Reproductive Health of Women: An Attempt to Define Prevention of Breast Cancer

Background. On the evidence-based information of breast cancer as a preventable disease, an attempt is made for definition of primary, non-chemical prevention of the epidemic breast cancer. The battle over healthcare reform, besides other priorities, is revolving around women’s issues and health protection too. Aim. To add to the knowledge and to advance the tested concept of the potential for primary (non-chemical) prevention of breast cancer as an epidemic disease. Ultimately, to present from a medical point of view the attempted definition of a preventive contraception against the epidemic breast cancer. Justification. The number of cases and the incidence of breast cancer is in a steady increase worldwide and in our country, Macedonia, (with more than 800 cases, or 76.2 crude rate per 100,000 female population, in 2008), followed by great losses and expenses in human lives, individual and familial sufferings and disasters, and material resources. It could be assessed that no healthcare reform could be achieved successfully as long as the half of the population, women of all ages, is threatened by a real risk of breast cancer as an epidemic disease. The changes in the biological micro-environment and ecosystem of the intimate (sexual) woman-man relations, which is still unknown, reflect gravely upon the health and lives of people, especially women of all ages. Primary (non-chemical) prevention of breast cancer is neither mentioned nor considered in the ongoing debate of healthcare reform, in the scientific literature, and at the conference meeting. Evidence and Discussion. The results of the initial field study and other ecological and experimental studies showed and corroborated the evidence that the mass condomization of women’s sexuality is the root cause of the perplexing emergence and rapid rise of the breast cancer epidemic all over the world along with the occurrence of the AIDS epidemic, after 1981. Prevention of breast cancer rather than programs of mass mammographic screening for early detection of cases of the disease are discussed. The views on contraception and marriage of the main religious denominations in the Western world, which were relevant to the aim of this study, are briefly presented. The negative consequences of screening of the disease and the recent debate of questioning the breast screening programs is discussed.Conclusion. From a medical standpoint, to achieve the suggested primary prevention of the breast cancer epidemic it is necessary to eliminate completely the barrier devices and methods of contraception, the condom use and withdrawal practice. Instead of use of barrier methods, a replacement is to be done by shifting to use of other, non-barrier methods and techniques for fertility-control and family-planning purposes during the reproductive life-span of women, which include: abstention, rhythm, IUDs, OC pills, and tubal ligation.

Country Rank, Journal Rank and H-Index in the Field of Medicine in the Republic of Macedonia (1996-2008) Using Data from SCImago

Aim. The aim of this study was to present the country rank, journal rank and H-index in the field of medicine in the Republic of Macedonia (1996-2008) using data from SCImago Journal & Country Rank (SCImago).Material and Methods. SCImago database was used for analysis of country rank, journal rank and H-index in the Republic of Macedonia and other former Yugoslav countries (Slovenia, Croatia, Serbia, Bosnia and Herzegovina, and Montenegro) for the period of 1996-2008, as they are presented in the Scopus database.Results. Of a total number of 222 countries for the period of 1996-2008, the Republic of Macedonia with H-index of 20 is placed on the 118th position of the country rank, the percentage of citable documents in the field of medicine is 88.92%, and the percentage of relative production of documents in the world is below 0.01. In 2008, Macedonian biomedical journal Prilozi is ranked on the 2484th place with 0.048 SJR of citable documents in the last three years. The biggest H-index of 10, for the period between 2007and 2008, in the Republic of Macedonia had nephrology subject category, followed by medicine (miscellaneous) with H-index of 7, haematology and endocrinology, diabetes and metabolism with H-index of 6, transplantation, oncology and pathology and forensic medicine with H-index of 5.Conclusion. There is only one Macedonian biomedical journal (Prilozi, Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences) included in the Scopus database for the period between 1996 and 2008, probably by mistake in the list of journals from Serbia, instead from the Republic of Macedonia. The priority task of the Editorial Boards of other Macedonian medical journals is to include their journals in the Scopus database.

Retraction: Ana Strezova. Genotyping of HLA-A, HLA-C and HLA-B Loci with Reverse Line Strip Hybridization in Macedonian Population and Association of HLA Class I Alleles with Spondilitis [MSc thesis]

Aim. The aim of this report is to retract the results of Ana Strezova submitted without permission of her mentor and her institution for Master of Science (MSc) degree at the Faculty of Medicine, University “Ss Cyril and Methodius”, Skopje, Republic of Macedonia. Material and Methods. Two populations were published from the same cohort: i) in the 15th International Histocompatibility and Immunogenetics Workshop 250 samples for HLA-A, 247 samples for HLA-B, 250 samples for HLA-C, 564 samples for HLA-DRB1, and 213 samples for HLA-DQB1 were included; and ii) in retracted MSc degree 250 samples for HLA-A, HLA-B and HLA-C were included. Results. HLA DNA typing results from Macedonian population were officially submitted for analysis and publication to the 15th International Histocompatibility and Immunogenetics Workshop (IHIWS). Results were prepared and submitted for publication in Tissue Antigens (received 7 July 2009; revised 12 January 2010; accepted 1 February 2010). Ana Strezova without permission of her mentor and director of the Institute of Immunobiology and Human Genetics submitted MSc thesis for defence with the identical results as in submitted manuscript. A total number of 5 HLA genes and 220 alleles are published by the 15th International Histocompatibility and Immunogenetics Workshop in comparison with 3 HLA genes and 58 alleles in retracted MSc thesis. Conclusion. The results of the MSc thesis of Ana Strezova with the title “Genotyping of HLA-A, HLA-C and HLA-B Loci with Reverse Line Strip Hybridization in Macedonian Population and Association of HLA Class I Alleles with Spondilitis” are retracted because: i) the content was already submitted for publication; ii) the statistical methods are inappropriate for ambiguous resolution of the data; and iii) the permission was not allowed by her mentor and director. Editors-in-Chief and employers are advised to be aware of possible acceptance of this thesis and the results submitted in the future for publication.

