Faculty of Medicine
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Item type:Publication, P158 Fungal airway colonisation in cystic fibrosis patients in the Institute for Respiratory Diseases in Children - Skopje, Republic of North Macedonia(Elsevier BV, 2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COVID-19 IN CHILDREN WITH DOWN SYNDROME-CASE SERIES(Macedonian Association of Anatomists and Morphologists, 2023-11-05) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multiplex PCR in Diagnosing Respiratory Tract Infections in Hospitalized Children(Macedonian Academy of Sciences and Arts, 2024-04-04); ; ; Smilevska Spasovska, OlgaObjectives: To elaborate the utility of multiplex quantitative polymerase chain reaction (multiplex qPCR) for the accurate diagnosis of severe respiratory tract infections (RTIs) in hospitalized children. Methods: In two separate periods during 2022, 76 respiratory specimens (combined throat/nasopharyngeal swabs) were submitted for multiplex qPCR regarding 26 respiratory pathogens. The specimens were obtained from children with severe RTIs hospitalized in the Institute for Respiratory Diseases in Children, Skopje. Results: Multiplex qPCR detected at least one respiratory pathogen in all examined specimens (76/76), with 83% (63/76) rate of co-infections. Considering that positive results are only the ones with Ct value below 28, the rates of detected pathogens and co-infections decrease to 75% and 22%, respectively. The most commonly detected pathogens during the spring period were Parainfluenza type 3 (PIV3) followed by Adenovirus (AdV) and Respiratory syncytial virus type B (RSVB) with frequency rate of 23%, 19% and 19%, respectively. During the autumn period, the most common were RSVB and Streptococcus pneumoniae with frequency rate of 31% and 17%, respectively. Conclusion: Multiplex qPCR is a powerful tool for diagnosing RTIs. Semi-quantification of the viral load by reporting Ct values added higher level of evidence for accurate diagnosis. Seasonal detection of the examined viruses was notable with higher prevalence of PIV3 in spring and RSVB in autumn period. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ACHALASIA OF THE CARDIA - A PEDIATRIC CASE REPORT(Macedonian Association of Anatomists and Morphologists, 2021); ; ; Chakalarovska, IrenaIntroduction: Achalasia is an esophageal motor disorder characterized by aperistalsis of the esophageal body and lack of relaxation of the lower sphincter in response to swallows. It affects both sexes and all age groups. The exact etiology of this degeneration is unclear though many theories have been proposed. Possible etiology of achalasia can be familial, infection or autoimmune. Patients often present with progressive dysphagia to solids and liquids, heartburn, chest pain, regurgitation, and varying degrees of weight loss or nutritional deficiencies. Case report: In January 2020, a 10 years old boy was admitted to our hospital due to vomiting, chest pain during swallowing, and prolonged cough. A lot of investigations were performed. Fyberbronchoscopy showed that the trachea, the right main bronchus and the left main bronchus were with anteroposterior narrowed lumen. Computed tomography of thorax and abdomen showed dilated esophagus with largest diameter of 45 mm subcarinal with retained content.There is a compression of the right hillus. The finding indicates achalasia of the cardia. One month after the hospital stay, the child was admitted at the Clinic for pediatric surgery. Laparoscopic Heller Myotomy (LHM) with antireflux Dor fundoplication was performed. The following period the boy has no gastric or respiratory symptoms. Conclusion: We can conclude that it is worth to suspect achalasia in a pediatric patient with prolonged cough and recurrent respiratory infections refractory to conventional treatments such as bronchodilators, especially if the patient also has a history of vomiting and dysphagia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Utility of exhaled nitric oxide in pediatric practice-review of literature.(Macedonian Association of Anatomists and Morphologists, 2019); ; ; ; Popova, GoricaThe field of interest for measurement of exhaled nitric oxide (NO) and nasal NO is significantly evolving over the last 25 years, with over 1000 publications published in that area. Inflammation of the airways is a central process in asthma and other lung disorders, but the monitoring of the inflammation has not been included in the current recommendations. The exhaled air contains volatile media such as nitric monoxide, carbon monoxide, ethane, pentane and non-volatile substances in the liquid phase in the exhalation, as a condensate (hydrogen peroxide). It is increasingly confirmed that the measurement of exhaled mediators in general, and especially NO, is a new way to monitor certain aspects of asthma, COPD and interstitial lung disease, which cannot be estimated with other methods, like lung function. In asthma, exhaled NO is recommended to be used as a marker for diagnosis, for monitoring the response of anti-inflammatory drugs, confirming the safety of therapy and predicting asthma exacerbation. Measurements of FeNO are easily performed, they are reproducible and technically less expensive than the analysis of induced sputum. In symptomatic patients, high FeNO levels (> 50 ppb), refer to significant eosinophilia in the airways, which will most likely respond to treatment with ICS. The current data provides support for the diagnostic use of FeNO in children with symptoms of asthma. For patients with chronic and/or severe asthma, FeNO levels are useful for determining whether eosinophilic inflammation of the airways is active or not. Both high (> 50ppb) and low (<25 ppb) levels of FeNO can be used to for predicting the outcome in patients with a definitive history of asthma who are currently in remission and who have stopped treatment with ICS. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gastrointestinal tract- reservoir of extenden spectrum β lactamases producing strains colonizing respiratory tract in infants(Macedonian Association of Anatomists and Morphologists, 2015); ; Ilievska, TanjaIntroduction The useage of broad spectrum antibiotics leads to emergence of ESBL (extended spectrum β lactamases) gram - negative strains. Members of the normal gastrointestinal (GI) tract flora may cause endogenous disease if they reach tissues where they can not be tolerated. Objectives The aims of this study are: to elaborate the prevalence of ESBL – producing strains obtained from patients with respiratory tract infections (RTIs), to investigate gastrointestinal colonization and possible endogenous reservoirs of infection, and to elaborate some epidemiological features of patients harboring ESBLs. Methods Standard microbiological procedures were used for detecting bacteria, modificate triple disk diffusion test for detecting ESBLs, and disc diffusion test for measurement of antibiotic susceptibility From 20 randomly selected patients with ESBLs cultivated from respiratory tract, stool samples and gastric contents were taken for detecting GIT colonization at the same time. Results Of all enterobacteriaceae, ESBLs producers were 62.21% (214/344). Of all stool samples, 100% (20/20) were with predominant ESBLs gram - negative flora, and of all gastric samples in 90% (18/20) ESBLs gram- negatives were isolated, of which 94.4% (17/18) identified to the species level were identical to those isolated from respiratory tract. Conclusion The prevalence of ESBLs isolated from respiratory tract in young patients is increasing. It seems that gram-negative ESBL-producers isolated from respiratory tract were indigenous gastrointestinal tract flora. Some epidemiological findings suggest possible risk factor for translocation of microbiological flora. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of Quantiferon TB gold test in diagnosis of latent tuberculosis infection(LTBI) in childhood and its correlation with tuberculin skin test(Macedonian Association of Anatomists and Morphologists, 2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Etiology, epidemiology, clinical implications and treatment of acute bronchiolitis-a review of the literature(Macedonian Association of Anatomists and Morphologists, 2013); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EVALUATION OF THE ANALYTICAL VALUE OF SARS-CoV-2 ANTIGEN TEST IN RELATION TO Ct-VALUES OF RT-qPCR IN PATIENTS SUSPECTED OF COVID-19(Македонско лекарско друштво = Macedonian Medical Association, 2021); ; Introduction. COVID-19 pandemic threatens global human health. Reverse-transcription quantitative polymerase chain reaction (RT-qPCR) is a reference test for identification of acute SARS-CoV-2 infection, but it is associated with results delay. There is a need of fast and reliable tests which can improve the efforts of controlling the transmission of SARS-CoV-2. Aim. The aim of this study was to determine the analytical value of the rapid SARS-CoV-2 Ag-test in relation to the Ct values of the RT-qPCR. Methods. The study group comprised outpatients suspected for COVID-19, sampled twice, first for the routine RT-qPCR, and second for SARS-CoV-2 antigen testing. The results obtained by the rapid antigen test (Panbio™ COVID-19) were evaluated in relation to Ct values of the SARS-CoV-2 E-gene, obtained by RTqPCR Allplex 19-nCoV multiplex assay platform. Results. SARS-CoV-2 prevalence, based on RT-qPCR, was 50.8% (186/366). Specificity of the PanbioTM COVID- 19 Ag Rapid Test was 100%. Test sensitivity was 73.8%. Restricting RT-qPCR to Ct-values<30 increased test sensitivity to 91.2%. Conclusion. The findings underscored the epidemiological value of the rapid Ag-test since it reliably identifies contagious SARS-CoV-2 infected individuals who actively spread the virus in the community. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PULSED-FIELD GEL ELECTROPHORESIS USED FOR TYPING OF EXTENDED-SPECTRUM-β-LACTAMASES- PRODUCING ESCHERICHIA COLI ISOLATED FROM INFANT ҆ S RESPIRATORY AND DIGESTIVE SYSTEM(Faculty of Veterinary Medicine-Skopje, 2018-10-15); ; Stojanovska - Dimzovska, BiljanaEscherichia coli infections are becoming increasingly difficult to treat because of emerging antimicrobial resistance, mostly to expanded-spectrum cephalosporins, due to the production of extended-spectrum β-lactamases (ESBLs).Despite extensive studies of ESBL- producing E.coli in adult patients, there is a lack of information about the epidemiology and spread of ESBL organisms in pediatric population. The aim of this study was to examine the gastrointestinal tract as an endogenous reservoir for the respiratory tract colonization with ESBL- E. coli in children, hospitalized because of the severity of the respiratory illness. The study group consists of 40 children with ESBL-producing E. coli strains isolated from the sputum and from the rectal samples. A control group of 15 E. coli isolated from rectal swabs of healthy children were included in the analysis. The comparison of the strains was done by using antimicrobial susceptibility patterns of the stains, and pulsed field gel electrophoresis was performed for molecular typing, using XbaI digestion. 90% of the compared pairs of strains in the study group were with identical antimicrobial susceptibility patterns and indistinguishable in 79.2% by the obtained PFGE – profiles.33.3% (5/15) of confirmed E. coli strains from the control group were found to be ESBL – producers. Resulting band profiles of all isolates demonstrated presence of 12 pulsotypes, with 100% similarity within the pulsotypes. Although, some isolates obtained from different patients were genetically indistinguishable, these strains were not hospital acquired, as none of the patients satisfied the criteria for hospital acquired pneumonia, and there was a lack of an obvious transmission chain. All ESBL –E. coli isolated from sputum in clinical cases were obtained from patients under the age of one. According to the resistance profile of the compared pairs and the PFGE comparison of all isolates, it can be concluded that the gastrointestinal tract is the main reservoir of ESBL-E. coli. Small age in infants is a risk factor for translocation of bacteria, enabling the colonization of the respiratory tract.