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Open Access Maced J Med Sci ; 6(2): 330-335, 2018 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-29531598


BACKGROUND: The fractures of the distal radius are one of the most frequent cases in the pediatric population. The primary way of treating these fractures is conservative, with manual reduction and cast immobilisation. In patients where reduction and retention of the fracture cannot be achieved, a surgical approach is the treatment of choice. AIM: To evaluate the benefits of using the minimally invasive surgical treatment of closed reduction using Sommer - pins in the treatment of the fractures of the distal radius in the pediatric population with the method of the Kapandji technique. MATERIAL AND METHODS: In this study, we used cases treated from 2012 to 2017, of 48 completely dislocated fractures of the distal radius in patients ages 6 -14 yrs., where the use of non-surgical treatment proved ineffective. In the surgical treatment, we used one or two Sommer - pins to achieve a correct reduction and fixation. RESULTS: The post-op immobilisation lasted 4 - 7 weeks with an underarm cast. The patients were closely followed in the period of 6 months following the intervention. The anatomic reduction was easily achieved with this type of technique in every case. In the post-op period, there was no significant loss of reduction and another surgical procedure was not needed in any of the cases. CONCLUSION: With the use of the closed reduction Kapandji technique, an easy and good anatomical reduction is achieved with good post-op results in the treatment of completely dislocated fractures in the distal radius in children.

J Med Virol ; 87(9): 1578-86, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25880030


High risk types of human papillomaviruses E6/E7 oncogenes and their association with tumor suppressor genes products are the key factors of cervical carcinogenesis. This study proposed them as specific markers for cervical dysplasia screening. The aim of the study is to compare the clinical and prognostic significance of HPV E6/E7 mRNA as an early biomarker versus HPV DNA detection and cytology in triage of woman for cervical cancer. The study group consists of 413 women: 258 NILM, 26 ASC-US, 81 LSIL, 41 HSIL, and 7 unsatisfactory cytology. HPV4AACE screening, real-time multiplex PCR and MY09/11 consensus PCR primers methods were used for the HPV DNA detection. The real-time multiplex nucleic acid sequence-based assay (NucliSENS EasyQ HPV assay) was used for HPV E6/E7 mRNA detection of the five most common high risk HPV types in cervical cancer (16, 18, 31, 33, and 45). The results show that HPV E6/E7 mRNA testing had a higher specificity 50% (95% CI 32-67) and positive predictive value (PPV) 62% (95% CI 46-76) for CIN2+ compared to HPV DNA testing that had specificity of 18% (95% CI 7-37) and PPV 52% (95% CI 39-76) respectively. The higher specificity and PPV of HPV E6/E7 mRNA testing are valuable in predicting insignificant HPV DNA infection among cases with borderline cytological finding. It can help in avoiding aggressive procedures (biopsies and over-referral of transient HPV infections) as well as lowering patient's anxiety and follow up period.

Detecção Precoce de Câncer/métodos , Testes de DNA para Papilomavírus Humano , Proteínas Oncogênicas Virais/genética , Papillomaviridae/genética , RNA Viral/análise , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Idoso , Alphapapillomavirus/genética , Células Escamosas Atípicas do Colo do Útero/virologia , Biomarcadores , Neoplasia Intraepitelial Cervical/diagnóstico , DNA Viral/análise , Feminino , Grécia , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Infecções por Papillomavirus/virologia , RNA Mensageiro/análise , RNA Mensageiro/genética , RNA Viral/genética , Sensibilidade e Especificidade , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologia , Adulto Jovem
Artigo em Inglês | MEDLINE | ID: mdl-25532093


The aim of this paper is to address the dilemmas of the paediatric surgeon when facing an isolated, unilateral, congenital hydronephrosis and discuss the strategic options for the management of this condition. Congenital hydronephrosis, the most commonly diagnosed uropathy in children, is usually a benign and self-resolving condition. Nonobstructive hydronephrosis does not require operative treatment, while timely treatment is imperative for obstructive hydronephrosis before significant renal damage ensues. Managing congenital hydronephrosis is a challenging task. Thirty-two children with unilateral, isolated hydronephrosis and nonobstructed renography curves were followed up for 3 years. On the initial evaluation according to the grade of hydronephrosis: 22.6% were grade I, 54.8% grade II and 22.6% grade III. After 12 months of follow-up: 30% were grade I, 51 .5% grade II and 18.5% grade III, respectively. After the three-year follow-up, there were no hydroneproses greater than grade II. The mean value of the separate GFR of the affected kidney at initial evaluation was 42.83%, and 40.33% after three years. In three children the treatment was converted from conservative to surgical. Nonobstructive, congenital hydronephrosis is a benign condition not requiring any medical treatment, but aggressive observation is indicated.

