Faculty of Medicine

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    Evaluation of pediatric patients with juvenile idiopathic arthritis treated with biological therapy tocilizumab (actemra)
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2021-10-06)
    Neshkovska Shumenkovska Marija
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    Gjurkova-Angelovska Beti
    Juvenile idiopathic arthritis (JIA) is the most common chronic disease in childhood. It manifests a heterogenic group of symptoms of arthritis, lasting at least 6 weeks and it appears before the age of 16. Patients who had no good therapeutic response to conventional therapy with Methotrexate were treated with biological therapy. The aim of this paper was to evaluate 9 patients who were receiving Tocilizumab at the Department of Rheumocariology, University Clinic of Pediatric Diseases in Skopje. Materials and methods: Our study included 9 patients treated at our Department with biological therapy with Tocilizumab. Prior to initiation of the biological therapy, all patients underwent laboratory investigations, purified protein derivate (PPD) skin test for tuberculosis, X ray of the lungs and heart, and analysis of hepatitis markers. All patients were treated with amp. Actemra( Tocilizumab) 8mg/kg /tt i.v. Two of the patients had a severe form of the disease (one with severe systemic form and one with severe oligoarticular form of JIA). All presented patients had clinical remission of the disease. Conclusion: Therapy with tocilizumab in patients with juvenile idiopathic arthritis is a good therapeutic choice. The results obtained in our study have shown a significant therapeutic effect of tocilizumab even in severe forms of the disease
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    Translation of questions: the International Study of Asthma and Allergies in Childhood (ISAAC) experience
    (International Union Against Tuberculosis and Lung Disease, 2009-09)
    Ellwood, P
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    Williams, H
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    Aït-Khaled, N
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    Björkstén, B
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    Robertson, C
    OBJECTIVE: To explore the consequences of translating the International Study of Asthma and Allergies in Childhood (ISAAC) English core questionnaires on asthma, rhinitis and eczema symptoms into other languages. DESIGN: ISAAC Phase III developed 49 language translations for adolescents and 42 for children following standardised guidelines, which included back-translating the questionnaires into English to check their accuracy and meaning. Language deviations were categorised and analysed with regard to infl uences on the reported symptom prevalence. RESULTS: Category 1 deviations for one or more questions were found in seven translations (14%) for adolescents and in three translations (7%) for children. Data for these questions were excluded from the worldwide analyses. Category 2 deviations were identifi ed in the publications, and Category 3 deviations were ignored. CONCLUSIONS: Translations of questionnaires should follow a consistent protocol in global epidemiological research. Cultural norms need to be considered when evaluating back-translations into English, as disease labels are not available in every language, nor are they understood in the same way. Deviations from literal translations of English should be permitted if the intent of the original meaning is retained. A web-based tool of medical terminology would be useful for international research requiring the use of translations.
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    Risk Factors for Childhood Asthma and Wheeze: Comparisons from an International Study
    (Research Triangle Park, N. C. National Institute of Environmental Health Sciences, 2018-09-24)
    Lawson, Joshua
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    Brozek, Grzegorz Marek
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    Beridze, Vakhtangi
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    Shpakov, Andrei
    Background: There is variation in childhood asthma between countries with typically higher prevalence in “Westernized” nations. We compared asthma, respiratory symptoms, and medication prevalence in Eastern and Central European regions and Canada. Methods: We conducted a cross-sectional survey study of children (5–15 years) from one urban centre in each of Canada, Belarus, Poland, Republic of Georgia (Adjara), Republic of Macedonia, and Ukraine. Surveys were distributed through randomly selected schools to parents (2013–2015). Results: The prevalence of asthma differed by country from 20.6% in Canada to 1.5% in Ukraine (p < 0.001). This association remained after confounder adjustment. Except for Canada (58.7%) and Poland (42.5%), less than 10% of children with a history of wheeze had a diagnosis of asthma. Regardless of country, more than 50% of children with a diagnosis of asthma used breathing medications in the past year. Finally, except for Georgia (12.1%), all countries had a prevalence of ever wheeze above 20% (23.8% in Poland to 30.9% in Macedonia). Conclusions: Despite large differences in asthma prevalence, respiratory morbidity was more comparable suggesting asthma prevalence may be underestimated. Further validation of asthma diagnosis is needed. It is important to promote best diagnostic practices among first contact physicians.