Faculty of Medicine
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Item type:Publication, Cognitive impairment in CKD patients: a guidance document by the CONNECT network(Oxford University Press (OUP), 2024-09) ;Bolignano, Davide ;Simeoni, Mariadelina ;Hafez, Gaye ;Pepin, MarionGallo, AntonioCognitive impairment is a prevalent and debilitating complication in patients with chronic kidney disease (CKD). This position paper, developed by the Cognitive Decline in Nephro-Neurology: European Cooperative Target network, provides guidance on the epidemiology, risk factors, pathophysiology, diagnosis and clinical management of CKD-related cognitive impairment. Cognitive impairment is significantly more common in CKD patients compared with the general population, particularly those undergoing haemodialysis. The development of cognitive impairment is influenced by a complex interplay of factors, including uraemic neurotoxins, electrolytes and acid-base disorders, anaemia, vascular damage, metabolic disturbances and comorbidities like diabetes and hypertension. Effective screening and diagnostic strategies are essential for early identification of cognitive impairment utilizing cognitive assessment tools, neuroimaging and circulating biomarkers. The impact of various drug classes, including antiplatelet therapy, oral anticoagulants, lipid-lowering treatments and antihypertensive drugs, on cognitive function is evaluated. Management strategies encompass pharmacological and non-pharmacological interventions, with recommendations for optimizing cognitive function while managing CKD-related complications. This guidance highlights the importance of addressing cognitive impairment in CKD patients through early detection, careful medication management and tailored therapeutic strategies to improve patient outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PSYCHOLOGICAL AND SOCIAL INFLUENCE OF IDIOPATHIC SCOLIOSIS ON ADOLESCENTS AND THEIR CAREGIVERS(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-05); ; ;Dimitrovski, AleksandarAndonovska, Spasovska NadicaAdolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine greater than 10° in children aged 10-18 years. The deformity may progress severely during adolescent development and if the curve is greater than 45°, an operative treatment should be considered. This condition is accompanied by cosmetic deformity and dissatisfaction of adolescents with their own body image, which results in changes in their mental health and lifestyle. In addition, family functioning and the emergence of parental anxiety and depression may be affected after a child is diagnosed with a chronic health condition. Objective: Recognition of mental health disorders in the patients and their parents in order to take appropriate measures that would improve the outcome of AIS treatment. Method: Research was performed, using available databases, including PubMed and Google Scholar, to capture relevant research published covering AIS. Results: Adolescents with scoliosis may show a less positive outlook on life, suffer from lower self-esteem, and have difficulty relating to peers. However, there is conflicting evidence whether the different stages of treatment, such as observation, bracing or surgery, affect the longterm psychological effect of scoliosis. Parents’ depression and anxiety were closely related to their children’s depression and anxiety. The parents face challenges such as acquiring adequate knowledge about scoliosis, participating in decisions about the type of treatment and managing their child undergoing invasive spine surgery. Conclusion: Psychosocial support is a key component in promoting better outcomes in adolescents as they cope with the challenges associated with idiopathic scoliosis. Providing parents with adequate information and resources on how to support their child can alleviate some of the emotional burden they experience. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Usage prevalence of angioedema patient-reported outcome measures: results from the UCARE and ACARE PROMUSE study(Elsevier BV, 2024-05-09) ;Cherrez-Ojeda, Ivan ;Bousquet, Jean ;Giménez-Arnau, Ana ;Godse, KiranKrasowska, Dorota - Some of the metrics are blocked by yourconsent settings
Item type:Publication, QUALITY OF LIFE IN WOMEN WITH STRESS URINARY INCONTINENCE(Institute of Knowledge Management, 2023-03); Murtezani, SejlanThe aims of the study were to make a comparison between the quality of life in women with stress urinary incontinence before and 6 months after operative treatment, that is, before and after plicated colposuspension and to prove that women after colposuspension have a better quality of life. The study is a prospective, crosssectional study. Material is represented by 66 women, diagnosed with stress urinary incontinence of moderate and severe degree, aged 35 to 75 years. The study did not include: women with overactive bladders or mixed urinary incontinence; women with fistulas of the urinary tract; women with congenital or acquired defects of the urethra or bladder; women with urinary tract infections and women taking medications that contribute to an overactive bladder. The study was conducted from January 2020 to January 2023 at the