Faculty of Medicine

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    Dyslipidaemia and hypertension in patients with subclinical hypothyroidism
    (Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12)
    Velkoska Nakova, Valentina
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    Dimitrovski, Chedomir
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    Serafimoski, Vladimir
    Objective: The aim of this study was to assess whether subclinical hypothyroidism (SCH) is associated with dyslipidaemia and arterial hypertension. Methods: At the Department of Endocrinology, Diabetes and Metabolic Disorders, Skopje, R. Macedonia, we examined 24 consecutive patients with SCH and 13 healthy controls in a period of 6 months. SCH was defined as an elevated thyrotropin (TSH) (> 4.2 mU/l) and normal free thyroxine (fT4) level (10.3-24.45 pmol/l). None of the patients had been previously treated with thyroxine. In all participants we determined blood pressure, body mass index (BMI), TSH, fT4, antibodies to thyroid peroxidise (TPOabs), total lipids (TL), total cholesterol (TH), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides. Results: Mean diastolic blood pressure increased in SCH patients vis-a-vis controls (85 vs. 74 mmHg; p < 0.05). Mean values of TL, TH, HDL-C, LDL-C, triglycerides, TC/HDL-C, and LDL-C/HDL-C were no different in patients with SCH compared with controls. Individual analysis revealed that the percentages of patients with SCH having arterial hypertension (29%), hypertriglyceridaemia (34.78%), elevated LDL-C (41.66%), elevated TC/HDL-C (21.7%), and LDL-C/HDL-C (21.74%) ratios were higher than the percentages in controls. No significant correlation between TSH and biochemical parameters was detected. Conclusion: Our study revealed that SCH patients have a greater prevalence of dyslipidaemia and arterial hypertension, and, as well, a greater value of mean diastolic pressure vs. control patients.
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    Association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus
    (Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12)
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    Velkoska Nakova, Valentina
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    Adamova, Gordana
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    Dimitrovski, Chedomir
    Objective: The aim of the study was to investigate the association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus (GDM). Methods: The study group included 200 consecutive pregnant women who attended the Endocrinology, Diabetes and Metabolic Disorders Outpatient Department in the period from 02.2006 to 02.2009 with singleton pregnancy and GDM diagnosed following ADA criteria. The following parameters were studied: pre-pregnancy maternal body mass index (BMI), 3-hours 100g oral glucose tolerance test (OGTT) results, glycosylated haemoglobin (HbA1c), total lipids (TL), total cholesterol (TH), triglycerides (TG), HDL- and LDL-cholesterol levels at admission. Neonatal birth weight and the prevalence of being large for gestational age (LGA) was an end-point. Results: We found a significant association between birth weight and pre-pregnancy BMI, HDL-C and birth weight of a large child born previously. Birth weight of a large child born previously was the strongest independent predictor for LGA. The prevalence of LGA (from 27% to 80%) was related to a number of altered maternal characteristics. Conclusion: Pre-pregnancy BMI, HDL-C and birth weight of a large child born previously are the independent predictors for LGA, but results of glucose levels during OGTT are not useful in the prediction of LGA in GDM pregnancies. Probably more factors and other maternal metabolic parameters than glucose levels during OGTT are responsible for the risk of LGA.
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    Gestational Diabetes Mellitus - the impact of maternal body mass index and glycaemic control on baby's birth weight
    (Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12)
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    Janevska, E
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    Objectives. To asses the influence of the maternal BMI and glycaemic control in women with GDM on the baby's birth weight (BW). Material and methods: We analysed 180 women with GDM. Macrosomia has been defined as BW > 4000 gm, small for gestational age < 2700 gm and appropriate for gestational age between both. According to the baby´s BW the pregnant women were divided into three groups: group 1 (G1) with BW < 2700 gm (n = 26); group 2 (G2) with BW between 2700 to 4000 gm (n = 117), and group 3 (G3) with BW > 4000 gm (n = 37). We also analysed BMI (kg/m²), HbA1c (%), PPG (mmol/L) and time of delivery (WG). Results: Comparisons between G1 and G2 showed: BMI (30.7 ± 5 & 31 ± 5.2; p < 0.7), HbA1c (6.4 ± 0.8 & 5.1 ± 0.8, p < 0.002), PPG (8.2 ± 1.7 & 6.9 ± 1.5, p < 0.02), time of delivery (35.2 ± 3.8 & 38.6 ± 1.5, p < 0.0001) and BW (2289 ± 504 & 3474 ± 334, p < 0.0001). Comparisons between G2 and G3 showed: BMI (31 ± 5. 2 & 33.4 ± 6.1; p < 0.02), HbA1c (5.2 ± 1.1 & 6.4 ± 2.3, p < 0.02), PPG (6.9 ± 1.5 & 8.2 ± 1.9, p < 0.02), time of delivery (38.6 ± 1.5 & 39.3 ± 1.4, p < 0.01) and BW (3474 ± 334 & 4431 ± 302, p < 0.0001). Comparisons between G1 and G3 showed the difference at delivery time and the baby's BW (p < 0.0001). Conclusions: Maternal obesity and PPG contribute to macrosomia and also PPG to SGE.
