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Volume 43 (2022): Issue 3 (November 2022)

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Volume 42 (2021): Issue 3 (December 2021)

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Volume 42 (2021): Issue 1 (April 2021)

Volume 41 (2020): Issue 3 (November 2020)

Volume 41 (2020): Issue 2 (September 2020)

Volume 41 (2020): Issue 1 (June 2020)

Volume 40 (2019): Issue 3 (December 2019)

Volume 40 (2019): Issue 2 (October 2019)

Volume 40 (2019): Issue 1 (May 2019)

Volume 39 (2018): Issue 2-3 (December 2018)

Volume 39 (2018): Issue 1 (July 2018)

Volume 38 (2017): Issue 3 (December 2017)

Volume 38 (2017): Issue 2 (September 2017)

Volume 38 (2017): Issue 1 (March 2017)

Volume 37 (2016): Issue 2-3 (November 2016)

Volume 37 (2016): Issue 1 (June 2016)

Volume 36 (2015): Issue 3 (December 2015)

Volume 36 (2015): Issue 2 (December 2015)

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

Volume 35 (2014): Issue 3 (December 2014)

Volume 35 (2014): Issue 2 (October 2014)

Journal Details
Format
Journal
eISSN
1857-8985
ISSN
1857-9345
First Published
08 Sep 2014
Publication timeframe
2 times per year
Languages
English

Search

Volume 36 (2015): Issue 2 (December 2015)

Journal Details
Format
Journal
eISSN
1857-8985
ISSN
1857-9345
First Published
08 Sep 2014
Publication timeframe
2 times per year
Languages
English

Search

20 Articles
Open Access

Life and Work of Academician Momir Polenakovic

Published Online: 30 Dec 2015
Page range: 7 - 18

Abstract

Abstract

Talking about Acad. Momir Polenakovic, on the occasion of his 75th anniversary and 50 years of work, it is my pleasure to say that he is one of the rare medical workers, researchers, visionaries and educators, especially in the field of nephrology. With his work he became famous in Macedonia and in the world and raised the Macedonian nephrology to a European level. He is characterized with the highest virtues of the scientist: knowledge, diligence, searching for truth and empathy. Acad. Polenakovic is an example to all younger counterparts for his exceptionally correct and friendly relations with all his associates, and, he also supports his younger colleagues in their work and development.

Keywords

  • anniversary
  • medicine
  • Macedonian nephrology
  • science
  • research

Клучни зборови

  • годишнина
  • медицина
  • маке- донска нефрологија
  • наука
  • истражување
Open Access

Contribution of Academician Momir Polenakovic to the Development of Nephrology in the Republic of Macedonia

Published Online: 30 Dec 2015
Page range: 19 - 37

Abstract

Abstract

Academician Momir H. Polenakovic, MD, Ph.D. is an outstanding researcher, educator and scientist, one of the founders of the nephrology in the Republic of Macedonia. With more than 500 published papers in national and international journals, of which more than 189 are on the PubMed, he is one of the most fruitful medical worker in our country. With his participation in national and international congresses he has contributed to the transfer of the world nephrology in Macedonia, as well as, to the dissemination of the reputation of the Macedonian nephrology and science in the world. He has educated a number of specialists in internal medicine and subspecialists in nephrology. He has introduced new tests and methods in diagnosis and treatment of renal disease, which was a basis for his research and publication. Analyzing the life opus of Academician Momir Polenakovic we can say that he has dedicated his life and work to the research, diagnosis and treatment of kidney patients.

Keywords

  • Macedonian nephrology
  • research
  • diagnosis
  • treatment of kidney patients

Клучни зборови

  • македонска нефрологија
  • истражу- вања
  • дијагностика
  • третман на бубрежно болни
Open Access

Momir H. Polenakovic – Founder of the Nephrology Associations in the Republic of Macedonia

Published Online: 30 Dec 2015
Page range: 39 - 84

Abstract

Abstract

Acad. Momir Polenakovic has devoted his life and work in the diagnosis and treatment of kidney patients, as well as in research of kidney disease. The great experience he has acquired in the work with kidney patients, and after the visit to the most renowned nephrology centers in Europe and the world, he has transferred it to his colleagues through the work in the medical and nephrology associations. The work of the associations was in fact a successful education of young doctors and specialists. Among his most distinguished positions, we can mention: President of the Macedonian Medical Association, founder and President of the MSNDTAO, President of the Yugoslav Society of Nephrology, founder and President of BANTAO, as well as member of the Boards of ESAO and ERA-EDTA. He has received a lot of recognitions for his work achievements.

Keywords

  • medical association
  • nephrology association

Клучни зборови

  • лекарско здружение
  • нефролошко здружение
Open Access

Life-Time Risk, Screening and The Cost of Cardiovascular Comorbidities in CKD Patients

Published Online: 30 Dec 2015
Page range: 85 - 90

Abstract

Abstract

CKD is a problem of epidemic dimension. The risk of death and cardiovascular complications in this condition is of the same order of that by myocardial infarction, which qualifies CKD as “risk equivalent”. Calculations made on the basis of the epidemiological data of the MONICA-Augsburg study and analyses of the costs of myocardial infarction in a large health insurance company in Germany show that the economic burden of cardiovascular comorbidities with CKD in this country is substantial. These estimates, which may be valid also for other large member states of the European Community, represent a call for studies looking at the cost-effectiveness of preventive interventions aimed at reducing the risk for CKD and at lowering the concerning incidence rate of death and disability due to CKD-triggered cardiovascular complications in CKD patients.

Keywords

  • Chronic Kidney Disease (CKD)
  • cardiovascular comorbidities
  • life-time risk

Клучни зборови

  • хронична бубрежна болест (ХББ)
  • кардиоваскуларни коморбидитети
  • целоживотен ризик
Open Access

Antiviral Combination Approach as a Perspective to Combat Enterovirus Infections

Published Online: 30 Dec 2015
Page range: 91 - 99

Abstract

Abstract

Human enteroviruses distributed worldwide are causative agents of a broad spectrum of diseases with extremely high morbidity, including a series of severe illnesses of the central nervous system, heart, endocrine pancreas, skeleton muscles, etc., as well as the common cold contributing to the development of chronic respiratory diseases, including the chronic obstructive pulmonary disease. The above mentioned diseases along with the significantly high morbidity and mortality in children, as well as in the high-risk populations (immunodeficiencies, neonates) definitely formulate the chemotherapy as the main tool for the control of enterovirus infections. At present, clinically effective antivirals for use in the treatment of enteroviral infection do not exist, in spite of the large amount of work carried out in this field. The main reason for this is the development of drug resistance. We studied the process of development of resistance to the strongest inhibitors of enteroviruses, WIN compounds (VP1 protein hydrophobic pocket blockers), especially in the models in vivo, Coxsackievirus B (CV-B) infections in mice. We introduced the tracing of a panel of phenotypic markers (MIC50 value, plaque shape and size, stability at 50℃, pathogenicity in mice) for characterization of the drug-mutants (resistant and dependent) as a very important stage in the study of enterovirus inhibitors. Moreover, as a result of VP1 RNA sequence analysis performed on the model of disoxaril mutants of CVB1, we determined the molecular basis of the drug-resistance.

The monotherapy courses were the only approach used till now. For the first time in the research for anti-enterovirus antivirals our team introduced the testing of combination effect of the selective inhibitors of enterovirus replication with different mode of action. This study resulted in the selection of a number of very effective in vitro double combinations with synergistic effect and a broad spectrum of sensitive enteroviruses. The most prospective attainment in our examinations in this field was the development of a novel scheme for the combined application of anti-enteroviral substances in coxsackievirus B1 neuroinfection in newborn mice. It consisted of a consecutive, alternating and non simultaneous administration of the substances in the combination. The triple combination - disoxaril- guanidine. HCl-oxoglaucine (DGO) showed a high effectiveness expressed in the marked reduction of the mortality rate in infected mice as compared both to the placebo group, and to the partner compounds used alone every day, and to the same combination applied simultaneously every day. The studies of the drug sensitivity of viral brain isolates from mice treated with DGO combination showed not only preserved, but even increased sensitivity to the drugs included in the combination. Obviously, the consecutive alternating administration of anti-enteroviral substances hinders the occurrence of drug-resistance in the course of the experimental enteroviral infections in mice.

