Kostadinoski, Kristin
Preferred name
Kostadinoski, Kristin
Official Name
Kostadinoski, Kristin
32 results
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Item type:Publication, Acute severe poisoning with disinfectant in senior aged patient-case report and overview of literature considering age influence on treatment decision in alcohol-based intoxications(2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, High-sensitivity troponin I in patients with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances(Taylor & Francis, 2022-05-27); ; ; ; Jurukov, IrenaObjective: We determine high-sensitivity troponin I (hs-Tnl) activity in patients with rhabdomyolysis following acute intoxication with psychotropic and chemical substances. Methods: This is a clinically controlled prospective study conducted in 2019 at the University Clinic of Toxicology in Skopje. In this study, 140 patients with rhabdomyolysis were divided into two groups depending on the intoxicating substance i.e. psychotropic or chemical. Rhabdomyolysis was defined according to the Poisoning Severity Score. High-sensitivity troponin (hs-TnI) was measured in all patients with rhabdomyolysis three times, on the first, third, and fifth days of hospitalization. Data were statistically analyzed in SPSS software, version 22.0 for Windows (SPSS, Chicago, IL, USA). Results: In all patients with rhabdomyolysis, the mean hs-TnI value on the first, third, and fifth days was 27.7 ± 78.3 mg/L, 43.7 ± 135.9 mg/L, and 28.73 ± 57.01 g/L, respectively. The comparison of hs-TnI in the three measurement times showed a significant difference (p ¼ 0.001). On the third day of hospitalization in all patients the hs-TnI was significantly higher compared to the fifth day (p ¼ 0.0001) as well as marginally insignificantly higher compared to the first day (p ¼ 0.057). The value of hs-TnI on the fifth day was insignificantly higher compared to the first day (p ¼ 0.021). We determined the highest values of hs-TnI in methadone intoxications (N ¼ 5, 279.7 ± 190.7 mg/L, other drugs (N ¼ 1, 138.4 mg/L); and benzodiazepines (N ¼ 3, 213.9 ± 232.5 mg/ L). Analysis by type of intoxication on the first, third, and fifth days showed that hs-TnI values were insignificantly higher in the psychotropic group compared with the chemical intoxication group. Conclusion: The value of hs-TnI was slightly higher in patients with rhabdomyolysis after acute psychotropic intoxication. Elevated levels of hs-TnI in psychotropic intoxications were likely related to the specific etiologies such as illicit substance use, while chemical intoxication was associated with the clinical outcome of intoxication. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CREATINE KINASE IN PATIENTS WITH RHABDOMYOLYSIS ACUTELY INTOXICATED WITH PSYCHOTROPIC AND CHEMICAL SUBSTANCES(Georgian Association of Business Press, 2022); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Corrosive poisonings during the COVID-19 pandemic: trends and demographic shifts in the pre- and early vaccination periods (2020–2021)(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2025-09-15); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of Rhabdomyolysis in Acutely Intoxicated Patients with Psychotropic and Chemical Substances(2023-06); ; ; ; Introduction: Rhabdomyolysis is characterized by a muscle injury that leads to the release of intracellular muscle contents/constituents into the systemic circulation. Aim: We examined the association between the severity of the clinical presentation and creatinine phosphokinase values in patients with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances. Materials and methods: This clinically controlled prospective study included 140 patients with rhabdomyolysis hospitalized at the University Clinic of Toxicology in 2019. They were divided into two groups by the substance used for intoxication (psychotropic or chemical). Results: On the third day of hospitalization, we found a significant association between the type of intoxication and the degree of rhabdomyolysis according to the poisoning severity score (p=0.0256). The significance was due to intoxications with neuroleptics – 50% (n=6), anticonvulsants – 20% (n=1), antidepressants – 16.67% (n=2), heroin – 25% (n=1), and methadone – 54% (n=6). According to the poisoning severity score, the majority of intoxicated patients with chemical substances – other gases 100% (n=1), and those intoxicated with psychotropic substances – methadone 46.67% (n=7), neuroleptics 42.67% (n=5), heroin 40% (n=2), antidepressants 8.33% (n=1), had severe rhabdomyolysis. In psychotropic intoxications, creatine kinase had a significant linear positive weak correlation with mortality (p=0.0234). Conclusions: Rhabdomyolysis and its clinical symptoms and signs were significantly more common in patients intoxicated with psychotropic substances compared to chemical intoxications. Intoxicated patients with psychotropic substances had more severe rhabdomyolysis on the third day of hospitalization. In psychotropic intoxication, with increasing creatine kinase level on the first day there was a significant increase in mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Somatic diseases in patients with Opioid Use Disorder(2021-06-03); ; ; ; Background: Compulsive opioid use leading to negative social, occupational, psychological, and physical consequences, including comorbid medical conditions. Aim: to assess the somatic diseases found in patients with opioid use disorder over a five-year period. Methods: This study has a retrospective cohort design over a five-year period (2013-2017). National patient electronic system “My Term” was used to collect data. The variables: gender, age, ethnicity, employment, duration and route of opioid administration, duration of hospitalization, somatic diseases, types of opioid substances used were analysed. Results: In all, 142 patients with opioid use disorder were analysed. The male gender was predominant. The mean age of patients in this study was 36.12±5.39, with average duration of opioid use disorder of 10.58±3.50 years. In the three groups of patients selected (current injectors, former injectors and oral users), methadone was the most frequently used drug (61.27%), followed by heroin (28.87%). Benzodiazepines were the second most frequently used drug (5.63%), mainly among current injectors (6.73%). About 33.10% of the patients had more than one somatic disease. Conclusions: Methadone was most commonly used as a single or combined substance in patients with opioid use disorder. Benzodiazepines were the second most frequently used drug, mainly among current injectors. The most frequent