Faculty of Medicine

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    Exercise-induced bronchoconstriction in female cleaners: effect of smoking
    (Арбилис - София, 2007)
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    Risteska-Kuc, Snezana
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    Stojanovski, Zoran
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    Background. Airborne particles and pollutants, such as dust, tobacco smoke and automobile exhaust, are considered as stimulants that contribute to the development of exercise-induced bronchoconstriction (EIB). Objective. To evaluate prevalence of EIB and its relation to smoking in female cleaners. Methods. We performed a cross-sectional study including 43 female cleaners aged 26 to 57 (mean age 36.9±7.6), with duration of exposure 5 to 24 years (mean duration 11.6±5.5). In addition, 45 female office workers (aged 27 to 58, mean age 38.1±5.7) were studied as a control. Evaluation of exposed and unexposed workers included completion of a questionnaire, skin prick tests to common aeroallergens, spirometry, and constant submaximal exercise challenge test (ECT) on cycle ergometer. Results. We found similar EIB prevalence in both cleaners and office workers (9.3% vs. 6.7%; P=0.276). Bronchial reaction to exercise, expressed as a mean fall index FEV1, was significantly greater in ECT positive cleaners (23.4% vs. 16.1%, P=0.041). EIB was strongly linked to atopy and positive family history for asthma in both groups. EIB was non-significantly associated with daily smoking in office workers (P=0.276), whereas in cleaners that association just missed significance (P=0.074). Association between EIB and daily mean of cigarettes consumed was significant in smoking cleaners (P=0.039), whereas its association with smoking experience was non-significant in both groups. Bronchial reaction to exercise was significantly greater in exposed than in unexposed smokers (9.4% vs. 4.5%; P=0.036). Association of EIB with exand passive smoking was non-significant in both occupation groups. Conclusions. Our data suggest that daily smoking could interact with workplace exposure in development and severity of EIB in female cleaners.
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    Exercise-induced bronchoconstriction and exercise-induced respiratory symptoms in workers exposed to tea dust
    (SCIENDO, 2005-12)
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    Risteska-Kuc, Snezana
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    Assuming that airborne particles and pollutants are important contributing factors in the development of exercise-induced bronchoconstriction (EIB), we performed a case-control study including 63 tea workers (36 men and 27 women, aged 36-55, duration of employment 3-30 years) and an equal number of office workers, matched by sex and age. Exercise-induced respiratory symptoms were recorded in a questionnaire. Skin prick tests, spirometry, as well as exercise and histamine challenge were carried out. Environmental measurements were performed on site during the work shifts. The prevalence of self-reported exercise-induced respiratory symptoms and EIB did not differ significantly between the exposed and control group (41.6% vs 36.8%, and 6.4% vs 4.8%, respectively). In both exposed and control workers, EIB was strongly linked to asthma (P < 0.01). In the exposed workers it was significantly associated with positive family history of asthma (P < 0.01) and positive family history of atopies (P < 0.05), whereas in the exposed smokers it was significantly related to smoking duration (P < 0.05). Bronchial reaction to exercise in the exposed smokers was significantly greater than in control smokers (P < 0.05). Self-reported exercise-induced respiratory symptoms were weakly associated with EIB, with a large proportion of false positive and a low proportion of false negative results in both groups.
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    Exercise-induced bronchoconstriction in textile and agricultural workers and in bakers
    (SCIENDO, 2006-12)
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    Risteska-Kuc, Snezana
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    To assess the prevalence and the characteristics of exercise-induced bronchoconstriction (EIB) in subjects occupationally exposed to organic dusts we performed a cross-sectional study including 152 exposed subjects (67 textile workers, 42 agricultural workers, and 43 bakers) and 72 unexposed controls. Evaluation of exposed and unexposed subjects included a questionnaire, skin prick tests to common inhalant allergens, spirometry, and exercise challenge tests (ECT). The EIB prevalence found in textile workers was 8.9 %, in agricultural workers 7.1 %, in bakers 6.9 %, and in office workers 5.5 %. The highest bronchial reaction to exercise was found in ECT-positive agricultural workers (26.1+/-6.9), followed by textile workers (25.2+/-7.4), bakers (23.0+/-5.8), and office workers (21.8+/-4.4). EIB was significantly associated with atopy and positive family history of asthma in all exposed groups. EIB was significantly associated with smoking duration in textile workers (P=0.039) and agricultural workers (P=0.027). Bronchial reaction to exercise was significantly greater in smoking than in non-smoking textile (P=0.045) and agricultural workers (P=0.032). Our data suggest that the combination of daily smoking and workplace exposure to certain types of organic dusts could contribute to EIB development and severity.
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    COMPARISONS AND CORRELATIONS OF THE ELECTROCARDIOGRAPHY CHANGES REGARDING THE FUNCTIONAL FEATURES BEFORE, DURING AND IMMEDIATELY AFTER THE TREADMILL TEST WITH ATHLETES
    (Faculty of Physical Education, Sport and Health in Skopje, 2019)
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    The need for cardiovascular screening in order to timely detect and diagnose the morphological and functional changes of the heart, which occur as a result of doing sport actively, and thus to avoid the occurrence of sudden cardiac death, is generally accepted. To achieve the objectives of the study, two noninvasive diagnostic methods for cardiovascular evaluation were used: electrocardiography (ECG) and the Bruce protocol test. The purpose of this study was to determine and examine the relationship of ECG changes to functional characteristics before, during, and/or immediately after exercise testing. This crosssectional study conducted during 2016/2017 involved 285 athletes aged 9 to 38, of both sexes. They were all given a 12-channel electrocardiogram (ECG) at rest, after which personal, family and sports history and anamnesis were given, followed by a Bruce protocol test and functional parameters were examined (symptoms, metabolic equivalents, METs, test duration, exercise capacity-VO2 max, rhythm disturbance, heart rate, heart rate reserve and recovery, chronotropic incompetence (CI), systolic and diastolic blood pressure). According to ECG changes and in accordance with international recommendations for its interpretation, athletes were divided into 4 groups: with normal, physiological, borderline or abnormal ECG findings. The results showed a significant positive connection between abnormal ECG and the occurrence of rhythm disturbance during the exercise test (r = 0.119; p = 0.045); Cardiovascular capacity expressed in (METs) compared to respondents with normal ECG was significantly higher in those with physiological ECG changes (p = 0.003), HR reserve percentage was lowest among athletes with abnormal ECG, and CI had the highest percentage. It can be concluded that an athlete with borderline, abnormal, and possibly physiologically assessed ECG should undergo further evaluation.