Nenad Joksimovic - Academia.edu (original) (raw)

Papers by Nenad Joksimovic

This study is a prospective clinical investigation that includes 596 patients aged 54 years on av... more This study is a prospective clinical investigation that includes 596 patients aged 54 years on average, with symptoms such as perirectal pain, rectal bleeding, and change in bowel habit and tenesmus that had been investigated at the Clinic. Rectal cancer was diagnosed by endoscopy and was pathohistologica lly confirmed in 377 cases. Demonstration of tumor, extension into perirectal fat and lymph node involment were evaluated. Tumors were successfully imaged by endorectal ultrasound. According to the endosonographical results, patients were divided into 3 groups: operable, inoperable and control group. All patients from the first group classified endosonographically as operable rectal carcinoma were compared with the definite surgical diagnosis. Endosonographicaly, 55 pts (9 5%) had I degree, 115 pts (19 5%) had II degree. The group classified as inoperable rectal tumors (207 pts) is compared with the operative findings of palliatively operated patients. Due to the complications of t...

A b s t r a c t: This study is a prospective clinical investigation that includes 158 patients (p... more A b s t r a c t: This study is a prospective clinical investigation that includes 158 patients (pts.), of whom 64 were diagnosed with gastric cancer by EUS in which opera- bility was determinate, and 94 pts. with gastric submucosal tumours. Endoscopy and pathohistological examination were used in the primary detec- tion and diagnosis of the gastric cancer,

Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences, 2012

(Full text is available at http://www.manu.edu.mk/prilozi). Gastroesophageal reflux disease is a ... more (Full text is available at http://www.manu.edu.mk/prilozi). Gastroesophageal reflux disease is a common disease with a multifactorial pathogenesis. Our aim was to analyse the role of the Gastroesophageal Disease Questionnaire in diagnosing reflux disease in the population of the Republic of Macedonia. The questionnaire on the severity of the symptoms related to GERD was used. An evaluation of the distal portion of the oesophagus was carried out in all patients with positive questionnaire results. All mucosal injury was classified by the Los Angeles criteria (LA). 642 patients were included. 58.73% females, with an average age of 37.5 ± 8.2. Females had a higher BMI than males 26.8 ± 4.1 vs. 24.9 ± 3.8 p < 0.001. Of the total number of examinees (642 patients), in those with erosive reflux disease and also in those with nonerosive reflux disease, as shown respectively in endoscopy, the sensitivity of the RDQ was 100%, and the specifity was 0%. The100 sensitivity means that the questionnaire verified/diagnosed patients with erosive reflux disease with 100% certainty. RESULTS were found in some studies comparing the positive Reflux Disease Questionnaire and the level of erosive esophagitis (LA classification). This study provides evidence that the RDQ represents a viable instrument for assessing symptom severity and response to treatment in clinical trials of patients with GERD, but in patients with a high score, endoscopic evaluation should not be excluded Key words: Gastroesophageal reflux disease (GERD), Reflux Disease Questionnaire, Upper Endoscopy.

(Full text is available at http://www.manu.edu.mk/prilozi). Endoscopic retrograde cholangiopancre... more (Full text is available at http://www.manu.edu.mk/prilozi). Endoscopic retrograde cholangiopancreatography provides precise imaging of malignant biliopancreatic strictures and allows palliative treatment with endoscopic stenting. Initial successful biliary stenting can be achieved in about 69-100% of patients with pancreatic head malignancies. Preliminary data from our Clinic reported a much lower success rate of endoscopic biliary stenting in obstructive jaundice caused by pancreatic head malignancies. These findings may be because patients are referred at more advanced stages, which could contribute to the lower success rate of biliary stenting. We aimed to determine the success rate of endoscopic biliary stenting prospectively in 50 patients with pancreatic head malignancies and to asses if clinical, laboratory and ultrasound findings can be predictive of success and safety in biliary stenting. Initial successful biliary stenting was achieved in 70% of our patients. No major complications (perforation, severe pancreatitis, massive bleeding, death) were noted. We were able to identify factors predictive of a lower success rate which were associated with a more advanced disease and a longer delay before treatment. Based on our results, we conclude that ERCP should be offered without delay as a primary treatment option for all patients with unresectable pancreatic head malignancy and as a possible treatment option in patients with resectable malignancy who are poor candidates for surgery. Key words: Pancreatic head malignancy, obstructive jaundice, endoscopic biliary stenting.

This study is a prospective clinical investigation that includes 195 patients (pts), of whom 64 w... more This study is a prospective clinical investigation that includes 195 patients (pts), of whom 64 were diagnosed with gastric cancer and endosonographically determined operability. Endosonography is not used in the primary detection and diagnosis of gastric cancer, but as a supplementary method that, besides the basic detection of the presence or absence of a tumour, gives additional information about the extent of the neoplasm. For this investigation the patients were divided into 3 groups. The first group of 58 pts (30%) were those with benign gastric lesions, 18 pts with polyps and 40pts with gastric ulcers respectively. The second groups of 64 pts (32.5%) consisted of those with gastric cancer. According to the endosonographic findings this group consisted of 2 subgroups: 45 operable patients and 19 inoperable patients with gastric cancers. The third group consisted of 73 pts (37.5%) who were without any changes in the gastric wall. The endosonographic findings in the first subgro...