Keywords

  • enteroviruses
  • antivirals
  • drug-resistance
  • combination effects

Клучни зборови

  • ентеровируси
  • антивирусни
  • отпор- ност на лекови
  • комбинирани ефекти
Open Access

Genetic, Genomic and Epigenomic Studies of Balkan Endemic Nephropathy (Ben)

Published Online: 30 Dec 2015
Page range: 101 - 108

Abstract

Abstract

BEN is a primary, chronic tubulointerstitial nephritis characterized with chronic anemia, absence of edema, xantoderma, normal blood pressure and normal findings on the fundus oculi. The disease is distributed in restricted areas in Bulgaria, Romania, Croatia, Bosnia, Former Yugoslavia. Despite numerous studies on genetic and environmental factors and their possible involvement in BEN, its etiopathogenesis still remains elusive.

Our recent study aim to elucidate the possible epigenetic component in BEN development. Whole genome DNA array methylation analysis was applied to compare the methylation profiles of male and female BEN patients from endemic regions in Bulgaria and Serbia and healthy controls.

All three most prominent candidate genes with aberrations in the epigenetic profile discovered with this study are involved in the inflammatory/immune processes and oncogenesis. These data are in concordance with the reported pathological alterations in BEN. This research supports the role of epigenetic changes in BEN pathology.

Exome sequencing of 22.000 genes with Illumina Nextera Exome Enrichment Kit revealed three mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients which encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. We suggest that an abnormal process of angiogenesis plays a key role in the molecular pathogenesis of BEN.

Keywords

  • next generation sequencing (NGS)
  • exome sequencing
  • methylation analysis
  • gene mutations
  • single nucleotide polymorphisms
  • Balkan Endemic Nephropathy

Клучни зборови

  • следна генерација секвенционира- ње (NGS)
  • егзом секвенционирање
  • метилациска ана- лиза
  • генетски мутации
  • полиморфизам на единечен нуклеотид
  • Балканска ендемска нефропатија
Open Access

Endocrine Abnormalities in Patients with Chronic Kidney Disease

Published Online: 30 Dec 2015
Page range: 109 - 118

Abstract

Abstract

In patients with chronic kidney disease the alterations of the endocrine system may arise from several causes. The kidney is the site of degradation as well as synthesis of many different hormones. Moreover, a number of concomitant pathological conditions such as inflammation, metabolic acidosis and malnutrition may participate in the pathogenesis of endocrine abnormalities in this group of patients. The most pronounced endocrine abnormalities in patients with chronic kidney disease are the deficiencies of: calcitriol, testosterone, insulin-like growth factor and, erythropoietin (EPO). Additionally accumulation of several hormones, such as: prolactin, growth hormone and insulin frequently also occur. The clinical consequences of the abovementioned endocrine abnormalities are among others: anemia, infertility and bone diseases.

Keywords

  • Chronic kidney disease
  • Endocrine abnormalities
  • Erythropoietin

Клучни зборови

  • хронична бубрежна болест
  • ендо- крини абнормалности
  • еритропоетин
Open Access

New Therapies for Hepatitis C Virus

Published Online: 30 Dec 2015
Page range: 119 - 132

Abstract

Abstract

Hepatitis C virus (HCV), the major etiologic agent of "non-A, non-B hepatitis" was discovered 26 years ago. Even before its discovery, interferon-α (IFN) was already being used for treatment of this infection. The next two decades saw a series of incremental improvements of the IFN therapies by extending the duration of therapy, using IFN in combination with oral ribavirin, using pegylated IFN with ribavirin, and most recently adding oral compounds that inhibit the HCV replication (directly acting antivirals - DAAs) to that regimen. DAAs target multiple steps in the HCV life cycle and are now used in combination to treat HCV infection without the need of IFN. These IFN-free, oral DAAs regimens are highly efficacious, have minimal toxicity and are given for short duration. Approved DAAs can cure more then 90% of persons with chronic HCV infection, thereby reducing the risk of death from cirrhosis and hepatocellular carcinoma. However, these drugs are very expensive, and currently their exorbitant cost significantly restricts the access to this therapy for many HCV infected patients.

Keywords

  • Hepatitis C
  • Treatment
  • Directly Acting Antivirals

Клучни зборови

  • хепатитис Ц
  • третман
  • директно дејствувачки антивирусни лекови
Open Access

Generic Drugs – Decreasing Costs and Room for Increased Number of Kidney Transplantations

Published Online: 30 Dec 2015
Page range: 133 - 138

Abstract

Abstract

Kidney transplantation is the best treatment option in comparison to dialysis, although patients are obliged to receive life-long medical treatment with immunosuppressive drugs (ISDs) for prevention of the graft rejection. Such immunosuppressive treatment may be costly and associated with multiple adverse effects. Since costs are viewed as one of the major constraints for the increasing number of transplantation, the use of generic ISDs may decrease the overall cost of transplantation and raise the possibility for its further development.

An ideal ISD should have the security margin between toxic and therapeutic dose, and prevent development of acute or chronic rejection of the transplanted kidney. This is particularly important for drugs with a "narrow therapeutical index" (NTI), where small differences in dose or concentration lead to dose and concentration-dependent, serious therapeutic failures and/or adverse drug reactions. The NTI generic drug is approved if within 90%-112% of the area under the curve of the original product the pharmacokinetics fulfills the strict criteria of pharmaceutical equivalence and bioequivalence. Every generic has to be proven to be bioequivalent to the innovator product, and not to other generic products because of the possible generic "drift". Thus, the generic ISDs may be economically attractive, but theoretically, they may pose a risk to transplant patients. Such risks may be reduced if a long-term clinical studies showing cost-effectiveness of generic ISDs in de novo and prevalent transplant patients for every new generic ISD are performed.

In conclusion, the increased number of solid organ transplantation goes in line with the increased health care expenditure for ISDs. The generic immunosuppressants could be a possible solution if safely substituted for innovator products or other generic drug of choice. The substantial cost reduction needs to be redirected into organ donation initiatives so that more patients can benefit from the further increase in transplantation.

Keywords

  • Kidney transplantation
  • immunosuppressive treatment
  • generic drugs
  • narrow therapeutical index

Клучни зборови

  • бубрежна трансплантација
  • имуно- супресивен третман
  • генерички лекови
  • тесен тера- писки индекс
Open Access

Visualisation of Microglia with the use of Immunohistochemical Double Staining Method for CD-68 and Iba-1 of Cerebral Tissue Samples in Cases of Brain Contusions

Published Online: 30 Dec 2015
Page range: 141 - 145

Abstract

Abstract

In the recent years it has been confirmed that the main component of the immune response in an injury of the nerve cell comes from microglia and macrophages. The main challenge in the field of microglia research is to detect the different stages of cellular activation by visualization of the cell morphology. The existing visualization techniques are based on surface molecules expression in resting and activated microglia cells. For visualization of the microglial cells and their functional state we used double labeling method for cd-68 and iba1 in brain contusions with different survival time. Microglia are stained brown with Iba-1, whereas microglia impregnated with black, grainy color, represents activated microglia stained with CD 68. We had significantly positive results, and we were able to observe changes in the morphology of the microglia that correlated with the survival time. Using double labeling with Iba-1 and cd68 we were able to determine their physiological state based on the morphology and immunoreactivity.

Keywords

  • microglia cells
  • immunohistochemistry
  • brain contusions

Клучни зборови

  • микроглија клетки
  • имунохистохе- мија
  • мозочни нагмечувања
Open Access

First Bioresorbable Vascular Scaffold Implantation in Patients with Acute Coronary Syndrome in the Republic of Macedonia

Published Online: 30 Dec 2015
Page range: 147 - 155

Abstract

Abstract

Background: The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia. These high-risk manifestations of coronary atherosclerosis are important causes of the use of emergency medical care and hospitalization. We evaluated the feasibility and the acute performance of the everolimus-eluting bioresorbable vascular scaffolds (BVS) for the treatment of patients presenting with ACS.

Methods and results: The present investigation was a prospective, single-centre study. Clinical outcomes were reported at the 30-day, 6-month, 1 year and 2 years follow-up. The procedural success was 100.0%. After the BVS implantation a TIMI flow 3 was achieved in all 15 patients and the postprocedure percentage diameter stenosis was 16.4 ± 8.6%. No patients had angiographically visible residual thrombus at the end of the procedure. Optical coherence tomography (OCT) analysis was performed in 8 patients (53.3%) and showed that the post-procedure mean lumen area was 7.86 ± 1.81 mm2, minimum lumen area 5.51 ± 1.58 mm2. At the 30-day, 6-month, 1 year (15 patients) and 2 years follow-up (5 patients) target-lesion failure rate was 0%. Non-target vessel revascularization and target vessel myocardial infarction were not reported. No cases of cardiac death or scaffold thrombosis were observed.

