frequently in patients with accessory pathways than in patients with AV nodal reentrant tachycardia. Mapping and ablation of an accessory pathway follows the same general electrophysiology principles applicable to patients without anomalous venous return.
{"title":"Ablation of a Left-Sided WPW in a Patient with Persistent Left Superior Vena Cava","authors":"D. Risteski, B. Taneva","doi":"10.1515/mmr-2015-0019","DOIUrl":"https://doi.org/10.1515/mmr-2015-0019","url":null,"abstract":"Abstract Anomalies of the venous system may impose serious limitations to the treatment of arrhythmias by means of ablation therapy. We describe a patient who had WPW syndrome with frequent supraventricular tachycardias in whom an ablation was performed. The patient was found to have a persistent left superior vena cava and a left-sided manifest accessory pathway. Persistent left superior vena cava is the most common congenital thoracic venous anomaly with a prevalence of 0.3-0.5% in the general population and is found more frequently in patients with accessory pathways than in patients with AV nodal reentrant tachycardia. Mapping and ablation of an accessory pathway follows the same general electrophysiology principles applicable to patients without anomalous venous return.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"100 - 102"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036517","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. This article summarizes the findings of a study about the influence of the factors of external professional environment on the professional motivation and behaviour of Bulgarian general practitioners (GP). Methods. A representative sample of a total of 4698 GPs in the country was involved in the survey. A special questionnaire was utilized, including 15 factors of external professional environment; these were subdivided into 4 groups on the basis of their nature: financial and economic; legal and regulatory, moral and ethical; and psychological. Their evaluation of the influence of these factors on the professional behaviour and of the factors’ weight was “taken” by means of a direct anonymous survey of 243 General Practitioners (5.2 % of the total number). Results. The findings of the study indicate that the professional environment in which doctors work affects adversely their motivation and conduct. The majority of the factors examined have a predominantly negative effectwith the exception of the financial and economic ones. Conclussion. GPs are of the opinion that most influential for their behaviour are the financial and economic factors (net profit; how much they get paid for their activities).
{"title":"Influence of the Professional Environment on the Motivation and Behaviour of General Practitioners in Bulgaria","authors":"Nevena Ivanova, L. Kirov","doi":"10.1515/mmr-2015-0013","DOIUrl":"https://doi.org/10.1515/mmr-2015-0013","url":null,"abstract":"Abstract Introduction. This article summarizes the findings of a study about the influence of the factors of external professional environment on the professional motivation and behaviour of Bulgarian general practitioners (GP). Methods. A representative sample of a total of 4698 GPs in the country was involved in the survey. A special questionnaire was utilized, including 15 factors of external professional environment; these were subdivided into 4 groups on the basis of their nature: financial and economic; legal and regulatory, moral and ethical; and psychological. Their evaluation of the influence of these factors on the professional behaviour and of the factors’ weight was “taken” by means of a direct anonymous survey of 243 General Practitioners (5.2 % of the total number). Results. The findings of the study indicate that the professional environment in which doctors work affects adversely their motivation and conduct. The majority of the factors examined have a predominantly negative effectwith the exception of the financial and economic ones. Conclussion. GPs are of the opinion that most influential for their behaviour are the financial and economic factors (net profit; how much they get paid for their activities).","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"59 - 64"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036469","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. Two-stage revision surgery for infected knee endoprosthesis using antibiotic articulating spacer is the best possible standard in most of the orthopedic centers worldwide. Methods. In the period from 2008 to 2012 we treated 21 patients with infected knee endoprosthesis. We used a single protocol for diagnosis and treatment of infection which included x-ray examination, serological examination (sedimentation and CRP), fine needle aspiration of the joint with further microbiological and biochemical examination of the smear. The surgical treatment was consisted of taking samples for microbiological and histological examination, removing the implanted endoprosthesis and excision of the avascular and necrotic tissue, implantation of articular antibiotic spacer. The postoperative steps included administration of parenteral antibiotics according to the previously made antibiogram in a two-week period followed by two oral antibiotics (ciprofloxacin and rifampicin) in the next four to six weeks. The second-stage procedure was performed when there were no clinical and serological signs of infection. Removing of the antibiotic spacer and implanatation of primary or revision prosthesis according to bone deficit was performed. Results. In one patient the procedure was carried out three times, arthrodesis of the knee joint was made in one patient and in nineteen patients reimplantation was performed. One patient after reimplanation had reinfection after 6 months. The follow-up period of the patients was 36 months. The functional results according to the Knee society score: preoperative 36, postoperative 74. Conclusion. Two-phase treatment is satisfactory in treatment of periprosthetic joint infection. Articulated antibiotic loaded bone cement spacer is superior in eradication of local infection. It allows partial function of the joint and makes easier the second surgical intervention. Infection with Staphylococcus aureus is difficult to be treated with a higher percent of recidives.
