Acta medica academica最新文献

{"title":"Effects of Anti-Gravity Treadmill Training on Functional Outcomes After Total Hip Arthroplasty: A Randomized Controlled Trial.","authors":"Ivana Dolusic, Ksenija Bazdaric, Silvije Segulja, Gordana Starcevic Klasan, Hrvoje Vlahovic, Bojan Miletic, Mirela Vuckovic","doi":"10.5644/ama2006-124.512","DOIUrl":"10.5644/ama2006-124.512","url":null,"abstract":"<p><strong>Objective: </strong>Total hip arthroplasty is one of the most common orthopedic procedures. When the surgery is successful and followed by high-quality physiotherapy, the patients' quality of life usually improves. This randomized controlled trial aimed to investigate the impact of anti-gravity treadmills on functional outcomes after total hip arthroplasty.</p><p><strong>Materials and methods: </strong>The trial was conducted at the Special Hospital for Medical Rehabilitation of Heart, Lung, and Rheumatic Diseases Thalassotherapia Opatija. The sample consisted of patients admitted for inpatient rehabilitation three months after total hip arthroplasty. A total of 34 subjects were randomly assigned to two groups: an experimental group (N=18) and a control group (N=16). The outcome measures included abductor muscle strength, range of motion, numeric pain rating scale, Timed Up and Go test, and 40-meter Fast-Paced Walk test.</p><p><strong>Results: </strong>A statistically significant between-group difference was observed only for hip abduction range of motion, favoring the experimental group (P=0.044). The other measured variables did not show any statistically significant intergroup differences.</p><p><strong>Conclusions: </strong>Anti-gravity treadmill training improved hip abduction range of motion but did not demonstrate superiority over conventional rehabilitation in the other assessed functional outcomes.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propranolol in the Treatment of Infantile Hemangiomas: A Single-Center Experience.","authors":"Jelena Roganović, Andrea Kevrić, Ana Đorđević","doi":"10.5644/ama2006-124.502","DOIUrl":"10.5644/ama2006-124.502","url":null,"abstract":"<p><strong>Objective: </strong>Infantile hemangiomas (IH) are common benign vascular tumors of infancy that typically undergo gradual spontaneous regression over several years, although a minority require treatment. Propranolol, a non-selective β‑adrenergic antagonist, is the first-line therapy for complicated or high-risk IH, demonstrating both efficacy and a favorable safety profile.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 37 infants treated with oral propranolol at a single center. Patients were monitored in-hospital during treatment initiation and at regular, outpatient visits. The response was assessed using clinical measurements, ultrasonography, and standardized photographs.</p><p><strong>Results: </strong>Most patients had solitary lesions predominantly located in the head region. Complete regression occurred in 26 patients (70.3%) and partial regression in 11 (29.7%). Treatment duration ranged from 2 to 24 months (mean 10.1 months). Adverse events were rare and mild, including one case of hypoglycemia and one of transient somnolence.</p><p><strong>Conclusion: </strong>Oral propranolol is a safe and effective first-line therapy for IH, particularly when initiated early during the proliferative phase.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"197-201"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications and Complications of Total Thyroidectomy in the Management of Thyroid Diseases: A Five-Year Retrospective Study in a Greek Population.","authors":"Georgios Kaklamanis, Dimosthenis Chrysikos, Panagiotis Voulgaris, Vaios Primikiris, Maria Piagkou, Theodoros Troupis","doi":"10.5644/ama2006-124.509","DOIUrl":"10.5644/ama2006-124.509","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study aimed to record, analyze, and evaluate data concerning patients who underwent total thyroidectomy, focusing on the main indications that led to surgical therapy, as well as postoperative complications and oncological outcomes.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted on 312 patients who underwent total thyroidectomy or lobectomy at the First Department of Surgery of Sismanogleio General Hospital in Athens between 2019 and 2024. Demographic data, indications, intraoperative parameters, complications, and histological findings were recorded. Statistical analyses were performed using SPSS v29.0.</p><p><strong>Results: </strong>Among the 312 patients, 222 (71.2%) were female, and 90 (28.8%) were male, with a mean age of 54.3±13.3 years. Total thyroidectomy was performed in 96.5% of the cases. The main indications were nodular hyperplasia (31.4%), autoimmune thyroiditis (18.9%), multinodular goiter (12.8%), and papillary carcinoma (17.3%). The overall complication rate was 31.7%, with transient postoperative hypocalcemia being the most common complication (25.3%). Permanent hypocalcemia occurred in 1.9% of patients, hemorrhage in 3.5%, and recurrent laryngeal nerve palsy in 1.3% of patients. Papillary carcinoma was the most frequent malignancy, followed by follicular, medullary, and anaplastic carcinomas. Approximately 20% of patients were diagnosed with incidental carcinoma-mostly papillary microcarcinoma-emphasizing the importance of total thyroidectomy, even for benign thyroid diseases.