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Background: C-reactive protein (CRP) is one of the acute-phase proteins which increases during inflammatory conditions. Nowadays, C-reactive protein (CRP) is a commonly used biomarker especially in emergency department (ED) for diagnostics of febrile and infectious patients. It is almost impossible to distinguish the bacterial from nonbacterial (viral) infection by CRP level only - so the detailed history of onset of disease is very important to establish the diagnosis of bacterial infection as a cause of acute abdominal pain.Objective: The aim of this study was to establish the diagnostic value of leucocyte and CRP count in in diagnosing acute abdominal pain.Material and methods: We retrospectively evaluated 159 patients with acute abdominal pain admitted to the surgical department of the Clinical Hospital of Tetova and PHO “Alba – Med” over a period of 2 yearsrespectively from January 20016 to January 2018. All patients included in this study was aged between five to 15 years old.Results: During the study period there were 158 patients (96 were females and 56 males). All the patients suffered from acute abdominal pain, whereas 45 of them had a surgical condition, respectively in 42 of them acute appendicitis as a cause of pain, Meckel’s diverticulitis, jejunal intussusception and ruptured ovarian cyst in three other patients. In 105 patients nonsurgical condition was the reason of acute abdominal pain. CRP was performed within 24 h after admission in all the patients. In the group of patients with surgical disease in 41 of them (91 %) the value of CRP was more than > 5g/L.Conclusions: According to our experience we conclude that the CRP level is not sufficient to predict patients with acute abdominal pain that require surgical treatment.

Background: Homocystinuria is a rare autosomal recessive disease complicated by early and aggressive occlusive arterial disease. This may be related to the grossly increased homocysteine concentrations seen in this disease. More recently, milder hyperhomocysteinemia has been proposed as an independent risk factor for coronary artery disease. Cardiovascular disease (CVD) is among the diseases with multiple contributing factors, hence making it difficult to pinpoint a particular factor alone. The main factor that is of relevance to this study is homocysteine. Coronary artery disease is the narrowing or blockage of the arteries and vessels that supply oxygen and nutrients to the heart (1, 2). CVD is the major cause of morbidity and mortality worldwide. Obesity, HTA, Diabetes mellitus, hypercholesterolemia, and smoking have been recognized as major risk factors for CVD. Aim: Aim of this paper is to examine concentrations of Hcyt and lipid profiles in patients with CVD and positive personal history for CVD, comparing them with the control group composed of healthy individuals. Our study aimed to verify the role of Homocysteine as a new independent risk factor on the onset of early atherosclerosis and atheromatous processes in coronary arteries in patients with CVD. Materials and methods: The results obtained represent the average value earned once every three months in the 3 year period. 5ccm serum with a few heparin spots was sent to the Clinical Laboratory of the University Clinic of Skopje. Results: The results obtained from patients with CVD and control groups are presented in the following text, where a statistically significant difference was observed for p

We performed a global self-assessment of continence following radical retropubic prostatectomy (RRP) and determined how this global self-assessment of continence correlates with commonly used definitions of continence.Between October 2000 and February 2002 all men who underwent RRP were encouraged to complete the University of California-Los Angeles Prostate Cancer Index 3, 6, 12 and 24 months postoperatively. Beginning October 2002 a single question capturing the patient global self-assessment of continence status was added to the postoperative continence assessment. The study design was cross-sectional since only continence surveys submitted between October 2002 through February 2003 were evaluated. Sensitivity, specificity and kappa coefficient was determined for the relationship between the patient global assessment of continence vs the definition of continence based on pad requirement, problem due to incontinence and frequency of incontinence.Continence progressively improved 3 to 24 months following RRP for all continence outcomes. At 24 months following RRP 97.1% of men considered themselves continent, while 97.1%, 94.1% and 97.1% were considered continent using continence definitions, including the requirement of no or 1 pad in a 24-hour interval, no or slight bother due to incontinence and total control or occasional dribbling, respectively. Our 3 definitions of continence derived from responses to the University of California-Los Angeles Prostate Cancer Index had excellent agreement with patient global self-assessment of continence (kappa coefficients between 0.76 and 0.83).The majority of men achieve continence without invasive intervention following RRP. Final continence status should be ascertained at 24 months. The patient global assessment of continence provides face validity for other definitions of continence based on responses to validated self-administered questionnaires.

