Author: zmc_piksel_dev

“As one of the members of the European Federation of Critical Care Nursing Associations, we regularly take part in meetings that are held, in order to keep up to date with the novelties in the nursing care or the changes in the standards of care in Europe and beyond”, says Zaneta Bogoevska Miteva, the nurse in-charge of the hospital section of Zan Mitrev Clinic, and also a representative of the Critical Care Nurses Association.

She clarifies that these are meetings of the member states’ representatives of the Federation, where each country has its own delegates who meet twice a year to exchange information, create new projects in the scientific and research activity, with the main purpose that all these member states are involved and contribute to these trends and to follow and implement the positive changes and experiences that, with the help of these scientific projects, influence the change of the guidelines and standards for nursing care.

Among the activities we would like to mention the following:

 

• MICU – Multiculturalism of Intensive Care, a project sponsored by ERASMUS Plus and successfully supported by the European Federation. This project will soon result in an e-course for nurses.
• DecubICUs – a project involving intensive care with over 11 000 patients. Our intensive care was among the participants and this project will contribute to changing or confirming the standards for the prevention and treatment of decubicus of the intensive care.
• One of the activities of this federation is the organization of congresses. At the eighth congress, organized by the federation, our representative – Nurse Zhaneta Bogoevska Miteva – is going to present two abstracts: the first one with the topic “How we at Zan Mitrev Clinic educate our nurses at the school we have organized and the second one is about The quality and specifications of the diet of our patients.

These are the abstracts I am going to present at the congress that is to be held in February next year – says Bogoevska Miteva.

All of our activities contribute to the improvement of quality and care so that we are able to  follow the European trends. As part of the scientific and research activity together with everyone else, we participate and act on positive changes in the improvement of the standards in these areas.

From the experience so far, we can establish that our experiences are welcomed and highly appreciated and they are accepted as well, due to the high ranking of the clinic because of the positive experience of our patients, thanks to which we established ourselves as an equal and valued associate.

 

 

Five years ago, the health conditionof the young architect from Moscow, Alexei Shestak, deteriorated in a very short period of time. With ahigh fever and almost unconscious he was taken to one of the hospitals in Moscow, where he was held for ten days without improvement of his condition.

– I had high fever continuously for 10 I had problems with the heart, but despite the persistence of the doctors there, I was not precisely diagnosed with any disease for all the time I was held in the hospital. It was obvious that I had to seek salvation elsewhere. I contacted Dr. Arthur Dormitor who, luckily for me, collaborated with Dr. Zan Mitrev for a long time, and he immediately recommended me here. Urgently by a plane, I was sent to the then hospital of Dr. Zan Mitrev, within the Military Hospital in Skopje. Almost without being aware of what happened to me I was fighting for my life – this is how our patient from Russian starts his life story, who is at our clinic again after 5 years, but now only for a control ecxamination initiated precisely by Dr. Zan Mitrev

Alexey Shestak stayed in our clinic for two months, a time during which an early sepsis and bacterial endocarditiswas diagnosed to him, since the very beginning. Our doctors immediately started fighting the infection so that they are further able to perform the aortic valve operation that was necessary. But it was not that simple at all. The infection was so strong that it could not be eradicated in a short time, so it was decided to perform the operation of the valvein conditions of an infectious syndrome. By this act, Alexei Shestak became the first patient this operation was performed to, under such conditions – with an infectious syndrome. The replacement of the aortic valve was successful and the fight with the infection continued. The top medical care and constant monitoring at every moment under the watchful eye of our doctors resulted Alexei being able to leave homein two months.

– I was nearly unconscious ofwhat happened to methose two months. Then I learned that a new method of haemofiltration was performed on me,for the first time, a method that was subsequently used successfully in other patients, too, which I am very glad for. I thank endlessly Dr. Zan Mitrev and the entire team that saved my life 5 years ago and enabled me to continue to live normally. I also do sports and I do not have any restrictions. Now, after 5 years, I see the new hospital and I am fascinated with the progress. I can say that we do not have such a hospital in Moscow, and that all of you should be grateful for having this kind of health facility in your country – said Alexey happily.

