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Presepsin in Neonatal Sepsis: A Single-Center Evaluation in Comparison to Conventional Markers

Sat, 21 Mar 2026 00:00:00 GMT

Objective: Neonatal sepsis is a leading cause of morbidity and mortality in newborns. Timely and accurate diagnosis remains a challenge due to the nonspecific clinical signs and the limited sensitivity and specificity of conventional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and white blood cell (WBC) count. Presepsin, a soluble CD14 subtype, has been proposed as a promising early marker of bacterial infection. This study aimed to assess the diagnostic value of serum presepsin in comparison with traditional inflammatory markers in neonates with suspected sepsis. Methods: In a prospective observational study conducted at a single tertiary care center, 18 neonates with clinical signs of sepsis were evaluated. The patients were divided into culture-proven (n=7) and culture-unproven (n=11) sepsis groups. Presepsin levels were measured using a chemiluminescent assay and compared to CRP, PCT, and WBC counts. Results: The median presepsin levels were higher in culture-proven cases (740 ng/L vs. 393 ng/L), but without statistical significance. Similar trends were observed for CRP and PCT, while WBC counts showed no diagnostic value. Conclusion: Although presepsin demonstrated potential as an early biomarker, its diagnostic performance in this small cohort was inconclusive. Combined use of presepsin with conventional markers and clinical evaluation may improve early sepsis diagnosis in neonates.

Irreversible Acute Kidney Injury after Heart Transplantation-Cardiorenal Syndrome Type 1

Sat, 21 Mar 2026 00:00:00 GMT

We report on a case of 55-year-old woman with diabetes, dilatative cardiomyopathy and end-stage heart failure (NYHA IV and ejection fraction of 26%) who underwent orthotopic heart transplantation and subsequently developed irreversible acute kidney injury (AKI) requiring permanent dialysis. Postoperatively she endured multiple problems associated with the orthotopic heart transplant: opportunistic infections, septic shock, and malnutrition. This culminated in anuric renal failure. A cardiorenal syndrome type 1 was diagnosed. Our patient’s course illustrates diabetes, pre-existing chronic kidney disease (CKD) and early AKI as identified risk factors for irreversible AKI after heart transplant. The deterioration of renal function after the heart transplantation is associated a with high risk of hospitalization, cardiovascular events and death. The authors analyze the possible pathophysiologic mechanisms and preventive and curative measures.

Objective Memory Impairment in Post-Traumatic Stress Disorder: a Systematic Review and Multilevel Meta-Analysis of Trauma-Exposed Adult Populations

Sat, 21 Mar 2026 00:00:00 GMT

Background: Post-traumatic stress disorder (PTSD) is traditionally conceptualized as a disorder of fear learning and emotional dysregulation; however, accumulating evidence indicates that objective cognitive dysfunction, particularly memory impairment, represents a core and enduring feature of the disorder. Prior quantitative syntheses have been limited by heterogeneous control groups, pooling of disparate cognitive outcomes, and inadequate handling of statistical dependence across outcomes. Objective: This systematic review and meta-analysis is aimed at determining whether trauma-exposed adults diagnosed with PTSD exhibit objective impairments in memory performance compared with trauma-exposed adults without PTSD. Methods: A comprehensive search of PubMed/MEDLINE, Embase, PsycINFO, and Web of Science was conducted up to December 17, 2025. Eligible studies included trauma-exposed adults (≥18 years) with PTSD diagnosed using DSM or ICD criteria and a trauma-exposed non-PTSD comparator group. Objective neuropsychological measures of verbal episodic memory and working memory were extracted. Risk of bias was assessed using the Newcastle–Ottawa Scale. Standardized mean differences (Hedges’ g) were pooled using multilevel random-effects meta-analytic models to account for within-study dependence. Results: Ninety studies met the criteria for the systematic review, of which 88 contributed quantitative data to the meta-analysis. Across studies, individuals with PTSD demonstrated significantly poorer memory performance compared with trauma-exposed controls without PTSD. Impairments were most consistent for verbal episodic memory and working memory, with effects observed across diverse trauma types and assessment instruments. Considerable heterogeneity was present but did not negate the overall pattern of PTSD-specific cognitive impairment. Sensitivity analyses confirmed the robustness of findings. Although funnel plot asymmetry suggested possible publication bias, trim-and-fill–adjusted estimates remained statistically significant. Conclusions: Trauma-exposed adults with PTSD exhibit reliable and clinically meaningful impairments in objective memory performance beyond the effects of trauma exposure alone. These findings support conceptualizations of PTSD as a disorder involving maladaptive memory processing and underscore the importance of incorporating cognitive assessment and intervention into PTSD research and clinical care.