University Clinic for Gynecology and Obstetrics in Skopje, Department of Urogynecology. In all women, we performed: urinary status with urine sediment and urine culture; ultrasound examination; Marshall's tests; urodynamics; plicated colposuspension; a survey questionnaire containing questions about women's demographic characteristics, social status, economic status, gynecological and reproductive history, life habits and the Incontinence Quality of Life (I-QOL) questionnaire, assessing two time periods: before surgery and six months after surgery. Our study showed an improvement in the quality of life in women with stress urinary incontinence after operative treatment, i.e. after plicated colposuspension. The improvement is shown by analyzing the answers in the three domains of the quality of life questionnaire [Avoidance and limitation of behaviors (p=0.018); Psychosocial influences (p=0.001); Social shame (p=0.012)]. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Психолошки дисбаланс при хронифициран стрес-пандемија со Ковид 19(2021); Introduction: The outbreak of the coronavirus disease (COVID-19) poses an unprecedented threat to public health. Current measures to control the spread include social distancing, isolation and quarantine, which may trigger mental health problems and create psychological disturbance under this continuous stress. Method and material: The sample (N = 122) constituted two groups: people that have been isolated and people not been isolated. The Goldberg Depression and Anxiety Scale as measures of depression and anxiety, respectively, and Quality of life scale QOLS were administered. A qualitative analysis of the most common verbalizations was made also. Results and conclusion: Depression and anxiety were reported by all respondents. Isolated respondents reported a higher likelihood to exhibit symptoms of depression and anxiety than those not been in isolation. The COVID-19 pandemic, social distance as part of preventive measures, and especially isolation as a preventive and therapeutic method in certain situations of suspected and infected with the virus are undoubtedly associated with increased anxiety and depression, as well as reduced quality of life. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COPING WITH CYSTIC FIBROSIS IN THE REPUBLIC OF MACEDONIA – PARENT PERSPECTIVE(Macedonian Academy of Sciences and Arts / Sciendo, 2019); ;Nada Pop-Jordanova; ; Lidija SpirevskaIntroduction: Cystic fibrosis (CF) is a progressive, life-threatening, genetic disease which mainly dam ages the lungs and the digestive system. It’s a complex medical condition, with several individual forms and variation in the symptoms severity. Few factors such as age of establishing the diagnosis, the number and the type of infections and their management, best treatment options, comorbid conditions etc. can influence the patient’s overall health, disease progression and quality of life. Many CF patients will reach adulthood, so coping with the chronic disease is very important for the overall health and everyday living. Aim of the study: To screen the quality of life in CF patients in the Republic of Macedonia, from the parent perspective. Subjects and methods: In the study we have included 55 parents of CF patients. We have created a ques tionnaire, specially designed for this survey, with questions related to their everyday coping with CF and quality of life. Results: The majority of the parents refer to the overall typical social and emotional life of their children, addressing some difficulties concerning the financial aspect of the disease and still significantly having fear from the stigma in the society. Conclusion: CF patients and their families in the Republic of Macedonia must overcome many obstacles on daily basis. Despite that, they can still have full and meaningful lives. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FACTORS INFLUENCING THE EARLY POSTOPERATIVE QUALITY OF LIFE IN PATIENTS TREATED SURGICALLY FOR GYNECOLOGICAL MALIGNANCIES(Macedonian association of anatomists and morphologists, 2019); ;Jovanovska V; ;Tanturovski DStojchevski SABSTRACT Aim: To evaluate the influence of inherent patient characteristics on early postoperative QoL in patients treated surgically for gynecological malignancies Materials and methods: The study was designed as a prospective cohort study. Patients scheduled for surgical treatment of a gynecological malignancy at the Department of gynecological oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2018. Quality of life was quantified using a standardized and validated questionnaire (FACT-G) preoperatively and 1 month after surgical treatment. We explored the effect of the following variables: age, BMI, nationality, education, marital status, place of residence, employment, primary location of the neoplasm, disease stage, extent of surgical resection, comorbidities and smoking. Results: Data from 123 patients were included in the final analysis. The average age of patients at the time of recruitment was 58±10 years (range 23-79 years). Eighty-four patients (68.29%) had endometrial cancer, 22 (17.89%) patients had cervical cancer, while 17 (13.82%) patients had ovarian cancer. Postoperative FACT-G