Faculty of Medicine

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Author: search.filters.author.Dejan TodevskiHas files: No

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    Complications associated with acute pulmonary embolism – data from the registry of patients with venous thrombembolism
    (Македонско лекарско друштво = Macedonian Medical Association, 2022)
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    Dejan Todevski
    ;
    Suzana Arbutina
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    Correct estimation of the severity, mortality, and complication risk are crucial for effective treatment of pulmonary embolism (PE). A total of 162 patients hospitalized with acute PE, treated either with standard treatment with heparin and vitamin K antagonists (VKA) or heparins, followed by direct oral anticoagulants (DOAC) were followed for a 90-days period. Demography, clinical and radiologic presentation, smoking status and concomitant comorbidities were analyzed. The mortality risk was estimated by calculating PESI and sPESI score. The results showed uneven utilization of both treatment modalities (93.8% treated with VKA versus 6.17% with DOAC). Smoking as an independent factor was detected in 55.56% of patients, and is greater than the overall smoking prevalence in Macedonia. Central propagation of PE was found in 57.79% of cases and together with the presence of pleural effusion was associated with a greater risk for complications. Estimation of 30-day mortality risk with PESI and sPESI showed their high predictive value, with an advantage of sPESI, in terms of better accuracy and simplicity of performance. Correct estimation of risk for complications and mortality is important for improving the overall safety of patients with PE and has a positive „cost-benefit“ effect for organization of the treatment.
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    Evaluation of IL-8 and MEF25-75 in patients with severe COPD who were treated with combined therapy of ICSs / LABAs plus tiotropium bromide
    (Europian Respiratory Society, 2013)
    ;
    Zlatica Gosheva
    ;
    Angelko Gjorchev
    ;
    Suzana Arbutina
    ;
    The aim of this study was to determine the effect of combined therapy of ICSs/LABAs plus tiotropiumbromide in patients with COPD, by analyzing of IL-8 and MEF25-75 at the beginning and after 6 months oftherapy. The study included 33 patients with severe COPD. In each of them were measured serum IL-8levels by the ELISA method and MEF25-75 which are indicated the small airways obstruction. They weretreated with combined therapy of ICSs/LABAs (500mcg) plus Tiotropium Bromide (18mcg) daily in durationof 6 months. The results were statistically elaborated according to the T-test for Dependent Samples. Theobtained results of IL-8 showed that the level of IL-8 before the start of therapy were much higher and thattreatment significantly reduces their value (t=3.13, p=0.003, p<0.05). The results of MEF 25-75 at the startof therapy were lower and after 6 months of treatment showed a slight improvement of lung function butstatistically insignificant (t= -0.83, p=0.41,p<0.05). The concentration of IL-8 is closely related with airwayobstruction in patients with COPD and may serve as a marker for evaluating the severity of airwayinflammation. ICSs/LABAs and tiotropium bromide have inhibitory effect on neutrophilic inflammationthrough the suppression of IL-8 production from epithelial cells and thus may contribute to lower cellularinflammation in COPD. Because it is a progressive disease and airflow limitation is not fully reversible, wecannot expect spectacular results like we show with the value of MEF25-75, but should strive to preventprogression and reduce airway remodeling with education, pharmacologic and non pharmacologic treatment
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    Total Eosinophyls, ECP and IL-5 in Peripheral Blood During Treatment with Inhaled Cortikosteroids in Patients with Asthma
    (Turkish Thoracic Society, 2019)
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    Dejan Todevski
    ;
    Monika Tushevska Mitkovska
    ;
    Nikola Chamurovski
    Objectives: The main attribute of asthma is inflammation, which leads to airway remodeling, bronchial hyper-reactivity and reversible or partly reversible airway obstruction. According to GINA, asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils (Eo), and T lymphocytes (GINA). Many cells and mediators take part in creating the asthmatic inflammatory reaction, but eosinophils play a central role. Methods: This study includes 30 patients of the Pulmology and Allergy Clinic, Skopje, with confirmed bronchial asthma, treated with ICS. In all of the patients we followed Eo count, ECP and IL-5 in peripheral blood at the beginning of the study, after 2 and 6 months treatment. Results: At the beginning of the study in all 30 (100 percent) of the patients the serum level of IL-5, Eo count and ECP were increased. Following the parameters during treatment with ICS we registered statistical significant changes in all of the tested parameters. Conclusion: Our conclusion is that the ICS objectively suppress the inflammatory reaction in asthma and the biologic markers (IL-5, Eo and ECP), which we have followed, can measure the accomplished effect. They could be used in every day practice, not only as diagnostic parameters but also as valid therapeutic guides in the treatment of asthma.