132 results on '"Zan, Mitrev"'
Search Results
2. Case Report: Omicron BA.2 Subvariant of SARS-CoV-2 Outcompetes BA.1 in Two Co-infection Cases
- Author
-
Marija Gjorgjievska, Sanja Mehandziska, Aleksandra Stajkovska, Slavica Pecioska-Dokuzovska, Anica Dimovska, Idriz Durmish, Sara Ismail, Teodora Pavlovska, Antonija Stojchevska, Haris Amedi, Jasna Andonova, Marija Nikolovska, Sara Velickovikj, Zan Mitrev, Ivan Kungulovski, and Goran Kungulovski
- Subjects
COVID-19 ,co-infection ,omicron ,next-generation sequencing ,SARS- CoV2 ,Genetics ,QH426-470 - Abstract
Trends from around the world suggest that the omicron BA.2 subvariant is increasing in proportion to the original BA.1 subvariant. Here we report two cases of co-infection with omicron BA.1 and omicron BA.2 in co-exposed individuals. In both individuals, genome sequencing and/or S-gene specific PCR identified omicron BA.1 at early time-points, which was replaced by omicron BA.2 at later time-points of the infection. The timeline of our data supports the proposition that BA.2 outcompetes BA.1 in a real-life scenario, and in time becomes the dominant variant in the upper respiratory tract of the host.
- Published
- 2022
- Full Text
- View/download PDF
3. Early Initiation of Extracorporeal Blood Purification Using the AN69ST (oXiris®) Hemofilter as a Treatment Modality for COVID-19 Patients: a Single-Centre Case Series
- Author
-
Petar Ugurov, Dijana Popevski, Tanja Gramosli, Dashurie Neziri, Dragica Vuckova, Marko Gjorgon, Emil Stoicovski, Sanja Marinkovic, Lidija Veljanovska-Kiridjievska, Katerina Ignevska, Sanja Mehandziska, Elena Ambarkova, Zan Mitrev, and Rodney Alexander Rosalia
- Subjects
COVID-19 ,Interleukin-6 ,Heparin ,TNF protein, human ,Tumor Necrosis Factor-alpha ,Respiratory Distress Syndrome, Adult ,C-Reactive Protein ,Blood Platets ,Respiratory Rate ,Cytokines ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Introduction: Severe coronavirus disease 2019 (COVID-19) is characterised by hyperinflammatory state, systemic coagulopathies, and multiorgan involvement, especially acute respiratory distress syndrome (ARDS). We here describe our preliminary clinical experience with COVID-19 patients treated via an early initiation of extracorporeal blood purification combined with systemic heparinisation and respiratory support. Methods: Fifteen patients were included; several biomarkers associated with COVID-19 severity were monitored. Personalised treatment was tailored according to the levels of interleukin (IL)-6, IL-8, tumour necrosis factor alpha, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, thrombocyte counts, D-dimers, and fibrinogen. Treatment consisted of respiratory support, extracorporeal blood purification using the AN69ST (oXiris®) hemofilter, and 300 U/kg heparin to maintain activation clotting time ≥ 180 seconds. Results: Ten patients presented with severe to critical disease (dyspnoea, hypoxia, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). The median intensive care unit length of stay was 9.3 days (interquartile range 5.3-10.1); two patients developed ARDS and died after 5 and 26 days. Clinical improvement was associated with normalisation (increase) of thrombocytes and white blood cells, stable levels of IL-6 (< 50 ng/mL), and a decrease of CRP and fibrinogen. Conclusion: Continuous monitoring of COVID-19 severity biomarkers and radiological imaging is crucial to assess disease progression, uncontrolled inflammation, and to avert irreversible multiorgan failure. The combination of systemic heparin anticoagulation regimens and extracorporeal blood purification using cytokine-adsorbing hemofilters may reduce hyperinflammation, prevent coagulopathy, and support clinical recovery.
- Published
- 2021
- Full Text
- View/download PDF
4. Continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters as adjuvant therapy for anaerobic descending necrotizing mediastinitis: a case report
- Author
-
Dijana Popevski, Magdelena Popovska-Cvetkova, Katerina Ignevska, Rodney A. Rosalia, and Zan Mitrev
- Subjects
Descending necrotizing mediastinitis (DNM) ,Anaerobic septic shock ,Extracorporeal blood oxygenation ,Medicine - Abstract
Abstract Background We describe a combinatorial intensive care approach and discuss the critical factors that allowed us to successfully manage a life-threatening case of acute anaerobic septic shock triggered by descending necrotizing mediastinitis. Case presentation We admitted a 38-year-old critically ill Kosovar Albanian man to our intensive care unit because of clinical manifestations of severe sepsis. His condition had worsened in the previous 2 weeks following unsuccessful antibiotic therapy for tonsillitis complicated by retropharyngeal abscesses. Computed tomography and intraoperative observations identified abscesses in the anterior and middle mediastinum regions and the distal part of the neck, directly on the border with the left lobe of the thyroid gland. Cultures indicated infections with α-hemolytic Streptococcus and Clostridium species: High procalcitonin and lactate levels, blood gas analysis, poor peripheral capillary oxygen saturation, and severe hemodynamic instability pointed to a case of acute septic shock. The entire treatment consisted of an aggressive antibiotic regimen, transthoracic and mediastinal surgical evacuation of the abscess, vacuum sealing drainage with a pleural chest tube, continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters, and extracorporeal blood hyperoxygenation. Conclusions Efficient treatment of severe anaerobic sepsis resulting from descending necrotizing mediastinitis should build on a multidisciplinary approach. In support of first-line therapies with targeted antibiotics and surgical debridement, clinicians should consider alternative therapies such as continuous venovenous hemodiafiltration with cytokine-adsorbing hemofilters and hyperoxygenation.
- Published
- 2019
- Full Text
- View/download PDF
5. Cardiac autotransplantation and ex vivo surgical repair of giant left atrium: a case presentation
- Author
-
Zan Mitrev, Milka Klincheva, Tanja Anguseva, Igor Zdravkovski, and Rodney Alexander Rosalia
- Subjects
Giant left atrium ,Warm blood perfusion ,Atrial fibrillation ,Cardiac autotransplantation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Chronic Mitral Valve disease is strongly associated with Left atrial enlargement; the condition has a high mortality risk. Clinical manifestations include atrial fibrillation, pulmonary hypertension, thromboembolic events, and in cases of Giant Left Atrium (GLA) and a distorted cardiac silhouette. Full sternotomy, conventional open-heart surgery, reductive atrioplasty and atrioventricular valve repair are required to resolve symptoms. However, these procedures can be complicated due to the posterior location of the GLA and concomitant right lateral protrusion. Cardiac autotransplantation is superior under these conditions; it provides improved visual access to the posterior atrial wall and mitral valve, hence, facilitates corrective surgical procedures. We aimed to assess the clinical outcome of patients undergoing cardiac autotransplantation as the primary treatment modality to resolve GLA. Moreover, we evaluated the procedural safety profile and technical feasibility. Case presentation Four patients, mean EuroSCORE II of 23.7% ± 7.7%, presented with heart failure, atrial fibrillation, left atrial diameter > 6.5 cm and a severe distorted cardiac silhouette; X-ray showed prominent right lateral protrusion. We performed cardiac autotransplantation using continuous retrograde perfusion with warm blood supplemented with glucose followed by atrioplasty, atrial plication, valve annuloplasty and valve repair on the explanted beating heart. The surgical approach reduced the left atrial area, mean reduction was − 90.71 cm2 [CI95% -153.3 cm2 to − 28.8 cm2, p = 0.02], and normalized pulmonary arterial pressure, mean decrease − 11.25 mmHg [CI95% -15.23 mmHg to − 7.272 mmHg, p = 0.003]. 3 out of 4 patients experienced an uneventful postoperative course; 2 out of 4 patients experienced a transient return to sinus rhythm following surgery. One was operated on in 2017 and is still in good condition; two other patients survived for more than 10 years; Kaplan-Meier determined median survival is 10.5 years. Conclusions Cardiac autotransplantation is an elegant surgical procedure that facilitates the surgical remodelling of Giant Left Atrium. Surgical repair on the ex vivo beating heart, under continuous warm blood perfusion, is a safe procedure applicable also to high-risk patients.
- Published
- 2018
- Full Text
- View/download PDF
6. Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines
- Author
-
Antonella Fara, Zan Mitrev, Rodney Alexander Rosalia, and Bakri M. Assas
- Subjects
covid-19 ,il-6 ,tnf-α ,ifn-γ ,sars ,coronavirus ,Biology (General) ,QH301-705.5 - Abstract
Coronavirus disease 2019 (COVID-19) has swept the world, unlike any other pandemic in the last 50 years. Our understanding of the disease has evolved rapidly since the outbreak; disease prognosis is influenced mainly by multi-organ involvement. Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock and multi-organ failure are strongly associated with morbidity and mortality. The COVID-19 disease pathology is plausibly linked to the hyperinflammatory response of the body characterized by pathological cytokine levels. The term ‘cytokine storm syndrome’ is perhaps one of the critical hallmarks of COVID-19 disease severity. In this review, we highlight prominent cytokine families and their potential role in COVID-19, the type I and II interferons, tumour necrosis factor and members of the Interleukin family. We address various changes in cellular components of the immune response corroborating with changes in cytokine levels while discussing cytokine sources and biological functions. Finally, we discuss in brief potential therapies attempting to modulate the cytokine storm.
- Published
- 2020
- Full Text
- View/download PDF
7. Workflow for the Implementation of Precision Genomics in Healthcare
- Author
-
Sanja Mehandziska, Aleksandra Stajkovska, Margarita Stavrevska, Kristina Jakovleva, Marija Janevska, Rodney Rosalia, Ivan Kungulovski, Zan Mitrev, and Goran Kungulovski
- Subjects
exome ,genome ,personalized medicine ,precision genomics ,clinical practice ,implementation ,Genetics ,QH426-470 - Abstract
To enable the implementation of precise genomics in a local healthcare system, we devised a pipeline for filtering and reporting of relevant genetic information to healthy individuals based on exome or genome data. In our analytical pipeline, the first tier of filtering is variant-centric, and it is based on the selection of annotated pathogenic, protective, risk factor, and drug response variants, and their one-by-one detailed evaluation. This is followed by a second-tier gene-centric deconstruction and filtering of virtual gene lists associated with diseases, and VUS-centric filtering according to ACMG pathogenicity criteria and pre-defined deleteriousness criteria. By applying this filtering protocol, we were able to provide valuable insights regarding the carrier status, pharmacogenetic profile, actionable cardiovascular and cancer predispositions, and potentially pathogenic variants of unknown significance to our patients. Our experience demonstrates that genomic profiling can be implemented into routine healthcare and provide information of medical significance.
- Published
- 2020
- Full Text
- View/download PDF
8. A Pediatric Case of Glioblastoma Multiforme Associated With a Novel Germline p.His112CysfsTer9 Mutation in the MLH1 Gene Accompanied by a p.Arg283Cys Mutation in the TP53 Gene: A Case Report
- Author
-
Aleksandra Stajkovska, Sanja Mehandziska, Rodney Rosalia, Margarita Stavrevska, Marija Janevska, Martina Markovska, Ivan Kungulovski, Zan Mitrev, and Goran Kungulovski
- Subjects
next-generation sequencing ,North Macedonia ,hereditary cancer syndromes ,Lynch syndrome ,TP53 ,MLH1 ,Genetics ,QH426-470 - Abstract
Targeted gene panel testing has the power to interrogate hundreds of genes and evaluate the genetic risk for many types of hereditary cancers simultaneously. We screened a 13-year-old male patient diagnosed with glioblastoma multiforme with the aim to get further insights into the biology of his condition. Herein, we applied gene panel sequencing and identified a heterozygous frameshift mutation c.333_334delTC; p.His112CysfsTer9 in the MLH1 gene in blood and tumor tissue accompanied by a known heterozygous missense variant of unknown significance c.847C > T; p.Arg283Cys in the TP53 gene. Parental screening revealed the presence of the same TP53 variant in the father and the same MLH1 variant in the mother, who was in fact undergoing treatment for early-stage breast cancer at the time of her son’s unfortunate diagnosis. This case reports for the first time the co-occurrence of a genetic mutation in the MLH1 gene of the mismatch repair pathway, commonly associated with the Lynch syndrome, accompanied by a rare variant in the TP53 gene. This report underlines the need for broad panel gene testing in lieu of single-gene or syndrome-focused gene screening and evaluation of the effects of multiple pathogenic or modifier variants on the phenotypic spectrum of the disease.
- Published
- 2019
- Full Text
- View/download PDF
9. Surgical plate fixation of multiple rib fractures: a case report
- Author
-
Konstantin Mitev, Dashurie Neziri, Emil Stoicovski, and Zan Mitrev
- Subjects
Multiple rib fractures ,Surgical rib fixation ,Reconstruction plates ,Republic of Macedonia ,Medicine - Abstract
Abstract Background The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit. Case presentation We admitted a 41-year-old Albanian man to our emergency department following a pedestrian-vehicle accident 5 days earlier. He presented with severe upper thoracic pain, chest deformity, dyspnea, tachycardia, subcutaneous emphysema, and hematoma. Chest radiography pointed to hypoventilated lung fields and a minor pleural effusion. Computed tomographic scans indicated displaced fractures of right lateral ribs 5 –11, hyperdensity regions from bone fragments, and pulmonary contusion. The treatment consisted of surgical fixation of ribs 7–10 using titanium reconstruction plates and cortical locking screws. The patient’s clinical condition rapidly improved postoperatively. Follow-up at 6 weeks confirmed a full return to preoperative daily activities and a high quality of life. Conclusions In this case report, we present a novel and promising development in the field of trauma medicine in the Republic of Macedonia. Trauma injuries can be treated via advanced multidisciplinary medical care according to international standards, allowing optimal health recovery.
- Published
- 2018
- Full Text
- View/download PDF
10. Trio Clinical Exome Sequencing in a Patient With Multicentric Carpotarsal Osteolysis Syndrome: First Case Report in the Balkans
- Author
-
Aleksandra Stajkovska, Sanja Mehandziska, Margarita Stavrevska, Kristina Jakovleva, Natasha Nikchevska, Zan Mitrev, Ivan Kungulovski, Gjorgje Zafiroski, Velibor Tasic, and Goran Kungulovski
- Subjects
next-generation sequencing ,exome sequencing ,case report ,multicentric carpotarsal osteolysis syndrome ,Balkan ,Genetics ,QH426-470 - Abstract
Exome sequencing can interrogate thousands of genes simultaneously and it is becoming a first line diagnostic tool in genomic medicine. Herein, we applied trio clinical exome sequencing (CES) in a patient presenting with undiagnosed skeletal disorder, minor facial abnormalities, and kidney hypoplasia; her parents were asymptomatic. Testing the proband and her parents led to the identification of a de novo mutation c.188C>T (p.Pro63Leu) in the MAFB gene, which is known to cause multicentric carpotarsal osteolysis syndrome (MCTO). The c.188C>T mutation lies in a hotspot amino acid stretch within the transactivation domain of MAFB, which is a negative regulator of RANKL-induced osteoclastogenesis. MCTO is an extremely rare autosomal dominant (AD) disorder that typically arises spontaneously and causes carpotarsal osteolysis, often followed by nephropathy. To the best of our knowledge, this is the first study reporting genetically diagnosed MCTO in the Balkans.