scores were significantly lower (p=0.015). A clinically relevant postoperative decrease in quality of life was identified in 51 patients (41.5%). Independent predictors of deteriorated postoperative QoL in this study were: advanced disease stage, extensive surgical resection, comorbidities and higher education. Conclusion: The results illustrate the physical, psychological, and social effects of the surgical treatment on the early postoperative QoL, thereby emphasizing the need for a comprehensive, multidisciplinary approach to the pre and postoperative care of these patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of systematic pelvic lymphadenectomy on short term postoperative quality of life in patients with early stage endometrial cancer(SHMSHM / AAMD, 2020-08); ; ; ;Tanturovski DraganStojchevski SashoObjective: to determine the potential impact of systematic lymphadenectomy vs. no lymphadenectomy on the perioperative change in QoL in patients undergoing surgical treatment for early stage endometrial cancer. Patients and methods: Patients scheduled for surgical treatment of clinically early stage endometrial cancer at the Department of gynecological oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2018 were approached for participation. Eligible subjects were divided into two groups: Group 1 (no LND) consisted of 60 patients who had hysterectomy plus bilateral salpingo-oophorectomy without lymph node dissection (LND); Group 2 consisted of 24 patients who had hysterectomy plus salpingo-oophorectomy plus systematic pelvic LND. Quality of life was quantified using a standardized and validated questionnaire (FACT-G) preoperatively and 30 days after surgical treatment. Results: The patients in the LND group exhibited statistically significantly lower postoperative scores for FACT-G (87.7 vs 75.8 for the no LND and LND groups respectively, p=0.002), as well as for the physical wellbeing domain (23.4 vs. 20, p=0.004) and emotional wellbeing domain (20.7 vs 17, p=0.008). Twelve patients from the group with no lymphadenectomy (20%) experienced a clinically significant decline in the postoperative QoL, compared to 12 patients (50%) in the lymphadenectomy group (p=0.006). Conclusion: There was a significant decrease in the postoperative QoL 30 days after surgery in patients that undergo systematic pelvic lymphadenectomy for early stage endometrial cancer compared to patients that do not. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Самоевалуација на здравјето кај лица со хемофилија како индикатор за квалитет на живот(SHMSHM / AAMD, 2016) ;Дејанова-Илијевска, В; ; ; Исмаили, А - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Adaptation and validation of the pediatric asthma quality of life questionnaire in Macedonian children with asthma(2015-09); ; Background: In order to better the control of asthma in the last decades, despit the use of clinical and pulmonary functional assessment, a lot of emphasis has been put on the assessment of quality of life (QL). The aim of the study was to evaluate the Macedonian version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Method: The study included 64 children with asthma from the ages ranging from 7 to 17 from a Macedonian nationality, treated in an ambulant or hospital facility within the University Children' s Hospital in Skopje in a time period of 2 years. The children were assess 3 times during a period of 3 months. To assess the control of the condition we used a Clinical Severity Score (CSS), and for the assessment of the QL we used the Macedonia version of the PAQLQ from Elizabeth Juniper which is contained od 23 questions organized into three domains: symptoms, activities and emotions. The results were analyzed with the appropriate statistical test. Result: There has been increase in the average values of the score of the PAQLQ, witch means better control of the asthma by the end of the 3 months. There was not a statistically significant difference (p>0,05) in the change of the QL and the age of the children with asthma in all the three domains and the overall score. Better scores on the PAQLQ were achieved by the children with persistent asthma, as well as the ones with better CSS. A significant correlation was determine between the assessed clinical parameters (asthma diary, FEV1, PEF and CCS) and the domain of activities, symptoms and overall score (p<0,05), and in the domain of emotions only in correlation to CSS (R=0,31). There was a significant improvement of all the scores of PAQLQ after the beginning of the anti-inflammatory therapy with ICS. According to CSS, at the end of the study all of the children were classified as stable (good QL), in contrast to beginning of the study witch was caracterized with 78% of stability. Conclusion: The Macedonian version of the PAQLQ shows exceptional validity, reliability, excellent responsiveness in the QL of the children with asthma. It can be used for the assessing of the condition, has good measurement properties for all children between 7 to 17, successfully assesses the effects of the anti-inflammatory therapy and achieves complete control of the condition. It is simple and easy for use and gives a new dimension to monitoring children with asthma.
