Faculty of Medicine

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Author: search.filters.author.Popova, GoricaSubject: search.filters.subject.children

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    COVID-19 IN CHILDREN WITH DOWN SYNDROME-CASE SERIES
    (Macedonian Association of Anatomists and Morphologists, 2023-11-05)
    Ivanovska, Julija
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    Nestorov, Hristijan
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    Popova, Gorica
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    Chakalaroska, Irena
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    Petlichkovska, Sandra
    Down syndrome (DS) is the most common genetic disease and presents withcognitive impairment, cardiac and gastrointestinal abnormalities, increasedrisk of hematological malignancy and several autoimmune conditions in additionto other miscellaneous clinical conditionsThe aim is to show if the comorbidities that children with Down Sy have, were risk factors for more severe form of COVID-19.We present three cases of children with Down Sy and COVID-19, with different clinical features. All of them had good clinical outcome, only the firstchild had more severe form of Covid 19 with needfor oxygen support, longer hospitalization but with good clinical improvement and withdrawal of the X-ray changes. Children with Down Sy are always a high-risk group for more severeand prolonged course of disease, which are partiallyattributed to defects of the immune system.
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    Multiplex PCR in Diagnosing Respiratory Tract Infections in Hospitalized Children
    (Macedonian Academy of Sciences and Arts, 2024-04-04)
    Popova, Gorica
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    Smilevska Spasovska, Olga
    Objectives: 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.
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    TUBERCULOUS LYMPHADENITIS IN CHILDREN –14 YEARS OF EXPERIENCE
    (Macedonian Association of Anatomists, 2023)
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    Ivanovska, Julija
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    Nestorov, Hristijan
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    Popova, Gorica
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    Petlichkovska, Sandra
    Tuberculosis (TB)is a major public health problem worldwide. It is one of the main causes of infectious disease and mortality, especially in developing countries. Extra pulmonary tuberculosis accounts for 15-20 % of all types of tuberculosis. Lymph nodes are the second most common localization after pleural TB. In childhood, the most commonly envolved are the hilar lymph nodes. Material and methods: We analyzed the frequency of tuberculous lymphadenitis in children treated at the Institute for respiratory diseses in children-Kozle, in the last 14 years. From January 2006 to February 2020 , we’ve treated 397 children with TB. 55 of them (13,8%), were with tuberculous lymphadenitis. Female children were 34 (61%), the others were male.The most frequent was hilar lymphadenitis at 40 (72%), second localization were cervical lymph nodes in 10( 18%). There was 1 child with submandibular localization,1 supraclavicular, 2children with axillary lymphadenitis and one with mesenterial lymphadenitis. Most of the patients had contact with TB. The diagnosis was confirmed pathohistological in the patients with peripheral lymphadenitis. Tuberculosis treatment was started in all patients based on clinical criteria, exposure, positive TST, chest X-ray, or histological confirmation. All of the patients have finished the treatment successfully. Tuberculous lymphadenitis can be a diagnostic and therapeutic challenge in children. Early diagnosis and timely initiation of therapy lead to favorable therapeutic outcome and reduce complications.
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    Utility of exhaled nitric oxide in pediatric practice-review of literature.
    (Macedonian Association of Anatomists and Morphologists, 2019)
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    Popova, Gorica
    The 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.
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    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)
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    Petrusevska Kolekevska, Lidija
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    Dilberovska, Mirjana
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    Dacevski, Dragan
    Tuberculosis is a significant health problem among children population worldwide. Timely diagnosis and treatment of the disease are the basis for prevention of its further spreading. However, the diagnosis of latent tuberculosis infection is a challenge because there is no gold standard. The aim of this study was to evaluate the importance of the diagnostic Quantiferon TB gold test in the diagnosis of latent TB infection and to correlate it with Tuberculin skin test according to the Mantoux method. For the realization of this study we analyzed 32 patients examined for possible M. tuberculosis infection at the Institute of Respiratory Diseases in Children, Kozle, Skopje. The study included 16 girls and 16 boys, aged 9 months to 17 years, with an average age of 6.96 ± 4.49 years. In all children basic biochemical analyses were made: аcid-alcohol-resistant bacilli in a direct sample of sputum, Levenstein Jensen cultures, chest X-ray, tuberculin skin test according to the Mantoux method and Quantiferon TB gold test. The results showed that 24 patients had a BCG scar. All participants in this study had normal radiographic findings of the lungs. In 4 cases Quantiferon TB gold test was positive, while in 28 patients the test was negative. Tuberculin skin test was positive in 13 subjects. In children with negative Quantiferon TB gold test LTBI was excluded and drug prevention with Isoniazid was not started or it was interrupted. Determination of IFN-γ contributes to better diagnosis of LTBI and in reducing the unnecessary drug use. Using Quantiferon TB gold test may be an alternative tool for Tuberculin skin test in the diagnosis of tuberculosis in countries where vaccination with BCG is widespread.
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    Comparison od IFN-γ levels in children with tuberculosis desease(TB) and latent tuberculosis infection (LTBI).
    (ID Design Press,Skopje, Republic of Macedonia, 2018-11-25)
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    Simonovska, Liljana
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    Dilberovska, Mirjana
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    Dacevski, Dragan
    AIM: This study aimed to evaluate the importance of IFN-γ in the diagnosis of pediatric TB and LTBI and to compare the IFN-γ levels. METHODS: We analysed 100 patients examined for possible M. tuberculosis infection or disease at the Institute of Respiratory Diseases in Children, Kozle, Skopje. Patients were divided into 2 groups: TB disease and LTBI. The following parameters were analyzed: demographic characteristics, history of previous exposure to active TB, BCG vaccination and presence of BCG scar, lung X-ray findings, tuberculin skin test by the Monteux method and the value of INF-γ according to the Quantiferon TB gold test, direct samples of acid-alcohol-resistant bacilli of sputum and Löwenstein Jensen cultures. Informed parental consent was obtained for each child included in the study. RESULTS: In the LTBI group 60.9% had a scar from the vaccination while in the TB group 50% had BCG scar. TST induration diameters in children with or without BCG scar were significantly larger in patients with active TB. Children with active TB had significantly higher IFN-γ levels than children with LTBI. The IFN-γ for the cut-off of 0.35 IU/ml, has 64% sensitivity for detection of LTBI, versus 80.6% sensitivity for active disease. Children with close TB contact had significantly higher IFN-γ levels. Correlation between TST induration diameter and IFN-γ levels was stronger in the TB group. CONCLUSION: IFN-γ levels are significantly higher in children with active TB, and children with close contact with TB patient. It has better sensitivity in active TB. Using both tests (IFN-γ and TST) can improve the diagnose of LTBI and TB in countries where vaccination with BCG is widespread.