Faculty of Medicine

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CHRONIC RESPIRATORY SYMPTOMS AND SPIROMETRIC PARAMETERS AMONG PROFESSIONAL DRIVERS - THE IMPACT OF OCCUPATIONAL EXPOSURE AND WORK TENURE
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-06-18)
Andonov, Goran
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Aim. To assess the prevalence of chronic respiratory symptoms, spirometric parameters and the effects of occupational exposure among professional drivers. Material and methods. A cross-sectional epidemiological study was conducted including 70 male professional drivers and 70 administrative staff matched by age, work tenure, occupational exposure and smoking status. Data on respiratory symptoms, smoking status, occupational exposure to harmful agents and work tenure were collected using a standardized questionnaire. Spirometry was performed to assess lung function. Results. Professional drivers had a significantly higher prevalence of respiratory symptoms compared to controls, including any respiratory symptom (81.4% vs. 58.6%, p=0.003), nasal symptoms (35.7% vs. 8.6%, p<0.001), cough (61.4% vs 34.3%, p=0.002), cough with phlegm (37.1% vs. 20.0%, p=0.040), dyspnea (31.4% vs. 17.1%, p=0.049) and wheezing (25.7% vs. 7.1%, p=0.006). All spirometric parameters were significantly lower in drivers, indicating involvement of both large and small airways (p<0.05). Drivers with ≥ 20 years of work tenure exhibited a significantly higher prevalence of symptoms and lower spirometric values. Multivariable logistic regression identified exposure to gases as the strongest independent predictor of respiratory symptoms (adjusted OR up to 12.4, p<0.01), followed by exposure to smoke (adjusted OR up to 6.31, p<0.05). Dust exposure showed a non-significant trend, while vapors were not associated with respiratory symptoms. Conclusion. Professional drivers are at increased risk of developing respiratory symptoms and lung function impairment compared to the control group. Occupational exposure to gases and smoke represents the main independent risk factor, while longer work tenure suggests a cumulative adverse effect.
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DERMATOGLYPHIC PATTERNS AMONG STUDENTS IN NORTH MACEDONIA
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-03-24)
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Introduction: Dermatoglyphics is a scientific discipline that studies the epidermal ridge patterns present on the palmar surfaces of the hands, the toes and the plantar surfaces of the feet. Aim. An analysis of individual dermatoglyphic characteristics in healthy medical students of Macedonian and Albanian ethnicity was conducted. Material and methods: The study included 234 healthy students; palm prints were obtained and dermatoglyphic parameters were read, classified and compared with data reported in the dermatoglyphic literature. Imprinting was done by the Cummins and Midlo ink method. The reading and classification of dermatoglyphic patterns were performed according to Henry's system. Results: Ulnar loops were the most prevalent patterns, followed by circular, arcuate and complex patterns, which were present in a small percentage in both genders; radial loop was present only on the second finger in both genders. There were differences on the right hand for the second, fourth and fifth finger, and on the left hand for the third, fourth and fifth finger between males and females. Also, significant differences were found in the third and fourth interdigital spaces and hypothenar area. The triradii distribution formula in females was: a > b > d > c > t; whereas in males it was: a > t > b > c = d. Additional triradii were rare in both genders. The atd angle was within the range of 32ᵒ -55ᵒ in females and 33ᵒ -50ᵒ in males, most often 40ᵒ in both groups. Conclusion: This population-based study have shown similarities and differences in the prevalence of some dermatoglyphic features in males and females among healthy students.
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Pathophysiology, prevention, and management of coronary microvascular obstruction
(Oxford University Press (OUP), 2026-05-26)
Cenko, Edina
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Badimon, Lina
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Vadalà, Giuseppe
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Merkus, Daphne
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Antoniades, Charalambos
Abstract Although prompt primary percutaneous coronary intervention (PCI) reduces mortality in patients with ST-elevation myocardial infarction (STEMI), the burden of post-infarction heart failure remains considerable and is expected to increase. A major contributory factor is suboptimal myocardial reperfusion, which persists in up to 60% of cases even with timely revascularization. This is largely driven by microvascular obstruction and ischaemia–reperfusion injury, culminating in the no-reflow phenomenon, a critical prognostic factor associated with impaired infarct healing, adverse left ventricular remodelling, and increased risk of heart failure and death. No-reflow is a complex and heterogeneous phenomenon, identifiable through different invasive and noninvasive technologies. When observed post-PCI, after excluding residual epicardial stenosis, it indicates poor microvascular perfusion and necessitates urgent management. Identifying patients at high risk and implementing early targeted interventions are essential to improving outcomes. Pharmacological therapies, including intracoronary adenosine and nitroprusside, have shown unclear benefit in improving microvascular flow. Non-pharmacological strategies, such as ischaemic postconditioning, intracoronary supersaturated oxygen therapy, stent-retriever thrombectomy, and mechanical left ventricular unloading, have demonstrated promise but require further validation in large-scale clinical trials. This clinical consensus statement summarizes current strategies for the prevention and treatment of no-reflow and underscores the need for improved risk stratification and novel microvasculature-targeted therapies. Addressing this persistent and significant unmet clinical need is crucial for improving care for STEMI patients and for mitigating its long-term complications, including heart failure and mortality.
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Prevalence and Characteristics of Allergic Asthma in a Sample of Dairy Farmers
(Scientific Foundation Spiroski, 2024-01)
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Atanasovska, Aneta
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Bislimovska, Dragana
AIM: The objective of the study is to evaluate the prevalence characteristics of allergic asthma in a sample of dairy farmers. METHODS: We performed a cross-sectional study including 83 dairy farmers (mean age: 52.6 ± 8.7 years; mean exposure duration: 23.7 ± 7.6 years) compared to 80 office controls (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Methods of evaluating examined subjects included a questionnaire on respiratory symptoms in the past 12 months, baseline spirometry and histamine challenge, and skin prick tests to standard inhalant and occupational allergens. RESULTS: The frequency of asthma was non-significantly higher in dairy farmers than in controls (7.2% vs. 5%). The frequency of allergic asthma was non-significantly higher in dairy farmers than in controls (6% vs. 3.8%). The frequency of allergic asthma was significantly higher compared to non-allergic asthma in both groups, while the frequency of subjects with allergic asthma who are sensitized to occupational allergens (wheat, corn, rye, cow hairs, molds) was similar in dairy farmers and controls. The risk of sensitization to occupational allergens was non-significantly higher among dairy farmers with allergic asthma (OR = 1,39 [0,18–12,28] CI 95%), compared to office controls. The risk for asthma development was non-significantly higher in subjects sensitized to occupational allergens compared to those who are not sensitized to them both in dairy farmers (OR = 2.00 [0.11–40.60] CI 95%) and office controls (OR = 3.00 [0.00–197.11] CI 95%). The risk for asthma development was about 4 times higher in subjects with atopy compared to those without atopy among dairy farmers (OR = 4.00 [0.22–104.88] CI 95%), while in office controls was almost identical (OR = 1.00 [0.00–39.77] CI 95%). Having in mind sensitization to certain inhalant allergens, asthma was significantly associated with sensitization to Dermatophagoides pteronyssinus both in dairy farmers (p < 0.01) and office controls (p < 0.05). CONCLUSION: The results suggest that occupational exposure among dairy farmers was associated with a higher prevalence respiratory symptoms, lung function impairment, and allergic asthma development. Study findings also can contribute in the detection of critical points for action, predict asthma development, and indicate the need for reduction of adverse occupational exposures by appropriate preventive measures, use of respiratory protective equipment, and implementation of engineering controls.

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