Faculty of Medicine

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PREVALENCE AND CHARACTERISTICS OF CHRONIC RESPIRATORY SYMPTOMS AND LUNG FUNCTION AMONG VINEYARD WORKERS
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-12-16)
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Atanasovska, Aneta
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Bislimovska, Dragana
Aim: To determine the frequency of chronic respiratory symptoms and ventilatory function in a group of vineyard workers. Results: Most of the vineyard workers believe that they are sufficiently informed about the health risks related to their work activities and the necessary measures needed for health protection. Also, most of them use the mandatory personal protective equipment, while almost all workers during their work, to a greater or lesser extent, were exposed to occupational respiratory hazards: dust, smoke, fumes, gases and pesticides. About 45% of subjects had one or more respiratory symptoms, and the most common symptoms were cough (40%), cough with phlegm (31.1%), as well as dyspnea and wheezing (22.2%). The frequency of chronic respiratory symptoms was higher in workers with more than 15 years of exposure, with a statistically significant difference in frequency of cough, cough with phlegm, and dyspnea. The risk of respiratory symptoms was about 3 times higher in active smokers and about 2 times higher in vineyard workers with exposure duration longer than 15 years. The mean values of all spirometric parameters were within the reference values, while lung function impairment of obstructive, restrictive and combined pattern was registered in about 20% of them. The mean values of spirometric parameters in vineyard workers with exposure duration longer than 15 years were lower than those with less than 15 years of experience, with a significant difference for small airways flow indices. Conclusion: The obtained results indicate the need to improve preventive measures.</jats:p>
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IMAGING OF PULMONARY SARCOIDOSIS AND ITS CORRELATION WITH SMOKING - OUR EXPERIENCE
(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-12)
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Introduction: Sarcoidosis is a multisystemic granulomatous disease that usually affects lung parenchyma with interstitial and granulomatous changes of varying intensity and expression, depending on the degree of the disease. The aim of the study: To detect pulmonary changes of sarcoidosis on high-resolution CT (HRCT) and to correlate them with smoking. Material and Methods: Computed tomography with high resolution was made on 128 slice CT scanner PHILIPS INCISIVE, using 1mm thin-slice thickness and high spatial frequencies algorithm for image reconstruction. A total of 50 patients diagnosed with sarcoidosis who came to our University Clinic of Pulmonology and Allergology – Skopje were included in this study and their HRCT findings were compared to smokers and non-smokers. Results: The gender structure of the patients is predominantly made up of female patients 92% vs 8% male. Reticular opacities on HRCT were more often seen in smokers compared to non-smokers, with a statistically significant difference confirmed for their peripheral and subpleural localization (p=0.0034 and p=0.0014, respectively in the upper and middle lung zones, and in the lower lung zones). Smoking patients had insignificantly more often peribronchovascular localization of reticular opacities in the upper and middle lung zones (26.67% vs 10%, p=0.28) and in the lower lung zones (26.67% vs 20%, p=0.74). Regarding the smoking status, 16% of the patients declared themselves as current smokers, 56% as ex-smokers, with an average smoking experience of 14.9 ± 4.8 years. Conclusion: HRCT is the method of choice in the evaluation of pathological changes in pulmonary sarcoidosis. It shows very precisely the characteristic findings of lymph nodes, micronodules and other lesions, their distribution, as well as atypical changes. Smoking plays a certain role in the interstitial changes of the patients with sarcoidosis, although we do not have data whether smoking has effects on the extent, course or outcome of the disease.
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SOCIO-DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF LUNG CANCER PATIENTS IN NORTH MACEDONIA
(Macedonian Association of Anatomists, 2024-04)
Dimitrievska, Ljubica
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Stefanoska, Julijana
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Nehteparova, Meliha
Lung cancer disease is one of the most common causes of mortality in the world, coming right after cardiovascular diseases. It is a big and is a special problem in the highly developed countries, especially in the USA, but also in developing countries. The reason for the research is the fact that the number of newly diagnosed and death cases from lung cancer is constantly growing, especially in the last few years. The aim of the study is to determine the influence of socio-demographic factors in the occurrence of lung cancer(gender, age, national and ethnic origin, place of residence) and smoking as the main risk factor associated with this neoplasm. The research is a descriptive study in which 82 patients with pathohistological confirmed lung cancer participated. It was implemented at the Institute for Oncology and Radiotherapy at the clinical center in Skopje for a period of 3 months. A total of 82 patients were registered from Institute for Oncology and Radiotherapy in Skopje, North Macedonia who were diagnosed with primary lung cancer. Of all, 64.7% of them were males and 35.3% were females. Histologically, 51.2% had adenocarcinoma, 25.6 had squamous cell carcinoma, 20.7% had small cell carcinoma and 7.4% had no small cell carcinoma. It was observed that the proportion of females diagnosed with primary lung cancer is increasing. Patients get diagnosed at a later stage of the disease, which calls for screening and early detection of lung cancer.