Conclusion: BVS implantation in patients presenting with ACS appeared feasible, with high rate of final TIMI-flow 3 and good scaffold apposition.

Keywords

  • Bioresorbable vascular scaffold
  • Acute coronary syndrome
  • Optical coherence tomography

Клучни зборови

  • биоресорптивен васкуларен скафолд
  • акутен коронарен синдром
  • оптичка кохерентна томо- графија
Open Access

Relation Between Frontal Alpha Asymmetry and Anxiety in Young Patients with Generalized Anxiety Disorder

Published Online: 30 Dec 2015
Page range: 157 - 177

Abstract

Abstract

Frontal alpha asymmetry (the relative difference in power between two signals in different hemispheres) has been suggested as biomarker for anxiety. The goal of this study was to evaluate alpha asymmetry in the frontal region for young people (7-18 years) with generalized anxiety disorder, diagnosed according to two statistic manuals (DMS-IV-R and ICD-10), the medical history and the neuropsychological assessment. The QEEG recording and analysis of the obtained results from alpha spectra power and log of alpha spectra power are made in four conditions (eyes open, eyes closed, VCPT and ACPT). The obtained results for alpha power in general showed higher cortical activity in the right hemisphere, associated with negative emotions. The calculated alpha asymmetry separate for eyes open, eyes closed, VCPT and ACPT conditions showed the right activation in all four conditions. In addition, the right frontal asymmetry was specific for the Fp1-Fp2 region, while a greater left frontal activation was recorded for the F7-F8 region. The log of alpha power in general was additionally analyzed. The calculated asymmetry score in general (in a way that the left log transformed score was subtracted from the right) confirmed a greater right activation. Testing the power of the whole alpha band (μV2) in general, for all four conditions and for frontal region confirmed the right alpha asymmetries in all participants. The right alpha asymmetry in the frontal region was specific only for the Fp1-Fp2 region (frontopolar region). The only greater left frontal activation was registered between the F7-F8 region. Our findings are supported by many other studies using specific localization methods like fMRI or LORETA source localization.

Keywords

  • generalized anxiety disorder
  • QEEG
  • frontal asymmetry
  • spectra power
  • log spectra power

Клучни зборови

  • генерализирано анксиозно растрој- ство
  • QEEG
  • фронтална асиметрија
  • спектрална моќ- ност
  • логаритам на спектралната моќност
Open Access

Molecular Response in Patients with Chronic Myeloid Leukemia Treated with Imatinib – Single Centre Experience

Published Online: 30 Dec 2015
Page range: 179 - 186

Abstract

Abstract

Introduction of tyrosine kinase inhibitors (TKI) dramatically improves the treatment and survival of the patients with chronic myeloid leukemia (CML) in the last decade. Imatinib (IM) and other TKI induce larger percentage of complete cytogenetic response (CCyR) and major molecular response (MMR). Treatment resistance to TKIs still remains an important problem in the treatment of CML. The aim of our study was to analyze the molecular response (MR) in CML patients treated with Imatinib in our institution.

We have analyzed 53 CML patients (pts), 28 females and 25 males, treated with IM as a front or second line treatment. Only 15 pts were treated with IM as a front-line therapy, while 38 pts were pretreated with hydroxyurea or/and interferon. Median duration of CML was 6 years (range: 1 year- 17 years). Median duration of IM treatment was 3 years (range: 1 year-10 years). MR was analyzed in one up to 8 time points with Real Time Quantitative RT-PCR method.

Forty six pts (87%) had complete hematological response and 55% of pts had MMR, 13/53(24.5%) pts had MMR at 4.0-4.5 log and 16/53(30.2%) pts had MMR at 3.0-4.0 log. MMR was not achieved in 24/53(45.3%).

Our results have shown smaller percentage of patients (55%) with MMR, mostly due to the fact that larger proportion of patients (38/53) were heavily pretreated with HU or/and Interferon for a prolonged period of time, before the IM treatment. This is a major risk factor for acquisition of additional molecular and cytogenetic abnormalities responsible for IM resistance and poor treatment response.

Keywords

  • chronic myeloid leukemia
  • tyrosine kinase inhibitors
  • molecular response

Клучни зборови

  • хронична миелоидна леукемија
  • тирозин киназни инхибитори
  • молекуларен одговор
Open Access

Clinical Characteristics of Patients with Intradialytic Hypertension

Published Online: 30 Dec 2015
Page range: 187 - 193

Abstract

Abstract

Introduction: Intradialytic hypertension with a prevalence of 15% among hemodialysis patients is with unknown pathophysiology, demographic, laboratoiy and clinical characteristic of patients, and it’s influence on longtenn clinical effects (cardiovascular morbidity and mortality, rate of hospitali­zation). The aim of the study is to present the clinical, laboratoiy and demographic characteristics of patients with intradialytic hypertension in our dialysis center.

Materials and methods: Out of 110 hemodialysis patients, 17 patients (15,45%) had intradialytic hy­pertension - started at a systolic pressure greater than 140 nun Hg or had an increase in systolic pres­sure more than 10 mm Hg during the session, and 17 patients were nonnotensive or had a drop in blood pressure dining the dialysis. HD were performed 3 times per week with a duration of 4-5 hours, on machines with controlled ultrafiltration and high flux syntetic membrane (polyetersulfon) sterilized with gamma rays. A dialysate with standard electrolytes content was used (Na+ 138 mmol/L, K+ 2,0 mmol/L, Ca++ 1,5 mmol/L, Mg +1,0 mmol/L, CH3COO- 3,0 mmol/L, Cl -110 mmol/1, HCO3- 35 mmol/L). We analysed the following demographic and clinical characteristics: gender, age, BMI, dialysis vintage, vascular acces, cardiovascular comorbidity (cardiomyopathy, ischemic cardiac disease, peripheral artery disease, heart valve disease), number and type of antihypertensive drugs, weekly dose of erythropoesis - stimulating agent, standard monthly, three and six months laboratoiy analyzes, and sp Kt/V and PCR. Statistical analysis was performed using the statistical software SPSS 17.0.

Results: hi both groups men were predominant (IDH group 88.23%, control group 64.07%). The IDH group was older (59.00 ± 7.64 versus 49.00 ± 13.91, p = 0.314) and with lower BMI (p = 0.246) compared to the control group. The DDH patients had significantly lower serum sodium and higher sodium gradient (135.75 ± 2.03 versus 137.33 ± 1.97, p = 0.042; 2.25 ± 1.98 versus 0.66 ± 1.44, p = 0.0267, respestively). All other laboratoiy findings showed no statistically significant differences between the two groups. The IDH group had significantly higher interdialysis weight gain and less effective ultrafiltration individually at each dialysis session compared to the control group (2.23 ± 0.866 versus 2.37 ± 0.69, p = 0.011; 3.87 ± 1,26 versus 3.56 ± 1.18, p = 0.025, respectively). The systolic and mean arterial pressure after the HD were statistically higher in the IDH group.

Conclusion: Older age, lower BMI, borderline hyponatremia, higher sodium gradient and smaller ultrafiltration rate are the clinical characteristics of patients with intradialytic hypertension.

Keywords

  • hypertension
  • hemodialysis
  • characteristics.

Клучни зборови

  • хипертензија
  • хемодијализа
  • карак- теристики.
Open Access

A Two Phase Treatment of an Infected Hip Endoprosthesis

Published Online: 30 Dec 2015
Page range: 195 - 202

Abstract

Abstract

The revision of the two phase treatment represents a golden standard in the treatment of infected endoprosthesis. Throughout this study, the results of 21 patients with an infected hip endoprosthesis treated in two phases have been processed, with the use of an antibiotic spacer, within the period of 2009 and 2012.

Thereby, a unique protocol for diagnosis and treatment of infections has been applied to all the patients, which entails a preoperational x-ray image, laboratory findings (Se, CRP), as well as a puncture aspiration with a microbiological and biochemical examination of the aspirated fragments. The operational treatment consists of: taking a sample for microbiological and histopathological diagnosis, removal of the implanted endoprosthesis, excision of the avascular and necrotic tissue and installing an antibiotic spacer. Postoperatively, the patients are treated with a parenteral application of an antibiotics based on an antibiogram, throughout a period of two weeks, and later on an oral treatment, a combination of two antibiotics, depending on the antibiogram, within the following four to six weeks. After the appeasement of the local findings and the laboratory results, a revision with a removal of the antibiotic spacer and reimplantation of an endoprosthesis - revisional or primary has been conducted on the patients, depending on the bone deficit. The functionality of the joint is graded based on the Haris Hip Score. The patients are being observed postoperatively for a period of 12 to 36 months.

