Faculty of Medicine
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Item type:Publication, Asthma in adolescents, consequences of transition from pediatric to adult pulmonology(Macedonian Respiratory Society, 2025-04-12); Asthma is a complex, heterogenous medical condition which is very common in children and adults. Transition is “the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered care to adult-oriented health care systems”. The significant changes in physical and mental health during this time, as well as the many unique developmental and psychosocial challenges that occur during adolescence can complicate and impede transition if not adequately addressed and managed. The transition period can also be a challenging time for health professionals to assess readiness for transition and manage some of the complications which are particularly common during this time, including poor adherence to therapy, smoking, drug use, and emerging mental health conditions. The natural history, presentation, symptoms, and management of asthma is often significantly different when comparing pediatric and adult practice. In addition, management in infants, toddlers, school aged children, and adolescents differs significantly, offering an additional challenge to pediatric physicians managing asthmatic children and young people. Despite these challenges, if the transition process for young people with asthma is planned and performed in a formalized manner, many of these issues can be addressed, allowing the transition to occur smoothly despite changes that may occur in medical and psychosocial domains. A successful transition, with minimal consequences, can only be achieved with the continuous cooperation of pediatric and adult pulmonologists. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COVID-19 and chronic respiratory diseases(Serbian Association of Allergology and Clinical Immunology, 2021) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Utility of exhaled nitric oxide in pediatric practice-review of literature.(Macedonian Association of Anatomists and Morphologists, 2019); ; ; ; Popova, GoricaThe field of interest for measurement of exhaled nitric oxide (NO) and nasal NO is significantly evolving over the last 25 years, with over 1000 publications published in that area. Inflammation of the airways is a central process in asthma and other lung disorders, but the monitoring of the inflammation has not been included in the current recommendations. The exhaled air contains volatile media such as nitric monoxide, carbon monoxide, ethane, pentane and non-volatile substances in the liquid phase in the exhalation, as a condensate (hydrogen peroxide). It is increasingly confirmed that the measurement of exhaled mediators in general, and especially NO, is a new way to monitor certain aspects of asthma, COPD and interstitial lung disease, which cannot be estimated with other methods, like lung function. In asthma, exhaled NO is recommended to be used as a marker for diagnosis, for monitoring the response of anti-inflammatory drugs, confirming the safety of therapy and predicting asthma exacerbation. Measurements of FeNO are easily performed, they are reproducible and technically less expensive than the analysis of induced sputum. In symptomatic patients, high FeNO levels (> 50 ppb), refer to significant eosinophilia in the airways, which will most likely respond to treatment with ICS. The current data provides support for the diagnostic use of FeNO in children with symptoms of asthma. For patients with chronic and/or severe asthma, FeNO levels are useful for determining whether eosinophilic inflammation of the airways is active or not. Both high (> 50ppb) and low (<25 ppb) levels of FeNO can be used to for predicting the outcome in patients with a definitive history of asthma who are currently in remission and who have stopped treatment with ICS. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Leptin, obesity parameters and atopy among children with asthma(Macedonian Academy of Sciences and Arts / De Gruyter, 2021-10-26); ; ; ; Leptin, as a major adipokine, positively correlates with the body’s fat, while atopy is an important feature in the development of childhood asthma. We aimed to evaluate the relationship between leptin, parameters of obesity, and atopy in children with asthma. The study included 112 children (73 boys, 39 girls, mean age 11.1±2.4). 41 were overweight, 38 had asthma and a normal body mass index (BMI), and 33 were overweight asthmatics. Serum leptin levels, BMI, waist circumference (WC), and waist to hips ratio (WHR) were measured. Skin prick test (SPT)/CAP, total serum IgE, fractional exhaled nitric oxide (FeNO), and pulmonary function tests were performed. In asthmatic children, serum leptin median level was 9.2±16.2 ng/ml, in overweight children was 30.6±21.6 ng/ml, and in overweight asthmatics was 31.1±20.3 ng/ml with a significant difference between the groups (p=0.0374), yet with a significantly lower median level in the group of children with asthma compared to the overweight children: with asthma (p=0.00001) and without asthma (p=0.00001). In the three groups of patients, BMI and WC displayed a significant positive correlation with leptin (for BMI r=0.652 vs. r=0.530 vs. r=0.563, respectively and for WC r=0.508 vs. r=0.426 vs. r=0.527, respectively). No significant correlations of leptin within atopy parameters (Eo, IgE, SPT/CAP, FeNO) in all three analyzed groups (p>0.05) was detected.Conclusion: Atopy was not confirmed as an underlying mechanism of the association between asthma and being overweight. Leptin had a significant linear correlation as a parameter of central obesity with BMI and WC in all three groups, but not with WHR. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Adaptation and validation of the pediatric asthma quality of life questionnaire in Macedonian children with asthma(2015-09); ; Background: In order to better the control of asthma in the last decades, despit the use of clinical and pulmonary functional assessment, a lot of emphasis has been put on the assessment of quality of life (QL). The aim of the study was to evaluate the Macedonian version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Method: The study included 64 children with asthma from the ages ranging from 7 to 17 from a Macedonian nationality, treated in an ambulant or hospital facility within the University Children' s Hospital in Skopje in a time period of 2 years. The children were assess 3 times during a period of 3 months. To assess the control of the condition we used a Clinical Severity Score (CSS), and for the assessment of the QL we used the Macedonia version of the PAQLQ from Elizabeth Juniper which is contained od 23 questions organized into three domains: symptoms, activities and