{"title":"Two-Stage Revision for Infected Knee Endoprosthesis","authors":"Jasmin Ciriviri, Darko Talevski, Zoran Nestorovski, Tode Vraniskovski, Snezana Pechinkova-Misevska","doi":"10.1515/mmr-2015-0015","DOIUrl":"https://doi.org/10.1515/mmr-2015-0015","url":null,"abstract":"Abstract Introduction. Two-stage revision surgery for infected knee endoprosthesis using antibiotic articulating spacer is the best possible standard in most of the orthopedic centers worldwide. Methods. In the period from 2008 to 2012 we treated 21 patients with infected knee endoprosthesis. We used a single protocol for diagnosis and treatment of infection which included x-ray examination, serological examination (sedimentation and CRP), fine needle aspiration of the joint with further microbiological and biochemical examination of the smear. The surgical treatment was consisted of taking samples for microbiological and histological examination, removing the implanted endoprosthesis and excision of the avascular and necrotic tissue, implantation of articular antibiotic spacer. The postoperative steps included administration of parenteral antibiotics according to the previously made antibiogram in a two-week period followed by two oral antibiotics (ciprofloxacin and rifampicin) in the next four to six weeks. The second-stage procedure was performed when there were no clinical and serological signs of infection. Removing of the antibiotic spacer and implanatation of primary or revision prosthesis according to bone deficit was performed. Results. In one patient the procedure was carried out three times, arthrodesis of the knee joint was made in one patient and in nineteen patients reimplantation was performed. One patient after reimplanation had reinfection after 6 months. The follow-up period of the patients was 36 months. The functional results according to the Knee society score: preoperative 36, postoperative 74. Conclusion. Two-phase treatment is satisfactory in treatment of periprosthetic joint infection. Articulated antibiotic loaded bone cement spacer is superior in eradication of local infection. It allows partial function of the joint and makes easier the second surgical intervention. Infection with Staphylococcus aureus is difficult to be treated with a higher percent of recidives.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"71 - 77"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036476","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}
Aleksandar Sumkovski, Stojan Gjosev, Ljubomir Ognjenovikj, M. Trajkovska, G. Spasovski
Abstract Introduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mucous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during preoperative imaging examinations, and particularly to unpleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical structures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pancreatic cephalic carcinoma (PCC). Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in operable stage. The method for estimation of both, the operability and the site of insertion of the CD into CHD consisted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopancreatectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treatment and denervation. Results. Of the total of 21 patients, we revealed low insertion of the CD (LICD) in 6 patients (28%). In 4 patients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma. Conclusions. Comparison with other reference radiological and anatomical studies, our results significantly differ in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed differences may be caused by the eventually present connection between the LICD and PCC. Therefore, further studies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.