A definite reimplantation has been applied to 20 patients, while one patient has been treated with a resection method. The Haris Hip Score was 45 preoperatively, and 80 postoperatively.

The applied protocol of the treatment of infected endoprosthesis is effective in the eradication of the infection and the final reimplantation.

Keywords

  • infection
  • hip
  • endoprosthesis
  • spacer

Клучни зборови

  • инфекција
  • колк
  • ендопротеза
  • спеј- сер
Open Access

Etiological Factors in Urgent Gastroduodenal Ulcer

Published Online: 30 Dec 2015
Page range: 203 - 210

Abstract

Abstract

Aim: The goal of the study is to assess the impact of the etiological and risk factors in the cases of urgent gastroduodenal ulcer.

Methods: This is a prospective study which included 67 patients selected randomly, all with urgent, life-threatening complications of the gastroduodenal ulcer, treated at the University Clinic for Digestive Surgery and the University Clinic for Gastroenterohepatology. For the purpose of the study the titer of IgG antibodies to Helicobacter pylori in serum is examined, as well as the use of NSAID and aspirin. We also tested the use of nicotine and alcohol. Besides these factors, we took into consideration the sex and the age.

Results: The serological test of Helicobacter pylori was positive in 89.6% of the cases. 31.3% used NSAID and 16.4% used aspirin. Large number, 65.7% of the patients were smokers, while 25.4% used alcohol.

With regard to the sex, 83.6% were male and 16.4% were female. The most frequent age group was the one from 41 to 60 years with 40.3% and those between 61 and 80 years of age with 35.8%.

Conclusion: The presence of Helicobacter pylori with the urgent gastroduodenal ulcer was exceptionally high, in 89.6% of the duodenal and gastric ulcers. NSAID and aspirin are factors that also influence the etiology of this disease. Smoking is a significant risk factor. Alcohol is less present, but still an important factor.

Keywords

  • Helicobacter pylori
  • nonsteroidal anti-inflammatory drugs (NSAID)
  • aspirin

Клучни зборови

  • Helicobacter pylori
  • НСАИЛ
  • аспи- рин
Open Access

The Impact of Psycho-Education on in Vitro Fertilisation Treatment Efficiency

Published Online: 30 Dec 2015
Page range: 211 - 216

Abstract

Abstract

Aim: The aim of the study was to examine the efficiency of psycho-education of candidates for the IVF in stress, anxiety and depression decreasing, and the impact of the psycho educative techniques on the successfulness of the treatment.

Method: A random sample of 64 candidates for IVF treatment is divided in two groups: control group without psycho-education (32 candidates) and intervention group of 32 candidates included in psycho-education. Depression, anxiety and stress scale (DASS) was used as a psychometric test. It’s a multiple choice, self-reported inventory for measuring the levels of stress, anxiety and severity of depression. For statistic evaluation SPSS software was used.

Results: The study shows that the intervention group included in psycho-education has a signifycantly lower scores on stress (t = 3.201, p < 0.05) and anxiety (t = 2.311, p < 0.05). The scale of depression did not show differences in the two compared groups. However, the success of the IVF treatment is more common among candidates that were included in psycho-education.

Conclusion: In our country, psycho-education of candidates for in vitro fertilization is not systematically integrated in the treatment. The study showed the efficiency of psycho-education in anxiety and stress decreasing, as well as significant impact in the successfulness of the treatment.

It was pointed out that psychological support of candidates for IVF is important for the lessening of the negative emotional reactions of candidates as well as for the successfulness of the treatment.

Keywords

  • treatment
  • stress
  • anxiety
  • depression
  • psycho-educational counseling

Клучни зборови

  • третман на кандидати за ин витро фертилизација
  • стрес
  • анксиозност
  • депресивност
  • пси- хоедукација
Open Access

Matrix Matalloproteinase-8 Gene Polymorphism in Chronic Periapical Lesions

Published Online: 30 Dec 2015
Page range: 217 - 224

Abstract

Abstract

Background/Aim: Increased levels of matrix metalloproteinase-8 (MMP-8) have been associated with risk of developing chronic periapical lesion (CPL). Gene polymorphisms are contributing factors in the pathogenesis of the inflammation. The aim of this study was to analyze polymorphism in the gene MMP-8 and its association and influence on clinical manifestation of CPL.

Methods: A total of 240 unrelated Macedonian subjects were included in the present study. Polymorphism -799 C/T in the gene MMP-8 detected with restriction enzyme BgIII was studied in 120 patients with CPL and 120 controls without any signs of chronic or acute inflammatory process in the jaw. The amplification of the region of selected gene was made with polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP).

Results: Our results showed that there were differences in the allele and genotype frequencies of the MMP8 -799 C/T polymorphisms between patients with CPL and controls (p < 0.05). Also this study suggests that MMP-8 polymorphism -799 C/T was a risk for expression of CPL (OR=8.27<3.44<OR<20.26).

Conclusion: The detection of this genetic polymorphism is relevant for obtaining providential treatment of patients who are at high risk of chronic periapical inflammation.

Keywords

  • chronic periapical lesion
  • single nucleotide polymorphism
  • matrix metalloproteinase-8

Клучни зборови

  • хронична периапикална лезија
  • еди- нечен нуклеотиден полиморфизам
  • матрикс метало- протеиназа-8
Open Access

Overdentures on Implants for Better Quality of Life Among the Fully Edentulous Patients – Case Reports

Published Online: 30 Dec 2015
Page range: 225 - 234

Abstract

Abstract

Global aging population has brought several challenges for their medical systems and total edentulism is one of them. The fabrication of removable acrylic dentures seems to be a simple and cheap treatment solution, but a majority of patients is not satisfied with their functional instability, causing limited diets, mouth soreness, speech and psycho-social problems etc. The results in many studies indicate an impact of oral conditions associated with the full denture wearing on oral-health related quality of life, especially in lower jaw. The reason for improper denture retention could be alveolar ridge bone resorption and numerous studies about this problem are plausible. Bone resorption in lower jaw may turn the alveolar ridge into a flabby soft tissue which is unable to sustain proper denture retention.

The implant-retained prosthesis is an alternative treatment option in these situations. Implants will provide retention, stability, function and aesthetics and they are not so expensive solution. The aim of this article is to show solving of retention problems of a lower denture in two different clinical cases using implants and without any special technology.

Keywords

  • overdentures
  • implants
  • quality of life

Клучни зборови

  • покровни протези
  • импланти
  • ква- литет на живеење
Open Access

Report on the Workshop and Regular Meeting of the Imode-CKD and Bcmolmed Marie Curie Training and Research Programs

Published Online: 30 Dec 2015
Page range: 235 - 240

Abstract

Abstract

A Workshop and Regular Meeting of the Marie Curie Training and Research Programs iMODECKD (Identification of the Molecular Determinants of established Chronic Kidney Disease) and BCMolMed (Molecular Medicine for Bladder Cancer) was held from 20-22 March at the Macedonian Academy of Science and Arts (MASA). The meeting was hosted by the participating center University of Skopje (SKO) - Goce Spasovski and MASA - Momir Polenakovic (R. Macedonia). The representative from MASA proteomic research center - Katerina Davalieva (R. Macedonia) had presentation on proteomic research in prostate cancer (PCa). 40 researchers from 13 different countries participated at the meeting. The Workshop was devoted on "Chronic Kidney Disease: Clinical Management issues", and consisted of 15 oral presentations given by nephrologists and experts in the field of CKD. Raymond Vanholder (Belgium) - past president of ERA-EDTA had a keynote lecture on "CKD: Questions that need to be answered and are not (or at least not entirely)". The workshop continued in four sessions with lectures from Alberto Ortiz (Spain), Olivera Stojceva-Taneva (R. Macedonia), Dimitrios Goumenos (Greece), Joachim Beige (Germany), Marian Klinger (Poland), Goce Spasovski (R. Macedonia), Joachim Jankowski (Germany), Adalbert Schiller (Romania), Robert Johnson (USA), Franco Ferrario (Italy), Ivan Rychlik (Czech Republic), Fulvio Magni (Italy) and Giovambattista Capasso (Italy), all covering a training theme. Within the meeting there were two lectures on complimentary skills for ethics in science and career advancement from two principal investigators - Goce Spasovski (R. Macedonia) and Joost Schanstra (France). During the Regular Meeting, 13 PhD students i.e. Early Stage Researchers and one Experienced Researcher from both Programs presented their work and progress within iMODE-CKD and BCMolMed projects. This meeting was a great opportunity to exchange experience and ideas in the field of systems biology approaches and translational medicine and planning future collaboration.

