bluuebunny/crossref_metadata_2025 huggingface dataset:
SURVEY OF ECOLOGICAL COMPETENCE OF STUDENTS WITH REGARD TO FOOD AS A RESOURCE AND WASTE
Authors: Todorova Borislava , Panayotova Margarita
Published: December 2021

Waste is defined as materials that have served their purpose, which also applies to food leftovers or edible food which has been mismanaged and has lost its nutritional value. Globally, due to population growth, this problem of loss of food resources is increasingly relevant and is further aggravated by the steadily increasing population. Alongside the lack of food resources, there are surpluses, which end up as waste. It can be noted that there is lack of attention and effective use of practices and innovations for the conservation of materials and energy. Therefore, improving the ecological culture of the population occupies a significant position in the management strategy of modern society. Currently, there are still no developed and tested didactic models to be adapted and implemented in education with regard to the issues of perception of the food and food waste, as a crucial resource and harmful waste. The development and modelling of didactic technology in this respect would improve and enhance the theoretical and practical aspect of Biology and Health education in the Republic of Bulgaria. Ecology education and training is a priority in the academic system. However, opportunities to create a pro-environmental relationship towards food and waste management are not being utilised effectively. This paper uses data from a survey performed among students in Bulgarian schools in 5-12 grade to establish attitudes and to register the daily practices related to food resources, products and waste management. The results were obtained using standardized surveys containing both open and closed questions on the topic. It examines the specific opinions of different groups of adolescents on their education and knowledge about food as resource and waste. Deficits in behaviour and attitudes towards the problem under study are reported. In this context, a content analysis of elementary and secondary school curricula in the natural sciences and ecology was conducted on topics and concepts related to food as a resource and waste. A future goal is to develop an experimental model of activity-based learning that enhances students' environmental competency and fosters food management culture.
TERRITORIAL ORGANIZATION, RELEVANT - TYPICAL AND TOURIST REGIONAL SPACE SPACES IN THE BLACK RIVER BASIN IN THE REPUBLIC OF NORTH MACEDONIA
Authors: Koteski Cane
Published: December 2021

The scientific work covers and presents: territorial organization, relief type and tourist regional units in the Black River basin in the Republic of Northern Macedonia. The Crna Reka has a length of 207 km, with a total catchment area of 5 774.99 km 2, of which 4 869.72 km2 belong to the Republic of Northern Macedonia, while 905.27 km2 to the Republic of Greece. Given the enormous importance of the territorial organization and the relief for the daily life of the population in the settlements and 13 municipalities, as well as for the development of tourism, field surveys have been conducted in the period 2003-2018. Three thematic maps for the territorial organization, relief - type and tourist regional spatial units in the Black River Basin in the Republic of Northern Macedonia have also been prepared. Methods used in scientific research are: geographical, statistical - mathematical, cartographic and informational. The results are favorable for the development of urban and rural tourism of the population living in the settlements of the Black River basin in the Republic of Northern Macedonia.
HEALTH AND SAFETY IN THE MECHANICAL ENGINEERING WORKPLACE
Authors: Milosevic Anica , Bogdanovic Gordana , Milosevic Masa
Published: December 2021

Risk assessment is the systematic recording and evaluation of all factors in the work process that can cause occupational injuries, illnesses or health damage. It can identify the options, ways of preventing, eliminating and reducing risks.The risk assessment considers the work organization, work processes, raw materials and materials used in technological and work processes, personal protective equipment and equipment at work, as well as other elements that may cause risk of personal injury, health damage or illness of the employee.The primary objective of occupational risk assessment is the protection, safety and health of employees.Risk assessment helps to minimize the risk of employees being compromised during work process activities. It also helps to maintain the efficiency of the business activity.A risk assessment act is an act containing a description of the work process with an assessment of the risk of injury and / or damage to workplace health in the work environment and measures to eliminate or reduce risks in order to improve safety and health at work.This act determines the possible types of hazards and harms in the workplace, assesses the risk of injury at work or health damage of the employee, determines ways and measures to eliminate them, or reduce their risk to minimum.Mechanical engineers design machines and tools, organize their production and handle their exploitation. They are experts for propulsion engines, vehicles and vessels, process and power plants, load-bearing structures. As designers, they design a product or manufacturing process so it can best meet the requirements and functions they need. In a process of designing a product, they take available raw materials and available production technology, and if they design the production process, they are guided by the type of input material and processing technology. Mechanical engineers in manufacturing plan, manage and supervise the production of machinery and plant. They systematically test the manufactured components, because they depend on the efficiency, reliability and safety of the whole system. For quality assurance, they constantly carry out tests and measurements of input materials and finished products with measuring instruments.This work is based on an analysis of the position of a mechanical engineer in the company named "Flamma-Systems Ltd." based in Nis. The company employs mechanical engineers and it deals primary with manufacturing of high-power boilers for heating greenhouses and buildings. The main market for this company is Sweden.
MONITORING AND QUALITY CONTROL IN THE PRODUCTION OF WORK UNIFORMS FOR FLIGHT ATTENDANTS
Authors: Jordeva Sonja , Zhezhova Silvana , Golomeova Longurova Sashka
Published: December 2021