Artificial Nutrition in Therapeutic Approach of Acute Caustic Poisonings

Acutes corrosive poisonings can cause serious chemical injuries of the upper gastrointestinal tract, and they are localized most frequently in the esophagus and the stomach because the poison remains there a long time. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, corticosteroids, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery.The damaged mucosa, submucosa and muscle layer regenerate with great difficulty because of the surrounding inflammation, necrosis and secondary complications. Tissue fibrosis, adhesions or circular stenosis appear, which greatly disturb the normal functioning (impeded peristaltic, impeded passage). All these complicate the entire general condition of the patient, including inadequate normal food intake, loss of body weight, prostration, cachexia. These patients are also into a severe general condition due to hypercatabolic state and negative alkali balance. Therefore, early nutritional support is of substantial importance in treatment of these patients. Nutritional support can be given by parenteral way in peripheral or central vein and by enteral way through specially designed tubes inserted in the stomach or intestines, prepyloric or postpyloric.The type of artificial nutritional support will depend on the grade of esophageal or gastric damage determined by endoscopy.

Antipsychotic Augmentation with Venlafaxine for Treatment of Negative Symptoms in Chronic Schizophrenia - A Case Series

Negative symptoms represent a core feature in schizophrenia and the deficit syndrome in chronic schizophrenic patients is closely related to their poor outcome and global failure in community adaptation. Atypical antipsychotics have been widely used in the treatment of negative symptoms in schizophrenia, and tend to produce a better response when used in association with antidepressants. We describe a case series of patients with a clinical diagnosis of residual type of schizophrenia, who have undergone an augmentative treatment of antipsychotic medication with venlafaxine. Both primary and secondary negative symptoms, as well as the overall functioning in these patients were substantially improved following this treatment. This is the first clinical study describing the combination of venlafaxine with both conventional antipsychotics and novel antipsychotics, such as risperidone, to treat successfully both secondary and primary negative symptoms in schizophrenia. We also discuss possible modes of action of the joint use of this particular antidepressant with antipsychotic medication.

Mediastinitis Due to Actinomyces Naeslundii

A 48-year-old man with retrosternal chest pain and upper abdominal pain with propagation to the back, with clinical signs of nausea, dyspnea and dysphagia was referred to the Clinics of thoracic surgery. After esophagography, operative treatment was indicated. Left thoracotomy with mediastinothomy were performed. During the operation, a sample of pus was taken and sent for a microbiological examination at the Institute of Microbiology and Parasitology, Medical Faculty in Skopje. Standard microbiological procedures were used. The sample was cultured anaerobically on Schaedler agar and incubated for 48 hours at 37ºC. Oval, smooth colonies were observed. Gram stained smear revealed short branching Gram-positive filaments suspected for genus Actinomyces. For a definitive diagnosis and differentiation of the Actinomyces species, an automated VITEK system was used. Two weeks after treatment by ceftriaxon, metronidazol and analgetics, all clinical signs improved and patient was released in good physical condition.

Macedonian Medical Master of Science (MSc) Theses Defended in 2009

We present abstracts of MSc theses defended in 2009 at the Faculty of Medicine, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia. English summaries are published as they are translated by authors and included in the final version of defended MSc. Macedonian Medical Master of Science (MSc) theses are deposited in the Central Medical Library in Skopje.Editorial Borad do not take any responsibility either for the content, nor the quality of the abstracts.At the Faculty of Medicine, 30 MSc theses were defended in 2009. Eight MSc theses are without abstarcts (26.7%), 8 MSc theses are with unstructured abstracts (26.7%), and 14 are with structured abstracts (46.7%) which is significant improvment in comparison with defended MSc in 2008. For one MSc there are not any details about the thesis (Elena Manoleva Nikolovska. Anthropometrical indicators for evaluation of the nutritive status in children between ages of 3 until 36 months), and one MSc was retracted (Ana Strezova. Genotyping of HLA-A, HLA-C and HLA-B loci with Reverse Line Strip hybridization in Macedonian Population and association of HLA class I alleles with spondilitis).We have to repeat that primary responsibility for the quality of the MSc theses belongs to the mentors, to the institutions they are representing, and to the Vice-Dean of science. All of them should be more actively involved in the preparation of Master of Science theses in order international standards to be achieved.