{"title":"Low Insertion of the Cystic Duct in the Common Hepatic Duct as a Coincidence with an Onset of a Pancreatic Cephalic Carcinoma","authors":"Aleksandar Sumkovski, Stojan Gjosev, Ljubomir Ognjenovikj, M. Trajkovska, G. Spasovski","doi":"10.1515/mmr-2015-0018","DOIUrl":"https://doi.org/10.1515/mmr-2015-0018","url":null,"abstract":"Abstract Introduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mucous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during preoperative imaging examinations, and particularly to unpleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical structures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pancreatic cephalic carcinoma (PCC). Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in operable stage. The method for estimation of both, the operability and the site of insertion of the CD into CHD consisted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopancreatectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treatment and denervation. Results. Of the total of 21 patients, we revealed low insertion of the CD (LICD) in 6 patients (28%). In 4 patients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma. Conclusions. Comparison with other reference radiological and anatomical studies, our results significantly differ in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed differences may be caused by the eventually present connection between the LICD and PCC. Therefore, further studies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"94 - 99"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036512","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}
Slavica Shubeska-Stratrova, Snezana Markovik-Temelkova, G. Petrovski
Abstract Introduction. Body composition and body fat distribution show difference in women with Cushing's syndrome (CS) compared to healthy control women (C) with almost equal body mass index (BMI) (28.89±3.53kg/m2 vs. 29.39±4.04kg/m2) and they were compared with DXA. Methods. Total and regional fat mass (FM), FM%, tissue mass (TM), TM%, android FM (A), gynoid FM (G), lean body mass (LBM), bone mineral density (BMD) and content (BMC) were determined as well as their relationships in 10 CS and 10 C women. Results. Regional FM, FM%, TM and TM% values were not different between CS and C except for arm TM % (45.06±3.1% vs. 40.23±6.29%) (p<0.043). Arms+legs/trunk TM and FM ratio were significantly lower in CS compared to C (p<0.0001). Arms/A (1.1±0.12), legs/A (3±0.41) and legs/trunk TM ratios (0.52±0.07) were significantly lower in CS compared to C (1.3±0.13) (p<0.002), (4.29 ±0.67) (p<0.0001) and (0.69±0.09) (p<0.0001). Legs/A (2.57±0.73), legs/trunk (0.48±0.13) and arms+legs/trunk FM ratio (0.66±0.14) in CS were significantly lower compared to C [(4.2±1.16; 0.71±0.12 (p<0.001) and 0.89±0.14 (p<0.002)]. A/GTM (0.67±0.1) and A/G FM ratio (0.72± 0.2) in CS were significantly higher compared to C (0.48±0.05) (p<0.0001) and (0.46±0.09) (p<0.001). Legs LBM in CS 10.8±1.95kg was lower compared to C 12.7±2.1 kg (p<0.046). Only spine BMD value in CS (0.89±0.09 kg/cm2) was lower compared to C (0.94±0.12 kg/cm2) (p<0.017). Conclusion. Central to peripheral regional TM, FM and LBM ratios differentiated significantly and precisely patients with CS and C and confirmed extreme central obesity in CS.