The basic prerequisite for successful work of an apparel company in conditions of enormous competition on the market is high level of quality of products and timely completion of orders according to concluded agreements with foreign and domestic partners. Without well-organized technical preparation in the apparel industry, this is not possible. Planning and monitoring of production are integral parts of the operational preparation. In this paper, firstly theoretically, and then practically, the monitoring of the production of two manufactured women's jackets and women's vest (as a part of the working uniforms of the flight attendants of the company Lufthansa) is being developed in the apparel company MK Amor Company from Kocani. At the same time, the quality control of the products was carried out, starting from the control of the materials until the final control of the finished products. The results show that good planning and monitoring of production leads to timely performance of high quality work on the two products monitored.
INFLUENCE OF KINESITHERAPY ON PATIENTS WITH GONARTHROSIS
Authors: Ristova Velika , Vasileva Danche
Published: December 2021

Degenerative changes in articular cartilage occur as a result of loss of mechanical resistance to it, resulting in a disruption of the degeneration and regeneration processes of the articular cartilage and are characterized by pain and impaired joint function. It begins as a degenerative alteration of the cartilage that subsequently reflects changes in the bone structures of the joints. In the acute period, joint immobilization is applied, isometric exercises of certain muscle groups are performed. Active and passive flexion and extension exercises are used to increase knee range of motion. Isotonic exercises are used to increase muscle strength and auxiliaries are used until muscle strength returns. Primary and secondary prophylaxis is applied, which includes weight regulation, prevention of articular cartilage and strengthening of knee stabilizer muscles, mainly of the medial and lateral muscle groups. The aim is to study the efficacy of CT based techniques of rehabilitation to improve the functional status of patients with GA. Material and methods: The study included 24 patients (18 women and 6 men) with gonarthrosis who were treated for one month approach. Patients were selected according to several criteria in order to have homogeneity of the study: to be between 45 and 65 years of age; have diagnosed gonarthrosis (unilateral and / or bilateral); not have severe cardiovascular and respiratory insufficiency as well as severe cognitive impairment; have stable hemodynamics, and arterial pressure is below 140/90; to move without auxiliary means. For the purposes of the study, a complex set of diagnostic methods is applied, and the results from which are evaluated on day 1, day 10, and month 1 of treatment are shown in a worksheet. Motor and balance options are assessed by: one-leg standing balance test, manual muscle test (MMT) of m.quadriceps femoris, circumcision centimeter 10cm above knee, knee mobility test - ° (°). A kinesiotherapy method is used in the study group. It is based on the basic principles of modern rehabilitation Results and Discussion: The presented results provide an opportunity to analyze the effect of applied kinesiotherapy. The specialized kinesiology method stabilizes permanently functional motor revascularization and equilibrium opportunities in patients with GA. Conclusion: The presence of positive change in all parameters was observed after the administration of specialized kinesiotherapy in all subjects. A thorough and in-depth analysis of the results provides us with the basis for claiming that kinesiotherapy has both a wounded and a late therapeutic effect associated with the continuity of application, the structure of administration and the appropriateness of the kinesis involved.
PATIENT AWARENESS OF THE RISK OF ATHEROSCLEROSIS – THE ROLE OF THE NURSE
Authors: Stambolova Ivanka , Stancheva Lilyana , Stambolov Stefan
Published: December 2021

Atherosclerosis is a general degenerative disorder of the entire arterial system of the person, the basis of which is a lipid exchange disorder. It is a generalized process of focal vascular endothelial damage and accumulation of lipids and other blood products in the intima of the arterial vessels, with subsequent development of fibrosis and calcium deposits. As the atherosclerosis progresses, the arteries stenose progressively, and after reaching critical stenosis levels, a thrombosis occurs with vessel obliteration, which is why the disease is known as obliterating atherosclerosis. Atherosclerosis is a major cause of chronic arterial insufficiency of the extremities (over 90% of cases), coronary artery disease as a major contributor to myocardial infarction, stroke as a result of cerebrovascular disease and other varied severe pathology that is the leading cause of mortality in the civilized world today. Aim: To be examined the awareness of patients in active and retirement age about the lifestyle and early symptoms of atherosclerosis, and outline the nurse's promotional and prophylactic activity in preventing the disease. Materials and Methods: The study used documentary, sociological method, observation and statistical methods. A questionnaire with 17 questions was developed for this purpose. The survey was conducted in the period December 2018-February 2019 with 235 persons from the territory of Sofia. Results and Discussion: The analysis of the results shows that the patients surveyed are not sufficiently informed about the disease atherosclerosis. They do not observe the nutritional and motor regimes necessary to delay atherosclerotic changes and symptoms. They are exposed to a number of risk factors - smoking, regular use of alcohol, impaired movement activity and consuming especially foods rich in fats and carbohydrates. Patients' awareness of the disease is an important element in raising and improving the quality of life. This necessitates the creation of opportunities to receive more information that would contribute to their active participation in preventive measures and the healing process. risk groups. It is necessary to develop a program targeting the appropriate age groups to prevent vascular pathology by overcoming risk factors and active movement and sports. The use of new medical and communication technologies will support the patient education process and save health system resources.
WORKING WITH PEOPLE WITH ANXIETY DISORDERS – THE NEED OF TRAINING FOR NURSES
Authors: Marinova Anna , Mihailova Iveta , Yordanov Nikolay
Published: December 2021