</p><p><strong>Conclusions: </strong>Total thyroidectomy is a safe and effective therapeutic option with low rates of permanent complications. The systematic identification and preservation of the parathyroid glands, intraoperative nerve monitoring, and meticulous hemostasis are key factors for minimizing inadvertent complications and optimizing outcomes.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"186-196"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Prevention of Lung Cancer in Europe: A Review of Burden, Disparities, and the Path to Equitable Early Detection.","authors":"Shahd Hamran, Zaineh Alnoubani, Raghad Elsherif, Zoran Gatalica, Semir Vranic, Giridhara Rathnaiah Babu","doi":"10.5644/ama2006-124.511","DOIUrl":"https://doi.org/10.5644/ama2006-124.511","url":null,"abstract":"<p><p>This review synthesizes current evidence on the global epidemiology and prevention of lung cancer, with a focused analysis of the Southeastern Europe region. Lung cancer remains the leading cause of cancer-related mortality worldwide, reflecting persistent exposure to modifiable risk factors and substantial inequities in early detection and treatment access. Data from GLOBOCAN, the Global Burden of Disease study, randomized controlled trials, and population-based registries were used to assess trends in incidence, mortality, and survival, and to examine the evolving distribution of histological subtypes and molecular profiles. While tobacco smoking remains the leading risk factor, a growing proportion of lung cancer, especially among never-smokers, is attributable to non-tobacco exposures, including ambient and household air pollution, occupational carcinogens, and residential radon. Despite advances in targeted therapies and immunotherapy, overall survival remains poor, largely due to late-stage diagnosis. Evidence from landmark trials demonstrates that low-dose computed tomography (LDCT) screening reduces lung cancer mortality primarily through stage migration, enabling detection at earlier, more treatable stages. Southeastern Europe continues to experience a high burden driven by tobacco exposure, limited screening implementation, and restricted access to molecular diagnostics. Inequities in screening eligibility, uptake, and access to advanced therapies worsen survival outcomes across socioeconomic and demographic groups. CONCLUSIONS: Effective lung cancer control requires a multilevel prevention strategy integrating strengthened tobacco control policies, risk-stratified LDCT screening, and equitable access to molecular testing and treatment. Future research priorities include understanding lung cancer in never-smokers, evaluating long-term risks of emerging exposures such as e-cigarettes, and utilizing multi-omics approaches to refine risk stratification and guide targeted therapy.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Stability of Warfarin and Acenocoumarol in Patients With Mechanical Heart Valves and Atrial Fibrillation: A One-Year Cohort Study.","authors":"Šahza Hajdari Toskić, Asija Mević, Aida Kulo Ćesić","doi":"10.5644/ama2006-124.497","DOIUrl":"10.5644/ama2006-124.497","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate which of the two vitamin K antagonists, warfarin or acenocoumarol, provides more stable anticoagulation control in patients with mechanical heart valves and atrial fibrillation.</p><p><strong>Patients and methods: </strong>This was a prospective, one-year clinical cohort study. In total, 73 outpatients with mechanical heart valves and atrial fibrillation who were already treated with warfarin or acenocoumarol were recruited from the Blood Transfusion Institute of the Federation of Bosnia and Herzegovina. The prothrombin time target values, expressed as the international normalized ratio (INR), were 2.0-3.0/4.0. Numerical data between the treatment groups were summarized descriptively.</p><p><strong>Results: </strong>Patients in the warfarin (N=35) and acenocoumarol (N=38) treatment groups were similar in terms of sex, age, body mass index, body surface area, and number of concomitant drugs known to interact with vitamin K antagonists. The number of INR measurements per patient, number of INR measurements within the therapeutic range per patient, mean time interval between successive INR measurements, and mean INR values across consecutive measurements were similar in both groups. However, compared to acenocoumarol, warfarin treatment seemed to be associated with more stable anticoagulation, i.e., with a higher mean time in the therapeutic range (TTR) (76.1±24.2 vs. 69.1±21.5%) and a smaller proportion of patients below all predefined TTR thresholds (<60%, <65%, and <70%).</p><p><strong>Conclusion: </strong>Our unadjusted descriptive results suggested that warfarin, compared to acenocoumarol, may provide more stable and therefore safer anticoagulation control in patients with mechanical heart valves and atrial fibrillation. To confirm this, larger prospective clinical studies are needed in patients with mechanical heart valves with or without atrial fibrillation.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Re-Resection for Isolated Local Recurrence of Pancreatic Cancer: A Case Series of 3 Patients and Literature Review.","authors":"Spiros Delis, Nikolaos Taprantzis, Dimosthenis Chrysikos, Amir Shihada, Theodore Troupis","doi":"10.5644/ama2006-124.495","DOIUrl":"10.5644/ama2006-124.495","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective case series study aims to assess the clinical role of surgical re-resection for isolated local recurrence of pancreatic cancer, integrating detailed case presentations with current evidence to clarify patient selection criteria, operative feasibility, and oncologic outcomes.