Faculty of Medicine

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SSRI-reduced platelet reactivity in non-responding patients with life-long Recurrent Depressive Disorder: Detection and involved mechanisms
(Elsevier BV, 2018-05)
Aleksovski, Boris
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Neceva, Violeta
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Vujović, Viktorija
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Adverse effects with bleeding disorders are often associated with the administration of SSRI in depression, although the exact mechanisms remain contradicting. This study is aimed at detecting and exploring the mechanisms of SSRI-induced changes in platelet reactivity in non-responding patients with Recurrent Depressive Disorder (RDD) and life-long exposure to antidepressants.
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Peripheral glutamate and TNF-α levels in patients with intracerebral hemorrhage: Their prognostic values and interactions toward the formation of the edemal volume
(VM Media SP. zo.o VM Group SK, 2018-03)
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Aleksovski, Boris
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Stojanov, Dragan
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Aleksovski, Vasko
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Mihajlovska Rendevska, Ana
We aimed to evaluate the prognostic values, contribution and interactions of the peripheral blood plasma glutamate and tumor-necrosis factor-α (TNF-α) levels toward the formation of the perifocal edema in patients with intracerebral hemorrhage (ICH).
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Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage
(Walter de Gruyter GmbH, 2017-12-01)
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Stojanov, Dragan
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Aleksovski, Boris
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Mihajlovska Rendevska, Ana
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<jats:title>Summary</jats:title> <jats:p>The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS). The surgical treatment was successful in 14 patients (37%), whereas it was unsuccessful in 24 patients (63%). We have detected a significant negative correlation between the Glasgow Coma Scale (GCS) scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding.</jats:p>
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Modeling prognostic factors for poor neurological outcome in conservatively treated patients with intracerebral hemorrhage: A focus on TNF-α
(Elsevier BV, 2018-09)
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Aleksovski, Boris
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Stojanov, Dragan
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Mihajlovska Rendevska, Ana
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Aleksovski, Vasko
Prognostic models for Intracerebral hemorrhage (ICH), mainly based on clinical evaluation, have remained inherently confounded by subjective scoring assessments and limited accuracy. In this study, we aimed at assessing the risk for poor outcome after ICH based on peripheral biochemical markers (TNF-α, glutamate and glucose) and radiological variables (both at admission and five days after patient's care), for modeling purposes of prognostication.
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Effects of data transformation on multivariate analyses in intracerebral hemorrhage
(Macedonian Pharmaceutical Association, 2016)
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Aleksovski, Boris
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Kolevska, Milena
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Stojanov, Dragan
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<jats:p>Multivariate statistical approaches have been increasingly applied in hemorrhagic stroke data analysis. Nevertheless, several aspects regarding their relevance and validity in respect of the application of data transformations have not been studied in details. This paper examines the effects of different data transformations in the standard statistical methods of the multivariate analysis of the intracerebral hemorrhage (ICH) parameters in small group samples. Two different methods for data transformations (log transformation (log(Xi )), square root transformation (√Xi ))have been carried out. The initial volume of the ICH have been studied using several test for skewness, kurtosis, histogram distribution method and different quartile-quartile (Q-Q) and probability-probability (P-P) plots as criteria for normal distribution. Multivariate analyses for the prediction of the perifocal edema was performed using raw and transformed data. Our results indicate that the data transformation operations should be performed very carefully because different analytical outputs lead to different scientific conclusions.</jats:p>
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Evaluation of peripheral serotonin content and α2-adrenergic receptor function as potential markers for life-long recurrent depressive disorder by using methodological improvements
(Informa UK Limited, 2018-09)
Aleksovski, Boris
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Vujović, Viktorija
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We aimed to evaluate the role and the relations between peripheral platelet serotonin content, blood plasma serotonin concentration and the function of platelet α2-adrenergic receptors (α2-AR) as potential state or trait biomarkers for recurrent depressive disorder (RDD).