Anxiety disorders are a common problem in modern society, as the number of people suffering from this type of psychological problems, has grown drastically in recent years. People with anxiety disorders often seek medical specialists for examinations or running tests, due to the physical and psychological discomfort that accompanies the condition. One of the most serious problems that we face is the wrong approach and communication of medical staff to them.Nurses are the type of health care professionals, who most often have to communicate with people with anxiety. The lack of sufficient knowledge and skills to work with people with anxiety disorders complicates all prophylactic and therapeutic activities aimed at this type of patients, whether they are related to their mental or physical health.Practice shows that in Bulgaria this process of developing the communication between the nurse and the patient is troubled and is accomplished incorrectly or ineffective. Many nurses often lack the necessary skills to maintain proper psychological and medical perspective towards patients with anxiety disorders. Misunderstanding and lack of proper approach makes the patient with anxiety to avoid medical assistance and to turn to self-medication, whether it is physiological or psychological problem. That puts him at risk and impedes the healing process in general. Simultaneously, patients with anxiety disorders endure the implementation of various manipulations much more dramatic, as they experience their interventions way more painful and at increased rates of anxiety. As a result, the stress level increases and so does the danger of unlocking an extra mental disorder such as depression, specific phobia, addiction, suicidal action.This study aims to establish awareness among the students specialty "nurse" concerning the characteristics of anxiety disorders, their knowledge and their skills to work with this type of patients. It shows the need to introduce additional classes or independent training for working with people with anxiety disorders in a wider aspect.Specific recommendations have been prepared to correct deficiencies in the education system. They are about the teachers in classes of Medical Psychology, Educational institutions and the subject "Medical psychology" in the Universities.
PROTECTION OF CHILDREN - YOUTH MENTAL HEALTH IN A SCHOOL ENVIRONMENT
Authors: Negrova Yoana
Published: December 2021

Maintaining good mental health in childhood is an important element of healthcare for each country. Efforts to protect child health are being are being carried out not only by medical, health and social care specialists, but also by the people who make up the social circle of the child. During this period, parenting techniques, as well as their behavior and attitude towards the child, play a vital role. Especially important is the support and assistance that parents and relatives give to the child in communicating with him. When unacceptable parenting practices, that degrade the child's personality, are undertaken, family counseling is needed to reduce the psycho-emotional stress and harassment applied to the child's psyche. To a great extent, worrying, depressive, neurotic and psychotic conditions are due to an inadequate family and social environment. The lack of conditions for development and proper social functioning of the child causes emotional imbalance, which the child can hardly cope with.In the case of untimely taken measures during school-age, psychotic disorders can cause many problems, the overcoming of which necessitates the inclusion of professionals from different fields. Child psychiatrists, clinical psychologists, psychologists, occupational therapists, social workers and educators form a multidisciplinary team that adequately takes decisions with regard to information received from parents, relatives and institutions. Mental health professionals have definedmanifestations of themental diseases as: emotional disorders, phobias, anxiety states and depression, aggression and antisocial behavior, hyperkinetic disorders, developmental disorders, primarily affecting children with autism and those with pervasive developmental disorders. The multidisciplinary team also takes action to implement the decisions taken to improve the quality of life of people experiencing difficulties in their personal development. Often in school age in people who do not have pathological changes in mental development, the social environment is this important factor that determines their behavior by which they are graded in society. Lack of attention by parents, excessive rigidity, strictness, hyperprotection, family conflicts and problems, school and social difficulties, predispose to a negative behavioral change. Behavioral anomalies are indicative of the low percentage of pupils with mental health problems attending mass schools. They self-exclude themselves from school and society as a whole because of the inability to meet the expectations of the environment. The individuals fall into social isolation as it predisposes them to participate in antisocial actions. This is a major reason for imprisonment, social degradation and marginalization.Teacherswithinschoolsarewellplacedtoobservechildrenday-to-dayandidentifybehaviourwhichsuggeststhatthechildmaybesufferingfrom a mentalhealthproblemorbeatrisk of developingone.
METHODICAL MODEL OF MANAGEMENT AS A TOOL FOR INCREASE OF THE HEALTHCARE QUALITY
Authors: Bogdanova Kamelia
Published: December 2021

