Faculty of Medicine
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Item type:Publication, EVALUATING CHRONIC RHINOSINUSITIS AS A COMORBID DRIVER IN COPD(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-07-18); ; ; Introduction: Chronic rhinosinusitis (CRS) is increasingly recognized as a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD), particularly under the framework of the “united airways” model, which emphasizes shared inflammatory mechanisms across the upper and lower respiratory tract. Aim: To evaluate inflammatory biomarker profiles among COPD patients with and without CRS, and to assess differences across distinct COPD phenotypes—non-exacerbators (NE), frequent exacerbators (E), and asthma-COPD overlap (ACO). Material and methods: A cross-sectional study was conducted on 36 COPD patients at a university clinic in Skopje, including 21 with CRS and 15 patients without CRS. All participants underwent clinical phenotyping, nasal endoscopy, sinus CT, and serum biomarker analysis (IL-4, IL-5, IL-6, IL-8, CRP, leukocytes). Statistical comparisons were made using Mann–Whitney U and Kruskal–Wallis tests. Results: CRS was predominantly found in patients with the ACO phenotype (71.4%, p = 0.0006). No statistically significant differences were observed in systemic biomarkers (IL‑4, IL‑5, IL‑6, IL‑8, CRP, leukocytes) between COPD patients with and without CRS. IL‑5 and IL‑6 were undetectable. Similarly, inflammatory profiles did not significantly differ among COPD phenotypes. Conclusion: CRS appears disproportionately represented in the ACO phenotype, likely due to shared type‑2 inflammatory pathways. However, conventional systemic biomarkers lack the sensitivity to detect upper airway involvement or differentiate COPD phenotypes. These findings highlight the need for comprehensive airway assessment and more specific biomarkers in future studies to better understand the interplay between CRS and COPD. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COPD prevalence and characteristics among sample of working population(Frontiers Media SA, 2025-05-27); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Systemic inflammatory profile in patients with chronic obstructive pulmonary disease(Macedonian Association of Anatomists and Morphologists, 2024-05-01); ; ; Chronic obstructive pulmonary disease(COPD)is heterogeneous condition with various phenotypes that have their own pathogenetic mechanisms and certain inflammatory mediators, as C-reactive protein, interleukins, circulating leukocytes. Uncovering the inflammatory profile may identify disease biomarkers. We aimedto compare the values of systemic inflammatory parameters in patients with different clinical phenotypes and determine their correlation with clinical parameters.In 30 COPD patients weanalyzeddemographic and clinical data, history of allergies, cigarette smoking and history of exacerbations. We phenotyped them intonon-exacerbator, exacerbator and COPD with asthma phenotype. COPD assessment test, modified dyspnea scale and the BODE (Body mass index, Obstruction, Dyspnea, Exercise capacity) index werecalculated. Spirometry and lung X-ray were performed. Peripheral blood was taken for analysis of inflammatory parameters.There were 16 patients(53.33%) with phenotype of non-exacerbator, and 7 (23.33%) with exacerbatorand COPD with asthma phenotype each. COPD assessment testhadsignificantly lowestvalue in non-exacerbator and modified dyspnea scalesignificantly highest value in exacerbatorphenotype. Therewere no mild gradepatientsin exacerbator,andno very severe grade in nonexacerbatorphenotype. C-reactive proteinand interleukin 8 had significantly lowest value in non-exacerbator; leucocytes significantly highest value in exacerbator; eosinophyls and interleukin 4 significantly highest value in COPD with asthma phenotype. There was no significant difference among the three phenotypes in neutrophyls andinterleukin 18. The three clinical phenotypes: non-exacerbator, exacerbator and COPDwith asthma have their own specific clinical and inflammatory features that have clinical, prognostic and therapeutic implications - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COPD PREVALENCE AND CHARACTERISTICS AMONG RETIRED WORKERS(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-04); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Strengthening Clinician-Researchers' Communication and Knowledge Translation Skills: An Innovative Game Model From the Breathe Well Group(Sage Publishing, 2024-09-12) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation of Clinical and Inflammatory Parameters in Chronic Obstructive Pulmonary Disease(SHMSHM - AAMD, 2023-04); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Engaging stakeholders to level up COPD care in LMICs: lessons learned from the "Breathe Well" programme in Brazil, China, Georgia, and North Macedonia(Springer Science and Business Media LLC, 2024-01) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, METABOLIC SYNDROME (METS) AS ONE OF THE MAJOR COMORBIDITIES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)(Association of pulmologists from Republika Srpska, 2023-05); ; Mickovski, IvanaAim: We aimed to investigate the association between COPD and MetS, the relation to the severity of airflow limitation. Methods: This is a cross-sectional study including 220 patients with initially diagnosed COPD (IG), aged 40 to 75 years and 58 non-COPD subjects matched by age, smoking status, body mass index, as controls (CG). All study participants underwent anthropometric measurements, fasting blood sugar (FBS), lipid profile, pulmonary evaluation (dyspnea severity assessment, baseline and postbronchodilator spirometry, gas analyses, chest X-ray). Results: Results presented statistically significant difference in presence of MetS in COPD patients compared to controls (32.27% vs 10.34%; P=0.0009). According to the GOLD classification, the frequencies of MetS in COPD patients were categorized in stages I, II, III, IV (17.54%, 37.10%, 34.62%, 40.82%, respectively). The proportion of patients with increased glycemic values was: a) GOLD1 - 18 (31.58%); b) GOLD 2 - 32 (51.61%); c) GOLD3 - 29 (55.77%); and d) GOLD4 - 31 (63.27%). There was no significant difference between IG and CG patients regarding HDL level. According to arterial hypertension the highest proportion was observed in GOLD3 - 22 (42.31%) followed by GOLD4 - 20 (40.82%), and GOLD3 - 22 (35.48 %), smallest in GOLD1 - 17 (29.82%). Conclusion: We found higher prevalence of MetS in patients with COPD even in early COPD stages compared to non-COPD. Our findings suggest an urgent need to develop comprehensive strategies for prevention, screening and start of treatment in early stage. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COVID-19 and chronic respiratory diseases(Serbian Association of Allergology and Clinical Immunology, 2021) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The burden of chronic respiratory diseases in Macedonia(2018)Aim: Chronic respiratory diseases involve a heterogeneous group of disease, including, COPD, asthma, sleep apnea syndrome, pulmonary hypertension and many occupational diseases. This study aims to estimate the burden of chronic respiratory diseases (CRDs) and 10-year mortality trend compared to other non-communicable diseases in Macedonia. Material and Methods: Data was retrieved from official reports by State Statistical Office, annual reports of the Health Insurance Fund, the burden of disease estimates by WHO Global Health Observatory data as well as the Institute for Health Metrics and Evaluation (IHME). Analytical and descriptive methods were used to present the results. Results: A total of 4 886 deaths due to chronic respiratory diseases were recorded in a 10-year period from 2007 to 2017 or 3% of total deaths in Macedonia, making it the 5th leading cause of death. The mortality rate increased from 18, 35 deaths per 100.000 population in 2007 to 30, 64 in 2017. Chronic respiratory diseases related Disability Adjusted Life-Year (DALYs) burden of approximately of 728.72 per 100.000 or rank 9 at the leading causes for disability and premature mortality. In Macedonia COPD is in the top 15 leading causes due to premature mortality, with an estimated burden of 504.84 DALYs per 100.000. Highest risk factors related burden was attributed to the environment and smoking. Conclusion: Although they are preventable, chronic respiratory diseases are in the top 10 leading causes for mortality and disability in Macedonia, with a projection to increase as air-pollution and smoking rates are still high and the population ages. The lack of epidemiological data, national guidelines for treatment and management allows these diseases to be on the rise, as effective policy and strategy is very much needed.
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