Faculty of Medicine

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    Association of Inflammatory Markers with Disease Severity and Outcome in Covid-19 Patients
    (Macedonian Academy of Sciences and Arts, 2023-03-01)
    Gjuzelova Aleksoska, Aleksandra
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    Nakova Velkoska, Valentina
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    Metodieva, Marija
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    Stojkoska Jorganovic, Aleksandra
    Objectives: The coronavirus pandemic was associated with a high mortality rate in the Republic of North Macedonia. Finding early markers of the disease's severity may predict outcomes and guide the treatment of the disease. The aim of our study was to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. Methods: The study included 104 PCR-confirmed COVID-19 patients who underwent hospital treatment at the Institute of Lung Diseases and Tuberculosis in Skopje, North Macedonia, between November 2020 and May 2021. Inflammatory markers were assessed in all patients and correlated with the disease severity and outcome in terms of survival or death. Results: IL-6 and LDH at admission were significantly elevated in patients with a severe or critical form of the disease and among non-survivors. In addition, IL-6 showed 87.9% of sensitivity and 61.8% of specificity for distinguishing non-survivors from survivors with a cut-off value of 21.7 pg/ml in the receiver operator curve (ROC). Procalcitonin was significantly increased in non-survivors. Parallel to the increase of disease severity, the values of CRP and LDH increased significantly during hospitalization. Conclusion: The results of the study indicate that a significant association exists between the highly increased levels of CRP, LDH, IL-6 and procalcitonin and the severity of the disease and mortality in COVID-19 patients. Their measurements and follow-up during the course of the disease could be used as predictors for prognosis and outcome but also as a subject for targeted therapy.
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    Interleukin 6 in pregnancy with gdm
    (2019-09-14)
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    Abstract Background: Gestational diabetes melitus is a glucose intolerance diagnosed for the first time in pregnancy which may lead to maternal, fetal and neonatal unfavourable outcome. In GDM inflammatory markers like interleukin 6 are elevated and may provide informations on pathophysiology and prediction of perinatal risk. Aim: to evaluate the average concentration of interleukin 6 in GDM and normoglycemic women and the influence of body mass index on concentration of IL-6 in these women. Material and Methods: A case control study was made at the University Clinic for obstetrics and gynecology, Skopje in a period of one year. 100 pregnant women were selected from the pregnant women that performed 75g OGTT in the second trimester for sreening for GDM. Body mass index was calculated according to the terms of Institute of medicine and pregnant women were divided in 4 groups: GDM, BMI>25 (n=25); GDM, BMI<25(n=25); normoglycemic, BMI>25(n=25); normoglycemic BMI<25(n=25). Serum levels of IL-6 were analysed with ELISA method. Results: The medium values of IL-6 were higher in GDM compared to controls (2.77 ± 1.1 pg/ml vs 2.16 ± 0.5 pg/ml, p=0.0016). Pregnant women with GDM and BMI>25 vs GDM and BMI < 25 had statistically different values of IL-6 (2.58 ± 1.1 vs 2.19 ± 0.5 pg/ml, p=0.0019). Overweight women with GDM had significantly higher interleukin 6 than overweight women without GDM (3.06 ± 1.4 pg/ml vs 2.28 ± 0.7 pg/ml, p=0.021). Average value of IL-6 in GDM women with normal weight was 2.48 ± 0.8 pg/ml and significantly higher than normoglycemic women with normal weight, 2.04 ± 0.1 pg/ml, p=0.016. IL- 6 had insignificantly higher values in the overweight women from the control group compared to normal weight women from the control group (2.28 ± 0.7 pg/ml vs 2.04 ± 0.1 pg/ml; p=0.11). Conclusion: IL-6 is significantly higher in GDM compared to normoglycemic women. It can be used in addition with other biomarkers in eventual prediction of this condition.
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    ROLE OF CYTOKINES AND THEIR PRESENCE IN THE AMNIOTIC LIQUID AS A SIGN OF EARLY DETECTION OF PREMATURE BIRTH IN PREGNANT WOMEN
    (Македонско лекарско друштво = Macedonian medical association, 2019)
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    Introduction. Cytokines play a significant role in the pregnancy. They are very powerful and important me-diators of the cell growth as well as regulators of the immune and inflammatory reactions. Several cytokines (IL-1, IL-6, IL-8, TNF- alfa) are of crucial importance during the pregnancy since they are produced by the placentain the amniotic fluid, in case there is intraute-rine inflammation. Inpatients with premature birth, the intrauterine inflammation and infection is often present and leads to inflammatory syndrome of the human fetus. The intrauterine infection of the choriodecidual space and the amniotic fluid are the most common reasons for this obstetric complication, hence the most commonly examined etiologic factor. Aim. The study was conducted in order to prove the ratiobetween the increased level ofIL-6in the amniotic liquid at the beginning of the second trimester (16-22 g.w.) and the premature birth (< 36 g.w.). Methods. This is a case control study that has included 36 patientsso far.The pregnant women wererecruited fromthe Clinic of Gynaecology and Obstetrics. They all gave a signed consent on being informed about the aims of the study, and following the protocol, they were analyzed and examinedi. e. all patients under went ultra-sound examination, vaginal cervicometry; cervical and vaginal swabs were taken and 5 ml. amniotic fluid du-ring the process of amniocentesis. The study was performed at the Clinic ofGynaecology and Obstetrics, the Institute of Microbiology and Para-sitologyas well as the Institute ofImmunology and Hu-man Genetics. Results. The results obtained inthisstudy have confirmed the role of the cytokines i.e. they have shown an in-crease when there is inflammation in the intrauterine cavity which could lead in future to premature birth. There was an association between the risk of premature birth and positive cervical and vaginal swabs, length of cer-vix, and not a single case showed positive amnio-culture.