Faculty of Medicine

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    Item type:Publication,
    African L0a mtDNA haplogroup in Republic of Macedonia
    (Elsevier B.V., 2017-12)
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    Mitochondrial DNA analysis from individuals from Republic of Macedonia as one of the south-eastern European countries showed that the phylogenetic characteristics of Macedonian population are similar as in other Europen countries, sharing west Eurasian haplogroups, predominantly European haplogroup H. Macedonian population is multiethnic and some of this ethnic groups have specific mtDNA haplogroup traced to their origin. In this article we present first finding of an African haplogroup L0a in orthodox Macedonian. From the published data it is evident that most likely L lineages arrived in Europe in rather recent historical times, what for today’s Republic of Macedonia from historical point of view could be in the last 2500 years.
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    Item type:Publication,
    Some Aspects of Women’s Health in Republic of Macedonia
    (Scientific Foundation SPIROSKI, 2022-10-12)
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    INTRODUCTION: Sex and gender “matters” in terms of the health status as well as a result of both biological and gender-related differences. Thus, sex must be considered in all aspects and all levels of biomedical research.AIM: This study aims to analyze sex- and gender-based differences in Republic of Macedonia through analysis of some aspects of mortality, the knowledge, and attitudes related to women’s health.METHODS: Analysis of the general and age-standardized mortality patterns and computer-assisted personal interview composed on different topics including women’s health for the period of 2017–2020 were used.RESULTS: Age-standardized mortality rates (all-causes of death, circulatory and respiratory diseases, and neoplasms) are prevalent and higher in the male population in Republic of Macedonia. A significantly higher all-cause mortality trend for both sexes was found in 2020 making this year hardly comparable with the previous years. A decreasing trend of malignant neoplasms rate of female genital organs and an increasing trend of breast cancer mortality is observed. The majority of the respondents (50.6%) rated their current health status as excellent with a statistically significant difference between the age and ethnical groups. One-third of the respondents reported regular physical activity, mostly on a daily basis. The majority (39.3%) are overweight and 27.5% belongs to the obesity Class I without a significant difference in terms of ethnicity. Respondents (27%) reported that have high blood pressure, 20.2% vaginal infections, 19.9% allergies, heart issues 15.1%, anemia 11.7%, while diabetes and cancer 8.5% and 2.5%, respectively. The youngest and oldest age groups of Albanian women are the least informed about the early detection procedures of malignant compared to Macedonian women and other ethnic groups.CONCLUSIONS: Analyzing some aspects of women’s health in Republic of Macedonia through the mortality and knowledge and attitudes of Macedonian women, we provide some further evidence for the development and implementation of targeted interventions and policies aimed to reduce the sex- and gender-based health inequalities in the country.
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    Item type:Publication,
    Particulate matter measurements in Macedonia for health impact assessment
    (Book of abstracts of the 22nd European Aerosol Conference, France Tours 2016, 2016)
    Rumrich, Isabell Katharina
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    Lappi, Sari
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    Stefanovska, Aneta
    Solid fuel combustion is a common heating source in Macedonia. Small scale combustion in combination with lacking legislation for other emissions lead to high air pollution levels in the Skopje valley. It is suspected that current air quality has significant impact on the population health. To investigate this topic further, risk assessment investigations have been introduced within the EU-funded Twinning project “Further strengthening the capacities for effective implementation of the acquis in the field of air pollution” (MoE 2016). Measured monthly mean concentration of particulate matter (PM) will be used in a pilot study on health impact assessment. The aim of the present work was to assess the correlations between the measured monthly particulate matter mass concentrations (PM2.5 and PM10) from different air quality monitoring stations, in order to evaluate their usability in the health impact assessment study. Method Monthly PM data were available from the national air quality monitoring network for the period of January 2012 to February 2016. PM2.5 was measured at two stations only (both within the city of Skopje) and PM10 at nine stations (4 Skopje city, 1 Skopje region, 4 outside Skopje region). Missing monthly values were imputed using the average PM2.5 or PM10 concentration calculated from measurements in the corresponding month of the other years at the same monitoring station. In addition, the average monthly ratios PM2.5:PM10 were calculated for the two stations in Skopje having parallel measurements of these two PM parameters with continuously acting instruments. Results The PM2.5:PM10 ratios at the two stations within Skopje city ranged between 0,61 in spring and 0,67 in autumn. Overall, the correlations in PM data between the different monitoring stations were high. The correlation in PM2.5 between the two stations in Skopje was excellent (R2>90%): The same applied to the PM10 stations within the city of Skopje, where only one monitoring station showed correlation lower than 90% with the others (Gazi Baba; R2>80%). all the Skopje region monitoring stations as well as the monitoring stations outside Skopje region showed generally intercorrelations higher than 70%. Only PM10 data from the station of Kavadarci, correlated poorly with the other stations. The rural background station of Lazaropole, located on a mountain, showed an inverse correlation with all the other monitoring stations. Conclusions. The limited size of the newly started national air quality monitoring programme in Macedonia poses challenges for air pollution exposure assessment. High PM2.5 and PM10 intercorrelations, however, suggest that the PM10 data can be used to improve spatial coverage of PM exposures. Most likely due to same sources, PM pollution levels have similar monthly profiles to those in Skopje city also at the three urban monitoring sites outside Skopje.