The healthcare management is performed by managers and they must have knowledge and skills to carry out management and administrative functions in the current social and economic conditions. The managers must have qualities, such as behavior and attitudes, that are specific to the healthcare sector. The work organizational level in the ward, which determines the efficiency and quality of care, depends mainly on manager competence. Solving the problems associated with determining the responsibilities, activities, rights and obligations of main and senior nurses is an important prerequisite for improving the quality of healthcare. A negative element in the existing practice in hospitals is the lack of opportunities to realize the professional qualifications of healthcare managers. The main reason for this is the imperfection of the regulatory documents. These documents must accurately determine hospital ward activities so that nurses and leaders can apply and develop their professional skills in conformity with their competence. The goal of the study is to investigate the possibilities of applying a methodological model for healthcare management and its importance for improving their quality and effectiveness. Object of the study is healthcare management in six hospitals for active treatment. The research is based on direct individual survey and covers 120 main and senior nurses. Signs related to quality of healthcare management in hospitals, work organization, control of health activities, the role and place of the main and senior nurses in the treatment process have been investigated. The analysis of the survey data focuses on the characteristics of nursing care and the applicability of a healthcare management model with a relevant information product to the hospital information system. Efficient use of resources determines the quality of healthcare, which is a major factor in the sustainable development of the healthcare facility in contemporary social and economic conditions. This determines the need to create and develop science-based models for health care management to ensure a clear regulation of the rights and responsibilities of health care managers and provide better organization of the hospital structure. The data obtained show that the most of the main and senior nurses take a positive view of the creation and introduction of methodical model of healthcare management. An important condition for its successful implementation in practice is the provision of quality software. This requires continuously improving the qualifications of healthcare managers to work with the unified information system of medical institutions.
THE ECONOMIC IMPACT OF TREATING CHRONIC HEPATITIS C
Authors: Nikolovska Evgenija , Markovski Velo
Published: December 2021

Hepatitis C is a viral infection of the liver. This infection is a global problem because over 180 million people worldwide have chronic hepatitis type C (about 3% of the world's population). The highest prevalence occurs among intravenous drug addicts (about 52%), the virus can be transmitted from mother to child during childbirth (4-8%), and further the virus is transmitted through medical interventions, piercing, tattooing. In the Republic of Macedonia in the period from 2011 to 2017, 511 newly infected with Hepatitis C from a total of 31 municipalities were registered. Among the healthy population in Macedonia, 0.4% were positive for HCV, while among the risk groups, 23% -52% were positive for HCV. In Macedonia, the groups at highest risk of HCV are: people who inject drugs (with a prevalence of 51.53%), people who are being treated with hemodialysis (with a prevalence of 37.91%), people who have become infected with HCV by transfusion (with a prevalence of 1,48%), people who have become HCV infected in other risky ways (with a prevalence of 9,08%). Hepatitis C virus is a serious health, but also an economic problem. Treatment of hepatitis C is expensive and therefore hardly accessible to people motivated to heal from hepatitis C. Тhe treatment of patients with chronic hepatitis C was performed with a combination of pegylated interferon alfa and ribavirin (dual therapy) for 24 or 48 weeks. Early detection of HCV infection is very important, because chronic hepatitis C is already a treatable disease, until the stage of decompensated cirrhosis and / or HCC. Disease control is successfully achieved by 30-60% with standard interferon, 40-70% depending on the genotype with pegylated interferon (in combination with ribavirin), and 40-90% with new direct-acting antivirals (DAAs). In addition, the benefit of treatment is that it reduces the risk of further spread of the virus. Treatment with the most recent direct-acting drugs (DAAs) started in 2011, lasts much shorter, 12 to 24 weeks, has the least risky effects and the highest percentage of negativity (up to 90%) but is not yet widely used (expensive in many countries not yet registered ). For example, sophosuvir is only regressed in some richer countries, and treatment with it costs about $ 84,000 ($ 1,000 per pill). In 2011, treatment with Copegus and Pegasus for 48 weeks of treatment, for patients under 75 kg, required a total of 1,215,974 MKD (44,831 MKD cost per one Copegus package and 15,993 MKD for a Pegasus injection). For patients over 75 kg the total cost is 1,305,636 MKD. For genotype 2 and 3 the total costs for all patients regardless of body weight were 563,156 MKD. Total costs in 2017 for Copegus and Pegasus for 48 weeks of treatment for patients with Hepatitis C genotype 1 and 4 in Macedonia cost 655,964 MKD, which means a 46% decrease compared to 2011.
PROSTHODONTIC STATUS AND NEED FOR PROSTHODONTIC REHABILITATION AMONG THE ELDERLY IN STRUMICA
Authors: Zlatanovska Katerina , Dimova Cena , Naskova Sanja
Published: December 2021