摘要介绍。库欣综合征(CS)女性的体成分和体脂分布与身体质量指数(BMI)几乎相等的健康对照(C)女性(28.89±3.53kg/m2 vs. 29.39±4.04kg/m2)存在差异，并与DXA进行比较。方法。测定10例CS和C组女性的总脂肪量、局部脂肪量(FM)、FM%、组织质量(TM)、TM%、android FM (A)、gynoid FM (G)、瘦体重(LBM)、骨矿物质密度(BMD)和含量(BMC)及其相互关系。结果。区域FM、FM%、TM和TM%值在两组间差异无统计学意义(p<0.043)，实验组TM%差异有45.06±3.1%比40.23±6.29%。CS组手臂+腿/躯干TM和FM比值显著低于C组(p<0.0001)。CS组臂/A(1.1±0.12)、腿/A(3±0.41)、腿/躯干TM(0.52±0.07)比C组(1.3±0.13)(p<0.002)、(4.29±0.67)(p<0.0001)和(0.69±0.09)(p<0.0001)显著降低。CS组腿/A(2.57±0.73)、腿/躯干(0.48±0.13)、臂+腿/躯干FM比(0.66±0.14)显著低于C组[(4.2±1.16);分别为0.71±0.12 (p<0.001)和0.89±0.14 (p<0.002)。A/GTM(0.67±0.1)和A/G FM(0.72±0.2)显著高于C(0.48±0.05)(p<0.0001)和(0.46±0.09)(p<0.001)。对照组下肢LBM(10.8±1.95kg)低于对照组(12.7±2.1 kg) (p<0.046)。CS组仅脊柱骨密度值(0.89±0.09 kg/cm2)低于C组(0.94±0.12 kg/cm2) (p<0.017)。结论。中枢到外周区域的TM、FM和LBM比值能够准确区分CS和C患者，并证实CS为中枢性极度肥胖。
{"title":"Dual-Energy X - Rayabsorptiometry (Dxa) Assessment of Body Composition and Body Fat Distribution in Cushing’s Women","authors":"Slavica Shubeska-Stratrova, Snezana Markovik-Temelkova, G. Petrovski","doi":"10.1515/mmr-2015-0017","DOIUrl":"https://doi.org/10.1515/mmr-2015-0017","url":null,"abstract":"Abstract Introduction. Body composition and body fat distribution show difference in women with Cushing's syndrome (CS) compared to healthy control women (C) with almost equal body mass index (BMI) (28.89±3.53kg/m2 vs. 29.39±4.04kg/m2) and they were compared with DXA. Methods. Total and regional fat mass (FM), FM%, tissue mass (TM), TM%, android FM (A), gynoid FM (G), lean body mass (LBM), bone mineral density (BMD) and content (BMC) were determined as well as their relationships in 10 CS and 10 C women. Results. Regional FM, FM%, TM and TM% values were not different between CS and C except for arm TM % (45.06±3.1% vs. 40.23±6.29%) (p<0.043). Arms+legs/trunk TM and FM ratio were significantly lower in CS compared to C (p<0.0001). Arms/A (1.1±0.12), legs/A (3±0.41) and legs/trunk TM ratios (0.52±0.07) were significantly lower in CS compared to C (1.3±0.13) (p<0.002), (4.29 ±0.67) (p<0.0001) and (0.69±0.09) (p<0.0001). Legs/A (2.57±0.73), legs/trunk (0.48±0.13) and arms+legs/trunk FM ratio (0.66±0.14) in CS were significantly lower compared to C [(4.2±1.16; 0.71±0.12 (p<0.001) and 0.89±0.14 (p<0.002)]. A/GTM (0.67±0.1) and A/G FM ratio (0.72± 0.2) in CS were significantly higher compared to C (0.48±0.05) (p<0.0001) and (0.46±0.09) (p<0.001). Legs LBM in CS 10.8±1.95kg was lower compared to C 12.7±2.1 kg (p<0.046). Only spine BMD value in CS (0.89±0.09 kg/cm2) was lower compared to C (0.94±0.12 kg/cm2) (p<0.017). Conclusion. Central to peripheral regional TM, FM and LBM ratios differentiated significantly and precisely patients with CS and C and confirmed extreme central obesity in CS.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"86 - 93"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/mmr-2015-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036508","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}
E. Ivanov, D. Karadzova, S. Nikolovski, A. Sivevski, K. Curlinov, M. Zlatkova, G. Dimitrov
Abstract Introduction. The number of caesarean sections has drastically increased and thus arose the idea to examine the effect of the type of anesthesia on the neonates. The objective was to compare vital parameters in the neonates, born under general and spinal anesthesia. Method. A total of 120 patients with need for caesarean section have been divided in two groups of 60, of which the first was lead in general and the second one in spinal anesthesia. The first one was given propophol (2.0-2.5 mg/kg/tt) and succinil colin (1-1.5 mg/kg/tt). The anesthesia was lead with fentanil 0,005 mg/kg/tt and rocuronium bromide 0.4-0.6 mg/kg/tt. O2:N2O was 3:3 l/min. The second group was lead in spinal anesthesia. 