Response Rate in CLL Patients Treated with Obinutuzumab - Single Centre Experience from University Clinic of Hematology, Skopje

Sat, 21 Mar 2026 00:00:00 GMT

The glycoengineered humanized monoclonal type II anti-CD20 antibody obinutuzumab is widely used in the treatment of patients with chronic lymphocytic leukemia (CLL), most commonly in combination with other therapeutic agents. The aim of this single-centre retrospective study was to evaluate the treatment patterns and clinical responses in patients with CLL treated with obinutuzumab-based combination regimens at the University Clinic of Hematology, Skopje. We analyzed 90 patients with CLL treated with obinutuzumab-based regimens between 2019 and 2024. Obinutuzumab was administered in combination with chlorambucil (56.6%), fludarabine–cyclophosphamide (26.6%), bendamustine (11.1%), CVP (4.4%), or venetoclax (5.5%). The treatment was given as first-line therapy in 57.7% of patients and in the relapsed/refractory setting in 42.3%. The median age at initiation of obinutuzumab-based therapy was 66.9 years. The overall response rate to obinutuzumab-based treatment was 45.5%. The median follow-up after treatment was 15.6 months. In this real-world single-centre experience, obinutuzumab-based combination regimens showed measurable clinical activity in routine practice across different treatment lines. Longer follow-up and larger patient cohorts are required to better characterize the durability of the responses and outcomes in the specific treatment subgroups.

Double Jeopardy – A Case of Overlapping Takotsubo Syndrome and Spontaneous Coronary Dissection

Sat, 21 Mar 2026 00:00:00 GMT

Acute coronary syndrome (ACS) includes a spectrum of clinical conditions, with increasing recognition of myocardial infarction with non-obstructive coronary arteries (MINOCA). Among its potential etiologies, Takotsubo syndrome (TTS) and spontaneous coronary artery dissection (SCAD) present with overlapping clinical features, posing diagnostic challenges. We present a case of a 56-year-old postmenopausal woman with recurrent chest pain and elevated troponin levels, initially diagnosed with TTS based on apical ballooning and a lack of obstructive coronary artery disease. However, persistent symptoms and echocardiographic wall motion abnormalities prompted further evaluation with cardiac magnetic resonance imaging (CMR), which demonstrated subendocardial late gadolinium enhancement (LGE) in the right coronary artery (RCA) and left anterior descending (LAD) artery territories, raising suspicion for an ischemic etiology. A subsequent coronary angiogram with optical coherence tomography (OCT) confirmed SCAD of the LAD, establishing an overlapping diagnosis of TTS and MINOCA due to SCAD. This case underscores the essential role of the multimodal imaging in refining MINOCA diagnoses and highlights the potential interplay between TTS and SCAD. Further research is needed to clarify their shared pathophysiology and improve diagnostic and therapeutic approaches in similar cases..

Liver Histiocytosis Masquerading as Hepatic Dysfunction: Rare Case Story

Sat, 21 Mar 2026 00:00:00 GMT

Introduction: Langerhans cell histiocytosis (LCH) is a rare histiocytic neoplasm occurring less frequently in adults than in children. Although various organs can be affected, resulting in a heterogenous clinical presentation, liver involvement is uncommon, particularly in adults. Herein, we present a case of LCH with liver involvement in an adult patient. Case Report: A 40-year-old man presented with painless jaundice and abnormal liver function tests. Diagnostic work-up revealed hepatosplenomegaly, and excluded common causes of liver dysfunction. Liver biopsy revealed microscopic findings typical of the disease and positive immunohistochemical markers. Hepatoprotective therapy resulted in improvement in liver function and withdrawal of symptoms. Conclusions: Isolated LCH-related liver injury is rare. The differential diagnosis with other liver pathology may pose a challenge for clinicians and radiologists.

