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    PREVALENCE OF VERTEBRAL FRACTURES IN POSTMENOPAUSAL PATIENTS WITH RHEUMATOID ARTHRITIS
    (Македонско лекарско друшство = Macedonian Medical Association, 2020-03)
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    Mishevska Perchinkova, Snezhana
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    Karadzova-Stojanoska, Anzelika
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    Osmani, Bashkim
    Introduction. Rheumatoid arthritis (RA) is an inflammatory arthritis that affects 0.5 to 1% of the general population. The risk of vertebral fractures and hip fractures is much higher in patients with RA than in those with primary osteoporosis (OP). This is due to the severity and activity of the disease in patients with RA, low BMI (body mass index), age, glucocorticoid (GK) use, and the duration of the disease. Aim. To evaluate the prevalence of vertebral fracture in postmenopausal patients with rheumatoid arthritis on glucocorticoid therapy and their association with risk factors. Methods. 92 patients were analyzed, all of whom were recorded for osteoporosis evaluation with a dualenergy x-ray absorptiometry -DXA scan, with built-in software for assessment of VF, VFA (Vertebral Fractures Assessments). Results. The prevalence of vertebral fractures in postmenopausal patients with RA is 63%. In 58 patients, the vertebral fractures are reduced by 2 degrees (height is reduced by 25 to 40%) 58.6%, mild fracture (loss of vertebral height from 20 to 25%) with 31.1% and severe fracture (height reduced by more than 40%) with 10.3%. In patients due to GC therapy, VF are more frequent, smoking is one of the most significant risk factors, while an increased BMI reduces the risk of developing these fractures. Conclusion. In all patients with RA, especially those on chronic therapy with GC, it is necessary to evaluate osteoporosis and determine the bone density of the vertebral bodies by means of VFA, to enable early, timely detection and prevention of vertebral and nonvertebrale fractures
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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.