Keywords

  • prostate tumor
  • system biology
  • translational medicine
  • urinary proteomics

Клучни зборови

  • тумор на простата
  • системска био- логија
  • транслациона медицина
  • уринарни протеомици
20 Articles
Open Access

Life and Work of Academician Momir Polenakovic

Published Online: 30 Dec 2015
Page range: 7 - 18

Abstract

Abstract

Talking about Acad. Momir Polenakovic, on the occasion of his 75th anniversary and 50 years of work, it is my pleasure to say that he is one of the rare medical workers, researchers, visionaries and educators, especially in the field of nephrology. With his work he became famous in Macedonia and in the world and raised the Macedonian nephrology to a European level. He is characterized with the highest virtues of the scientist: knowledge, diligence, searching for truth and empathy. Acad. Polenakovic is an example to all younger counterparts for his exceptionally correct and friendly relations with all his associates, and, he also supports his younger colleagues in their work and development.

Keywords

  • anniversary
  • medicine
  • Macedonian nephrology
  • science
  • research

Клучни зборови

  • годишнина
  • медицина
  • маке- донска нефрологија
  • наука
  • истражување
Open Access

Contribution of Academician Momir Polenakovic to the Development of Nephrology in the Republic of Macedonia

Published Online: 30 Dec 2015
Page range: 19 - 37

Abstract

Abstract

Academician Momir H. Polenakovic, MD, Ph.D. is an outstanding researcher, educator and scientist, one of the founders of the nephrology in the Republic of Macedonia. With more than 500 published papers in national and international journals, of which more than 189 are on the PubMed, he is one of the most fruitful medical worker in our country. With his participation in national and international congresses he has contributed to the transfer of the world nephrology in Macedonia, as well as, to the dissemination of the reputation of the Macedonian nephrology and science in the world. He has educated a number of specialists in internal medicine and subspecialists in nephrology. He has introduced new tests and methods in diagnosis and treatment of renal disease, which was a basis for his research and publication. Analyzing the life opus of Academician Momir Polenakovic we can say that he has dedicated his life and work to the research, diagnosis and treatment of kidney patients.

Keywords

  • Macedonian nephrology
  • research
  • diagnosis
  • treatment of kidney patients

Клучни зборови

  • македонска нефрологија
  • истражу- вања
  • дијагностика
  • третман на бубрежно болни
Open Access

Momir H. Polenakovic – Founder of the Nephrology Associations in the Republic of Macedonia

Published Online: 30 Dec 2015
Page range: 39 - 84

Abstract

Abstract

Acad. Momir Polenakovic has devoted his life and work in the diagnosis and treatment of kidney patients, as well as in research of kidney disease. The great experience he has acquired in the work with kidney patients, and after the visit to the most renowned nephrology centers in Europe and the world, he has transferred it to his colleagues through the work in the medical and nephrology associations. The work of the associations was in fact a successful education of young doctors and specialists. Among his most distinguished positions, we can mention: President of the Macedonian Medical Association, founder and President of the MSNDTAO, President of the Yugoslav Society of Nephrology, founder and President of BANTAO, as well as member of the Boards of ESAO and ERA-EDTA. He has received a lot of recognitions for his work achievements.

Keywords

  • medical association
  • nephrology association

Клучни зборови

  • лекарско здружение
  • нефролошко здружение
Open Access

Life-Time Risk, Screening and The Cost of Cardiovascular Comorbidities in CKD Patients

Published Online: 30 Dec 2015
Page range: 85 - 90

Abstract

Abstract

CKD is a problem of epidemic dimension. The risk of death and cardiovascular complications in this condition is of the same order of that by myocardial infarction, which qualifies CKD as “risk equivalent”. Calculations made on the basis of the epidemiological data of the MONICA-Augsburg study and analyses of the costs of myocardial infarction in a large health insurance company in Germany show that the economic burden of cardiovascular comorbidities with CKD in this country is substantial. These estimates, which may be valid also for other large member states of the European Community, represent a call for studies looking at the cost-effectiveness of preventive interventions aimed at reducing the risk for CKD and at lowering the concerning incidence rate of death and disability due to CKD-triggered cardiovascular complications in CKD patients.

Keywords

  • Chronic Kidney Disease (CKD)
  • cardiovascular comorbidities
  • life-time risk

Клучни зборови

  • хронична бубрежна болест (ХББ)
  • кардиоваскуларни коморбидитети
  • целоживотен ризик
Open Access

Antiviral Combination Approach as a Perspective to Combat Enterovirus Infections

Published Online: 30 Dec 2015
Page range: 91 - 99

Abstract

Abstract

Human enteroviruses distributed worldwide are causative agents of a broad spectrum of diseases with extremely high morbidity, including a series of severe illnesses of the central nervous system, heart, endocrine pancreas, skeleton muscles, etc., as well as the common cold contributing to the development of chronic respiratory diseases, including the chronic obstructive pulmonary disease. The above mentioned diseases along with the significantly high morbidity and mortality in children, as well as in the high-risk populations (immunodeficiencies, neonates) definitely formulate the chemotherapy as the main tool for the control of enterovirus infections. At present, clinically effective antivirals for use in the treatment of enteroviral infection do not exist, in spite of the large amount of work carried out in this field. The main reason for this is the development of drug resistance. We studied the process of development of resistance to the strongest inhibitors of enteroviruses, WIN compounds (VP1 protein hydrophobic pocket blockers), especially in the models in vivo, Coxsackievirus B (CV-B) infections in mice. We introduced the tracing of a panel of phenotypic markers (MIC50 value, plaque shape and size, stability at 50℃, pathogenicity in mice) for characterization of the drug-mutants (resistant and dependent) as a very important stage in the study of enterovirus inhibitors. Moreover, as a result of VP1 RNA sequence analysis performed on the model of disoxaril mutants of CVB1, we determined the molecular basis of the drug-resistance.

The monotherapy courses were the only approach used till now. For the first time in the research for anti-enterovirus antivirals our team introduced the testing of combination effect of the selective inhibitors of enterovirus replication with different mode of action. This study resulted in the selection of a number of very effective in vitro double combinations with synergistic effect and a broad spectrum of sensitive enteroviruses. The most prospective attainment in our examinations in this field was the development of a novel scheme for the combined application of anti-enteroviral substances in coxsackievirus B1 neuroinfection in newborn mice. It consisted of a consecutive, alternating and non simultaneous administration of the substances in the combination. The triple combination - disoxaril- guanidine. HCl-oxoglaucine (DGO) showed a high effectiveness expressed in the marked reduction of the mortality rate in infected mice as compared both to the placebo group, and to the partner compounds used alone every day, and to the same combination applied simultaneously every day. The studies of the drug sensitivity of viral brain isolates from mice treated with DGO combination showed not only preserved, but even increased sensitivity to the drugs included in the combination. Obviously, the consecutive alternating administration of anti-enteroviral substances hinders the occurrence of drug-resistance in the course of the experimental enteroviral infections in mice.

Keywords

  • enteroviruses
  • antivirals
  • drug-resistance
  • combination effects

Клучни зборови

  • ентеровируси
  • антивирусни
  • отпор- ност на лекови
  • комбинирани ефекти
Open Access

Genetic, Genomic and Epigenomic Studies of Balkan Endemic Nephropathy (Ben)

Published Online: 30 Dec 2015
Page range: 101 - 108

Abstract

Abstract

BEN is a primary, chronic tubulointerstitial nephritis characterized with chronic anemia, absence of edema, xantoderma, normal blood pressure and normal findings on the fundus oculi. The disease is distributed in restricted areas in Bulgaria, Romania, Croatia, Bosnia, Former Yugoslavia. Despite numerous studies on genetic and environmental factors and their possible involvement in BEN, its etiopathogenesis still remains elusive.

Our recent study aim to elucidate the possible epigenetic component in BEN development. Whole genome DNA array methylation analysis was applied to compare the methylation profiles of male and female BEN patients from endemic regions in Bulgaria and Serbia and healthy controls.