2-3 ml Bupivacain 0.5% was spinally applied between L2-L3. Apgar score was defined in the neonates in the first and fifth minutes. The acido-basic status of the neonate was examined through pH values in the blood and the base excess. Results. In the first minute after birth giving with Apgar, 8 newborns 37(61,67%) were born to the group of patients with SA and 29 (48.33%) to the group of patients with GA. In 11 (18.33%) newborns born to the patients led with SA had Apgar score of 9-10, while only 3 (5%) of the newborns born to the patients led with GA had Apgar score of 9-10. Similar ratio was noted in the fifth minute after birth. Ph of the newborns’ blood as well as the base excess (BE) demonstrated significantly lower values in the group of patients led with SA than in the group of patients led with GA. Ph = 7.33 vs 7.37; BE=-4.57±1.8 vs -2.96±2.3. Conclusion. The newborns from the second group had significantly higher Apgar scores than those in the first group. The newborns’ relative acidose (lower SpO2 and BE) did not affect the newborns’ Apgar score in the first and fifth minute.
{"title":"Influence of Spinal and General Anesthesia on Newborn’s Status","authors":"E. Ivanov, D. Karadzova, S. Nikolovski, A. Sivevski, K. Curlinov, M. Zlatkova, G. Dimitrov","doi":"10.1515/mmr-2015-0014","DOIUrl":"https://doi.org/10.1515/mmr-2015-0014","url":null,"abstract":"Abstract Introduction. The number of caesarean sections has drastically increased and thus arose the idea to examine the effect of the type of anesthesia on the neonates. The objective was to compare vital parameters in the neonates, born under general and spinal anesthesia. Method. A total of 120 patients with need for caesarean section have been divided in two groups of 60, of which the first was lead in general and the second one in spinal anesthesia. The first one was given propophol (2.0-2.5 mg/kg/tt) and succinil colin (1-1.5 mg/kg/tt). The anesthesia was lead with fentanil 0,005 mg/kg/tt and rocuronium bromide 0.4-0.6 mg/kg/tt. O2:N2O was 3:3 l/min. The second group was lead in spinal anesthesia. 2-3 ml Bupivacain 0.5% was spinally applied between L2-L3. Apgar score was defined in the neonates in the first and fifth minutes. The acido-basic status of the neonate was examined through pH values in the blood and the base excess. Results. In the first minute after birth giving with Apgar, 8 newborns 37(61,67%) were born to the group of patients with SA and 29 (48.33%) to the group of patients with GA. In 11 (18.33%) newborns born to the patients led with SA had Apgar score of 9-10, while only 3 (5%) of the newborns born to the patients led with GA had Apgar score of 9-10. Similar ratio was noted in the fifth minute after birth. Ph of the newborns’ blood as well as the base excess (BE) demonstrated significantly lower values in the group of patients led with SA than in the group of patients led with GA. Ph = 7.33 vs 7.37; BE=-4.57±1.8 vs -2.96±2.3. Conclusion. The newborns from the second group had significantly higher Apgar scores than those in the first group. The newborns’ relative acidose (lower SpO2 and BE) did not affect the newborns’ Apgar score in the first and fifth minute.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"65 - 70"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036472","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, Zora Popovska, M. Avramovska
Abstract Introduction. The most common risk factor for intraepithelial lesions and cervical carcinoma is infection with human papillomavirus (HPV), especially with high-risk HPV genotypes. Only persistent, high-risk HPV infections represent a major risk factor for intraepithelial lesions and cervical cancer. The aims of the study were: detection and typisation of HPV genotypes, which are the most common causes of intraepithelial lesions and cervical cancer, determination of the correlation between HPV infection and histopathological diagnosis, and the correlation between the grade of lesion of the cervix and oncogenic potential of the virus as well as determination of the most affected age group of patients. Methods. This cross-sectional study included 