After sightseeing in Skopje and several places throughout the country, he leaves home, continuing his life. We wish success and happiness.

The team of interventional cardiologists at Zan Mitrev Clinic for the first time in the country performed an ablation in a child, namely, ablation of the accessory path in the right-posteroseptal region.

It is a matter of an eight year old child who has had a problem with tachycardia (accelerated heartbeat) for a longer period of time. The intervention ended successfully, whereupon soon the child will be discharged home, together with his parents. The members of the team that performed this intervention said that the patient’s safety was first, and a lot of attention was dedicated to it, as well as to the positive final outcome.

The parents contacted us and asked for help for this small child who suffered of tachycardia. We admitted him and today with three teams of anesthesiologists, cardiologists and electrophysiologists, we performed an electrophysiological study. One cardia is provoked where the impulse travels along the normal path and returns along the accessory path along the right posteroseptal region and here we interrupted that impulse. The result is a successful ablation of the accessory path in the right posteroseptal region. The child had tachycardia, and also circulation of the impulse between the atrium, the ventricle and the accessory path, and we interrupt only one part of the path, thus only the tachycardia is interrupted. We interrupt the path that leaves no consequences, and it is this accessory route. In this way we solve this problem. Because it is a matter of a child, this means that a specific anesthetic is required, therefore smaller and thinner material should be used, which we have and we use in Zan Mitrev Clinic – explained the team members of our clinic.

“A friend of mine, born in Macedonia, recommended your hospital”, Yuan Shi started the story with these words. She is the daughter of our patient Huazhu Shi, who came from Beijing, China. He was operated by Dr. Zan Mitrev, the surgery included valve replacement and implantation of two coronary bypasses.

“After my father started to feel heart difficulties, we decided to come to ZAN MITREV CLINIC in Macedonia because there are many patients in China and there is a lack of good surgeons, so you have to wait very long for a surgery term. Moreover, the services in Chinese hospitals are not like the services in this clinic, and if my father was supposed to stay there, at least two relatives would have to take care of him during his stay. We had little time, and we did not have the energy to search for good doctors in our country, so I accepted the recommendation to come here, because I was looking for a good service and modern technology” – she pointed out.

Ms. Yuan is impressed by the look of the hospital and the hospitality of the medical staff.

“Quality medical service makes me particularly happy because my father was not able to receive food, and the doctors and nurses did everything to help us. We very much appreciate that professional attitude”, stated the guest from Beijing.

She said that such a VIP apartment, like the one in Zan Mitrev Clinic, is difficult to find in China, even if you are a significant political person, and especially if you are ordinary people, because there is a lack of facilities there, so she is especially surprised by the convenience and the overall atmosphere which have exceeded her expectations.

“The professionalism of Dr. Zan Mitrev made me very happy and gave me confidence about the surgery, which went well and my father recovered very quickly”, concluded Mr. Huazhu’s daughter and she thanked for the superior service of the entire surgical team.

Mr. Huazhu Shi recovered and few days after the surgery and before he left, he met Dr. Zan Mitrev who once again wished him good health. The Shi family went to a several-day vacation in Ohrid in order to continue the rehabilitation and to spend some time sightseeing the tourist attractions of our country.

Anton Moritz, former director of the University Cardiovascular Center Frankfurt, Germany

You frequently visit our country and our clinic, what are the impressions of those visits?

A.M. – So far, I have been in Macedonia several times. As early as 1979, with my wife, we decided to return from camping through Greece and then Ohrid. After the opening of the hospital in 2000, I was invited to visit the former Military Hospital. On the occasion of the gathering of the Macedonian Society for Cardiology and Cardiac Surgery, we were in Ohrid and we held lectures, and then we visited many interesting sights on the return to Skopje. At the 18^th anniversary of the existence of Zan Mitrev Clinic in 2018, I was invited to the ceremony, also as an expert lecturer, and a special moment was the reception by the President of the Republic of Macedonia.

