Дијагностицирање и превенција на најчестите анемии во источниот регион на Р.Македонија

Анемијата е состојба каде циркулирачката маса на крвта не ја задоволува потребата на ткивата за кослород. Според СЗО анемијата се дијагностицира кога вредностите на Н6 се пониски од 130 §/1, за мажи, или под 120 §/1 за жени. Редукцијата на хемоглобин најчесто е следена и со пад на бројот на ертитроцитите и вредностите на хематокритот

Прирачник за спроведување на мерките за следење на комуникациите

Проектот „Прирачник за спроведување на мерките за следење на комуникациите”е дел од Програмата на DCAF за реформа на безбедносно – разузнавачките служби во Република Северна Македонија која започна во 2017 година за поддршка на националните реформски напори за развој на одговорноста во безбедносно-разузнавачкиот сектор во согласност со европските стандарди и добри практики. Проектот има за цел да го зајакне судскиот капацитет и експертизата во овластувањето и надзорот над употребата на посебните истражни мерки (ПИМ) за собирање информации од страна на безбедносно-разузнавачките служби. Прирачникот е подготвен од правни експерти и од самите членови на правосудниот систем за кои првенствено е наменет. Процесот на креирање на овој Прирачник траеше околу една година и беше реализиран од страна на Одборот за надзор - група македонски судии, обвинители и правни експерт

Bioactivity of essential oils from cultivated winter savory, sage and hyssop

Species of the Lamiaceae family have enjoyed a rich tradition of use for flavoring, food preservation, and medicinal purposes, due to their curative and preventive properties. Cultivated winter savory (Satureja montana L.), sage (Salvia officinalis L.) and hyssop (Hyssopus officinalis L.) are produced for seed, herb, and essential oil. Dominant compounds in S. montana essential oil were carvacrol (43.2%) and thymol (28.4%), while cis-thujone (27.1%) and camphor (19.3%), followed by trans-thujone and 1,8-cineole were the major compounds in S. officinalis essential oil. As for H. officinalis essential oil, cis- and trans-pinocamphone (41.1% and 20.5%, respectively) were the most abundant compounds, followed by β-pinene. The highest antimicrobial properties, as well as antioxidant capacity, showed S. montana essential oil compared to other tested essential oils. Furthermore, H. officinalis essential oils showed higher antioxidant activity than that of S. officinalis. The aim of this investigation was to determine the composition and bioactivity of essential oils of mentioned varieties. Presented results show that S. montana essential oil could be proposed as a valuable source of natural preservatives

Novel insights to the anti-proliferative activity of rosemary (Rosmarinus officinalis L.) co-treatment

The aim of this study was to characterize volatile and non-volatile compounds of rosemary from the North Adriatic region and to determine its antiproliferative activity, alone or in combination with radiomimetic bleomycin (BLM) on three malignant and one non-transformed human cell line. Chemical analysis of the volatile compounds revealed the presence of monoterpenes (93.8%), in which 1.8-cineol (32.9%) and camphor (15.5%) were the dominant compounds. Also, obtained results showed that the major polyphenolic constituents in rosemary extract were phenolic acids (rosmarinic acid and its derivatives up to 69.2 mg 100 g-1), as well as flavones and flavonols in the following order: luteolin>isorhamnetin>quercetin>kaempferol>apigenin. Cell growth test showed that rosemary extract alone exerted moderate antiproliferative activity, as well as a synergistic antiproliferative effect with bleomycin (EC50 344.3-461.5 µg mL-1 and 58.6-292 µg mL-1, respectively). The anti-tumor effect of rosemary extract in combination with BLM was much stronger, compared to BLM itself on the breast cancer cells. Through their proposed sensitizing effect, rosemary extracts, in combination with the standard chemotherapeutics, could be used for the investigations of possible therapeutic modalities

Evaluation of the effects of nursing interventions in patients with neutropenic fever entered into the prospective study of empiric antibiotic therapy

