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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

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

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


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


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

Verica Ivanovska and Kathleen Anne Holloway

sheet N°194 February 2011. World Health Organization, Geneva, 2011. 17. Kaplan W, Laing R. Priority medicines for Europe and the world. World Health Organization, Geneva,, 2004. 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

Floriana Elvira Ionică, Simona Negreș, Oana Cristina Șeremet and Cornel Chiriță


Background and Aims: In the last three decades, obesity and its related co morbidities has quickly increased. Sometime, obesity was viewed as a serious health issue in developed countries alone, but now is recognized as a worldwide epidemic, and its associated costs are enormous. Obesity is related with various diseases, like hypertension, type 2 diabetes mellitus (T2DM), dyslipidemia, chronic cardiovascular diseases, respiratory conditions, alongside chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This review purpose is to provide data on the current anti-obesity drugs, also available and in the development. Material and Methods: We searched MEDLINE from 2006 to the present to collect information on the anti-obesity pharmacotherapy. Results and Conclusions: In the patients with obesity related comorbidities, there may be an adaptation of the anti-obesity pharmacotherapy to the patients’ needs, in respect to the improvements of the cardiometabolic parameters. Although their efficacy was proven, the anti-obesity pharmacotherapies have presented adverse events that require a careful monitoring during treatment. The main obstacle for approve new drugs seems to be the ratio between the risks and the benefits, because of a long-time background of perilous anti-obesity drugs.

Open access

Safa’a A. Al-Zeidaneen, Maha T. Hdaib, Yahya W. Najjar and Marwa A. Al-Zidaneen


Background: The number of elderly people is increasing worldwide, and elevated body mass index is a common problem that occur with elderly people, which can be directly or indirectly affected by level of physical activity and gender. So, it is essential to study the effect of both physical activity and gender on body mass index in elderly people.

Material and methods: A cross-sectional, observational study was conducted on 120 elderly Jordanian people who live in Amman (62 women; 58 men) and evaluated for body mass index. Those participants were 40 elderly persons who attended the gym at least twice a week for the last 2 years, and 80 elderly who were home resident or physically inactive. A structured questionnaire was used to collect data about personal, social, health and life-style information including the daily activities and the anthropometric measurements for the study participants.

Results: The results of this study showed that as elderly people become physically inactive, their body mass index will increase to become as overweight or obese. The results of this study also showed that body mass index of 30 and more was associated with gender, with majority of female elderly (50%) having body mass index of 30 or more.

Conclusion: Physical activity should be maintained by both genders in order to prevent obesity, primarily in women as they are more likely to become obese that men. Furthermore, body mass index should not exceed 30 in elderly. Physical activity is essential in order to obtain healthy weight.

Open access

Daniela Pătru, Silviu Daniel Preda, Agnesa Pcela, Călin Alexandru Voiculescu, Simona Dionisie and Maria Moța


Background and Aims: The aim of this paper was to demonstrate the necessity to evaluate the needs of patients with type 2 diabetes (assessing degrees of dependency) and nursing intervention for each of the 14 fundamental needs of human beings. Material and

method: The study was prospective and interventional, with a focus on educational methods, conducted over a period of 12 months on a group of 100 patients with type 2 diabetes. The stages of the study were: signing the informed consent, collecting data on a „nursing sheet”, statistical processing and analysis of the obtained results. Results: The distribution of cases according to the total degree of dependence in carrying out the fundamental needs shows that, regardless of the stage of disease evolution, no cases of independence or total severe dependence were registered. On hospital admission, the number of minimum total dependence cases was lower than at discharge while the number of cases of average total dependence was higher on admission than at discharge, regardless of the stage of disease evolution. Conclusions: The assessment of the 14 fundamental needs of patients with diabetes is necessary to identify the degree of dependence, to plan nursing interventions and to apply individualized care for each patient.

Open access

Paula Ionilă, Ruxandra Jurcuţ, Nicoleta Ferariu, Monica Roşca, Monica Chivulescu, Adriana Mursă, Sebastian Militaru, Alin A. Ionescu, Cristina Căldăraru, Ana G. Fruntelată, Silvia F. Goanţă, Simina Crişan, Adina Ionac, Ana-Maria Avram, Attila Frigy, Radu Sascău, Cătălina Arsenescu-Georgescu, Ioan M. Coman, Bogdan A. Popescu, Carmen Ginghină and Eduard Apetrei


Introduction. Hypertrophic cardiomyopathy (HCM) is a disease with increased left ventricular (LV) wall thickness not solely explained by abnormal loading conditions, with great heterogeneity regarding clinical expression and prognosis. The aim of the present study was to collect data on HCM patients from different centres across the country, in order to assess the general characteristics and therapeutic choices in this population.

Methods. Between December 2014 and April 2017, 210 patients from 11 Romanian Cardiology centres were enrolled in the National Registry of HCM. All patients had to fulfil the diagnosis criteria for HCM according to the European Society of Cardiology guidelines. Clinical, electrocardiographic, imaging and therapeutic characteristics were included in a predesigned online file.

Results. Median age at enrolment was 55 ± 15 years with male predominance (60%). 43.6% of the patients had obstructive HCM, 50% non-obstructive HCM, while 6.4% had an apical pattern. Maximal wall thickness was 20.3 ± 4.8 mm (limits 15-37 mm) while LV ejection fraction was 60 ± 8%. Heart failure symptoms dominated the clinical picture, mainly NYHA functional class II (51.4%). Most frequent arrhythmias were atrial fibrillation (28.1%) and non-sustained ventricular tachycardia (19.9%). Mean sudden cardiac death risk score (SCD-RS) was 3.0 ± 2.3%, with 10.4% of the patients with high risk of SCD. However, only 5.7% received an ICD. Patients were mainly treated with beta-blockers (72.9%), diuretics (28.1%) and oral anticoagulants (28.6%). Invasive treatment of LVOT obstruction was performed in a small number of patients: 22 received myomectomy and 13 septal ablation. Cardiac magnetic resonance was reported in only 14 patients (6.6%).

Conclusions. The Romanian registry of HCM illustrates patient characteristics at a national level as well as the gaps in management which need improvement – accessibility to high-end diagnostic tests and invasive methods of treatment.