Faculty of Medicine
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Item type:Publication, Effects of Vitamin D Supplementation on Exacerbation in Patients with Severe COPD(MedDocs Publishers LLC, 2022-07-12); ; ;Petrova, Tatjana ;Kamchevska Kochovska, NadeIntroduction: Results from several studies indicated that vitamin D plays a role in a variety of immunologic processes such as modulation of inflammatory pathways and susceptibility to infections. Aim of the study: To assess the effects of vitamin D supplementation on bacterial exacerbations in patients with severe chronic obstructive pulmonary disease (COPD) with low vitamin D serum level. Methods: We performed an observational, non-randomized, open-label study including 36 patients with severe COPD who besides the recommended chronic treatment for stable disease took oral vitamin D supplementation in dose of 2000 IU daily during a six month-period (Group 1). In addition, 35 patients with severe COPD, matched to the study subjects of the Group 1 by sex, age and serum vitamin D level, who did not receive vitamin D supplementation served as controls (Group 2). Analysis of exacerbations, including their incidence and duration, as well as incidence of relapses and duration of exacerbation-free interval, was done for each study subjects based on daily diary cards maintained by all of them during the mentioned period. Results: Mean serum vitamin D levels at baseline did not differ significantly between examined groups (21.7 vs. 22.1; P = 0.457). At the end of the study its mean level was significantly higher in the Group 1 as compared to Group 2 (30.1 vs. 23.4; P = 0.000). Mean number of the first exacerbation over a six month-period was significantly lower in the Group 1 as compared to their mean number in the Group 2 (0.8 vs. 0.9; P = 0.001). Mean duration of the first exacerbation in the Group 1 (6.7 ± 1.2 days) was significantly lower as compared to its mean duration in the Group 2 (7.2 ± 1.3 days) (P = 0.033). Mean number of relapses registered in the Group 1 (0.2 ± 0.1) was significantly lower than its mean number registered in the Group 2 (0.4 ± 0.2) (P = 0.000). Mean exacerbation-free interval in the Group 1 (39.3 ± 10.1 days) was significantly longer than in the Group 2 (33.7 ± 11.8 days) (P = 0.052). Conclusion: Our findings indicated that vitamin D supplementation may impact the incidence and duration of bacterial exacerbations in patients with COPD. There is a need of further studies to elucidate the role of vitamin D supplementation on the course of COPD. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Efficacy and Safety of Levofloxacin in Outpatient Treatment of Exacerbations of COPD and Bronchiectasis(European Journal of Respiratory Medicine, 2022-01); ; ;Petrova, Tatjana; Atanasovska, AnetaIntroduction: Majority of the exacerbations of chronic obstructive pulmonary disease (COPD) and bronchiectasis could be treated on outpatient basis. Aim of the study: To assess efficacy and safety of levofloxacin as empirical treatment of exacerbations of COPD and bronchiectasis in outpatient setting. Methods: We performed an observational, non-randomized, open-label study including 74 patients with exacerbation of COPD and 34 patients with exacerbation of bronchiectasis of bacterial origin which met criteria for outpatient treatment. The patients were treated with oral levofloxacin 500 mg once daily for 10 days (COPD exacerbations) and 14 days (exacerbations of bronchiectasis). Efficacy of the treatment was assessed by a number of patients with clinical remission of exacerbation, while the safety was assessed by a number of patients with side effects during the treatment. Results: Clinical remission of exacerbation, i.e. complete resolution of clinical symptoms and signs or their return to their baseline severity, was achieved in 87.8% of patients with COPD, as well as in 82.3% of patients with bronchiectasis. In addition, the mean time to clinical remission of exacerbation in patients with COPD and bronchiectasis was 6.2 and 9.6 days, respectively. Incidence of side effects during the treatment with levofloxacin was 9.4% in patients with COPD and 11.7% in patients with bronchiectasis. Registered side effects were mild and self-limited and did not require premature discontinuation of the treatment with levofloxacin. Conclusion: Our findings confirmed high efficacy and good tolerability of levofloxacin in empirical treatment of exacerbations of COPD and bronchiectasis in outpatient setting. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CEFPODOXIME IN THE OUTPATIENT TREATMENT OF LOWER RESPIRATORY TRACT INFECTIONS(Faculty of Medicine, Skopje, 2021-05-15); ; ;Petrova, Tatjana; Introduction. According to the recent data, lower respiratory tract infections (LRTIs), i.e. a broad terminology including acute bronchitis (AB), influenza, community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and acute exacerbation of bronchiectasis (AEBX), represent the fourth most common cause of death at global level. Aim of the study. To assess efficacy and safety of cefpodoxime in the empirical treatment of LRTIs of bacterial origin in an outpatient setting. Methods. We performed an observational, non-randomized, open-label study (a real life-study) including 126 patients with LRTI of bacterial origin, 59 patients with AECOPD, 32 patients with CAP and 35 patients with AEBX, who met criteria for treatment in an outpatient setting. All study subjects were treated with cefpodoxime 200 mg twice daily, and had intermediate visits at 3, 5, and 7 days (patients with AECB) and at 3, 5, 7, and 10 days (patients with CAP and AEBX) at which their symptoms as well as eventual side effects were evaluated. The treatment was considered to be successful if complete resolution of symptoms or their return to the baseline severity was achieved. Results. Percentage of clinical success, i.e., complete resolution of clinical symptoms and signs or their return to the baseline severity, varied from 77.9% in patients with AECOPD, 81.3% in patients with CAP to 77.1% in patients with AEBX. Mean time to clinical remission varied from 6.5 0.3 days in patients with AECOPD, 7.8 0.5 days in patients with CAP to 10.7 1.2 days in patients with AEBX. Incidence of side effects during the treatment varied from 10.2% in patients with AECOPD, 12.5% to 8.6% in patients with AEBX. Registered side effects were mild and self-limited and did not require premature discontinuation of the treatment. Conclusion. Our findings supported the use of cefpodoxime in the treatment of bacterial LRTI due to its high efficacy and good tolerability. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Efficacy and Tolerability of Various Antimicrobial Regimens in the Treatment of Exacerbations of Chronic Bronchitis and Chronic Obstructive Pulmonary Disease in Outpatients(ID Design Press, 2009-06-01); ; ;Petrova, Tatjana; Risteska-Kuc, SnezanaObjective. To compare the efficacy and tolerability of different antibiotics empirically administered for exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD). Methods. We performed an observational, non-randomized, open-label study including 226 outpatients with exacerbations of chronic bronchitis and mild or moderate COPD, 123 males and 103 females, aged 24 to 81. All patients were followed up for 30 days, with an intermediate visits at 5 and 10 days at which they were asked about the duration of symptoms (increased expectoration, increased dyspnea and/or presence of purulent sputum) and the side-effects of the drug. Five antibiotic regimens were evaluated: amoxicillin/clavulanic acid 875 mg/125 mg twice daily for 10 days, cefuroxime 250 mg twice daily for 10 days, cefixime 400 mg once daily for 10 days, clarithromycin 500 mg twice daily for 10 days, and ciprofloxacin 500 mg twice daily for 10 days. Results. The clinical success rate, defined as a complete resolution or a return of the symptoms to the baseline severity, in the groups receiving amoxicillin/clavulanic acid, cefuroxime, cefixime, clarithromycin, and ciprofloxacin was 68.9%, 75.0%, 73.5%, 72.7%, and 77.1%, respectively. The mean time to relief of symptoms varied from 6.8 days with amoxicillin/clavulanic acid to 6.1 days with cefuroxime. Relapse within the first month was registered in the group receiving clarithromycin and ciprofloxacin (3.1% and 2.6%, respectively). The prevalence of the adverse events varied from 10.4% with ciprofloxacin, following by 8.9% for amoxicillin/clavulanic acid, 7.5% for cefixime, 6.8% with clarithromycin to 6.1% with cefuroxime. Conclusion. Our findings suggest high efficacy and safety of all studied regimens in the treatment of exacerbations of chronic bronchitis and COPD. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of Pleuran (β-glucan from Pleurotus ostreatus) Supplementation on Incidence and Duration of Bronchiectasis Exacerbations(Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia, 2020-09-15); ; ; ;Petrova, TatjanaBACKGROUND: Patients with non-cystic fibrosis bronchiectasis (BE) have frequent exacerbations that are causes of significant morbidity and sometimes mortality, and which it is desirable to prevent. AIM: We aimed to assess the effects of pleuran on the incidence and duration of exacerbations in patients with BE. METHODS: A prospective, observational, open-label, and active-controlled study was realized as a comparison of the frequency and duration of