Faculty of Medicine
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Item type:Publication, Temporal trends in asthma and asthma-like symptom prevalence in Skopje, The Republic of Macedonia(European Respiratory Soc Journals LTD, 2016-09); ; ; ;Kimovska, MicaSeckova, LidijaBackground: There have been differences in temporal trends of asthma prevalence by geographic region. It is important to consider local patterns to plan health care. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of Macedonia as a developing country. Methods: Data was obtained from 3 cross-sectional surveys (2002, 2006 and 2015) 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 confounders. Results: The prevalence of asthma increased although the changes were not statistically significant (2002: 1.7%; 2006: 2.1%; 2015: 2.6%; p=0.13). The prevalence of ever wheeze differed by year (2002: 18.4%; 2006: 15.3%; 2015: 26.4%; p<0.001). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006 and 2015) were observed for current wheeze (8.8%, 7.2% and 5.9%), exercise-induced wheeze (14.2%, 7.9% and 2.1%), and night cough (16.5%, 13.6% and 10.2%). After adjustment for potential confounders, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.35, 95%CI=0.74-2.44; 2015: OR=2.12, 95%CI=1.04-4.35). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results. Conclusion: A significant decrease in asthma symptoms contrary to a slight increase in asthma diagnosis in Skopje during a period of 13 years was established. Improved diagnostics and treatment may explain some of these changes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Asymptomatic bronchogenic cyst in a six-year old girl(Медицински факултет - Скопје, 2006); ;Nikolovski, Ljupco ;Sazdovski, Angelce; Seckova, LidijaBronchogenic cysts in childhood are rare congenital anomalies resulting from the abnormal development of the tracheo-bronchial tree. They are usually found in the mediatinum around the tracheo-bronchial tree or in the lung parenchyma. We report a case of bronchogenic cyst in a six-year old girl presented with fever, cough and chest pain 7 days prior to admission in the hospital. The patient did not have history of any pulmonary disease before. The initial clinical and laboratory findings were suggestive of a lung abscess. Chest x-ray showed a round shadow with an air-fluid level in the middle parts of the right lung. Antibiotic treatment was initiated and the control chest-x ray did not show significant improvement. Computed tomography of the chest further confirmed the cyst with an air-fluid level and better defined its location and size. The cyst was removed by total excision and the histological analysis revealed its bronchogenic origin. The postoperative course was free from complications. Bronchogenic cysts are rare in childhood. Presented as a lung mass with or without infection they should be surgical treated. Surgery establishes the diagnosis and removes the symptoms, additionally preventing complications (infections, haemorrhage, pneumothorax, sudden respiratory compromise and malignant transformation), - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Socioeconomic status hypothesis in asthma and eczema in young adolescents(The Balkan Societies of Allergology and Clinical Immunology, 2006); ;Stavric, Katerina; ;Seckova, LidijaKimovska, MilicaBackground: 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Overweight hypothesis in asthma and eczema in young adolescents(Elsevier BV, 2006); ;Stavric, Katerina; ;Seckova, LidijaKimovska, MilicaBACKGROUND: 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Acetaminophen intake and risk of asthma, hay fever and eczema in early adolescence(2007-09); ;Stavric, Katerina; ;Seckova, LidijaKimovska, MilicaA 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Influence of physical activity and television-watching time on asthma and allergic rhinitis among young adolescents: preventive or aggravating?(Elsevier BV, 2008); ;Stavric, Katerina ;Seckova, Lidija ;Kimovska, MilicaBACKGROUND: 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Do household tobacco smoking habits influence asthma, rhinitis and eczema among 13-14 year-old adolescents?(Elsevier BV, 2011); ;Stavric, Katerina ;Seckova, Lidija ;Kimovska, MilicaBACKGROUND: 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The self-reported density of truck traffic on residential streets and the impact on asthma, hay fever and eczema in young adolescents(Elsevier BV, 2014); ;Stavric, Katerina ;Seckova, Lidija ;Kimovska Hristova, MilicaBACKGROUND: Conflicting results have been reported, mostly in developed countries, on the relationship between exposure to traffic and allergic diseases. This study aims to examine the impact of truck traffic on asthma, rhinitis and eczema in early adolescence in Skopje, the capital of the Republic of Macedonia, as a developing country with a lower middle rate of high truck traffic exposure and low prevalence rates of allergic diseases. METHODS: Self-reported data was used, obtained through the International Study of Asthma and Allergies in Childhood Phase 3 written questionnaires, from 3026 adolescents aged 13-14 years from Skopje. Truck traffic density on the street of residence on weekdays was correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) in binary logistic regression, with and without adjustments for potential confounding factors separately and for their joint effect. RESULTS: A positive association of truck traffic density appeared to be limited to current dry night cough (aOR: 1.63; 1.07-2.47; aOR: 2.17; 1.40-3.35; and aOR: 2.33; 1.43-3.79 for truck traffic seldom, frequently through the day, and almost the whole day, respectively) with an exposure-response relationship and to current wheeze only for truck traffic almost the whole day (aOR: 1.87; 1.02-3.42). CONCLUSION: The findings suggest an aggravating effect of truck traffic on current asthma symptoms, but not on asthma, allergic rhinitis and eczema diagnoses. It seems that it probably has an impact as a direct respiratory irritant in early adolescence.
