Faculty of Medicine

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    Impaired glucose tolerance in obese children and adolescents
    (Blackwell Munksgaard, 2008)
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    Spasevska, Simonida
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    Sukarova Angelovska, Elena
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    P330 Clinical effects of probiotic supplementation in patients with cystic fibrosis in the Republic of Macedonia
    (Elsevier BV, 2019-06)
    Jakovska Maretti, T
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    Gjinovska Tasevska, Elena
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    The association of C3435T single-nucleotide polymorphism, Pgp-glycoprotein gene expression levels and carbamazepine maintenance dose in patients with epilepsy.
    (Dove Medical Press, 2012)
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    The ABCB1 gene encodes the P-glycoprotein (Pgp) protein, which is thought to transport various antiepileptic drugs. The single nucleotide polymorphism (SNP) (C3435T) in exon 26 of this gene correlates with the altered expression levels of P-glycoprotein, range of drug response and clinical conditions. In order to investigate the influence of this polymorphism on the susceptibility to and efficacy of carbamazepine therapy, we evaluated the allelic frequency and genotype distribution of this variant in 162 epilepsy patients from the Republic of Macedonia. Statistically significant differences were detected neither in the allelic frequency and genotype distribution between carbamazepine-resistant and carbamazepine-responsive epilepsy patients nor between the subgroups of carbamazepine (CBZ)-responsive patients treated with different CBZ doses. However, the T-allele was enriched in CBZ-responsive patients who required higher maintenance CBZ doses, This observation was substantiated by the findings that the median total plasma levels were the lowest in patients with CC (20 μmol/L) followed by CT (23 μmol/L) and TT (29 μmol/L) genotypes. Patients with a CC genotype also had a higher likelihood of response compared to patients with CT or TT genotypes over a wide range (400-1000 mg/day) of initial doses of CBZ. The T allele showed a reduced expression of ~5% compared to the C allele in peripheral blood mononuclear cells in heterozygotes for the variant. This difference might be translated into ~10% difference in homozygotes for the variant, which would explain the trend towards a dose-dependent efficacy of the CBZ treatment in patients with different genotypes. A larger prospective study is warranted to clarify the clinical utility of a genotypespecific individualized CBZ therapy.
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    Declining malformation rates with changed antiepileptic drug prescribing: An observational study.
    (Wolters Kluwer (American Academy of Neurology), 2019-08)
    Tomson T
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    Battino D
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    Bonizzoni E
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    Craig J
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    Lindhout D
    Objective: Changes in prescribing patterns of antiepileptic drugs (AEDs) in pregnant women with epilepsy would be expected to affect the risk of major congenital malformations (MCMs). To test this hypothesis, we analyzed data from an international pregnancy registry (EURAP). Methods: EURAP is an observational prospective cohort study designed to determine the risk of MCMs after prenatal exposure to AEDs. The Cochrane-Armitage linear trend analysis was used to assess changes in AED treatment, prevalence of MCMs, and occurrence of generalized tonic-clonic seizures (GTCs) over 3 time periods: 2000-2005 (n = 4,760), 2006-2009 (n = 3,599), and 2010-2013 (n = 2,949). Results: There were pronounced changes in the use of specific AEDs over time, with a decrease in the use of valproic acid and carbamazepine and an increase in the use of lamotrigine and levetiracetam. The prevalence of MCMs with monotherapy exposure decreased from 6.0% in 2000-2005 to 4.4% in 2010-2013. The change over time in MCM frequency after monotherapy exposure showed a significant linear trend in the crude analysis (p = 0.0087), which was no longer present after adjustment for changes in AED treatment (p = 0.9923). There was no indication of an increase over time in occurrence of GTCs during pregnancy. Conclusions: There have been major changes in AED prescription patterns over the years covered by the study. In parallel, we observed a significant 27% decrease in the prevalence of MCMs. The results of adjusting the trend analysis for MCMs for changes in AED treatment suggest that changes in prescription patterns played a major role in the reduction of teratogenic events.
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    Promotion of exercise to children and young people - mechanisms of action
    (European Federation of Sports Medicine Associations, 2019)
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    Incidental prostate cancer in patients undergoing radical cystoprostatectomy in treatment for bladder cancer: our five-year results
    (SHMSHM - AAMD, 2013)
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    Dohchev, S
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    The aim of the paper was to verify the incidence and features of incidental prostate cancer in patients who underwent radical cystoprostatectomy for invasive bladder cancer. Methods and results: A total of 96 patients underwent radical cystoprostatectomy between January 2006 and December 2010 in the University Clinic of Urology in Skopje. 10 patients were excluded for incomplete data. The average age of the study group was 61.2 years (range 32-78). Prostate cancer was found in 10 (11.6%) cases. Seven patients were clinically insignificant. Conclusion: Incidentally diagnosed prostate cancer was frequently insignificant. Digital rectal examination and prostate specific antigen should be part of the diagnostic procedure in patients who undergo cystoprostatectomy. Standard RCP which include removal of bladder with prostate gland and seminal vesicles is safer for radicality and prevention of residual prostate cancer.
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    Management of primary bladder tumors at the University Clinic of Urology in Skopje in 2010 during one-year follow up.
    (2016)
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    Georgiev, V
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    Popov, Z
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    Penev, M
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    Objective: The purpose of this study is to present the major clinical, pathological and outcome monitoring data from patients treated for urinary bladder cancer (UBC)during one-year follow-up. Methods: A total of 151 patients with primary bladder cancer were treated from 1 December 2010 to 30 November 2011 at University Clinic of Urology in Skopje. Histopathologicaly, 146 urothelial, 3 squamous, one adenocarcinoma and one metastatic cancer was confirmed. All patients were evaluated preoperatively by routine laboratory, urinoculture, ultrasonography and cystoscopy. Transurethral resection (TUR) was applied as a golden method for diagnostics and surgical treatment. Postoperative cystoscopy was performed in all patients at 3, 6, 9 and 12 months and the specimens were examined for progression (pathological grade and stage). The study was conducted on the 129 patients with urothelial UBC with pT1 or lower at the time of diagnosis, divided into two groups: first (n=123) treated by primary TUR alone and second group (n=6) treated by TUR and adjuvant chemo/immunotherapy. Seventeen patients with pT2 were treated by radical cystectomy with urine derivation. Results: The median patient age was 65 years (35-89). Urothelial carcinoma was confirmed in 146 (96.7%) and other carcinomas in 5 (3.3%) patients. Statistical analysis showed a significant correlation of pathological stage with the grade of malignancy (p<0.01). Recidivism, as well as grade and/or stage progression was observed in the group treated by TUR only. In the group of patients treated with TUR and chemo/immunotherapy, only grade, but not stage progression or recidivism was recorded. Conclusion: The application of EAU guidelines for bladder tumors contribute to the reduction of recidivism rate and progression of the disease.