All three most prominent candidate genes with aberrations in the epigenetic profile discovered with this study are involved in the inflammatory/immune processes and oncogenesis. These data are in concordance with the reported pathological alterations in BEN. This research supports the role of epigenetic changes in BEN pathology.

Exome sequencing of 22.000 genes with Illumina Nextera Exome Enrichment Kit revealed three mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients which encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. We suggest that an abnormal process of angiogenesis plays a key role in the molecular pathogenesis of BEN.

Keywords

  • next generation sequencing (NGS)
  • exome sequencing
  • methylation analysis
  • gene mutations
  • single nucleotide polymorphisms
  • Balkan Endemic Nephropathy

Клучни зборови

  • следна генерација секвенционира- ње (NGS)
  • егзом секвенционирање
  • метилациска ана- лиза
  • генетски мутации
  • полиморфизам на единечен нуклеотид
  • Балканска ендемска нефропатија
Open Access

Endocrine Abnormalities in Patients with Chronic Kidney Disease

Published Online: 30 Dec 2015
Page range: 109 - 118

Abstract

Abstract

In patients with chronic kidney disease the alterations of the endocrine system may arise from several causes. The kidney is the site of degradation as well as synthesis of many different hormones. Moreover, a number of concomitant pathological conditions such as inflammation, metabolic acidosis and malnutrition may participate in the pathogenesis of endocrine abnormalities in this group of patients. The most pronounced endocrine abnormalities in patients with chronic kidney disease are the deficiencies of: calcitriol, testosterone, insulin-like growth factor and, erythropoietin (EPO). Additionally accumulation of several hormones, such as: prolactin, growth hormone and insulin frequently also occur. The clinical consequences of the abovementioned endocrine abnormalities are among others: anemia, infertility and bone diseases.

Keywords

  • Chronic kidney disease
  • Endocrine abnormalities
  • Erythropoietin

Клучни зборови

  • хронична бубрежна болест
  • ендо- крини абнормалности
  • еритропоетин
Open Access

New Therapies for Hepatitis C Virus

Published Online: 30 Dec 2015
Page range: 119 - 132

Abstract

Abstract

Hepatitis C virus (HCV), the major etiologic agent of "non-A, non-B hepatitis" was discovered 26 years ago. Even before its discovery, interferon-α (IFN) was already being used for treatment of this infection. The next two decades saw a series of incremental improvements of the IFN therapies by extending the duration of therapy, using IFN in combination with oral ribavirin, using pegylated IFN with ribavirin, and most recently adding oral compounds that inhibit the HCV replication (directly acting antivirals - DAAs) to that regimen. DAAs target multiple steps in the HCV life cycle and are now used in combination to treat HCV infection without the need of IFN. These IFN-free, oral DAAs regimens are highly efficacious, have minimal toxicity and are given for short duration. Approved DAAs can cure more then 90% of persons with chronic HCV infection, thereby reducing the risk of death from cirrhosis and hepatocellular carcinoma. However, these drugs are very expensive, and currently their exorbitant cost significantly restricts the access to this therapy for many HCV infected patients.

Keywords

  • Hepatitis C
  • Treatment
  • Directly Acting Antivirals

Клучни зборови

  • хепатитис Ц
  • третман
  • директно дејствувачки антивирусни лекови
Open Access

Generic Drugs – Decreasing Costs and Room for Increased Number of Kidney Transplantations

Published Online: 30 Dec 2015
Page range: 133 - 138

Abstract

Abstract

Kidney transplantation is the best treatment option in comparison to dialysis, although patients are obliged to receive life-long medical treatment with immunosuppressive drugs (ISDs) for prevention of the graft rejection. Such immunosuppressive treatment may be costly and associated with multiple adverse effects. Since costs are viewed as one of the major constraints for the increasing number of transplantation, the use of generic ISDs may decrease the overall cost of transplantation and raise the possibility for its further development.

An ideal ISD should have the security margin between toxic and therapeutic dose, and prevent development of acute or chronic rejection of the transplanted kidney. This is particularly important for drugs with a "narrow therapeutical index" (NTI), where small differences in dose or concentration lead to dose and concentration-dependent, serious therapeutic failures and/or adverse drug reactions. The NTI generic drug is approved if within 90%-112% of the area under the curve of the original product the pharmacokinetics fulfills the strict criteria of pharmaceutical equivalence and bioequivalence. Every generic has to be proven to be bioequivalent to the innovator product, and not to other generic products because of the possible generic "drift". Thus, the generic ISDs may be economically attractive, but theoretically, they may pose a risk to transplant patients. Such risks may be reduced if a long-term clinical studies showing cost-effectiveness of generic ISDs in de novo and prevalent transplant patients for every new generic ISD are performed.

In conclusion, the increased number of solid organ transplantation goes in line with the increased health care expenditure for ISDs. The generic immunosuppressants could be a possible solution if safely substituted for innovator products or other generic drug of choice. The substantial cost reduction needs to be redirected into organ donation initiatives so that more patients can benefit from the further increase in transplantation.

Keywords

  • Kidney transplantation
  • immunosuppressive treatment
  • generic drugs
  • narrow therapeutical index

Клучни зборови

  • бубрежна трансплантација
  • имуно- супресивен третман
  • генерички лекови
  • тесен тера- писки индекс
Open Access

Visualisation of Microglia with the use of Immunohistochemical Double Staining Method for CD-68 and Iba-1 of Cerebral Tissue Samples in Cases of Brain Contusions

Published Online: 30 Dec 2015
Page range: 141 - 145

Abstract

Abstract

In the recent years it has been confirmed that the main component of the immune response in an injury of the nerve cell comes from microglia and macrophages. The main challenge in the field of microglia research is to detect the different stages of cellular activation by visualization of the cell morphology. The existing visualization techniques are based on surface molecules expression in resting and activated microglia cells. For visualization of the microglial cells and their functional state we used double labeling method for cd-68 and iba1 in brain contusions with different survival time. Microglia are stained brown with Iba-1, whereas microglia impregnated with black, grainy color, represents activated microglia stained with CD 68. We had significantly positive results, and we were able to observe changes in the morphology of the microglia that correlated with the survival time. Using double labeling with Iba-1 and cd68 we were able to determine their physiological state based on the morphology and immunoreactivity.

Keywords

  • microglia cells
  • immunohistochemistry
  • brain contusions

Клучни зборови

  • микроглија клетки
  • имунохистохе- мија
  • мозочни нагмечувања
Open Access

First Bioresorbable Vascular Scaffold Implantation in Patients with Acute Coronary Syndrome in the Republic of Macedonia

Published Online: 30 Dec 2015
Page range: 147 - 155

Abstract

Abstract

Background: The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia. These high-risk manifestations of coronary atherosclerosis are important causes of the use of emergency medical care and hospitalization. We evaluated the feasibility and the acute performance of the everolimus-eluting bioresorbable vascular scaffolds (BVS) for the treatment of patients presenting with ACS.

Methods and results: The present investigation was a prospective, single-centre study. Clinical outcomes were reported at the 30-day, 6-month, 1 year and 2 years follow-up. The procedural success was 100.0%. After the BVS implantation a TIMI flow 3 was achieved in all 15 patients and the postprocedure percentage diameter stenosis was 16.4 ± 8.6%. No patients had angiographically visible residual thrombus at the end of the procedure. Optical coherence tomography (OCT) analysis was performed in 8 patients (53.3%) and showed that the post-procedure mean lumen area was 7.86 ± 1.81 mm2, minimum lumen area 5.51 ± 1.58 mm2. At the 30-day, 6-month, 1 year (15 patients) and 2 years follow-up (5 patients) target-lesion failure rate was 0%. Non-target vessel revascularization and target vessel myocardial infarction were not reported. No cases of cardiac death or scaffold thrombosis were observed.

Conclusion: BVS implantation in patients presenting with ACS appeared feasible, with high rate of final TIMI-flow 3 and good scaffold apposition.

