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

{"title":"Irreversible Acute Kidney Injury after Heart Transplantation-Cardiorenal Syndrome Type 1.","authors":"Katerina Ristoska, Ninoslav Ivanovski, Fljamure Zeqiri-Keka, Ilina Hamamdzieva, Biljana Gerasimovska-Kitanovska, Ognen Ivanovski, Zivko Popov","doi":"10.2478/prilozi-2026-0008","DOIUrl":"https://doi.org/10.2478/prilozi-2026-0008","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"47 1","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492348","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":"Quality of Recovery after Open Gynecological Surgery.","authors":"Goran Mitreski, Nevenka Laban Guceva, Valentina Mitreska","doi":"10.2478/prilozi-2026-0012","DOIUrl":"https://doi.org/10.2478/prilozi-2026-0012","url":null,"abstract":"<p><p><b>Introduction</b>: 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. <b>Objective</b>: 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. <b>Patients and Methods</b>: 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. <b>Results and conclusion</b>: 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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"47 1","pages":"111-122"},"PeriodicalIF":0.0,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491632","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":"Effect of Insulin Sensitizers on Glycemic and Lipid Profile in Patients with Polycystic Ovary Syndrome (PCOS).","authors":"Aleksandra Stevchevska, Tatjana Milenkovic","doi":"10.2478/prilozi-2025-0022","DOIUrl":"10.2478/prilozi-2025-0022","url":null,"abstract":"<p><p><b>Introduction</b>: 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. <b>Objectives</b>: To evaluate the impact of Metformin and Myoinositol therapy on glycemic and lipid profiles in PCOS patients, based on body mass index (BMI). <b>Methods</b>: 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. <b>Results</b>: 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). <b>Conclusion</b>: 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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"51-62"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710300","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":"Radial Extracorporeal Shock Wave Therapy Decreases Hand Spasticity After Stroke.","authors":"Cvetanka Gjerakaroska Savevska, Erieta Nikolikj Dimitrova, Valentina Koevska, Biljana Mitrevska, Marija Gocevska, Biljana Kalcovska, Maja Manoleva, Daniela Gecevska","doi":"10.2478/prilozi-2025-0024","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0024","url":null,"abstract":"<p><p><b>Introduction</b>: Hand spasticity after a stroke reduces residual hand functions and decreases independence in everyday activities. It is a cause of pain, discomfort and one of the biggest obstacles encountered during the rehabilitation of patients with stroke consequences. Radial extracorporeal shock wave therapy (RESWT) is an enticing non-invasive treatment option for this medical problem. <b>Objectives</b>: The main goal of this clinical study was to evaluate the effects of RESWT in the treatment of hand spasticity after a stroke. <b>Material and methods</b>: This prospective controlled clinical study included 90 patients with post-stroke hand spasticity. At the beginning of the study, patients who met the inclusion criteria were divided into two groups: an examined group (EG) that received RESWT and a standard rehabilitation and a control group (CG) that received only a standard rehabilitation. In order to evaluate the efficiency of the treatment, the following clinical scales were used: Modified Ashworth Scale (MAS) and Disability Assessment Scale (DAS). Clinical findings were evaluated at the same time points in both groups of patients: before the start of the rehabilitation, immediately at the end of the 2nd, 6th and 14th week after the start of the rehabilitation (i.e., for the EG before the application of RESWT, immediately after the completion of RESWT, and at one and three months after the completion of RESWT). <b>Results</b>: The results indicated a significantly lower MAS score in the EG.DAS results from the analysis of all domains (hygiene, dressing, hand position, pain) indicated a significant decrease in disability in the EG compared to the CG by more than one average score in all control time measurement points. <b>Conclusions</b>: RESWT significantly reduced hand and fingers spasticity at the 2nd, 6th and 14th week following the start of the rehabilitation for more than one average MAS score (p<0.05). RESWT contributed to a significant decrease in disability of hygiene maintenance, dressing, hand position, and pain after the 2nd, 6th and 14th week of the start of the rehabilitation of post-stroke hand spasticity (p<0.05). No side effects were observed during and after application of RESWT. It is a safe, non-invasive therapeutic modality for hand spasticity after stroke.