Faculty of Medicine

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    RELATIONSHIPS AMONG BIOCHEMICAL MARKERS IN EARLY NEONATATAL INFECTIONS
    (2014)
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    Antevska, Maja
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    Kovacev, Bogdan
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    Introduction: Many infection markers are components of the inflammatory cascade and reflect the host's immunological status and response to infection. The use of biochemical markers in neonatal infection has remained an important area of research in the past decades. The aims of this small prospective study were: - To present the blood biochemical findings in newborns experiencing clinical features of early onset infections. -To analyze statistically the two relevant parameters (percent of granulocytes and CRP). These markers are widely used in the diagnosis neonatal infection and inflammation. Material and method: Data was retrieved from the neonatal histories from newborns that were born at the University clinic for Gynecology and obstetrics in Skopje. During the period from November 18th 2013 until April 15th 2014, data from 122 newborns was collected. Inclusion criteria for data collection included: Blood analysis of the specific parameters for infection-percent of Granulocytes (as a marker of bacterial infection), CRP (as a marker for inflammation and/or infection) and 100 newborns without clinical manifestations of infection and with normal values of CRP/Granulocytes. The clinical picture of visible infection was considered "Gold standard,,. Positive predictive value and negative predictive value were calculated. Results: Out of 122 newborns studied, 13.11% (15) presented with clinical manifestations of infection. Out of these 16 newborns 75% (12) had increased level of CRP and 43.75% (7) of them had percent of Granulocytes >70%. For increased Granulocytes PPV=0,148; NPV= 0,92 and for increased of CRP PPV=0,25; NPV=0,94. Conclusion: High NPV suggest: normal value of Granulocytes/CRP has low level of likelihood of clinical manifestation. The low PPV suggest that positive values of Granulocytes/CRP have low level of likelihood of infection in newborns. ln case there is not clear clinical manifestation other method should be considered.
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    LABORATORY RESULTS THAT SUGGEST USING PROGNOSTIC MARKERS IN THE ASSESSMENT AND DIAGNOSIS OF RHEUMATOID ARTHRITIS
    (Macedonian Association of Anatomists, 2022-03)
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    ESR and CRP reactants reflect synovitis indirectly. Simultaneously, they are the cause of objectivization and measurement of immune-mediated inflammatory responses in RA. CRP, RF, and ESR testing accompanied with clinical variables of inflammatory synovitis are suggested to evaluate the disease’s activity. Aim: Assessment of RA’s activity with the reactants of the acute phase, ESR, CRP, and RF as prognostic markers for disease activity in patients treated with Methotrexate for early RA. This study focuses on 70 patients in total: 35 patients with early RA and 35 patients in the healthy control group. Patients (pts) were given Methotrexate once a week at a dose of 10 mg on average. We were able to analyze ESR, RF, and CRP in every patient at certain time intervals (0 times, after 6, 9, and 12 months). RA was assessed following the dynamics of changes in the mean values of CRP, RF, and ESR. The analysis showed statistically notable differences among the mean values of ESR in the four-time intervals (p=0,00002). The mean values of CRP also showed differences in all four-time intervals (p=0,0428). On the other hand, no noteworthy statistical differences were detected among the mean values of RF in the four-time intervals (p=0,573). High values of CRP and RF were detected in most patients. The process of disease progression continues despite the Methotrexate therapy, especially in those patients that have elevated values of ESR, CRP, and RF. They are shown to be predictors of the aggressive course of the disease. This enables the selection of the high-risk group of patients for an aggressive course of the disease and points to the necessity for early and aggressive treatment.
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    C-REACTIVE PROTEIN AND NEUTROPHIL-LYMPHOCYTE RATIO AS PREDICTORS OF CLINICAL SEVERITY OF COVID-19
    (INSTITUTE OF PUBLIC HEALTH OF REPUBLIC OF NORTH MACEDONIA, 2021-11-12)
    Pandilov, Stefan
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    Klenkoski, Suzana
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    Mehmeti, Gazmend
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    COVID-19 is an infectious disease that can manifest quite differently. In this study we examined the relationship between the value of serum CRP(C-reactive protein) andneutrophil-lymphocyte ratio (NLR) as predictor factors for the development of a severe clinical manifestation in COVID19 patients. Materials and methods: We followed 95 COVID-19 positive patients who were hospitalized at the University Clinic for Eye Diseases - COVID Center. We analyzed the initial laboratory parameters of white blood cells and CRP on admission of the patients and the results of laboratory analyses performed before they left the Clinic, or the last parameters before the lethal outcome in those patients who died. Several models of logistic regression were tested to analyze the predictive value of these markers of inflammation for lethal outcome in patients hospitalized for COVID-19. Results: Bivariate analysis demonstrated that the length of hospital stay was significantly shorter in patients with lethal outcome (p=0.001). The NLR was significantly higher in patients with lethal outcome at both times (p=0.005; and p=0.017). Leukocyte’s count (p=0.046, and p<0.001) and CRP (p=0.013,and p=0.005) were also significantly higher in patients with lethal outcome at both times. The increase on the NLR scale both at hospitalization and at discharge (or the last analysis before death) leads to increase in the odds of lethal outcome (T1:40.4% increased odds; T2:36% increased odds). Conclusion: CRP and NLR are laboratory parameters that can predict the severity of the clinical manifestation in patients with COVID-19.