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Volume 36 (2015): Issue 1 (May 2015)

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Journal Details
Format
Journal
eISSN
1857-8985
First Published
08 Sep 2014
Publication timeframe
2 times per year
Languages
English

Search

Volume 36 (2015): Issue 1 (May 2015)

Journal Details
Format
Journal
eISSN
1857-8985
First Published
08 Sep 2014
Publication timeframe
2 times per year
Languages
English

Search

26 Articles
Open Access

Publication Ethics: What Next?

Published Online: 16 Jun 2015
Page range: 4 - 4

Abstract

Open Access

Proteomics in Diagnosis of Prostate Cancer/ Протеомика Во Дијагноза На Простатниот Карцином

Published Online: 16 Jun 2015
Page range: 5 - 36

Abstract

Abstract

Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. The introduction of prostate specific antigen (PSA) has greatly increased the number of men diagnosed with PCa but at the same time, as a result of the low specificity, led to overdiagnosis, resulting to unnecessary biopsies and high medical cost treatments.

The primary goal in PCa research today is to find a biomarker or biomarker set for clear and effecttive diagnosis of PCa as well as for distinction between aggressive and indolent cancers. Different proteomic technologies such as 2-D PAGE, 2-D DIGE, MALDI MS profiling, shotgun proteomics with label-based (ICAT, iTRAQ) and label-free (SWATH) quantification, MudPIT, CE-MS have been applied to the study of PCa in the past 15 years. Various biological samples, including tumor tissue, serum, plasma, urine, seminal plasma, prostatic secretions and prostatic-derived exosomes were analyzed with the aim of identifying diagnostic and prognostic biomarkers and developing a deeper understanding of the disease at the molecular level.

This review is focused on the overall analysis of expression proteomics studies in the PCa field investigating all types of human samples in the search for diagnostics biomarkers. Emphasis is given on proteomics platforms used in biomarker discovery and characterization, explored sources for PCa biomarkers, proposed candidate biomarkers by comparative proteomics studies and the possible future clinical application of those candidate biomarkers in PCa screening and diagnosis. In addition, we review the specificity of the putative markers and existing challenges in the proteomics research of PCa.

Keywords

  • Prostate cancer
  • benign prostate hyperplasia
  • diagnostics biomarkers
  • comparative proteomics
  • gel-based proteomics
  • shotgun proteomics

Клучни зборови

  • канцер на простата
  • бенигна прос- татна хиперплазија
  • дијагностички биомаркери
  • ком- паративна протеомика
  • гел-базирана протеомика
  • shotgun- протеомика
Open Access

A Review of the Role of Exercise and Factors Affecting its Uptake for People with Chronic Kidney Disease (Ckd) not Requiring Renal Replacement Therapy/ Преглед На Улогата На Вежбањето И Факторите Што Влијаат На Неговата Примена Кај Лица Со Хронична Бубрежна Болест (Хбб) За Кои Не Е Потребна Бубрежна Заменска Терапија

Published Online: 16 Jun 2015
Page range: 37 - 46

Abstract

Abstract

Chronic Kidney Disease (CKD) is a long-term progressive condition affecting 10-15% of people. The overlap of diabetes, hypertension and CKD in an aging population means that prevalence will only increase. CKD increases the risk of all-cause mortality, secondary to the elevated cardiovascular risk. It also significantly affects the patients’ ability to engage in functional activities and their quality of life.

The evidence base suggests that exercise has the capacity to improve symptom burden, functional ability and mental health. The majority of the patient population are pre-dialysis yet previous research has concentrated on dialysing patients. This review will focus on the patient group not requiring renal replacement therapy (non-RRT) as this is an area where further work is urgently needed.

A large majority of people with CKD tend to be inactive despite emerging guidelines emphasising the positive effect of exercise for both people with chronic disease and healthy populations. This paper will review the evidence to support exercise to improve outcomes and quality of life and report on common barriers that patients experience and advocate the need for supported exercise interventions to help patients become more active and gain the potential resultant health benefits.

Keywords

  • kidney disease
  • exercise
  • quality of life

Клучни зборови

  • болести на бубрезите
  • вежбање
  • квалитет на животот.
Open Access

A Survey of Solitary Deaths in Japan for Shortening Postmortem Interval Until Discover/ Студија На Смртни Случаи На Самци Во Јапонија За Скратување На Постмортем Интервалот До Откривањето

Published Online: 16 Jun 2015
Page range: 47 - 51

Abstract

Abstract

Recently in advanced nations, the number of solitary households is increasing. Data from Japanese population survey in 2010 showed that the percent of solitary households was 32.4% and that was the largest category of household types. The Japanese government regards solitary death as important problem, but a useful survey on solitary death has not been performed. We have focused on the postmortem interval until discovery of the death as a measure of solitary deaths.

We conducted a survey of 582 forensic autopsy cases in the Osaka medical examiner’s office over three years, from April in 2010 till March in 2012. We excluded suicide cases. We collected data on the, gender, age, postmortem interval (PMI) until discovery, family structure, situation of discovery of the body, cause of death, and the time interval from the last hospital visit.

Here, we found that people who had high risk of solitary death ranged in, age from 60 to 69 which is the age of retirement for many people. In order to prevent solitary death, we suggest that people who live alone should take better care of themselves and participate in a community setting after their retirement. We can show that the recent efforts of the Japanese government for reducing solitary death had been working well. The government care givers take care of the person living alone almost like their own family. We also suggest that the people who unfortunately do not have any home care should subscribe to a newspaper for shortening the PMI.

Keywords

  • Solitary death
  • Postmortem interval
  • Periodic hospital care.

Клучни зборови

  • смрт на самци
  • постмортем интер- вал
  • периодична болничка нега
Open Access

Pharmacogenetics and Antipsychotic Treatment Response/ Фармакогенетски Тестирања И Одговор Кон Третман Со Антипсихотоци

Published Online: 16 Jun 2015
Page range: 53 - 67

Abstract

Abstract

Antipsychotic drugs are widely used in the treatment of schizophrenia and psychotic disorder. The lack of antipsychotic response and treatment-induced side-effects, such as neuroleptic syndrome, polydipsia, metabolic syndrome, weight gain, extrapyramidal symptoms, tardive dyskinesia or prolactin increase, are the two main reasons for non-compliance and increased morbidity in schizophrenic patients. During the past decades intensive research has been done in order to determine the influence of genetic variations on antipsychotics dosage, treatment efficacy and safety. The present work reviews the molecular basis of treatment response of schizophrenia. It highlights the most important findings about the impact of functional polymorphisms in genes coding the CYP450 metabolizing enzymes, ABCB1 transporter gene, dopaminergic and serotonergic drug targets (DRD2, DRD3, DRD4, 5-HT1, 5HT-2A, 5HT-2C, 5HT6) as well as genes responsible for metabolism of neurotransmitters and G signalling pathways (5-HTTLPR, BDNF, COMT, RGS4) and points their role as potential biomarkers in everyday clinical practice. Pharmacogenetic testing has predictive power in the selection of antipsychotic drugs and doses tailored according to the patient’s genetic profile. In this perception pharmacogenetics could help in the improvement of treatment response by using different medicinal approaches that would avoid potential adverse effects, reduce stabilization time and will advance the prognosis of schizophrenic patients.

Keywords

  • Pharmacogenetics
  • antipsychotics
  • schizophrenia
  • biomarkers
  • CYP450
  • P-glycoprotein
  • serotonergic receptors
  • dopaminergic receptors
  • COMT
  • BDNF

Клучни зборови

  • фармакогенетика
  • шизофренија
  • биомаркери
  • CYP450
  • П-гликопротеин
  • сeротонински рецептори
  • допамински рецептори
  • COMT
  • BDNF
Open Access

Expression of p53 Protein Product in Triple Negative Breast Cancers and Relation with Clinical and Histopathological Parameters/ Експресија На Р53 Протеинскиот Продукт Кај Тројно Негативните Карциноми На Дојка Во Сооднос Со Клиничките И Хистопатолошките Параметри

Published Online: 16 Jun 2015
Page range: 69 - 79

Abstract

Abstract

Introduction: "Triple" negative breast cancer is a subgroup of so-called basal-like breast cancer. They are represented with 15% of all breast cancers, characterized with lack of hormone receptor as well as with negative expression of HER2 test. These tumors are more frequent in Afro-Americans and Latin-Americans, in patients with BRCA1 mutations and in patients with recent delivery. The aim of this study is to present the immunohistochemical and clinico-pathological characteristics of the triple negative breast cancer and their correlation with expression of the protein product of the tumor suppressor gene p53.

Methods: A retrospective analyses of 24 patients with triple negative breast cancer was performed. All of the patients were evaluated in the Histopathological Laboratory of the Clinical Hospital Sistina, during the period from June 2009, until June 2011. The standard immunohistochemical procedures, including the hormone receptor status, HER2 status, proliferative index - Ki67 and p53 gene protein product were performed, as well as additional immunohistochemical staining for socalled basal keratins (Cytokeratin 5/6 and high molecular weight cytokeratin 34BE12).

Results: The age of the patients ranged from 29-77 years. Positive lymph nodes were found in 14 (59%) patients. The tumor was poorly differentiated in 19 patients (79%). Overexpression of the p53 protein product was evaluated in 19 (79%) of the cases. All p53 negative patients (5/5) had poorly differentiated tumors (G3), associated with positive regional lymph nodes. The p53 positive group expressed quite opposite correlation, only 9/19 (47%) were with positive lymph nodes (p = 0.03). The expression of p53 protein product was also associated with the nuclear grade (p = 0.005), the mitotic index (p = 0.001), lymph-vascular invasion (p = 0.005) and with the proliferation index Ki67 (p = 0.003). There was a trend for association with the tumor size - pT (p = 0.05).

Conclusion: According to the results, the triple negative breast cancers are subgroup of the poorly differentiated neoplasms frequently associated in the younger age groups. The majority of these have overexpression of the p53 protein product, which in other hand, are inversely correlated with lymph nodes metastases. Hence, the necessity of enriching the immunohistochemical protocol of these patients with new antibodies, in order to evaluate their expression, which would be helpful for prediction the outcome of different therapeutical modalities.

Keywords

  • breast cancer
  • triple negative
  • p53 protein product

Клучни зборови

  • карцином на дојка
  • тројно негати- вeн тумор супресорски ген р53
Open Access

Morphological Characteristics of the Superior Cerebellar Artery/ Морфолошки Карактеристики На Горната Церебеларна Артерија

Published Online: 16 Jun 2015
Page range: 80 - 84

Abstract

Abstract

With the introduction of new techniques in diagnostic and interventional radiology and progress in micro neurosurgery, accurate knowledge of the brain blood vessels is essential for daily clinical work. The aim of this study was to describe the morphological characteristics of the superior cerebellar artery and to emphasize their clinical significance.

In this study we examined radiographs of 109 patients who had CT angiography at the University Clinic for Radiology in Skopje, R. Macedonia. This study included 49 females and 60 males, ranging in age from 27 to 83 years; mean age 57.4 ± 11.8 years.

In 105 patients SCA arose from the basilar artery on both sides as a single vessel. In two patients SCA arose as a duplicate trunk from the basilar artery. We found unilateral duplication on the right SCA in one patient, and bilateral duplication in one patient. In two patients was noticed origin of the SCA from PCA as a single trunk from adult type of the PCA.

Through knowledge of the anatomy and variations of SCA is important for clinicians as well as basic scientists who deal with problems related to intracranial vasculature in daily basis for save performance of diagnostic and interventional procedures.