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"73-82"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710390","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":"Venous Malformations in Pediatric Patients: Clinical Manifestations, Diagnostic Methods, and Treatment Strategies.","authors":"Shaban Memeti, Marijan Kamiloski, Roza Sokolova, Haris Sulejmani, Njomza Ljumani Bakiu, Violeta Zahovska, Gani Ceku","doi":"10.2478/prilozi-2025-0021","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0021","url":null,"abstract":"<p><p><b>Introduction</b>: 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. <b>Materials and methods</b>: 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. <b>Results</b>: 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. <b>Conclusion</b>: 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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"43-50"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710398","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":"Pyridoxine-Dependent Epilepsy in Newborn - A Rare and Challenging Diagnosis.","authors":"Matej Pal, Aneta Soltirovska-Šalamon","doi":"10.2478/prilozi-2025-0027","DOIUrl":"10.2478/prilozi-2025-0027","url":null,"abstract":"<p><p>Pyridoxine-dependent epilepsy (PDE) is a developmental, epileptic encephalopathy historically characterized by seizures that are resistant to the standard anti-seizure medications. The administration of pharmacological doses of pyridoxine (vitamin B6) often results in a dramatic clinical response, with many patients achieving complete seizure remission. However, a significant delay between seizure onset, diagnosis of PDE due to ALDH7A1 mutations, and the initiation of pyridoxine therapy is common. Such delays can lead to prolonged periods of poorly controlled seizures and, in rare instances, may result in mortality. Even when seizure control is eventually achieved, the majority of patients exhibit intellectual or developmental impairments. In this report, we describe a case of pyridoxine-responsive neonatal seizures in a newborn who initially responded to conventional anti-seizure medications but subsequently experienced a relapse characterized by recurrent seizures, ultimately leading to a diagnosis of PDE. The whole exome sequencing identified a homozygous mutation, c.328C>T (p.Arg110Ter), in exon 4 of the ALDH7A1 gene, confirming the diagnosis. Given the established association between the early diagnosis and treatment of PDE and the improved neurological outcomes, we emphasize the critical importance of the timely recognition and initiation of pyridoxine therapy in affected neonates, in order to optimize long-term neurodevelopmental outcomes.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"105-112"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710437","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":"Not Just Numbers: Exploring the Inner Landscape of Youth Anxiety and Stress.","authors":"Haris Sulejmani, Nada Pop-Jordanova","doi":"10.2478/prilozi-2025-0020","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0020","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"27-42"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710374","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":"Factors Affecting the Occurrence of Hypoxemia During One-Lung Ventilation.","authors":"Marija Jovanovski-Srceva, Anita Kokareva, Aleksandra Brzanov-Gavrilovska","doi":"10.2478/prilozi-2025-0028","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0028","url":null,"abstract":"<p><p><b>Introduction</b>: 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. <b>Materials and Methods</b>: 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. <b>Results</b>: 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). <b>Conclusion</b>: 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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"113-120"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710429","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":"Postherpetic Abdominal Pseudohernia Possibly Associated With Myasthenia Gravis: A Case Report.","authors":"Petra Temelkova, Nora Polozhani, Simona Popovski, Marija Dimitrievska-Chuleva, Irena Dimitrovska, Martin Angjelov, Katerina Damevska","doi":"10.2478/prilozi-2025-0029","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0029","url":null,"abstract":"<p><p>Herpes zoster, caused by the reactivation of the varicella-zoster virus, predominantly affects individuals over the age of 65 and those with compromised immune systems. It may result in both sensory and motor neurological complications. Approximately 95% of postherpetic complications are sensory, whereas motor neuropathy involving abdominal muscles is rarely reported, affecting only 0.17% of cases. We present a case of a 74-year-old male diagnosed with postherpetic right abdominal pseudohernia, due to affection of the motor fibers of the spinal nerves. The dermatological examination revealed a characteristic vesicular rash in the Th 9-11 dermatomal distribution, along with a visible abdominal bulge on the right abdominal flank. The coexistence of myasthenia gravis may have predisposed VZV reactivation. It is essential to distinguish this condition from more common causes such as true abdominal hernias that often require surgical intervention. Continued follow-up is crucial to ensure complete resolution and prevent long-term complications.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710455","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":"Use and Adverse Effects of Vacuum-Formed Retainers - Comparison of the Experiences of Orthodontists in Croatia and North Macedonia.","authors":"Biljana Dzipunova, Martina Zigante, Klara Balic, Matea Dzipunova, Stjepan Spalj","doi":"10.2478/prilozi-2025-0023","DOIUrl":"https://doi.org/10.2478/prilozi-2025-0023","url":null,"abstract":"<p><p><b>Objective</b>: To investigate experiences with vacuum-formed retainers (VFR), possible adverse effects and problems associated with their use among Croatian and Macedonian orthodontists. <b>Subjects and Methods</b>: 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%. <b>Results</b>: 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). <b>Conclusion</b>: 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.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"46 3","pages":"63-72"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710411","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}