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Mirko Spiroski

Report on Self-Evaluation of the Faculty of Medicine in Skopje, Republic of Macedonia (2001-2002)

Background. The self-evaluation is a process that provides a realistic reflection on the work and perspectives of a higher level educational institution, such as the Faculty of Medicine in Skopje. Thus, it is necessary to identify the positive and especially the negative elements of the overall functioning of the organization in order to suggest measures and professional staff to accomplish them.

Aim. The aim of this paper is to present the results of the first self-evaluation of the Faculty of Medicine at the University "Ss Kiril and Metodij" in Skopje, Republic of Macedonia (2001-2002) in order to be a model for future activities.

Material and methods. The process of self-evaluation was realized as follows: i) formation of working groups for separate segments of the self-evaluation process; ii) giving instructions to the Chiefs of the Cathedras and the administrative personnel of Cathedras on the process of collecting data; iii) discussions with the Chiefs of the Cathedras about the self-evaluation process; iv) preparation of the questionnaire; v) preparation of the interview based on previously prepared questionnaire; vi) interview with the Dean and the Vice-Deans of the Faculty of Medicine; vii) collecting of data from the Administration services of the Dean's Office; viii) checking and completion of the data; ix) development of a computer database; x) preparation of the first version of the Self-evaluation Report; and xi) final discussions and completing the Final Report.

Results. The Committee prepared a Self-evaluation Report and after a thorough discussion (for three months) they completed the final version.

Conclusions. The self-evaluation process and the evaluation of the Report for the first time presented the Faculty of Medicine in Skopje from all aspects of an higher level educational institution.

Open access

R Sutka, J Pec and T Pecova

Abstract

The introduction of new pharmacotherapy entities in the last decade accentuate the necessity to set up treatment guidelines based on real life evidence. Randomized controlled trials remain golden standard of a research. Data derived from studies aiming on daily clinical practice should bring needed, added value. Disease prevalence growth, due to increased life expectancy, better diagnostic procedures and earlier medical intervention, as well as ever growing demand for highly priced, sophistically produced drugs put stress on healthcare budgets even in developed countries. Large databases commonly called - therapy registries are implemented to collect data on therapy effectivity in terms of effectiveness, safety and patient long-term on therapy survival. Registries importance rose together with biological therapies introduction. New in class molecules entered the market conditionally being obliged to provide additional e.g. safety data. Such procedures require involvement of many different professionals, e.g. physicians, professional medical bodies, IT experts, database administrators, statisticians and government institutions. Paper based, followed by computer based forms were distributed among physicians to collect these data. eHealth technologies provide physicians with centralized, more intuitive applications. The particularities of different diagnosis caused great variations within each specific registry launched. Important information was missing since they were pointed out as optional and many were redundant causing frustration among physicians due to inadequate administrative workload. The main objective of this work was to set up the therapy registry standards and procedures. Methodology of „ideal“ moderate to severe plaque psoriasis biology therapy registry development, introduction, administration and evaluation was prepared to assist any government institution or professional body when planning registry deployment. Electronic application based on widely used MS Excel platform was developed and installed in the biological therapy centers as a standalone application for the pilot use.

Open access

Jean Gogusev, Yves Chretien and Dominique Droz

Aberrant Expression of Polycystin-1 in Renal Cell Tumors

Polycystin-1 (PC1) is a cellular transmembrane protein coded by the polycystic kidney disease (PKD1) gene, prevalently expressed in developing/mature kidney and in autosomal polycystic kidney disease (ADPKD). Limited data are available concerning the PC1 involvement in renal tumorigenenesis. Polycystin-1 expression was evaluated in 8 clear cell renal cell carcinomas (RCCs), 7 tubulopapillary cell type tumors, 3 solid RCCs developed in patients with von Hippel-Lindau disease (VHLD), one RCC developed in a patient on chronic haemodialysis and one angiomyolipoma in a patient with Tuberous sclerosis (TS). In the normal kidney, consistent level of polycystin-1 was detected in distal tubules, collecting duct, glomerular podocytes and vascular smooth muscle cells. The strongest immunoreactivity against polycystin-1 was observed in epithelial cells lining the cystic components in all ADPKD tissues. Five cases of clear cell type RCCs and two-tubulopapillary cell type RCCs consistently expressed PC1. In the VHL disease associated renal carcinomas, both the neoplastic cells and cystic tissue areas weakly expressed PC1. In TS-associated angiomyolipoma, the vascular component was PC1 positive, while the tumoral cells were scarcely stained. The present report indicates consistent expression of the PKD1 gene product polycystin-1, in normal kidney, ADPKD tissues, and renal cell carcinomas. The findings suggest that the level of PC1 expression is linked to tumor cell type, being a more frequent event in clear cell RCC.