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    Item type:Publication,
    Assessing environmental and health risks from chemicals in Republic of Macedonia
    (Istituto Superiore di Sanità, Italy, 2016)
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    The paper presents the current status of the contaminated sites in Republic Macedonia including policy aspects. Special emphasize has been put on the most dangerous site of the ex chemical plant near the capital city of Skopje. The Republic of Macedonia faces similar problems in the environmental sector to those of many other former command economies in Central and Eastern Europe. In particular, inadequate solid waste management and numerous industrial hotspots (including historical industrial pollution sites) have in some cases led to threatened public health with environmental implications. The lack of suitable infrastructure hampers adequate waste disposal in general and disposal of hazardous waste in particular. There is only one licensed (though not acquiscompliant) landfill in the country compared to around a thousand illegal dumps; there are no incineration (except for medical waste), no composting and few recycling facilities. Hazardous waste is exported in accordance with the Basel Convention. A register and maps for pollutants and polluting substances for solid and hazardous waste and waste waters were completed in September 2005. Decades of industrialization and extensive exploitation of natural resources have left certain number of areas heavily polluted in the country. Since independence no significant concrete investments in this regard have taken place for the protection of the environment. As a result many uncontrolled municipal, as well as industrial landfills and wild dumps proliferated. With regard to economic activities contributing to soil contamination expressed in percentage, the highest share belongs to mining and metallurgy with 31.25%, followed by organic chemical industry with 12.5% and oil refining and leather manufacturing industry with 6.25% (2). There are many barriers in the management of the hot spots such are: no official National Strategy for remediation of contaminated sites; no specific law on soil protection; lack of technical guidelines for investigation of contamination, human health and/or environmental risk assessment and prioritizing the need of actions and management of contaminated sites; insufficient institutional capacity for contaminated site management; no permanent intergovernmental or inter-institutional coordination bodies established for the coordination of contaminated sites management, with the consequence of improper inspection on site
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    Item type:Publication,
    Assessing Health Impact of Air Pollution in Macedonian Cities
    (Biomedical Research Network, LLC, 2018-10-15)
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    Item type:Publication,
    The Effects of COVID-19 Lockdown on Air Quality in Macedonia
    (Scientific Foundation SPIROSKI, 2020-10)
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    BACKGROUND: Faced with the novel coronavirus outbreak (2019-nCoV), various urgent and coordinated actions have been taken worldwide to reduce spread of the disease. Slowing down economic activities, transportation, restrictions of the human public gatherings, and interaction resulted with a tremendous decline in air pollutant concentration especially in nitrogen dioxide, registered by National Aeronautics and Space Administration and European Space Agency satellites. AIM: The aim of the study was to assess the impact of COVID-19 lockdown conditions on the air quality in selected cities in Macedonia. METHODS: Daily mean concentration of the particulate matter (PM10 and PM2.5), nitrogen dioxide, ozone, and carbon monoxide measured in the national air quality monitoring network, was analyzed separately comparing following periods: past week of February 2020 to the end of May 2020 with the same period in 2017–2019. Depending on the data distribution, parametric independent-samples t-test or nonparametric Mann–Whitney U-test was run to determine if there were differences in the pollutants concentration during the COVID-19 and non-COVID-19 period. RESULTS: Implementation of strict restrictions of the movement along with reduced economic activities and vehicular transport, led to notable decrement of air pollutant concentrations. We have found an evident decrease in the concentration levels of all pollutants measured during COVID-19 period in 2020, compared to those from 2017 to 2019 with exceptions for PM2.5 in Kumanovo and carbon monoxide in Skopje (7% and 3% higher concentration). The most notable decrement was for NO2, with a concentration 5–31% lower during COVID-19 period. CONCLUSIONS: Although beneficial to human health, there is a need to assess economic implications of the lockdown that could have a negative impact on the health as well.