Objectives To determine the value of intraoperative biopsy during radical retropubic prostatectomy. Methods Between October 2000 and August 2002, 500 men with clinically localized prostate cancer underwent radical retropubic prostatectomy by a single surgeon. A 2 to 3-mm circumferential biopsy was routinely obtained from the apical and bladder neck soft-tissue margin and submitted for frozen section examination. In selective cases suspicious for capsular incision, a biopsy was sent from what was believed to be the contiguous neurovascular bundle/lateral pedicle. Results Prostate cancer was observed in 4.5%, 0.8%, and 1.6% of the intraoperative biopsies sent from the apical, bladder neck, and neurovascular bundle/lateral pedicle soft-tissue margins, respectively. Patient age, Gleason score, perineural invasion on diagnostic prostate biopsy, and clinical stage were not associated with prostate cancer at the apical soft-tissue margin. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the surgical specimen to predict cancer in the apical soft-tissue margin was 57.7%, 98.2%, 62%, 97.7%, and 96%, respectively. Intraoperative biopsy of the apical soft-tissue margin reduced the positive margin rate by 3.8%. Conclusions The yield of intraoperative biopsy of the bladder neck and neurovascular bundle/lateral pedicle is too low to justify it in routine practice. Biopsy of the apical soft tissue should be routinely performed to reduce the positive surgical margin rate.

We determined the impact of radical retropubic prostatectomy on continence and lower urinary tract symptoms (LUTS).Between October 2000 and August 2002, 500 men with clinically localized prostate cancer underwent radical retropubic prostatectomy by a single surgeon, and completed the UCLA Prostate Cancer Index and American Urological Association (AUA) symptom index at baseline, 3, 6, 12 and 24 months after radical prostatectomy. Univariate analysis was performed to identify factors predisposing the early return of continence.A total of 100%, 98.3%, 97.1%, 94.2% and 98.6% of patients filled out the UCLA Prostate Cancer Index and AUA symptom index at baseline, and 3, 6, 12 and 24 months, respectively. Based on protective pad requirement or frequency of incontinence 100%, 90.9%, 87.2%, 92.1% and 98.5% vs 98.8%, 80.6%, 91.2%, 95.2% and 98.5% of men were continent at baseline, 3, 6, 12 and 24 months after surgery, respectively. Age, severity of lower urinary tract symptoms, Gleason score, nerve sparing status, blood loss or presence of benign prostatic tissue in the apical soft tissue margin did not predict early return of continence. All of the individual urinary symptoms captured by the AUA symptom score showed significant improvement after radical retropubic prostatectomy. Radical prostatectomy was associated with a mean 5.4 unit decrease in AUA symptom score (40% decrease) in men with baseline moderate/severe LUTS (AUA symptom score 8 or greater).The majority of men regain continence after radical retropubic prostatectomy and maximal continence is achieved by 24 months. No factors were identified that predicted early return of continence in our cohort of men undergoing radical prostatectomy. Radical prostatectomy has a clinically significant impact on improving LUTS.

Objectives To determine the impact of recent advances in surgical technique, management, and early detection on outcome after open radical retropubic prostatectomy. Methods Between October 2000 and August 2002, 500 men with clinically localized prostate cancer underwent radical retropubic prostatectomy by a single surgeon (H.L.). One of the unique aspects of this prospective outcomes analysis was that both data acquisition and entry were conducted totally independent of the primary surgeon. Results The mean operative and prostatectomy time was 142.9 and 65.2 minutes, respectively. A single ureteral injury was the only intraoperative complication. The overall incidence of pulmonary embolus and/or deep vein thrombosis was 0.4%. The overall risk of allogeneic transfusion was 4.6%. The mean length of hospital stay was 2.11 ± 0.04 days. Of the catheters, 83.6% were removed by postoperative day 8. The positive surgical margin rate was 8%. Conclusions In the hands of experienced surgeons, outcomes after open radical prostatectomy are excellent. Laparoscopic and robotic prostatectomy must be compared with concurrent experiences with open radical prostatectomy.