100 sexually active patients with an abnormal Pap test at the age from 20 to 69 years (39±10.77), and was conducted at the University Clinic of Gynecology and Obstetrics in Skopje and University Clinic of Radiotherapy and Oncology in Skopje in the period from January 2014 to August 2014. In all patients colposcopic cervical biopsy was made with endocervical curettage for histopathological analysis and cervical biopsy for detection and HPV typisation. HPV detection and typisation were done using polymerase chain reaction (PCR) and reverse hybridization. Results. HPV DNA was detected in 81.0% (81/100) of the examined women. The relationship between the prevalence of high-risk and low-risk HPV DNA genotypes was 72.0%:9.0%. The frequency of high-risk HPV DNA genotypes ranged from: 54.5% (12/22) in productive HPV infection-mild dysplasia, 86.4% (19/22) with moderate dysplasia, 91.2% (21/23) in severe dysplasia to 100% of squamous cell carcinoma in situ (6/6) and invasive squamous cell carcinoma (5/5). Mixed HPV infection was detected in 19.0% (19/100) of all patients, in 23.5% (19/81) of HPV DNA positive patients. The most common HPV DNA genotypes, in descending order, were HPV 16 (43.2%), HPV 31 (28.4%), HPV 18 (14.8%), etc. The highest frequency of HPV infection was found in patients under 30 years of age. Conclusion. There was an association between HPV infection and squamous intraepithelial lesions and squamous invasive carcinoma of the cervix. There was a correlation between the grade of cervical lesion and the oncogenic potential of the virus. The results of this study may be useful for building a national strategy in the fight against cervical cancer.
{"title":"Tissue Detection and Typisation of Human Papillomavirus in Women with Squamous Intraepithelial Lesions and Squamous Invasive Carcinoma of the Cervix","authors":"D. Dabeski, D. Danilovski, V. Antovska, N. Basheska, Zora Popovska, M. Avramovska","doi":"10.1515/mmr-2015-0016","DOIUrl":"https://doi.org/10.1515/mmr-2015-0016","url":null,"abstract":"Abstract Introduction. The most common risk factor for intraepithelial lesions and cervical carcinoma is infection with human papillomavirus (HPV), especially with high-risk HPV genotypes. Only persistent, high-risk HPV infections represent a major risk factor for intraepithelial lesions and cervical cancer. The aims of the study were: detection and typisation of HPV genotypes, which are the most common causes of intraepithelial lesions and cervical cancer, determination of the correlation between HPV infection and histopathological diagnosis, and the correlation between the grade of lesion of the cervix and oncogenic potential of the virus as well as determination of the most affected age group of patients. Methods. This cross-sectional study included 100 sexually active patients with an abnormal Pap test at the age from 20 to 69 years (39±10.77), and was conducted at the University Clinic of Gynecology and Obstetrics in Skopje and University Clinic of Radiotherapy and Oncology in Skopje in the period from January 2014 to August 2014. In all patients colposcopic cervical biopsy was made with endocervical curettage for histopathological analysis and cervical biopsy for detection and HPV typisation. HPV detection and typisation were done using polymerase chain reaction (PCR) and reverse hybridization. Results. HPV DNA was detected in 81.0% (81/100) of the examined women. The relationship between the prevalence of high-risk and low-risk HPV DNA genotypes was 72.0%:9.0%. The frequency of high-risk HPV DNA genotypes ranged from: 54.5% (12/22) in productive HPV infection-mild dysplasia, 86.4% (19/22) with moderate dysplasia, 91.2% (21/23) in severe dysplasia to 100% of squamous cell carcinoma in situ (6/6) and invasive squamous cell carcinoma (5/5). Mixed HPV infection was detected in 19.0% (19/100) of all patients, in 23.5% (19/81) of HPV DNA positive patients. The most common HPV DNA genotypes, in descending order, were HPV 16 (43.2%), HPV 31 (28.4%), HPV 18 (14.8%), etc. The highest frequency of HPV infection was found in patients under 30 years of age. Conclusion. There was an association between HPV infection and squamous intraepithelial lesions and squamous invasive carcinoma of the cervix. There was a correlation between the grade of cervical lesion and the oncogenic potential of the virus. The results of this study may be useful for building a national strategy in the fight against cervical cancer.