Faculty of Medicine
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Item type:Publication, The Paradox of SMURF-less Outcomes and its Implication for Diabetes(Oxford University Press (OUP), 2026-01-28) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COMPARISON OF THREE SEVERITY SCORING MODELS FOR MORTALITY PREDICTION OF COMMUNITY-ACQUIRED PNEUMONIA(Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10); ; ; Cana, FadilIntroduction: Community-acquired pneumonia (CAP) is among the leading cause of morbidity and mortality worldwide. Several scoring models have been developed to accurately asses a disease severity and early to predict the outcome, however an optimal prognostic tool still is not clearly defined. The aim of this study was to compare three commonly used scores in patients with CAP, in order to determine the best tool that will early identify those with increased risk for mortality. Methods: The study included 129 patients aged ≥18 years with CAP hospitalized at the intensive care unit (ICU) at the University Clinic for Infectious Diseases in Skopje, during a 3-year period. Demographic, clinical and biochemical parameters were recorded and three scores were calculated at admission: SOFA (Sequential Organ Failure Assessment Score), SAPS II (Simplified Acute Physiology Score) and APACHE II (Acute Physiology and Chronic Health Evaluation II). Primary outcome was 30-day in-hospital mortality. Receiver Operating Curve (ROC) analysis was performed and areas under the curve (AUC) were compared to evaluate mortality prediction capacities of the scores. Results: The mean age of the patients was 61 year, predominantly were males (66,7%), most (79,1%) had co-morbid condition and Charlson Comorbidity index was significantly increased in non-survivors. An overall mortality was 43.4%. All severity scores had higher values in patients who died, that was statistically significant with the outcome. The AUC values of the scores were 0,749 for SOFA, 0.749 for SAPS II and 0.714 for APACHE II, showing similar prediction ability. Conclusion. Commonly used severity scoring models accurately identified patients with CAP that had an increased risk for poor outcome, but none of them showed to be superior over the others in ability to predict the mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Factors that have impact on natural population change in Republic of North Macedonia(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2023-12); ; The planning of public health programmes is directly related with the demographic characteristics and the population change has long term impact on the health, health care and community interventions. The objective of this paper is to analyze the factors influencing the trend of population change in the Republic of North Macedonia. Material and methods: Data from the National Statistical Office and World Health Organization have been used. Literature review was conducted applying public health approach and descriptive method. Results: The natural population change in North Macedonia has negative trend in the last 10 years, the birth rate has declined, while the mortality is increasing. The biological factors and fertility rate have significantly influenced the birth rate, while the burden of chronic noncommunicable diseases, road injures, violence and COVID-19 are lead causes of mortality. Numerous factors indirectly affect the negative trend of population change such as the high rate of unemployment, poverty, socioeconomic and political context, migration and availability and quality of health care. Conclusion: А detailed analysis of the factors affecting the natural population change and an appropriate national response with the aim of reducing the negative trends is needed. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clinical outcomes during anticoagulant therapy in fragile patients with venous thromboembolism.(2017) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of severity scoring models in mortality prediction of severe community acquired pneumonia.(2023-09); ; Rangelov GoranBackground: community-acquired pneumonia (CAP) is one of the most common infection worldwide and major cause of death particularly in elderly and patients with comorbidities. Severe CAP (sCAP) refers to acute lung infection that require intensive care treatment due to disease severity. Recently, two major criteria are widely accepted to define sCAP: need of mechanical ventilation or need of vasopressors for shock. Several prediction models are designed for assessment of disease severity and for early prediction of pneumonia outcome. Aim of this study was to evaluate the mortality prediction capacities of the most commonly used severity scoring models in patients with sCAP. Material and methods: the study included 129 adult patients with sCAP hospitalized at ICU within Clinic for Infectious Diseases in Skopje during a 3-year period. Primary outcome was 30-day in-hospital mortality. Demographic, clinical and biochemical parameters were recorded and seven severity scores were calculated: Charlson comorbidity Index, CURB 65, SCAP at admission, SAPS II and APACHE II after 24 hours, MPM and SOFA during the first 48 hours. Receiver Operating Curve (ROC) analysis was performed and areas under the curve (AUC) were calculated to evaluate the prediction capacities of analysed scores. Results: the mean age of studied patients was 61 year and 66,7% were