Keywords

  • Bioresorbable vascular scaffold
  • Acute coronary syndrome
  • Optical coherence tomography

Клучни зборови

  • биоресорптивен васкуларен скафолд
  • акутен коронарен синдром
  • оптичка кохерентна томо- графија
Open Access

Relation Between Frontal Alpha Asymmetry and Anxiety in Young Patients with Generalized Anxiety Disorder

Published Online: 30 Dec 2015
Page range: 157 - 177

Abstract

Abstract

Frontal alpha asymmetry (the relative difference in power between two signals in different hemispheres) has been suggested as biomarker for anxiety. The goal of this study was to evaluate alpha asymmetry in the frontal region for young people (7-18 years) with generalized anxiety disorder, diagnosed according to two statistic manuals (DMS-IV-R and ICD-10), the medical history and the neuropsychological assessment. The QEEG recording and analysis of the obtained results from alpha spectra power and log of alpha spectra power are made in four conditions (eyes open, eyes closed, VCPT and ACPT). The obtained results for alpha power in general showed higher cortical activity in the right hemisphere, associated with negative emotions. The calculated alpha asymmetry separate for eyes open, eyes closed, VCPT and ACPT conditions showed the right activation in all four conditions. In addition, the right frontal asymmetry was specific for the Fp1-Fp2 region, while a greater left frontal activation was recorded for the F7-F8 region. The log of alpha power in general was additionally analyzed. The calculated asymmetry score in general (in a way that the left log transformed score was subtracted from the right) confirmed a greater right activation. Testing the power of the whole alpha band (μV2) in general, for all four conditions and for frontal region confirmed the right alpha asymmetries in all participants. The right alpha asymmetry in the frontal region was specific only for the Fp1-Fp2 region (frontopolar region). The only greater left frontal activation was registered between the F7-F8 region. Our findings are supported by many other studies using specific localization methods like fMRI or LORETA source localization.

Keywords

  • generalized anxiety disorder
  • QEEG
  • frontal asymmetry
  • spectra power
  • log spectra power

Клучни зборови

  • генерализирано анксиозно растрој- ство
  • QEEG
  • фронтална асиметрија
  • спектрална моќ- ност
  • логаритам на спектралната моќност
Open Access

Molecular Response in Patients with Chronic Myeloid Leukemia Treated with Imatinib – Single Centre Experience

Published Online: 30 Dec 2015
Page range: 179 - 186

Abstract

Abstract

Introduction of tyrosine kinase inhibitors (TKI) dramatically improves the treatment and survival of the patients with chronic myeloid leukemia (CML) in the last decade. Imatinib (IM) and other TKI induce larger percentage of complete cytogenetic response (CCyR) and major molecular response (MMR). Treatment resistance to TKIs still remains an important problem in the treatment of CML. The aim of our study was to analyze the molecular response (MR) in CML patients treated with Imatinib in our institution.

We have analyzed 53 CML patients (pts), 28 females and 25 males, treated with IM as a front or second line treatment. Only 15 pts were treated with IM as a front-line therapy, while 38 pts were pretreated with hydroxyurea or/and interferon. Median duration of CML was 6 years (range: 1 year- 17 years). Median duration of IM treatment was 3 years (range: 1 year-10 years). MR was analyzed in one up to 8 time points with Real Time Quantitative RT-PCR method.

Forty six pts (87%) had complete hematological response and 55% of pts had MMR, 13/53(24.5%) pts had MMR at 4.0-4.5 log and 16/53(30.2%) pts had MMR at 3.0-4.0 log. MMR was not achieved in 24/53(45.3%).

Our results have shown smaller percentage of patients (55%) with MMR, mostly due to the fact that larger proportion of patients (38/53) were heavily pretreated with HU or/and Interferon for a prolonged period of time, before the IM treatment. This is a major risk factor for acquisition of additional molecular and cytogenetic abnormalities responsible for IM resistance and poor treatment response.

Keywords

  • chronic myeloid leukemia
  • tyrosine kinase inhibitors
  • molecular response

Клучни зборови

  • хронична миелоидна леукемија
  • тирозин киназни инхибитори
  • молекуларен одговор
Open Access

Clinical Characteristics of Patients with Intradialytic Hypertension

Published Online: 30 Dec 2015
Page range: 187 - 193

Abstract

Abstract

Introduction: Intradialytic hypertension with a prevalence of 15% among hemodialysis patients is with unknown pathophysiology, demographic, laboratoiy and clinical characteristic of patients, and it’s influence on longtenn clinical effects (cardiovascular morbidity and mortality, rate of hospitali­zation). The aim of the study is to present the clinical, laboratoiy and demographic characteristics of patients with intradialytic hypertension in our dialysis center.

Materials and methods: Out of 110 hemodialysis patients, 17 patients (15,45%) had intradialytic hy­pertension - started at a systolic pressure greater than 140 nun Hg or had an increase in systolic pres­sure more than 10 mm Hg during the session, and 17 patients were nonnotensive or had a drop in blood pressure dining the dialysis. HD were performed 3 times per week with a duration of 4-5 hours, on machines with controlled ultrafiltration and high flux syntetic membrane (polyetersulfon) sterilized with gamma rays. A dialysate with standard electrolytes content was used (Na+ 138 mmol/L, K+ 2,0 mmol/L, Ca++ 1,5 mmol/L, Mg +1,0 mmol/L, CH3COO- 3,0 mmol/L, Cl -110 mmol/1, HCO3- 35 mmol/L). We analysed the following demographic and clinical characteristics: gender, age, BMI, dialysis vintage, vascular acces, cardiovascular comorbidity (cardiomyopathy, ischemic cardiac disease, peripheral artery disease, heart valve disease), number and type of antihypertensive drugs, weekly dose of erythropoesis - stimulating agent, standard monthly, three and six months laboratoiy analyzes, and sp Kt/V and PCR. Statistical analysis was performed using the statistical software SPSS 17.0.

Results: hi both groups men were predominant (IDH group 88.23%, control group 64.07%). The IDH group was older (59.00 ± 7.64 versus 49.00 ± 13.91, p = 0.314) and with lower BMI (p = 0.246) compared to the control group. The DDH patients had significantly lower serum sodium and higher sodium gradient (135.75 ± 2.03 versus 137.33 ± 1.97, p = 0.042; 2.25 ± 1.98 versus 0.66 ± 1.44, p = 0.0267, respestively). All other laboratoiy findings showed no statistically significant differences between the two groups. The IDH group had significantly higher interdialysis weight gain and less effective ultrafiltration individually at each dialysis session compared to the control group (2.23 ± 0.866 versus 2.37 ± 0.69, p = 0.011; 3.87 ± 1,26 versus 3.56 ± 1.18, p = 0.025, respectively). The systolic and mean arterial pressure after the HD were statistically higher in the IDH group.

Conclusion: Older age, lower BMI, borderline hyponatremia, higher sodium gradient and smaller ultrafiltration rate are the clinical characteristics of patients with intradialytic hypertension.

Keywords

  • hypertension
  • hemodialysis
  • characteristics.

Клучни зборови

  • хипертензија
  • хемодијализа
  • карак- теристики.
Open Access

A Two Phase Treatment of an Infected Hip Endoprosthesis

Published Online: 30 Dec 2015
Page range: 195 - 202

Abstract

Abstract

The revision of the two phase treatment represents a golden standard in the treatment of infected endoprosthesis. Throughout this study, the results of 21 patients with an infected hip endoprosthesis treated in two phases have been processed, with the use of an antibiotic spacer, within the period of 2009 and 2012.

Thereby, a unique protocol for diagnosis and treatment of infections has been applied to all the patients, which entails a preoperational x-ray image, laboratory findings (Se, CRP), as well as a puncture aspiration with a microbiological and biochemical examination of the aspirated fragments. The operational treatment consists of: taking a sample for microbiological and histopathological diagnosis, removal of the implanted endoprosthesis, excision of the avascular and necrotic tissue and installing an antibiotic spacer. Postoperatively, the patients are treated with a parenteral application of an antibiotics based on an antibiogram, throughout a period of two weeks, and later on an oral treatment, a combination of two antibiotics, depending on the antibiogram, within the following four to six weeks. After the appeasement of the local findings and the laboratory results, a revision with a removal of the antibiotic spacer and reimplantation of an endoprosthesis - revisional or primary has been conducted on the patients, depending on the bone deficit. The functionality of the joint is graded based on the Haris Hip Score. The patients are being observed postoperatively for a period of 12 to 36 months.

A definite reimplantation has been applied to 20 patients, while one patient has been treated with a resection method. The Haris Hip Score was 45 preoperatively, and 80 postoperatively.

The applied protocol of the treatment of infected endoprosthesis is effective in the eradication of the infection and the final reimplantation.