Background: Febrile neutropenia (FN) is a potentially lethal complication of severe neutropenia induced mainly by chemotherapy. The treatment of FN is one of the most important fields in supportive therapy in cancer patients. We evaluated the effects of health care measures in patients with FN entered in randomized prospective study of the two empiric antibacterial regimens Cefoperazone versus the combination of cefoperazone and amikacin. All patients were admitted in the Oncology Intensive Care Unit for the treatment of FN and intensive monitoring. This study is currently ongoing in cooperation with the Department for Medical Oncology, from which patients are recruited into the study. The objective of this report is to show the importance of nursing interventions in health care of patients with FN for Timely recognition of neutropenia, prevention of infections in neutropenic patients, prompt reaction in urgent conditions of FN and infection, and effective treatment of neutropenia. Patients and methods: From February 2001 to May 2003, 483 patients with grade 4 neutropenia (according to the WHO criteria) were registered at the Department of Medical Oncology. Eighty of these patients were entered into the study, 39 patients were treated with cefoperazone alone (group A), and 41 patients with the combination of cefoperazone and amikacin (group B). The data about planned nursing interventions were collected from the health care plan. Nursing interventions serving in prevention of development of FN in severely neutropenic patients are as follows: Everyday check-up, the control of body temperature every 6 hours, the observation of patients and monitoring for symptoms and signs of infection, and detailed inspection of patients (exposed spots risky for infection, oral mucous membrane, intravenous spots catheters, wounds), control of drugs which patient takes (some of them can mask signs and symptoms of infection), control of patient's personal hygiene. Nursing interventions performed during the period of FN are as follows: Continual check-ups, control of vital functions every 6 h, and more frequently, as needed, 2 samples of hemoculture for aerobes and anaerobes within 30-minute period, urinoculture, smears of skin lesions and of oral mucus. As neutropenic patients are very often at high risk for severe stomatits, identification of its symptoms and aseptic care of oral cavity are very important nursing interventions directed toward prevention of the development of stomatitis and its complications. Results: Two hundred and forty eight out of 483 patients with severe neutropenia (51,3%) developed FN. Eighty patients of them entered our clinical study. The median duration of severe neutropenia for a group of 39 patients treated with cefoperazone alone was 5 days, while median duration of FN was 4,4 days. In 41 patients treated with cefoperazone and amikacin, the median duration of neutropenia grade 4 was 6 days, and the duration of FN was 4 days. Documented clinical infections in both groups of patients are presented on Table 1. In 7 and 14 patients in groups A and B, respectively urinoculture was positive. Furthermore, hemoculture was positive in 8 patients in both treatment arms. Nine patients developed stomatitis grade 1 and grade 2, without further complications. Conclusion: Our results reveal the substantial contribution of nursing health care in neutropenic patients and those with FN in preventing and in time treating these complications

Gastrointestinal stromal tumors (gists): Definition, clinical, histological, immunohistochemical and molecular genetic features and predictors of malignant potential and differential diagnosis

Gastrointestinal stromal tumors (GISTs) represent a distinct and the most important subset of mesenchymal tumors of the gastrointestinal (GI) tract GISTs occur throughout the GI tract but are usually located in the stomach and small intestine. The cellular origin, differentiation, nomenclature and prognosis of GISTs are controversial. Because GISTs, like the interstitial cells of Cajal, the GI pacemaker cells, express CD117 (c-kit protein), the origin of GISTs from the Cajal cells has recently been suggested. GISTs are also known for their wide variability in clinical behavior and for the difficulty to determine their malignant condition The most reproducible predictors of malignancy are mitotic count >1-5 per10 high-powered fields (HPF), size >5 cm, tumor necrosis, infiltration and metastasis to other sites. However, some tumors with mitotic activity <1/10 HPF may metastasize indicating some uncertainty in malignant potential of GISTs, especially those larger than 5 cm. Recently, mutations in c-kit gene (exon 11) preferentially occur in malignant GISTs and may be a clinically useful adjunct marker in evaluation of GISTs. In conclusion, the strong CD117 expression mostly defines primary GI mesenchymal tumors as GIST. Specific identification of GIST may become clinically important if therapies targeting the c-kit tyrosine kinase activation become available

Pathogenesis of malignant ascites in ovarian cancer patients

Peritonitis carcinomatosa, indicating the presence of malignant cells in the peritoneal cavity, is a well- known complication of malignant disease. The collection of intraperitoneal fluid in a patient with ovarian cancer is most likely due to intraperitoneal spread of disease. The recognition of small quantities of intraperitoneal fluid may have staging and prognostic significance, while symptomatic large collections may reflect end-stage disease, which permits only palliative therapeutic options. In this paper we dis- cussed the pathogenesis of malignant ascites in ovarian cancer patients and suggested potential new treatment approaches

The use of discharge haemoglobin and NT-proBNP to improve short and long-term outcome prediction in patients with acute heart failure

AIMS: To examine the prognostic value of admission (A) and discharge (D) haemoglobin (Hb) and its relationship with N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) in patients hospitalised for acute heart failure (AHF). The outcomes of interests were rehospitalisation or death after one, six or twelve months after discharge. METHODS: 317 hospitalised AHF patients (74.7±9.4 years) were enrolled in two academic centres in Belgrade and Rome. Laboratory analyses, including NT-proBNP were assessed at admission, and Hb also at discharge. Patients were divided into two groups according to the presence of anaemia. Follow-up contact was made by telephone. Statistical analyses were performed using SPSS software version 21.0. RESULTS: According to A and DHb levels (<120 g/l for women and <130 g/l for men), anaemia was present in 55% and 62% of patients, respectively ( P=0.497). Lower DHb was associated with the rehospitalisation risk after one (OR=0.96, P=0.004), six (OR=0.97, P<0.001) and 12 months (OR=0.97, P<0.001). For every g/l decrease of DHb, the risk of rehospitalisation after one year was increased by 3.3%. In the first six months, DHb contributed to increased risk of death (OR=0.97, P=0.005), but NT-proBNP showed greater power (OR=2.1, P<0.001). CONCLUSIONS: In AHF patients discharge anaemia is a strong predictor for short and long-term rehospitalisation, while NT-proBNP seems to be a better predictor for mortality. Discharge Hb and NT-proBNP should be assessed together in order to detect the patients with higher risk of future death and rehospitalisation