- Published
- 2018
- Full Text
- View/download PDF
11. Transesophageal Evaluation of Reconstructive Surgery for Aortic Valve Stenosis
- Author
-
Milka Zdravkovska, Zan Mitrev, and Tanja Anguseva
- Subjects
Aortic valve ,Transvalvular energy loss index ,medicine.medical_specialty ,Reconstructive surgery ,Transesophageal two dimensional and three dimensional imaging ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Prosthesis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Pericardium ,030212 general & internal medicine ,Cardiac skeleton ,Clinical outcome ,business.industry ,Aortic stenosis ,Stent ,General Medicine ,medicine.disease ,Surgery ,Stenosis ,medicine.anatomical_structure ,Clinical medicine ,Aortic valve stenosis ,cardiovascular system ,business - Abstract
BACKGROUND: With transesophageal echocardiography (TEE), were evaluated morphological characteristics and early hemodynamic parameters of stentless three leaflets pericardial patch in patients with aortic stenosis (AS) undergoing aortic valve (AV) surgery. AIM: The aim of the study was to point the importance of two-dimensional and three-dimensional TEE imaging intra and early postoperatively. METHODS: At Zan Mitrev Clinic, 2002–2020, were included 377 patients following the actual guidelines of European Society of Cardiology for valvular disease, whereas patients with dilatation of aortic annulus, rheumatoid arthritis, and chronic program on hemodialysis were excluded from the study. Instead of using a standard prosthesis, we made a reconstructive surgery implanting three new created leaflets using bovine/equine pericardium by replacing destroyed valve cusps. Leaflets were implanted separately, using continuous sutures with two supported stitches and that is how real stentless AV without any stent or sowing ring was created. Intraoperative and post-operative TEE was performed. RESULTS: 377 pts with aortic valvular disease (211–56% male, and 166–44% female; 82–21, 75% with AS, 32–8, 49% with aortic insufficiency, and 263–69, 76% with combined stenosis and insufficiency) were included in the study. Post-operative TEE showed aortic morphology close to normal AV, average pressure gradient was 8 mmHg. 121 pts got a combination with aortocoronary bypass (2.3 grafts per pts). 4 patients were re-operated. Mortality rate was 12.46% (44 pts). Follow-up period was 18 years. CONCLUSIONS: Real stentless aortic bioprosthesis is with a close morphology and hemodynamic parameters as a normal valve. TEE such as tool for assessment of AV morphology, anatomy of aortic root, pre-, and intra-operative plays a pivotal role in guiding case selection, surgical planning, and in evaluating procedural success.
- Published
- 2020
12. The AKR1D1*36 (rs1872930) Allelic Variant Is Independently Associated With Clopidogrel Treatment Outcome
- Author
-
Rodney A. Rosalia, Petar Ugurov, Aleksandra Kapedanovska-Nestorovska, Nadica Matevska Geskovska, Zan Mitrev, Zoran Sterjev, Aleksandar Dimovski, and Ljubica Suturkova
- Subjects
0301 basic medicine ,Pharmacology ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hazard ratio ,CYP2C19 ,Clopidogrel ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Median follow-up ,030220 oncology & carcinogenesis ,Internal medicine ,Cohort ,medicine ,Molecular Medicine ,Risk factor ,business ,medicine.drug ,Cohort study - Abstract
Aims The present observational cohort study evaluated the association between the AKR1D1*36 (rs1872930) allele and the risk of major adverse cardiovascular and cerebrovascular events (MACCE) in clopidogrel treated patients. Methods We screened 198 consecutive cardiovascular patients on clopidogrel therapy admitted in October to November 2010 with cardiovascular or cerebrovascular symptoms; of these 118 met the study protocol entry criteria; the median age of the cohort was 62.5 years (IQR 57-66 years), and 55% were females. Results The median follow up time was 38.5 (IQR 24-48) months; Kaplan-Meier/Log-rank analysis showed that patients carrying the AKR1D1*36 allelic variant have a shorter event-free-survival compared to wild type patients, hazard ratio = 2.193 (95% CI, 1.091 to 4.406); p = 0.0155. Multivariable Cox regression analysis confirmed the AKR1D1*36 allele as an independent risk factor (HR = 2.36; 95% CI, 1.34 to 4.18) and identified 3 other risk factors for MACCE; previous percutaneous interventions (PCI), HR = 2.78; (95% CI, 1.34 to 5.78), and a history of myocardial infarction, HR = 2.62; (95% CI, 1.48 to 4.64) at baseline and the previously reported CYP2C19*2 polymorphism (HR = 2.33; 95% CI, 1.33 to 4.06). Conclusion The AKR1D1*36 (rs1872930) variant is independently associated with a higher risk for MACCE and shorter event-free survival time.
- Published
- 2019
13. Severe COVID-19 is associated with sustained biochemical disturbances and prolonged symptomatology; A retrospective single-centre cohort study
- Author
-
Rodney A. Rosalia, Gianluca Villa, Zan Mitrev, Marija Simjanoska, and Daniel O. Griffin
- Subjects
medicine.medical_specialty ,biology ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Incidence (epidemiology) ,Acute infection ,Ferritin ,Single centre ,Internal medicine ,Cohort ,medicine ,biology.protein ,Clinical severity ,business ,Cohort study - Abstract
Introduction Coronavirus disease 2019 (COVID-19) is associated with significant acute clinical manifestations, and reports indicate that some patients experience prolonged symptomatology and morbidity. These late clinical manifestations have been termed Post-Acute Sequelae of COVID-19 (PASC) and hypothesised to be associated with clinical severity in the acute infection phase and biochemical abnormalities. Aim Evaluate the incidence of PASC in previously hospitalised COVID-19 patients and compare the admission and follow-up levels of biochemical parameters stratified according to baseline clinical severity. Methods N = 168 COVID-19 patients previously hospitalised at the Zan Mitrev Clinic in Skopje, North Macedonia, with matched laboratory data at baseline and follow-up clinical visit > 30 days post-discharge, were stratified according to National Institute of Health clinical severity guidelines as mild, moderate, severe or critical according to admission clinical presentation. We assessed the incidence of PASC and compared the biochemical profile. Results The median hospitalisation and clinical follow-up period were 11 (9-20) and 53 (30-105) days. The overall incidence of PASC was 56.5% (95/168); most PASC cases were confined to the severe sub-group (61/101, 61.4%). Contrary to mild and moderate cases and a healthy “non-COVID-19” control cohort, we observed that severe COVID-19 cases experienced sustained biochemical disturbances, most notably elevated D-dimers and Ferritin of 600 ng/ml (283-1168) and 432 ng/ml (170-916), respectively. Conclusions Previously hospitalised severe COVID-19 patients are more likely to experience Post-Acute Sequelae of COVID-19 and prolonged biochemical disturbances, evident by abnormal values of D-dimers and Ferritin.
- Published
- 2021
14. Early Initiation of Extracorporeal Blood Purification Using the AN69ST (oXiris®) Hemofilter as a Treatment Modality for COVID-19 Patients: a Single-Centre Case Series
- Author
-
Sanja Marinkovic, Dijana Popevski, Zan Mitrev, Marko Gjorgon, Rodney A. Rosalia, Elena Ambarkova, Katerina Ignevska, Dashurie Neziri, Tanja Gramosli, Petar Ugurov, Sanja Mehandziska, Emil Stoicovski, Dragica Vuckova, and Lidija Veljanovska-Kiridjievska
- Subjects
ARDS ,RD1-811 ,030204 cardiovascular system & hematology ,Fibrinogen ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Respiratory Rate ,Interquartile range ,law ,Coagulopathy ,Diseases of the circulatory (Cardiovascular) system ,Medicine ,biology ,Blood Platets ,business.industry ,Interleukin-6 ,Heparin ,Tumor Necrosis Factor-alpha ,C-reactive protein ,Respiratory Distress Syndrome, Adult ,COVID-19 ,General Medicine ,Hypoxia (medical) ,medicine.disease ,Intensive care unit ,TNF protein, human ,C-Reactive Protein ,RC666-701 ,Anesthesia ,biology.protein ,Cytokines ,Surgery ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Introduction: Severe coronavirus disease 2019 (COVID-19) is characterised by hyperinflammatory state, systemic coagulopathies, and multiorgan involvement, especially acute respiratory distress syndrome (ARDS). We here describe our preliminary clinical experience with COVID-19 patients treated via an early initiation of extracorporeal blood purification combined with systemic heparinisation and respiratory support. Methods: Fifteen patients were included; several biomarkers associated with COVID-19 severity were monitored. Personalised treatment was tailored according to the levels of interleukin (IL)-6, IL-8, tumour necrosis factor alpha, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, thrombocyte counts, D-dimers, and fibrinogen. Treatment consisted of respiratory support, extracorporeal blood purification using the AN69ST (oXiris®) hemofilter, and 300 U/kg heparin to maintain activation clotting time ≥ 180 seconds. Results: Ten patients presented with severe to critical disease (dyspnoea, hypoxia, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). The median intensive care unit length of stay was 9.3 days (interquartile range 5.3-10.1); two patients developed ARDS and died after 5 and 26 days. Clinical improvement was associated with normalisation (increase) of thrombocytes and white blood cells, stable levels of IL-6 (< 50 ng/mL), and a decrease of CRP and fibrinogen. Conclusion: Continuous monitoring of COVID-19 severity biomarkers and radiological imaging is crucial to assess disease progression, uncontrolled inflammation, and to avert irreversible multiorgan failure. The combination of systemic heparin anticoagulation regimens and extracorporeal blood purification using cytokine-adsorbing hemofilters may reduce hyperinflammation, prevent coagulopathy, and support clinical recovery.
- Published
- 2021
15. The systemic immune-inflammation index is associated with early postoperative morbidity and mortality following cardiac surgery
- Author
-
Nikola Hristov, Zan Mitrev, M Klimkarov, P Milojevik, Rodney Alexander Rosalia, M Klincheva, and R Zimoski
- Subjects
Toll-like receptor ,medicine.medical_specialty ,business.industry ,Surgical mortality ,Inflammation ,medicine.disease ,medicine.disease_cause ,Preoperative care ,Cardiac surgery ,Autoimmunity ,Atheroma ,Anesthesia ,medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Immune inflammation - Abstract
Background The pathogenesis of cardiovascular diseases (CVD) is sustained by persistent low-grade systemic inflammation. Lipid deposition, atherosclerotic plaque formation, toll-like receptor activation, leukocyte infiltration and secretion of pro-inflammatory mediators collectively promote chronic low-grade inflammation which drives CVD-progression. Despite the well-described inflammatory processes in CVD, its perioperative clinical significance in cardiac surgery is ill-defined. Aim To evaluate the association between the preoperative chronic inflammation and postoperative outcome. We hypothesized that an elevated systemic inflammation predisposes patients to adverse postoperative outcome. Methods A retrospective analysis of 1251 consecutive adults undergoing cardiac surgery between July 2018 and Dec 2019. We used the systemic-immune-inflammation index (SII) as a marker for chronic inflammation and was calculated as follows: “platelet counts x (Neutrophil/Lymphocyte ratio)”. A Receiver Operating Characteristic (ROC) curve was generated by plotting the SII values for in-hospital mortality cases vs successfully discharged patients, the Wilcoxon estimate of area under ROC curve = 0.67; an optimum cut-off point of 647 (sensitivity = 0.72, specificity = 0.59) was chosen to classify patients with an elevated inflammatory status. We used the Fisher's exact test to assess whether the preoperative SII was related with adverse outcome. Finally, we included the SII in a multivariable logistic regression controlling for 11 established cardiac surgery mortality risk-factors. Results The median age was 65 years (range 18–88), 361 (29%) were females. The mean ACEF II operative mortality was 3.49%. The median SII before surgery was 576 (IQR 402 - 855). In comparison, the SII of a healthy control non-surgical cohort (N=60) was 434 (IQR 290–559), median difference = 142 [CI95% 84 to 223), p Sub-group analysis revealed that patients who passed away during hospitalisation were admitted with a significantly higher preoperative SII (= 824), median difference 255 [CI95% 143–388], p Contrary to patients with low-grade systemic inflammation (= SII Multivariable logistic regression revealed that an SII ≥647 is an independent risk factor for in-hospital mortality, adjusted OR 2.67, p=0.004. Conclusion A high SII (≥647) is independently associated with postoperative morbidity and mortality following cardiac surgery. The SII may support clinical decision making and stratification of high-risk patients undergoing cardiac surgery. Funding Acknowledgement Type of funding source: None
- Published
- 2020
16. Early Initiation of Extracorporeal Blood Purification Using the AN69ST (oXiris
- Author
-
Petar, Ugurov, Dijana, Popevski, Tanja, Gramosli, Dashurie, Neziri, Dragica, Vuckova, Marko, Gjorgon, Emil, Stoicovski, Sanja, Marinkovic, Lidija, Veljanovska-Kiridjievska, Katerina, Ignevska, Sanja, Mehandziska, Elena, Ambarkova, Zan, Mitrev, and Rodney Alexander, Rosalia
- Subjects
Intensive Care Units ,Respiratory Distress Syndrome ,Heparin ,SARS-CoV-2 ,COVID-19 ,Humans - Abstract
Severe coronavirus disease 2019 (COVID-19) is characterised by hyperinflammatory state, systemic coagulopathies, and multiorgan involvement, especially acute respiratory distress syndrome (ARDS). We here describe our preliminary clinical experience with COVID-19 patients treated via an early initiation of extracorporeal blood purification combined with systemic heparinisation and respiratory support.Fifteen patients were included; several biomarkers associated with COVID-19 severity were monitored. Personalised treatment was tailored according to the levels of interleukin (IL)-6, IL-8, tumour necrosis factor alpha, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, thrombocyte counts, D-dimers, and fibrinogen. Treatment consisted of respiratory support, extracorporeal blood purification using the AN69ST (oXiris®) hemofilter, and 300 U/kg heparin to maintain activation clotting time ≥ 180 seconds.Ten patients presented with severe to critical disease (dyspnoea, hypoxia, respiratory rate30/min, peripheral oxygen saturation90%, or50% lung involvement on X-ray imaging). The median intensive care unit length of stay was 9.3 days (interquartile range 5.3-10.1); two patients developed ARDS and died after 5 and 26 days. Clinical improvement was associated with normalisation (increase) of thrombocytes and white blood cells, stable levels of IL-6 (50 ng/mL), and a decrease of CRP and fibrinogen.Continuous monitoring of COVID-19 severity biomarkers and radiological imaging is crucial to assess disease progression, uncontrolled inflammation, and to avert irreversible multiorgan failure. The combination of systemic heparin anticoagulation regimens and extracorporeal blood purification using cytokine-adsorbing hemofilters may reduce hyperinflammation, prevent coagulopathy, and support clinical recovery.
- Published
- 2020
17. Extracorporeal Blood Purification in moderate and severe COVID-19 patients: a prospective cohort study
- Author
-
Dimche Kuzmanov, Rodney A. Rosalia, Aleksandar Trifunovski, Dashurie Neziri, Gianluca Villa, Zan Mitrev, Simona Despotovska, Dijana Popevski, Emilija Kostoska, Lidija Veljanovska-Kiridjievska, and Petar Ugurov
- Subjects
Adult ,Male ,medicine.medical_specialty ,ARDS ,medicine.medical_treatment ,Fibrinogen ,Gastroenterology ,Procalcitonin ,Extracorporeal ,Anticoagulation ,Internal medicine ,Hemofiltration ,medicine ,Coagulopathy ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Mechanical ventilation ,Coronavirus disease 2019 ,Respiratory distress ,Interleukin-6 ,Heparin ,SARS-CoV-2 ,business.industry ,Patient Acuity ,Acute-phase protein ,COVID-19 ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,oXiris ,Coronavirus ,C-Reactive Protein ,Nephrology ,Cohort ,Female ,business ,Research Article ,medicine.drug - Abstract
IntroductionCOVID-19 is characterised by hyperinflammation and coagulopathy. Severe cases often develop respiratory distress, requiring mechanical ventilation and critical cases progressing to ARDS. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19; extracorporeal blood purification (EBP) modalities offer an attractive mean to ameliorate maladaptive inflammation.With this work, we describe the longitudinal variation of parameters of systemic inflammation in critically ill COVID-19 patients treated with blood purification using AN69ST (oXiris®) hemodiafilter.MethodsWe performed a time-series analysis of 44 consecutive COVID-19 cases treated with the AN69ST (oXiris®) cytokine adsorbing hemodiafilter; we visualise longitudinal results of biochemical, inflammatory, blood gas- and vital sign parameters.ResultsBlood purification was indicated for suspected hyperinflammation or hypercoagulation, (= CRP ≥ 100 mg/L and/or IL-6 ≥ 40 pg/mL and/or Ferritin ≥ 500 ng/mL and/or Lactate Dehydrogenase > 365 U/L or D-dimers > 2000 ng/mL). All patients were treated with ≥ 1 cycle extracorporeal continuous venovenous hemofiltration (CVVHF) with cytokine adsorbing hemodiafilter (CAH); of these, 30 severe patients received CVVHF-CAH within 4 – 12 hours of hospitalisation. Another 14 patients admitted with mild-to-moderate symptoms progressed to severe disease and placed on EBP during the course of hospitalisation. The treatment was associated with a reduction of Ferritin, C-reactive protein, Fibrinogen, several inflammatory markers and a resolution of numerous cytopenias. The observed mortality across the cohort was 36.3% across the cohort.ConclusionExtracorporeal blood purification with cytokine adsorbing hemofilter was associated with a decrease in the acute phase proteins CRP, Ferritin, and resolution of numerous cytopenias. Repetitive hemofiltration has been associated with lower levels of IL-6 in COVID-19 patients.