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SOCIAL DIMENSION OF SMOKING WITHIN YOUNG POPULATION
(Македонско лекарско друштво = Macedonian Medical Association, 2017-06-01)
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I. Brchina
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G. Pejchinovski
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P. Malinska
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Sh. Musa
Introduction According to the Strategy for Tobacco Control in order to provide and improve health protection of the population of the Republic of Macedonia, and a number of international documents, basic strategic directions are that the health is the most important investment in the social and economic development of the community, and epidemic of smoking presents an increasing threat to people’s health. It is considered that there are 1.3 billion smokers worldwide, and current projections of the WHO show that this number will rise to 1.7 billion smokers by 2025, if the global prevention of tobacco use remains unchanged. Objectives The goal of this research is to determine the knowledge and views of the young people in the Republic of Macedonia concerning the use of tobacco, its influence on the social environment as a certain socio-pathological phenomenon or risk factor for certain diseases of the people. Materials and Methods The survey was conducted in the following municipalities in the Republic of Macedonia: Centar, Karpos, Gazi Baba, Kisela Voda, Cair, Aerodrom, Gorce Petrov and Butel in the city of Skopje, then municipalities Prilep, Kumanovo, Struga and Gostivar. Random sample. Target groups: young people at the age from 15 to 22. Research tools: a survey questionnaire no. 1. Subjects from sample were divided into 2 groups: subjects who smoked and those who did not smoke. Following statistical tests were applied: Pearson Chi-square, Kolmogorov-Smirnov, Kruskal-Wallis ANOVA, Mann-Whitney, Spearmanov Rank Correlations, Pearson-ov koeficient na korelacija. Results Boys smoke significantly more than girls (X2= 13.3 df=1 p<0.0003). Among students smokers are significantly dominant (56.71%). Ethnic background of the young smokers/non-smokers corresponds with the population structure. Young people try their first cigarette at the age of 14-16 (r = .12744). Young people smoke everywhere (Dmax = 0.11 p>0.05). Young people smoke every day (86.59%). Young people usually smoke 5-10 cigarettes a day and they buy them at the news-stands. Young people in the R.M. rarely do sports (only 34.15%). Young people at the age of 15-20 usually smoke while they listen to music, while young people at the age of 21-22 usually smoke while they watch TV. More than half of the subjects think that the community they live in is a good place for living. Reasons for smoking are: habit, family problems, love problems, school, peer pressure, etc. There are no significant differences with regard to this question in municipalities. Conclusion In general, young people in Macedonia think that their peers who smoke are not well accepted by the community. Young people in Republic of Macedonia are well informed on smoking as a social-pathological phenomenon, and also that smoking is a risk factor for certain diseases.
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Social and medical aspects of smoking at the adolescent age in Republic of Macedonia
(Македонско лекарско друштво = Macedonian Medical Association, 2012-04-26)
Malinska, P
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Pejcinovski, G
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Brcina,I
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Introduction: The health is the most important investment in the social and economic development of the community. Goal: epidemic of smoking presents an increasing threat At the Adolescent Age health in Republic of Macedonia Material and method: Prospective survey research was conducted with survey questionnaire.Random sample. Target groups: young people at the age from 15 to 22. Subjects from both samples were divided into 2 groups: subjects who smoked and those who did not smoke. Results and Discussion: Boys smoke significantly more than girls (X2 = 13.3 df=1 p<0.0003). Young people try their first cigarette at the age of 14-16 (r = .12744). Young people smoke everywhere (Dmax = 0.11 p>0.05). Young people think that selling tobacco products to under age children should be banned (X2 = 10.13 df =1 p<0.0014). In Education of the mother of the subjects has influence on them so that they would not start smoking (Dmax = 0.18 p<0.05). The families of the young smokers damages that come from smoking are rarely discussed. In general, young people in Macedonia think that their peers who smoke are not well accepted by the community. More than half of the subjects think that the community they live in is a good place for living. Reasons for smoking are: habit, family problems, love problems, school, peer pressure, etc. Conclusions: Young people in Republic of Macedonia are well informed on smoking as a social-pathological phenomenon, and also that smoking is a risk factor for certain diseases. Regarding the young people’s views on smoking in the family, they consider mother to be the pillar of the family, and that she can considerably influence them to quit smoking. In general, young people in Macedonia think that their peers who smoke are not well accepted by the community.