A Rectus Sheath Block in Open Hysterectomy

Sat, 21 Mar 2026 00:00:00 GMT

Introduction: Open gynecological surgery results in a large wound and severe postoperative pain, and adequate postoperative analgesia is necessary. Rectus sheath block (RSB) is used to block the sensory nerves of the anterior abdominal wall, thereby contributing to pain relief after lower abdominal surgeries. RSB provides effective perioperative analgesia and is related to lower perioperative opioid consumption and decreased opioid-related adverse effects. The prospective randomized study explores the effect of RSB on the evaluation of the postoperative pain following transabdominal open hysterectomy. Objective: The aim of this study is to evaluate the use of bilateral Ultrasound (US)-guided RSB on the evaluation of the postoperative pain. Patients and Methods: This prospective randomized study was carried out on 70 females, ASA I or II, presented for elective open hysterectomy under general anesthesia (GA) and randomly classified into 2 equal Groups 1 and 2, of 35 patients each; Group 1 (n=35) is the control Group, where the patients received standard general endotracheal anesthesia; patients in Group 2 (n=35), the tested Group, received RSB with 40 ml ropivacaine 0.375% (20ml each side) before surgery and standard endotracheal anesthesia. Mean arterial Blood pressure (MAP) and Heart rate (HR) were measured as baseline, after induction of general anesthesia (GA), every 15 min until completion of surgery, immediately after recovery, at 6h, 12h, and 24 h postoperatively. The primary outcome was the evaluation of the postoperative pain using the Visual Analogue Scale (VAS). Secondary outcomes included the measurement of the opioid consumption (intraoperative) and the amount of analgesics (postoperative) and some postoperative medical data as well. Results and conclusion: Postoperative VAS scores showed significantly high pain scores in patients in Group 1, VAS 0 with a mean value of 9.46 (9.14-9.78), VAS 1 mean value of 8.46 (7.49-8.97), and VAS 2 with a mean value of 7.03 (6.44-7.62). Comparatively, Group 2 recorded significantly low pain scores - VAS 0 with a mean value of 1.26 (-,65-1.87), VAS 1 had a mean value of 2.74 (2.18-3.3), and VAS 2 had a mean value of 3.75 (0.25-1.25), respectively. The use of RSB as an adjuvant to GA had reduced intraoperative opioid consumption, time to first bowel motility and discharge from bed, postoperative analgesic consumption and shorter post-anesthesia care unit discharge time. Furthermore, patients of the test Group 2 showed greater satisfaction.

Quality of Recovery after Open Gynecological Surgery

Sat, 21 Mar 2026 00:00:00 GMT

Introduction: Hysterectomies are one of the most common major open gynecologic surgeries. Open gynecological surgery results in a large wound and severe postoperative pain, and adequate postoperative analgesia is necessary. As part of multimodal analgesia strategies, regional anesthesia techniques are widely used in such surgeries to reduce opioid consumption and enhance analgesic efficacy. Spinal anesthesia, as a regional anesthesia technique, and Rectus Sheath Block (RSB) can provide adequate anesthesia and are explored in this prospective randomized study. Objective: The aim of this study was to evaluate and compare the effect of standard general endotracheal anesthesia, regional block-spinal anesthesia, and bilateral Ultrasound (US)-guided RSB on the quality of recovery after open gynecological surgery. Patients and Methods: This prospective randomized study was carried out on 51 females, ASA I or II presented for elective gynecological surgery randomly classified into 3 equal groups (each of 17 patients): Group C (n=17) is control group where the patients received standard general endotracheal anesthesia; patients in Group S (n=17) - received regional- spinal block with applied intrathecal 20 mg (4.0 ml) of 0.5 % hyperbaric bupivacaine and 20 µg fentanyl; patients in Group R (n=17)- received Rectus sheath block with 40 ml ropivacaine 0.375% (20ml each side) before the surgery and standard endotracheal anesthesia. The primary outcome, the quality of recovery, was assessed by the 15-item Quality of Recovery questionnaire (QoR-15). Secondary outcomes included intraoperative opioid consumption, time to first flatus, time to first discharge from bed, postoperative nausea and vomiting (PONV), postoperative analgesic consumption and patient satisfaction. Results and conclusion: Postoperative global QoR-15 scores in the patient group R were in the range of 101.94-117.30 (103-119), and those among the in-patient Group S were in the range of 98.71-107.58 (102-109). The patients from Group R, with applied preoperative RSB, had reduced intraoperative opioid consumption, moderate time to first flatus and time to first discharge from bed, low postoperative analgesic consumption, and shorter post-anesthesia care unit discharge time (p<0.05). Patients from Group S, with applied spinal anesthesia, had less or absent initial postoperative pain, abbreviated time to first flatus and time to first discharge from bed, a lower incidence of postoperative nausea and vomiting (PONV), and an early ability to ambulate. Regarding patient satisfaction, for patient group C was average, group S displayed moderate patient satisfaction and group R had high patient satisfaction. According to the obtained results, the use of regional techniques (RSB or spinal anesthesia) are recommended for open gynecological surgery.