Open access

R Sutka, J Pec and T Pecova

Abstract

Introduction: Biology therapies in a various medical specializations and for a broad spectrum of indications were launched during last two decades. As a new in class the therapies were obliged to provide additional data re gar ding efficacy and safety after their real medical practice integration. Patient registries, databases collecting various patient data, were introduced to grant data on the treatment effectiveness, safety, and long-term on treatment survival. Satisfactory treatment effect and acceptable safety profile were confirmed after couple of years of careful observation. However, the benefits were usually offered at much higher treatment costs compared to the standard therapies. Biologically similar drugs, so-called biosimilars (B.S), are being launched after original molecule patent protection expiry during recent years. They were expected as an ideal solution to avoid distinct impact on the medical budget: comparable effect for less money. The unsubstantiated doubts about biosimilar efficacy and safety were the reason of the late launch in many markets. Since biosimilars are considered as new therapy entities, the cautiousness to certain extent should be required. Information gained from post-marketing observations and patient registries over several years, confirmed the biosimilar product comparable quality. Healthcare budget savings could secure easier therapy access for more new patients.

Open access

Dimitrinka Jordanova Peshevska, Marija Raleva, Izabela Filov, Dinesh Sethi, Tamara Jordanova, Kadri Hazdi Hamza, Fimka Tozija and Vesna Damchevska Ilievska

Abstract

OBJECTIVES: One of the main objectives of this paper is to analyze the associations between physical abuse and neglect and health risk behaviours among young adolescents in the country.

METHOD: A representative sample consisted of total 1277 students (58.6% female and 41.6%), aged 18 and above. About 664 of them are in last (fourth) year of secondary school and 613 respondents are first- and second-year university students. The data were obtained using Adverse Childhood Experiences Study Questionnaires (Family Health History Questionnaire) for collecting information on child maltreatment, household dysfunction and other socio-behavioural factors, applying WHO/CDC-recommended methodology. Statistical significance was set up at p<0.05.

RESULTS: Physical abuse (21.1%) and physical neglect (20%) were reported with similar prevalence rates. Disciplining children by spanking or corporal punishment was presented with very high rate of 72.4%.

CONCLUSION: The results demonstrated a relationship between physical abuse and later manifestation of health risk behaviours such as: smoking and early pregnancy. Physical neglect increased the chances for drug abuse, drink-driving, having early sex, having more sexual partners.

Open access

Marija Raleva, Dimitrinka Jordanova Peshevska, Izabela Filov, Dinesh Sethi, Antoni Novotni, Dimitar Bonevski and Kadri Haxhihamza

Abstract

OBJECTIVES: One of the main objectives of this paper is to analyze the associations between childhood abuse, household dysfunction and the risk of attempting suicide among young adolescents in the country.

METHOD: A representative sample consisted of total 1277 students (58.6% female and 41.6% male), aged 18 and above in year four of 664 secondary school and 613 first- and second-year university students. The data were obtained using Adverse Childhood Experiences Study Questionnaires (Family Health History Questionnaire) for collecting information on child maltreatment, household dysfunction and other socio-behavioural factors, applying WHO/CDCrecommended methodology. Statistical significance was set up at p<0.05.

RESULTS: Emotional neglect, physical abuse and physical neglect were the most frequent abusive experiences students had. Overall, suicide attempts were reported by 3.1 % of respondents (4.7% by females and 0.8% by males). Those respondents who had been emotionally abused were almost three times as likely to attempt suicide, physical abuse almost doubles the chances of attempting suicide, substance abuse in the family increased the chances 2.3 times for attempting suicide, violent treatment of the mother almost quadrupled them for attempted suicide, having a family member who had been in prison increased the odds of almost 3.5 times for attempting suicide. Attempted suicide was found to be 1.5 times more likely as the number of ACEs reached 3 and 3.4 times more likely as the number of adverse childhood experiences reached four or more.