What is your assessment of the situation primarily in cardiac surgery in regard to the development and application of new methods?

A.M. – Diagnostics and surgical treatment as well as further treatment are on the same level as in the other European centers. The building is nicely furnished and equipped with modern medical equipment. Dr. Zan Mitrev took care of the further development of surgical techniques, many of the procedures were awarded international acknowledgements at professional congresses. The clinic provides very good medical care to patients. In certain areas, diagnostics and therapy are at the highest and the most innovative level. For a clinic, which is not directly a part of a university clinic, the scientific activities are excellent.

You have stated: “Cardiac surgery is a new branch, many things have changed, there are new possibilities”, what are these possibilities and what do they refer to?

A.M. – Considering that cardiac surgery to a significant extent has existed since the mid-70s, one can say that the development so far is remarkable. There has been a significant increase in the average age of the patient. At the beginning of the eighties, there were lectures on whether cardiosurgery is possible in patients older than 70 years of age, while today the average age of treated patients exceeds the age of 70 years. New techniques, implants, the extracorporeal circulation machine, and the improvement of intensive care have created the possibility of treating complex heart diseases in adult patients, by limiting multiple organ systems.

Nowadays operating methods offer treatment options in severely sick patients without opening the chest and without the use of an extracorporeal circulation machine, which besides the described improvements, and in today’s conditions still pose too much risk for conventional cardiac surgeries.

As a director of the University Cardiovascular Center in Frankfurt, Germany, can you compare what is happening to us and generally in the Balkans when it comes to cardiac surgery?

A.M. – For 22 years I managed the Clinic for Thoracic and Cardiovascular Surgery at the University Clinic in Frankfurt. I retired after this position. For that reason, I had to dedicate more time to the support of the departments that were run or formed by my former associates and students.

Since I do not know other centers in the Balkans except Zan Mitrev Clinic, I would not like to make a general comparison in this area. But undoubtedly, many clinics in the wider region do not dispose of such equipment, expertise, organization and quality control, as they do in Zan Mitrev Clinic. In terms of equipment, this clinic is by no means lagging in comparison with the standard I have experienced in Germany. As an institution focused on patient care, the processes are organized impressively and the institution has experienced specialists.

 

“I am impressed by your hospital”, said Dr. Gianluca Pontone during a visit to Zan Mitrev Clinic. As a cardiologist and radiologist, he runs the MR Department and he is the Deputy Director of the Cardiovascular CT Department at the Cardiology Center Monzino (Centro Cardiologico Monzino), Italy, which is associated with Milan and the University of Milan. Dr. Pontone came as a lecturer at the Symposium on Acute Coronary Syndrome, organized by the Macedonian Association of Cardiology, which was held on September 4 and 5, 2018, in Skopje.

“I am glad that I have the opportunity to participate in the Symposium in Skopje and that I can visit this hospital, which is very impressive both in terms of size and technology. It is a great honor for me to be here, considering that I am a specialist in cardiac diseases and that the main activity in this hospital is specifically the treatment of this type of diseases”, stated Dr. Pontone after the tour in Zan Mitrev Hospital.

Previously he did not have any information about our hospital, therefore he pointed out that he was very surprised by the high standard and all the possibilities that he managed to see here. Comparing the conditions with the hospitals in Italy, Dr. Pontone underlined that a parallel cannot be made with the average Italian hospitals, but only with the best ones because it is obvious that it is a matter of a modern medical center with an advanced technology.

The meetings with Dr. Zan Mitrev were also attended by Anton Moritz, a Director of the University Cardiovascular Center in Frankfurt, Germany. Experiences and future directions for the development of modern radiology and cardiology were exchanged at the meetings, where a part of the team of Zan Mitrev Clinic also took part.