Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)最新文献

{"title":"Assessment of the Level of Middle Colic Artery Ligation Influence on Survival in Right-Sided Colon Cancer.","authors":"Cemal Ulusoy, Mehmet Güray Duman, Andrej Nikolovski","doi":"10.2478/prilozi-2025-0012","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0012","url":null,"abstract":"<p><p><b>Aim</b>: This study aims to investigate whether the addition of ligation of the Middle Colic Artery in its origin to Complete Mesocolic Excision (CME) with Central Vascular Ligation (CVL) affects overall survival and lymph node retrieval. <b>Method</b>: Patients with right-sided colon cancer who underwent curative right or extended right hemicolectomy with CME and CVL were included. In cases with tumors located in the distal part of the ascending colon and the hepatic flexure, the middle colic artery was ligated in its origin. For the cecal and proximal localization of the tumor, the point of ligation was decided on the surgeons' decision. <b>Results</b>: A total number of 169 patients were operated. In 78 patients the tumor was localized in the caecum, in 70 patients in the ascending colon, and 21 in the hepatic flexure. In 59 patients, the middle colic artery was ligated in its origin. Different artery ligation sites according to tumor localization subgroup presented with statistical significance (P = 0.004). The mean number of harvested lymph nodes between the groups was presented with a difference (33.4 vs. 28.5; P = 0.037). Survival rates for cecal, ascending, and hepatic flexure cancer were as follows: 61.5%, 67.1%, and 85.7%, respectively (P = 0.22). The survival rate for all patients was 66.9% (69.5% for patients with middle colic artery ligation and 65.5% for the right branch of middle colic artery ligation, P = 0.42). <b>Conclusion</b>: Ligation of the middle colic artery in its origin did not improve overall survival. However, it resulted in a significantly higher number of harvested lymph nodes.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"39-48"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568191","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":"Lymphocyte Subsets Changes in Children with Acute Lymphoblastic Leukemia during Chemotherapy.","authors":"Arijeta Hasani, Aleksandar Petlickovski, Irina Panovska, Teodora Brnjarcevska, Nevenka Ridova, Svetlana Kocheva","doi":"10.2478/prilozi-2025-0013","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0013","url":null,"abstract":"<p><p><b>Background</b>: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, with chemotherapy significantly impacting immune cell populations. This study evaluates changes in lymphocyte subsets in children with ALL during treatment. <b>Methods</b>: A retrospective-prospective study analyzed 17 pediatric patients (aged 2-12 years) treated at the University Clinic for Children's Disease- Skopje following the BFM ALL-IC 2002 protocol. Lymphocyte subsets (CD3, CD4, CD19, CD45) were assessed before chemotherapy, after induction, and after reinduction using flow cytometry. <b>Results</b>: Children with ALL exhibited reduced cellular immunity at the end of therapy. Lymphocyte depletion was observed in all patients following the induction phase. A statistically significant difference in CD19+ cell values across the three time points was confirmed (p=0.017). Post-hoc analysis revealed significantly lower CD19+ cell values after induction compared to baseline (1.22 vs. 15.3, p=0.008) and significantly lower values at the end of therapy compared to pre-therapy levels (2.5 vs. 15.3, p=0.021). <b>Conclusion</b>: Intensive chemotherapy induces profound immunosuppression in pediatric ALL patients, primarily affecting B cells. These findings highlight the necessity for immune function assessment and consideration of supportive immunotherapy.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"49-56"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568197","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":"Cystatin C Versus Urea and Creatinine in Early Detection of Acute Kidney Injury after Laparoscopic Prostatectomy.","authors":"Natka Petrova Chemerski, Aleksandra Gavrilovska-Brzanov, Aleksandra Panovska Petrusheva, Bashkim Shabani, Andrijan Kartalov, Biljana Kuzmanovska, Marija Jovanovski Srceva, Jasmina Pluncevic Glogoroska","doi":"10.2478/prilozi-2025-0014","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0014","url":null,"abstract":"<p><p><b>Introduction</b>: Acute kidney injury (AKI) is a potentially serious complication subsequent to laparoscopic radical prostatectomy (LRP). Serum creatinine, the prevailing standard biomarker, has demonstrated inadequacy for the early identification of AKI due to its delayed elevation in the initial stages. There is a necessity for innovative biomarkers that facilitate early detection and prompt intervention, hence enhancing patient outcomes. <b>Objectives</b>: To assess and compare the values of biochemical markers of renal function (serum urea, creatinine, and cystatin C) in the preoperative and postoperative periods in patients undergoing LRP. <b>Materials and