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The impact of various factors related to the COVID-19 pandemic on the mental health of healthcare workers in the Republic of North Macedonia
(Macedonian Pharmaceutical Association, Ss. Cyril and Methodius University in Skopje, Faculty of Pharmacy, 2021)
Filkova, Sanja
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Pashaliska Cvetkov, Branka
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Aleksovski, Vasko
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Krstic Nakovska, Olivera
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<jats:p>Since December 2019, the world has been facing an unprecedented infection caused by a new strain of coronavirus called SARS-CoV-2. The COVID-19 pandemic, in addition to affecting every aspect of daily life, further affects the already high levels of stress, anxiety and depression faced by healthcare workers (HCWs) globally. Protecting the mental health of HCWs should be recognized as an imperative during a pandemic. This paper aims to examine, by means of an anonymous survey, the attitudes and opinions of HCWs regarding the COVID-19 pandemic, as well as their mental health condition and the causes of mental disabilities. The survey encompassed HCWs (doctors, nurses/technicians and pharmacists) engaged in COVID-19 centers at the University Clinical Center „Majka Tereza“, Skopje. The results of the conducted research indicate that during the engagement in the COVID-19 centers, the HCWs faced the burnout syndrome, fear of infecting primarily family members, colleagues or negative patients, isolation etc. Most of the participants never sought psychological help, sometimes thought about how they could no longer endure the situation, and often experienced problems sleeping, but they didn’t use sleeping or calming pills. Almost half of the participants felt that they were not adequately protected in the workplace. The negative consequences of mental health are more pronounced in HCWs who are directly engaged in the treatment of patients with COVID-19. This research contributes to a better understanding of the mental health of HCWs and the need for interventions by the system in the form of education and care. Keywords: COVID-19, healthcare workers, risks, measures, mental health</jats:p>
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Patients' attitude toward AED withdrawal: A survey among individuals who had been seizure-free for over 2 years
(Elsevier BV, 2020)
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Babunovska, Marija
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Kuzmanovski, I
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Boskovski, Bojan
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Sazdova-Burneska, Slobodanka
The study aimed to evaluate the attitudes of seizure-free patients toward the antiepileptic drug (AED) withdrawal and to highlight the factors that affect their perspectives.
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Evaluation of APOE Genotype and Vascular Risk Factors As Prognostic and Risk Factors for Alzheimer’s Disease and Their Influence On Age of Symptoms Onset
(Scientific foundation SPIROSKI, 2019-02-14)
Novotni, Gabriela
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Jakimovska, Milena
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Plaseska-Karanfilska, Dijana
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Kuzmanovski, I
BACKGROUND: Alzheimer’s disease (AD), the most common cause of dementia, is evolving to become a threatening epidemy of the 21st century. Only 21% of the predicted number of AD patients in Macedonia have been diagnosed and treated, which means that almost 80% are underdiagnosed or misdiagnosed. Apolipoprotein E gene (APOE) is recognised as the strongest genetic risk factor for sporadic AD. Whether and when Alzheimer’s disease develops, depends on the very complex interaction between genetic and modifiable risk factors. It has been known that vascular factors like hypertension, diabetes mellitus, hypercholesterolemia and obesity increase the risk of developing both AD, vascular dementia and mixed AD and vascular pathology AIM: This study aims to evaluate the influence of APOEε4 allele presence and modifiable vascular risk factors (hypertension, diabetes mellitus and dyslipidemia) as prognostic and risk factors for AD and their influence on the age of onset of AD symptoms among 144 AD patients from Macedonia. MATERIAL AND METHODS: Study group of a total of 144 patients diagnosed with AD was evaluated. APOE genotyping was performed using APOE haplotype-specific sequence specific-primer (SSP)-PCR (Polymerase Chain Reaction) methodology. The non-standardized questionnaire was used to obtain information about demographics, lifestyle and modifiable risk factors that could influence disease onset and phenotype. RESULTS: Statistically significant association was found between the presences of APOEε4 allele in AD group versus controls. The presence of APOEε4 allele increases the risk of developing AD in a 3-fold manner. The average age of disease onset in the ε4 carrier group was 67.2 ± 8.3 and in the ε4 non-carrier group 69.7 ± 9.4. This confirms that the presence of APOEε4 allele shifts towards earlier disease onset, though the difference is not statistically significant. Out of the vascular risk factors, only hypertension was significantly associated with earlier AD onset. Out of total 144 patients, in 22.9% the first symptom onset was before the age of 65, that can be considered as early onset Alzheimer’s Disease (EOAD), which is much higher than 5% for EOAD as most of the studies report. CONCLUSIONS: The average age of disease onset of 68.4 years could be considered earlier than the average age of AD onset worldwide. Out of all the vascular risk factors analysed in this study, only hypertension and dyslipidemia were found to significantly increase the risk for developing AD and only the presence of hypertension influences the age of onset, shifting towards earlier disease onset. Public awareness campaigns should be organised to influence general population knowledge about Alzheimer’s disease, early recognition and the influence of modifiable vascular risk factors.</jats:p>

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