Faculty of Medicine

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    Clinical characteristics of human brucellosis in different age groups in the Republic of North Macedonia-A case series
    (Springer Science and Business Media LLC, 2024-12-04)
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    Khezzani, Bachir
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    Osmani Lloga, Arlinda
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    Background Brucellosis is a zoonotic infection that presents a major challenge to public health worldwide. Aim This research compares demographic characteristics, clinical features, and outcomes across different age groups in patients with human brucellosis. Material and methods Between 2003 and 2022 a total of 508 patients with brucellosis were subjected to diagnostics and treatment at the Clinic for Infectious Diseases in Skopje. The patients were classified into three age groups: children (up to 14 years old), adults (from 14–64 years) and older adults (older than 64 years). The demographics, clinical characteristics, and outcomes between patients from the different age groups were retrospectively evaluated. Results A family history of brucellosis (p < 0.001), fever (p = 0.013), and hepatosplenomegaly (p < 0.001) were significantly more prevalent in children compared to other age groups. Direct contact with animals (p < 0.001), arthralgia (p = 0.007), and weight loss (p = 0.004) were significantly less frequent in children, whereas the duration of illness before brucellosis diagnosis was significantly shorter in children (p < 0.001) compared to other age groups. Sacroiliitis was more predominant in adults than children (p = 0.043), while focal hematological involvement was more prevalent in children than in adults (p = 0.004). Spondylitis was more dominant in the old age group compared to the other two age groups (p < 0.001). Favorable outcomes were achieved in 88.5% of children, 89.9% of adults, and 87.1% of older patients with specific treatment. Conclusion Brucellosis presents highly variable clinical and epidemiological features across all age groups; however, certain characteristics may be associated with age.
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    Foreign body ingestion in children: At a glance
    (2022-11)
    Diego Falchi
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    This article discusses the symptoms, diagnosis, and treatment options available for children who have accidentally swallowed foreign objects. It may be helpful for primary care physicians to recognize the wide spectrum of presentations of ingested foreign bodies in children. As a result, primary care physicians should emphasize the importance of considering ingested foreign bodies in the differential diagnosis of many respiratory and vague gastrointestinal complaints. In addition to this, it suggests a method for dealing with asymptomatic children who have swallowed a foreign body and identifies certain categories of foreign bodies that call for additional consideration.
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    The Association between Asthma and Obesity in Children -1 Inflammatory and Mechanical Factors
    (ID Design / Scientific Foundation Spiroski, 2019-04-29)
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    BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterized by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.