Faculty of Medicine
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Item type:Publication, A novel id-iri score: development and internal validation of the multivariable community acquired sepsis clinical risk prediction model(Springer Science and Business Media LLC, 2020-04) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Overlap syndrome in refractory case(Macedonian Association of Anatomists, 2022); ; This is a report of the case of a 23 years-old girl with refractory dermatomyositis, complications in her treatment and the unfortunate fatal end. Dermatomyositis can be a notoriously difficult disease to treat, and remission is often elusive or short-lived despite aggressive therapy. In the years after the diagnosis, many aggressive modalities of treatment were tried, including rituximab. The patient had frequent exacerbations of the myositis, needed aggressive therapy and developed many side effects associated with the treatment. Most common of these were infections. After suffering severe stress, she developed fever, was diagnosed with sepsis and despite exhaustive treatment at the intensive care unit she passed away. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Epidemiology of Community-Acquired Sepsis in Adult Patients: A Six Year Observational Study(Macedonian Academy of Sciences and Arts/Sciendo, 2018-07-01); ; ; ; Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection and it is a major cause of morbidity and mortality worldwide. The aim of this study is to describe epidemiology of community-acquired sepsis in the Intensive care unit (ICU) of the Macedonian tertiary care University Clinic for Infectious Diseases. A prospective observational study was conducted over a 6-year period from January, 2011 to December, 2016. All consecutive adults with community-acquired sepsis or septic shock were included in the study. Variables measured were incidence of sepsis, age, gender, comorbidities, season, source of infection, complications, interventions, severity indexes, length of stay, laboratory findings, blood cultures, 28-day and in hospital mortality. Of 1348 admissions, 277 (20.5%) had sepsis and septic shock. The most common chronic condition was heart failure (26.4%), and the most frequent site of infection was the respiratory tract (57.4%). Median Simplified Acute Physiology Score (SAPS II) was 50.0, and median Sequential Organ Failure Assessment (SOFA) score was 8.0. Blood cultures were positive in 22% of the cases. Gram-positive bacteria were isolated in 13% and Gram-negatives in 9.7% of patients with sepsis. The overall 28-day and in hospital mortality was 50.5% and 56.3% respectively. The presence of chronic heart failure, occurrence of ARDS, septic shock and the winter period may influence an unfavorable outcome. Mortality compared to previous years is unchanged but patients that we have been treating these last 6 years have had more severe illnesses. Better adherence to the Surviving Sepsis guidelines will reduce mortality in this group of severely ill patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association of Systemic Inflammatory Response Syndrome with Bacteremia in Patients with Sepsis(Macedonian Academy of Sciences and Arts/Sciendo, 2019-10-01); ; ; ; The aim of this study was to evaluate the usability of systemic inflammatory response syndrome (SIRS) and commonly used biochemical parameters as predictors for positive blood culture in patients with sepsis. The study included 313 patients aged ≥18 years with severe sepsis and septic shock consecutively admitted in the Intensive Care Unit (ICU) of the University Clinic for Infectious Diseases in Skopje, Republic of North Macedonia. The study took place from January 1, 2011 to December 31, 2017. We recorded demographic variables, common laboratory tests, SIRS parameters, site of infection, comorbidities and Sequential Organ Failure Assessment (SOFA) score. Blood cultures were positive in 65 (20.8%) patients with sepsis. Gram-positive bacteria were isolated from 35 (53.8%) patients. From the evaluated variables in this study, only the presence of four SIRS parameters was associated with bacteremia, finding that will help to predict bacteremia and initiate early appropriate therapy in septic patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Procalcitonin-early biochemical marker for diagnosis, prognosis and treatment of sepsis in neonates and oncological patients with febile neutropenia(Macedonian Association of Anatomists, 2020); ; ; Kimovska Hristova, MicaPediatric sepsis is a life - threatening condition, in which the immune system, instead of controlling the infection,causes damage to tissues and organs. The aim of this study was to determine the role of procalcitonin (PCT)in the early diagnosis of sepsis in high - risk infants and Oncological patients with febrile neutropenia,its prognostic value,and the role of PCT in the cho ice of antibiotic. The study is designed as retrospective - prospective, it is being worked at the PHI UC for Children Diseases Skopje. I t includes 60 critical newborns and 40 O ncology patients.The examined group were divided into two subgroups:30 critical i nfants with bacterial sepsis in the intensive care unit and 20 O ncological patients with sepsis and febrile neutropenia. PCT was determined the first 24h,3 - 5 days and 6 - 14 days of hospitalization. The value of PCT during the first 24 hours of admission was increased in all 50 patients .Most of them had signs of severe sepsis and few od them had signs of septic shock . In all of them, double parenteral antibiotic therapy was started .Seven patients has died in the first five days. After 3 - 5 days of the start of antibiotic therapy, PC T values decreased . After the third measurement, PCT values continued to decrease and in majority of the patients the antibiotic therapy was discontinued. By measuring the values of PCT, an early diagnosis of sepsis can be made. This is important to start with antibiotics to prevent sepsis and septic shock . T he dynamic in the values of PCT determine the duration of antibiotic,its modification,the rational uses of antibiotics and the emergence of resistance to it. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EVALUATION THE VALUE OF INFLAMMATORY BIOCHEMISTRY MARKERS AT THE NEWBORNS WITH SEPSIS IN THE INTENSIVE CARE UNIT(SHMSHM / AAMD, 2020); ; ; Olivera JordanovaObjective: The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as a early diagnostic and prognostic biochemical marker for sepsis in newborns in correlation withC reactive protein (CRP) and white blood cells count(WBC). Methods: In a prospective study, 110 newborns with two or three clinical signs of sepsis who admitted at the Intensive Care Unit (ICU) at the PHI University Clinic of Pediatric Diseases-Skopje were included . Diagnosis of sepsis in newborns diagnosed according to standard protocols for diagnosis of disease. Sample for blood culture, PCT CRP and WBC obtained by peripheral venous puncturewere taken the first at the admission, before initiation of antibiotic therapy in newborns suspected of sepsis, the second on 3-5 days and the third 6-14 days. Results: 110 newborns were recruited. At first 24 hours of the admission , PCT have a higher discriminative ability than the WBC in distinguishing a bacterial infection from another inflammatory process the early infection diagnosis, and also found to have been more reliable than that of the CRP. The highest average values of PCT (40.37±53.79) were measured during admission with a subsequent sharp jump. The highest average values of CRP were measured (42.17±61.84) after the second during with a subsequent sharp jump. In the three measurements they had an average value WBC (16.83±8.35, 16.71±9.64. 16.31±11.72).Conclusion: The values of procalcitonin (PCT) is a important clinical significance in diagnosis treatment and predicting the prognosis of newborns with sepsis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PROMISING DIAGNSOTIC MARKER AT NICU AND PICU-NEW APPROACHES FOR DIAGNOSTIC AND TREATMENT(Macedonian Association of Anatomists, 2019); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Acute complications in multiple myeloma(Association of medical doctors "Sanamed" Novi Pazar, 2017); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MOST COMMON FACTORS AFFECTING OCCURRENCE OF NEONATAL SEPSIS - CHALLENGE AND EXPERIENCE FOR TREATMENT AT NEONATAL INTENSIVE CARE UNIT(Macedonian association of anatomists and morphologists, 2018); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DIAGNOSTIC VALUES OF BIOCHEMICAL MARKERSIN ASPHYXED NEWBORNS WITH PROVEN SEPSIS(Macedonian Association of Anatomists, 2020); ; ;