- Published
- 2020
18. Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines
- Author
-
Rodney A. Rosalia, Bakri M. Assas, Antonella Fara, and Zan Mitrev
- Subjects
medicine.medical_treatment ,Immunology ,Pneumonia, Viral ,coronavirus ,Disease ,Review ,Review Article ,Biology ,medicine.disease_cause ,General Biochemistry, Genetics and Molecular Biology ,Proinflammatory cytokine ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Immune system ,medicine ,Humans ,Interleukin 6 ,lcsh:QH301-705.5 ,IFN-γ ,Pandemics ,030304 developmental biology ,Coronavirus ,SARS ,Inflammation ,0303 health sciences ,IL-6 ,SARS-CoV-2 ,General Neuroscience ,Interleukin ,COVID-19 ,medicine.disease ,Cytokine ,lcsh:Biology (General) ,030220 oncology & carcinogenesis ,TNF-α ,biology.protein ,Cytokines ,Cytokine storm ,Coronavirus Infections ,Cytokine Release Syndrome - Abstract
Coronavirus disease 2019 (COVID-19) has swept the world, unlike any other pandemic in the last 50 years. Our understanding of the disease has evolved rapidly since the outbreak; disease prognosis is influenced mainly by multi-organ involvement. Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock and multi-organ failure are strongly associated with morbidity and mortality. The COVID-19 disease pathology is plausibly linked to the hyperinflammatory response of the body characterized by pathological cytokine levels. The term ‘cytokine storm syndrome’ is perhaps one of the critical hallmarks of COVID-19 disease severity. In this review, we highlight prominent cytokine families and their potential role in COVID-19, the type I and II interferons, tumour necrosis factor and members of the Interleukin family. We address various changes in cellular components of the immune response corroborating with changes in cytokine levels while discussing cytokine sources and biological functions. Finally, we discuss in brief potential therapies attempting to modulate the cytokine storm.
- Published
- 2020
19. A hybrid procedure for the closure of a large muscular ventricular septal defect in a 6-month-old infant
- Author
-
Zan Mitrev, Ivan Milev, Dijana Popevski, Rodney Alexander Rosalia, Simona Despotovska, and Steven Bibevski
- Subjects
medicine.medical_specialty ,business.industry ,MUSCULAR VENTRICULAR SEPTAL DEFECT ,medicine ,Closure (topology) ,business ,Surgery - Abstract
Background: Transthoracic device closure (TTDC), also known as a Hybrid procedure, has been proposed as an alternative, less invasive approach compared to open-heart surgery for the treatment of ventricular septal defect (VSD). Case Presentation: We present our first national case of TTDC in a 6-month-old female baby with a muscular 8mm ventricular septal defect, 3 mm atrial defect, enlarged right and left ventricle and a dilated pulmonary artery complicated by severe pulmonary hypertension.Treatment consisted of two pulmonary artery banding attempts at the age of 2 months to control pulmonary hypertension – the interventions were combined with diuretics and angiotensin-converting enzymes inhibitors. Yet, the initial approach was suboptimal as we noticed a failure to thrive continuous sweating and tachypnea. Because of the worsening condition at the age of 6 months, and a weight of 6.6 kg, we performed TTDC. After median sternotomy, a 10mm muscular VSD occluder was implanted under trans-oesophagal echocardiography guidance on the beating heart. The procedure lasted 90 min and was performed without incident; the hemodynamics were stable with only a minor residual VSD. The child was extubated after 2 hours and discharged after five days from the hospital.Conclusions: Transthoracic device closure (TTDC) is a promising treatment modality for large muscular VSD in small infants with low weight. TTDC is feasible in cases with heavy myocardial right ventricle trabeculae and who previously underwent open-heart surgery.
- Published
- 2020
20. Early initiation of Extracorporeal Blood Purification using the AN69ST (oXiris®) hemofilter as a treatment modality for COVID - 19 patients: a single-centre case series
- Author
-
Petar Ugurov, Dijana Popevski, Tanja Gramosli, Dashurie Neziri, Dragica Vuckova, Emil Stoicovski, Lidija Veljanovska-Kiridjievska, Katerina Ignevska, Sanja Mehandziska, Elena Ambarkova, Rodney Alexander Rosalia, and Zan Mitrev
- Abstract
Introduction: Our understanding of the COVID-19 disease has been steadily evolving since the original outbreak in December 2019. Advanced disease is characterised by a hyperinflammatory state, systemic coagulopathies and multiorgan involvement, in particular respiratory distress. We here describe our initial experience with treating of COVID-19 patients based on early initiation of extracorporeal blood purification, systemic heparinisation and respiratory support.Methods: 15 patients were included; 2 were females. We monitored real-time several biochemical, immunological and coagulation biomarkers associated with disease severity following admission to our dedicated COVID-19 intensive care unit. To guide personalised treatment, we monitored among others levels of IL-6, IL-8, TNF-α, C-Reactive Protein (CRP), Neutrophil-to-Lymphocyte ratios, Thrombocyte counts, D-Dimers, Fibrinogen, and Activation Clotting time (ACT).Treatment consisted of individualised respiratory support supplemented with 1 - 4 cycles of 24-hour Extracorporeal Organ Support (ECOS) and Blood Purification using the AN69ST (oXiris®) hemofilter. We administered heparin (300 U/kg) to counter suspected hypercoagulability (= elevated Fibrinogen or D-dimers) states to maintain ACT ≥ 180 seconds.Results: N = 10 presented with severe to critical disease (= dyspnoea, hypoxia, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). A single case was admitted with a critical condition (= respiratory failure). One patient died after 5 days of hospitalisation after developing Acute Respiratory Syndrome. 8 Patients have been discharged - average ICU length-of-stay was 9.9 ± 2.4 days. Clinical improvement was associated with normalisation (increase) of thrombocytes, white blood cells, stable levels of IL-6 (< 50 ng/mL) and a decrease of CRP and Fibrinogen. Conclusion: Means to monitor COVID-19 disease severity during hospitalisation are crucial to control disease progression and prevent hyperinflammation and irreversible multiorgan failure. We present here a real-time monitoring system accounting for biochemical, immunological, coagulation parameters and radiological imaging. The combination of systemic heparin anticoagulation regimens and blood purification may prevent hyperinflammation, thromboembolism during hospitalisation and thus support clinical recovery.
- Published
- 2020
21. Author response for 'Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines'
- Author
-
Rodney Alexander Rosalia, Zan Mitrev, Antonella Fara, and Bakri M. Assas
- Subjects
Coronavirus disease 2019 (COVID-19) ,business.industry ,Immunology ,medicine ,Cytokine storm ,medicine.disease ,business ,Proinflammatory cytokine - Published
- 2020
22. Workflow for the Implementation of Precision Genomics in Healthcare
- Author
-
Aleksandra Stajkovska, Kristina Jakovleva, Ivan Kungulovski, Marija Janevska, Zan Mitrev, Margarita Stavrevska, Sanja Mehandziska, Rodney A. Rosalia, and Goran Kungulovski
- Subjects
0301 basic medicine ,lcsh:QH426-470 ,Computer science ,Genomics ,Computational biology ,03 medical and health sciences ,0302 clinical medicine ,precision genomics ,Genetics ,implementation ,Exome ,genome ,Genetics (clinical) ,Selection (genetic algorithm) ,Protocol (science) ,business.industry ,personalized medicine ,Brief Research Report ,Risk factor (computing) ,Pipeline (software) ,clinical practice ,lcsh:Genetics ,030104 developmental biology ,Workflow ,030220 oncology & carcinogenesis ,Molecular Medicine ,Personalized medicine ,business ,exome - Abstract
To enable the implementation of precise genomics in a local healthcare system, we devised a pipeline for filtering and reporting of relevant genetic information to healthy individuals based on exome or genome data. In our analytical pipeline, the first tier of filtering is variant-centric, and it is based on the selection of annotated pathogenic, protective, risk factor, and drug response variants, and their one-by-one detailed evaluation. This is followed by a second-tier gene-centric deconstruction and filtering of virtual gene lists associated with diseases, and VUS-centric filtering according to ACMG pathogenicity criteria and pre-defined deleteriousness criteria. By applying this filtering protocol, we were able to provide valuable insights regarding the carrier status, pharmacogenetic profile, actionable cardiovascular and cancer predispositions, and potentially pathogenic variants of unknown significance to our patients. Our experience demonstrates that genomic profiling can be implemented into routine healthcare and provide information of medical significance.
- Published
- 2020
23. Outcomes with Ventricular Assist Device Therapy for Advanced Heart Failure in North Macedonia: First Annual Report
- Author
-
Petar Risteski, Rodney A. Rosalia, Milka Klincheva, Marjan Sokarovski, Aron-Frederik Popov, Venko Filipce, Sonija Grazdani, Zan Mitrev, Sasko Jovev, and Tanja Anguseva
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Quality of life ,medicine ,Humans ,cardiovascular diseases ,Registries ,Adverse effect ,Retrospective Studies ,Heart Failure ,Ischemic cardiomyopathy ,business.industry ,Hypertrophic cardiomyopathy ,Retrospective cohort study ,Dilated cardiomyopathy ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Republic of North Macedonia ,Ventricular assist device ,Heart failure ,Emergency medicine ,Quality of Life ,Surgery ,Female ,Heart-Assist Devices ,Morbidity ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Introduction: Mechanical circulatory support by a continuous-flow ventricular assist device (VAD) improves survival and quality of life in selected patients with advanced heart failure. Developing countries have been struggling to construct a contemporary and effective health care system to manage advanced heart failure. This observation represents the first annual report on clinical outcomes with VAD for patients with advanced heart failure in the Republic of North Macedonia. Methods: Data from all patients with VAD implantations between November 2018 and December 2019 were collected. The etiology of the heart failure was dilated cardiomyopathy in 4 patients (57%), ischemic cardiomyopathy in 2 (28%), and hypertrophic cardiomyopathy in 1 (14%). The primary outcome was survival; secondary outcomes included adverse events defined according to the Interagency Registry for Mechanically Assisted Circulatory Support. Results: A total of 7 patients (85% males, median age 56 years) received a VAD; 5 of them received left VAD, and the remaining 2 received biventricular VAD. There were no deaths. Observed morbidity during a mean follow-up of 216 days included 3 bleeding events in 1 patient, 2 patients with superficial driveline infection, and 1 minor stroke and a pump thrombosis, which were treated with VAD exchange. Significant improvement in quality of life, as assessed by the Kansas City Cardiomyopathy Questionnaire and the Functional Independence Measure™ instrument, was seen with all patients. Conclusions: Our results demonstrate a successful initiation of the VAD program in the Republic of North Macedonia. Proper training of a dedicated HF team supports the reproducibility of this treatment in developing countries.
- Published
- 2020
24. Genetic aberrations in chromatin factors are pervasive, mutually exclusive, associated with a high mutational burden and improved response to checkpoint immunotherapy in cancer
- Author
-
Rodney A. Rosalia, Ivan Kungulovski, Martina Markovska, Marija Janevska, Zan Mitrev, Aleksandra Stajkovska, Goran Kungulovski, and Sanja Mehandziska
- Subjects
medicine.medical_treatment ,medicine ,Cancer ,Immunotherapy ,Computational biology ,Biology ,Gene deletion ,Mutually exclusive events ,medicine.disease ,Chromatin - Abstract
Background: In recent years, it has been shown that many of the pervasive genetic defects in cancer occur in chromatin modifiers. In order to obtain insights in regards to their biology and clinical relevance in cancer, we analyzed the distribution and mutual relationships of genetic aberrations in relevant chromatin modifiers in tens of thousands of publicly available cancer datasets. Results: We observed that in general, they are mutually exclusive, and their prevalence is higher in some types of cancers compared to others. Moreover, we observed a strong association between aberrations in selected chromatin modifiers and tumor mutational burden, leading to an improved response to checkpoint immunotherapy. Conclusion: All in all, this study uncovered interesting relationships between chromatin factors and features of cancer in regards to cancer biology, and cancer therapy. These insights could set the stage for follow up functional and clinical studies.
- Published
- 2019
- Full Text
- View/download PDF
25. A Pediatric Case of Glioblastoma Multiforme Associated With a Novel Germline p.His112CysfsTer9 Mutation in the MLH1 Gene Accompanied by a p.Arg283Cys Mutation in the TP53 Gene: A Case Report
- Author
-
Sanja Mehandziska, Rodney A. Rosalia, Ivan Kungulovski, Margarita Stavrevska, Martina Markovska, Marija Janevska, Aleksandra Stajkovska, Zan Mitrev, and Goran Kungulovski
- Subjects
0301 basic medicine ,North Macedonia ,lcsh:QH426-470 ,Biology ,medicine.disease_cause ,MLH1 ,Germline ,Frameshift mutation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Genetics ,Missense mutation ,case report ,TP53 ,Gene ,Genetics (clinical) ,hereditary cancer syndromes ,Mutation ,medicine.disease ,Lynch syndrome ,lcsh:Genetics ,030104 developmental biology ,Li–Fraumeni syndrome ,030220 oncology & carcinogenesis ,Molecular Medicine ,next-generation sequencing ,Li-Fraumeni - Abstract
Targeted gene panel testing has the power to interrogate hundreds of genes and evaluate the genetic risk for many types of hereditary cancers simultaneously. We screened a 13-year-old male patient diagnosed with glioblastoma multiforme with the aim to get further insights into the biology of his condition. Herein, we applied gene panel sequencing and identified a heterozygous frameshift mutation c.333_334delTC; p.His112CysfsTer9 in the MLH1 gene in blood and tumor tissue accompanied by a known heterozygous missense variant of unknown significance c.847C > T; p.Arg283Cys in the TP53 gene. Parental screening revealed the presence of the same TP53 variant in the father and the same MLH1 variant in the mother, who was in fact undergoing treatment for early-stage breast cancer at the time of her son’s unfortunate diagnosis. This case reports for the first time the co-occurrence of a genetic mutation in the MLH1 gene of the mismatch repair pathway, commonly associated with the Lynch syndrome, accompanied by a rare variant in the TP53 gene. This report underlines the need for broad panel gene testing in lieu of single-gene or syndrome-focused gene screening and evaluation of the effects of multiple pathogenic or modifier variants on the phenotypic spectrum of the disease.