Keywords

  • superior cerebellar artery
  • anatomy
  • variations
  • basilar artery.

Клучни зборови

  • горна церебеларна артерија
  • анато- мија
  • варијации
  • базиларна артерија
Open Access

Protective Effects of At1-Receptor Blocker and Ca Antagonist Combination on Renal Function in Salt Loaded Spontaneously Hypertensive Rats/ Протективни Ефекти На Комбинацијата На Ат1 Рецепторен Блокатор И Калциум Антагонист Врз Реналната Функција Кај Спонтано Хипертензивни Стаорци Оптоварени Со Сол

Published Online: 16 Jun 2015
Page range: 85 - 91

Abstract

Abstract

Salt sensitive hypertension is known to be a contributing factor for the progression of kidney disease. This study was undertaken to investigate the role of excessive dietary salt on renal function and to evaluate the effect of valsartan and amlodipin given as a combination therapy on blood pressure and parameters specific to the renal function in salt loaded SHR rats. 48 male SHR rats at age of 20 weeks and body weight ranging between 270-350 g were used. SHR rats were divided into 3 groups: control group of rats -SHRC (n = 16) given tab water ad libitum and two salt treated groups in which tab water was replaced with a solution of NaCl (1%) from age of 8 weeks given ad libitum: SHRVAL+AMLO group (n = 16) where investigated drugs were administered at a dose of 10 mg/kg/ b.w. (valsartan) and 5 mg/kg/ b.w. (amlodipin) by gavage and SHR NaCl group (n = 16) that received saline in the same volume and the same time intervals as the SHRVAL+AMLO group. For a period of 12 weeks we have investigated the effect of the VAL+AMLO drug combination on systolic blood pressure (SBP), body weight and renal function tests. Salt loading with 1% solution in the SHR NaCl group has lead to significant increase of blood pressure, proteinuria and decrease in creatinine clearance. Combined treatment with АТ1-receptor blocker and calcium antagonist has managed to control blood pressure and ameliorated renal damage.

Keywords

  • Salt loading
  • SHR rats
  • renal function
  • valsartan
  • amlodipin

Клучни зборови

  • оптоварување со сол
  • бубрежна функција
  • СХР-стаорци
  • валсартан
  • амлодипин.
Open Access

Novel Ret Mutations in Macedonian Patients with Medullary Thyroid Carcinoma: Genotype-Phenotype Correlations/ Нови Ret-Мутации Кај Македонски Пациенти Со Медуларен Карцином На Тироидната Жлезда: Генотипско-Фенотипски Корелации

Published Online: 16 Jun 2015
Page range: 93 - 107

Abstract

Abstract

Medullary thyroid carcinomas (MTCs) are rare neoplasms comprising 2-10% of all thyroid malignnancies. More than 75% are sporadic tumors and the remainder is familial and MEN2 related. Both sporadic and syndromic MTCs frequently show mutations in the RET proto-oncogene. It has been noted that some MTC cases present an indolent, and some an aggressive clinical course. Ki-67 expression is generally low, with documented exceptions, whereas high expression of Bcl-2 has been reported in majority of the cases. Some studies have shown that Ki-67 and Bcl-2 expressions have prognostic value, as well as RET mutational status. We analyzed 20 unrelated MTC cases for Ki-67, Bcl-2 expression and RET mutations and tested their intercorrelations, correlations to the morphologic features and stage of the tumors, as well as their influence on survival. In 13 of the 20 analyzed cases we found 23 sequence changes distributed in exons 8, 10-13 and 16. There were 11 different missense mutations, single nucleotide deletion with frameshift, and 8 different synonymous mutations. Only 4 of the sequence changes have been previously published. Twelve patients (60%) had tumors expressing one or more missense mutations or single nucleotide deletion and 7 of them (35%) had at least one damaging or possibly damaging RET mutation. Most of the tumors had low Ki-67 expression (mean 6.48% of cells) and high Bcl-2 expression (mean 68.3%). Significantly better survival was observed in cases with low Ki-67 (< 6.5%; p < 0.05), high Bcl-2 expression (> 68.3%; p < 0.01) and younger age at diagnosis (< 51 years; p < 0.05).

Keywords

  • RET mutations
  • Medullary thyroid carcinoma
  • Ki-67
  • Bcl-2.

Клучни зборови

  • RET-мутации
  • медуларен карци- ном на тироидна жлезда
  • Ki-67
  • Bcl-2.
Open Access

Single Nucleotide Polymorphisms of the Inflamatory Cytokine Genes: Interleukin-1B, Tumor Necrosis Factors-A and Tumor Necrosis Factor-B in Adult Patients with Immune / Thrombocytopenia Единечни Нуклеотидни Полиморфизми Во Цитокинските Гени: Интерлеукин-1Б, Тумор Некрозис Фактор-А И Тумор Некрозис Фактор-Б Кај Пациенти Со Имуна Тромбоцитопенија

Published Online: 16 Jun 2015
Page range: 109 - 115

Abstract

Abstract

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by thrombocytopenia due to platelet autoantibodies, causing an accelerated clearance of opsonized platelets by phagocytes. The etiology of ITP remains unclear, both genetic and environmental factors may have a role in the disease development. The aim of our study was to investigate a possible association of three single nucleotide polymorphisms (SNP) in the genes for interleukin beta (IL1B-511C/T), tumor necrosis factor beta (TNF+252G/A) and tumor necrosis factor alpha (TNFA-308G/A) with ITP. We have analyzed 125 adult patients with ITP and 120 healthy matched controls. Genotyping was performed by using PCR- RFLP methods.

Our results demonstrated significantly different genotype distributions and allele frequencies for TNFB+252G/A in patients with ITP, p = 0.005 and p = 0.009 with Yates correction. We did not find any significant differences in the genotype distribution or allele frequencies for the other two genes. We have found significantly different genotype distribution and allele frequencies for TNFA- 308G/A between patients with unresponsive and responsive ITP patients, p = 0.016 and p = 0.009. There were no significant differences in genotype distribution and allele frequencies for ILB-511C/T and TNFB+252G/A polymorphisms between those two groups of patients. We did not find any significant differences in genotype distribution and allele frequencies for all three polymorphisms between splenectomized and unsplenectomized ITP patients.

The obtained data indicate that the A allele of TNFB+252G/A is more frequent in these patients than in the controls and that this polymorphism may play a significant role in disease susceptibility. The A allele of TNFA-308G/A was more frequent in patients with unresponsive ITP, indicating that this gene polymorphisms may contribute to therapy resistance.

Keywords

  • immune thrombocytopenia
  • thrombocytopenia
  • cytokine genes
  • single nucleotide polymorphisms.

Клучни зборови

  • имуна тромбоцитопенија
  • цито- кински гени
  • единечни нуклеотидни полимор- физми.
Open Access

Evaluation of Changes in Serum Concentration of Sodium in a Transurethral Resection of the Prostate/ Евалуација На Промените Во Серумската Концентрација На Натриум При Трансуретралнa Ресекција На Простатa

Published Online: 16 Jun 2015
Page range: 117 - 127

Abstract

Abstract

Introduction and objectives: The purpose of this study was to evaluate changes in serum electrolytes during Transurethral resection of the prostate (TURP) and to evaluate the degree of correlation of hyponatremia and the factors that affect the incidence of TURP syndrome and to show the impact of the duration of the procedure on the severity of hyponatremia due to absorption of irrigation fluid in the systemic circulation.

Materials and Methods: This study examined 60 male patients planned for elective TURP. The level of serum electrolytes are determined by taking venous blood samples preoperatively and Postoperatively and when the duration of the operation was longer than 60 minutes, the level of serum electrolytes was determined intraoperative. The amount of used irrigation fluid, the weight of resection prostate, and duration of surgery, were also followed. Patients were divided in two groups according to the length of the surgical procedure: Group 1 (30- 60 min) and Group 2 (> 60 min).

Results: Statistically significant reduction of serum sodium and the elevation of the potassium level in serum observed postoperatively and was directly proportional to the volume of of the used irrigation fluid, the duration of the procedure and volume of the resected prostate.

Conclusions: To evaluate changes in serum electrolyte during TURP is simple and economical method for the indirect estimation of irrigation fluid absorption into the systemic circulation during TURP and opportunity for early identification of TURP syndrome

Keywords

  • TURP
  • TURP syndrome
  • hiponatremia
  • hiperkalemia

Клучни зборови

  • TURP
  • TURP-синдром
  • хипонатре- мија
  • хиперкалемија.
Open Access

Operative Treatment of Degenerative Lumbar Spine Spondylolisthesis/ Оперативен Третман На Лумбосакрална Дегенреативна Спондилолистеза

Published Online: 16 Jun 2015
Page range: 129 - 135

Abstract

Abstract

Introduction: Management of degenerative lumbosacral spondylolisthesis with spinal stenosis is still controversial. Surgery is widely used, as well as non-surgical treatment. Aim: To evaluate the clinical results and functional outcome after operative treatment in Grade II and III lumbar spine spondylolisthesis.

Material and methods: Twelve patients with symptoms and image-confirmed degenerative spondylolisthesis entered the study. Mean patient age was 57 years. Spondylolisthesis Grade II or III, segment L4-L5 or L5-S1 were evaluated. All patients underwent similar protocols. Operative treatment was decompressive laminectomy, posterior one segment fixation, and fusion with autologous bone grafting. Functional outcome measures were Visual Analog Scale (VAS, 10-point scale) and Oswestry Disability Index (ODI, 100-percent scale) after 6 and 12 months.

Results: Patient follow-up was 12 months. Preoperatively, 7 patients had severe disability according to ODI, 4 had moderate disability. VAS measured 6 and 7 points in 6 patients, lowest score of 4 points and the highest score of 9. After 6 months, ODI showed 5 patients had minimal and 7 had moderate disability; 2 patients had 0 points on the VAS, 2 had a score of 1, 4 had a score of 2, highest score of 4 points. Treatment outcome effects after 1 year were 9 patients with minimal disability, 3 with moderate; VAS - 2 patients with O points, 3 with 1 point, 4 with 2 points.

Conclusion: Patients with degenerative spondylolisthesis and spinal stenosis treated surgically showed substantially greater improvement in pain and functional outcome during a period of 1 year.

Keywords

  • decompressive laminectomy
  • Oswestry Disability Index
  • spondylolisthesis
  • Visual Analog Scale

Клучни зборови

  • визуелна аналогна скала
  • деком- пресивна ламинектомија
  • Oswestry Disability Index
  • спондилолистеза.
Open Access

Can Oral Anaerobic Bacteria cause Adverse Pregnancy Outcomes?/ Дали Оралните Анаеробни Бактерии Можат Да Доведат До Лоши Опстетрички Исходи?

Published Online: 16 Jun 2015
Page range: 137 - 143

Abstract

Abstract

Aim: Maternal periodontal infection has been recognized as a risk factor for premature and low birthweight infants. It is suspected that pathogens causing periodontal disease may translocate to the amniotic cavity and so contribute to triggering an adverse pregnancy outcome. The aim of this study was to evaluate whether the presence of specific periodontal pathogens may influence the incidence of preterm labor and premature birth.

Material and Methods: This study was designed as a hospital-based case-control study. A total of 70 pregnant women, aged 18-40 with single live pregnancy were recruited from the Departement of Gynecolgy and Obstetrics at a General hospital in Sibenik, Croatia, between March 2013 to March 2014. The case group: 30 pregnant women who were hospitalised with signs of premature labor. Control group: 40 patients with normal pregnancy post-delivery up to 48 hrs, who had given birth at term, and the baby had a weight of more than 2500 gr. These women had undergone microbiological examination at the time of recruitment, microbial samples, paper point subgingival swabs were obtained in both groups and processed by anaerobic culturing. Standard procedures were used for culture and identification of bacteria. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may have influence the premature delivery.

