Faculty of Medicine
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Item type:Publication, THE IMPACT OF MATERNAL OBESITY ON PREGNANCY – A REVIEW ARTICLE(Macedonian Association of Anatomists and Morphologists, 2025-11)Maternal obesity has been estimated as a global epidemic, affecting 40% of pregnant women in developed nations. The weight of females that are pregnant has become one of the most concerning points in the modern obstetrics. For this matter after consulting the most accurate literature from academic books in the field and from internet sources from the year 2020 until the year 2025 available on PubMed, Scopus, Data of Science, Google Scholar, ResearchGate, Academia and others we have created a review article that takes in consideration the impact of maternal obesity on the pregnancy itself. Women may have been obese before becoming pregnant or they may have rapidly gained weight during pregnancy and the types of maternal obesity have their challenges for the pregnancy outcome. The maternal obesity must be carefully treated since it is directly responsible for the impact on gestational diabetes mellitus (GDM), hypertensive disorders, and various perinatal complications. By analyzing the types of maternal obesity and complications that occur during pregnancy we take care not only for the current health of the pregnant mothers and their babies but also of their future to take preventive measures, lifestyle changes and thus to improve their health and the health of their babies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effect of angiotensin II type 1 (AT1) receptor antagonist on the endothelial dysfunction in spontaneously hypertensive rats in correlation with the nitric oxide system(Comenius University, School of Medicine - AEPRESS SRO, 2003); ; ; Jovanoska, EHypertension is associated with impaired endothelial function, which can be explained by a decrease in nitric oxide (NO) generation or by an enhanced inactivation of NO after its release from endothelial cells. The aim of this study was to investigate the effect of long-term treatment with losartan, an angiotensin II (AT1) receptor antagonist, on endothelial dysfunction in an animal model of hypertension in relation to the nitric oxide system. Losartan was administered to 48 sixteen-week-old spontaneously hypertensive rats, in a dose of 10 mg/kg bw/daily in drinking water, for 12 weeks. Systolic blood pressure (SBP) was measured at the beginning, after 4, 8 and 12 weeks of treatment, by the tail-cuff plethysmographic method. At each mentioned time point, a group of 12 animals was sacrificed and blood was withdrawn from the abdominal aorta. Plasma samples were used for determination of total nitrate/nitirite levels, cyclic guanosine monophosphate (cGMP) and endothelin (ET) 1 levels. Statistical evaluation of the results was performed by the use of a computer statistical programme Statistica for Windows 5.0. Losartan produced a significant decrease of SBP at all time points. On the other hand, long-term treatment with this AT1 receptor antagonist produced a significant increase of nitrate/nitrite and cGMP plasma levels. When we compared the values of SBP with plasma nitrate/nitrite as well as with cGMP values, a statistically significant correlation was established. A statistically significant decrease in plasma endothelin 1 values was found during the whole study period. Also, a positive correlation between SBP and plasma endothelin 1 concentrations was observed. Long-term losartan (AT1 receptor antagonist) treatment, apart from its blood pressure lowering effect in hypertension, has beneficial effects on the endothelial dysfunction which is at least partially due to the activation of the nitric oxide system. (Tab. 1, Fig. 2, Ref. 33.) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Dual inhibition of angiotensin converting enzyme and neutral endopeptidase produces effective blood pressure control in spontaneously hypertensive rats(AEPress Bratislava, 2005); ; ; ; Background: The synergistic effects of the combined ACE and NEP inhibition is based both on the blockade of angiotensin II synthesis and degradation of vasoactive peptides and NEP substrates (ANP, arginine, endothelial cells, guanylat cyclase etc.), including bradykinine and the natriuretic peptides, which contribute to vasodilatation, diuresis and improvement of myocardial function. Objectives: This study was undertaken to asses the hypotensive effect of a dual ACE/NEP inhibitor (omapatrilat) in comparison to a NEP inhibitor (candoxatril) and ACE inhibitor (enalapril) in SHRS. Methods: The study was performed in 130 male spontaneously hypertensive rats (SHRS) that were divided into 4 groups and treated orally by a gastric tube for 14 days according to the following dosage regimen: omapatrilat (40 mg/kg b.w./24 h); candoxatril (30 mg/kg b.w./24 h); enalapril (20 mg/kg b.w./ 24 h) and control (water). Systolic blood pressure values were determined at the beginning of the study by the tail-cuff pletysmographic method, at the 7th and 14th day of the treatment, as well as 