Submucosal against Intramuscular Administration of Dexamethasone in Treatment of Postoperative Edema after Odontectomy of Impacted Mandibular Third Molars

Sat, 21 Mar 2026 00:00:00 GMT

Aim: To clinically evaluate the efficacy of Dexamethasone depending on the method of administration in the treatment of postoperative complications following odontectomy of lower impacted third molars. Materials and Methods: At the Clinic for Oral Surgery at USKC “St. Panteleimon” in Skopje, North Macedonia, 45 patients, 20 to 40 years, indicated for odontectomy of lower impacted third molars, were included. 15 patients were treated with DXP (Dexamethasone), ampule of 4mg/1ml, applied submucosally (SM). Another 15 patients were treated with DXP administered intramuscularly (IM) into the deltoid muscle. No DXP was applied to the control group (CG). Edema was monitored by measuring three facial lines: tragus to labial commissure (Tr-Co), tragus to gnathion (Tr-Gn), and lateral eye canthus to angulus mandibulae (Cn-Am). The clinical effects in the three study groups were monitored at 24 hours (T1), 48 hours (T2), and 7 days (T3) post-op. Results: Cn-Am direction in T1, showed significantly larger edema in the CG vs the examined groups. In all time points there were no statistically significant differences between the examined groups (p>0.05). In T1 and T2, in the Tr-Co direction, the results showed the biggest reduction of the edema with a statistically significant difference (p=0.012) in IM vs SM application at T2. T3 showed least edema in the SM group. Tr-Gn direction, at T1, a significant difference in edema dimensions was found between the IM and CG (p=0.015), indicating a significantly smaller measured edema in the IM group. Identical findings were seen at T2. T3 showed better results in edema control in the SM vs. other groups. Conclusion: The intramuscular application technique of DXP was more effective than the submucosal technique across all measurement lines and time points in managing postoperative edema following surgical extraction of lower impacted third molars.

Emotional Intelligence and Coping Styles in Adolescents and Young Adults: Differential Associations with Adaptive and Maladaptive Coping

Sat, 21 Mar 2026 00:00:00 GMT

Background: Emotional intelligence has been identified as an important psychological factor influencing how individuals manage stress and regulate emotions. However, evidence regarding its differential association with adaptive and maladaptive coping styles in adolescents and young adults remains limited. Objective: This study aimed to examine the relationships between emotional intelligence and adaptive and maladaptive coping styles in a large sample of adolescents and young adults. Methods: A cross-sectional study was conducted among 700 participants aged 15–25 years. Emotional intelligence was assessed using the Wong and Law Emotional Intelligence Scale, while coping styles were measured using a 28-item COPE inventory aggregated into adaptive and maladaptive coping dimensions. Descriptive statistics, Pearson correlation analyses, and multiple linear regression models adjusted for age, gender, and education level were performed. Results: Emotional intelligence was positively associated with both adaptive coping (r = .16, p < .001) and maladaptive coping (r = .54, p < .001). Regression analyses indicated that emotional intelligence independently predicted both coping styles; however, the effect size was substantially larger for maladaptive coping. Age, gender, and education level were not significant predictors in either model. Conclusion: Emotional intelligence is differentially associated with coping styles in adolescents and young adults, with a particularly strong relationship observed for maladaptive coping. These findings underscore the importance of emotional intelligence in coping processes and suggest that interventions targeting emotional intelligence may help reduce maladaptive coping behaviors in youth.