males. An overall mortality was 43.4%. Charlson Comorbidity Index has higher value in non-survivors and it was associated with poor outcome. All scores showed significantly increased values among non-survivors, except CURB-65 that had similar results in both groups, and no significance with the outcome. AUC for all scores had close values, ranging from 0.714 for APACHE II to 0.755 for SCAP. The highest AUC showed MPM and SOFA when calculated at 48 hour upon admission, with values of 0.800 and 0.839 respectively. Conclusion: the results of our study showed that the most commonly used severity scoring models had great ability to identify the patients with pneumonia that had increased risk for poor outcome, however, none of them presented stronger capacity over the others to predict the disease mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Assessment of Severity Scoring Indexes in mortality prediction of Severe Community Acquired Pneumonia(2022-11); ; ; Introduction: community acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Approximately 8-36% require treatment in the intensive care unit (ICU) due to disease severity. Aim of the study: to asses the capacity of severity scoring indexes to predict the mortality of severe CAP. Methods: the study included 129 adult patients with CAP hospitalized at ICU of the University Clinic for Infectious Diseases in Skopje during a 3-year period. Primary outcome variable was 30-day in-hospital mortality. Demographic, clinical and biochemical parameters were recorded and seven severity scores were calculated: Charlson comorbidity Index, CURB 65, SCAP at admission, SAPS II and APACHE II after 24 hours, MPM and SOFA score during the first 48 hours. Receiver Operating Curve (ROC) analysis was performed and areas under the curve (AUC) were calculated for all analyzed severity indexes to evaluate their capacities to predict the mortality. Results: the mean age of studied patients was 61 year and 66,7% were males. An overall mortality was 43.4%. Charlson Comorbidity Index has higher value in non-survivors and it was associated with a poor outcome. All scores had significantly increased values among non-survivors, except CURB-65 that had similar results in both groups, with no statistical significance with the outcome. AUC for all scores had close values, ranging from 0.714 for APACHE II to 0.755 for SCAP. The highest AUC showed MPM and SOFA score when calculated at 48 hour after the admission, with values of 0.800 and 0.839 respectively. Conclusion: according to the results of our study, the most commonly used severity scoring indexes had strong ability to detect patients with pneumonia that had increased risk for poor outcome, but none of them showed to be superior over the others in pneumonia mortality prediction. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of the radiological variables, clinical picture and values of CRP and leukocytes in the brain edema development and early intrahospital mortality in patients with hemorrhagic cerebrovascular insult(2020); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of Rhabdomyolysis in Acutely Intoxicated Patients with Psychotropic and Chemical Substances(2023-06); ; ; ; Introduction: Rhabdomyolysis is characterized by a muscle injury that leads to the release of intracellular muscle contents/constituents into the systemic circulation. Aim: We examined the association between the severity of the clinical presentation and creatinine phosphokinase values in patients with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances. Materials and methods: This clinically controlled prospective study included 140 patients with rhabdomyolysis hospitalized at the University Clinic of Toxicology in 2019. They were divided into two groups by the substance used for intoxication (psychotropic or chemical). Results: On the third day of hospitalization, we found a significant association between the type of intoxication and the degree of rhabdomyolysis according to the poisoning severity score (p=0.0256). The significance was due to intoxications with neuroleptics – 50% (n=6), anticonvulsants – 20% (n=1), antidepressants – 16.67% (n=2), heroin – 25% (n=1), and methadone – 54% (n=6). According to the poisoning severity score, the majority of intoxicated patients with chemical substances – other gases 100% (n=1), and those intoxicated with psychotropic substances – methadone 46.67% (n=7), neuroleptics 42.67% (n=5), heroin 40% (n=2), antidepressants 8.33% (n=1), had severe rhabdomyolysis. In psychotropic intoxications, creatine kinase had a significant linear positive weak correlation with mortality (p=0.0234). Conclusions: Rhabdomyolysis and its clinical symptoms and signs were significantly more common in patients intoxicated with psychotropic substances compared to chemical intoxications. Intoxicated patients with psychotropic substances had more severe rhabdomyolysis on the third day of hospitalization. In psychotropic intoxication, with increasing creatine kinase level on the first day there was a significant increase in mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Sex differences and disparities in cardiovascular outcomes of COVID-19(Oxford University Press (OUP), 2023-01-18) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Relationship between pulmonary artery diameter and mortality in COVID-19 patients(Здружение на физијатри на РС Македонија, 2022-09); ; ; Nikolovski Robert