- Published
- 2019
26. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module
- Author
-
Víctor Daniel Rosenthal, Hail M. Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S.G. Buenaflor, Michael M. Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y. Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos, J.E. Desse, D.M. Maurizi, A.M. Montanini, G.J. Chaparro, J.P. Stagnaro, A. Romani, A.C. Bianchi, G. Álvarez, A. Palaoro, M. Bernan, R. Cabrera-Montesino, C. Domínguez, C.G. Rodríguez, C.G. Silva, E. Bogdanowicz, F.O. Riera, G. Benchetrit, I. Perez, J. Vimercati, L.S. Marcos, L. Ramasco, M. Caridi, M.C. Oyola, M.C. Rodríguez, M.L. Spadaro, M.S. Olivieri, P. Saul, P.D. Juarez, R.H. Pérez, P. Botta, D.Q. Quintana, A.M. Ríos, V. Chediack, W. Chilon, Ameena Isa Alsayegh, Fatema Hasan Yaseen, Lateefa Fardan Hani, Saleh Fakher Sowar, Tahira Anwar Magray, E.A. Medeiros, A. Alves De Oliveira, A. Romario-Mendes, C. Fernandes-Valente, C. Santos, D. Escudeiro, D. Azevedo-Ferreira Lima, D. Azevedo-Pereira, E.M. Onzi-Siliprandi, F. Serpa-Maia, F. Aguiar-Leitao, G. Assuncao-Ponte, J. Dos Anjos-Lima, J. Olszewski, K. Harten Pinto Coelho, L.F. Alves De Lima, M. Mendonca, M.L. Maciel-Canuto Amaral, M.T. Tenorio, S. Gerah, M. Andrade-Oliveira-Reis, M. Moreira, M. Ximenes-Rocha Batista, R.S. Campos-Uchoa, R. Rocha-Vasconcelos Carneiro, R. Amaral De Moraes, S.C. Do Nascimento, T. Moreira-Matos, T.M. Lima-De Barros Araujo, T. De Jesus Pinheiro-Bandeira, V.L. Machado-Silva, W.M. Santos Monteiro, E. Hristozova, E.D. Kostadinov, K. Angelova, V.A. Velinova, V.J. Dicheva, X. Guo, G. Ye, R. Li, L. Song, K. Liu, T. Liu, G. Song, C. Wang, X. Yang, H. Yu, Y. Yang, A. Martínez, A.R. Vargas-García, A. Lagares-Guzmán, A.P. González, C. Linares, C. Ávila-Acosta, D. Santofimio, D. Yepes-Gomez, D.A. Marin-Tobar, D.P. Mazo-Elorza, E.G. Chapeta-Parada, G. Camacho-Moreno, G.E. Roncancio-Vill, I.A. Valderrama-Marquez, J.E. Ruiz-Gallardo, J.O. Ospina-Martínez, J. Osorio, J.I. Marín-Uribe, J.C. López, S. Gualtero, J.R. Rojas, K. Gomez-Nieto, L.Y.M. Rincon, L. Meneses-Ovallos, L.M. Canas-Giraldo, L.D. Burgos-Florez, M. Amaral-Almeida Costa, M. Rodriguez, N. Barahona-Guzmán, O. Mancera-Paez, P.A. Rios-Arana, R. Ortega, S.L. Romero-Torres, S.M. Pulido-Leon, S. Valderrama, V.M. Moreno-Mejia, W. Raigoza-Martinez, W. Villamil-Gomez, Y.A. Pardo-Lopez, A. Argüello-Ruiz, A. Solano-Chinchilla, G.A. Muñoz-Gutierrez, I. Calvo-Hernández, L. Maroto-Vargas, M.A. Zuniga, M. Valverde-Hernandez, O. Chavarria-Ugalde, B. Herrera, C. Díaz, M.M. Bovera, C. Cevallos, C. Pelaez, E. Jara, V. Delgado, E.E. Coello-Gordon, F. Picoita, F.M. Guerrero-Toapant, F. Valencia, G. Santacruz, H. Gonzalez, L.N. Pazmino, M.F. Garcia, M. Arboleda, M. Lascano, N. Alquinga, V. Ramírez, Reham H.A. Yousef, Abd El Moniem Moustafa, A. Ahmed, A.M. Elansary, Ahmad Mahmoud Ali, Ahmed Hasanin, Antoine Abdel Messih, Arwa Ramadan, B.A. El Awady, D.M. Hassan, Doaa Abd El Aziz, Hala Hamza, Hala Mounir Agha, Islam Abdullorziz Ghazi, J. ElKholy, May Abdel Fattah, Mervat Elanany, M. Mansour, M.M.A. Haleim, R. Fouda, Rasha Hamed El-Sherif, S. Bekeit, V. Bayani, Y.S. Elkholy, Y.M. Abdelhamid, Zeinab Salah, D.M. Rivera, A. Chawla, A.N. Manked, A. Azim, A. Mubarak, A. Thakur, A.V. Dharan, A. Patil, A. Sasidharan, Anil Kumar Bilolikar, A. Anirban Karmakar, A.M. Mathew, Anuja Kulkarni, Anuradha Agarwal, Anuradha Sriram, A. Dwivedy, Arnab Dasgupta, A. Bhakta, Arul Rose Suganya, A. Poojary, Ashwin Kumar Mani, Asmita Sakle, Babu K. Abraham, Baby Padmini, B. Ramachandran, Banambar Ray, Basanta Kumar Pati, Bhaskar Narayan Chaudhury, Biraj Mohan Mishra, S. Biswas, M. Bri Saibala, Burhan Q. Jawadwala, C. Rodrigues, Chirag Modi, Chirag Patel, D.K. Khanna, Dedeepiya Devaprasad, Deepa Divekar, Deepesh G. Aggarwal, J.V. Divatia, Dolatsinh Zala, Edwin Pathrose, Fazil Abubakar, Felcy Chacko, G.S. Gehlot, Gautam Khanna, H.K. Sale, Indranil Roy, Jayant Shelgaonkar, Jehangir Sorabjee, Jincy Eappen, Justin Mathew, Jyotishka Pal, Karthikeya Varma, Kashmira Limaye Joshi, Kavita Sandhu, R. Kelkar, Lakshmi Ranganathan, L. Pushparaj, Madhav Lavate, Madhavi Latha, Madhupriya Suryawanshi, M. Bhattacharyya, Maithili Kavathekar, Manoj Kumar Agarwal, Mayur Patel, Mehul Shah, M.N. Sivakumar, Mohit Kharbanda, Mrinmoy Bej, Mrunalini Potdar, M. Chakravarthy, M. Karpagam, S.N. Myatra, N. Gita, N.P. Rao, N. Sen, N. Ramakrishnan, N. Jaggi, N. Saini, N.K. Pawar, Nikhil Modi, Nirav Pandya, Nisith Mohanty, Pooja Thakkar, Pradnya Joshi, Prafulla Kumar Sahoo, Pravin Kumar Nair, Priyadarshini Senthil Kumar, Priyanka Patil, Purnima Mukherjee, P. Mathur, Purvi Shah, R. Sukanya, Rajalakshmi Arjun, Rajesh Chawla, Ram Gopalakrishnan, Ramesh Venkataraman, S. Raut, Ravikumar Krupanandan, Reshma Tejam, Richa Misra, Ritesh Debroy, S. Saranya, Sajith Narayanan, Sanghamitra Mishra, Sanjith Saseedharan, Sankar Sengupta, S.K. Patnaik, Saswati Sinha, Seelas Blessymole, Seema Rohra, Senthilkumar Rajagopal, Shanta Mukherjee, Sharmila Sengupta, Sheeba John, Shefali Bhattacharya, null Sijo, Sinchan Bhattacharyya, S. Singh, T. Sohanlal, Sonali Vadi, S.S. Dalal, S.K. Todi, Subodh Kumar, Sudha Kansal, Sudhjan Misra, Sudipta Bhattacharyya, Suhas Nirkhiwale, Sujit Kar Purkayastha, Sujoy Mukherjee, S. Sahu, Sunil Sharma, Suresh Kumar, S. Basu, S. Shetty, S. Shah, T. Singhal, Thara Francis, Thejasvini Anand, V. Venkateshwar, Valsa Thomas, V. Kothari, null Velupandi, Vini Kantroo, Gortap Sitohang, Retno Kadarsih, Anahita Sanaei, Behzad Maghsudi, Golnar Sabetian, Mansoor Masjedi, Masoud Alebouyeh, Somayeh Jahani Sherafat, Yassir Khidir Mohamed, Abdulrahim Al Khamis, Adnan Soliman Alsaadi, Ahmed Abdoh Al-Jarie, Aisha Hassan Mutwalli, A.S.K. Rillorta, Anumol Thomas, Ashraf Kelany, Athena Manao, Dhaffer Moghram Alamri, E.B. Santiago, E.P. Cruzpero, Fahad Ahmed Sawan, Fatima Abdullah Al Qasmah, Haeel Alabdaly, Hajer Am Al-Dossary, Hala Ahmed, Hala Roshdi, Halima Yahia Al-Alkami, Hana Hanafi, Hassan Eisa Ammari, Hatem Mohd Al Hani, Ibrahim A.M. Alzaydani Asiri, Jeffrey Asidera Mendoza, Jomol Philipose, Joy Ola Selga, null Kehkashan, Khalid Mohammed Ghalilah, Leide Shyrine Redito, L. Josph, M. Al-Alawi, Manal Mansour Al-Gethamy, Marjory Madco, M.G. Manuel, M. Girvan, Mervat Aldalaton, M. De Guzman, Modhi Alkhamaly, Mohammad Masfar, Mohammed Ahmed Ali Karrar, Munayfa Musallam Al Azmi, Myrna Lim Quisai, Myrna Misador Torres, N. Al-Abdullah, Nader Ahmed Tawfic, Nashwa Elsayed, Nawal Salah Abdulkhalik, Nehad Abdulshakour Bugis, Neilia Cardinal Ariola, N. Gad, Nesreen Alghosn, Nidal Tashkandi, N. Al Zharani, P.A. De Vera, Radhika Krishnan, Raed Hassan Al Shehri, Rasha Nour Aldeen Jaha, Reny Thomas, Rhea Lynn Cresencia, R. Penuliar, R.V. Lozada, S. Al Qahtani, Sameh Twfik, Sarah Hassan Al Faraj, Sherin El-Sherbiny, Siti Jhulmina B. Alih, Solita Briones, Syed Zahid Bukhari, Tariq Saad Abdulhadi Alotaibi, Uma Gopal, Usha Nair, Wael Abdulrahman Abdulatif, Waleed Mohd Hussain, Wynndale Mae Demotica, G. Spahija, N. Baftiu, A. Gashi, Abeer A. Omar, A.M. Mohamed, F.M. Rebello, Haifaa Hassan Almousa, Naglaa Mahmoud Abdo, S.M. George, Soad Khamis, Suja Thomas, A. Ahmad Zaatari, A. Anwar Al Souheil, H. Ayash, I. Zeid, J. Tannous, N.K. Zahreddine, R. Ahmadieh, T. Mahfouz, T. Kardas, V. Tanzi, Z. Kanafani, Z. Hammoud, A. Dagys, D. Grinkeviciute, R. Kevalas, T. Kondratas, Milena Petrovska, Katja Popovska, Zan Mitrev, Zaneta Bogoevska Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Chin Seng Gan, Ainul Auzani Othman, Aliza Mohamad Yusof, Anis Siham Zainal Abidin, Fadzlina Abdul Aziz, Foong Kit Weng, Hasimah Zainol, Kamal Bashar Abu Bakar, Lucy Chai See Lum, Marzida Mansor, Mazuin Kamarul Zaman, Mohamad Fadhil Hadi Jamaluddin, Mohd Shahnaz Hasan, Raha Abdul Rahman, Rhendra Hardy Mohamad Zaini, Rosliza Zhazali, Sasheela Sri La Sri Ponnampala, Soo Lin Chuah, Wan Fadzlina Wan Mohd Shukeri, Wan Nazaruddin Wan Hassan, Wan Nurbayah Wan Yusoff, Wan Rahiza Wan Mat, M.A. Cureno-Diaz, G. Aguirre-Avalos, A. Flores-Alvarado, A. Cerero-Gudino, A. Zamores-Pedroza, B. Cano-Munoz, B.E. Hernandez-Chena, C.C. Carreon-Martinez, H. Coronado-Magana, F. Corona-Jimenez, E. Rodriguez-Noriega, E. Alcala-Martinez, E. Gonzalez-Diaz, F.M. Guerra-Infante, G. Arteaga-Troncoso, G. Martinez-Falcon, G. Leon-Garnica, H.A. Delgado-Aguirre, H.R. Perez-Gomez, I.E. Sosa-Gonzalez, J.A. Galindo-Olmeda, J.J. Ayala-Gaytan, J. Rodriguez-Pacheco, L. Zamorano-Flores, J.A. Lopez-Pulgarin, M.G. Miranda-Novales, M. Ramírez, M. Lopez-Hurtado, M. Lozano, M.E. Gomez, M.E. Sanchez-Castuera, M. Kasten-Monges, M. Gonzalez-Martinez, M. Sanchez-Vargas, M.C. Culebro-Burguet, M.A. Altuzar-Figueroa, J.C. Mijangos-Mendez, O.G. Ramires, O.S. Espinosa, R. De Leon-Escobedo, R. Salas-Flores, R. Ruiz-Rendon, S. Petersen-Morfin, S.A. Aguirre-Diaz, S. Esparza-Ahumada, S. Vega-Gonzalez, V. Gaona-Flores, V.A. Monroy-Colin, Z. Cruz-Rivera, A. Bat-Erdene, Batsaikhan Narankhuu, Batsuren Choijamts, Battsetseg Tuvdennyam, Byambadorj Batkhuu, K.H. Chuluunchimeg, D. Enkhtsetseg, G. Batjargal, G. Bayasgalan, M. Dorj, Naranpurev Mendsaikhan, Otgon Baatar, P. Suvderdene, S. Baigalmaa, T. Khajidmaa, Tsolmon Begzjav, null Tsuyanga, Z. Ariyasuren, A.A. Zeggwagh, K. Berechid, K. Abidi, N. Madani, R. Abouqal, Anjeela Koirala, Rashmi Giri, Samana Sainju, Subhash Prasad Acharya, Abeera Ahmed, Aun Raza, Azra Parveen, Faisal Sultan, Maria Khan, Nadeem Paul, Nargis Daud, Sana Yusuf, Summiya Nizamuddin, E. Garcia-Mayorca, E.G. Castaño, J.L. Moreno-Castillo, J.M. Ballinas-Aquino, L. Lara, M. Vargas, M.I. Rojas-Bonilla, S.J. Ramos, T. Mapp, V. De Iturrado, C.E. La Hoz Vergara, C.F. Linares-Calderon, D. Moreno, E. Ramirez, F.M. Ramírez Wong, G.M. Montenegro-Orrego, H.R. Sandoval-Castillo, J. Pichilingue-Chagray, J. Mueras-Quevedo, K.F. Aibar-Yaranga, L.I. Castillo-Bravo, L.M. Santivanez-Monge, M.J. Mayorga-Espichan, M.L.G. Rosario-Tueros, M.V. Changano-Rodriguez, N.E. Salazar-Ramirez, V.A. Marquez-Mondalgo, Anna Lyn N. Tajanlangit, Arnefelina S. Tamayo, Cristina Mari Jean P. Llames, Ever Labro, Ana P. Dy, J.D. Fortin, L.D. Bergosa, L.G. Salvio, V. Bermudez, M.C. Sg-Buenaflor, M.F. Trajano, M.T. Mendoza, O.P. Javellana, R.R. Maglente, Y. Arreza-Galapia, J.A. Navoa-Ng, A. Kubler, B. Barteczko-Grajek, B. Dragan, M. Zurawska, M. Mikaszewska-Sokolewicz, M. Zielinska, G.Y. Ramos-Ortiz, A. Florin-Rogobete, C. Daliborca Vlad, D. Muntean, D. Sandesc, M. Papurica, M. Licker, Ovidiu Horea Bedreag, R. Popescu, S.D. Grecu, V. Dumitrascu, A. Molkov, D. Galishevskiy, M. Furman, A. Simic, D. Lekic, G. Ristic, J. Eremija, J. Kojovic, L. Nikolic, M. Bjelovic, A. Lesnakova, S. Hlinkova, M.O. Gamar-Elanbya, Namphon Supa, Pornpheth Prasan, Rungratchanee Pimathai, Suthinee Wanitanukool, Suwara Somabutr, N. Ben-Jaballah, A. Borgi, A. Bouziri, A. Dilek, A. Oncul, A. Kaya, Ali Pekcan Demiroz, A. Gunduz, A. Ozgultekin, Asuman Inan, A.N. Yalcin, A. Ramazanoglu, A. Engin, A. Willke, Basak Ceyda Meco, C. Aygun, C. Bulut, C. Uzun, C. Becerik, Cigdem Ataman Hatipoglu, Cigdem Yildirim Guclu, D. Ozdemir, D. Yildizdas, D. Ugurcan, E. Azak, E. Guclu, Esmeray Mutlu Yilmaz, F. Sebnem-Erdinc, F. Sirmatel, F. Ulger, Ferhat Sari, Filiz Kizilates, G. Usluer, G. Ceylan, G. Ersoz, G. Kaya, Gunay Tuncer Ertem, G. Senol, Hasan Agin, Hatice Cabadak, H. Yilmaz, Hulya Sungurtekin, Humeyra Zengin, H. Turgut, I. Ozgunes, I. Devrim, I. Erdem, Inşa Gul Ekiz Işcanlı, M. Mehmet Bakir, M.F. Geyik, M. Oral, M. Meric, M. Cengiz, M. Ozcelik, M. Altindis, M. Sunbul, N. Elaldi, N. Kuyucu, N. Unal, N. Oztoprak, N. Yasar, Nurettin Erben, Nuri Bayram, Oguz Dursun, Oguz Karabay, O. Coskun, Ozden Ozgur Horoz, Ozge Turhan, Ozlem Sarac Sandal, Recep Tekin, Saban Esen, Selvi Yener Erdogan, Serhat Unal, Sevim Karacorlu, Suha Sen, Suzan Sacar, Volkan Yarar, Yeliz Oruc, Yusuf Sahip, Zeynep Kaya, Anamma Philip, Ashraf Elhoufi, Hussain Alrahma, E. Sachez, F. Perez, G.D. Empaire, H. Vidal, L. Montes-Bravo, M.E. Guzman Siritt, N. Orozco, N. Navarrete, Y. Ruiz, Z. Duran-Gil De Anez, Dang Thi Van Trang, Dao Quang Minh, Dao Xuan Co, Dinh Pham Phuong Anh, Le Thi Anh Thu, Le Thi Diem Tuyet, Le Thi Thu Nguyet, Ngo uy Chau, Nguyen Gia Binh, Nguyen Phuc Tien, Nguyen Quoc Anh, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Truong Anh Thu, Vo Thi Hong Thoa, Ondokuz Mayıs Üniversitesi, and MERİÇ KOÇ, MELİHA
- Subjects
Male ,0301 basic medicine ,Pediatrics ,Imipenem ,Antibiotic resistance ,Epidemiology ,health care facilities, manpower, and services ,Ceftazidime ,Global Health ,0302 clinical medicine ,Bloodstream infection ,Prospective Studies ,030212 general & internal medicine ,Child ,Aged, 80 and over ,Cross Infection ,Urinary tract infection ,Incidence ,Health Policy ,Ventilator-associated pneumonia ,Middle Aged ,Intensive Care Units ,Infectious Diseases ,Amikacin ,Child, Preschool ,Limited resources countries ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Health care-associated infection ,030106 microbiology ,Catheter-associated urinary tract infection ,Developing countries ,Young Adult ,03 medical and health sciences ,Intensive care ,medicine ,Humans ,Hospital infection ,Aged ,business.industry ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Device use ,Nosocomial infection control ,medicine.disease ,Emergency medicine ,Central line-associated bloodstream infections ,business - Abstract