This study is a prospective clinical investigation that includes 158 patients (pts.), of whom 64 ... more This study is a prospective clinical investigation that includes 158 patients (pts.), of whom 64 were diagnosed with gastric cancer by EUS in which operability was determinate, and 94 pts. with gastric submucosal tumours. Endoscopy and pathohistological examination were used in the primary detection and diagnosis of the gastric cancer, and EUS was a supplementary method that revealed additional information about the extent of the neoplasms. According to the findings of the EUS, the patients were divided into 2 groups. The first group consisted of 94 pts (59.5%) with gastric submucosal lesions, and 64 pts (40.5%) with gastric cancer respectively. The first group consisted of 94 pts. with submucosal tumours of the stomach. There were 71 pts with Leiomyoma, 11 pts with Leiomyosarcoma, 7 with an aberrant pancreas, 3 with submucosal cysts, one lipoma and one varix at fundus. The second group consisted of 64 pts (40.5%) with gastric cancer. According to the EUS findings this group was div...

This study is a prospective clinical investigation that includes 587 patients aged on average 55.... more This study is a prospective clinical investigation that includes 587 patients aged on average 55.3 years with symptoms such as perirectal pain, rectal bleeding, and change in bowel habit and tenesmus that had been investigated at the Clinic. Rectal cancer was diagnosed by endoscopy and pathohistologically confirmed in 377 cases. Demonstration of tumor, extension into perirectal fat and lymph node involment were evaluated. Tumors were successfully imaged by endorectal ultrasound. According to the endosonographical results patients were divided into 3 groups: operable, consisting of 168 pts (29%), inoperable group of 205 pts. (35%) and control group with 214 pts (36%). However, transrectal sonography as a usable supplementary method has to provide approximate sensitivity as the method to which it is supplementary, in fact to be able to detect the lesion that was proved beyond doubt in this study. The results suggest that transrectal sonography has an important role in the determinatio...

Case Reports in Gastrointestinal Medicine, 2014

The gastrointestinal tract is the most common extranodal site involved with lymphoma accounting f... more The gastrointestinal tract is the most common extranodal site involved with lymphoma accounting for 5-20% of all cases. Lymphoma can occur at any site of the body, but diffuse and extensive involvement of the peritoneal cavity is unusual and rare. We report a case of diffuse large B-cell lymphoma in a 57-year-old female infiltrating the peritoneum and omentum and presenting with ascites and pleural effusion. The performed examinations did not discover any pathological findings affecting the digestive tract or parenchymal organs, except for diffuse thickening of the peritoneum and omentum. Peripheral, mediastinal, or retroperitoneal lymphadenopathy was not registered. The blood count revealed only elevated leukocytes and on examination there were no immature blood cells in the peripheral blood. The cytology from the ascites and pleural effusion did not detect any malignant cells. Due to the rapid disease progression the patient died after twenty-two days of admission. The diagnosis was discovered postmortem with the histological examination and immunohistochemical study of the material taken during the surgical laparoscopy performed four days before the lethal outcome. Although cytology is diagnostic in most cases, laparoscopy with peritoneal biopsy is the only procedure which can establish the definitive diagnosis of peritoneal lymphomatosis.

Ultrasound in Medicine & Biology, 1997

Journal of Hepatology, 2000

Acta Facultatis Medicae Naissensis, 2000

Updates in Surgery, 2012

Topical formulations are widely used in anti-haemorrhoidal treatment, but often lacking controlle... more Topical formulations are widely used in anti-haemorrhoidal treatment, but often lacking controlled clinical trials. Here, we report the results from a controlled clinical trial performed with a new gel medical device (Proctoial) containing hyaluronic acid with tea tree oil and methyl-sulfonyl-methane as major components. The total number of 36 haemorrhoidal patients (grade 1-3) was enrolled in a double-blind, placebo-controlled clinical trial and divided into 2 equal parallel groups. The anal pain, pain during defecation, visible bleeding, pruritus and irritation/inflammation were recorded before and after 14-day treatment using a visual analogue scale both by the investigators and by the patients. Safety and tolerability of the treatments were also recorded. The new gel medical device statistically significantly reduced all the symptoms after the treatment compared to placebo. The results indicated also a very good tolerability and safety of the treatments.

Case Reports in Gastrointestinal Medicine, 2014

Ultrasound in Medicine & Biology, 1997

Journal of Hepatology, 2000

Acta Facultatis Medicae Naissensis, 2000

Updates in Surgery, 2012