Faculty of Medicine

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Author: search.filters.author.Elizabeta ShuperliskaLanguage: search.filters.language.English

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    THE ROLE OF RISK OF RENAL FAILURE, INJURY TO THE KIDNEY, FAILURE OF KIDNEY FUNCTION, LOSS OF KIDNEY FUNCTION AND ENDSTAGE RENAL FAILURE (RIFLE) CLASSIFICATION IN IDENTIFICATION AND PREDICTION SEVERITY OF THE KIDNEY INJURY IN NEWBORNS
    (SHMSHM / AAMD, 2021)
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    Olivera Jordanova
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    Elizabeta Shuperliska
    Objective: Acute kidney injury is a serious condition with various clinical manifestations ranging from minimal kidneys disordsers to kidney injury requiring substitution therapy. Because of need of timely diagnosis of kidney injury, RIFLE classification could be used. The aim of the study was to determine the role of RIFLE classification in detecting and follow up the progression of kidney injury in newborns. Methods: This study was realized at University Clinic of Pediatrics in Skopje from period of two years. It was analyzed the medical records of 80 newborns (40 with kidney injury and 40 without kidney injury) treated in intensive care unit. The severity of the disease was determined by RIFLE classification. Results: During the study period 6.25% of newborns have developed acute kidney injury acording standard clasification. Most of the newborns analyzed in the study were male (66 and 59%) and term (67% and 61%). RIFLE classification was applied in this study. We reported “risk” in 32%, “injury” in 57% and “failure” in 11% of newborns with AKI. Of these, 69% showed progression to “injury “and 15% to “failure”. In 17% of newborns with verified “injury” the condition progressed to “failure”. Conclusion: By using RIFLE classification we could not only identify kidney injury, but also detected the progression of the disease. Hence the significance of this classification as a solid tool in the diagnosis and follow-up of kidney injury in newborns.
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    INCIDENCE, RISK FACTORS AND OUTCOMES OF ACUTE KIDNEY INJURY IN PRETERM NEWBORNS
    (Macedonian Association of Anatomists, 2021)
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    Elizabeta Shuperliska
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    Acute kidney injury is a sudden loss of renal function that results indeterioration ofthe renal’s ability to excrete urine in sufficient quantity and adequate composition. The aim of the study was to determine the incidence, risk factors and outcomes of acute kidney injury in pretermnewborns.The study was conducted at theUniversity Clinic of Pediatrics–Skopje.It was a clinical, epidemiological prospective study. In the period of two years, 40preterm newbornshospitalized at the Intensive Care Unit (ICU)with documentedkidney injury were analyzed. Medical data records of hospitalized preterm infants with kidney injury were processed. The material was statistically analyzed using methods of descriptive statistics. We evaluated 40 preterm newbornswith documented acute kidney injury,who at the period of 2 years were treated in the ICU. The prevalence of kidney injury was 6.9%. Most of the involved preterm newbornswere male(72%),and born at 32 to 37 weeks with low birth weight (58%). Prerenal injury was evaluated in 79.5% of the cases.The mortality rate was 36% and it was significantly higher in the group of preterm infants born under 28 weeks,with Extremely Low Birth Weight Newborns ELBW. (P=0.01). Acute kidney injury is a life threatening condition with a still high mortality rate. Appropriate treatment of kidney injury in newbornswith ELBW improves the outcomes and reduces the mortality of the disease.
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    RELATIONSHIP OF SERUM PROCALCITONIN LEVELS AND C-REACTIVE PROTEIN LEVELS IN NEWBORNS WITH SEPSIS IN DIFFERENT TYPES OF RESPIRATORY SUPPORT IN INTENSIVE CARE UNIT
    (Institute of Public Health of the Republic of North Macedonia, 2021)
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    Elizabeta Shuperliska
    Sepsis in newborns with RDSy and asphyxia is essential; it is a life-threatening condition and still represents an important cause of mortality and morbidity. The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as an early diagnostic and prognostic biochemical marker for sepsis in newborns with RDS and asphyxia. Material and methods: The study was designed as prospective and we examined 110 newborns with proven sepsis admitted in the Intensive Care Unit at the University Clinic of Pediatrics – Skopje in the period between December 2018 and Јanuary 2021. Procalcitonin levels were measured by using the immunoassay system Vidas based on the ELFA principles. The newborns with proven sepsis were divided into two groups. The first group comprised 55 newborns with RDS and proven sepsis and the second group included 55 newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in first group of newborns with RDS and proven sepsis, p<0.001. The highest average values (40.37±53.79) were measured on admission with a high level of peak compared to the second group of newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in the first group of newborns with RDS and proven sepsis with mechanical ventilation (MV) and bubble continuous positive airway pressure (BCPAP) compared to the second group of newborns with asphyxia and proven sepsis, p<0.001. PCT is a promising sepsis marker in newborns with RDSy, capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection at the time of ICU admission.