Early Risk Stratification in Acute Pulmonary Embolism using Inflammatory and Hematologic Biomarkers

Sat, 21 Mar 2026 00:00:00 GMT

Background: Accurate early risk stratification in acute pulmonary embolism (PE) remains challenging, particularly in intermediate-risk patients. Readily available hematologic and inflammatory markers may provide additional prognostic value. Objective: To evaluate the predictive role of hematologic and inflammatory markers for in-hospital adverse events in patients with acute pulmonary embolism. Methods: This retrospective study included 88 pts diagnosed with acute PE between 2023 and 2024. Clinical, echocardiographic, and laboratory data, including red blood cell distribution width (RDW), white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP), were analyzed. Adverse events were defined as hemodynamic instability, cardiac arrest, or death during hospitalization. Logistic regression identified independent predictors; ROC curves assessed discriminative performance. Results: Adverse events occurred in 13 pts (14.8%), including four deaths. Pts with adverse events had significantly higher RDW (p = 0.008), WBC (p = 0.002), NLR (p = 0.001), PLR (p = 0.001), and CRP (p = 0.028). Multivariable analysis identified RDW (OR 1.48; 95% CI 1.12–1.96; p = 0.006), WBC (OR 1.20; 95% CI 1.02–1.41; p = 0.032), and NLR (OR 1.14; 95% CI 1.02–1.27; p=0.018) as independent predictors. ROC analysis showed improved discrimination when these markers were combined (AUC 0.880). Conclusion: Red blood cell distribution width, white blood cell count, and neutrophil-to-lymphocyte ratio independently predict in-hospital adverse events in acute pulmonary embolism. Their combined use may enhance early risk stratification.

What Psychology Can Do For Everyday Life

Sat, 21 Mar 2026 00:00:00 GMT

It was proven that psychology can help us in everyday life by improving communication skills, relationships, and ability to manage stress. It can also help us make better decisions in school, healthcare, and work, and improve mental health and general well-being. Results from different studies demonstrate that people are happier and less depressed after completing exercises targeting positive emotions. Consequently, the ultimate goal of psychology is to make people happier by understanding and building positive emotions, gratification, and meaning. Positive psychology focuses on enhancing wellbeing by studying what makes life worth living, emphasizing strengths, virtues, and positive experiences. It encourages the cultivation of positive emotions, engagement and meaning to improve overall life satisfaction or resilience. Applying positive psychology principles can lead to personal growth, improved relationships, and a more fulfilling life. In this article we focus on the role of positive psychology in the daily lives of children and adolescents suffering from malignancies, diabetes, chronic diseases, and poverty. Enhancing the well-being of the youth is an urgent public health need and concern today. Positive psychology aims to provide a comprehensive scientific knowledge of the human experience and better integrate and complement the illness framework with concepts related to positive mental health and then use them at scale to solve public health issues.

Venous Malformations in Pediatric Patients: Clinical Manifestations, Diagnostic Methods, and Treatment Strategies