Hasan, M. Shahnaz/0000-0002-7493-7416; Abouqal, Redouane/0000-0002-6117-4341; Altindis, Mustafa/0000-0003-0411-9669; Masjedi, Mansoor/0000-0001-6175-9289; Popescu, Roxana/0000-0002-9387-1141; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; Meco, Basak Ceyda/0000-0003-2951-9634; Kumar, Perikala Vijayananda/0000-0001-8315-7000; Zand, Farid/0000-0003-3489-3372; Maghsoudi, Behzad/0000-0002-1279-8799; KAMARUL ZAMAN, MAZUIN/0000-0002-7920-6399; Gan, Chin Seng/0000-0002-6758-4798; Horoz, Ozden Ozgur/0000-0001-7590-650X; Medeiros, Eduardo A/0000-0002-6205-259X; Sabetian, Golnar/0000-0001-8764-2150; UNAL, SERHAT/0000-0003-1184-4711; Gan, Chin Seng/0000-0002-6758-4798; Delia, Muntean/0000-0001-9100-4530; Yalcin, Ata Nevzat/0000-0002-7243-7354; Leblebicioglu, Hakan/0000-0002-6033-8543; Horhat, Florin George/0000-0001-6133-0204; Yousef, Reham H. A./0000-0003-4004-3008; Delgado Aguirre, Hector Alberto/0000-0001-5448-7975; El Kholy, Amani/0000-0002-0645-7664; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Sanaei Dashti, Anahita/0000-0002-2827-3575; KARABAY, OGUZ/0000-0003-1514-1685; Barahona G., Nayide/0000-0003-3559-6900; Stagnaro, Juan Pablo/0000-0003-3836-9957; Alexandru Florin, Rogobete/0000-0003-1286-4431; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Duszynska, Wieslawa/0000-0002-5880-4904; Ngo, Quy Chau/0000-0002-6787-2757; Elmanakhly, Arwa/0000-0001-8557-0536; yildizdas, dincer/0000-0003-0739-5108; Kanj, Souha/0000-0001-6413-3396; Gupta, Umesh/0000-0001-7717-1404 WOS: 000392626300014 PubMed: 27742143 Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DAHAI), we collected prospective data from861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central lineassociated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheterassociated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. VDR; Foundation to Fight against Nosocomial Infections The funding for design, development, maintenance, technical support, data validation, and report generation of the Surveillance Online System, and the activities carried out at International Nosocomial Infection Control Consortium headquarters, were provided by VDR and the Foundation to Fight against Nosocomial Infections.
- Published
- 2016
27. Succesful Regional Anaesthesia and Surgical Gastrostomy for Head and Neck Cancer patients with Airway Obstruction
- Author
-
Zan Mitrev, Emil Stoicovski, Dijana Popevski, Marko Gjorgon, Tanja Gramosli, and Dragica Vezenkova Vuchkova
- Published
- 2019
28. ESRA19-0343 Regional anesthesia technique for carotid surgery
- Author
-
Zan Mitrev, T Gramosli, Emil Stoicovski, Nikola Hristov, D Popevski, Marko Gjorgon, and D Vuckova
- Subjects
Bupivacaine ,medicine.medical_specialty ,Lidocaine ,business.industry ,medicine.medical_treatment ,Infarction ,Dilated cardiomyopathy ,Carotid endarterectomy ,medicine.disease ,Chest pain ,Surgery ,medicine ,Myocardial infarction ,medicine.symptom ,business ,Stroke ,medicine.drug - Abstract
Background and aims The decision for general anesthesia (GA) vs regional anesthesia (RA) for staged carotid endarterectomy (CEA) is an ongoing debate 1 2 and should be done on an individual basis.3 We present a case of a highly-comorbid patient with dilated cardiomyopathy (DCM) undergoing staged CEA using RA. Methods A 72-year-old patient with previous stroke and soft carotid bifurcation plaque was admitted for right CEA. He experienced an infarction 4 years previously, left untreated, thus developing dilated cardiomyopathy, diabetic with an GFR of 43.7 mL/min/1.73 m2. Preoperative evaluation showed dyspnea at rest NYHA IV; and intermittent chest pain CCS IV. We opted for staged CEA shortly followed by coronary revascularization. Due to minimal invasiveness, RA was chosen because of the high-risk of myocardial infarction, intraoperative stroke and renal insufficiency. Deep cervical plexus block was performed, from C2 to C4 using 10 ml 0,5% bupivacaine and 10 ml 1% lidocaine [4]. Surgery was uneventful and pain free, with stable hemodynamics, using eversion endarterectomy and no shunt. Results Postoperative recovery was uneventful, patient was discharged on the 2nd day following surgery. Conclusions Staged CEA in high risk coronary patients can be safely performed using minimal invasive RA. Our ongoing study for RA vs GA in this patient will give definitive answer.
- Published
- 2019
29. ESRA19-0342 Successful regional anaesthesia and surgical gastrostomy for head and neck cancer patients with airway obstruction
- Author
-
T Gramosli, D Vezenkova Vuchkova, D Popevski, Marko Gjorgon, Emil Stoicovski, and Zan Mitrev
- Subjects
Bupivacaine ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Head and neck cancer ,Cancer ,Airway obstruction ,medicine.disease ,Gastrostomy ,Surgery ,Cachexia ,Radiation therapy ,Esophageal stricture ,medicine ,business ,medicine.drug - Abstract
Background and aims Malnutrition and cachexia are frequent in head and neck cancer (HNC) patients. These complications occur as a result of the cancer but are worsened by surgery, radiotherapy or chemotherapy that further challenge oral intake but also airway obstruction. Methods We present case of 82-year-old male with nasopharyngeal carcinoma, severe malnutrition following multimodality therapy and difficult airway. He was unable to consume solid foods and liquids, developing severe cachexia due to esophageal stricture, confirmed during an unsuccessful gastroscopy. Refused by several hospitals, we opted for surgical gastrostomy under regional anesthesia, using epidural catheter placed T10/T11 and continuous 5% bupivacaine. Results The procedure was uneventful and pain free. The epidural catheter was removed on the 2nd postoperative day; patient discharged on the 4th postop day, with functional gastrostomy. First follow up showed increase in body weight. Conclusions Regional anesthesia and surgical gastrostomy can be successfully performed in a frail geriatric patient when the underlying disease cause severe airway obstruction.
- Published
- 2019
30. Regional anesthesia technique for carotid surgery
- Author
-
Zan Mitrev, Emil Stoicovski, Dijana Popevski, Marko Gjorgon, Dragica Vezenkova Vuchkova, Nikola Hristov, and Tanja Gramosli
- Published
- 2019
31. Continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters as adjuvant therapy for anaerobic descending necrotizing mediastinitis: a case report
- Author
-
Katerina Ignevska, Dijana Popevski, Zan Mitrev, Rodney A. Rosalia, and Magdelena Popovska-Cvetkova
- Subjects
Adult ,Male ,medicine.medical_specialty ,Continuous Renal Replacement Therapy ,medicine.medical_treatment ,lcsh:Medicine ,Case Report ,030204 cardiovascular system & hematology ,Procalcitonin ,law.invention ,Sepsis ,Necrosis ,03 medical and health sciences ,0302 clinical medicine ,law ,Anaerobic septic shock ,Intensive care ,Extracorporeal blood oxygenation ,medicine ,Humans ,Abscess ,Septic shock ,business.industry ,lcsh:R ,Mediastinum ,General Medicine ,medicine.disease ,Combined Modality Therapy ,Intensive care unit ,Mediastinitis ,Surgery ,Descending necrotizing mediastinitis (DNM) ,Chest tube ,Treatment Outcome ,030220 oncology & carcinogenesis ,Drainage ,Tomography, X-Ray Computed ,business - Abstract
Background We describe a combinatorial intensive care approach and discuss the critical factors that allowed us to successfully manage a life-threatening case of acute anaerobic septic shock triggered by descending necrotizing mediastinitis. Case presentation We admitted a 38-year-old critically ill Kosovar Albanian man to our intensive care unit because of clinical manifestations of severe sepsis. His condition had worsened in the previous 2 weeks following unsuccessful antibiotic therapy for tonsillitis complicated by retropharyngeal abscesses. Computed tomography and intraoperative observations identified abscesses in the anterior and middle mediastinum regions and the distal part of the neck, directly on the border with the left lobe of the thyroid gland. Cultures indicated infections with α-hemolytic Streptococcus and Clostridium species: High procalcitonin and lactate levels, blood gas analysis, poor peripheral capillary oxygen saturation, and severe hemodynamic instability pointed to a case of acute septic shock. The entire treatment consisted of an aggressive antibiotic regimen, transthoracic and mediastinal surgical evacuation of the abscess, vacuum sealing drainage with a pleural chest tube, continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters, and extracorporeal blood hyperoxygenation. Conclusions Efficient treatment of severe anaerobic sepsis resulting from descending necrotizing mediastinitis should build on a multidisciplinary approach. In support of first-line therapies with targeted antibiotics and surgical debridement, clinicians should consider alternative therapies such as continuous venovenous hemodiafiltration with cytokine-adsorbing hemofilters and hyperoxygenation. Electronic supplementary material The online version of this article (10.1186/s13256-019-2123-7) contains supplementary material, which is available to authorized users.
- Published
- 2019
32. P360Acute ST elevation myocardial infarction in a middle-aged woman resulting from a giant left anterior descending coronary artery aneurysm
- Author
-
M Klincheva, L Veljanovska Kiridjievska, Zan Mitrev, and Rodney Alexander Rosalia
- Subjects
medicine.medical_specialty ,Aneurysm ,business.industry ,St elevation myocardial infarction ,Internal medicine ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Anterior Descending Coronary Artery ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Published
- 2019
33. SURGICAL TREATMENT OF MULTYLOCULAR HYDATID CYST OF THE LEFT VENTRICLE–A CASE REPORT: G-042
- Author
-
Zan, Mitrev and Anguseva, T
- Published
- 2007
34. Cardiac autotransplantation and ex vivo surgical repair of giant left atrium: a case presentation
- Author
-
Rodney A. Rosalia, Zan Mitrev, Milka Klincheva, Igor Zdravkovski, and Tanja Anguseva
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Mitral Valve Annuloplasty ,medicine.medical_treatment ,Heart Valve Diseases ,Case Report ,Cardiomegaly ,030204 cardiovascular system & hematology ,Transplantation, Autologous ,03 medical and health sciences ,0302 clinical medicine ,Warm blood perfusion ,Internal medicine ,Mitral valve annuloplasty ,Mitral valve ,Left atrial enlargement ,medicine ,Humans ,Cardiac autotransplantation ,030212 general & internal medicine ,Heart Atria ,Giant left atrium ,Aged ,Heart Valve Prosthesis Implantation ,Atrioventricular valve ,business.industry ,Atrial fibrillation ,Recovery of Function ,Middle Aged ,medicine.disease ,Autotransplantation ,Cardiac surgery ,medicine.anatomical_structure ,Treatment Outcome ,lcsh:RC666-701 ,Echocardiography ,Heart failure ,Cardiology ,cardiovascular system ,Heart Transplantation ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Chronic Mitral Valve disease is strongly associated with Left atrial enlargement; the condition has a high mortality risk. Clinical manifestations include atrial fibrillation, pulmonary hypertension, thromboembolic events, and in cases of Giant Left Atrium (GLA) and a distorted cardiac silhouette. Full sternotomy, conventional open-heart surgery, reductive atrioplasty and atrioventricular valve repair are required to resolve symptoms. However, these procedures can be complicated due to the posterior location of the GLA and concomitant right lateral protrusion. Cardiac autotransplantation is superior under these conditions; it provides improved visual access to the posterior atrial wall and mitral valve, hence, facilitates corrective surgical procedures. We aimed to assess the clinical outcome of patients undergoing cardiac autotransplantation as the primary treatment modality to resolve GLA. Moreover, we evaluated the procedural safety profile and technical feasibility. Case presentation Four patients, mean EuroSCORE II of 23.7% ± 7.7%, presented with heart failure, atrial fibrillation, left atrial diameter > 6.5 cm and a severe distorted cardiac silhouette; X-ray showed prominent right lateral protrusion. We performed cardiac autotransplantation using continuous retrograde perfusion with warm blood supplemented with glucose followed by atrioplasty, atrial plication, valve annuloplasty and valve repair on the explanted beating heart. The surgical approach reduced the left atrial area, mean reduction was − 90.71 cm2 [CI95% -153.3 cm2 to − 28.8 cm2, p = 0.02], and normalized pulmonary arterial pressure, mean decrease − 11.25 mmHg [CI95% -15.23 mmHg to − 7.272 mmHg, p = 0.003]. 3 out of 4 patients experienced an uneventful postoperative course; 2 out of 4 patients experienced a transient return to sinus rhythm following surgery. One was operated on in 2017 and is still in good condition; two other patients survived for more than 10 years; Kaplan-Meier determined median survival is 10.5 years. Conclusions Cardiac autotransplantation is an elegant surgical procedure that facilitates the surgical remodelling of Giant Left Atrium. Surgical repair on the ex vivo beating heart, under continuous warm blood perfusion, is a safe procedure applicable also to high-risk patients.