Oral health among the elderly population is an integral part of their overall health. Good oral health facilitates effective chewing, contributes positively to speech, social confidence and is associated with better cognitive and functional capacity in the elderly. According to the World Health Organization (WHO) it is generally acceptable if older patients have about 20 functional teeth in the oral cavity. Toothlessness is today seen as a physical disability, as the imperative part of the body is lost and this in turn affects patients' personal satisfaction.The main goal of this research was to determinate the prosthetic status and the need for prosthetic rehabilitation at the elderly in the city of Strumica, Macedonia, and as specific goals were set as follows: to assess the overall oral health of patients, including the frequency of visiting a dentist, to determine oral hygiene habits; to determine the number of lost teeth associated with the patients’ age; to determine the type of prosthetic appliance and their current state in the patients' mouth; to indicate negative and positive criticism and the level of satisfaction of patients from prosthetic devices (in terms of aesthetics); to determine the type of diet and general health status of patients; to determine the status of total prostheses in terms of retention, stabilization, extension and occlusion.The study included 40 patients from Strumica aged 50 to 75 years, 18 women and 22 men. The presented data were obtained from the research conducted in the period from 20.06.2018 to 30.08.2018 in which the following procedures were performed: anamnestic data, clinical examination and completing a questionnaire by patients.Based on the data obtained, their analysis, and the results of our research, we can make the following conclusions: Hygiene habits and attitudes may be related to gender distribution, level of education, and they do not always produce positive results; Education is one of the most important factors contributing to patients' awareness of their health and the need for regular check-ups in dental practice and daily oral hygiene; General illnesses often play a major role in the oral cavity, and poor habits such as smoking, alcohol consumption and other harmful products, including diet, are major contributing factors to caries and periodontal disease leading to tooth loss; With increasing age, patients have a growing number of lost teeth and their awareness of replacing them is linked to both aesthetic and functional aspects; The dentist should always take care to preserve the natural teeth in the patient's mouth, to get the most out of the situation and to seek the most appropriate prosthetic rehabilitation and prosthetic compensation.
DETERMINATION OF HEAVY METALS IN CUSTOMIZED BABY MILK FORMULATIONS
Authors: Nakova Elizabeta , Gjorgjeska Biljana
Published: December 2021

The best substitutes for breast milk are industrially customized milk formulations. There is a huge range of products on the market from universal to specially customizedmilk formulations with the appropriate label for babies with health concerns. The degree of modification distinguishes initial, sequential, and dairy formulations for nutrition after 12 months of age.Each of them is with relevant age-adjusted composition labeled with packages 1, 2 and 3. The rise of industrialization, urbanization, natural disasters, climate change, and the fact that modern life cannot be imagined without agro-chemicals, pharmaceuticals, paints, plastics leads to the daily increase of chemical agents in the environment. Of particular concern is the presence of heavy metals. Some of them such as zinc, manganese, copper as trace elements are necessary for the metabolic functions of the human body, while lead, cadmium, arsenic and mercury are toxic.Infants and young children are more sensitive to toxic heavy metals due to their higher absorption than adults. The aim of this paper is to show the specific concentrations of zinc (Zn), manganese (Mn), copper (Cu), lead (Pb), cadmium, (Cd), arsenic (As) and mercury (Hg) in customized milk formulations for infants and young children present on the market or imported in the Republic of North Macedonia, which will be an indicator of the safety or insecurity of this food. Analyzes were made on data from 61 analyzed cow's milk formulations intended for infants and young children by age as initial - labeled 1, sequential - labeled 2, milk formulations numbered 3 and milk formulations with appropriate label designated for infants with health issues. A descriptive method for the period of 5 years from 2014 - 2018 was used to collect the data from the analyzes of Zn, Mn, Cu, Pb, Cd, As and Hg in the customized milk formulations. The technique used to determine heavy metals is AAS - Atomic Absorption Spectrometry. For the determination of Mn, Cu, Pb, Cd, As the ETAAS-Electrothermal Atomic Absorption Spectrometry technique was used, FAAS-Flame Atomic Absorption Spectrometry was used for the determination of Zn, Hg was determined by CVAAS -cold vapors using a continuous injection mercury system.The Cu content of two customized milk formulations -initialand sequentialis 1.5 mg/kg(l) and is within the MAC but does not exceed the maximum value. The content of Pb in a customized milk formulation - initialis 0.02 mg/kg(l) and is within the MAC but does not exceed the maximum value. According to the mean value of the essential metals, Zn, then Cu, and Mn are the most common. According to the results, from the analysis of the samples performed in the Institute of Public Health of the Republic of North Macedonia it can be concluded that no metal exceeds the Maximum Allowed Concentrations and is in compliance with the regulations of the Republic of North Macedonia, thus confirming their safety.
THE IMPACT OF IONIZED WATER SUPPLEMENTED WITH GLUTATION AND VITAMIN C DURING ACUTE HYPERTHERMIC EXPOSURE ON THE CONCENTRATION OF TOTAL PROTEINS IN THE BLOOD SERUM AT WHITE LABORATORY RATS
Authors: Ademi Majlinda , Gjorgoski Icko , Ademi Ilbert
Published: December 2021