Sat, 06 Dec 2025 00:00:00 GMT

Introduction: Venous malformations (VMs) are a prevalent type of congenital vascular disorder, affecting nearly 1% of the population. These low-flow vascular anomalies often lead to chronic swelling, pain, and mobility challenges, often interfering with a child’s daily life. Their development is mostly caused by genetic abnormalities in the TIE2/TEK and PIK3CA pathways, which cause poor venous remodeling and vascular proliferation. This study aims to assess the clinical manifestations, diagnostic methods, and therapeutic alternatives for pediatric venous malformations, emphasizing the effectiveness of different treatment modalities. Recognizing clinical presentations and understanding treatment outcomes are essential for improving early diagnosis and optimizing patient-centered care strategies. Materials and methods: Between 2019 and 2023, the Clinic for Pediatric Surgery in Skopje treated 38 pediatric patients with venous abnormalities. Patient demographics, lesion characteristics, and treatment options (including conservative management, sclerotherapy, and surgical intervention) were examined. Results: The majority of patients (39.5%) received conservative treatment, whereas 23.7% underwent sclerotherapy and 34.2% needed surgical intervention. Sclerotherapy results were evaluated according to lesion size. Treatment was effective for smaller lesions (<5 cm), while bigger or recurring cases required multiple treatment sessions. Conclusion: The results highlight the importance of early identification and individualized treatment strategies for pediatric venous malformations. Sclerotherapy is the primary therapeutic option for minor to moderate lesions, whereas surgical intervention is designated for symptomatic or refractory patients. A multidisciplinary approach is crucial for enhancing patient outcomes, and future research should focus on the advancement of minimally invasive therapeutic techniques and the exploration of targeted genetic medicines.

Well-Being Among Anesthesia Providers: Results from a National Survey

Sat, 06 Dec 2025 00:00:00 GMT

Introduction:Anesthesiology is a demanding medical specialty that requires intense focus, long working hours, and frequent exposure to high-stress situations. These factors often lead to significant occupational stress. Supporting the well-being of anesthesiologists is essential for maintaining patient safety and a stable healthcare workforce. Methods: We conducted a survey among anesthesiology residents and specialists in North Macedonia. Standardized tools were used, including the Safety Attitudes Questionnaire (SAQ), WHO-5 Well-Being Index, and custom questions related to workplace culture, mental health, and teamwork. Data were collected anonymously via Google Forms and analyzed with SPSS v29.0, focusing on work conditions, psychological well-being, and burnout levels. Results: A total of 100 participants participated—60% residents and 40% specialists. Residents reported significantly higher stress and burnout, along with lower perceived support from institutions and weaker team dynamics (p < 0.05). Specialists noted better job satisfaction and stronger organizational backing (p < 0.05). Both groups highlighted a lack of mental health support and weak safety culture, particularly in under-resourced settings; however, these differences were not statistically significant (p > 0.05). Overall, resource limitations were widely recognized as key contributors to workplace challenges in middle-income countries (p < 0.05). Conclusion: Anesthesiology residents face higher levels of stress and lower job satisfaction compared to specialists, with resource constraints worsening these disparities. To address these issues, targeted interventions are needed, including mental health support services, mentoring programs, stress management training, and policies that promote a positive work environment and psychological safety.

Effect of Insulin Sensitizers on Glycemic and Lipid Profile in Patients with Polycystic Ovary Syndrome (PCOS)

Sat, 06 Dec 2025 00:00:00 GMT

Introduction: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk later in life. Insulin resistance, common in PCOS, heightens the risk of type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease. This study explored whether insulin sensitizers could modify traditional cardiovascular risk factors, through influence on insulin resistance. Objectives: To evaluate the impact of Metformin and Myoinositol therapy on glycemic and lipid profiles in PCOS patients, based on body mass index (BMI). Methods: A prospective, randomized clinical study was conducted at the UC for Endocrinology in Skopje (2022–2023). Women aged 18–40 with PCOS (Rotterdam 2003 criteria) were assigned to either Metformin (1500 mg XR) or Myoinositol (2 g + 200 mg folic acid TID) for 6 months. Parameters monitored included BMI, fasting plasma glucose (FPG), HOMA-IR, total cholesterol, LDL-C, HDL-C, triglycerides, lipid accumulation product (LAP), and TG/HDL ratio. Results: Baseline BMI significantly influenced HDL, triglycerides, TG/HDL, and LAP. Myoinositol significantly improved cholesterol regardless of BMI. Among patients with BMI ≥25 kg/m², Metformin significantly reduced FPG (4.65 ± 0.5 vs 5.01 ± 0.3 mmol/L) and HOMA-IR (2.25 ± 0.6 vs 2.94 ± 1.1 mmol/L). HOMA-IR positively correlated with TG/HDL ratio (R=0.2086, p=0.016). Conclusion: Myoinositol improved cholesterol in PCOS patients regardless of BMI. Metformin significantly affected glycemic control in overweight patients. The TG/HDL ratio may serve as a predictive marker for insulin resistance in PCOS.

