Faculty of Medicine

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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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    Item type:Publication,
    PROMISING DIAGNSOTIC MARKER AT NICU AND PICU-NEW APPROACHES FOR DIAGNOSTIC AND TREATMENT
    (Macedonian Association of Anatomists, 2019)
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    Mica Kimovska-Hristova
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    Tamara Voinovska
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    The aim of this study is evaluate the initial PCT levels on the outcome of patients in pediatric intensive care units and find out if these biomarker can be used to predict sepsis. The study was designed as a prospective, clinical, investigation conducted in the period sixth months, which included 45 (M:F=25:20) newborns with two or three clinical signs of sepsis hospitalized in the Intensive Care Unit at the PHI University Clinic for Children Diseases. The patient have been divided into two groups: I group included 31 septic newborns with negative blood culture and II group - 14 septic newborns with positive blood cultures. Results of blood count (WBC), CRP and PCT, were recorded. Procalcitonin PCT levels at first 24 hours of the admission were increased in all 45 newborns (≥2 ng/mL). The values of C-reactive protein gradually increase after 12-36 hours at admission. The second measurement, after 3 days usage of an adequate antibiotic treatment, the levels of PCT is decreased,regardless of whether blood culture is positive or negative, except 5 patients develop severe sepsis, and three patients develop septic shock. After the third measurement the levels of PCT and CRP is decreased. NIV was used in 39.8% patients and Invasive MV was used in 29.8% patients.Sensitivity of procalcitonin 83.5%, Specificity of procalcitonin 81.3%. Procalcitonin value is a early prognostic factor for sepsis and it is a reliable parameter whether an appropriate antibiotic for the treatment is used,thus increasing newborns safety,and reducing costs .
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    Item type:Publication,
    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.