Results: The levels of periodontal pathogens tended to be higher in the premature (case group) labor compared to the term deliveries (control group). Levels of Porphyromonas gingivalis, Fuscobacterium nucleatum, Actinomyces actinomycetecomitans were statistically significantly higher in premature births as compared to term deliveries, adjusting for baseline levels. The joint effects of red and orange microbial clusters were significantly higher in the premature group compared to the term group.

Conclusions: The study shows a significant association betwen periodontal anaerobic infection and adverse pregnancy outcome. High levels of periodontal pathogens during pregnancy are associated with an increased risk for preterm delivery. Further studies elucidating the role of the microbial load and maternal immune response as related to pregnancy outcome seem merited.

Keywords

  • oral anaerobic bacteria
  • preterm labor
  • preterm delivery

Клучни зборови

  • орални анаеробни бактерии
  • пре- течко предвремено породување (ППП).
Open Access

Sentinel Lymph Node Detection in Breast Cancer – First Experience/ Детекција На Сентинелни Лимфни Јазли Кај Карцином На Дојка – Први Искуства

Published Online: 16 Jun 2015
Page range: 145 - 151

Abstract

Abstract

Introduction: Breast cancer accouns for 22.9% of all cancers in women and 13.7% of cancer deaths. Positive axillary lymphnodes (ALN) predict the development of distant metastases. The status of the sentinel lymphnode (SLN) is crutial for the treatment selection.

Aim: To determine the benefits of SLN detection in patients with breast cancer. Material and methodology: 38 female patients (pts), age 44 ± 12 years, with T1-2 N0 M0 breast cancer, without enlarged ALN on ultrasound (US), were included. SLN detection was performed using gamma camera and gamma detection probe after periareolar subcutaneous and/or peritumoral injection of (99m-Technetium-SENTISCINT). Blue dye was administered 20 min before the operation. SLN was extirpated and ex tempore histopathology was performed.

Results: Ex tempore SLN evaluation was negative and the lymphatic pathways preserved in 28/38 (74%) pts. In 10/38 (26%) pts SLN was positive, followed by radical surgery. In 3/28 ex tempore negative patients, histopathological analysis showed metastatic involvement (false negative). In 3/10 ex tempore positive patients micro metastases 0,2-2 mm were detected. 12 pts had 2 SLN, 8/12 (66%) had negative and 4/12 (34%) had positive SLN. 3 pts had a rare double drainage to axilla and a. mammaria int.

Conclusion: Our results confirm that SLN detection technique is non-invasive, safe and reliable and should be incorporated into the guidelines for breast cancer pts (T1-2 N0 M0). The most reliable option for colloid application is the combined technique of periareolar and peritumoral injection. Patients with drainage to a. mammaria interna should be selected for adjuvant protocols.

Keywords

  • breast cancer
  • sentinel lymph node
  • blue dye.

Клучни зборови

  • карцином на дојка
  • сентинелни лимфни јазли
  • метиленско плаво
Open Access

MMPI for Personality Characteristics of Patients with Different Diseases / MMPI За Психолошките Разлики Кај Пациенти Со Разни Заболувања

Published Online: 16 Jun 2015
Page range: 153 - 164

Abstract

Abstract

In the field of psychosomatic medicine the relationship between personality characteristics and diseases is supposed to be an important issue.

The aim of this article is to present group’s MMPI profiles obtained for patients with different chronic diseases and to discuss about possible specific features of these different groups.

We summarized results obtained by psychological testing of following groups of patients: adult patients treated with chronic maintenance dialysis, patients with diabetic retinopathy, general anxiety group, attack panic syndrome, parents of children with rheumatoid arthritis, as well as adolescents with mental anorexia, cystic fibrosis, diabetes mellitus and leukemia. Two control groups comprised adults and adolescents, both without any health problems, selected randomly. As a psychometric test MMPI-201 was used. Statistic 10 package is used for statistical analysis.

In our presentation it can be seen some typical personality characteristics for patients with chronic conditions. These findings could be helpful for clinicians concerning treatment planning and followup. In general, the MMPI helps us to obtain a global, factual picture from the self-assessment of the patient, explained in a psycho-technical language. Group’s profile could be used in clinical practice for planning treatment and to suppose the prognosis of the illness.

Keywords

  • personality profile
  • MMPI-201
  • chronic diseases

Клучни зборови

  • профили на личност
  • MMPI-201
  • хронични болести
Open Access

Basics of the Ascetical (Christian) Psychotherapy/ Основи Н-Л. Ас Кетската (Христшанска) Психотерапша

Published Online: 16 Jun 2015
Page range: 165 - 173

Abstract

Abstract

It is obvious that contemporary man is suffering. His sufferings often seem pointless and causeless. Modern science more and more comes to reveal and acknowledge that human sufferings have a psychosomatic basis. In some of the cases, these sufferings are noogenic neuroses. They do not originate from the psychological dimension but from the noological or spiritual one of human existence. Тhe pointlessness of life is the basic cause for the noogenic neurosis and depression from which the humankind suffers. Hence, the many escapes from such experienced reality into various addictions. Possible way towards healing is to retrieve one’s meaning of life, to strengthen his will to meaning. Religion has always been-and still remains-a powerful and appealing purpose that fulfills the life and being of the believers. This article demonstrates the systematization of the spiritual development of a person presented in a table of the harmony of the ascetic-hesychastic struggle, according which everyone can find his place on the ladder of spiritual development, become aware, and reconciliate the mode of personal struggle according to his spiritual development. The reconciliation of the primary function of the mind with its secondary function-the intellect, is of an essential importance. Contemporary religious psychology do not regard man merely as a biological or a psychological being. The subject matter of research is the human being as a whole, as a spiritual person that is characterized by autonomy, regarding the biological and psychological processes. The importance of understanding the spiritual level of human existence enables holistic approach and experiencing of the human personality as a whole. Furthermore, it offers new perspectives of psychotherapeutic action not only within the range of the classical psychotherapeutic modalities but also within the range of the applied Christian Psychotherapy.

Keywords

  • noogenic neurosis
  • reconciliation of the mode of life according to one’s spiritual development
  • ascetical-hesychastic struggle
  • healing

Клучни зборови

  • ноогена невроза
  • усогласување на начинот на живот со степенот на духовниот развој
  • аскетско-исихастички подвиг
  • исцеление
Open Access

Serum Cortisol and DHEA-S Levels in Schizophrenic Patients with Different Response to Antipsychotic Therapy: Association with Psychopathology / Серумски Концентрации На Кортизол И DHEA-S Кал Пациенти Со Шизофренша Со Различен Одговор На Антипсихотичната Терапша Асоци.1Аци.1А Со Психопатологшата

Published Online: 16 Jun 2015
Page range: 175 - 182

Abstract

Abstract

Background: Previous studies suggested that alterations in serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Imbalance in serum cortisol and DHEA-S levels may be related to responsivity to antipsychotic treatment.

Aim: To compare serum cortisol and DHEA-S levels between patients with schizophrenia and healthy controls and to evaluate their association with psychopathology in schizophrenic patients with different response to antipsychotic treatment.

Material and Methods: This clinical prospective study included 60 patients with schizophrenia and 40 healthy age and sex matched controls. All patients experienced an acute exacerbation of the illness (PANSS: P1 and P3 ≥ 4). Clinical evaluation of patients was performed using the Positive and Negative Symptom Scale. A questionnaire for socio-demographic and clinical data collection was used. For the purposes of the study, the examined group was divided in two subgroups: responders and nonresponders. Serum cortisol and DHEA-S levels were measuredat baseline in all participants and after 3 and 6 weeks of the antipsychotic treatment in patients with schizophrenia.

Results: Patients with schizophrenia had significantly higher serum cortisol and DHEA-S levels comparedwith control group. Responders had significantly higher serum cortisol and DHEA-S levels compared with nonresponders. Responders group had significant correlation between serum cortisol and PANSS positive scale score as well as between hostility and serum DHEA-S.

Conclusion: Elevated serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Serum cortisol and DHEA-S are associated with psychopathology in schizophrenic patients with different response to antipsychotic therapy.

Keywords

  • schizophrenia
  • cortisol
  • DHEA-S
  • psychopathology
  • responders
  • nonresponders

Клучни зборови

  • шизофреника
  • кортизол
  • ОНЕА-8. психопатологи|а
  • позитивен одговор
  • негативен одговор.
Open Access

Neutrophil Functional Disorder in Childhood/ Функционални Нарушувања На Неутрофилите Во Детството

Published Online: 16 Jun 2015
Page range: 183 - 190

Abstract

Abstract

Neutrophil functional disorders thought to be uncommon, yet important as a cause of morbidity and mortality in infants and children. During the first years of life, when the immune system is still not completely mature, when the viral infections are frequent and antibiotic overuse can damage and alter the immune response, the inadequate nutrition followed with iron deficient anemia and malnutrition can lead the child`s organism in state of immunodeficiency. Sometimes is difficult to distinguish at the beginning weather the cause of patient suffering from frequent infections is existing of primary immunodeficiency disorder or the cause of the immunodeficiency state is just from exogenous factors.

Fortunately, primary immune deficiencies are rare diseases and only 6-7% of all of them, due to the neutrophilic functional disorders. Unfortunately, many exogenous and environmental factors have influence to the immune system, and the percentage of secondary caused neutrophilic functional disorders is much higher and should be considered when children are investigated for immunodeficiency. So, when to suspect neutrophil functional disorder? The hallmarks for diseases related to the neutrophilic functional disorders are discussed in this article.

Keywords

  • neutrophil
  • phagocytosis
  • NBT test
  • Neutrophil function
  • Neutrophil functional disorder
  • malnutration

Клучни зборови

  • неутрофил
  • фагоцитоза
  • НБT-тест
  • неутрофилна функција
  • функционални нарушувања на неутрофилите
  • малнутриција
Open Access

Depression of Neutrophil Function Followed by Severe Infection in a Child with Marasmic Kwashiorkor/ Намалување На Неутрофилната Функција Придружена Со Тешка Инфекција Кај Дете Со Маразмичен Квашиоркор

Published Online: 16 Jun 2015
Page range: 191 - 195

Abstract

Abstract

Malnutrition in childhood continues to be one of the most important risk factor for secondary immunodeficiency in the world; therefore one should think of existence of malnutrition in a child suffering of frequent infections, not only in developing country, rarely but still possible in developed country also.

Undernourishment in the early childhood is a trigger for starting a vicious cycle of impaired immunity, recurrent infections, and worsening malnutrition. Taking out from that cycle is an urgent and complex process, in which in parallel the infection should be controlled and the nutritional status solved out, and then, slowly follows the restoration of the immune system.

We present a patient at the age of 13 months, with marasmic kwashiorkor accompanied by severe infection manifested with sepsis. The laboratory investigations revealed severe anaemia, hypoproteinemia and impaired immunological response, first of all neutrophil dysfunction with decreased oxidative metabolic response during the phagocytosis, paralyzed first line of defense of the organism and open possibility for bacterial or fungal invasion, multiorgan failure and high risk for fatal outcome. Because malnutrition and infections had many causes, only multiple and synergistic interventions embedded in true multisectoral programs, fortunately, were effective and got positive outcome.