Not Just Numbers: Exploring the Inner Landscape of Youth Anxiety and Stress

Sat, 06 Dec 2025 00:00:00 GMT

Anxiety and perceived stress are increasingly prevalent among youth; however, empirical data from Southeast Europe remain limited. This study examines the prevalence, interrelation, and psychological implications of anxiety and perceived stress in youth from North Macedonia, utilizing validated psycho-metric tools. A cross-sectional study included 204 participants aged 15 and older (mostly under 30), recruited from various educational institutions. Participants completed the Beck Anxiety Inventory (BAI) and the Perceived Stress Questionnaire (PSQ-30) under standardized conditions. Analyses included descriptive statistics, Latent Profile Analysis, k-means clustering, MANOVA, linear regression, and Exploratory Factor Analysis to evaluate symptom patterns and demographic predictors. Additionally, machine learning models (logistic regression and random forest) were employed to predict subgroup membership. High levels of perceived stress and anxiety were observed, with significant gender- and age-related differences. Correlation analyses demonstrated a strong positive association between PSQ-30 and BAI scores. The Pearson correlation coefficient was r = 0.66, confirming the statistical strength of this association. Factor analysis revealed multiple latent dimensions of anxiety, while cluster analysis identified distinct psychological profiles. These findings underscore the co-occurrence and interplay of anxiety and perceived stress in Macedonian youth, emphasizing the need for targeted mental health interventions and region-specific policy development.

Factors Affecting the Occurrence of Hypoxemia During One-Lung Ventilation

Sat, 06 Dec 2025 00:00:00 GMT

Introduction: Hypoxemia that occurs during one-lung ventilation (OLV) in thoracic surgery increases the risk of perioperative and postoperative complications, affecting mortality and morbidity. The aim of this study is to analyze the occurrence of perioperative hypoxemia (SpO₂ ≤ 90%) and to determine whether preoperative spirometry results and arterial blood gas analyses influence its development. Materials and Methods: In this retrospective study, we evaluated 80 elective patients who underwent lung resection (segmentectomy, lobectomy, bilobectomy, pneumonectomy) due to malignancy under one-lung ventilation. The patients had ASA I-III, EF >50%, FEV₁ >40%, and PaO₂ >60 mmHg. We administered anesthesia in accordance with a standard protocol. We excluded patients under the age of 18, those with pathological arrhythmias, metastatic changes in the contralateral lung, endocrine disorders, renal or hepatic dysfunction, coagulation disorders, or those who had previously undergone radiotherapy or chemotherapy. We evaluated demographic, clinical, and surgical data, with a special focus on the results of preoperative spirometry and blood gas analyses and their correlation with the occurrence of desaturation (SpO2 ≤ 90%), which was measured every 10 minutes from the start of OLV. Results: Desaturation had the highest percentage of occurrences 20 minutes after the initiation of OLV (27.5%). It was more common in patients with right-sided surgery, patients with FEV₁% ≥ 70 and FVC%≥70, and in overweight patients (BMI ≥ 25). Conclusion: The risk factors for hypoxemia during one-lung ventilation in thoracic surgery include right-sided surgery, which poses higher anatomical challenges for oxygenation, and pulmonary function values such as FEV and FVC at or above 70 percent. Additionally, a higher body mass index (BMI) is a key predictor of oxygen saturation drops. These factors highlight the need for careful preoperative assessment to manage oxygenation effectively.

