Faculty of Medicine

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PROCALCITONIN AS A PROMISING BIOCHEMICAL MARKER FOR EARLY DETECTION AND TREATMENT OF SEPSIS IN NEONATES AT INTENSIVE CARE UNIT AND ONCOLOGIC PATIENTS WITH FEBRILE NEUTROPENIA
(Macedonian Association of Anatomists and Morphologists, 2020)
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Tankoska Maja
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Pandovska Bisera
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Kimovska, Milica
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Divergent trends in the prevalence of asthma-like symptoms and asthma in a developing country: three repeated surveys between 2002 and 2016
(Elsevier, 2020-04-10)
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Kimovska, Milica
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Lawson, Joshua A
INTRODUCTION AND OBJECTIVES: There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. SUBJECTS AND METHODS: Data was obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. RESULTS: The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p = 0.075). Statistically significant (p < 0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR = 1.22, 95%CI = 0.67-2.22; 2016: OR = 2.45, 95%CI = 1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared. CONCLUSIONS: Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.
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Socioeconomic status hypothesis in asthma and eczema in young adolescents
(The Balkan Societies of Allergology and Clinical Immunology, 2006)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
Background: As studies in different populations have shown conflicting results about the relationship between asthma and socioeconomic status and its association with eczema has been less extensively studied, the study was aimed to explore the socioeconomic status hypothesis in asthma and eczema in young adolescents in the Republic of Macedonia. Methods: The self-reported data from 3026 children aged 13/14 years from randomly selected schools in Skopje, the capital of Macedonia, were obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires. Family size, mother’s educational level, tobacco smoke at home, wood/coal/oil heating at home and body mass index, as some socioeconomic status measures, were statistically correlated to asthma and eczema symptoms by odds ratios with 95% confidence interval (OR, 95% CI) in binary logistic regression. Results: Small families and overweight significantly increased the risk of ever-diagnosed asthma (OR 2.160, 95% CI 1.110-4.203 P=0.023 and OR 2.085, 95% CI 1.109-3.922 P=0.023, respectively). As well overweight was significantly associated with increased risk of current night cough (OR 1.365, 95% CI 1.053-1.771 P=0.019), while mother’s university education with decreased risk of the same symptom (OR 0.759, 95% CI 0.620-0.930 P=0.008). A significant association between the severity of asthma, eczema and investigated measures of socioeconomic status was not found. Conclusion: The results support the positive association between socioeconomic status and asthma only, without any effect of socioeconomic status on asthma severity and eczema.
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Overweight hypothesis in asthma and eczema in young adolescents
(Elsevier BV, 2006)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
BACKGROUND: A positive association between body mass index (BMI) and allergic diseases has recently been suggested; however the sex-dependence of this association remains controversial. The aim of the present study was to explore the relationship between BMI and asthma and eczema, as well as its sex-dependence in young adolescents. METHODS: Self-reported data obtained through the standardized International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three written questionnaires of 2926 young adolescents aged 13-14 years old from randomly selected schools in Skopje (Republic of Macedonia) were used. The BMI for each individual was calculated and used-both unadjusted and adjusted for confounding factors-as a variable for analysis. The international cut-off points for BMI for overweight and obesity by sex and age were used. Because of the very low prevalence of obesity (1.5 %), obese respondents were included in the overweight group. The data were statistically analyzed by the chi-square test, the t-test for independent samples and odds ratios (OR, 95 % CI) in binary logistic regression. RESULTS: Being overweight was significantly associated with an increased risk of having a dry night cough without a cold or chest infection (adjusted OR: 1.54; 95 % CI: 1.09-2.16; p = 0.01) and with having had self-reported asthma at some time (adjusted OR: 2.36; 95 % CI: 1.02-5.44; p = 0.04) in boys only. A significant association between overweight and other symptoms of asthma or atopic eczema was not established. CONCLUSION: These findings suggest a male-specific positive association between overweight and a current dry night cough and having received a diagnosis of asthma at some time. No association was found with other asthma symptoms or atopic eczema in young adolescents.