</p><p><strong>Case presentations: </strong>We present three patients with locally recurrent pancreatic cancer who underwent repeat pancreatic resection. Patient 1, who previously underwent distal pancreatectomy for an Intraductal Papillary Mucinous Neoplasm (IPMN)-associated adenocarcinoma, developed a new pancreatic head lesion three years later and underwent pylorus-preserving pancreaticoduodenectomy; histopathology confirmed a small invasive IPMN, and the patient remains alive 8 years after the initial diagnosis and 5 years after the reoperation. Patient 2, who had previously undergone Pylorus-Preserving Pancreaticoduodenectomy for distal bile duct adenocarcinoma, developed recurrent disease in the pancreatic body and tail three years later. He underwent distal pancreatectomy but developed liver recurrence due to hematogenous metastasis one month postoperatively and succumbed 6 months later from generalized widespread disease. Patient 3, who previously underwent a Whipple procedure for IPMN-associated adenocarcinoma, developed a recurrent mass at the pancreatojejunostomy five years later and underwent distal pancreatectomy, with an uneventful recovery.</p><p><strong>Conclusion: </strong>Our findings suggest that repeat pancreatic resection may be feasible in carefully selected patients with isolated local recurrence, potentially offering a survival benefit. Strict selection criteria, including the absence of distant metastases, good performance status, and technically resectable disease, appear essential to optimize outcomes, supporting the consideration of surgical re-resection as an option within a multidisciplinary management framework.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrocolic Trunk: Anatomical Variations and Surgical Significance.","authors":"Grigorios Stefanou, Dimosthenis Chrysikos, Dimitrios Filippou, George Tsakotos, Theodore Troupis","doi":"10.5644/ama2006-124.501","DOIUrl":"10.5644/ama2006-124.501","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to summarize the Henle trunk configurations and tributary patterns presented in cadaveric, intraoperative, and imaging studies.</p><p><strong>Background: </strong>The Henle gastrocolic trunk is a highly variable venous structure formed by the confluence of the gastric, colic, and pancreatic veins. It has notable surgical importance, particularly during laparoscopic procedures, such as right colectomy and pancreaticoduodenectomy.</p><p><strong>Methods: </strong>A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted using the PubMed/MEDLINE and Google Scholar databases.</p><p><strong>Discussion: </strong>Twenty-one publications comprising 2,454 cases were analyzed to classify Henle trunk configurations and tributary patterns. The trunk was identified in 92.5% of the cases, with the gastropancreatocolic (GPC) type being the most prevalent (73.1%). A total of 38 unique venous confluences were recorded, highlighting the considerable anatomical complexity and variability of the trunk. The Henle gastrocolic trunk is a common anatomical structure with significant heterogeneity in its venous configurations. The GPC type, most frequently formed by the confluence of the right gastroepiploic vein, the anterior superior pancreaticoduodenal vein, and either the right colic vein or the superior right colic vein, predominates across cadaveric, intraoperative, and imaging studies. Understanding this variability is crucial for ensuring safe dissection during pancreatic and colorectal resections.</p><p><strong>Conclusion: </strong>Comprehensive knowledge of the Henle trunk anatomy and its variations enhances operative planning, minimizes the risk of vascular injury, and supports safer and more efficient minimally invasive abdominal surgery.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"60-71"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Cadaveric Case Report of the Median Nerve Passing Through the Brachialis Muscle.","authors":"Georgios Paraskevas, Christos Lyrtzis, Georgios Trikoilis, Alexia Maistrellis, Maria Piagkou","doi":"10.5644/ama2006-124.503","DOIUrl":"10.5644/ama2006-124.503","url":null,"abstract":"<p><strong>Objective: </strong>To describe a rare cadaveric topographical variation of the median nerve (MN) involving an atypical relationship with the brachialis muscle (BM). Such variations, although uncommon, may complicate surgical procedures, regional anesthesia, and imaging interpretation. This report documents a variation in which the MN traverses the BM without providing motor innervation.</p><p><strong>Case report: </strong>During the routine dissection of the right upper limb of a 75-year-old male donated cadaver, a unilateral (right-sided) topographical variation of the MN was identified. The MN diverged from its usual close association with the brachial artery (BA) and followed a medial and posterior course toward the BM. Within the middle third of the arm, the nerve penetrated a macroscopically distinct bundle of BM fibers, traversed the muscle belly, and exited in its distal third. Distally, the MN resumed a superficial course, re-approached the BA, and continued normally through the cubital fossa. No motor or accessory branches from the MN to the BM were identified during its intramuscular course. The surrounding muscle fibers closely encircled the nerve along its intramuscular segment, indicating a restricted anatomical corridor. The musculocutaneous nerve, BA, and the remaining neurovascular structures followed their typical anatomical pathways.