- Published
- 2018
35. Minimally Invasive Surgical Repair of Vertebral Artery Ostium Stenosis in Patients with Ischemic Stroke: A Single-Center Case Series
- Author
-
Rodney Alexander Rosalia, Zan Mitrev, Lidija Veljanoska-Kiridjievska, Riste Zimoski, Nikola Hristov, Neda Milevska-Kostova, Petar Ugurov, Enver Idoski, and Marko Gjorgon
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Vertebral artery ,Ischemia ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,medicine.artery ,Vertebrobasilar Insufficiency ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Subclavian artery ,Aged ,Ischemic Stroke ,Retrospective Studies ,Endarterectomy ,Cerebral Revascularization ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,Ostium ,Stenosis ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Ischemic stroke is the second leading cause of death in North Macedonia. Posterior circulation disease, caused by vertebral artery (VA) ostium (VAo) stenosis, is a common cause of ischemic stroke. We established a treatment approach using surgical revascularization of posterior circulation disease. In the present observational study, we assessed the outcome after surgical revascularization of the posterior circulation ischemia caused by VAo stenosis. Methods A retrospective analysis of 20 consecutive patients who had undergone surgery from January 2017 to December 2019. The VA was accessed through a 3-cm incision in the upper medial clavicle. The corrective procedures consisted of resection and anastomosis (15 of 20), VA to subclavian artery transposition (16 of 20), endarterectomy (10 of 20), vein graft interposition techniques (4 of 20), and vein graft bypass (1 of 20). Results The cohort included 9 acute cases. The mean patient age was 66.5 years (range 46–77). Of the 20 patients, 8 were women and 12 were men. Left-sided VA pathology was present in 75% of the cases. We observed rapid clinical improvement in 19 patients (95%). The total study period was 321 patient-months, with a median follow-up of 18 months (interquartile range, 5–24 months). One patient had died of an unknown cause after 12 months. During the follow-up period, 15 patients (75%) had reported permanent clinical improvement with no significant relapse of symptoms. Conclusions Minimally invasive surgical revascularization of the posterior brain circulation is a clinically effective therapeutic approach to manage ischemia caused by VAo stenosis. It can be performed safely, promote long-lasting symptom relief, and prevent recurrent strokes.
- Published
- 2021
36. Endothelial Nitric Oxide Synthase T-786C Mutation, Prothrombin Gene Mutation (G-20210-A) and Protein S Deficiency Could Lead to Myocardial Infarction in a Very Young Male Adult
- Author
-
Elena Ambarkova Vilarova, Milka Klincheva, Ivan Milev, Tanja Angjusheva, Zan Mitrev, and Enver Idoski
- Subjects
0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,prothrombin gene mutation (G-20210-A) ,lcsh:Medicine ,Case Report ,030204 cardiovascular system & hematology ,Gene mutation ,Thrombophilia ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,Myocardial infarction ,protein S deficiency ,business.industry ,lcsh:R ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Clopidogrel ,young male ,(eNOS) T-786C mutation ,myocardial infarction ,030104 developmental biology ,Right coronary artery ,Cardiology ,Medicine ,Surgery ,medicine.symptom ,business ,TIMI ,medicine.drug - Abstract
INTRODUCTION: Myocardial infarction is a rare medical event in young people. The main reasons include congenital coronary abnormalities, coronary artery spasm, and coronary thrombosis due to hypercoagulable states (hereditary and acquired).AIM: We present a case of a young male adult with myocardial infarction caused by a combination of gene mutations and anticoagulation protein deficiency.CASE PRESENTATION: A 19 years old young man was admitted to our hospital complaining of chest pain during the last two weeks. The patient did not have any known cardiovascular risk factors, except a positive family anamnesis. Subacute inferior nonST segment myocardial infarction was diagnosed according to the patient’s history, electrocardiographic and laboratory findings. Coronary angiography revealed suboclusive thrombus in the proximal, medial and distal part of the right coronary artery (TIMI 2). Percutaneous coronary intervention was performed. Anticoagulant and antiagregant therapy (heparin, acetilsalicilic acid and clopidogrel) according to protocol was started. The hospital stay was uneventful. Homozygous endothelial nitric oxid synthase (eNOS) T-786-C mutation, heterozygote prothrombin gene mutation (G-20210-A), and protein S deficiency were verified from the thrombophilia testing. Other trombophilic tests were normal. Three months after discharge from hospital another coronary angiography was performed. It revealed normal coronary arteries. Four years after the attack, the patient is free of symptoms and another cardiovascular event.CONCLUSION: Combination of genetic mutations and anticoagulation protein deficiency could be a reasonable cause for myocardial infarction in a very young male adult without any other cardiovascular risk factors.
- Published
- 2016
37. Trio Clinical Exome Sequencing in a Patient With Multicentric Carpotarsal Osteolysis Syndrome: First Case Report in the Balkans
- Author
-
Margarita Stavrevska, Gjorgje Zafiroski, Zan Mitrev, Kristina Jakovleva, Ivan Kungulovski, Sanja Mehandziska, Velibor Tasic, Aleksandra Stajkovska, Goran Kungulovski, and Natasha Nikchevska
- Subjects
0301 basic medicine ,Proband ,Osteolysis ,lcsh:QH426-470 ,030105 genetics & heredity ,Bioinformatics ,Asymptomatic ,DNA sequencing ,Nephropathy ,03 medical and health sciences ,Skeletal disorder ,Balkan ,medicine ,Genetics ,case report ,Genetics (clinical) ,Exome sequencing ,business.industry ,multicentric carpotarsal osteolysis syndrome ,medicine.disease ,lcsh:Genetics ,030104 developmental biology ,MAFB ,Molecular Medicine ,next-generation sequencing ,medicine.symptom ,business ,exome sequencing - Abstract
Exome sequencing can interrogate thousands of genes simultaneously and it is becoming a first line diagnostic tool in genomic medicine. Herein, we applied trio clinical exome sequencing in a patient presenting with undiagnosed skeletal disorder, minor facial abnormalities, and kidney hypoplasia; her parents were asymptomatic. Testing the proband and her parents led to the identification of a de novo mutation c.188C>T (p.Pro63Leu) in the MAFB gene, which is known to cause multicentric carpotarsal osteolysis syndrome (MCTO). The c.188C>T mutation lies in a hotspot amino acid stretch within the transactivation domain of MAFB, which is a negative regulator of RANKL-induced osteoclastogenesis. MCTO is an extremely rare autosomal dominant (AD) disorder that typically arises spontaneously and causes carpotarsal osteolysis, often followed by nephropathy. To the best of our knowledge, this is the first study reporting genetically diagnosed multicentric carpotarsal osteolysis syndrome in the Balkans.
- Published
- 2018
38. Emergencies in Cardiovascular Surgery- A Clinical Judgment and Treatment Strategy
- Author
-
Zan Mitrev and Tanja Anguseva
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,business.industry ,Cardiomyopathy ,General Medicine ,medicine.disease ,Clinical judgment ,Surgery ,Dissection ,Geriatric cardiology ,medicine ,Endocarditis ,Intensive care medicine ,business ,Leriche Syndrome ,Angiology - Abstract
Urgent sorgely, is part of a daily practice on cardiovascular units, and it may be required in patients with conditions such as acute coronary syndrome, endocarditis and valvular diseases, trauma, acute aOl1ic dissection as well as acute vascular embolisations and Leriche syndrome. In emergency situation, preoperative patient work-up for cardia-vascular surgery is quite different from the elective setting.
- Published
- 2017
39. Trauma of the Heart and Great Vessels
- Author
-
Zan Mitrev, Tanja Anguseva, and Zvonko Atanasov
- Subjects
Surgical repair ,medicine.medical_specialty ,business.industry ,Cardiomyopathy ,General Medicine ,medicine.disease ,Geriatric cardiology ,Blunt ,Great vessels ,Mechanism of injury ,cardiovascular system ,medicine ,Anatomic Location ,Intensive care medicine ,business ,Angiology - Abstract
Thoracic great vessel and cardiac trauma are characterized by anatomic location and mechanism of injury: blunt or penetrating. Management strategies are also directed by the extent and mechanism of injury. Advances in imaging and catheter-based technologies have allowed easier and more accurate diagnosis and less-invasive treatments. Although the advantages of endovascular techniques are attractive, open surgical repair remains the definitive treatment for many of these thoracic injuries. Given the increasing sophistication of these technologies and the demonstrated usefulness of a disease-oriented approach toward patient management, trauma centers have adopted a multidisciplinary team model for management of multitrauma victims. In this review, the authors detail the diagnosis and management of blunt or puncture aortic, non-aortic great vessel, blunt cardiac, and penetrating cardiac injuries.
- Published
- 2017
40. Right Ventricular Myxoma
- Author
-
Zan Mitrev and Tanja Anguseva
- Subjects
medicine.medical_specialty ,business.industry ,Dental surgery ,medicine ,Ventricular Myxoma ,business ,Colorectal surgery ,Surgery - Published
- 2017
41. Percutaneous Interventional Treatment of Atrial Septal Defect Secundum in Macedonia
- Author
-
Sashko Nikolov, Tanja Angjuseva, Ivan Milev, Zan Mitrev, Shpend Idrizi, Planinka Zafirovska, Vilma Ampova-Sokolov, and Zan Zimbakov
- Subjects
medicine.medical_specialty ,right ventricle overload ,Percutaneous ,congential heart disease ,Septum secundum ,lcsh:Medicine ,Hemodynamics ,Internal medicine ,percutaneous intervention ,Medicine ,atrial septal defect ,atrial septal occluder ,business.industry ,lcsh:R ,Atrial fibrillation ,General Medicine ,medicine.disease ,Surgery ,Catheter ,medicine.anatomical_structure ,Ventricle ,Congenital heart disorder ,Cardiology ,business ,Shunt (electrical) - Abstract
Background: Atrial septal defect (ASD) is a common congenital heart disorder (CHD). While conventional open surgical treatment is the standard procedure in our country, percutaneous device closure with implantation of an atrial septal defect occluder is a promising alternative with very few peri and post procedural complications.Aim: The aim of the study was to present the rate of success and complications in percutaneous ASD closure with the implantation of an atrial septal defect occluder.Material and Methods: We treated 153 patients (ages 2-76; 65% female) with ASD secundum with percutaneous trans catheter closure using a septal occluder. Follow up was on a 3 month interval and assessment included clinical, electrophysiological and echocardiographic status. Results: The mean diameter of ASD obtained via balloon sizing was 16 ± 16 mm. Multiple ASDs were found in 20 (13%) patients and deficitary aortic and anterior rim (< 5 mm) was present in 16 (10%) patients. Due to inadequate placement and/or sizing, the device was removed and replaced in seven patients (5%). During follow up, trivial shunt was present in 4 (2.6%) patients. The diameter of the right ventricle corrected for age was reduced by an average of 20% by the first month and in 130 (86%) of patients it had normalized by one year of follow up. During follow up, 16 (10%) patients reported transient headaches and 3 (1.9%) patients had transient atrial fibrillation (AF).Conclusion: In conclusion, the implantation of a septal occluder was found to be a safe procedure that resulted in improved hemodynamic parameters that result from right ventricular volume overload with favorable short- and mid-term results.
- Published
- 2014
42. Life-Threatening Surgery for Mycotic Aneurysm
- Author
-
Zan Mitrev and Tanja Anguseva
- Subjects
medicine.medical_specialty ,Aorta ,business.industry ,Fulminant ,Mortality rate ,Case Reports ,Mycotic aneurysm ,medicine.disease ,Surgery ,Sepsis ,Aneurysm ,medicine.anatomical_structure ,medicine.artery ,cardiovascular system ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,Aortic rupture ,business ,Artery - Abstract
Infected aneurysm (or mycotic aneurysm) is defined as an infectious disease of the wall of an artery with formation of a blind, saccular out-pouching that is contiguous with the arterial lumen. Symptoms are frequently absent or nonspecific during the early stages. Once clinically presented, infected aneurysms are often at an advanced stage of development and associated with complications such as rupture. Nontreatment or delayed treatment of infected aneurysms has a poor outcome, with high morbidity and mortality rate via fulminant sepsis or hemorrhage. In clinically suspected cases, computed tomography is used for diagnosis. Urgent surgery, performed to prevent aortic rupture carries high morbidity and mortality rates.
- Published
- 2013
43. Qualitative and Quantitative Analysis of the Parenting Styles, Coping Strategies and Perceived Stress in Mothers of Children who have Undergone Cardiac Interventions
- Author
-
Naumoska Ljubica, Ristovska Frosina, Dojcinovski Ilija, Suzana T. Paunovska, Sait Saiti, and Zan Mitrev
- Subjects
Coping (psychology) ,business.industry ,Parenting styles ,Perceived stress ,Disease ,Congenital heart diseases ,Psychotherapeutic care ,Basic medicine ,Family dynamics ,Clinical medicine ,Cardiac interventions ,Health care ,Summer camp ,Medicine ,General Materials Science ,Coping ,business ,Psychosocial ,Clinical psychology - Abstract
Exploring the parenting styles, coping strategies and perceived stress in parents of children who have undergone cardiac intervention are challenging issues because they affect the whole family dynamics. Ten mothers of children who have undergone cardiac intervention and ten mothers of healthy children, aged 5 to 14 were administered three questionnaires: Parenting styl es Questionnaire, Cope and Perceived stress Questionnaire. The testing was conducted at the final day of their five-day summer camp in June 2011.Exploration of psychosocial characteristics of parents living with the diagnosis of cardiac disease in their child is crucial for the entire team of those providing healthcare. Adequate medical as well as psychological diagnosis can provide adequate psychotherapeutic interventions which can have multi-faceted benefits both for the parents and children in the process of coping.
- Published
- 2013
44. Body Mass Index and Health-related Quality of Life in Patients Preparing for Coronary Angiography
- Author
-
F. Ristovska, I. Dojcinovski, Lj Naumoska, and Zan Mitrev
- Subjects
Health related quality of life ,Coronary angiography ,medicine.medical_specialty ,business.industry ,Health-related quality of life ,Health counseling ,Functional health ,Positive health behavior ,humanities ,Health problems ,Physical therapy ,medicine ,General Materials Science ,In patient ,Health profile ,Health behavior ,business ,Body mass index - Abstract
There is evidence that body mass index (BMI) is related to some extent to the health related quality of life (HRQoL) in diffe rent populations. The purpose of our study was to investigate the relationship between the BMI and the HRQoL in patients awaiting coronary angiography. The sample consisted of 100 patients (68 males and 32 females) with symptomatology indicated for coronary angiography. For all of them BMI was calculated. They were also administered Duke Health profile questionnaire which measures adult self-reported functional health status. The findings reveal that BMI is related to some aspects of HRQoL. Considering this, health counseling directed at regulating body weight as part of the positive health behavior can benefit and improve some domains of the HRQoL and the QoL per se of the individuals having health problems.
- Published
- 2013
45. Transcatheter Closure of Patent Foramen Ovale: A Single Center Experience
- Author
-
Zan Zimbakov, Tanja Anguseva, Shpend Idrizi, Nikola Hristov, Vilma Ampova-Sokolov, Goce Tosheski, Emilija Gorgieva, Planinka Zafirovska, Liljana Ilievska, Ljubica Georgievska-Ismail, Ivan Milev, Zan Mitrev, and This research did not receive any financial support.