Hidronefrose/terapia , Renografia por Radioisótopo/métodos , Doenças Urológicas/terapia , Adolescente , Criança , Pré-Escolar , Constrição Patológica , Feminino , Seguimentos , Humanos , Hidronefrose/congênito , Hidronefrose/patologia , Lactente , Recém-Nascido , Masculino , Doenças Urológicas/patologia
Artigo em Inglês | MEDLINE | ID: mdl-24285353


OBJECTIVE: To provide virological and epidemiological information on patients laboratory-tested for influenza A/ H1N1pdm during the pandemic season April 2009/May 2010. MATERIALS AND METHODS: Demographic and other data were obtained from the request form arriving with the samples of patients whose symptoms met the clinical definition of influenza A infection. The RNA was tested for the presence of influenza virus using the CDC real-time RT-PCR assay. A total of 3010 suspect patients (pts) were tested from week 18 2009 to week 20 2010. RESULTS: 1632 pts (54.2%) were oositive for influenza. From them 1556 samples were confirmed as H1N1pdm. There was a domination of H1N1pdm positivity among young persons in age groups 5-17 (34.4%) and 18-49 (31.4%) years. The pandemic influenza was presented in two waves. The first wave started on 20 June with the first positive case and peaked early in August (week 32). The second wave started from week 44. The majority of positive cases were between week 45 and week 52. 37.7% of the positive pts were hospitalized--66.7% of pts at age 65+ and 63.3% of children in the age group 0-4 years. The highest percentage of patients with underlying medical conditions were in the age group 50-64 (49.35%) years and 65+ (88.23%) years. 1.15% of the positive pts for H1N1pdm gave data for vaccination with seasonal influenza. CONCLUSIONS: Data obtained from laboratory and epidemiological surveillance of pandemic influenza will serve public health to a full understanding of the pandemic 2009/2010 influenza in R. Macedonia and dealing with future challenges.

Técnicas de Laboratório Clínico , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Pandemias , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H1N1/genética , Vacinas contra Influenza/administração & dosagem , Influenza Humana/diagnóstico , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Vigilância da População , Valor Preditivo dos Testes , RNA Viral/genética , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Estações do Ano , Fatores de Tempo , Vacinação , Adulto Jovem
Mater Sociomed ; 25(4): 250-4, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24511268


AIM: To examine the existing situation, barriers and consequences of the intercultural communication in health institutions and to offer training models for strengthening and improving communication skills of health professionals in the Republic of Macedonia. METHODS: A cross-sectional survey was conducted to assess the relationship between patients and health professionals. A total of 813 health professionals (302 physicians and 511 other medical staff) from different healthcare institutions, and 1016 patients participated in cross-sectional survey performed in autumn 2010. RESULTS: The research has showed that each third examined patient thought that his/her physician or the other medical personnel had no understanding for his/her emotions and gave no answer to all of his/her questions. From the other side, 60% of the physicians declare that they have a good communication with patients speaking other language than their mother tongue. Only 60% of physicians said that they know good the culture of their patient and 52% of the other medical staff said that they adjusted the treatment to the patient culture (religion, attitudes, language, life style). CONCLUSION: There are some gaps in current provision of health care practice in an aspect of effective interactions and communication skills of health professionals to meet patient needs in a multicultural and multilingual setting. A training model is proposed for strengthening communication skills of health professionals.

Med Glas (Zenica) ; 9(2): 393-6, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22926383


Development of antibiotic resistance represents a major global and Macedonian public health problem. To assess the opinion and knowledge of the citizens of Macedonia about the usage of antibiotics, voluntary and anonymous survey was realized. A total of 239 persons (age 10-67 years) were interviewed. Following information was obtained: 73.64% get antibiotics with a medical prescription; and 87.03% receiving the antibiotic on time, dosage and prescribed duration. When asked about knowledge about antibiotics, 38% of the interviewed persons gave the right answer, 43.1% of respondents made false statements that antibiotics are effective against viral infections and 25.52% did not express any opinion.

Antibacterianos/uso terapêutico , Adolescente , Adulto , Idoso , Criança , Coleta de Dados , Uso de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem