Faculty of Medicine

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Why physicians underuse patient-reported outcomes in atopic dermatitis and chronic urticaria — Insights from the UCARE/ADCARE PROMUSE study
(Elsevier BV, 2026-07)
Cherrez-Ojeda, Ivan
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Robles-Velasco, Karla
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Giménez-Arnau, Ana
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Godse, Kiran
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Krasowska, Dorota
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‘What’ and ‘How’ to Measure in Allergy and Clinical Immunology: A Systematic Review of Core Outcome Sets and Outcome Harmonisation Processes
(Wiley, 2026-04-13)
Demidova, Anastasia
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Kiknavelidze, Nata
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Purtskhvanidze, Kristine
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Alieva, Elvina
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Ebrahimnejad, Mehrshad
Background Heterogeneity in outcome reporting and inconsistent use of outcome measurement instruments in allergy and clinical immunology research affects the comparability, synthesis, and clinical applicability of study findings. Harmonisation efforts, particularly Core Outcome Set (COS) development, aim to address these challenges by establishing standardised, evidence‐based and consensus‐driven outcome recommendations. This systematic review aims to map available COS and other harmonisation processes (HP) in allergy and clinical immunology, evaluate their methodological approaches, and assess their alignment with established development standards. Methods We systematically searched MEDLINE, EMBASE, and the COMET Initiative database until June 7, 2024 to identify COS and HP. We included studies if they provided recommendations on ‘core’ outcomes and/or outcome measurement instruments. Data extraction included disease focus, methodological approach, stakeholder involvement, and adherence to the Core Outcome Set‐STAndards for Development criteria. We synthesised the data at the initiative (process) level rather than the publication level because harmonisation initiatives are frequently iterative and reported across multiple papers (e.g., protocol, Delphi rounds, consensus statement, and subsequent instrument‐selection outputs). Results A total of 15,612 records were identified, with 44 studies (representing 22 initiatives both finished and in development) meeting inclusion criteria. The majority of initiatives focused on asthma ( n = 9), followed by eczema (atopic dermatitis n= 2; hand eczema = 1; eczema = 1), urticaria ( n= 2), allergic rhinitis ( n= 2), chronic rhinosinusitis ( n = 1), celiac disease ( n = 1), Immunoglobulin E (IgE)—mediated food allergy ( n = 1), eosinophilic esophagitis ( n = 1), and hereditary angioedema ( n= 1). No COS or HP addressed drug allergy, anaphylaxis, or other immune‐mediated allergic conditions. ‘Quality of life’ was consistently included in all COS with ‘signs and symptoms’, ‘exacerbations’ and ‘disease control’ frequently selected as well. Methodological approaches to COS development varied widely, with most employing Delphi surveys, consensus meetings, and stakeholder involvement, though levels of engagement differed. COS developers inconsistently adhered to Core Outcome Set‐STAndards for Development criteria, with some initiatives demonstrating rigorous methodology while others lacked transparency in key developmental steps. Conclusion This review highlights growing efforts to harmonise outcome assessment in allergy and clinical immunology. Major gaps remain in coverage and methodological rigour. Quality of life and patient‐reported symptoms are frequently recommended outcomes, yet definitions and measurement tools are inconsistent. Strengthening methodological consistency and expanding COS development to neglected areas are critical next steps to improve outcome reliability and comparability in the field.
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CLINICAL OUTCOMES FROM COVID-19 INFECTION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: 5 YEARS LATER
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-12-16)
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Atanasovska, Aneta
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Introduction: Evidence of impact of COVID-19 infection on course of chronic obstructive pulmonary disease (COPD) is still limited. Aim: To assess clinical outcomes of moderate COVID-19 infection in patients with moderate COPD by comparison of disease control, i.e., the frequency and severity of symptoms, level of health status impairment, values of spirometrc parameters and exacerbation risk, registered at two points in time: 2020 and 2025. Material and methods: We performed a cross-sectional study including 74 patients with moderate COPD divided in two groups. The first group (COVID-19 group) included 37 COPD patients who had COVID-19 infection of moderate severity in 2020. The second group (non-COVID-19 group) included patients with COPD who did not have coronavirus disease in the period 2020-2025. The frequency and severity of symptoms and level of health impairment were assessed by COPD Assessment Test (CAT): lung function was assessed by spirometric measurements, and exacerbation risk was predicted by exacerbation rate registered in the previous year. Conclusion: Our findings indicated significant impact of the COVID-19 infection on symptoms, patient’s health and daily life, as well as on the lung function and exacerbation risk emphasizing a need of careful monitoring of these patients upon recovery from COVID-19 infection in order to minimize the impact of infection on COPD progression.
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PREVALENCE AND CHARACTERISTICS OF CHRONIC RESPIRATORY SYMPTOMS AND LUNG FUNCTION AMONG VINEYARD WORKERS
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-12-16)
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Atanasovska, Aneta
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Bislimovska, Dragana
Aim: To determine the frequency of chronic respiratory symptoms and ventilatory function in a group of vineyard workers. Results: Most of the vineyard workers believe that they are sufficiently informed about the health risks related to their work activities and the necessary measures needed for health protection. Also, most of them use the mandatory personal protective equipment, while almost all workers during their work, to a greater or lesser extent, were exposed to occupational respiratory hazards: dust, smoke, fumes, gases and pesticides. About 45% of subjects had one or more respiratory symptoms, and the most common symptoms were cough (40%), cough with phlegm (31.1%), as well as dyspnea and wheezing (22.2%). The frequency of chronic respiratory symptoms was higher in workers with more than 15 years of exposure, with a statistically significant difference in frequency of cough, cough with phlegm, and dyspnea. The risk of respiratory symptoms was about 3 times higher in active smokers and about 2 times higher in vineyard workers with exposure duration longer than 15 years. The mean values of all spirometric parameters were within the reference values, while lung function impairment of obstructive, restrictive and combined pattern was registered in about 20% of them. The mean values of spirometric parameters in vineyard workers with exposure duration longer than 15 years were lower than those with less than 15 years of experience, with a significant difference for small airways flow indices. Conclusion: The obtained results indicate the need to improve preventive measures.</jats:p>
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Emerging topics in occupational medicine in south-eastern European (SEE) countries
(Croatian Society on Occupational Health, 2024-11-07)
The South-East European Network on Workers’ Health (SEENWH) is a network of experts in the field of occupational health from nine countries in the SEE subregion (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, R.N. Macedonia, Romania, Serbia, and Türkiye). It was established in 2006, aimed at strengthening occupational health systems in the SEE subregion through strong collaboration with the WHO Regional Office for Europe. The objectives of the SEENWH as a sustainable and international framework are: improvement of workers’ health and well-being; strengthening of OH systems, policies, and services; and building of human/ institutional capacities in the SEE subregion. SEENWH provides a forum for exchanging information and knowledge, developing training programmes in the field of occupational health, promoting research, developing and sharing good practices, and collaboration through joint projects. The emerging issues on which the SEENWH experts are focused involve, among others, occupational health system and policy, universal health coverage, verification and reporting of occupational diseases, vulnerable groups of workers (including persons with disabilities), health and well-being of health workers, mental health at work, occupational skin diseases, work-related musculo-skeletal disorders, new and emerging occupational risks, climate change and workers’ health, and evidence syntheses in occupational health. During the COVID-19 pandemic (October-December 2021), more than 1,600 health workers from SEENWH countries have been trained in occupational health and safety in the context of COVID-19 through a project supported by WHO/Europe. In addition, the SEENWH conducted an online survey on job stress in health workers during the COVID-19 pandemic (over 4,600 respondents), and found significant differences between SEENWH countries related to burnout, job engagement, as well as job demands and job resources. As a conclusion, SEENWH should be continuously used as a platform for collaboration at subregional level, to work together towards workers’ health, and to translate research into practice.
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Artificial Intelligence in Medical Education and Vocational Education and Training
(2025-10-17)
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Association between occupational exposure and cancer in developing countries: a systematic review
(2025-10-08)
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Petrovska, Ekaterina
Objective: This systematic review aims to identify, evaluate, and synthesize existing evidence about the association between occupational exposure and cancer in developing countries, to conduct risk of bias assessment (RBA), and to identify knowledge gaps to guide future research. Material and Methods: A systematic review is currently conducted across three major databases—MEDLINE (via PubMed), EBSCO, and DynaMed—including studies published between 1990 and 2025. The search strategy was developed in accordance with the PICOs framework, using a combination of search terms, Medical Subject Headings (MeSH), and Boolean operators (AND, OR, NOT) to identify relevant studies. The ongoing first phase of this systematic review (MEDLINE database) initially identified a total of 1,759 records which were screened based on title and abstract. For the resulting 41 records, the full-text articles were assessed for eligibility. Following the exclusion criteria, four articles without an existing abstract and 28 review articles were removed. In accordance with the inclusion criteria, only original research articles were considered, resulting in 9 full-text articles being included for qualitative synthesis. Screening of EBSCO and DynaMed databases will be conducted in the next phase of the review. RBA was based on the criteria proposed by Shamliyana et al. Results: Preliminary data showed that the most frequently analysed occupational carcinogens in developing countries were: asbestos, silica dust, pesticides, arsenic, and particulate matters. Mostly investigated cancer sites were: lung cancer, melanoma, leukaemia, and colo-rectal cancer. The RBA showed external and internal validity issues for most of the studies. Conclusion: There is a clear need to improve evidence synthesis on occupational exposure and cancer in developing countries, where the burden could be greater but research is limited. Acknowledgements: The authors declare no funding or conflicts of interest.
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Artificial Intelligence-Generated Answers to Patients' Questions on Asthma: The Artificial Intelligence Responses on Asthma Study
(Elsevier BV, 2025-09)
Nigro, Mattia
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Aliverti, Andrea
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Angelucci, Alessandra
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Braido, Fulvio
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Canonica, Giorgio W
Asthma is a prevalent chronic respiratory disease requiring ongoing patient education and individualized management. The increasing reliance on digital tools, particularly generative artificial intelligence (AI), to answer health-related questions has raised concerns about the accuracy, reliability, and comprehensibility of AI-generated information for people living with asthma.
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Data from the Researcher Mental Health Observatory STAIRCASE survey
(Center for Open Science, 2025-05-24)
Lasser, Jana
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Mol, Stefan Thomas
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Čontala, Alja
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Slavec, Ana
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de Swarte, Andreja Zulim
The data presented here derives from the STAIRCASE survey on researcher mental health. The survey reached 4,296 researchers predominantly from European countries who completed an online questionnaire about mental health outcomes such as depression, anxiety, stress, burnout, and well-being, as well as working conditions and leadership behaviour. Data and materials of the study are available at https://doi.org/10.21249/DZHW:remo:1.0.0 as a fully anonymised downloadable Campus Use File and a pseudonymised Scientific Use File, accessible in a secure remote analysis environment. Data can be reused for secondary analyses, educational purposes, or combined with similar data sets.
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The Prevalence of Symptomatic Dermographism: Results of the International UCARE PREVALENCE-D Study
(Wiley, 2025-09-13)
Kulthanan, Kanokvalai
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Bernstein, Jonathan A
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Rudenko, Michael
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Salameh, Pascale
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Komoltri, Chulaluk
The prevalence of symptomatic dermographism (SD) in the general population remains unclear. This study aimed to internationally estimate the prevalence of SD and two other dermographic subtypes-physiological red dermographism and simple urticarial dermographism-among adults worldwide.

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