Keywords

  • infection
  • hip
  • endoprosthesis
  • spacer

Клучни зборови

  • инфекција
  • колк
  • ендопротеза
  • спеј- сер
Open Access

Etiological Factors in Urgent Gastroduodenal Ulcer

Published Online: 30 Dec 2015
Page range: 203 - 210

Abstract

Abstract

Aim: The goal of the study is to assess the impact of the etiological and risk factors in the cases of urgent gastroduodenal ulcer.

Methods: This is a prospective study which included 67 patients selected randomly, all with urgent, life-threatening complications of the gastroduodenal ulcer, treated at the University Clinic for Digestive Surgery and the University Clinic for Gastroenterohepatology. For the purpose of the study the titer of IgG antibodies to Helicobacter pylori in serum is examined, as well as the use of NSAID and aspirin. We also tested the use of nicotine and alcohol. Besides these factors, we took into consideration the sex and the age.

Results: The serological test of Helicobacter pylori was positive in 89.6% of the cases. 31.3% used NSAID and 16.4% used aspirin. Large number, 65.7% of the patients were smokers, while 25.4% used alcohol.

With regard to the sex, 83.6% were male and 16.4% were female. The most frequent age group was the one from 41 to 60 years with 40.3% and those between 61 and 80 years of age with 35.8%.

Conclusion: The presence of Helicobacter pylori with the urgent gastroduodenal ulcer was exceptionally high, in 89.6% of the duodenal and gastric ulcers. NSAID and aspirin are factors that also influence the etiology of this disease. Smoking is a significant risk factor. Alcohol is less present, but still an important factor.

Keywords

  • Helicobacter pylori
  • nonsteroidal anti-inflammatory drugs (NSAID)
  • aspirin

Клучни зборови

  • Helicobacter pylori
  • НСАИЛ
  • аспи- рин
Open Access

The Impact of Psycho-Education on in Vitro Fertilisation Treatment Efficiency

Published Online: 30 Dec 2015
Page range: 211 - 216

Abstract

Abstract

Aim: The aim of the study was to examine the efficiency of psycho-education of candidates for the IVF in stress, anxiety and depression decreasing, and the impact of the psycho educative techniques on the successfulness of the treatment.

Method: A random sample of 64 candidates for IVF treatment is divided in two groups: control group without psycho-education (32 candidates) and intervention group of 32 candidates included in psycho-education. Depression, anxiety and stress scale (DASS) was used as a psychometric test. It’s a multiple choice, self-reported inventory for measuring the levels of stress, anxiety and severity of depression. For statistic evaluation SPSS software was used.

Results: The study shows that the intervention group included in psycho-education has a signifycantly lower scores on stress (t = 3.201, p < 0.05) and anxiety (t = 2.311, p < 0.05). The scale of depression did not show differences in the two compared groups. However, the success of the IVF treatment is more common among candidates that were included in psycho-education.

Conclusion: In our country, psycho-education of candidates for in vitro fertilization is not systematically integrated in the treatment. The study showed the efficiency of psycho-education in anxiety and stress decreasing, as well as significant impact in the successfulness of the treatment.

It was pointed out that psychological support of candidates for IVF is important for the lessening of the negative emotional reactions of candidates as well as for the successfulness of the treatment.

Keywords

  • treatment
  • stress
  • anxiety
  • depression
  • psycho-educational counseling

Клучни зборови

  • третман на кандидати за ин витро фертилизација
  • стрес
  • анксиозност
  • депресивност
  • пси- хоедукација
Open Access

Matrix Matalloproteinase-8 Gene Polymorphism in Chronic Periapical Lesions

Published Online: 30 Dec 2015
Page range: 217 - 224

Abstract

Abstract

Background/Aim: Increased levels of matrix metalloproteinase-8 (MMP-8) have been associated with risk of developing chronic periapical lesion (CPL). Gene polymorphisms are contributing factors in the pathogenesis of the inflammation. The aim of this study was to analyze polymorphism in the gene MMP-8 and its association and influence on clinical manifestation of CPL.

Methods: A total of 240 unrelated Macedonian subjects were included in the present study. Polymorphism -799 C/T in the gene MMP-8 detected with restriction enzyme BgIII was studied in 120 patients with CPL and 120 controls without any signs of chronic or acute inflammatory process in the jaw. The amplification of the region of selected gene was made with polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP).

Results: Our results showed that there were differences in the allele and genotype frequencies of the MMP8 -799 C/T polymorphisms between patients with CPL and controls (p < 0.05). Also this study suggests that MMP-8 polymorphism -799 C/T was a risk for expression of CPL (OR=8.27<3.44<OR<20.26).

Conclusion: The detection of this genetic polymorphism is relevant for obtaining providential treatment of patients who are at high risk of chronic periapical inflammation.

Keywords

  • chronic periapical lesion
  • single nucleotide polymorphism
  • matrix metalloproteinase-8

Клучни зборови

  • хронична периапикална лезија
  • еди- нечен нуклеотиден полиморфизам
  • матрикс метало- протеиназа-8
Open Access

Overdentures on Implants for Better Quality of Life Among the Fully Edentulous Patients – Case Reports

Published Online: 30 Dec 2015
Page range: 225 - 234

Abstract

Abstract

Global aging population has brought several challenges for their medical systems and total edentulism is one of them. The fabrication of removable acrylic dentures seems to be a simple and cheap treatment solution, but a majority of patients is not satisfied with their functional instability, causing limited diets, mouth soreness, speech and psycho-social problems etc. The results in many studies indicate an impact of oral conditions associated with the full denture wearing on oral-health related quality of life, especially in lower jaw. The reason for improper denture retention could be alveolar ridge bone resorption and numerous studies about this problem are plausible. Bone resorption in lower jaw may turn the alveolar ridge into a flabby soft tissue which is unable to sustain proper denture retention.

The implant-retained prosthesis is an alternative treatment option in these situations. Implants will provide retention, stability, function and aesthetics and they are not so expensive solution. The aim of this article is to show solving of retention problems of a lower denture in two different clinical cases using implants and without any special technology.

Keywords

  • overdentures
  • implants
  • quality of life

Клучни зборови

  • покровни протези
  • импланти
  • ква- литет на живеење
Open Access

Report on the Workshop and Regular Meeting of the Imode-CKD and Bcmolmed Marie Curie Training and Research Programs

Published Online: 30 Dec 2015
Page range: 235 - 240

Abstract

Abstract

A Workshop and Regular Meeting of the Marie Curie Training and Research Programs iMODECKD (Identification of the Molecular Determinants of established Chronic Kidney Disease) and BCMolMed (Molecular Medicine for Bladder Cancer) was held from 20-22 March at the Macedonian Academy of Science and Arts (MASA). The meeting was hosted by the participating center University of Skopje (SKO) - Goce Spasovski and MASA - Momir Polenakovic (R. Macedonia). The representative from MASA proteomic research center - Katerina Davalieva (R. Macedonia) had presentation on proteomic research in prostate cancer (PCa). 40 researchers from 13 different countries participated at the meeting. The Workshop was devoted on "Chronic Kidney Disease: Clinical Management issues", and consisted of 15 oral presentations given by nephrologists and experts in the field of CKD. Raymond Vanholder (Belgium) - past president of ERA-EDTA had a keynote lecture on "CKD: Questions that need to be answered and are not (or at least not entirely)". The workshop continued in four sessions with lectures from Alberto Ortiz (Spain), Olivera Stojceva-Taneva (R. Macedonia), Dimitrios Goumenos (Greece), Joachim Beige (Germany), Marian Klinger (Poland), Goce Spasovski (R. Macedonia), Joachim Jankowski (Germany), Adalbert Schiller (Romania), Robert Johnson (USA), Franco Ferrario (Italy), Ivan Rychlik (Czech Republic), Fulvio Magni (Italy) and Giovambattista Capasso (Italy), all covering a training theme. Within the meeting there were two lectures on complimentary skills for ethics in science and career advancement from two principal investigators - Goce Spasovski (R. Macedonia) and Joost Schanstra (France). During the Regular Meeting, 13 PhD students i.e. Early Stage Researchers and one Experienced Researcher from both Programs presented their work and progress within iMODE-CKD and BCMolMed projects. This meeting was a great opportunity to exchange experience and ideas in the field of systems biology approaches and translational medicine and planning future collaboration.

Keywords

  • prostate tumor
  • system biology
  • translational medicine
  • urinary proteomics

Клучни зборови

  • тумор на простата
  • системска био- логија
  • транслациона медицина
  • уринарни протеомици

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