Keywords

  • malnutrition
  • marasmic kwashiorkor
  • neutrophil dysfunction
  • NBT test
  • infections

Клучни зборови

  • неисхранетост
  • маразмичен квашиор- кор
  • неутрофилна дисфункција
  • NBT-тест
  • инфекции
Open Access

Body Mass Index, Underweight and Overweight in Children 3 to 5 Years of Age from Skopje/ Индекс На Телесната Тежина, Неисхранетост И Прекумерна Исхранетост Кај Деца На 3–5 Години Од Скопје

Published Online: 16 Jun 2015
Page range: 197 - 203

Abstract

Abstract

The aim of this research is to present body mass index (BMI) data in children 3-5 years of age from Skopje and provide the information on the prevalence of different categories of nutritional status during the early childhood.

Material and methods: The study included 420 preschool children (210 boys and 210 girls). Stature and body weight were measured, and the BMI value was calculated. Twelve anthropometric parameters were measured using standard equipment and measurement technique according to the International Biological Programme.

Results: The majority of anthropometrical parameters have shown significant age and sex specific differences in favor of male subjects. Values at the 50th percentile in our male subjects aged 3, 4 and 5 years for the weight-for-age index were 19 kg, 19.1 and 21 kg, respectively whereas in the female subjects the corresponding values were 16.8 kg, 20 kg and 21 kg. The height-for-age index values corresponding to the 50th percentile showed slightly higher values in our male subjects (100 cm, 109.5 cm and 116 cm) than those in our female subjects (102 cm, 108.5 cm and 116 cm). The values of 50th percentile of BMI in our males subjects were 18.1 kg/m², 16.2 kg/m² and 16 kg/m² whereas in our females were 16.5 kg/m², 16.7 kg/m² and 16.4 kg/m².

Conclusion: These results show that underweight is a health problem of the rising generation in Skopje and needs to be considered along with the problem of overweight. It is recommended that the detected values could be applied for evaluation of deviations in growth and nutritional status in children aged 3-5.

Keywords

  • anthropometry
  • preschool children
  • underweight
  • overweight.

Клучни зборови

  • антропометрија
  • претшколски деца
  • неисхранетост
  • прекумерна исхранетост
Open Access

Emanuel Syndrome (Es): New Case-Report and Review of the Literature/ Емануел Синдром (Es): Презентација На Нов Случај И Преглед На Литературата

Published Online: 16 Jun 2015
Page range: 205 - 208

Abstract

Abstract

Multiple congenital anomalies and craniofacial dysmorphism are characterizing the so-called Emanuel or supernumerary der(22)t(11;22) syndrome (OMIM609029). Mental and developmental retardation are major clinical features. The der(22) may arise from a parental balanced t(11;22)(q23;q11.2) or can be created de novo.

Here we present a 2 years old boy with normal prenatal history, cyanotic at delivery and with ear anomalies, a preauricular tag, high-arched palate and micrognathia. There were neither microcephaly, nor heart or kidney defects. Psychological and motor testing at the age of 2 years confirmed significant mental and developmental delay. In addition, the child had seizures and an abnormal electroencephalogram. Cytogenetic and molecular analyses revealed a karyotype 47,XY,+der(22)t(11;22)(q23;q11.2). As parents refused further tests it could not be determined if the der(22) arose de novo or was parentally derived.

Overall the present report should alert physician to offer cytogenetic and/or molecular diagnostics in comparable cases.

Keywords

  • Emanuel syndrome
  • congenital anomalies
  • derivative chromosome 22 {der(22)t(11;22)}.

Клучни зборови

  • Емануел синдром
  • вродени анома- лии
  • дериват хромозом 22 {дер(22)t(11;22)}.
Open Access

Severe Scoliosis, Torticollis and Short Stature in a Woman with Wildervanck Syndrome (WS)/ Изразена Сколиоза, Тортиколис И Низок Раст Кај Жена Со Wildervanck Syndrome (Синдром На Вилдерванк)

Published Online: 16 Jun 2015
Page range: 209 - 211

Abstract

Abstract

Wildervanck syndrome (WS) combines features of Klippel-Feil syndrome (KFS), sixth nerve palsy, and deafness. This is a case of a 23 year old woman, diagnosed with KFS (a triad of short neck, low posterior hairline and restricted neck movements) at the age of 20 days. The manifestations of the WS in this patient are severe: she has torticollis, and an extremely severe scoliosis. In addition, she is short (-3 SD; parental target height + 0.8SD) and has mixed sensorineural and conductive deafness. She also has ptosis, strabismus and a high myopia. Radiologically, there are multiple coalitions of cervical vertebrae. Intelligence is unaffected (IQ 95), but deafness, strabismus and high myopia forced her early out of school. Karyotype is 46, XX. In brief, this is a patient with severe WS and additional anomalies. Short and/or reduced parental target height is a part of WS.

Keywords

  • Wildervanck syndrome
  • short stature
  • Duane retraction syndrome
  • Klippel Feil anomaly
  • deafness
  • torticollis
  • severe scoliosis.

Клучни зборови

  • Wildervanck syndrome
  • низок раст
  • Duane ретракционен синдром
  • Klippel Feil аномија
  • глувост
  • тортиколис
  • тешка сколиоза.
Open Access

Renal Dysplasia in Bardet-Biedl Syndrome/ Бубрежна Дисплазија Кај Бардет Бидл Синдром

Published Online: 16 Jun 2015
Page range: 213 - 217

Abstract

Abstract

Background: Bardet-Biedl syndrome (BBS) is a multisystem genetic disorder characterized with central obesity, pigmentary retinopathy, polydactyly, mental retardation, and hypogenitalism. Renal abnormalities have been recognized as a cardinal feature of the disease with serious prognostic implication. The aim of this study was to analyze the renal status in children with BBS and to implement appropriate interventions in those with progressive course

Patients and methods: The diagnosis of BBS was established on the basis of criteria proposed by Beales et al. (J Med Genet 1999). Imaging of the kidneys and urinary tract was performed with ultrasound study, Tc99mDMSA scan and a cystographic study. Twenty four hour urine collections were obtained for estimation of proteinuria and creatinine clearance. Blood pressure was monitored at clinical visits or as 24-hour ambulatory monitoring.

Results: There were 4 children (2 males, 2 females). All four children displayed abnormal kidney ultrasound and Tc99mDMSA scan resembling dysplastic kidney(s). Two of them had overt proteinuria (glomerulo-tubular pattern). Three children had normal blood pressure and glomerular filtration rate (GFR): 107, 145 and 95 ml/min/1.73m2, and the fourth had hypertension and progressive worsening of the GFR at 65 ml/min/1.73m2. Conclusion: Children with BBS should undergo imaging studies of the kidneys and urinary tract at initial work up; in those with renal dysplasia proteinuria, GFR and blood pressure should be regularly monitored to slow down progression to terminal renal failure.

Keywords

  • Bardet Biedl syndrome
  • renal dysplasia
  • chronic kidney disease
  • proteinuria
  • hypertension.

Клучни зборови

  • Бардет Бидл синдром
  • бубрежна дисплазија
  • хронична бубрежна болест
  • протеинури- ја
  • хипертензија
Open Access

Synchronous Occurrence of Ileal Stromal Tumor (GIST) and Colonic Adenocarcinoma: A Case Report/ Синхроно Јавување На Илеален Стромален Тумор (Гист) И Аденокарцином На Колон – Приказ На Случај

Published Online: 16 Jun 2015
Page range: 219 - 223

Abstract

Abstract

Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. The most reported cases include gastric synchronous occurrence of gastrointestinal stromal tumors and adenocarcinoma and gastric gastrointestinal stromal tumors and colonic adenocarcinoma.

Case report: We present a case of a 77-old female, with synchronous cecal moderately differentiated adenocarcinoma in Stage IIA according to the TNM classification and ileal spindle cell type GIST with low malignant potential, positive for c-Kit, CD34, vimentin, Actin, and negative for S100.

Conclusion: The synchronous occurrence of small bowel gastrointestinal stromal tumors and other primary gastrointestinal malignancies has been rarely reported. There is a need of further investigations to identify the relationship between gastrointestinal stromal tumors and colorectal cancers.

Keywords

  • gastrointestinal stromal tumors
  • adenocarcinoma
  • colon

Клучни зборови

  • гастроинтестинален стромален ту- мор
  • аденокарцином
  • колон
Open Access

Evaluation of Different in Vitro Testing Methods for Mechanical Properties of Veneer Ceramics/ Евалуација На Тестовите In Vitro За Одредување На Механичките Особини На Порцеланските Маси За Фасетирање

Published Online: 16 Jun 2015
Page range: 225 - 230

Abstract

Abstract

Metal-ceramic and all-ceramic prosthetic restorations in the patient mouth are often damaged by esthetic and functional problems that reduce their success and longevity.

Аim: To evaluate methods for testing mechanical characteristics of dental ceramics through analysis of different testing methods.

Material and methods: Dental ceramic materials are tested with in vivo and in vitro methods for their most important mechanical characteristics: hardness, toughness, flexural strength and abrasion. In vitro testing methods are faster and more efficient, without subjective factors from the patient according to ISO standards. Testing is done with universal testing machines, like Zwick 1445, Universal Testing Machine (Zwick DmbH & Co.KG, Ulm, Germany), Instron 4302 (Instron Corporation, England), MTS Sintech ReNew 1123 or in oral chewing simulators.

Results: According to the testing results, flexure strength is one of the most important characteristic of the dental ceramic to be tested, by the uniaxial and biaxial tests. Uniaxial tests three-point and four-point flexure are not most appropriate because the main stress on the lower side of the tested specimens is tension that causes beginning fractures at the places with superficial flow. Uniaxial results for flexural strength are lower than actual force, while with biaxial test defects and flows on the edges of tested specimens are not directly loaded.

Conclusion: Biaxial flexural method has advantages over uniaxial because of real strength results, but also for simple shape and preparing of the testing specimens.

Keywords

  • dental ceramics
  • dental crowns
  • bridges
  • testing methods
  • flexural strength.

Клучни зборови

  • дентална керамика
  • коронки
  • мос- тови
  • тестирачки методи
  • сила на свиткување
Open Access

International Nephrology Days/ Меѓународни Нефролошки Денови

Published Online: 16 Jun 2015
Page range: 231 - 233

Abstract

Abstract

The International Nephrology Days in honor of the 75th anniversary of Academician Momir Polenakovic and 50 years of his scientific work were held in the Macedonian Academy of Sciences and Arts (MASA) on 26 and 27 September 2014. Organizers of the meeting were the Macedonian Academy of Sciences and Arts and the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO). The days were programmed with the VII Macedonian-Croatian Nephrology Meeting and the Continuing Medical Education (CME) Course on "Renal Replacement Therapy - when & how - update on the outcome and cost-efficacy" organized by the MSNDTAO in cooperation with the European Renal Association (ERA-EDTA). Prominent academicians, researchers and nephrologists from Europe and neighboring countries contributed with their lectures and discussion at this scientific event. On September 26, 2014 the opening talk was given by Acad. V. Kambovski, President of the MASA, about the Life and Work of Academician Momir Polenakovic. In honor of his anniversary and valuable scientific opus, during the meeting Acad. Momir Polenakovic was awarded with Certificate of the European Renal Association (ERA-EDTA) for his significant role in the development of nephrology in the Balkan region and couple of other diplomas and acknowledgement. Prof. Polenakovic is founder of the MSNDTAO and his lifetime honorary president.