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Acetaminophen intake and risk of asthma, hay fever and eczema in early adolescence
(2007-09)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
A positive association between acetaminophen intake and allergic diseases has recently been reported in developed countries with impaired oxidant/antioxidant balance and promotion of atopy as proposed underlying mechanisms. The aim of the study was to explore the relationship between acetaminophen intake and asthma, hay fever, and eczema in The Republic of Macedonia as a country with acetaminophen intake not physician-controlled, high passive smoke exposure and dietary antioxidant intake, and moderately low prevalence of allergic diseases. Self-reported data obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires of 3026 adolescents aged 13/14 years from randomly selected schools in Skopje, the capital of Macedonia, were used. The frequency of current acetaminophen intake--both unadjusted and adjusted for confounding factors--was correlated to current and ever-diagnosed asthma, hay fever and eczema by odds ratios (OR, 95% CI) in binary logistic regression. Use of acetaminophen at least once monthly increased the risk of current wheeze (adjusted OR 2.04, 1.31-3.20 p = 0.002), asthma 'ever' (adjusted OR 2.77, 1.06-7.26 p=0.039), current allergic rhinoconjunctivitis (adjusted OR 2.95, 1.79-4.88 p=0.000) and hay fever 'ever' (adjusted OR 2.25, 1.36-3.70 p=0.002). A significant association between frequent acetaminophen intake and atopic eczema and also between infrequent acetaminophen intake and investigated allergic diseases was not established. The findings suggest an increased risk of asthma and hay fever, but not atopic eczema associated with frequent acetaminophen use in a developing country.
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Influence of physical activity and television-watching time on asthma and allergic rhinitis among young adolescents: preventive or aggravating?
(Elsevier BV, 2008)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
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BACKGROUND: Related to exercise hypothesis, the aim of the present study was to explore the influence of physical activity on asthma and allergic rhinitis in a developing country where publicity campaigns about the benefits of exercise are scarce. METHODS: The analysed data were self-reported and obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires completed by 3026 adolescents 13/14 year old in Skopje (Republic of Macedonia). Vigorous physical activity and television-watching timeboth unadjusted and adjusted for confounding factorswere used as variables for analysis. Odds ratios (OR, 95 % CI) in binary logistic regression were employed for statistic analysis of the data. RESULTS: Vigorous physical activity both > or = 3 times and 1-2 times per week was associated with an increased risk of current wheeze (aOR: 1.66; 1.08-2.55; p = 0.020 and aOR: 1.70; 1.23-2.36; p = 0.001, respectively), speech-limiting wheeze (aOR: 3.15; 1.13-8.77; p = 0.028 and aOR: 4.62; 2.22-9.62; p = 0.000, respectively) and exercise-induced wheeze (aOR: 2.72; 1.93-3.83; p = 0.000 and aOR: 4.01; 3.12-5.14; p = 0.000, respectively). Frequent physical activity was positively associated only with current allergic rhinitis symptoms (aOR: 1.40; 1.04-1.90; p = 0.029). Television watching > or = 3 hours a day increased the risk of current wheeze (aOR: 1.34; 1.01-1.77; p = 0.042) and exercise-induced wheeze (aOR: 1.32; 1.05-1.65; p = 0.016). CONCLUSION: The findings support the aggravating role of sedentary regimen and poor physical fitness on asthma symptoms, but not on allergic rhinitis. Physical activity may trigger asthma symptoms when physical fitness is poor and asthma is not controlled.
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Do household tobacco smoking habits influence asthma, rhinitis and eczema among 13-14 year-old adolescents?
(Elsevier BV, 2011)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
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BACKGROUND: Although the harmful impact of environmental tobacco smoke on respiratory health in early childhood is well known, its effect in adolescence is still ambiguous. This study aims to examine if parents' and household tobacco smoking habits influence asthma, rhinitis and eczema in early adolescence in The Republic of Macedonia, as a country with a very high rate of household tobacco smoke exposure despite the smoking cessation campaign, and low prevalence rates of asthma, rhinitis and eczema. METHODS: Children aged 13-14 years (n=3026) from randomly selected schools in Skopje, the capital of Macedonia, completed by themselves the standardised International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three written questionnaires on asthma, rhinitis, eczema and potential environmental risk factors. Maternal and paternal tobacco smoking habits and the number of smokers in households were separately correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) with and without adjustments for potential confounders using binary logistic regression. RESULTS: The maternal smoking habit was significantly positively associated only with current night dry cough apart from chest infection (aOR: 1.26; 1.03-1.54; p=0.026). No significant association was observed in relation to the other studied variables with either parental smoking habits or the number of smokers in the household. CONCLUSION: Household tobacco smoking habits were not found to have a significant influence on asthma, rhinitis and eczema in young adolescents. The established results point out the dominant influence of maternal smoking on cough as an unspecific asthma symptom.

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