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COPD IN A SAMPLE OF GENERAL ADULT POPULATION FROM THE SKOPJE REGION
(University Ss. Cyril and Methodius in Skopje, 2022)
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Atanasovska, Aneta
Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity, disability and mortality in the last decades worldwide. Aim of the study. To determine the COPD prevalence in a sample of general adult population from the Skopje region and its distribution by sex, age, smoking status, working status, family history of chronic bronchitis/asthma, and mode of household heating and cooking. Methods. A cross-sectional study (prevalence study) including 2,348 participants (1,239 males and 1,109 females, aged 18 to 86 years) from the Skopje region was performed at the Institute for Occupational Health of RN Macedonia, Skopje, in the period 2018-2021. The study protocol included completion of a questionnaire and spirometric measurements (pre and post-bronchodilator spirometry). COPD was defined by spirometric finding of persistent airflow limitation in symptomatic study subjects. Results. COPD prevalence in the whole study sample was 4.6%, being non-significantly higher in men (5.1%) than in women (4.1%). Fourfold higher prevalence of COPD was registered in the study subjects aged over 45 years as compared to the younger ones (6.7% vs. 1.6%; P = 0.000). COPD prevalence was significantly higher in active smokers as compared to non-smoking study subjects (9.4% vs. 1.9%; P = 0.000). In regard to working status, COPD prevalence among active workers was 3.9%, in the group of retired persons 8.7%, while in the group of students there was not a single subject with COPD. In addition, COPD prevalence in the workers occupationally exposed to noxious particles or gases was significantly higher than in unexposed workers (4.7% vs. 2.4%; P = 0.021). There was no statistically significant difference in the COPD prevalence between study subjects with positive and negative family history of asthma/chronic bronchitis (4.8% vs. 4.5%), as well as between study subjects who used biomass fuels for heating and cooking (6.2%) and those who did not use traditional fuels for household needs (4.0%). Conclusion. Our findings have indicated the age, active smoking and occupational exposures to noxious particles or gases as the factors significantly related to COPD prevalence in the examined sample of general adult population from the Skopje region.
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Exercise-induced bronchoconstriction in female cleaners: effect of smoking
(Арбилис - София, 2007)
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Risteska-Kuc, Snezana
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Stojanovski, Zoran
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Background. Airborne particles and pollutants, such as dust, tobacco smoke and automobile exhaust, are considered as stimulants that contribute to the development of exercise-induced bronchoconstriction (EIB). Objective. To evaluate prevalence of EIB and its relation to smoking in female cleaners. Methods. We performed a cross-sectional study including 43 female cleaners aged 26 to 57 (mean age 36.9±7.6), with duration of exposure 5 to 24 years (mean duration 11.6±5.5). In addition, 45 female office workers (aged 27 to 58, mean age 38.1±5.7) were studied as a control. Evaluation of exposed and unexposed workers included completion of a questionnaire, skin prick tests to common aeroallergens, spirometry, and constant submaximal exercise challenge test (ECT) on cycle ergometer. Results. We found similar EIB prevalence in both cleaners and office workers (9.3% vs. 6.7%; P=0.276). Bronchial reaction to exercise, expressed as a mean fall index FEV1, was significantly greater in ECT positive cleaners (23.4% vs. 16.1%, P=0.041). EIB was strongly linked to atopy and positive family history for asthma in both groups. EIB was non-significantly associated with daily smoking in office workers (P=0.276), whereas in cleaners that association just missed significance (P=0.074). Association between EIB and daily mean of cigarettes consumed was significant in smoking cleaners (P=0.039), whereas its association with smoking experience was non-significant in both groups. Bronchial reaction to exercise was significantly greater in exposed than in unexposed smokers (9.4% vs. 4.5%; P=0.036). Association of EIB with exand passive smoking was non-significant in both occupation groups. Conclusions. Our data suggest that daily smoking could interact with workplace exposure in development and severity of EIB in female cleaners.