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"78 - 85"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036504","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. Exercise tolerance is one of the life quality parmeters in chronic heart failure patients. The aim of our study was to assess the quality of life of patients with chronic heart failure by estimating their exercise tolerance. Methods. We examined 113 patients with stable chronic heart failure in the period of 18 months. They were divided in two groups, a control group (on conventional therapy of angiotensin-converting enzyme inhibitors and diuretics) and a therapy group (conventional therapy plus beta-blockers). The therapy group was divided into 3 subgroups according to the beta-blocker taken (a Metoprolol Bisoprolol and Carvedilol subgroup). Exercise tolerance was detected by coronary trade-mill stress testing every 6 months (only in patients of NYHA FC II and III), symptoms limited or modified after 6-minutes Bruce test. Results. Our results showed that there was a statistically significant difference between the control group and all the therapy subgroups in NYHA FC, NYHA score and exercise tolerance at the end of the study, but there was no difference among the subgroups. Conclusion. Beta-blockers improve the exercise tolerance as a variable defining quality of life.
摘要介绍。运动耐量是慢性心力衰竭患者的生活质量指标之一。我们研究的目的是通过评估慢性心力衰竭患者的运动耐受性来评估他们的生活质量。方法。我们对113例稳定性慢性心力衰竭患者进行了为期18个月的研究。他们被分为两组，对照组(常规治疗血管紧张素转换酶抑制剂和利尿剂)和治疗组(常规治疗加-受体阻滞剂)。治疗组根据服用受体阻滞剂分为3个亚组(美托洛尔、比索洛尔、卡维地洛亚组)。每6个月通过冠状动脉运动负荷测试检测运动耐受性(仅在NYHA FC II和III患者中)，6分钟布鲁斯试验后症状得到限制或改善。结果。我们的结果显示，对照组与各治疗亚组在NYHA FC、NYHA评分和研究结束时的运动耐量方面有统计学差异，但亚组间无差异。结论。-受体阻滞剂可以改善运动耐受性，这是决定生活质量的一个变量。
{"title":"Coronary Stress Test as a Predictor of Quality of Life in Chronic Heart Failure Patients","authors":"B. Taneva, Dejan Ristevski","doi":"10.1515/mmr-2015-0005","DOIUrl":"https://doi.org/10.1515/mmr-2015-0005","url":null,"abstract":"Abstract Introduction. Exercise tolerance is one of the life quality parmeters in chronic heart failure patients. The aim of our study was to assess the quality of life of patients with chronic heart failure by estimating their exercise tolerance. Methods. We examined 113 patients with stable chronic heart failure in the period of 18 months. They were divided in two groups, a control group (on conventional therapy of angiotensin-converting enzyme inhibitors and diuretics) and a therapy group (conventional therapy plus beta-blockers). The therapy group was divided into 3 subgroups according to the beta-blocker taken (a Metoprolol Bisoprolol and Carvedilol subgroup). Exercise tolerance was detected by coronary trade-mill stress testing every 6 months (only in patients of NYHA FC II and III), symptoms limited or modified after 6-minutes Bruce test. Results. Our results showed that there was a statistically significant difference between the control group and all the therapy subgroups in NYHA FC, NYHA score and exercise tolerance at the end of the study, but there was no difference among the subgroups. Conclusion. Beta-blockers improve the exercise tolerance as a variable defining quality of life.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"26 - 29"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036404","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}
I. Bitoska, B. Krstevska, T. Milenković, Snezana Markovik-Temelkova, Sasa Jovanovska-Misevska, G. Petrovski, K. Adamová, E. Stojovska-Jovanovska, Biljana Novakovik-Zafirova