14 days after the end of the drug administration. For evaluation of the effect of omapatrilat, candoxatril and enalapril on the investigated parameters (plasma atrial natriuretic peptide and serum ACE), 10 ani- mals from the control group were sacrificed at the beginning of the study, and afterwards 10 animals from each group were also sacrificed on the 7th and 14th day of the treatment, as well as 14 days after the end of the drug administration (28th day). Results: The dual ACE/NEP inhibitor, omapatrilat and the ACE inhibitor, enalapril lowered SBP more effectively than the NEP inhibitor, candoxatril at all time points of the experiment (p<0.01). Omapatrilat was slightly more effective than the enalapril treatment. Conclusions: Two-week treatment with the dual ACE/NEP inhibitor omapatrilat caused a significant decrease of the SBP, inhibition of the serum ACE activity and increase of the plasma ANP values, and therefore it should be considered as a new potential therapeutic agent in blood pressure management. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Hypertension in athletes(MIT University, 2023-03); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RENAL OUTCOME IN PATIENTS DIAGNOSED WITH VESICOURETERAL REFLUX IN CHILDHOOD(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2017-11); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MARTORELL’S ULCER-THERAPEUTIC APPROACH(Македонско лекарско друштво = Macedonian Medical Association, 2020); ; ; In the last sixty years, as a result of numerous researches and studies, the approach in the treatment of wounds has significantly changed, which has contributed to greater efficiency of the treatment. Acute wounds by definition are those wounds that heal without complications in the estimated time period, when the structural and functional integrity of the skin is restored. Chronic woundsdo not follow a normal trajectory of healing, and no complete functional and structural integrity of the skin is achieved. Chronic wounds usually take monts to heal, leading to disruption in patients, lives and risk of amputations. They are afinancial burden for the health systems. Martorell’s ulcer is an ischemic and very painful lesion of lower limbs, associated with poorly controlled hypertension. It is located in the distal third of the lower limbs. Hyperbaric oxygen therapy has a significant place in the therapeutic approach in addition to the conventional one. Treatment involves breathing 100% oxygen at the pressure higher than the atmospheric pressure in order to provide better oxygenation of the tissues and to enhance the wound healing processes. The aim of the study wasto evaluate the effect of 100% oxygen under pressure applied as an adjuvant treatment in a patient with Martorell’s ulcer of the lower limb. In this report, we present a patient with painful ulcers of the distal part of the lower limb and poorly controlled systemic arterial hypertension treated withadjuvant hyperbaric oxygen therapy. The results of the investigations and the local and systemic therapy are shown in details. The treatment improved and accelerated the process of granulation and epithelialization, and provided absence of a wound infection. Hyperbaric oxygen therapy as an adjuvant treatment is effective in accelerating the wound healing processes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of Essential Hypertension on Coronary Microcirculation: Case Report(Southeast European Medical Forum, 2019, 2013); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MATERNAL OBESITY AS A PREDICTOR OF UNFAVORABLE PREGNANCY OUTCOME(Македонско лекарско друштво = Macedonia Medical Association, 2017); ; ; ; Introduction: Obesity is a growing concern worldwide. Maternal obesity has significant health implications, contributing to increased morbidity for mother and baby. Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. Aim. The aim of the study was to show a correlation between BMI, delivery mode, hypertension, and prematurity. Methods. The study was done at the University Clinic for Gynecology and Obstetrics. It was a case-control observational prospective study, in which 63 pregnant women were evaluated. According to BMI pregnant women were divided into 3 groups: normal, overweight, and obese. Women were recruited in the 28th gestational weeks and were followed until they delivered. Of interest were: hypertensive disorders in pregnancy, delivery mode, prematurity, Apgar score, and newborns weight. Results. We found that increased BMI has a strong association with hypertensive disorders in pregnancy, prematurity as well as with an increased Cesarean section. We found that more than 76% of obese patients (BMI>30 kg/m2 ) were delivered with a cesarean section, median gestational age at delivery was 35.0 gestational weeks and hypertension in pregnancy was seen in 71% of these patients. Conclusion. Maternal BMI shows strong associations with pregnancy complications and outcomes. Preventive strategies have to be introduced to reduce obesity and improve perinatal outcomes for both mother and baby.