Alkaline water is in the focus of scientific interest over the last decade, due to its ability to alkalize the organism as well as its antioxidant effect. The aim of our research is to determine the impact of ionized water by adding enzymatic and non-enzymatic antioxidants, glutathione and vitamin C, during hyperthermic stress, on the concentration of total proteins. The experiment performed on a white laboratory Wistar rats, a female sex, weighing 180-220 g, young rats, divided into three groups of 15 individuals. Oxidative stress was caused by acute hyperthermic exposure at 41˚C. The first group is the control group (KPM), the second group is treated with ionized water (TAM), and the third group with ionized water with added glutathione and vitamin C (TAD). The duration of treatment lasted 21 days. Acute hyperthermic exposure caused a significant difference in total protein concentration between the 7th and 14th day taken as the starting points and the 21st day of treatment, respectively, on the day of hyperthermic exposure of rats. Such a significant difference was observed in the KPM and the TAM group (p <0.001), whereas the TAD group is an exception where no statistically significant difference was observed in the same period (p> 0.05). Animals treated with ionized water on day 14 showed a significantly higher total protein concentration (p <0.01) compared to the group receiving only natural water, which is consistent with the finding obtained by comparison between the KPM and TAD group at 21st day where the difference is also statistically significant (p <0.05). The acute application of the treatment with ionized water, without or in combination with other antioxidants, in the absence of hyperthermic stress does not lead to a significant alteration in protein concentration. The hyperthermic exposure intensifies the production of oxygen radicals and the potential for oxidative modification of proteins and molecules with a protein structure. Individual action of ionized water as well as synergism with the added antioxidants caused a high protective effect on oxidative damage. Because of this, the effect of oxidative cleavage is less pronounced in rats treated with ionized water and antioxidants because they have a stronger antioxidant defense that prevents oxidative modification of proteins and all biomolecules in the body.
RELATIONSHIP BETWEEN ERYTROCYTE AND PLASMA CONCENTRATION OF MALONDIALDEHYDE IN PATIENTS WITH CORONARY ARTERY DISEASE
Authors: Kamcheva Mihailova Gordana
Published: December 2021

Introduction: The oxidative stress contributes for the development of the atherosclerosis and leads to instability of the atheromatous plaque in the vascular wall. The serum biomarkers of lipid peroxidation, such as malondialdehyde, may represent an independent indicator of risk for patients with coronary artery disease (CAD).Aim: To be examined if there is a difference in the erythrocyte and plasma concentrations of thiobarbituric acid (Thiobarbituric acid reactive supplements, TBARS) degradable lipid peroxidation products, expressed through a concentration of malondialdehyde (MDA) between patients with coronary artery disease and healthy blood donors.Material and methods: The examination represents a cross – sectional study involving 300 patients, divided in two groups: patients with an acute coronary artery disease and a chronic (ischemic) heart disease, divided into appropriate subgroups. The specimens processed in the biochemistry laboratory and it was used spectrophotometric test for quantitative determination of malondialdehyde in blood plasma and for an interpretation of the results standard reference values are used. Results: The results indicate statistically significant difference regarding the mean values of malondialdehyde concentration in the patients with and without coronary artery disease. There was no statistically significant difference between those with an acute and with a chronic coronary artery disease, althougt higher concentrations were observed in patients in the acute coronary artery disease than in the patients with the chronic (ischemic) coronary artery disease group. Statistical analysis of the data showed that there was also a statistically significant difference in mean values of malondialdehyde (MDA) concentration between subjects in the acute CAD group: between patients with STEMI and NSTEMI (p = 0.0237) and between patients with APNS and NSTEMI (p = 0.0164), and no statistically significant difference was found between the subjects in the chronic CAD group. Conclusion: The results of the performed research indicate to an increased level of malondialdehyde in the blood plasma at the patients with a coronary artery disease that indicates an existence of a redox imbalance compared with healthy patients. It is necessary, in future, these analyses to be used as a part of the panel of already known and/or new biomarkers with a goal appropriately to act toward the prevention or a certain treatment when curing patients with CAD, especially in patients with acute CAD.
DETERMINATION OF PARAPROTEIN IN SERUM AND URINE BY ELECTROPHORESIS FOR DIAGNOSING MULTIPLE MYELOMA (MM), EXPERIENCES FROM THE PHF UNIVERSITY CLINIC OF HEMATOLOGY FOR THE PERIOD FROM 2015 TO 2017
Authors: Gjorgjievski Bosko , Karpicarov Dino , Gjorgjeska Biljana
Published: December 2021