Keywords

  • anniversary
  • nephrology
  • scientific work
  • renal replacement therapy.

Клучни зборови

  • годишнина
  • нефрологија
  • научна работа
  • бубрежна заменска терапија
26 Articles
Open Access

Publication Ethics: What Next?

Published Online: 16 Jun 2015
Page range: 4 - 4

Abstract

Open Access

Proteomics in Diagnosis of Prostate Cancer/ Протеомика Во Дијагноза На Простатниот Карцином

Published Online: 16 Jun 2015
Page range: 5 - 36

Abstract

Abstract

Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. The introduction of prostate specific antigen (PSA) has greatly increased the number of men diagnosed with PCa but at the same time, as a result of the low specificity, led to overdiagnosis, resulting to unnecessary biopsies and high medical cost treatments.

The primary goal in PCa research today is to find a biomarker or biomarker set for clear and effecttive diagnosis of PCa as well as for distinction between aggressive and indolent cancers. Different proteomic technologies such as 2-D PAGE, 2-D DIGE, MALDI MS profiling, shotgun proteomics with label-based (ICAT, iTRAQ) and label-free (SWATH) quantification, MudPIT, CE-MS have been applied to the study of PCa in the past 15 years. Various biological samples, including tumor tissue, serum, plasma, urine, seminal plasma, prostatic secretions and prostatic-derived exosomes were analyzed with the aim of identifying diagnostic and prognostic biomarkers and developing a deeper understanding of the disease at the molecular level.

This review is focused on the overall analysis of expression proteomics studies in the PCa field investigating all types of human samples in the search for diagnostics biomarkers. Emphasis is given on proteomics platforms used in biomarker discovery and characterization, explored sources for PCa biomarkers, proposed candidate biomarkers by comparative proteomics studies and the possible future clinical application of those candidate biomarkers in PCa screening and diagnosis. In addition, we review the specificity of the putative markers and existing challenges in the proteomics research of PCa.

Keywords

  • Prostate cancer
  • benign prostate hyperplasia
  • diagnostics biomarkers
  • comparative proteomics
  • gel-based proteomics
  • shotgun proteomics

Клучни зборови

  • канцер на простата
  • бенигна прос- татна хиперплазија
  • дијагностички биомаркери
  • ком- паративна протеомика
  • гел-базирана протеомика
  • shotgun- протеомика
Open Access

A Review of the Role of Exercise and Factors Affecting its Uptake for People with Chronic Kidney Disease (Ckd) not Requiring Renal Replacement Therapy/ Преглед На Улогата На Вежбањето И Факторите Што Влијаат На Неговата Примена Кај Лица Со Хронична Бубрежна Болест (Хбб) За Кои Не Е Потребна Бубрежна Заменска Терапија

Published Online: 16 Jun 2015
Page range: 37 - 46

Abstract

Abstract

Chronic Kidney Disease (CKD) is a long-term progressive condition affecting 10-15% of people. The overlap of diabetes, hypertension and CKD in an aging population means that prevalence will only increase. CKD increases the risk of all-cause mortality, secondary to the elevated cardiovascular risk. It also significantly affects the patients’ ability to engage in functional activities and their quality of life.

The evidence base suggests that exercise has the capacity to improve symptom burden, functional ability and mental health. The majority of the patient population are pre-dialysis yet previous research has concentrated on dialysing patients. This review will focus on the patient group not requiring renal replacement therapy (non-RRT) as this is an area where further work is urgently needed.

A large majority of people with CKD tend to be inactive despite emerging guidelines emphasising the positive effect of exercise for both people with chronic disease and healthy populations. This paper will review the evidence to support exercise to improve outcomes and quality of life and report on common barriers that patients experience and advocate the need for supported exercise interventions to help patients become more active and gain the potential resultant health benefits.

Keywords

  • kidney disease
  • exercise
  • quality of life

Клучни зборови

  • болести на бубрезите
  • вежбање
  • квалитет на животот.
Open Access

A Survey of Solitary Deaths in Japan for Shortening Postmortem Interval Until Discover/ Студија На Смртни Случаи На Самци Во Јапонија За Скратување На Постмортем Интервалот До Откривањето

Published Online: 16 Jun 2015
Page range: 47 - 51

Abstract

Abstract

Recently in advanced nations, the number of solitary households is increasing. Data from Japanese population survey in 2010 showed that the percent of solitary households was 32.4% and that was the largest category of household types. The Japanese government regards solitary death as important problem, but a useful survey on solitary death has not been performed. We have focused on the postmortem interval until discovery of the death as a measure of solitary deaths.

We conducted a survey of 582 forensic autopsy cases in the Osaka medical examiner’s office over three years, from April in 2010 till March in 2012. We excluded suicide cases. We collected data on the, gender, age, postmortem interval (PMI) until discovery, family structure, situation of discovery of the body, cause of death, and the time interval from the last hospital visit.

Here, we found that people who had high risk of solitary death ranged in, age from 60 to 69 which is the age of retirement for many people. In order to prevent solitary death, we suggest that people who live alone should take better care of themselves and participate in a community setting after their retirement. We can show that the recent efforts of the Japanese government for reducing solitary death had been working well. The government care givers take care of the person living alone almost like their own family. We also suggest that the people who unfortunately do not have any home care should subscribe to a newspaper for shortening the PMI.

Keywords

  • Solitary death
  • Postmortem interval
  • Periodic hospital care.

Клучни зборови

  • смрт на самци
  • постмортем интер- вал
  • периодична болничка нега
Open Access

Pharmacogenetics and Antipsychotic Treatment Response/ Фармакогенетски Тестирања И Одговор Кон Третман Со Антипсихотоци

Published Online: 16 Jun 2015
Page range: 53 - 67

Abstract

Abstract

Antipsychotic drugs are widely used in the treatment of schizophrenia and psychotic disorder. The lack of antipsychotic response and treatment-induced side-effects, such as neuroleptic syndrome, polydipsia, metabolic syndrome, weight gain, extrapyramidal symptoms, tardive dyskinesia or prolactin increase, are the two main reasons for non-compliance and increased morbidity in schizophrenic patients. During the past decades intensive research has been done in order to determine the influence of genetic variations on antipsychotics dosage, treatment efficacy and safety. The present work reviews the molecular basis of treatment response of schizophrenia. It highlights the most important findings about the impact of functional polymorphisms in genes coding the CYP450 metabolizing enzymes, ABCB1 transporter gene, dopaminergic and serotonergic drug targets (DRD2, DRD3, DRD4, 5-HT1, 5HT-2A, 5HT-2C, 5HT6) as well as genes responsible for metabolism of neurotransmitters and G signalling pathways (5-HTTLPR, BDNF, COMT, RGS4) and points their role as potential biomarkers in everyday clinical practice. Pharmacogenetic testing has predictive power in the selection of antipsychotic drugs and doses tailored according to the patient’s genetic profile. In this perception pharmacogenetics could help in the improvement of treatment response by using different medicinal approaches that would avoid potential adverse effects, reduce stabilization time and will advance the prognosis of schizophrenic patients.

Keywords

  • Pharmacogenetics
  • antipsychotics
  • schizophrenia
  • biomarkers
  • CYP450
  • P-glycoprotein
  • serotonergic receptors
  • dopaminergic receptors
  • COMT
  • BDNF

Клучни зборови

  • фармакогенетика
  • шизофренија
  • биомаркери
  • CYP450
  • П-гликопротеин
  • сeротонински рецептори
  • допамински рецептори
  • COMT
  • BDNF
Open Access

Expression of p53 Protein Product in Triple Negative Breast Cancers and Relation with Clinical and Histopathological Parameters/ Експресија На Р53 Протеинскиот Продукт Кај Тројно Негативните Карциноми На Дојка Во Сооднос Со Клиничките И Хистопатолошките Параметри

Published Online: 16 Jun 2015
Page range: 69 - 79

Abstract

Abstract

Introduction: "Triple" negative breast cancer is a subgroup of so-called basal-like breast cancer. They are represented with 15% of all breast cancers, characterized with lack of hormone receptor as well as with negative expression of HER2 test. These tumors are more frequent in Afro-Americans and Latin-Americans, in patients with BRCA1 mutations and in patients with recent delivery. The aim of this study is to present the immunohistochemical and clinico-pathological characteristics of the triple negative breast cancer and their correlation with expression of the protein product of the tumor suppressor gene p53.

Methods: A retrospective analyses of 24 patients with triple negative breast cancer was performed. All of the patients were evaluated in the Histopathological Laboratory of the Clinical Hospital Sistina, during the period from June 2009, until June 2011. The standard immunohistochemical procedures, including the hormone receptor status, HER2 status, proliferative index - Ki67 and p53 gene protein product were performed, as well as additional immunohistochemical staining for socalled basal keratins (Cytokeratin 5/6 and high molecular weight cytokeratin 34BE12).

Results: The age of the patients ranged from 29-77 years. Positive lymph nodes were found in 14 (59%) patients. The tumor was poorly differentiated in 19 patients (79%). Overexpression of the p53 protein product was evaluated in 19 (79%) of the cases. All p53 negative patients (5/5) had poorly differentiated tumors (G3), associated with positive regional lymph nodes. The p53 positive group expressed quite opposite correlation, only 9/19 (47%) were with positive lymph nodes (p = 0.03). The expression of p53 protein product was also associated with the nuclear grade (p = 0.005), the mitotic index (p = 0.001), lymph-vascular invasion (p = 0.005) and with the proliferation index Ki67 (p = 0.003). There was a trend for association with the tumor size - pT (p = 0.05).

Conclusion: According to the results, the triple negative breast cancers are subgroup of the poorly differentiated neoplasms frequently associated in the younger age groups. The majority of these have overexpression of the p53 protein product, which in other hand, are inversely correlated with lymph nodes metastases. Hence, the necessity of enriching the immunohistochemical protocol of these patients with new antibodies, in order to evaluate their expression, which would be helpful for prediction the outcome of different therapeutical modalities.

Keywords

  • breast cancer
  • triple negative
  • p53 protein product

Клучни зборови

  • карцином на дојка
  • тројно негати- вeн тумор супресорски ген р53
Open Access

Morphological Characteristics of the Superior Cerebellar Artery/ Морфолошки Карактеристики На Горната Церебеларна Артерија

Published Online: 16 Jun 2015
Page range: 80 - 84

Abstract

Abstract

With the introduction of new techniques in diagnostic and interventional radiology and progress in micro neurosurgery, accurate knowledge of the brain blood vessels is essential for daily clinical work. The aim of this study was to describe the morphological characteristics of the superior cerebellar artery and to emphasize their clinical significance.

In this study we examined radiographs of 109 patients who had CT angiography at the University Clinic for Radiology in Skopje, R. Macedonia. This study included 49 females and 60 males, ranging in age from 27 to 83 years; mean age 57.4 ± 11.8 years.

In 105 patients SCA arose from the basilar artery on both sides as a single vessel. In two patients SCA arose as a duplicate trunk from the basilar artery. We found unilateral duplication on the right SCA in one patient, and bilateral duplication in one patient. In two patients was noticed origin of the SCA from PCA as a single trunk from adult type of the PCA.

Through knowledge of the anatomy and variations of SCA is important for clinicians as well as basic scientists who deal with problems related to intracranial vasculature in daily basis for save performance of diagnostic and interventional procedures.

Keywords

  • superior cerebellar artery
  • anatomy
  • variations
  • basilar artery.