Methods</b>: This prospective, comparative study included 30 patients who underwent LRP. The investigated serum parameters-urea, creatinine, and cystatin C-were assessed at three time points: preoperatively (T1), immediately after LRP (T2), and 12 hours after the start of LRP (T3). <b>Results</b>: All patients exhibited normal preoperative biochemical indicators of renal function. Postoperatively, AKI was identified in three patients. Out of a total of 30 patients who underwent LRP, only three patients (10%) met the criteria for AKI diagnosis. One patient (3%) developed AKI based on increased serum creatinine levels, while three patients (6%), including the one who met the creatinine-based criteria, were diagnosed with AKI based on elevated serum cystatin C levels. Serum cystatin C levels were significantly elevated in patients with AKI at T2 and remained elevated at T3 in comparison to T1. <b>Conclusion</b>: The results indicate that serum cystatin C has greater sensitivity for identifying AKI than serum urea and creatinine in the initial 12 hours post- LRP.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568193","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":"Various Cases of Venous Thrombembolism.","authors":"Ivica Bojovski, Emilija Lazarova Trajkovska, Dimitar Galachev, Simona Jovchevska, Ivona Bogevska Naumovska, Tomislav Konjanovski, Elif Vrajnko, Vegim Zhaku, Ile Kuzmanoski, Miroslav Boskovski, Irena Bede, Bekim Pocesta, Marijan Bosevski, Enes Shehu, Robert Nikolovski, Natasha Skrcheska, Mario Jovanoski, Valentina Andova, Irena Mitevska","doi":"10.2478/prilozi-2025-0009","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0009","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) with its two forms: deep vein thrombosis (DVT) and pulmonary embolism (PE) occurs due to interacting genetic and environmental risk factors. The strongest risk factors are major surgery, major trauma and malignancies. Over the last decade many new risk factors for venous thrombosis have been identified. Even risk factors, clinical signs, symptoms and diagnostic methods of venous thromboembolism (VTE) are well known, there are still uncommon scenarios for this disease. This paper includes eight case reports of venous thromboembolism with different etiologies. Ongoing studies in this field are focused on improving diagnostic strategies for suspected venous thrombosis, comparing different direct oral anticoagulants (DOACs), developing safer anticoagulants, and further individualizing approaches for the prevention and management of VTE.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568200","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":"The Role of Erector Spinae Block in Urological Surgeries as a Promising Alternative to Conventional Analgesia: A Prospective Observational Study.","authors":"Aleksandra Gavrilovska-Brzanov, Marija Jovanovski-Srceva, Nikola Brzanov, Aleksandra Panovska Petrusheva, Ognen Ivanovski, Aleksandar Trifunovski, Viktor Stankov, Martina Ambardjieva, Marjana Burmuzoska, Tijana Nastasovic, Biljana Kuzamanovska","doi":"10.2478/prilozi-2025-0010","DOIUrl":"10.2478/prilozi-2025-0010","url":null,"abstract":"<p><p><b>Introduction</b>: The erector spinae plane block (ESPB) is a regional anesthesia technique that provides somatic and visceral analgesia by targeting the dorsal and ventral rami of the spinal nerves. It is performed under ultrasound guidance. ESPB is particularly beneficial in urological surgeries, which often require multimodal analgesia due to complex pain management needs and patient comorbidities. However, its efficacy in urological procedures remains insufficiently studied. Therefore, our aim was to assess the effectiveness and advantages of ESPB in urological procedures. <b>Material and Methods</b>: This prospective observational study was conducted at a tertiary referral hospital. The study included all consecutive patients scheduled for urological surgery, classical approach, or laparoscopic surgery under general anesthesia. Patients were ASA I-III, aged ≥18 years. Exclusion criteria included coagulopathy, infection at the injection site, allergy to local anesthetics, and chronic opioid therapy. ESPB was performed under ultrasound guidance, and a 20G echogenic needle was used to administer 20-30 mL of 0.5% bupivacaine at the Th8-L2 vertebrae level, depending on surgical requirements. The primary outcome, postoperative pain, was measured using a visual analog scale at 2, 6, 12, and 24 hours. The incidence of postoperative nausea and vomiting (PONV), the total amount of opioids consumed in a 24-hour period, and intraoperative hemodynamic stability were the secondary outcomes. IV fentanyl and paracetamol were used for postoperative analgesia, and metoclopramide was used to control nausea. <b>Results</b>: Fifty patients (42 males, 8 females, mean age 66±9.8 years) were analyzed. The majority were ASA II (44%) and ASA III (50%). Open surgeries were performed on 21 patients, while 19 underwent laparoscopic procedures. Primary Outcome: Pain scores (VAS) at 6h, 12h, and 24h were significantly lower in laparoscopic groups compared to open surgeries (p<0.05). Secondary Outcomes: Only three patients (6%) from the open classical approach surgery required rescue opioids. PONV occurred in two patients (4%): one from the open and the other from the laparoscopic approach surgery. Intraoperative hemodynamics remained stable, with no significant fluctuations in MAP or HR. <b>Conclusion</b>: ESPB provided effective analgesia, reduced opioid consumption, and maintained hemodynamic stability in urological surgeries, supporting its role in multimodal pain management strategies.