exacerbations between a group of patients with BE (30 patients, 14 males and 16 females, aged 44–72 years) who received a combination supplement containing pleuran 100 mg, Vitamin C 60 mg and zinc 5 mg over a 3-month period and a group of patients with BE (31 patients, 15 males and 16 females, aged 45–74 years) treated over a 3-month period with a combination supplement containing Vitamin C 60 mg and zinc 5 mg. RESULTS: Over the study period, altogether 46 exacerbations were documented (19 in the patients receiving pleuran and 27 in the patients who did not receive pleuran), nine of which required hospital treatment (four in the patients receiving pleuran [21.5%] and five in the patients who did not receive pleuran [18.6%]). The mean number of exacerbations over the study period was significantly lower in the patients receiving pleuran (0.6 ± 0.4) as compared to the mean number in the patients who did not receive pleuran (0.8 ± 0.3) (p = 0.0297). The mean duration of exacerbations, expressed in days, needed for cure or clinical improvement in the patients receiving pleuran (11.2 ± 1.7 days) was significantly shorter than that of exacerbations in the patients who did not receive pleuran (12.4 ± 1.3 days) (p = 0.0029). We found significantly lower incidence and significantly shorter duration of exacerbations in the patients with BE who received pleuran as compared to their incidence and duration in the patients with BE who did not receive pleuran. CONCLUSION: Our findings indicated a need for further investigations in this domain to define the possible role of pleuran in the prevention of BE exacerbations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of a Long-Term Use of Carbocysteine on Frequency and Duration of Exacerbations in Patients with Bronchiectasis(ID Design Press/Scientific Foundation SPIROSKI, 2019-12-15); ; ;Petrova, Tatjana; The failure of mucus clearance in bronchiectasis can be improved by chest physiotherapy or/and mucoactive agents. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Carbocysteine in the Management of Stable COPD: Are Its Antioxidant and Anti-Inflammatory Properties Clinically Relevant?(ID Design Press, 2017-12-27); ; ;Petrova, Tatjana; The recent epidemiological and experimental evidence suggest possible antioxidant effect of carbocysteine in patients with chronic obstructive pulmonary disease (COPD).AIM: To assess efficacy and tolerability of carbocysteine in the management of stable COPD.METHODS: We performed an observational, non-randomized, open study (a real life study) including 87 patients with stable COPD (group B and D by combined COPD assessment) divided in two groups, examined group (EG) and control group (CG). All participants were treated with the regular treatment of the stable disease, but in the participants of the EG carbocysteine 1,500 mg daily was added to their regular treatment during the period of two months. The study protocol included completion of the COPD Assessment Test (CAT) and spirometric measurements at initial visit and at the end of the mentioned period.RESULTS: We found significantly lower mean value of the overall CAT score in the EG at the end of the study as compared to its mean value registered at initial visit (26.9 vs. 24.3; P = 0.007). In regard to certain CAT items, we found significantly lower values of the mean scores related to cough phlegm and sleep disturbances as compared to their mean scores at initial visit. In addition, the mean values of the overall CAT scores at initial visit and at the end of the study in controls were similar. In EG we found significantly higher mean value of the MEF 25-75 at the end of the study as compared to its mean value registered at initial visit (59.3% vs. 67.2%; P = 0.003). There was no significant difference in the mean values of other spirometric parameters at the end of the study as compared to their mean values at initial visit. In controls we registered similar values of all measured spirometric parameters at the end of the study as compared to their values registered at initial visit. Mild gastrointestinal manifestations were registered in 13.3% of the participants of the EG during the examined period.CONCLUSION: Our findings indicate positive effects of carbocysteine regarding the symptoms and lung function, as well as its good tolerability in the patients with stable COPD.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Moxifloxacin in the Outpatient Treatment of Moderate Exacerbations of Chronic Obstructive Pulmonary Disease(ID Design Press/Scientific Foundation SPIROSKI, 2018-11-25); ; ;Petrova, Tatjana; Bacterial infections are involved in more than a half of the exacerbations of chronic obstructive pulmonary disease (COPD).