Music Changes Brain Functioning and Development

Sat, 06 Dec 2025 00:00:00 GMT

It is well documented that music is a basic and ubiquitous socio-cultural domain in humans. Across human cultures music was a source of affective and pleasurable experience, moving people both physically and emotionally. Researches confirmed that music shapes brain structure and brain function as well. The neuroscience of music suggests that neural oscillations synchronize with musical stimuli. Fundamental dynamical principles based on known neural mechanisms can explain the basic aspects of music perception and performance, as summarized in “neural resonance theory”. Music is an integral part of every human society. Music can bring pleasure, calm anxiety, soothe sorrow, inspire and/or stimulate movement, and promote social connections. Musical experiences may also have the remarkable ability to enhance brain and cognitive development, improve function and well-being, optimize the quality of life, and possibly ameliorate the symptoms of a broad range of diseases and disorders. This article summarizes some effects of music on brain functioning and development.

Use and Adverse Effects of Vacuum-Formed Retainers – Comparison of the Experiences of Orthodontists in Croatia and North Macedonia

Sat, 06 Dec 2025 00:00:00 GMT

Objective: To investigate experiences with vacuum-formed retainers (VFR), possible adverse effects and problems associated with their use among Croatian and Macedonian orthodontists. Subjects and Methods: In 2023, a questionnaire on retention protocols was distributed by e-mail to 150 orthodontists in North Macedonia (78% of practicing orthodontists), with a response rate of 58%, and to 185 orthodontists in Croatia (85% of practicing orthodontists), with a response rate of 75%. Results: VFR were the more frequently used retention appliance in Croatia than North Macedonia, both in maxilla (79 vs. 53%, p<0.001) and mandible (66 vs. 44%, p=0.001) mostly because of the availability of the appliance (66% in Croatia vs. 53% in North Macedonia; p=0.056). The most used foil thickness for the VFRs was the 1 mm (71% in Croatia vs. 59% in North Macedonia; p=0.019). The expected duration of the VFRs was 1-2 years (60% in Croatia vs. 47% in North Macedonia; p=0.015), however, less than 25% of the patients agreed to make new VFRs in both countries. Clinicians had rarely observed adverse reactions to VFRs (3% in Croatia and none in North Macedonia). Reasons for changing the VFR material were more often costs in North Macedonia than in Croatia (62 vs. 2%; p<0.001). Conclusion: VFRs are preferred retention appliances among Croatian and North Macedonian orthodontists, mostly because of their availability. Patients tolerate them well, but failures mostly occur after 1-2 years and only ¼ of patients decide to make new retainers which can impose problems regarding relapse.

When Words Fail: Investigating Alexithymia And Coping Strategies In Adolescent Mental Health

Sat, 06 Dec 2025 00:00:00 GMT

Introduction: Alexithymia, defined by difficulty identifying and verbalizing emotions, has emerged as a significant factor influencing emotional regulation and coping behaviors in youth. Adolescents with high levels of alexithymia may be at greater risk of psychological distress due to maladaptive coping mechanisms and reduced social support engagement. Materials and Methods: This cross-sectional study was conducted among 141 high school students aged 15–18 in Skopje, North Macedonia. Participants completed validated instruments including the Toronto Alexithymia Scale (TAS-20) and the Adolescent Coping Orientation for Problem Experiences (COPE-A). Statistical analyses included descriptive statistics, Pearson correlations, to examine associations between alexithymia and coping strategies. Results: The mean TAS-20 score suggested a high prevalence of alexithymic traits in the sample. Approximately 44% of adolescents in the sample scored above the clinical threshold for alexithymia (TAS-20 > 61), highlighting the prevalence of emotional processing difficulties in this population. Significant correlations were found between higher alexithymia and maladaptive emotion regulation strategies such as self-blame, rumination, and catastrophizing. Conversely, positive coping strategies like positive reappraisal and acceptance were negatively correlated with alexithymia levels. Participants with high alexithymia reported a greater tendency to engage in maladaptive coping behaviors. Discussion: Findings underscore alexithymia as a trait associated with emotion dysregulation and diminished coping flexibility in adolescents. The results highlight the interplay between poor emotional awareness and a tendency to adopt dysfunctional cognitive responses to stress, which may exacerbate vulnerability to psychological problems. Conclusion: Early identification of alexithymic traits and the promotion of emotional literacy and adaptive coping in adolescence are crucial. Preventive school-based programs focusing on emotional skill development and peer support may buffer the impact of alexithymia and enhance youth mental health outcomes.