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    EARLY DIAGNOSTIC OF SEPSIS IN NEWBORNS WITH RESPIRATORY DISTRESS SYNDROME
    (SHMSHM / AAMD, 2020)
    Elizabeta Shuperliska
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    Avdi Murtezani
    Objective: Early diagnosis of sepsis in newborns with RDS is essential for life-threatening condition, for reducing severe sepsis and septic shock in the Intensive care Unit at the University Children’s Hospital in Skopje.Methods: In this prospective study, we included 100 (M:F=59:41) newborns with Respiratory distress syndrome (RDS) suspected for sepsis admitted in the Intensive Care Unit in period of December 2019 till 31 May 2020 y. Procalcitonin levels were measured by using a immunoassay system Vidas based on the ELFA principles. Results: The newborns with RDS suspected for sepsis have been divided into two groups The first group included 50 newborns with RDS and positive blood culture and the second group included 50 newborns with RDS and negative blood culture. Тhe average gestational age of the newborn with RDS and positive blood culture was 36,01± 3,1 weeks and the newborn with RDS and negative blood culture 36,26± 3,2 weeks. Preterm newborns in both groups dominated (64,2% and 58,2%). Тhe average birth weight of the newborn with RDS and positive blood culture was 2490,5 ±791,6 grams, and the newborn with RDS and negative blood culture was 2690,2±788,5grams. There is statistically significant difference in average PCT between the two groups overtime (p<0.05). There is statistically significant difference in average PCT between the two groups overtime procedure (MV , BCPAP, OXYGEN MASK) (p<0.05).Conclusions: PCT is promising sepsis markers in newborns with RDS, capable of complementing clinical signs and routine lab parameters suggestive of severe infection at the time of ICU admission
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    EVALUATION THE VALUE OF INFLAMMATORY BIOCHEMISTRY MARKERS AT THE NEWBORNS WITH SEPSIS IN THE INTENSIVE CARE UNIT
    (SHMSHM / AAMD, 2020)
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    Elizabeta Shuperliska
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    Olivera Jordanova
    Objective: The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as a early diagnostic and prognostic biochemical marker for sepsis in newborns in correlation withC reactive protein (CRP) and white blood cells count(WBC). Methods: In a prospective study, 110 newborns with two or three clinical signs of sepsis who admitted at the Intensive Care Unit (ICU) at the PHI University Clinic of Pediatric Diseases-Skopje were included . Diagnosis of sepsis in newborns diagnosed according to standard protocols for diagnosis of disease. Sample for blood culture, PCT CRP and WBC obtained by peripheral venous puncturewere taken the first at the admission, before initiation of antibiotic therapy in newborns suspected of sepsis, the second on 3-5 days and the third 6-14 days. Results: 110 newborns were recruited. At first 24 hours of the admission , PCT have a higher discriminative ability than the WBC in distinguishing a bacterial infection from another inflammatory process the early infection diagnosis, and also found to have been more reliable than that of the CRP. The highest average values of PCT (40.37±53.79) were measured during admission with a subsequent sharp jump. The highest average values of CRP were measured (42.17±61.84) after the second during with a subsequent sharp jump. In the three measurements they had an average value WBC (16.83±8.35, 16.71±9.64. 16.31±11.72).Conclusion: The values of procalcitonin (PCT) is a important clinical significance in diagnosis treatment and predicting the prognosis of newborns with sepsis.
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    DIAGNOSTIC VALUES OF BIOCHEMICAL MARKERSIN ASPHYXED NEWBORNS WITH PROVEN SEPSIS
    (Macedonian Association of Anatomists, 2020)
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    Elizabeta Shuperliska
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    Olivera Jordanova
    Introduction: The aim of this study was to investigate the predictive values of biochemical parameters, including Procalcitonin (PCT), as an early diagnostic and prognostic marker for sepsis in asphyxed newborns with proven sepsis. Materials and Methods: This study was designed as a prospective study, where we included 110 (M:F=67:43) newborns with proven sepsis hospitalized in the Intensive Care Unit at the PHI University Children’s Hospital – Skopje.PCT and CRP,WBC one serum blood sample was obtained from each patient at the 24h at admission, as well asday 3 and day 7. Procalcitoninlevels were measured by using an immunoassay system Vidas, based on the Enzyme Linked Fluorescent Assay (ELFA) principles. Results: The newborns with proven sepsis have been divided into two groups. The first group included 50 proven septicpreterm newborns with a positive blood culture and the second group included 50 proven sepsis full-term newborns.We isolated forty two that had two or three bacteria at the same time. The identified bacteria included Staphylococcus aureus (n=56) mecA,Streptococcus (n=6), Acinetobacter baumannii (n=18), Serratia marcescens (n=9) and Entrobacteriaceae (n=31), Candida albicans(n= 1), Candida parapsilosis(n=1).Statistical analysis confirmed significantly different values of PCT in the analyzed time period in preterm newborns with proven sepsis p<0.001.Statistical analysis confirmed significantly different values of PCT in the analyzed time period in newborns with proven sepsis with asphyxia p<0.001. Conclusion: The levels of PCT have important clinical significance in predicting the prognosis of asphyxed newborns with sepsis, to prevent the development of severe sepsis and septic shock.