Introduction: Multiple myeloma is a clonal disorder characterized by the proliferation of mature B cells (plasma cells) in the bone marrow i.e. the appearance of monoclonal immunoglobulin fraction (M component, paraprotein) in the serum or occasionally only during electrophoresis, in the urine. Generally, multiple myeloma is the most common primary bone cancer which can be defined as a malignant tumor of the bone marrow. Regarding the benign form (MGUS, monoclonal gammopathy of undetermined significance), it should be noted that it is about 100 times more common than the myeloma. In order to diagnose this disease, serum and urine are examined by electrophoresis because this technique firstly enables the separation of the proteins and then the detection of the desired group of proteins, in the specific case, the paraprotein group. However, the presence of such proteins in serum or urine is not always a sign for multiple myeloma, so in order to diagnose this disease, additional tests need to be done. These tests include: determination of the number of blood cells, determination of the level of blood calcium, determination of the level of urea and creatinine, determination of the percentage of plasma cells in the bone marrow. Besides these tests, the usual additional test includes detection of β–2–microglobulin, which is another protein that can be produced by multiple myeloma cells.Aims of the study: Overview of the diagnosis of multiple myeloma by determination of the paraprotein in serum or urine by electrophoresis; Determination of the prevalence of multiple myeloma in patients on the territory of the Republic of N. Macedonia from 2015 to 2017; Analysis of the obtained data in relation to the gender and the age of the patients.Materials and methods: For the purpose of this study, data obtained from multiple myeloma patients, diagnosed and treated at the PHF University Clinic of Hematology, were analyzed. The data were collected over a period of three years (from 2015 to 2017). The study included patients over 40 years of age. The entire research was done in the laboratory of PHF University Clinic of Hematology.Results: According to the research, 19 patients with multiple myeloma were registered in 2015, 22 patients with multiple myeloma were registered in 2016 and 25 patients with multiple myeloma were registered in 2017. In terms of gender, this disease is more common in men and in terms of age, the same disease is most prevalent in patients between 70 and 90 years of age.Conclusion: The incidence of multiple myeloma is approximately 5 to 7 patients per 100,000 persons annually. The disease data obtained in this study are identical to those of the World Health Organization (WHO). In most patients who were diagnosed with multiple myeloma, renal dysfunction was also observed.
HOW CHALLENGING AN ELECTIVE SIMPLE CASE PROCEDURE CAN BE?
Authors: Ivanov Asen , Gonovski Todor , Stoev Hristo
Published: December 2021

The cardiopulmonary bypass, or heart-lung machine is one of the biggest medical inventions in the mid -20th century and the advances in cardiac surgery would not have been possible without this contrivance. Nevertheless it is not without its share of side-effects, with post-perfusion acute lung injury being among one of the most severe and life-threatening complications. We report a case of 65-year-old female patient diagnosed with left main and three-vessel coronary artery disease and admitted for an elective coronary artery bypass grafting(CABG). Triple bypass grafting procedure was performed. After weaning from bypass, the patient developed severe pulmonary edema with calculated Murray score of 4 points suggesting ECMO(extracorporeal membrane oxygenation) as the only salvage procedure. Peripheral venoarterial ECMO was implanted. After 5 days the mechanical support was withdrawn with full pulmonary recovery. Innovative cardiopulmonary bypass circuit and techniques, lung-protective mechanical ventilation strategies, ECMO etc. are amid possibilities to avoid this potentially lethal complication.
NEEDS OF PATIENTS NEEDING PALIATIVE CARE
Authors: Boycheva Tsvetka , Dimitrova Mariya
Published: December 2021

