Faculty of Medicine
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Item type:Publication, Trend of Kidney Replacement Therapy in North Macedonia from the Years 2015 Through 2020(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2024-11-01); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, VASCULAR COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS TYPE 2 AND CORRELATION WITH ELEVATED HOMOCYSTEINE LEVELS AS A RISK FACTOR(2020-01); ; Background Elevated homocysteine levels (tHcy), oxidative stress and prolonged hyperglycemia are considered as potential factors for vascular endothelial damage. Correlation between elevated plasma homocysteine and microvascular or macrovascular complications of diabetes mellitus patients, and its possible role as an early predictor for endothelial imparement, is a scientific challenge up to date.Methods diabetes mellitus type 2 more than 12 months, glycosylated haemoglobin HbA1c ≥ 7,5%, BMI ≤ 40 kg/m2 and prescribed oral antidiabetic drugs (OAD) and / or insulin therapy, divided into two groups: 50 patients diagnosed with vascular complications and 30 patients without vascular complications. Complete haemogram, glycemic profile. HbA1c, lipid prorenal function tests, plasma tHcy levels, ultrasound, doppler sonography, blood preasure measurements, oftalmoscopy and urine test for microalbuminuria were performed in each patient. ResultsElevated levels of homocysteine within 16,05 ± 0,83 μmol/l were detected in the group of diabetic subjects with microvascular and macrovascular complications compared to the group where no complications were diagnosed and levels of homocysteine were 10,44 ± 0,24 μmol/l. Elevated homocisteine levels represent an additional risk factor for endothelial imparement in patients with diabetes Conclusion mellitus type 2. However, further research would provide clear evidence of the impact on endothelial vascular damage and long-term vascular complications - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE EFFECT OF METHYLPREDNISOLONE VERSUS DEXAMETHASONE IN INCREASING THE DIABETOGENIC EFFECT OF SARS-CoV-2 INFECTION AND THE DEVELOPMENT OF A NEW-ONSET DIABETES MELLITUS(Macedonian Association of Anatomists, 2022); ; ; Milenkovski, MarijanSARS-CoV-2 causes predominantly lung disease, but by way of binding to the angiotensinconverting enzyme 2 (ACE2) receptors, it can attack key metabolic organs and may lead to alterations of glucose metabolism. The aim of the study was to examine the effect of methylprednisolone compared with dexamethasone on the glycaemic control as well as the development of new-onset diabetes in patients who were hospitalized due toCOVID-19 pneumonia. We reviewed the records of 203 consecutive patients who were hospitalized with a clinical presentation of COVID-19 pneumonia in the modular hospital at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, from December 2020until May 2021. We identified 65 patients with diabetes (32,0%), 49 patients (75%) of whichwith pre-existing diabetes, and 16 (25%) with newly diagnosed diabetes. Impaired glycoregulation was recorded in 19,2% of patients, of whom 5,5% did not receive any corticosteroid-therapy, 22,4% were treated with methylprednisolone – pulse doses,and 21,4% were treated with dexamethasone. Patients with diabetes had a 1,9 times (CI 0,9-3,9) higher mortality rate than nondiabetic patients. We suggest that, if corticosteroid therapy is necessary during the treatment of COVID-19 pneumonia, it is safer to administer dexamethasone than methylprednisolone, especially in patients who have pre-existingdiabetes or are at risk ofdeveloping diabetes. Deterioration of glycoregulation and the need to replace oral antidiabetic therapy with insulin are common. New-onset diabetes often persists even after recovering from Covid-19 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Carotid ultrasound, blood lipids and waist determination can predict a future coronary revascularisation in the type 2 diabetic cohort(Macedonian Academy of Science and Art (MANU), 2007-12-28); ; ; The aim of the study was to identify incremental values of carotid ultrasound measurements (carotid plaques and stenosis) on the prediction of future coronary revascularization among type 2 diabetic patients. The second objective was to determine the predictive value of the assessment of blood lipids, BMI, abdominal obesity and the ankle-brachial index (ABI). Three hundred and thirty three (333) patients with type 2 diabetes and manifested coronary artery disease were randomly selected in a cohort prospective study. Univariate and multivariate logistic regression analyses were conducted to identify variables predictive of the need for future revascularization: percutaneus coronary interventions (PCI) or coronary bypass surgery (CABG) followed 24 months after the study starting point. The presence of arterial hypertension, hyperlipidemia, physical inactivity, intermittent claudication, the value of systolic pressure, BMI, waist and hip measurement, glycemia and blood lipid fraction (total cholesterol, HDL, LDL, non-HDL, triglycerides) were entered in a model. Ultrasound measurements: carotid IMT, presence of carotid plaques and stenosis, and ABI were also included in the analysis. Based on the univariate and multivariate findings, the presence of internal carotid artery (ICA) stenosis (OR 4,562, 95% CI 1,327-15,687), carotid plaque (OR 1,465, 95% CI 0,829-2,591), and increased waist measurement (OR 1,371, 95% CI 0,757-2,483) were found as significant independent predictors of future PCI. LDL and non HDL cholesterol were found to be factors independently associated with the need for future CABG by univariate analysis, which was not confirmed by multivariate analysis. In conclusion, the current study has provided an identification of predisposing factors for the future need of coronary revascularization among type 2 diabetic patients that permits risk stratification and may facilitate improved patient selection or optimization. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Burden and Characteristics of the Comorbidity Tuberculosis-Diabetes in Europe: TBnet Prevalence Survey and Case-Control Study(Oxford University Press (OUP), 2019-01)