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    Item type:Publication,
    Strategy for Developing a Smoking Cessation Program in Macedonia
    (E-Cronicon, 2020)
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    Arben Rexhepi
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    Macedonia has one of the highest smoking rates in Europe and ranks among the top ten globally. Although there is a moderately strict anti-smoking legislation, tobacco free policies are not financially supported and smoking cessation activities are not included in the regular educational process of health workers in the country. Smoking cessation is not considered a medical intervention, there is no consistent access to nicotine replacement therapy or other cessation medications, nor are they covered by health insurance. The goal of the partners from Henry Ford Health System and the University St Cyril and Method in Skopje was to develop and adapt a Certified Tobacco Treatment Specialists program (aCTTS). A team of physician champions was created to facilitate implementing the program and to educate respiratory and internal medicine specialists, as well as general practitioners who proceeded treating patients for tobacco dependence. During the first four months of the intervention 64,668 patients visits were registered, 25,710 (40%) of them for tobacco-related diseases. Of the latter, 18,558 (72%) included smoking cessation counseling, which by itself is a great progress to reaching a striving population of smokers.
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    Item type:Publication,
    Functional Foods in Macedonia: Consumers’ Perspective and Public Health Policy
    (ID Design 2012/DOOEL Skopje, 2013-12-15)
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    Milosevic, Jasna
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    Kendrovski, Vladimir
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    Naunova-Spiroska, Daniela
    Background: The objective of our study was to explore the knowledge, attitudes and practices of Macedonian consumers towards functional foods, to predict future trends and to assess the national public health policies encompassing the functional foods market. Methods: Total of 518 respondents aged 18+, from all regions in the country participated in the study. They were sampled through three-staged national representative sampling procedures. The questionnaire comprised questions regarding the level of information about functional foods, trust in health claims, frequency of consumption and knowledge and attitudes related to those foods. Statistical significance was determined at p<0.05. Results: Respondents aged 18-34 were more informed compared to the total population (22 and 16 % respectively, p<0.05). Most of the consumers consume these products once a day. Employed consumers were willing to increase daily consumption from 3 to 18 % (p<0.05). On average 65.1% of the statements assessing knowledge were answered correctly. On a scale from -3 to +3 functional foods were considered as very healthy (mean=2.03, SD=1.42). Conclusion: On average, Macedonian consumers have a positive attitude and high expectations of functional foods. Public health policies still lag when compared to comprehensive approach of the food industry in market placement of these products.
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    Item type:Publication,
    Nutritional status and growth parameters of school-age Roma children in the Republic of Macedonia
    (2011-06)
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    Dimitrovska, Zlatanka
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    Mikik, Vladimir
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    Efremova-Stefanoska, Vesna
    Main objective of the study was to assess the nutritional status of school age Roma children in Macedonia in order to detect precursors of possible health risks at an early age. The study was designed as a comparative case control study. Study group consisted of 229 Roma school children from the 1st and 272 from the 5th grade residing in different towns in Macedonia. The control group was recruited from other than Roma ethnic background and consisted of 283 children attending 1st and 356 children attending 5th grade. Every participant was measured for his/hers body height and weight. The t-test and Chi square (Chi2) were applied to test statistical significance of variables. The WHO's AnthroPlus software was applied to assess growth parameters and population at risk. There were significant differences in values of the body weight (p = 0.001) and height (p = 0.001) between Roma and non-Roma children attending the 1st grade of primary school. Weight-for-age, height-for-age and BMI-for-age indexes of the 1st grade children significantly differred in in the same intervals of SD (> or = -2SD and < -1SD; > or = -1SD and median; > +1SD and < or = +2SD; between Roma and non-Roma 5th graders. Anthropometric parameters of nutritional status of Roma children in Macedonia are significantly different than those of their non-Roma peers. Their health risks are predominantly related to underweight. The parameters related to health risks of overweight or obesity are lower in Roma than in non-Roma children.