CONCLUSION: Identifying and treating children, adolescents and young adults who have been affected by adverse childhood experiences may have substantial value in our evolving efforts to prevent suicide

Open access

Katja Popovska, Milka Zdravkovska, Vesna Gerasimovska, Kiril Mihajlov, Bozhica Blazevska and Konstantin Icev

Evaluation of Different Methods for Hygienic Microbiological Control from the Working Surfaces in the Microbiological Laboratories

Background: The role of the inter-hospital non-living environment in spreading of some infections is not universally accepted attitude, but still there is a proof that in some cases it is a risk factor for causing infections with some pathogenic microorganisms. Isolation of microorganisms from the non-living environment can significantly vary in reproducibility and sensitivity of different methods of collecting specimen and its cultivation.

Aim: In aim to develop and assess hygienic control strategies with incorporating better monitoring and improved cleaning, we have undertaken this survey in microbiological labs to offer better approach in infection control procedures for sampling specimens from inanimate environment in health care facilities.

Material and Methods: Three issues might have influence on isolation rates of the mircroorganisms: sampling technique, cultivation methods and professional behaviour of the staff regarding the recommendations and guidelines for hygiene of the workplace. Staphylococcus aureus was almost the only isolated opportunistic microorganism from the surfaces of the workplaces (five from ten), beside Enterococcus, and there was no obvious differentiation in isolation capability between both used swabs. Semi-quantitative method was used for cultivation of saprophytic bacteria. Average of cfu from all used nutrient media was used to estimate bio-mass.

Results: Mann-Whitney U test has confirmed statistically significant differentiation between average of cfu (colony-forming unit) (p = 0.0215) sampled with Quanti swab in comparison with wet traditional cotton swab. Plating with swab on trypticase soy agar showed a statistically significant difference between the number of cfu after 24h and 48 h (Wilcoxon Matched Pairs Test: Z = 2.66; p = 0.0076). Plating with pouring on trypticase soy agar at 45°C revealed a statistically significant difference between the number of cfu after 24h and 48 h (Wilcoxon Matched Pairs Test: Z = 2.52; p = 0.01171).

Conclusion: This survey suggests that pour plate method is a more sensitive and appropriate cultivation method for hygienic control in healthcare facilities.

Open access

Rlnoy Varghese, S. Jyothy and A.A. Mohamed Hatha

11-S23. 11. Moncheva P, Tishkov S, Dimitrova N, Chipeva V, Nikolova SA, Nevena K, Bogatzevska N. Characteristics of soil actinomycetes from Antartica. J Cult Collect 2002; 3, 3-14. 12. Oskay M, Tamer AU, Azeri C. Antibacterial activity of some actinomycetes isolated from farming soils of Turkey. Afr J Biotechnol 2004; 3, 441-446. 13. Saadoun I, Gharaibeh R. The Streptomyces flora of Badia region of Jordan and its potential as a source of antibiotics active against antibiotic- resistant bacteria. J. Arid Environ. 2003

Open access

Verica Ivanovska and Kathleen Anne Holloway

sheet N°194 February 2011. World Health Organization, Geneva, 2011. www.who.int/mediacentre/factsheets/fs194/en/ 17. Kaplan W, Laing R. Priority medicines for Europe and the world. World Health Organization, Geneva,, 2004. http://hinfo.humaninfo.ro/gsdldata/collect/medicinedocs/index/assoc/s14208e/s14208e.pdf. 18. Goossens H et al. European Surveillance of Antimicrobial Consumption Project Group. Comparison of outpatient systemic antibacterial use in 2004 in the United States and 27 European countries. Clin Infect Dis 2007, 44

Open access

E. Veniou, I. Sofatzis, I. Kalantzis, M. Karakosta, M. Logothetis, E. Lianos and N. Ziras

Center for Health Statistics, which is part of the CDC, NCI is supporting the use of activity monitors to collect objective physical activity, sleep, and strength data for NHANES. Genes, Environment and Health Initiative (GEI) This trans-NIH includes an NCI-led component that invests in new technology to measure environmental toxins, dietary intake, and physical activity and to determine an individual’s biological response to those influences on the level of the genome, the proteome, and the metabolome. Measures Registry Catalogue of Surveillance