Клучни зборови

  • горна церебеларна артерија
  • анато- мија
  • варијации
  • базиларна артерија
Open Access

Protective Effects of At1-Receptor Blocker and Ca Antagonist Combination on Renal Function in Salt Loaded Spontaneously Hypertensive Rats/ Протективни Ефекти На Комбинацијата На Ат1 Рецепторен Блокатор И Калциум Антагонист Врз Реналната Функција Кај Спонтано Хипертензивни Стаорци Оптоварени Со Сол

Published Online: 16 Jun 2015
Page range: 85 - 91

Abstract

Abstract

Salt sensitive hypertension is known to be a contributing factor for the progression of kidney disease. This study was undertaken to investigate the role of excessive dietary salt on renal function and to evaluate the effect of valsartan and amlodipin given as a combination therapy on blood pressure and parameters specific to the renal function in salt loaded SHR rats. 48 male SHR rats at age of 20 weeks and body weight ranging between 270-350 g were used. SHR rats were divided into 3 groups: control group of rats -SHRC (n = 16) given tab water ad libitum and two salt treated groups in which tab water was replaced with a solution of NaCl (1%) from age of 8 weeks given ad libitum: SHRVAL+AMLO group (n = 16) where investigated drugs were administered at a dose of 10 mg/kg/ b.w. (valsartan) and 5 mg/kg/ b.w. (amlodipin) by gavage and SHR NaCl group (n = 16) that received saline in the same volume and the same time intervals as the SHRVAL+AMLO group. For a period of 12 weeks we have investigated the effect of the VAL+AMLO drug combination on systolic blood pressure (SBP), body weight and renal function tests. Salt loading with 1% solution in the SHR NaCl group has lead to significant increase of blood pressure, proteinuria and decrease in creatinine clearance. Combined treatment with АТ1-receptor blocker and calcium antagonist has managed to control blood pressure and ameliorated renal damage.

Keywords

  • Salt loading
  • SHR rats
  • renal function
  • valsartan
  • amlodipin

Клучни зборови

  • оптоварување со сол
  • бубрежна функција
  • СХР-стаорци
  • валсартан
  • амлодипин.
Open Access

Novel Ret Mutations in Macedonian Patients with Medullary Thyroid Carcinoma: Genotype-Phenotype Correlations/ Нови Ret-Мутации Кај Македонски Пациенти Со Медуларен Карцином На Тироидната Жлезда: Генотипско-Фенотипски Корелации

Published Online: 16 Jun 2015
Page range: 93 - 107

Abstract

Abstract

Medullary thyroid carcinomas (MTCs) are rare neoplasms comprising 2-10% of all thyroid malignnancies. More than 75% are sporadic tumors and the remainder is familial and MEN2 related. Both sporadic and syndromic MTCs frequently show mutations in the RET proto-oncogene. It has been noted that some MTC cases present an indolent, and some an aggressive clinical course. Ki-67 expression is generally low, with documented exceptions, whereas high expression of Bcl-2 has been reported in majority of the cases. Some studies have shown that Ki-67 and Bcl-2 expressions have prognostic value, as well as RET mutational status. We analyzed 20 unrelated MTC cases for Ki-67, Bcl-2 expression and RET mutations and tested their intercorrelations, correlations to the morphologic features and stage of the tumors, as well as their influence on survival. In 13 of the 20 analyzed cases we found 23 sequence changes distributed in exons 8, 10-13 and 16. There were 11 different missense mutations, single nucleotide deletion with frameshift, and 8 different synonymous mutations. Only 4 of the sequence changes have been previously published. Twelve patients (60%) had tumors expressing one or more missense mutations or single nucleotide deletion and 7 of them (35%) had at least one damaging or possibly damaging RET mutation. Most of the tumors had low Ki-67 expression (mean 6.48% of cells) and high Bcl-2 expression (mean 68.3%). Significantly better survival was observed in cases with low Ki-67 (< 6.5%; p < 0.05), high Bcl-2 expression (> 68.3%; p < 0.01) and younger age at diagnosis (< 51 years; p < 0.05).

Keywords

  • RET mutations
  • Medullary thyroid carcinoma
  • Ki-67
  • Bcl-2.

Клучни зборови

  • RET-мутации
  • медуларен карци- ном на тироидна жлезда
  • Ki-67
  • Bcl-2.
Open Access

Single Nucleotide Polymorphisms of the Inflamatory Cytokine Genes: Interleukin-1B, Tumor Necrosis Factors-A and Tumor Necrosis Factor-B in Adult Patients with Immune / Thrombocytopenia Единечни Нуклеотидни Полиморфизми Во Цитокинските Гени: Интерлеукин-1Б, Тумор Некрозис Фактор-А И Тумор Некрозис Фактор-Б Кај Пациенти Со Имуна Тромбоцитопенија

Published Online: 16 Jun 2015
Page range: 109 - 115

Abstract

Abstract

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by thrombocytopenia due to platelet autoantibodies, causing an accelerated clearance of opsonized platelets by phagocytes. The etiology of ITP remains unclear, both genetic and environmental factors may have a role in the disease development. The aim of our study was to investigate a possible association of three single nucleotide polymorphisms (SNP) in the genes for interleukin beta (IL1B-511C/T), tumor necrosis factor beta (TNF+252G/A) and tumor necrosis factor alpha (TNFA-308G/A) with ITP. We have analyzed 125 adult patients with ITP and 120 healthy matched controls. Genotyping was performed by using PCR- RFLP methods.

Our results demonstrated significantly different genotype distributions and allele frequencies for TNFB+252G/A in patients with ITP, p = 0.005 and p = 0.009 with Yates correction. We did not find any significant differences in the genotype distribution or allele frequencies for the other two genes. We have found significantly different genotype distribution and allele frequencies for TNFA- 308G/A between patients with unresponsive and responsive ITP patients, p = 0.016 and p = 0.009. There were no significant differences in genotype distribution and allele frequencies for ILB-511C/T and TNFB+252G/A polymorphisms between those two groups of patients. We did not find any significant differences in genotype distribution and allele frequencies for all three polymorphisms between splenectomized and unsplenectomized ITP patients.

The obtained data indicate that the A allele of TNFB+252G/A is more frequent in these patients than in the controls and that this polymorphism may play a significant role in disease susceptibility. The A allele of TNFA-308G/A was more frequent in patients with unresponsive ITP, indicating that this gene polymorphisms may contribute to therapy resistance.

Keywords

  • immune thrombocytopenia
  • thrombocytopenia
  • cytokine genes
  • single nucleotide polymorphisms.

Клучни зборови

  • имуна тромбоцитопенија
  • цито- кински гени
  • единечни нуклеотидни полимор- физми.
Open Access

Evaluation of Changes in Serum Concentration of Sodium in a Transurethral Resection of the Prostate/ Евалуација На Промените Во Серумската Концентрација На Натриум При Трансуретралнa Ресекција На Простатa

Published Online: 16 Jun 2015
Page range: 117 - 127

Abstract

Abstract

Introduction and objectives: The purpose of this study was to evaluate changes in serum electrolytes during Transurethral resection of the prostate (TURP) and to evaluate the degree of correlation of hyponatremia and the factors that affect the incidence of TURP syndrome and to show the impact of the duration of the procedure on the severity of hyponatremia due to absorption of irrigation fluid in the systemic circulation.

Materials and Methods: This study examined 60 male patients planned for elective TURP. The level of serum electrolytes are determined by taking venous blood samples preoperatively and Postoperatively and when the duration of the operation was longer than 60 minutes, the level of serum electrolytes was determined intraoperative. The amount of used irrigation fluid, the weight of resection prostate, and duration of surgery, were also followed. Patients were divided in two groups according to the length of the surgical procedure: Group 1 (30- 60 min) and Group 2 (> 60 min).

Results: Statistically significant reduction of serum sodium and the elevation of the potassium level in serum observed postoperatively and was directly proportional to the volume of of the used irrigation fluid, the duration of the procedure and volume of the resected prostate.

Conclusions: To evaluate changes in serum electrolyte during TURP is simple and economical method for the indirect estimation of irrigation fluid absorption into the systemic circulation during TURP and opportunity for early identification of TURP syndrome

Keywords

  • TURP
  • TURP syndrome
  • hiponatremia
  • hiperkalemia

Клучни зборови

  • TURP
  • TURP-синдром
  • хипонатре- мија
  • хиперкалемија.
Open Access

Operative Treatment of Degenerative Lumbar Spine Spondylolisthesis/ Оперативен Третман На Лумбосакрална Дегенреативна Спондилолистеза

Published Online: 16 Jun 2015
Page range: 129 - 135

Abstract

Abstract

Introduction: Management of degenerative lumbosacral spondylolisthesis with spinal stenosis is still controversial. Surgery is widely used, as well as non-surgical treatment. Aim: To evaluate the clinical results and functional outcome after operative treatment in Grade II and III lumbar spine spondylolisthesis.

Material and methods: Twelve patients with symptoms and image-confirmed degenerative spondylolisthesis entered the study. Mean patient age was 57 years. Spondylolisthesis Grade II or III, segment L4-L5 or L5-S1 were evaluated. All patients underwent similar protocols. Operative treatment was decompressive laminectomy, posterior one segment fixation, and fusion with autologous bone grafting. Functional outcome measures were Visual Analog Scale (VAS, 10-point scale) and Oswestry Disability Index (ODI, 100-percent scale) after 6 and 12 months.

Results: Patient follow-up was 12 months. Preoperatively, 7 patients had severe disability according to ODI, 4 had moderate disability. VAS measured 6 and 7 points in 6 patients, lowest score of 4 points and the highest score of 9. After 6 months, ODI showed 5 patients had minimal and 7 had moderate disability; 2 patients had 0 points on the VAS, 2 had a score of 1, 4 had a score of 2, highest score of 4 points. Treatment outcome effects after 1 year were 9 patients with minimal disability, 3 with moderate; VAS - 2 patients with O points, 3 with 1 point, 4 with 2 points.

Conclusion: Patients with degenerative spondylolisthesis and spinal stenosis treated surgically showed substantially greater improvement in pain and functional outcome during a period of 1 year.

Keywords

  • decompressive laminectomy
  • Oswestry Disability Index
  • spondylolisthesis
  • Visual Analog Scale

Клучни зборови

  • визуелна аналогна скала
  • деком- пресивна ламинектомија
  • Oswestry Disability Index
  • спондилолистеза.
Open Access

Can Oral Anaerobic Bacteria cause Adverse Pregnancy Outcomes?/ Дали Оралните Анаеробни Бактерии Можат Да Доведат До Лоши Опстетрички Исходи?

Published Online: 16 Jun 2015
Page range: 137 - 143

Abstract

Abstract

Aim: Maternal periodontal infection has been recognized as a risk factor for premature and low birthweight infants. It is suspected that pathogens causing periodontal disease may translocate to the amniotic cavity and so contribute to triggering an adverse pregnancy outcome. The aim of this study was to evaluate whether the presence of specific periodontal pathogens may influence the incidence of preterm labor and premature birth.

Material and Methods: This study was designed as a hospital-based case-control study. A total of 70 pregnant women, aged 18-40 with single live pregnancy were recruited from the Departement of Gynecolgy and Obstetrics at a General hospital in Sibenik, Croatia, between March 2013 to March 2014. The case group: 30 pregnant women who were hospitalised with signs of premature labor. Control group: 40 patients with normal pregnancy post-delivery up to 48 hrs, who had given birth at term, and the baby had a weight of more than 2500 gr. These women had undergone microbiological examination at the time of recruitment, microbial samples, paper point subgingival swabs were obtained in both groups and processed by anaerobic culturing. Standard procedures were used for culture and identification of bacteria. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may have influence the premature delivery.

Results: The levels of periodontal pathogens tended to be higher in the premature (case group) labor compared to the term deliveries (control group). Levels of Porphyromonas gingivalis, Fuscobacterium nucleatum, Actinomyces actinomycetecomitans were statistically significantly higher in premature births as compared to term deliveries, adjusting for baseline levels. The joint effects of red and orange microbial clusters were significantly higher in the premature group compared to the term group.

Conclusions: The study shows a significant association betwen periodontal anaerobic infection and adverse pregnancy outcome. High levels of periodontal pathogens during pregnancy are associated with an increased risk for preterm delivery. Further studies elucidating the role of the microbial load and maternal immune response as related to pregnancy outcome seem merited.

Keywords

  • oral anaerobic bacteria
  • preterm labor
  • preterm delivery

Клучни зборови

  • орални анаеробни бактерии
  • пре- течко предвремено породување (ППП).
Open Access

Sentinel Lymph Node Detection in Breast Cancer – First Experience/ Детекција На Сентинелни Лимфни Јазли Кај Карцином На Дојка – Први Искуства

Published Online: 16 Jun 2015
Page range: 145 - 151

Abstract

Abstract

Introduction: Breast cancer accouns for 22.9% of all cancers in women and 13.7% of cancer deaths. Positive axillary lymphnodes (ALN) predict the development of distant metastases. The status of the sentinel lymphnode (SLN) is crutial for the treatment selection.

Aim: To determine the benefits of SLN detection in patients with breast cancer. Material and methodology: 38 female patients (pts), age 44 ± 12 years, with T1-2 N0 M0 breast cancer, without enlarged ALN on ultrasound (US), were included. SLN detection was performed using gamma camera and gamma detection probe after periareolar subcutaneous and/or peritumoral injection of (99m-Technetium-SENTISCINT). Blue dye was administered 20 min before the operation. SLN was extirpated and ex tempore histopathology was performed.

Results: Ex tempore SLN evaluation was negative and the lymphatic pathways preserved in 28/38 (74%) pts. In 10/38 (26%) pts SLN was positive, followed by radical surgery. In 3/28 ex tempore negative patients, histopathological analysis showed metastatic involvement (false negative). In 3/10 ex tempore positive patients micro metastases 0,2-2 mm were detected. 12 pts had 2 SLN, 8/12 (66%) had negative and 4/12 (34%) had positive SLN. 3 pts had a rare double drainage to axilla and a. mammaria int.

Conclusion: Our results confirm that SLN detection technique is non-invasive, safe and reliable and should be incorporated into the guidelines for breast cancer pts (T1-2 N0 M0). The most reliable option for colloid application is the combined technique of periareolar and peritumoral injection. Patients with drainage to a. mammaria interna should be selected for adjuvant protocols.

Keywords

  • breast cancer
  • sentinel lymph node
  • blue dye.

Клучни зборови

  • карцином на дојка
  • сентинелни лимфни јазли
  • метиленско плаво
Open Access

MMPI for Personality Characteristics of Patients with Different Diseases / MMPI За Психолошките Разлики Кај Пациенти Со Разни Заболувања

Published Online: 16 Jun 2015
Page range: 153 - 164

Abstract

Abstract

In the field of psychosomatic medicine the relationship between personality characteristics and diseases is supposed to be an important issue.

The aim of this article is to present group’s MMPI profiles obtained for patients with different chronic diseases and to discuss about possible specific features of these different groups.

We summarized results obtained by psychological testing of following groups of patients: adult patients treated with chronic maintenance dialysis, patients with diabetic retinopathy, general anxiety group, attack panic syndrome, parents of children with rheumatoid arthritis, as well as adolescents with mental anorexia, cystic fibrosis, diabetes mellitus and leukemia. Two control groups comprised adults and adolescents, both without any health problems, selected randomly. As a psychometric test MMPI-201 was used. Statistic 10 package is used for statistical analysis.

In our presentation it can be seen some typical personality characteristics for patients with chronic conditions. These findings could be helpful for clinicians concerning treatment planning and followup. In general, the MMPI helps us to obtain a global, factual picture from the self-assessment of the patient, explained in a psycho-technical language. Group’s profile could be used in clinical practice for planning treatment and to suppose the prognosis of the illness.

Keywords

  • personality profile
  • MMPI-201
  • chronic diseases

Клучни зборови

  • профили на личност
  • MMPI-201
  • хронични болести
Open Access

Basics of the Ascetical (Christian) Psychotherapy/ Основи Н-Л. Ас Кетската (Христшанска) Психотерапша

Published Online: 16 Jun 2015
Page range: 165 - 173

Abstract

Abstract

It is obvious that contemporary man is suffering. His sufferings often seem pointless and causeless. Modern science more and more comes to reveal and acknowledge that human sufferings have a psychosomatic basis. In some of the cases, these sufferings are noogenic neuroses. They do not originate from the psychological dimension but from the noological or spiritual one of human existence. Тhe pointlessness of life is the basic cause for the noogenic neurosis and depression from which the humankind suffers. Hence, the many escapes from such experienced reality into various addictions. Possible way towards healing is to retrieve one’s meaning of life, to strengthen his will to meaning. Religion has always been-and still remains-a powerful and appealing purpose that fulfills the life and being of the believers. This article demonstrates the systematization of the spiritual development of a person presented in a table of the harmony of the ascetic-hesychastic struggle, according which everyone can find his place on the ladder of spiritual development, become aware, and reconciliate the mode of personal struggle according to his spiritual development. The reconciliation of the primary function of the mind with its secondary function-the intellect, is of an essential importance. Contemporary religious psychology do not regard man merely as a biological or a psychological being. The subject matter of research is the human being as a whole, as a spiritual person that is characterized by autonomy, regarding the biological and psychological processes. The importance of understanding the spiritual level of human existence enables holistic approach and experiencing of the human personality as a whole. Furthermore, it offers new perspectives of psychotherapeutic action not only within the range of the classical psychotherapeutic modalities but also within the range of the applied Christian Psychotherapy.

Keywords

  • noogenic neurosis
  • reconciliation of the mode of life according to one’s spiritual development
  • ascetical-hesychastic struggle
  • healing

Клучни зборови

  • ноогена невроза
  • усогласување на начинот на живот со степенот на духовниот развој
  • аскетско-исихастички подвиг
  • исцеление
Open Access

Serum Cortisol and DHEA-S Levels in Schizophrenic Patients with Different Response to Antipsychotic Therapy: Association with Psychopathology / Серумски Концентрации На Кортизол И DHEA-S Кал Пациенти Со Шизофренша Со Различен Одговор На Антипсихотичната Терапша Асоци.1Аци.1А Со Психопатологшата

Published Online: 16 Jun 2015
Page range: 175 - 182

Abstract

Abstract

Background: Previous studies suggested that alterations in serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Imbalance in serum cortisol and DHEA-S levels may be related to responsivity to antipsychotic treatment.

Aim: To compare serum cortisol and DHEA-S levels between patients with schizophrenia and healthy controls and to evaluate their association with psychopathology in schizophrenic patients with different response to antipsychotic treatment.

Material and Methods: This clinical prospective study included 60 patients with schizophrenia and 40 healthy age and sex matched controls. All patients experienced an acute exacerbation of the illness (PANSS: P1 and P3 ≥ 4). Clinical evaluation of patients was performed using the Positive and Negative Symptom Scale. A questionnaire for socio-demographic and clinical data collection was used. For the purposes of the study, the examined group was divided in two subgroups: responders and nonresponders. Serum cortisol and DHEA-S levels were measuredat baseline in all participants and after 3 and 6 weeks of the antipsychotic treatment in patients with schizophrenia.

Results: Patients with schizophrenia had significantly higher serum cortisol and DHEA-S levels comparedwith control group. Responders had significantly higher serum cortisol and DHEA-S levels compared with nonresponders. Responders group had significant correlation between serum cortisol and PANSS positive scale score as well as between hostility and serum DHEA-S.

Conclusion: Elevated serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Serum cortisol and DHEA-S are associated with psychopathology in schizophrenic patients with different response to antipsychotic therapy.

Keywords

  • schizophrenia
  • cortisol
  • DHEA-S
  • psychopathology
  • responders
  • nonresponders

Клучни зборови

  • шизофреника
  • кортизол
  • ОНЕА-8. психопатологи|а
  • позитивен одговор
  • негативен одговор.
Open Access

Neutrophil Functional Disorder in Childhood/ Функционални Нарушувања На Неутрофилите Во Детството

Published Online: 16 Jun 2015
Page range: 183 - 190

Abstract

Abstract

Neutrophil functional disorders thought to be uncommon, yet important as a cause of morbidity and mortality in infants and children. During the first years of life, when the immune system is still not completely mature, when the viral infections are frequent and antibiotic overuse can damage and alter the immune response, the inadequate nutrition followed with iron deficient anemia and malnutrition can lead the child`s organism in state of immunodeficiency. Sometimes is difficult to distinguish at the beginning weather the cause of patient suffering from frequent infections is existing of primary immunodeficiency disorder or the cause of the immunodeficiency state is just from exogenous factors.

Fortunately, primary immune deficiencies are rare diseases and only 6-7% of all of them, due to the neutrophilic functional disorders. Unfortunately, many exogenous and environmental factors have influence to the immune system, and the percentage of secondary caused neutrophilic functional disorders is much higher and should be considered when children are investigated for immunodeficiency. So, when to suspect neutrophil functional disorder? The hallmarks for diseases related to the neutrophilic functional disorders are discussed in this article.

Keywords

  • neutrophil
  • phagocytosis
  • NBT test
  • Neutrophil function
  • Neutrophil functional disorder
  • malnutration

Клучни зборови

  • неутрофил
  • фагоцитоза
  • НБT-тест
  • неутрофилна функција
  • функционални нарушувања на неутрофилите
  • малнутриција
Open Access

Depression of Neutrophil Function Followed by Severe Infection in a Child with Marasmic Kwashiorkor/ Намалување На Неутрофилната Функција Придружена Со Тешка Инфекција Кај Дете Со Маразмичен Квашиоркор

Published Online: 16 Jun 2015
Page range: 191 - 195

Abstract

Abstract

Malnutrition in childhood continues to be one of the most important risk factor for secondary immunodeficiency in the world; therefore one should think of existence of malnutrition in a child suffering of frequent infections, not only in developing country, rarely but still possible in developed country also.

Undernourishment in the early childhood is a trigger for starting a vicious cycle of impaired immunity, recurrent infections, and worsening malnutrition. Taking out from that cycle is an urgent and complex process, in which in parallel the infection should be controlled and the nutritional status solved out, and then, slowly follows the restoration of the immune system.

We present a patient at the age of 13 months, with marasmic kwashiorkor accompanied by severe infection manifested with sepsis. The laboratory investigations revealed severe anaemia, hypoproteinemia and impaired immunological response, first of all neutrophil dysfunction with decreased oxidative metabolic response during the phagocytosis, paralyzed first line of defense of the organism and open possibility for bacterial or fungal invasion, multiorgan failure and high risk for fatal outcome. Because malnutrition and infections had many causes, only multiple and synergistic interventions embedded in true multisectoral programs, fortunately, were effective and got positive outcome.