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568199","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":"Impact of the Covid-19 Pandemic on Childhood Obesity in North Macedonia: A Comparative Study.","authors":"Аrjeta Raufi, Danijela Vojtikiv Samoilovska, Naser Durmishi","doi":"10.2478/prilozi-2025-0015","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0015","url":null,"abstract":"<p><p>Childhood obesity is an escalating global health concern, with North Macedonia ranking among the top 10 European countries with a high prevalence of overweight and obesity. This study aimed to assess the impact of the COVID-19 pandemic on children's Body Mass Index (BMI) by comparing data collected before and after the pandemic. A prospective cross-sectional study was conducted between February and April 2022, involving 1,004 children (ages 6-13) from the northwestern region of North Macedonia. These findings were compared with retrospective data from 2019, which included 1,034 participants of the same age group. Our results indicate that restrictive measures contributed to an increase in overweight prevalence from 13.5% in 2019 to 15.9% in 2022 and obesity from 19.6% to 21.9%. Overall, the combined prevalence of overweight and obesity rose from 33.0% to 37.4% during this period. The statistical analysis confirmed a significant association between the pandemic and increased childhood obesity rates (Pearson's Chi-Square test: χ² = 13.813, df = 3, p < 0.003). Gender disparities were also observed. In 2019, overweight and obesity were 1.42 times more common in boys than in girls (OR = 1.42; 95% CI: 1.09-1.84). By 2022, this ratio had slightly increased to 1.45 (OR = 1.45; 95% CI: 1.12-1.88). Furthermore, a general decrease in undernutrition was observed in 2022 compared to 2019. A significant reduction in undernutrition was noted among boys aged six (p = 0.008) and overall among boys (p = 0.017). According to the World Obesity Federation (WOF), if no effective prevention and intervention strategies are implemented, North Macedonia could see childhood overweight and obesity rates rise to 52.4% by 2030-meaning that one in two children would be affected. These findings highlight the urgent need for targeted public health initiatives to mitigate the long-term consequences of childhood obesity.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"67-74"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568196","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":"Multistage Hybrid Treatment of Aortic Aneurysm and Management of Postoperative Complications: A Case Report.","authors":"Marjan Shokarovski, Nadica Mehmedovic, Sonja Grazhdani, Elena Grueva, Vasil Papestiev","doi":"10.2478/prilozi-2025-0011","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0011","url":null,"abstract":"<p><p>The Frozen Elephant Trunk (FET) is a surgical procedure developed for simultaneous repair of the aortic arch and the proximal descending thoracic aorta. Experience has shown its technical feasibility and good clinical results, although complications remain possible. <b>Case Presentation</b>: A 66-year-old male presented for evaluation due to findings from computed tomography angiography of aneurysms in the ascending aorta, aortic arch, and abdominal aorta. The patient had a history of a quadruple coronary artery bypass graft (CABG) and placement of two stents in the descending thoracic aorta, which were improperly aligned, thrombosed, and further complicated the case. The patient underwent surgery involving sternotomy to perform the FET procedure, replacing the ascending aorta and aortic arch and placing a stent graft in the proximal descending thoracic aorta. Simultaneously, two coronary artery bypass grafts were performed. Postoperatively, the patient was stable, and the intervention outcome was satisfactory. Subsequently, endovascular treatment was carried out on the remaining thoracic aorta and abdominal blood vessels. However, respiratory failure necessitated the placement of stent grafts in the left main bronchus on two occasions. Despite extensive efforts, the patient succumbed to respiratory insufficiency. <b>Conclusion</b>: Timely intervention and a multidisciplinary approach played a key role in addressing complications, although the patient ultimately experienced a fatal outcome due to multiorgan failure.