Abstract Introduction. In women with diabetes, the changes that accompany menopause may further diminish glycemic control. Little is known about how hormone replacement therapy (HRT) affects glucose metabolism in diabetes. The aim of this study was to examine whether HbA1C levels are influenced by current HRT among postmenopausal women with type 2 diabetes. Methods. A total of 40 postmenopausal women with type 2 diabetes were enrolled. All of them fulfilled the criteria of natural menopause, with intact uterus, low estrogen levels (E2) and high follicle-stimulating hormone (FSH) levels. Half of them (20 women) were assigned to take HRT (DM-HRT group). The other half (20 women) were assigned to the control group, those who did not take HRT (DM-non HRT group). HRT consisted of 17 β-estradiol (E2) 1 mg and drospirenone (DRSP) 2 mg. Fasting plasma glycemia, insulinemia and HbA1C were followed in both groups throughout 12 months. Results. The mean age was 49 years (SD±3,3) and 48,5 (SD±3.1), respectively. HRT was associated with statistically significant decrease in serum fasting glucose, HbA1C and insulinemia levels in the DM-HRT group. There was no significant reduction in glucose levels and HbA1C together with no significant increase in insulinemia levels in the DM non-HRT group throughout 12 months. Conclusion. HRT was associated with statistically significant decrease of plasma glucose levels and HbA1C level. Larger clinical trials are necessary to understand whether HRT may improve glycemic control in women with diabetes, especially when it is given shortly after entering menopause.
{"title":"Association Between Hormone Replacement Therapy and Glycemic Control in Postmenopausal Women with Type 2 Diabetes","authors":"I. Bitoska, B. Krstevska, T. Milenković, Snezana Markovik-Temelkova, Sasa Jovanovska-Misevska, G. Petrovski, K. Adamová, E. Stojovska-Jovanovska, Biljana Novakovik-Zafirova","doi":"10.1515/mmr-2015-0007","DOIUrl":"https://doi.org/10.1515/mmr-2015-0007","url":null,"abstract":"Abstract Introduction. In women with diabetes, the changes that accompany menopause may further diminish glycemic control. Little is known about how hormone replacement therapy (HRT) affects glucose metabolism in diabetes. The aim of this study was to examine whether HbA1C levels are influenced by current HRT among postmenopausal women with type 2 diabetes. Methods. A total of 40 postmenopausal women with type 2 diabetes were enrolled. All of them fulfilled the criteria of natural menopause, with intact uterus, low estrogen levels (E2) and high follicle-stimulating hormone (FSH) levels. Half of them (20 women) were assigned to take HRT (DM-HRT group). The other half (20 women) were assigned to the control group, those who did not take HRT (DM-non HRT group). HRT consisted of 17 β-estradiol (E2) 1 mg and drospirenone (DRSP) 2 mg. Fasting plasma glycemia, insulinemia and HbA1C were followed in both groups throughout 12 months. Results. The mean age was 49 years (SD±3,3) and 48,5 (SD±3.1), respectively. HRT was associated with statistically significant decrease in serum fasting glucose, HbA1C and insulinemia levels in the DM-HRT group. There was no significant reduction in glucose levels and HbA1C together with no significant increase in insulinemia levels in the DM non-HRT group throughout 12 months. Conclusion. HRT was associated with statistically significant decrease of plasma glucose levels and HbA1C level. Larger clinical trials are necessary to understand whether HRT may improve glycemic control in women with diabetes, especially when it is given shortly after entering menopause.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"69 1","pages":"35 - 39"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67036415","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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