Faculty of Medicine

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    Comorbid Conditions in a Cohort of Inpatients with SARS-CoV-2 and their Association with In-Hospital Mortality During the Early Phases of the Pandemic
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2023-12-01)
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    Cibrev, Dragan
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    Chamurovski, Nikola
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    Introduction: Studies determined that age and associated comorbidities are associated with worse outcomes for COVID-19 patients. The aim of the present study is to examine previous electronic health records of SARS-CoV-2 patients to identify which chronic conditions are associated with in-hospital mortality in a nationally representative sample. Materials and Methods: The actual study is a cross-sectional analysis of SARS-CoV-2 infected patients who were treated in repurposed hospitals. The study includes a cohort of patients treated from 06-11-2020 to 15-03-2021 for COVID-19 associated pneumonia. To examine the presence of comorbidities, electronic health records were examined and analyzed. Results: A total of 1486 in-patients were treated in the specified period, out of which 1237 met the criteria for case. The median age of the sample was 65 years. The overall in-hospital mortality in the sample was 25.5%, while the median length of stay was 11 days. From whole sample, 16.0% of the patients did not have established diagnoses in their electronic records, while the most prevalent coexisting condition was arterial hypertension (62.7%), followed by diabetes mellitus (27.3%). The factors of age, male gender, and the number of diagnoses showed a statistically significant increase in odds ratio (OR) for in-hospital mortality. The presence of chronic kidney injury was associated with the highest increase of OR (by 3.37) for in-hospital mortality in our sample. Conclusion: The study reaffirms the findings that age, male gender, and the presence of comorbidities are associated with in-hospital mortality in COVID-19 treated and unvaccinated patients. Our study suggests that chronic kidney injury showed strongest association with the outcome, when adjusted for age, gender, and coexisting comorbidities.
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    COPD as a risk factor for Coronary Artery Disease (CAD): Overview of 10-year atherosclerotic cardiovascular disease (ASCVD) risk assessment
    (2022-12-01)
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    Mickovski Ivana
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    Baloski Marjan
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    Doneva Daniela
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    Neshovska Radmila
    We aimed to investigate the association between COPD and CAD (overview of 10-year risk of fatal cardiovascularevent), and the relation to the severity of airflow limitation.Cross-sectional study including 220 patients with stable COPD as investigated group (IG), aged 40 to 75 yearsand 58 non-COPD subjects, matched by gender, age, BMI, smoking status, as control group (CG). All studysubjects underwent pulmonary, cardiological evaluation, lipid and glycemic status.The analysis compared the 10-year established ASCVD risk between COPD stages (according to GOLDclassification 1, 2, 3, 4) and between IG vs. CG. ASCVD score was classified as low (score <5%), borderline (5 to<7.5%), moderate (≥7.5 to <20) and high risk (score ≥20%). Results presented statistically significant differencebetween mean ASCVD value in IG 21,69±13,86% vs. CG 15,83±9,92% (p=0.0028). The median risk of ASCVDfor fatal cardiovascular events was high in IG and moderate in CG. The mean and median values of 10-yearASCVD risk in the IG subgroups were: GOLD1 16,79±8,04% (50% of the subjects with risk >15,7%), GOLD222,67±16,49% (50% of the subjects with risk >20,6%), GOLD3 26,81±14,15% (50% of the subjects with risk >27,6%) and GOLD4 20,70±13,52% (50% of the subjects with risk > 18,4%). The average ASCVD risk of fatalcardiovascular event was moderate in GOLD1 and GOLD4, and high in GOLD2 and GOLD3.We found higher risk for fatal cardiovascular outcome in patients with COPD, even in the early COPD stages(GOLD2), compared to non-COPD group. Our findings suggest that an urgent need to develop comprehensivestrategies for prevention, screening and early treatment are needed.
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    Some Peripheral Biofeedback Modules i n t he Treatment o f Chronic Diseases i n Children
    (Scholink, 2018)
    Pop-Jordanova N.
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    Biofeedback therapy is a non drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate . In this paper we present results obtained with E lectro D ermal R esponse (EDR) and H eart R ate V ariability (HRV) applied as adjuvant therapy in chronic pediatric p atients. The methodology can be used in scholar settings for stress r educing in pupils and teachers. The evaluated group comprises children and adolescents with : a) cystic fibrosis (N = 40 mean age = 17.5 years ± 23.18 SD ); b) bronchial asthma (N = 35 , mean age = 1 1 .5 years ± 18.84 SD c) epilepsy (N = 45, mean age = 13 .5 years ± 15.34 SD and d) diabetes mellitus (N = 30 , mean age = 12.5 years ± 12.3 SD Study showed that peripheral biofeedback is very helpful tool for chronic disorders in children. Both (EDR and HRV) methods confirmed changes on the stress level very significantly. This therapy is non invasive, easy for application, children accept i t with int erest and it is cost effective.