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568198","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":"Antidepressant Therapy and Depression Disorder.","authors":"Aneta Spasovska Trajanovska, Zanina Pereska, Zora Mitic","doi":"10.2478/prilozi-2025-0016","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0016","url":null,"abstract":"<p><p><b>Introduction</b>: Treatment-resistant depression represents a serious clinical problem and a significant public health challenge. Research highlights the importance of combining selective serotonin reuptake inhibitors (SSRIs) with antidepressants that act as antagonists of presynaptic α2-autoreceptors and α2-heteroreceptors, such as Mianserin, Trazodone, and Mirtazapine. <b>Aim</b>: to evaluate the effectiveness of combined therapy using Mirtazapine (α2-autoreceptor antagonist) and Sertraline (serotonin reuptake inhibitor) in treating depression. <b>Materials and Methods</b>: This prospective study included 30 patients of both sexes, aged between 21 and 39 years, diagnosed with depressive disorder (F32). Patients were evaluated at the private psychiatric institution \"Dr. Zora Mitic\" over a period of three months. Participants were assessed at baseline and after one and three months of treatment with combined antidepressant therapy consisting of Mirtazapine (15-30 mg/day) and Sertraline (50-100 mg/day). Sociodemographic characteristics (age, sex, marital status, education level, and employment) were collected using a specifically designed questionnaire. Depressive symptoms were evaluated using the Hamilton Depression Rating Scale (HDRS), and sexual dysfunction was assessed using the Sexual Dysfunction Scale. <b>Results</b>: A Wilcoxon signed-rank test indicated a statistically significant decrease in Hamilton Rating Scale (HRS) scores after one month (Z = -4.717, P ≤ 0.001) and three months (Z = -4.787, P ≤ 0.001) of treatment compared to pre-treatment scores. Additionally, the difference in HRS scores between one-month and three-month treatment periods was also significant (Z = -4.717, P ≤ 0.001). <b>Conclusion</b>: The results of our study demonstrate that initiating combined antidepressant therapy at the outset of treatment is highly effective.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"75-81"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568190","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":"Dental Specializations and Sub-Specializations in North Macedonia: Then and Now.","authors":"Vlatko Kokolanski, Kjiro Ivanovski, Julijana Nikolovska, Maja Milosevic Markovic, Spiro Spasovski, Bojan Poposki, Marija Andonovska","doi":"10.2478/prilozi-2025-0017","DOIUrl":"10.2478/prilozi-2025-0017","url":null,"abstract":"<p><p>Тhe development of dental specialization in the Republic of North Macedonia has evolved over the last few decades, beginning with a limited scope of specializations and progressing to a more diverse range of disciplines in recent years. Initially, the focus was on jaw orthopedics with prosthetics and maxillofacial surgery, but with the introduction of new regulations and reforms in the legal and educational framework, additional specializations emerged, including endodontics, periodontics, and pediatric dentistry. The privatization of dental services and the modernization of the legal system in recent decades have led to a significant increase in the number of specialists, with oral surgery, orthodontics, and dental prosthetics being the most frequently chosen fields. This paper provides a comprehensive analysis of the development of dental specialization in Republic of North Macedonia, comparing it to international experience, particularly those in European Union countries. The study aims to assess the current status of the dental specialization workforce and to explore the ongoing challenges and opportunities in aligning training with evolving healthcare needs.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"83-94"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568194","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":"Children also Suffer and Feel Pain as Adults.","authors":"Nada Pop-Jordanova","doi":"10.2478/prilozi-2025-0008","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0008","url":null,"abstract":"<p><p>Pain and suffering are the most misunderstood, under diagnosed, and under treated/untreated medical problems, particularly in children. Therefore one of the most challenging roles of medical providers serving children is to appropriately assess and treat their pain. Pain is truly both a physical and an emotional experience perceived and processed by the brain, and it is a real health problem as well. Experienced pain is influenced by biological, psychological and social factors. Pain assessment in children is particularly challenging due to the wide variation in physiological responses, communication abilities and developmental stages of this group of patients. Assessment of pain in children is linked to their level of development. Children of the same age vary widely in their perception and tolerance of pain. Children are particularly responsive to pain-controlling strategies that involve their imaginations and senses of play.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 2","pages":"5-14"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568192","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}