Keywords

  • malnutrition
  • marasmic kwashiorkor
  • neutrophil dysfunction
  • NBT test
  • infections

Клучни зборови

  • неисхранетост
  • маразмичен квашиор- кор
  • неутрофилна дисфункција
  • NBT-тест
  • инфекции
Open Access

Body Mass Index, Underweight and Overweight in Children 3 to 5 Years of Age from Skopje/ Индекс На Телесната Тежина, Неисхранетост И Прекумерна Исхранетост Кај Деца На 3–5 Години Од Скопје

Published Online: 16 Jun 2015
Page range: 197 - 203

Abstract

Abstract

The aim of this research is to present body mass index (BMI) data in children 3-5 years of age from Skopje and provide the information on the prevalence of different categories of nutritional status during the early childhood.

Material and methods: The study included 420 preschool children (210 boys and 210 girls). Stature and body weight were measured, and the BMI value was calculated. Twelve anthropometric parameters were measured using standard equipment and measurement technique according to the International Biological Programme.

Results: The majority of anthropometrical parameters have shown significant age and sex specific differences in favor of male subjects. Values at the 50th percentile in our male subjects aged 3, 4 and 5 years for the weight-for-age index were 19 kg, 19.1 and 21 kg, respectively whereas in the female subjects the corresponding values were 16.8 kg, 20 kg and 21 kg. The height-for-age index values corresponding to the 50th percentile showed slightly higher values in our male subjects (100 cm, 109.5 cm and 116 cm) than those in our female subjects (102 cm, 108.5 cm and 116 cm). The values of 50th percentile of BMI in our males subjects were 18.1 kg/m², 16.2 kg/m² and 16 kg/m² whereas in our females were 16.5 kg/m², 16.7 kg/m² and 16.4 kg/m².

Conclusion: These results show that underweight is a health problem of the rising generation in Skopje and needs to be considered along with the problem of overweight. It is recommended that the detected values could be applied for evaluation of deviations in growth and nutritional status in children aged 3-5.

Keywords

  • anthropometry
  • preschool children
  • underweight
  • overweight.

Клучни зборови

  • антропометрија
  • претшколски деца
  • неисхранетост
  • прекумерна исхранетост
Open Access

Emanuel Syndrome (Es): New Case-Report and Review of the Literature/ Емануел Синдром (Es): Презентација На Нов Случај И Преглед На Литературата

Published Online: 16 Jun 2015
Page range: 205 - 208

Abstract

Abstract

Multiple congenital anomalies and craniofacial dysmorphism are characterizing the so-called Emanuel or supernumerary der(22)t(11;22) syndrome (OMIM609029). Mental and developmental retardation are major clinical features. The der(22) may arise from a parental balanced t(11;22)(q23;q11.2) or can be created de novo.

Here we present a 2 years old boy with normal prenatal history, cyanotic at delivery and with ear anomalies, a preauricular tag, high-arched palate and micrognathia. There were neither microcephaly, nor heart or kidney defects. Psychological and motor testing at the age of 2 years confirmed significant mental and developmental delay. In addition, the child had seizures and an abnormal electroencephalogram. Cytogenetic and molecular analyses revealed a karyotype 47,XY,+der(22)t(11;22)(q23;q11.2). As parents refused further tests it could not be determined if the der(22) arose de novo or was parentally derived.

Overall the present report should alert physician to offer cytogenetic and/or molecular diagnostics in comparable cases.

Keywords

  • Emanuel syndrome
  • congenital anomalies
  • derivative chromosome 22 {der(22)t(11;22)}.

Клучни зборови

  • Емануел синдром
  • вродени анома- лии
  • дериват хромозом 22 {дер(22)t(11;22)}.
Open Access

Severe Scoliosis, Torticollis and Short Stature in a Woman with Wildervanck Syndrome (WS)/ Изразена Сколиоза, Тортиколис И Низок Раст Кај Жена Со Wildervanck Syndrome (Синдром На Вилдерванк)

Published Online: 16 Jun 2015
Page range: 209 - 211

Abstract

Abstract

Wildervanck syndrome (WS) combines features of Klippel-Feil syndrome (KFS), sixth nerve palsy, and deafness. This is a case of a 23 year old woman, diagnosed with KFS (a triad of short neck, low posterior hairline and restricted neck movements) at the age of 20 days. The manifestations of the WS in this patient are severe: she has torticollis, and an extremely severe scoliosis. In addition, she is short (-3 SD; parental target height + 0.8SD) and has mixed sensorineural and conductive deafness. She also has ptosis, strabismus and a high myopia. Radiologically, there are multiple coalitions of cervical vertebrae. Intelligence is unaffected (IQ 95), but deafness, strabismus and high myopia forced her early out of school. Karyotype is 46, XX. In brief, this is a patient with severe WS and additional anomalies. Short and/or reduced parental target height is a part of WS.

Keywords

  • Wildervanck syndrome
  • short stature
  • Duane retraction syndrome
  • Klippel Feil anomaly
  • deafness
  • torticollis
  • severe scoliosis.

Клучни зборови

  • Wildervanck syndrome
  • низок раст
  • Duane ретракционен синдром
  • Klippel Feil аномија
  • глувост
  • тортиколис
  • тешка сколиоза.
Open Access

Renal Dysplasia in Bardet-Biedl Syndrome/ Бубрежна Дисплазија Кај Бардет Бидл Синдром

Published Online: 16 Jun 2015
Page range: 213 - 217

Abstract

Abstract

Background: Bardet-Biedl syndrome (BBS) is a multisystem genetic disorder characterized with central obesity, pigmentary retinopathy, polydactyly, mental retardation, and hypogenitalism. Renal abnormalities have been recognized as a cardinal feature of the disease with serious prognostic implication. The aim of this study was to analyze the renal status in children with BBS and to implement appropriate interventions in those with progressive course

Patients and methods: The diagnosis of BBS was established on the basis of criteria proposed by Beales et al. (J Med Genet 1999). Imaging of the kidneys and urinary tract was performed with ultrasound study, Tc99mDMSA scan and a cystographic study. Twenty four hour urine collections were obtained for estimation of proteinuria and creatinine clearance. Blood pressure was monitored at clinical visits or as 24-hour ambulatory monitoring.

Results: There were 4 children (2 males, 2 females). All four children displayed abnormal kidney ultrasound and Tc99mDMSA scan resembling dysplastic kidney(s). Two of them had overt proteinuria (glomerulo-tubular pattern). Three children had normal blood pressure and glomerular filtration rate (GFR): 107, 145 and 95 ml/min/1.73m2, and the fourth had hypertension and progressive worsening of the GFR at 65 ml/min/1.73m2. Conclusion: Children with BBS should undergo imaging studies of the kidneys and urinary tract at initial work up; in those with renal dysplasia proteinuria, GFR and blood pressure should be regularly monitored to slow down progression to terminal renal failure.

Keywords

  • Bardet Biedl syndrome
  • renal dysplasia
  • chronic kidney disease
  • proteinuria
  • hypertension.

Клучни зборови

  • Бардет Бидл синдром
  • бубрежна дисплазија
  • хронична бубрежна болест
  • протеинури- ја
  • хипертензија
Open Access

Synchronous Occurrence of Ileal Stromal Tumor (GIST) and Colonic Adenocarcinoma: A Case Report/ Синхроно Јавување На Илеален Стромален Тумор (Гист) И Аденокарцином На Колон – Приказ На Случај

Published Online: 16 Jun 2015
Page range: 219 - 223

Abstract

Abstract

Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. The most reported cases include gastric synchronous occurrence of gastrointestinal stromal tumors and adenocarcinoma and gastric gastrointestinal stromal tumors and colonic adenocarcinoma.

Case report: We present a case of a 77-old female, with synchronous cecal moderately differentiated adenocarcinoma in Stage IIA according to the TNM classification and ileal spindle cell type GIST with low malignant potential, positive for c-Kit, CD34, vimentin, Actin, and negative for S100.

Conclusion: The synchronous occurrence of small bowel gastrointestinal stromal tumors and other primary gastrointestinal malignancies has been rarely reported. There is a need of further investigations to identify the relationship between gastrointestinal stromal tumors and colorectal cancers.

Keywords

  • gastrointestinal stromal tumors
  • adenocarcinoma
  • colon

Клучни зборови

  • гастроинтестинален стромален ту- мор
  • аденокарцином
  • колон
Open Access

Evaluation of Different in Vitro Testing Methods for Mechanical Properties of Veneer Ceramics/ Евалуација На Тестовите In Vitro За Одредување На Механичките Особини На Порцеланските Маси За Фасетирање

Published Online: 16 Jun 2015
Page range: 225 - 230

Abstract

Abstract

Metal-ceramic and all-ceramic prosthetic restorations in the patient mouth are often damaged by esthetic and functional problems that reduce their success and longevity.

Аim: To evaluate methods for testing mechanical characteristics of dental ceramics through analysis of different testing methods.

Material and methods: Dental ceramic materials are tested with in vivo and in vitro methods for their most important mechanical characteristics: hardness, toughness, flexural strength and abrasion. In vitro testing methods are faster and more efficient, without subjective factors from the patient according to ISO standards. Testing is done with universal testing machines, like Zwick 1445, Universal Testing Machine (Zwick DmbH & Co.KG, Ulm, Germany), Instron 4302 (Instron Corporation, England), MTS Sintech ReNew 1123 or in oral chewing simulators.

Results: According to the testing results, flexure strength is one of the most important characteristic of the dental ceramic to be tested, by the uniaxial and biaxial tests. Uniaxial tests three-point and four-point flexure are not most appropriate because the main stress on the lower side of the tested specimens is tension that causes beginning fractures at the places with superficial flow. Uniaxial results for flexural strength are lower than actual force, while with biaxial test defects and flows on the edges of tested specimens are not directly loaded.

Conclusion: Biaxial flexural method has advantages over uniaxial because of real strength results, but also for simple shape and preparing of the testing specimens.

Keywords

  • dental ceramics
  • dental crowns
  • bridges
  • testing methods
  • flexural strength.

Клучни зборови

  • дентална керамика
  • коронки
  • мос- тови
  • тестирачки методи
  • сила на свиткување
Open Access

International Nephrology Days/ Меѓународни Нефролошки Денови

Published Online: 16 Jun 2015
Page range: 231 - 233

Abstract

Abstract

The International Nephrology Days in honor of the 75th anniversary of Academician Momir Polenakovic and 50 years of his scientific work were held in the Macedonian Academy of Sciences and Arts (MASA) on 26 and 27 September 2014. Organizers of the meeting were the Macedonian Academy of Sciences and Arts and the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO). The days were programmed with the VII Macedonian-Croatian Nephrology Meeting and the Continuing Medical Education (CME) Course on "Renal Replacement Therapy - when & how - update on the outcome and cost-efficacy" organized by the MSNDTAO in cooperation with the European Renal Association (ERA-EDTA). Prominent academicians, researchers and nephrologists from Europe and neighboring countries contributed with their lectures and discussion at this scientific event. On September 26, 2014 the opening talk was given by Acad. V. Kambovski, President of the MASA, about the Life and Work of Academician Momir Polenakovic. In honor of his anniversary and valuable scientific opus, during the meeting Acad. Momir Polenakovic was awarded with Certificate of the European Renal Association (ERA-EDTA) for his significant role in the development of nephrology in the Balkan region and couple of other diplomas and acknowledgement. Prof. Polenakovic is founder of the MSNDTAO and his lifetime honorary president.

Keywords

  • anniversary
  • nephrology
  • scientific work
  • renal replacement therapy.

Клучни зборови

  • годишнина
  • нефрологија
  • научна работа
  • бубрежна заменска терапија

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