Makarovska Bojadzieva, Tatjana
Preferred name
Makarovska Bojadzieva, Tatjana
Official Name
Makarovska Bojadzieva, Tatjana
Translated Name
Макаровска Бојаџиева, Татјана
Main Affiliation
Email
tmakarovska@yahoo.com
10 results
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Item type:Publication, Secondary Thromboprophylaxis in Hereditary Thrombophilia(SCIENCEDOMAIN International, 2018-02); ; ; Aims: The aim of this study is to show how the coagulation laboratory and clinical findings worked together in the management of a patient with hereditary thrombophilia and pulmonary embolism (PE) in terms of diagnosis, the choice of anticoagulation treatment and the duration of secondary thromboprophylaxis. Study Design: A case report with the presentation of clinical and laboratory findings, treatment and long-term follow up of the patient. Place and Duration of Study: Institute of Transfusion Medicine and University Clinics of Cardiology, St Cyril and Methodius University, Skopje, Macedonia in the period from February 2015 and December 2017. Case Presentation: Computer tomography confirmed the diagnosis of PE in a 32-year-old man who was admitted to the cardiology emergency department with D-dimer level of 5980 ng/mL after an episode of syncope. After the initial anticoagulation with unfractionated heparin 30.000i.e./24 h,enoxaparin 80 mg/12 h and acenocoumarol were introduced. The therapeutic INR rang could not be achieved so the acenocoumarol was switched to rivaroxaban 2x15 mg/day. One year later the anticoagulation with rivaroxaban 20 mg/day was discontinued. Thrombophilia testing included: prothrombin (PTB), Factor V Leiden and methylene tetrahydrofolate reductase (MTHFR) C677T gene mutation, as well as antiphospholipid antibodies, antithrombin, protein C and S. Results: The patient was homozygous for the PTB. His parents were heterozygous for the same mutation; his mother also being heterozygous for MTHFR C677T. His brother was compound heterozygote for PTB and MTHFR C677T and his sister was heterozygous for the PTB. Coagulation status monitoring showed hypercoagulability (APTT was 24-26 seconds) and increment of D-dimer (2100-2400 ng/ml) when rivaroxaban was discontinued and normal APTT (28-38 seconds) and Ddimer (< 500 ng/mL) when it was reintroduced. Conclusion: According to the laboratory findings and also having in mind that this was a second episode of a thrombotic event, we decided for an extended secondary thromboprophylaxis. Although it sometimes implies that it will be continued life-long we consider worthwhile to apply the patientoriented approach to the decision when and whether to terminate anticoagulation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rare blood groups in ABO, Rh, Kell systems – biological and clinical significance(2022); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between lipoprotein(a) and parameters of fibrinolytic system in patients with deep venous thrombosis(Medical faculty, Ss Cyril and Methodius University Skopje, Macedonia, 2020); Todorovska, ElizabetaReduced fibrinolytic capacity in lipid metabolism disorder causes impairment of intravascular thrombogenesis resulting in a thrombotic process. Thrombogenesis imbalance is done in the wall of vascular endothelial cells. They synthesize activators and inhibitors of the fibrinolytic system, they also participate in expression and degradation of different substances, among which circulatory lipids play an important role. Dyslipidemia and impaired fibrinolysis are risk factors for thrombotic processes that include deep venous thrombosis (DVT). Having this in mind, it was our aim to examine and evaluate concentrations of fibrinolytic parameters, such as tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1) and D-dimers (DD) on one hand, and on the other hand concentrations of lipid fractions, such as lipoprotein (a) - Lp(a). The principal aim of this study was to determine whether there is a correlation between three parameters of the fibrinolytic system (t-PA, PAI and D-dimers) and Lp(a). DVT was examined by applying ELISA for quantitative determination of the fibrinolytic parameters t-PA, PAI and DD and of the lipid fraction lipoprotein (a). The results obtained have shown decrease of t-PA concentration and increase of PAI-1 and DD concentrations and Lp(a) concentrations in comparison with the control group. Analysis of the results revealed several correlations between certain parameters of the fibrinolytic system and lipoprotein (a). In order to precisely define diagnosis and prophylaxis of thrombotic processes, routine application of tests for determination of fibrinolytic system parameters and lipid profile is an imperative. Thetesting of Lp(a) and fibrinolytic parameters such as t-PA, PAI-1 and DD is of great importance, especially in critical patients for early diagnosis and treatment which would significantly reduce the mortality rate of venous thromboembolism and other thrombotic disorders. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Meeting the needs while keeping the source-blood inventory management(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.N.Macedonia, 2020); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The role of hemostatic monitoring of dabigatran etexilate in patients with proximal femur fracture undergoing bipolar endoprosthesis(Medical faculty, Ss Cyril and Methodius University Skopje, Macedonia, 2020); Thromboembolic diseases are major cause of morbidity and mortality in the developed world as a result of an excessive stimulation of coagulation. Major surgery, especially in trauma patients with femur fracture, is recognized as risk factor for thromboembolic event because of which thromboprophylactic medicaments are necessary. Thrombin is a key serine protease in coagulation cascade and numerous efforts have been made to develop safe and effective orally active direct thrombin inhibitor (DTI). Dabigatran etexilate is a synthetic, reversible DTI with high affinity and specificity for its target, binding both free and clot -bound thrombin and offers a favorable pharmacokinetic profile. The study was conducted to evaluate the role of haemostatic monitoring in patients with bipolar prosthesis after proximal femur fracture using dabigatran for thromboprophylaxis. The study was performed according the third degree criteria for clinical investigation for drug application. Patients were divided in two groups according to the age related dabigatran dosage (150mg/twice daily in 65-70 years group and 110mg/twice daily in 70-75 years group). Informed consent was provided from all the patients. There were 42 investigated patients with implanted femur prosthesis. Haemostatic monitoring (platelet count, PT, APTT, TT, DD, PC, PS, ATIII) of patients receiving dabigatran was performed in order to evaluate the anticoagulant effect of the drug. Haemostatic monitoring was performed preoperative and also at 1, 7, 14, 21, 28 and 35 postoperative day. Color doppler ultrasonography investigation was performed at 7 and 35 days after the operation. In all of the patients, significant changes were observed only in APTT, TT and DD values which was not related to the dabigatran dose regiment. There were no thrombotic or hemorrhagic complications observed in none of the investigated patients which is due to the appropriate prophylactic doses of dabigatran. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Blood proficiency testing as an external quality control of the laboratory performance(SHMSHM - AAMD, 2019); Ismani, EkremObjective. To compare the results obtained from the participation in a blood proficiency testing study (B-PTS) in order to assess the corrective measures towards improving blood safety undertaken in the transfusion-transmissible infection (TTI) testing laboratory. Methods. The B-PTS study was designed, organized and conducted by European directorate for the quality of medicines (EDQM). The 3 laboratories for TTI testing participated in 2017 and 2018 by testing the B-PTS samples and reporting the results on the online result data sheet. Each laboratory performed TTI testing on a set of B-PTS-samples contained 4 panels: anti-HCV, anti-HIV/p24, anti-Treponema and HBsAg panel. The samples were subjected to serological testing with two assays: enzyme immunoassay with Enzygnost system, Siemens using BEP2000 and chemiluminescent microparticle immunoassay with Architect system, Abbott using Architect i2000. Results. In 2017, the performance of all of the participating laboratories was classified as “satisfactory” for B-PTS anti-HCV and anti-Treponema panel. For B-PTS anti-HIV/p24 panel the classification was “non evaluable” because the results were not properly submitted. The B-PTS HBsAg results were classified as “unsatisfactory” because two laboratories reported nonconforming result for one of the reactive samples from the panel, one laboratory with the Enzygnost assay and one laboratory with the Architect assay. The single observed non-conformity was that the S/Co (1.22) of the positive control for the Architect HBsAg assay was out of rang (1.65-4.96) for the corresponding reagent lot. As a corrective measure additional training of the staff was introduced and a decision was made for each laboratory to send the results and the correspondent interpretations itself in order to avoid the previous technical errors. In 2018, the performance of all of the participating laboratories was classified as “satisfactory” for each of the B-PTS panels. Conclusion: The participation in a B-PTS study provides an objective and independent evaluation of the overall performance of the laboratory aimed to detect non-conformities and to undertake corrective measures. This is an excellent tool for external control of the quality of laboratory testing which is necessary for further improvement of blood safety concerning TTI. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Development of Transfusion Medicine in Republic of North Macedonia(2022); ; ; Ristovska, ElenaTransfusion medicine has been successfully practiced in North Macedonia for 76 years. Since its foundation, the Transfusion Medicine Unit is constantly growing and developing through the experiences of a large number of professional medical workers who left a lasting mark and paved the way toward modern transfusion activity. The Institute for transfusion medicine of North Macedonia constantly follows the latest world achievements in the field of transfusion medicine and they invest their energy in constant education, new technologies, and appropriate practices that ensure a high level of health services for donors and patients. This manuscript presents the journey of transfusion medicine in the Republic of North Macedonia covering various topics like the History, changes in legislation over time, blood donation activity ,other services and the future directions for the field of transfusion medicine in the country. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rh D genotyping in pregnancy-present and future(ECronicon Open Access, 2021-11-01); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prevalence of unexpected red blood cell antibodies in blood donors(2018); Ismani, EkremRed blood cell (RBC) antibody screening is an obligatory part of our national blood testing strategy. It has been performed on regular basis, on every donation from each donor. In the last decade we have introduced more sensitive methods for detecting RBC antibodies. Aim of the study: To estimate the prevalence and the nature of the irregular RBC antibodies detected in the period from 2009 to 2014 and to analyze demographic characteristics of blood donors with specific antibodies. Material and methods: A total of 158170 blood units were screened for irregular RBC antibodies using pooled screening cells (2 donors) in combination with the indirect antiglobulin test (IAT), performed by gel technique and the automated system Techno Twin Sampler. Samples with confirmed positive antibody screening were subjected to antibody identification with commercial red cell panels (DiaMed and Ortho). We used blood donor data from the donor information system. Results: The total number of samples with positive antibody screening was 122 (0.078%). The ratio of female to male donors with positive antibody screening was 64 (52%): 58 (48%) respectively. Specific antibodies were identified in 67 (55%) out of 122 samples from which 53 (79.1%) were clinically significant (CS). The overall prevalence rate of the specific antibodies was 0.04%. The specificity of antibodies was as fallows: anti-D, 15 (22%); -E, 11 (16%); -C, 4 (6%); -c, 3 (4.5%); -Cw, 2 (3%); -K, 13 (19.5%); -Kpa, 2 (3%); -Fya, 1 (1.5%); -Lua, 2 (3%); -M, 11 (16.5%); -P, 2 (3%) and anti-Leb, 1 (1.5%). The average age in donors with CS antibodies was 48.2 years. The average number of donation prior to the antibody detection was 1.7 with mean interval between donations of 1.8 years. Conclusion: The prevalence of RBC irregular antibodies in our blood donors is very low mainly due to the good donor selection programme, as well as to the currently used screening method which contributes to the decrease of false positive and nonspecific reactions. The low prevalence of antibodies raises the question of cost-effectiveness of red cell antibody screening on regular basis. However, permanent donor education and further analysis of the possible impact on the safety of our blood supply is essential to establish cost-effective and safe RBC antibody screening model by targeting of donors which are at particular risk of RBC alloimmunization. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE ROLE OF ABO BLOOD GROUP SYSTEM IN THE OCCURRENCE OF VENOUS THROMBOEMBOLISM(Македонско здружение по кардиологија, 2024-12); ; ; ; Dejanova Ilievska, VioletaAbstract Background. The association of blood group antigens, especially those from the ABO system and some diseases is well known. The alleles of the ABO locus have functional effect on the level of some plasma coagulation factors which contributes to a thrombophilic condition and increase the risk for occurrence of venous thromboembolism. Aim. To examine relationship between ABO blood genotype with the occurrence of thromboembolic disease in our population, as well as to asses the risk for thrombosis in individuals with non-OO blood group genotype in comparison to those who poses it. Material and methods. This prospective case control study included 52 patients with a confirmed diagnosis of venous thromboembolism (VTE) and a control group of 50 healthy subjects who do not have a personаl or family history of thrombosis. The tests wеre performed on a sample of venous blood 2-6 ml in EDTA, in the laboratories of the Institute of transfusion medicine in R.N. Macedonia. In addition to the serological ABO typing, ABO aleles from ABO system (A1, A2, O1, O2, B) were determined by molecular methods (PCR-SSP and RT-PCR). Results. The results from ABO phenotyping and ABO genotyping performed in patients with VTE, as well as in the control group, show significant correlation with non-OO genotypes and occurrence of VTE in our population, in manner of increased additional trombotic risk, as a result of ABO system. Patients with VTE with non-OO genotype are with significant higher prevalence with 86.5%, in comparison with 13.5% occurrence of OO genotypes (x2 test p=0,027 (p<0.05)). The most frequent genotype in group of patients with VTE is O1A1 with 40.4%, while in control group is O1O1 with 32% occurrence. The genotype O1A1 is most frequent genotype in three groups of patients with VTE, in group of patients with deep vein thrombosis (DVT), pulmonary embolism (PE) and in those where is diagnosed DVT and PE in the same time, with occurrence of 35.7%, 55.5% and 50% respectively, but with significant lower occurrence of this genotype in control group with 24%. Genotype A1A1 has statistically significant correlation with occurrence of PE in our population. In correlation with occurrence of DVT are O1A1 and O1B genotypes and in correlation with PE is O1A1 genotype. Conclusion. The results confirm association on ABO blood group system with the occurrence of venous thromboembolism, so non-OO genotypes are connected with higher trombotic risk in comparison with OO genotypes in population in R.N. Macedonia.