- Subjects
medicine.medical_specialty ,Percutaneous ,patent foramen ovale ,Cardiology ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,transcatheter closure ,Stroke ,cerebrovascular insult ,a migraine ,interventional closure ,Interventional treatment ,business.industry ,Incidence (epidemiology) ,lcsh:R ,General Medicine ,Clinical Science ,medicine.disease ,Surgery ,Migraine ,Patent foramen ovale ,Medicine ,Headaches ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine.AIM: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed PFO.MATERIAL AND METHODS: Transcatheter closure of PFO was performed in 52 patients (67.3% women, mean age 40.7 ± 11.7 years). Patients were interviewed for subjective grading of the intensity of headaches before and after the PFO closure.RESULTS: During 2 years of follow-up, there was no incidence of new stroke, TIA and/or syncope. Follow-up TCD performed in 35 patients showed complete PFO closure in 20 patients (57.1%). Out of 35 patients, 22 (62.9%) reported having a migraine before the procedure with an intensity of headaches at 8.1 ± 1.9 on a scale from 1 to 10. During 2 years of follow-up, symptoms of a migraine disappeared in 4 (18.2%) and the remaining 18 patients reported the significant decrease in intensity 4.8 ± 2.04 (p = 0.0001). In addition, following PFO closure the incidence of the headaches decreased significantly (p = 0.0001).CONCLUSIONS: Percutaneous transcatheter closure of PFO is a safe and effective procedure showing mid-term relief of neurological symptoms in patients as well as significant reduction of migraine symptoms.
- Published
- 2016
46. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience
- Author
-
Planinka Zafirovska, Zan Mitrev, Vilma Ampova-Sokolov, Zan Zimbakov, Shpend Idrizi, Goce Tosheski, Tanja Angjuseva, and Ivan Milev
- Subjects
medicine.medical_specialty ,Percutaneous ,Cardiology ,lcsh:Medicine ,Regurgitation (circulation) ,Single Center ,Pericardial effusion ,pulmonary regurgitation ,Internal medicine ,medicine ,percutaneous pulmonary valvuloplasty ,pulmonary stenosis ,interventional treatment ,congenital heart disease ,business.industry ,lcsh:R ,General Medicine ,Clinical Science ,medicine.disease ,Surgery ,Stenosis ,medicine.anatomical_structure ,Ventricle ,Pulmonary valve ,Pulmonary valve stenosis ,Medicine ,business - Abstract
BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74%) of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg) to 39.1 mmHg (20-80 mmHg). Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9%) required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55%) patients, and four (9%) patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.
- Published
- 2015
47. Transplantation or Alternative Surgical Treatment of Patients with Ischemic Dilative Cardiomyopathy and Aneurysmatic Dilation of the Left Ventricular Cavity
- Author
-
Tanja Anguseva, Petar Risteski, Vasileva A, Nikola Hristov, and Zan Mitrev
- Subjects
Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,Heart Ventricles ,medicine.medical_treatment ,030232 urology & nephrology ,Biomedical Engineering ,Medicine (miscellaneous) ,Hemodynamics ,Coronary Disease ,Bioengineering ,Dilative cardiomyopathy ,030204 cardiovascular system & hematology ,Revascularization ,Biomaterials ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,Myocardial Revascularization ,medicine ,Humans ,Heart Aneurysm ,business.industry ,Ultrasound ,General Medicine ,Middle Aged ,medicine.disease ,Transplantation ,Dyskinesia ,Left ventricular cavity ,Cardiology ,Heart Transplantation ,Female ,medicine.symptom ,business - Abstract
Background Patients with terminal ischemic heart disease (IHD), severely depressed pump function with large LV dyskinesis with or without fibrosis do not benefit from revascularization alone; in time they are listed for transplantation. The long waiting list and lack of organ donors have imposed implementation of Direct Circular Repair (DCR) with total revascularization as an alternative. Methods DCR was performed on 17 patients with terminal IHD, after total revascularisation. The resected dyskinetic tissue was pathohistologicaly examined. Transesophageal ultrasound was performed pre- and early post-operatively and hemodynamic parameters measured invasively. Results Pathohistology showed that even in macroscopically viable myocardium where only dyskinesia without fibrosis persists, there are irreversible lesions on the ultrastructural level. Along with revascularization, with the application of DCR the LV spherical geometry was reconstructed with hemodynamic improvement. Conclusion Total revascularisation with DCR offers an alternative to transplantation in patients with wide anterior wall dyskinesia with or without fibrosis due to terminal IHD, the most frequent group listed for transplantation.
- Published
- 2002
48. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module
- Author
-
Víctor Daniel Rosenthal, Dennis George Maki, Yatin Mehta, Hakan Leblebicioglu, Ziad Ahmed Memish, Haifaa Hassan Al-Mousa, Hanan Balkhy, Bijie Hu, Carlos Alvarez-Moreno, Eduardo Alexandrino Medeiros, Anucha Apisarnthanarak, Lul Raka, Luis E. Cuellar, Altaf Ahmed, Josephine Anne Navoa-Ng, Amani Ali El-Kholy, Souha Sami Kanj, Ider Bat-Erdene, Wieslawa Duszynska, Nguyen Van Truong, Leonardo N. Pazmino, Lucy Chai See-Lum, Rosalia Fernández-Hidalgo, Gabriela Di-Silvestre, Farid Zand, Sona Hlinkova, Vladislav Belskiy, Hussain Al-Rahma, Marco Tulio Luque-Torres, Nesil Bayraktar, Zan Mitrev, Vaidotas Gurskis, Dale Fisher, Ilham Bulos Abu-Khader, Kamal Berechid, Arnaldo Rodríguez-Sánchez, Florin George Horhat, Osiel Requejo-Pino, Nassya Hadjieva, Nejla Ben-Jaballah, Elías García-Mayorca, Luis Kushner-Dávalos, Srdjan Pasic, Luis E. Pedrozo-Ortiz, Eleni Apostolopoulou, Nepomuceno Mejía, May Osman Gamar-Elanbya, Kushlani Jayatilleke, Miriam de Lourdes-Dueñas, Guadalupe Aguirre-Avalos, Diego Marcelo Maurizi, Adriana Montanini, Maria Laura Spadaro, Lorenzo Santiago Marcos, Priscila Botta, Florencia Maria Jerez, Maria Constanza Chavez, Lucia Ramasco, Maria Isabel Colqui, Maria Silvia Olivieri, Ana Silvia Rearte, Gladys Edith Correa, Paola Deolinda Juarez, Paola Fabiana Gallardo, Miriam Patricia Brito, Gabriel Horacio Mendez, Julia Rosa Valdez, Lorena Paola Cardena, Jose Maria Harystoy, Gustavo Jorge Chaparro, Claudia Gabriela Rodriguez, Rodolfo Toomey, Maria Caridi, Monica Viegas, Marisa Liliana Bernan, Adriana Romani, Claudia Beatriz Dominguez, Luis Kushner Davalos, Rosana Richtmann, Camila Almeida Silva, Tatiane T. Rodrigues, Amaury Mielle Filho, Ernandi Dagoberto Seerig Palme, Aline Besen, Caroline Lazzarini, Caroline Batista Cardoso, Francisco Kennedy Azevedo, Ana Paula Fontes Pinheiro, Aparecida Camacho, Braulio Matias De Carvalho, Maria Jose Monteiro De Assis, Ana Paula Vasconcelos Carneiro, Maria Lilian Maciel Canuto, Keyla Harten Pinto Coelho, Tamiris Moreira, Agamenon Alves Oliveira, Marcela Maria Sousa Colares, Marcia Maria De Paula Bessa, Tereza De Jesus Pinheiro Gomes Bandeira, Renata Amaral De Moraes, Danilo Amâncio Campos, Tânia Mara Lima De Barros Araújo, Maria Tereza Freitas Tenório, Simone Amorim, Manuela Amaral, Julianne Da Luz Lima, Lindalva Pino Da Silva Neta, Caphiane Batista, Fabio Jorge De Lima Silva, Maria C. Ferreira De Souza, Katia Arruda Guimaraes, Julia Marcia Maluf Lopes, Karina M. Nogueira Napoles, Lorena Luiza Silva Neto Avelar, Lilian Aguiar Vieira, Luis Gustavo De Oliveira Cardo, Christianne F.V. Takeda, Glaydson A. Ponte, Fco Eduardo Aguiar Leitão, Ricardo De Souza Kuchenbecker, Rodrigo Pires Dos Santos, Erci Maria Onzi Siliprandi, Luiz Fernando Baqueiro Freitas, Ianick Souto Martins, Daiane Casi, Maria Angela Maretti Da Silva, Sergio Blecher, Margarete Villins, Reinaldo Salomao, Solange Regina Oliveira Castro, Daniela V. Da Silva Escudero, Mariana Andrade Oliveira Reis, Marcelo Mendonca, Valter Furlan, Antonio Claudio do Amaral Baruzzi, Tarquino Eristidesg Sanchez, Marina Moreira, Wania Vasconcelos de Freitas, Leonardo Passos de Souza, Velmira Angelova Velinova, Michael M. Petrov, Dimitar Georgiev Karadimov, Emil D. Kostadinov, Violeta Jivkova Dicheva, Chaohua Wang, Xiuqin Guo, Xihua Geng, Shufang Wang, Jinzhi Zhang, Ling Zhu, Shufang Zhuo, Chunli Guo, Tao Lili, Li Ruisheng, Liu Kun, Xuesong Yang, Li Yimin, Mao Pu, Li Changan, Yiang Shumei, Wu Kangxiong, Lin Meiyi, Guxiang Ye, Xu Ziqin, Suo Yao, Song Liqiang, Luis Marino Cañas Giraldo, Elsa Margarita Trujillo Ramirez, Paola Andrea Rios, Juan Carlos Torres Millan, Edwin Giovanny Chapeta Parada, Andres Eduardo Mindiola Rochel, Andres H. Corchuelo Martinez, Ana Marãa Perez Fernandez, Nayide Barahona Guzman, Alfredo Lagares Guzman, Marena Rodriguez Ferrer, Yazmin Leon Vega, Heidi Johanna Munoz, Germán Camacho Moreno, Sandra Liliana Romero Torres, Herlidia Taboada Hernandez, Ismael A. Valderrama MarquezClaudia Linares, Monica Espinosa Valencia, Lusayda Sanchez Corrales, Sandra Milena Bonilla, Jorge Ivan Marin Uribe, David Yepes Gomez, Javier Ospina Martinez, Luz Dary Burgos Florez, Johanna Osorio, Dagoberto Santofimio, Lorena Matta Cortes, Wilmer Villamil-Gomez, Gabriel Munoz Gutierrez, Adela Arguello Ruiz, Carlos Gonzalez Fuentes, Antonio Solano Chinchilla, Ivar Calvo Hernandez, Olber Chavarria Ugalde, Humberto Guanche Garcell, Clara Morales Perez, Selin Bardak, Sumru Ozkan, Nepomuceno Mejia, Adrian M. Puello Guerrero Glenny Mirabal, Margarita Delgado, Ramona Severino, Eliesel Lacerda, Gilda Tolari, María Marcela Bovera, Diego Barahona Pinto, Pedro Fernández González, Gasdali Santacruz, Nelly Alquinga, Celso Zaruma, Nelson Remache, Diego Morocho, Mario Arboleda, Mario Cadena Zapata, Maria Fernanda Garcia, Fabricio Picoita, Jorge Velez, Marcia Valle, Estuardo Salgado Yepez, Diego Morocho Tutillo, Ricardo Arteaga Mora, Andrea Peña Padilla, Mayra Chango, Karina Cabezas, Shirley Tenorio López, Ana Lucía Bonilla Escudero, Gladys Tatiana Sánchez, Hugo Alberto Gonzalez Flores, Islam Abdullorziz Ghazi, Mohamed Hassan, Ghada A. Ismail, Reham Hamed, Mona Mohiedden Abdel-Halim, May Abd El-Fattah, Doaa Abdel-Aziz, Zeinab Salah Seliem, Rasha Hamed Elsherif, Reham Ali Dewdar, Abeer Ahmed Mohmed, Lamiaa Abdel-Fatteh Ahmed, Lilian De Jesus Machuca, Concepcion Bran De Casares, Prokopis Kithreotis, Maria Daganou, Dimitrios Veldekis, Maria Kartsonaki, Achilleas Gikas, Marco Tulio Luque Torres, Denis Padgett, Doris Maribel Rivera, Namita Jaggi, Camilla Rodrigues, Bhagyesh Shah, Keyur Parikh, Jigar Patel, Riya Thakkar, Murali Chakravarthy, B.N. Gokul, R. Sukanya, Leema Pushparaj, Thejas Vini, Sukanya Rangaswamy, Saroj Kumar Patnaik, Vempati Venkateshwar, Biju John, Shamsher Dalal, Suneeta Sahu, Samir Sahu, Banambar Ray, Sudhiranjan Misra, Nisith Mohanty, Biraj Mohan Mishra, Prafulla Sahoo, Naresh Parmar, Sanghamitra Mishra, Basanta Kumar Pati, Santosh Singh, Bhabani Shankar Pati, Aparajita Panda, Swarna Banergee, Dipankar Padhihari, Soumya Samal, Karthikeya Varma, Velu Pandi Suresh Kumar, Ram Gopalakrishnan, Nagarajan Ramakrishnan, Babu Kuruvilla Abraham, Senthilkumar Rajagopal, Ramesh Venkatraman, Ashwin Kumar Mani, Dedeepiya Devaprasad, Lakshmi Ranganathan, Thara Francis, Kotturathu Mammen Cherain, Bala Ramachandran, Ravikumar Krupanandan, S. Muralidharan, Murali Karpagam, Baby Padmini, S. Saranya, Siva Kumar, Nirav Pandya, Rajesh Kakkar, Tenzin Zompa, Narinder Saini, Srinivas Samavedam, Ganshyam Jagathkar, Suhas Nirkhiwale, G.S. Gehlot, Shefali Bhattacharya, Sanjeev Sood, Suman Singh, Sanjeev Singh, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Susmita Basu, Anuradha Agarwal, Manoj Agarwal, Mohit Kharbanda, Sankar Sengupta, Anirban Karmakar, Debkishore Gupta, Ajoy Krishna Sarkar, Rimita Dey, Chandramouli Bhattacharya, Mammen Chandy, V.R. Ramanan, Aseem Mahajan, Manas Roy, Sanjay Bhattacharya, Saswati Sinha, Indranil Roy, Umesh Gupta, Sujoy Mukherjee, Mrinmoy Bej, Purnima Mukherjee, Sumana Baidya, Afzal Azim, Asmita Sagar Sakle, Jehangir Soli Sorabjee, Mrunalini Subhash Potdar, Vaibhavi R. Subhedar, F.E. Udwadia, Hena Francis, Arpita Dwivedy, Sheena Binu, Suvin Shetty, Pravin Kumar Nair, Devendra K. Khanna, Felcy Chacko, Seelas Blessymole, Preeti Rajeev Mehta, Tanu Singhal, Sweta Shah, Vatsal Kothari, Reshma Naik, Mayur Harshadrai Patel, Deepesh Gokulchand Aggarwal, Burhanuddin Qutbuddin Jawadwala, Niketa Kaul Pawar, Shoeb Nizamuddin Kardekar, Abizer Nuruddin Manked, S.N. Myatra, J.V. Divatia, R. Kelkar, S.K. Biswas, V. Raut, S. Sampat, Alka Thool, Anil Karlekar, Sumi Nandwani, Sudhir Gupta, Sanjay Singhal, Madhu Gupta, Purva