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    Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes and diabetes type 1
    (Macedonian Academy of Sciences and Arts/De Gruyter, 2010-12)
    Velkoska Nakova, Valentina
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    Dimitrovski, Chedomir
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    The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during pregnancy in women with diabetes type 1 and gestational diabetes mellitus (GDM).
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    Contrast-enhanced power doppler sonography in detection and differentiation of focal liver lesions
    (2005-08)
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    Neshkovski, Metodija
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    The aim of the study is to evaluate the contrast enhanced power doppler technique as a method to detect and differentiate vascular patterns of focal liver lesions. Fourty-nine patients with focal liver lesions were included in the study, twenty-nine of them with malignant liver lesions (9 HCC, 20 metastatic), twenty patients with benign lesions (12 haemangiomas, 5 focal nodular hyperplasia, 3 focal steatosis). In all patients classic B-mode and power doppler sonography was performed prior to administration of the contrast medium Levovist (300 mg/ml) and a power doppler examination subsequent to medium administration. Contrast administration led to lowering the number of "no-flow" lesions from 19 to 11. Postcontrast scan analysis revealed markedly enhanced flow in 15 cases in comparison to only 4 in pre-contrast examinations. The pre-contrast power doppler showed central flow in 7, and peripheral in 26 focal liver lesions. On the other hand, the postcontrast study revealed a central flow in 14, and peripheral in 34 focal liver lesions. Statistical significance between pre- and post-contrast power doppler detection of vascularization existed in malignant focal liver lesions and haemangiomas. The same pre- and post-contrast evaluation proved to be statistically non-significant in the focal nodular hyperplasia and focal steatosis groups. Administration of contrast medium enables a better visualization of intratumor blood vessels in focal liver lesions. This, in combination with the power doppler technique, brings such scans close to angiographic findings.
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    Prevalence and predictors of impaired glucose tolerance and diabetes mellitus type 2 in patients with polycystic ovary syndrome
    (Macedonian Academy of Sciences and Arts / Sciendo, 2021)
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    Velkoska Nakova, Valentina
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    Serafimoski, Vladimir
    Aim: To estimate the prevalence of impaired glucose tolerance (IGT) and diabetes mellitus type 2 (DMT2), as well as the predictors for glucose abnormalities in women with polycystic ovary syndrome (PCOS). Material and methods: A cross-sectional study with 80 consecutive patients with newly diagnosed PCOS who underwent the standard 75g oral glucose tolerance test (OGTT) and the measurement of sex steroid hormone and lipid profile. Results: According to the results from the OGTT, 63% had a normal test (NT), 23% had IGT, and 9% had DMT2. The NT group was younger with lower BMI than IGT and DMT2 groups (25.1 ± 7.3, 31.5 ± 6.5, 37.4 ± 4.0 years, and 29.1 ± 8.3 kg/m2, 31.7 ± 4.6 kg/m2, and 34.5 ± 5.6 kg/m2, respectively). The testosterone levels were highest in the group with a normal test (2.7 ± 0.8 nmol/l) and lowest in the DMT2 group (1.9 ± 0.8 nmol/L), with statistical significance. The sex hormone bounding globulin (SHBG) levels were low in all three groups, with statistically significant differences between NG and IGT, and the NT and DMT2 groups. The multivariate linear regression model identified age, BMI, SHBG and testosterone as major independent predictors for abnormal glucose metabolism. Conclusion: It seems that the prevalence of IGT and DMT2 among PCOS women in our country is not as high as in Western countries. Age, BMI, and SHBG increase the risk for the development of IGT and DMT2. Thus, close monitoring of older, obese women with low SHBG is needed because of the higher risk for the development of IGT and DMT2 in such patients.
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    Factors That Influence the Virological Response in Patients with Chronic Hepatitis C Treated with Pegylated Interferon and Ribavirin
    (Walter de Gruyter GmbH/Macedonian Academy of Sciences and Arts, 2017-03-01)
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    Joksimovic, Nenad
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    The success of the antiviral treatment in patients with chronic hepatitis C depends on the factors related to the virus and the host. The aim of the study is the analysis of the antiviral therapy which is a combination of pegylated interferon and ribavirin, considering various factors that will identify the predictors of the sustained virological response.