</p><p><strong>Conclusion: </strong>This anatomical configuration may represent a potential anatomical substrate for proximal MN irritation or compression and may clinically resemble pronator teres syndrome. Awareness of such variants is important for clinicians evaluating MN neuropathies and for surgeons, anesthesiologists, and radiologists working in the anterior compartment of the arm.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental Trajectories and Outcomes of Online Child Sexual Abuse: A Systematic Review of Longitudinal Studies.","authors":"Krešimir Prijatelj","doi":"10.5644/ama2006-124.500","DOIUrl":"10.5644/ama2006-124.500","url":null,"abstract":"<p><strong>Background: </strong>OCSA includes adult grooming or solicitation and peer electronic sexual coercion. Due to its negative consequences, it has become a public mental health concern. While prevalence is well established, the developmental timing of onset, predictors, and outcomes can only be clarified through longitudinal studies.</p><p><strong>Objective: </strong>This review synthesizes longitudinal evidence on online child sexual abuse (OCSA) in minors, with an emphasis on developmental timing, prospective risk and protective factors, and downstream outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted according to the PRISMA 2020 guidelines. Eligible studies enrolled participants under 18 years of age at baseline, used a longitudinal design, and examined OCSA. Twelve studies were identified through database searches (2000-2025) and citation chasing, all of which were published from 2013 onwards.</p><p><strong>Discussion: </strong>The narrative synthesis identified that the risk for OCSA was concentrated in mid-adolescence. Peer electronic coercion rose through early-mid adolescence and plateaued around the age of 16-17. The cumulative onset reached approximately one in three by age 18. The predictors included depressive symptoms, maltreatment, adverse childhood experiences, and risky digital behaviors. Protective parental monitoring buffered escalation, especially in early adolescence. In terms of consequences, adult solicitation predicted poorer quality of life and emotional distress, whereas peer coercion increased depression and delinquency. Bidirectional feedback loops emerged between adolescent sexting and adult solicitation. A school-based trial demonstrated that even brief prevention efforts can reduce the risk of OCSA.</p><p><strong>Conclusion: </strong>Longitudinal evidence suggests that OCSA follows an age-graded developmental pattern and is associated with potentially modifiable risk and protective factors. Prevention should focus on mid-adolescent hazard windows, minority-sensitive support, family-based monitoring, and digital safety education. The proposed Developmental-Online-Trajectories of Sexual abuse (DOTS) framework integrates these findings to guide future research, practice, and prevention.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"92-109"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Cytology and Age in HPV-Infected Women in North Macedonia: A Cross-Sectional Study.","authors":"Vjollca Shabani, Mije Reçi, Vesna Veselievska Stojkovska","doi":"10.5644/ama2006-124.498","DOIUrl":"10.5644/ama2006-124.498","url":null,"abstract":"<p><strong>Objective: </strong>HPV infection is a key etiological factor in cervical epithelial alterations and neoplasia. Its prevalence and cytological impact vary with age, co-infections, and screening practices. This study investigated the association between HPV infection, age, and cervical cytological findings in women from North Macedonia.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 300 women aged 26-66 years, who were screened over a 13-month period (June 2023-July 2024). The participants were divided into two age groups (26-36 and 37-66 years). All participants underwent Pap testing, HPV screening, and microbiological evaluation. Ordinal regression analysis was used to examine the associations between age, microbial factors, and HPV positivity.</p><p><strong>Results: </strong>HPV prevalence was higher in the 37-66 group (12.33%) than in the 26-36 group (6.0%). However, younger age showed a stronger statistical association with HPV positivity (OR=2.10; P<0.1). Cytological abnormalities, particularly LSIL/CIN I, were more prevalent in HPV-positive participants. The use of conventional Pap smears was associated with lower HPV detection (OR=0.16; P<0.05). Co-infection with Candida spp. and atrophic inflammation were inversely associated with HPV positivity.</p><p><strong>Conclusion: </strong>This study confirmed the association between HPV infection and cytological changes, particularly in younger age groups. These results highlight the importance of age-tailored screening approaches and support the continued use of conventional Pap smears as cost-effective tools. Integrating virological and microbiological assessments may further refine cervical cancer prevention strategies, particularly in transitional healthcare systems across the Western Balkans.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}