Palliative care satisfies the physical, mental, social, cultural and spiritual needs of terminally ill patients. They target the family and loved ones of the sick, provide support and training, help people overcome the grief and sorrow of losing a loved one. Palliative care for a lot of people becomes a necessity at some point in their lives, enabling them to adequately complete their earthly journey. The patients undergoing these care have gone through diagnosis and treatment and are in the last stages of their lives, filled with much suffering, pain and hopelessness. The purpose of this study is to determine the extent to which the healthcare system is able to meet the specific needs of patients in need of palliative care. The study focuses on 602 relatives of seriously ill patients and 376 healthcare professionals caring for terminally ill patients. Using a direct individual survey, their opinion was examined. Statistical methods have been used to process and analyze the results. The study was conducted from 01.11.2017 to 30.11.2018 in a total of 30 hospitals, hospices and social homes in the country. Results: Almost half of the healthcare professionals surveyed (46.0%) devised an individual care plan for each patient, and every third of the seriously ill relatives (36.8%) felt that they were tailored to the individual needs of each patient. In the current health care system, the offered palliative care is able to meet patients' physical and social needs, but their mental, spiritual and cultural needs remain somewhat unmet. Conclusions: The lack of sufficient time to communicate with the patient and the lack of staff in the healthcare system are the reasons for the unmet need of the terminally ill. Creating training programs for healthcare professionals to improve their communication knowledge and skills, as well as the inclusion of different specialists in palliative care teams, will increase care coverage and improve the quality of life of seriously ill patients and their families.
COMPARAÇÃO DE MÉTODOS DE AVALIAÇÃO CORPÓREA DE CÃES DA RAÇA LABRADOR E TECKEL
Authors: Leite Manara , Gama Fabiana , Mata Diogo , Brito Areane , Escodro Pierre , Notomi Marcia
Published: December 2021

Uma nutrição apropriada é um dos pré-requisitos mais importantes para a saúde e bem-estar animal, e a manutenção do peso ideal pode prevenir inúmeras doenças. Diferentes métodos de avaliação da condição corpórea vêm sendo empregados na medicina veterinária. Apesar da alta reprodutibilidade do escore de condição corpórea (ECC), ainda existem preocupações sobre subjetividade e precisão, e os métodos morfológicos, como o índice de massa corporal canina (IMCC), aparecem como uma alternativa para essa desvantagem, por ser um método quantitativo. O estudo avaliou o IMCC de 50 cães, 30 da raça labrador e 20 da raça teckel e comparou com os ECCs. Informações sobre características dos animais, hábito alimentar e tipo de manejo, também foram analisados quanto à condição corpórea apresentada. A comparação entre os métodos de ECC e IMCC apresentou discrepância de classificação em um elevado número de animais, a característica da morfologia corporal dos cães pode interferir com sua precisão.
OBESIDADE EM FELINOS DOMÉSTICOS: FATORES DE RISCO, IMPACTOS CLÍNICOS, METABÓLICOS, DIAGNÓSTICO E TRATAMENTO
Authors: Moura de Lima Camila , Pereira Mendes Miriane , Da Silveira Flores Anne Karoline , Boff Gustavo Antônio , Ferraz Alexsander , Hoeppner Rondelli Mariana Cristina , De Oliveira Nobre Márcia
Published: December 2021

O aumento da composição corporal pode promover alterações metabólicas e locomotoras, além de diminuir a expectativa de vida dos animais. Desse modo, o objetivo deste artigo é fornecer informações sobre a obesidade, elucidar os fatores de risco, diagnóstico, tratamento, assim como, ressaltar maneiras de enriquecimento ambiental e prevenção da obesidade. A obesidade possui origem multifatorial e pode contribuir para o surgimento de comorbidades. O diagnóstico baseia-se na avaliação nutricional e na identificação do grau de obesidade. Para isso existem algumas técnicas, como avaliação do peso, classificação do escore de condição corporal (ECC), índice de massa magra (IMM), raios-x de dupla energia (DEXA), tomografia computadorizada, ressonância magnética e em métodos que auxiliam a estimar o índice de massa corporal dos felinos e o percentual de gordura. O tratamento consiste no planejamento nutricional, para isso deve-se realizado a troca de dieta para um alimento para perda de peso com densidade energética reduzida, baixo teor de gorduras e alto teor de proteínas e fibras. É fundamental que haja o retorno quinzenal ou mensal do paciente para a verificação da velocidade de perda e caso seja necessário realizar ajustes na dieta. Acrescido a dieta é essencial a introdução de enriquecimento ambiental para aumentar a atividade física. Diante do exposto, é de grande importância realizar o tratamento para obesidade, além de conscientizar os tutores sobre o correto manejo ambiental e nutricional, a fim de promover qualidade de vida a esses animais.
PATHOPHYSIOLOGY OF PAIN AND USE OF OPIOIDS IN CATTLE
Authors: Gaia de Sousa Felipe , Carvalho Souza Rogério , Lilian Beier Suzane , Sousa Barcelos Briza , José Souza Araújo Kennedy
Published: December 2021

Pain control is an area that is currently gaining great importance, mainly for beef production. Determining the origin and causes of the painful process is a task that demands great attention from professionals, especially so that they can intervene in the best possible way. In addition to seeking to remove the factors that prompted them, they act in the prevention and treatment of the pain mechanism with the use of various drugs available on the market. The use of opioids has been the subject of studies as a pharmacological strategy for the control and management of animal suffering, a fact that induces serious losses and losses for bovine production, at the productive, reproductive and economic level. However, more and more studies are needed regarding the benefits they can provide to cattle, since there are some limitations such as cost and adverse effects.