emotions. The results were analyzed with the appropriate statistical test. Result: There has been increase in the average values of the score of the PAQLQ, witch means better control of the asthma by the end of the 3 months. There was not a statistically significant difference (p>0,05) in the change of the QL and the age of the children with asthma in all the three domains and the overall score. Better scores on the PAQLQ were achieved by the children with persistent asthma, as well as the ones with better CSS. A significant correlation was determine between the assessed clinical parameters (asthma diary, FEV1, PEF and CCS) and the domain of activities, symptoms and overall score (p<0,05), and in the domain of emotions only in correlation to CSS (R=0,31). There was a significant improvement of all the scores of PAQLQ after the beginning of the anti-inflammatory therapy with ICS. According to CSS, at the end of the study all of the children were classified as stable (good QL), in contrast to beginning of the study witch was caracterized with 78% of stability. Conclusion: The Macedonian version of the PAQLQ shows exceptional validity, reliability, excellent responsiveness in the QL of the children with asthma. It can be used for the assessing of the condition, has good measurement properties for all children between 7 to 17, successfully assesses the effects of the anti-inflammatory therapy and achieves complete control of the condition. It is simple and easy for use and gives a new dimension to monitoring children with asthma. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Inflammatory markers in peripheral blood in patients with asthma(2020-12); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Asthma Control Test™ in Assessment of Clinical Asthma Control(ID Design Press, 2009-12-01); ; ; Snezana Risteska-KucBackground. The goal of asthma treatment is to achieve and maintain control of the disease. Objective. To assess validity and reliability of Asthma Control TestTM (ACT) as a patient-based tool for quantifying the control of the disease in the subjects with persistent asthma. Methods. A cross-sectional study including 396 subjects with persistent asthma drown from a population of treated patients was performed. Evaluation of the examined subjects included completion of the ACT, spirometry, and asthma specialist rating of control. Results. The mean derived ACT score in all study subjects was 19.2±3.3. Prevalence of the study subjects with totally controlled (TC), well-controlled (WC) and not well-controlled (NWC) asthma by derived ACT score was 9.1%, 43.2% and 47.7%, respectively. Results from the spirometry showed that in 45% of the study subjects FEV1 value was less than 80%. Prevalence of the study subjects with TC, WC and NWC asthma by asthma specialist rating was 8.1%, 41.1% and 50.7%, respectively. A strong correlation between the derived ACT scores and asthma specialist rating of control was observed (r = 0.51, P = 0.000). Conclusion. Our data confirm the usefulness of the ACT as a valid and reliable screening tool for asthma control. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prevalence of the Respiratory Allergies among Adult Population in the City of Skopje in Relation to Climatic Change and Change in Pollen Micro Flora(Scientific Research Publishing, Inc., 2012); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RESPIRATORY SYMPTOMS, LUNG FUNCTION IMPAIRMENT, AND CHRONIC RESPIRATORY DISEASES AMONG CROP FARMERS: ASSESSMENT BY JOB EXPOSURE MATRICES(European Medical Group LTD, 2016-08); ; ; Objective: To evaluate the prevalence of chronic respiratory symptoms, lung function impairment, and chronic obstructive respiratory diseases in crop farmers. Our objective is to then examine their relation to exposure duration, and to explore the usefulness of job exposure matrices as tools for exposure assessment, and predictors for respiratory health impairment. Methods: A cross-sectional study was performed, including 50 males (mean age: 45.4±10.7 years) employed as crop farmers (duration of exposure: 21.6±9.7 years) and 50 male office workers as a control group (mean age: 44.1±9.8 years) matched for age, smoking habits, and socioeconomic status. Methods of evaluating examined subjects included the completion of a questionnaire on respiratory symptoms in the last 12 months (cough, phlegm, dyspnoea, wheezing, chest tightness, and nasal symptoms), spirometry and histamine challenge (provocative concentration producing a 20% fall in forced expiratory volume in 1 second [FEV1]: ≤8 mg/mL), as well as use of job exposure matrices. Results: Crop farmers had a significantly higher prevalence of cough (29.4%), phlegm (16.7%), and wheezing (11.9%), than the control group (p<0.05). All spirometric parameters (forced vital capacity [FVC], FEV1, FEV1/FVC%, maximal expiratory flow (MEF) at 75%, 50%, and 25%) were lower in crop farmers compared to the control patients, but statistical significance was confirmed only for MEF at 25%, 50%, and 25–75% (p=0.021, p=0.011, and p=0.003, respectively). The prevalence of bronchial hyperresponsiveness, asthma, and chronic obstructive pulmonary disease was higher in crop farmers but without statistical significance. JEM were useful tools for exposure assessment and predictors of factors for asthma and COPD development. Conclusion: The results suggest that occupational exposure among crop farmers is associated with a higher prevalence of respiratory symptoms, lung function impairment, and a higher prevalence of chronic respiratory diseases. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Asthma and small airways(2016-10-29)Asthma is a chronic inflammatory disease of the airway characterized by episodic airway obstruction and increased bronchial responsiveness. The concept that inflammation is a major component of asthmatic pathology was establishe more than 100 years ago, but the attention had been focussed on the large asthmatic airways. That the distal airways and the lung parenchyma play a role in asthma has been suggested later. The distal airways have now been recognized as a predominant site of airflow obstruction in asthmatics. It is now accepted that in asthmatics, recruitment of inflammatory cells, in particular eosinophils and T cells, also occurs in the distal lung and the lung parenchyma.[In addition, in asthmatics there is an abundance of Th2-type cytokines and chemokines present at this distal site. The current therapeutic challenge is to develop better inhalation technologies to improve the delivery of anti-inflammatory agents to the lung periphery. This article aims to evaluate the pathological and physiological evidence presented in the literature to date, which outlines the contribution of the distal lung and the lung parenchyma to the pathophysiology of asthma.