Mathur, Subodh Kumar, Kavita Sandhu, Arnab Dasgupta, Abhijeet Raha, Padmalatha Raman, Ashoo Wadhera, Binesh Badyal, Sarika Juneja, Bikas Mishra, Sunil Sharma, Megha Mehrotra, Jayant Shelgaonkar, Vikram Padbidri, Rohini Dhawale, Sheena Mary Sibin, Dileep Mane, Hanamant Kashinath Sale, Mohammad Mukhit Abdul Gaffar Kazi, Supriya Chabukswar, Anju Mathew, Dipti Gaikwad, Amol Harshe, Gita Nadimpalli, Sunil Bhamare, Soniya Thorat, Omnarayan Sarda, Pattabhiramarao Nadimpalli, Angelina Mendonca, Sujata Malik, Asmita Kamble, Nilakshi Kumari, Sohini Arora, Nita Munshi, Deepa Ganesh Divekar, Maithili Satish Kavathekar, Anuja Kedar Kulkarni, Madhupriya Vijay Suryawanshi, Madhavi Latha Bommala, Anil Bilolikar, Kashmira Limaye Joshi, Charulata Pamnani, Harvinder Wasan, Sonali Khamkar, Leena Steephen, Arjun Rajalakshmi, Anzar Thair, Aisha Mubarak, Swathy Sathish, Suresh Kumar, H. Sunil, Sujith Sujith, null Dinesh, Nagamani Sen, Nitin Shinde, Masoud Alebouyeh, Somayeh Jahani-Sherafat, Mohammad Reza Zali, Mohammad Reza Sarbazi, Nahid Mansouri, Elahe Tajeddin, Maryam Razaghi, Simasadat Seyedjavadi, Marjan Rashidan, Mansoor Masjedi, Behzad Maghsudi, Golnar Sabetian, Anahita Sanaei, Atefeh Yousefipour, Abdullah Mufareh Assiri, Elaine Mari Furukawa-Cinquini, Areej Dhafer Alshehri, Alysia Faye Giani, Nadia Lynette Demaisip, Elizabeth Laungayan Cortez, Analen Fabros Cabato, Jerlie Mae Gonzales Celiz, Ibrahim A.M. Al-Zaydani Asiri, Yassir Khidir Mohammed, Mohammed Abdullah Al Raey, Ali Omer Abdul Aziz, Saeed Ali Al Darani, Misbah Rehman Aziz, Roaa Hasan Basri, Duaa Khalil Al-Awadi, Syed Zahid Bukhari, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Apsia Musa Molano, Hessa Abdullah Al Enizy, Celia Flores Baldonado, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Avigail M. Tan, Sonia Joseph, Deepa Sasidharan Nair, Nabeela Abdullah Al-Abdullah, Grace Sindayen, Annalyn Amor Malificio, Diaa Abdullah Mohammed, Hanan Mesfer Al Ghamdi, Ameurfina Curioso Silo, Marianina Brenda V. Valisto, Nektarios Foteinakis, Sameeh Salem Ghazal, Mercy V. Joseph, Ahmed Hakawi, Antigona Hasani, Ismet Jusufi, Gazmend Spahija, Nehat Baftiu, Agreta Gecaj-Gashi, Nasser Yehia Aly, Mohammad El-Dossoky Noweir, Suga Thomas Varghese, Ruby Jose Ramapurath, Amna Mostafa Mohamed, Sneha Mary George, Anu Kurian, Amani Fouad Sayed, Mona Foda Salama, Abeer Aly Omar, Flavie Maria Rebello, Dennis Malungcot Narciso, Nada Kara Zahreddine, Zeina Kanafani, Tala Kardas, Bassel Molaeb, Lamia Jurdi, Anwar Al Souheil, Mohamad Ftouni, Hasan Ayash, Tahsine Mahfouz, Tomas Kondratas, Dovile Grinkeviciute, Rimantas Kevalas, Greta Gailiene, Algirdas Dagys, Milena Petrovska, Katja Popovska, Zaneta Bogoevska-Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Tanja Anguseva, Wan Nurbayah Wan Yusoff, Anis Shiham Zainal Abidin, Chin Seng Gan, Hasimah Zainol, Vineya Rai, Wong Kang Kwong, Mohd Shahnaz Hasan, Sasheela Sri La Sri Ponnampala, Jeyaganesh Veerakumaran, Ojan Assadian, Doan Mai Phuong, Nguyen Gia Binh, Kerinjeet Kaur, Joelene Lim, Lian-Huat Tan, Jegathesan Manikavasagam, Yuet-Meng Cheong, Hilario Coronado Magaña, Julio Cesar Mijangos Méndez, Federico Corona Jiménez, Sergio Esparza-Ahumada, Rayo Morfin-Otero, Eduardo Rodriguez-Noriega, Susana Gutierrez-Martinez, Hector Raul Perez-Gomez, Gerardo León-Garnica, Christian Mendoza-Mujica, Martha Cecilia Culebro Burguet, Jorge Horacio Portillo-Gallo, Fernando Aguilera Almazán, Gaspar Iglesias Miramontes, Maria del Rosario Vázquez Olivas, Lucio Alberto Aguilar Angel, Marisol Sanchez Vargas, Angel Orlando Flores Alvarado, Roberto Carlos Mares Morales, Luis Carlos Fernandez Alvarez, Hector Armando Rincon Leon, Karla Reyna Navarro Fuentes, Yuri Mariela Perez Hernandez, Gabriela Martinez Falcon, Angel Gonzalez Vargas, Marco A. Trujillo Juarez, Antonio Martinez Mulia, Paulina Alma Ulloa Camacho, Martha Y. Martinez-Marroquin, Marco Montell Garcia, Araceli Martinez Martinez, Elena Leon Sanchez, Guadalupe Gomez Flores, Marisela del Rocío González Martínez, Jesús Alfonso Galindo Olmeda, Georgina Olivarez, Enrique Barbachano Rodriguez, María Magdalena Gutierrez Castillo, María Guadalupe Villa González, Isaura Beatriz Sauceda Castañeda, Jaime Martínez Rodriguez, Otgon Baatar, Byambadorj Batkhuu, Kabiri Meryem, Barkat Amina, Rédouane Abouqal, Amine Ali Zeggwagh, Tarek Dendane, Khalid Abidi, Naoufel Madani, Syed Faisal Mahmood, Badaruddin A. Memon, Gul Hassan Bhutto, Nadeem Paul, Azra Parveen, Aun Raza, Amjad Mahboob, Summiya Nizamuddin, Faisal Sultan, Hammad Nazeer, Ashraf Ali Khan, Arifa Hafeez, Lydia Lara, Trudell Mapp, Balkys Alvarez, Magda Ivonne Rojas-Bonilla, Elizabeth Castano, Daisy A. De Moros, Roberto Espinoza Atarama, Maria Elena Calisto Pazos, Alfredo Paucar, Marlene Tasayco Ramos, Jenny Jurado, Dafne Moreno, Marãa E. Cruz Saldarriaga, Eliza Ramirez, Carlos Enrique La Hoz Vergara, Walter Enrique Prudencio Leon, Luis Isidro Castillo Bravo, Katya Fernanda Aibar Yaranga, Janet E. Pichilingue Chagray, Vanessa A. Marquez Mondalgo, Socorro Torres Zegarra, Nazario Silva Astete, Francisco Campos Guevara, Javier Soto Pastrana, Carlos F. Linares Calderon, Manuel Jesus Mayorga Espichan, Luis Martin Santivanez Monge, Maria V. Changano Rodriguez, Zoila Rosa Diaz Tavera, Fernando Martin Ramirez Wong, Selene Manga Chavez, Teodora Atencio-Espinoza, Victoria D. Villanueva, Maria Teresa Blanco-Abuy, Arnefelina S. Tamayo, Lailane D. Bergosa, Cristina Mari Jean P. Llames, Marilou F. Trajano, Suzette A. Bunsay, Jessica C. Amor, Regina Berba, Maria Carmen Sg Buenaflor, Ever Labro, Myrna T. Mendoza, Ofelia P. Javellana, Lilibeth G. Salvio, Rhoda Gay Rayco, Vanessa Bermudez, Andrzej Kubler, Marzena Zielinska, Magdalena Kosmider-Zurawska, Barbara Barteczko-Grajek, Ewa Szewczyk, Barbara Dragan, Malgorzata Anna Mikaszewska-Sokolewicz, Tomasz Lazowski, Elsie Cancel, Monica Sorina Licker, Liliana Alina Dragomirescu, Victor Dumitrascu, Dorel Sandesc, Ovidiu Bedreag, Marius Papurica, Delia Muntean, Igor Kotkov, Vladimir Kretov, Vladimir Shalapuda, Alexander Molkov, Sergey Puzanov, Ivan Utkin, Alexander Tchekulaev, Valentina Tulupova, Ljubica Nikolic, Goran Ristic, Jelena Eremija, Jelena Kojovic, Dragana Lekic, Sladjana Vasiljevic, Anna Lesnakova, Alzbeta Marcekova, Katarina Furova, May Osman Gamar Elanbya, Malik Abdo Ali, Shobhana Kumari Kadankunnel, Suwara Somabutr, Rungratchanee Pimathai, Suthinee Wanitanukool, Montri Luxsuwong, Namphon Supa, Pornpheth Prasan, Visanu Thamlikitkul, Silom Jamulitrat, Nonglak Suwalak, Parichart Phainuphong, Bouziri Asma, Borgi Aida, Bel Hadj Sarra, Khaldi Ammar, Gunay Tuncer Ertem, Cemal Bulut, Cigdem Ataman Hatipoglu, Fatma Sebnem Erdinc, Ali Pekcan Demiroz, Menekse Ozcelik, Basak Ceyda Meco, Mehmet Oral, Necmettin Unal, Cigdem Yildirim Guclu, Tanıl Kendirli, Erdal İnce, Ergin Çiftçi, Ayhan Yaman, Çağlar Ödek, Adem Karbuz, Bilge Aldemir Kocabaş, Nilgün Altın, Salih Cesur, Begum Atasay, Omer Erdeve, Hasan Akduman, Dilek Kahvecioglu, Ufuk Cakir, Duran Yildiz, Atila Kilic, Saadet Arsan, Dilek Arman, Serhat Unal, Yasemin Gelebek, Humeyra Zengin, Suha Sen, Hatice Cabadak, Ayse Erbay, Ata Nevzat Yalcin, Ozge Turhan, Melike Cengiz, Oguz Dursun, Perihan Gunasan, Sehnaz Kaya, Atilla Ramazanoglu, Cemal Ustun, Aliye Yasayacak, Hayrettin Akdeniz, Fatma Sirmatel, Ali Metin Otkun, Suzan Sacar, Alper Sener, Huseyn Turgut, Hulya Sungurtekin, Dogaç Ugurcan, Ceyda Necan, Cansu Yilmaz, Davut Ozdemir, Mehmet Faruk Geyik, Nevin Ince, Ayse Danis, Selvi Yener Erdogan, Nurettin Erben, Gaye Usluer, Ilhan Ozgunes, Cengiz Uzun, Oral Oncul, Levent Gorenek, Hakan Erdem, Orhan Baylan, Asu Ozgultekin, Asuman Inan, Sibel Bolukcu, Gunes Senol, Halil Ozdemir, Zeynel Gokmen, Sonay Incesoy Ozdemir, Ali Kaya, Gulden Ersoz, Necdet Kuyucu, Sevim Karacorlu, Zeynep Kaya, Ertugrul Guclu, Gulsume Kaya, Oguz Karabay, Saban Esen, Canan Aygun, Fatma Ulger, Ahmet Dilek, Hava Yilmaz, Mustafa Sunbul, Aynur Engin, Mehmet Bakir, Nazif Elaldi, Iftihar Koksal, Dincer Yildizdas, Ozden Ozgur Horoz, Ayşe Willke, Meliha Meriç Koç, Emel Azak, Naheed Elahi, Philip Annamma, Ashraf El Houfi, Maria Catalina Pirez Garcia, Hector Vidal, Fernando Perez, Gabriel D. Empaire, Yvis Ruiz, Dulce Hernandez, Dayana Aponte, Evelyn Salinas, Claudia Diaz, María Eugenia Guzmán Siritt, Zenaida Durán Gil De Añez, Luis Montes Bravo, Nelva Orozco, Eugenia Mejías, Nguyen Viet Hung, Nguyen Quoc Anh, Ngo Quy Chau, Truong Anh Thu, Le Thi Diem Tuyet, Dang Thi Van Trang, Vo Thi Hong Thoa, Nguyen Phuc Tien, Le Thi Anh Thu, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Dinh Pham Phuong Anh, Ondokuz Mayıs Üniversitesi, KILIÇ, ATİLA, and MERİÇ KOÇ, MELİHA
- Subjects
Imipenem ,medicine.medical_specialty ,Pediatrics ,Low income countries ,Asia ,Epidemiology ,Klebsiella pneumoniae ,Health care-associated infection ,Antibiotic resistance ,Catheter-associated urinary tract infection ,Ceftazidime ,Network ,Bloodstream infection ,Developing countries ,Nosocomial infection ,Intensive care ,medicine ,Ventilator-associated pneumonia ,Humans ,Hospital infection ,Prospective Studies ,Urinary tract infection ,Cross Infection ,Infection Control ,biology ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,medicine.disease ,Nosocomial infection control ,biology.organism_classification ,Device-associated infection ,United States ,Europe ,Pneumonia ,Intensive Care Units ,Infectious Diseases ,Latin America ,Amikacin ,Emergency medicine ,Africa ,Limited resources countries ,Central line-associated bloodstream infections ,Centers for Disease Control and Prevention, U.S ,business ,medicine.drug - Abstract
Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
- Published
- 2014
49. Emergencies in cardiovascular surgery
- Author
-
Tanja Anguseva and Zan Mitrev
- Subjects
Pulmonary and Respiratory Medicine ,Aortic dissection ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,Abdominal aortic aneurysm ,Cardiac surgery ,Surgery ,Coronary artery disease ,Aortic aneurysm ,Cardiothoracic surgery ,cardiovascular system ,medicine ,Oral Presentation ,Cardiology and Cardiovascular Medicine ,business - Abstract
Methods In emergency situation, preoperative patient work-up for cardio-vascular surgery is quite different from the elective setting. Since 03/2000 till 01/2012 we have analyzed a consecutive series of 12 172 cases out of which 2214 underwent emergency procedures (18.19%). The most frequent problems requiring urgent intervention were thoracic aortic aneurysms (448 cases; 20.24%); coronary artery disease (1006 cases; 45.47%) abdominal aortic aneurysms (125 cases 66 with rupture; 2.96%), peripheral vascular (364 cases; 16.46%), and others (329 cases: 14.87%).
- Published
- 2013
50. Reconstructive surgery for aortic valve stenosis
- Author
-
Tanja Anguseva, Nikola Hristov, Enver Idoski, Emil Stoicovski, and Zan Mitrev
- Subjects
Pulmonary and Respiratory Medicine ,Aortic valve ,Aorta ,medicine.medical_specialty ,Reconstructive surgery ,business.industry ,General Medicine ,medicine.disease ,Surgery ,Stenosis ,medicine.anatomical_structure ,Cardiothoracic surgery ,medicine.artery ,Aortic valve stenosis ,Ascending aorta ,cardiovascular system ,medicine ,Oral Presentation ,Pericardium ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The native aortic valve can be explained with rules of the equal side triangle, and as a part of the aortic root it is wedged between the heart and the ascending aorta. Beside different types of aortic valve replacements, reconstructive techniques are increasingly performed to restore normal aortic valve function. Reconstructive techniques themselves can be divided into isolated reconstruction of aortic valve/root structures and the isolated replacement of one or more structures. With this study we evaluated clinical results of reconstructive surgery of the aortic root with 3 leaflets pericardial patch. Methods We created this reconstructive technique using bovine/ equine pericardium, replacing valve cusps on aortic fibrous ring of patient. The leaflets are made from same pericardium from which other biologic valve prosthesis are done. The ring of patient’s aorta was used as guide for sizing this valve. Leaflets are implanted separately; using continuous sutures with 2 supported stitches at newly created commissure, without a stent or sowing ring. Main including criteria was stenosis of the aortic valve and patients with aortic annuli ring dilatation had been excluded. Intraoperative and postoperative TEE was performed for every created valve. Results
- Published
- 2013
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.