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CHRONIC RESPIRATORY SYMPTOMS AND VENTILATORY FUNCTION IN WORKERS EXPOSED TO TEA DUST: EFFECT OF DURATION OF EXPOSURE AND SMOKING
(University of Niš, 2005)
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Risteska-Kuc, Snezana
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Many studies reviewed show that both workplace exposure to organic dust and smoking may cause chronic respiratory symptoms and airflow limitation in susceptible subjects. We performed a case-control study including 63 tea workers (36 male and 27 female, aged 36-55, duration of employment 3–30 years) and an equal number of office workers, matched by sex and age. Chronic respiratory symptoms (chronic cough, phlegm, dyspnea gr. 3-4, wheezing, wheezing with dyspnea, and chest tightness) were recorded by questionnaire. Skin prick tests and spirometric measurements were carried out. Environmental measurements were performed on site during the work shifts. Prevalence of chronic respiratory symptoms in exposed workers was insignificantly higher (44.8% vs. 33.6%). Significantly higher prevalence of individual chronic respiratory symptoms was found for phlegm (P<0.05) and dyspnea gr. 3-4 (P<0.05). Chronic respiratory symptoms in exposed workers were significantly associated with duration of exposure (P<0.05) and current smoking (P<0.05, P=0.011), whereas relation of chronic respiratory symptoms and current smoking in controls just missed the significance (P=0.056). Values of FVC, FEV1, FEV1/FVC% and small airways indices in exposed workers were significantly lower. Small airways changes in exposed workers were strongly linked to duration of exposure (P<0.05) and current smoking (P<0.01), whereas relation of small airways changes and current smoking in controls was not significant. Our data suggest interactive influence of workplace exposure to tea dust and current smoking in development of chronic respiratory symptoms and airflow limitation with predominantly smaller airways affecting.
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Bronchial hyperresponsiveness in women cooks and cleaners
(Walter de Gruyter GmbH, 2007-06)
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Risteska-Kuc, Snezana
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The aim of this cross-sectional study was to assess the prevalence and characteristics of bronchial hyperresponsiveness (BHR) in 43 women cleaners (aged 26 to 57) and 37 women cooks (aged 29 to 55) and compare them with 45 controls (women office workers aged 27 to 58). The evaluation of all subjects included a questionnaire, skin prick tests to common aeroallergens, spirometry, and histamine challenge (PC20 < or = 8 mg mL(-1)). We found higher BHR prevalence in cleaners and cooks than in office workers (30.2 % and 29.7 %, vs. 17.7 %, respectively), but statistical significance was not reached. The prevalence of mild and moderate to severe BHR was similar in all groups. Borderline BHR prevalence was significantly higher in cleaners than in controls (16.2 % vs. 6.6 %, P=0.032) whereas the difference was on the verge of significance in cooks (13.5 % vs. 6.6 %, P=0.081). Moderate to severe BHR was strongly associated with positive family history of asthma and atopy in all groups. Mild BHR was significantly associated with daily smoking in cleaners (P=0.031) and cooks (P=0.021), as well as with the duration of exposure in cleaners (P=0.038). Borderline BHR was closely related to daily smoking and duration of exposure in both cleaners and cooks. Our findings indicate an important role of workplace exposure in borderline BHR development, as well as the significant effect of smoking on mild BHR development in women cleaners and cooks.
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Exercise-induced bronchoconstriction and exercise-induced respiratory symptoms in workers exposed to tea dust
(SCIENDO, 2005-12)
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Risteska-Kuc, Snezana
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Assuming that airborne particles and pollutants are important contributing factors in the development of exercise-induced bronchoconstriction (EIB), we performed a case-control study including 63 tea workers (36 men and 27 women, aged 36-55, duration of employment 3-30 years) and an equal number of office workers, matched by sex and age. Exercise-induced respiratory symptoms were recorded in a questionnaire. Skin prick tests, spirometry, as well as exercise and histamine challenge were carried out. Environmental measurements were performed on site during the work shifts. The prevalence of self-reported exercise-induced respiratory symptoms and EIB did not differ significantly between the exposed and control group (41.6% vs 36.8%, and 6.4% vs 4.8%, respectively). In both exposed and control workers, EIB was strongly linked to asthma (P < 0.01). In the exposed workers it was significantly associated with positive family history of asthma (P < 0.01) and positive family history of atopies (P < 0.05), whereas in the exposed smokers it was significantly related to smoking duration (P < 0.05). Bronchial reaction to exercise in the exposed smokers was significantly greater than in control smokers (P < 0.05). Self-reported exercise-induced respiratory symptoms were weakly associated with EIB, with a large proportion of false positive and a low proportion of false negative results in both groups.

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