medical problems among current and former injectors were vascular changes, followed by skin changes and infections. Respiratory medical problems were common among patients with opioid use disorder who used drugs via inhalation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Frequency of cannabis and amphetamine use past month in patients on opioid maintenance treatment with buprenorphine(2024-10-23); ; ; Background Maintenance treatment for opioid use disorder, either with methadone or buprenorphine-based medications, improves retention in the treatment and reduces abuse of illicit opioids. We aimed to examine the cannabis and amphetamine use before and while the treatment with buprenorphine, as well as the correlation of this findings with the demographic characteristics and duration of opioid use disorder. Methods This analytical cross-sectional study was implemented at the Skopje University Clinic for Toxicology. Participants diagnosed with opioid use disorder receiving pharmacological treatment buprenorphine, were asked to self-report the past month cannabis and amphetamine use. Specially for this study designed questionnaire adapted to the “treatment demand indicator” was used to collect the data. Results Тotal of 112 participants (88.39% male and 11.61% female) were enrolled. Before the buprenorphine treatment, cannabis use was permanent in 60 (53.57%), and periodic or not used in 52 (46.43%) participants, and amphetamine use was permanent in 40 (35.71%), and periodic or not used in 72 (64.29%) participants. After the buprenorphine treatment cannabis was not used or used occasionally by 71 (63.39%) of the participants, ones per week or less was used by 14 (12.50%), 2-6 days per week was used by 9 (8.04%), daily used by 6 (5.36%) and unknown by 12 (10.71%) participants, with not significant association with the gender (p=0.732). negative not significant correlation with the age (R=-0.011; p=0.951) and positive not significant correlation with the duration of opioid dependence (R=0.032; p=0.733). Amphetamine after the buprenorphine treatment was not used or used occasionally by 103 (91.96%) participants, used ones per week or less by 6 (5.36%) and 2-6 days per week by 3 (2.68%) participants with significant association of male gender with no use (p=0.009), negative not significant correlation with the age (R=-0.073; p=0.445) and positive not significant correlation with the duration of opioid dependence (R=0.027; p=0.774). Conclusions Before starting treatment of opioid use disorder with buprenorphine, more than half of the patients had a permanent use of cannabis, while more than a third use amphetamines. After initiation of buprenorphine treatment, although some of the patients occasionally use cannabis and amphetamines, the permanent use of these psychoactive substances is reduced. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SEVERE DELIBERATE METFORMIN POISONING-CASE REPORT AND LITERATURE REVIEW WITH REFERENCE TO CURRENT TREATMENT MODALITIES AND OUTCOME(Macedonian Association of Internal Medicine, 2022-05); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rhabdomyolysis and Aminotransferase Activity Due to Acute Intoxication With Psychotropic and Chemical Substances(Arak University of Medical Sciences, 2023-01); ; ; ; Background: Rhabdomyolysis is caused by the release of enzymes from skeletal muscles into the blood, which leads to systemic complications with diverse etiologies. This study evaluated the serum aminotransferases in patients with rhabdomyolysis following acute intoxication with either psychotropic drugs or other chemical agents. Methods: This study randomly recruited 140 patients suffering from rhabdomyolysis. They were divided into two groups affected by either psychotropic drugs or chemical agents. Rhabdomyolysis was defined as having serum creatine kinase (CK) levels greater than 250 U/L, based on the poisoning severity score. Results: On day 1, the CK/AST correlation was significantly stronger in the psychotropic than the chemical group (P=0.0009). On day 5, patients in the psychotropic group had significantly higher AST (P=0.0138) and ALT (P=0.0129) than those poisoned with other chemicals. The difference in the strength of the CK/ALT correlation between the two groups was insignificant. Between the two groups, the differences between the CK levels and the following serum parameters were insignificant: Alkaline phosphatase; gamma-glutamyl transferase; prothrombin time; total bilirubin; and albumin. Conclusion: The elevated aminotransferases in patients with rhabdomyolysis due to acute psychotropic toxicity might have resulted from the skeletal muscle injury rather than hepatotoxicity. In rhabdomyolysis patients poisoned with other chemicals, the elevated serum aminotransferases are likely due to liver toxicity arising from the consumed substances. These patients are likely to manifest clinically severe long-term multi-organ failure. Intoxications with typical agents, such as herbicides, petroleum distillates, and corrosives were responsible for the rhabdomyolysis in the second group - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Severity and outcome in acutely intoxicated patients with elevated creatine kinase(2023-05); ; ; ; Bekjarovski, NikoObjective: Rhabdomyolysis is a clinical entity characterized by the release of intracellular enzymatic content from skeletal muscle into the bloodstream that leads to systemic complications. We determine the causes of mortality in patients with rhabdomyolysis following acute intoxication with psychotropic and chemical substances. Methods: This was a prospective clinical study, which included 140 patients with rhabdomyolysis divided into two groups depending on the substance taken, psychotropic or chemical intoxications. The severity of rhabdomyolysis was assessed according to the Poison Severity Score. Patients were divided into 3 groups a) mild rhabdomyolysis, CPK level from 250 to 1,500 U/L); b) moderate rhabdomyolysis CPK level from 1,500 to 10,000 U/L) and c) severe rhabdomyolysis CPK greater than 10,000 U/L. We included adult patients ages 18 and older with rhabdomyolysis in the study. They had been acutely intoxicated with either psychotropic or chemical substances within 48 hours prior to hospital admission. Results: In the group with psychotropic intoxications, the level of CPK on the first day in patients with a fatal outcome was significantly higher (p ¼ 0.0242) compared to survivors. In the chemical intoxication group, the patients with fatal outcomes compared to survivors had lower CPK levels on the first day, but this difference was not significant (p ¼ 0.2747 versus p ¼ 0.5779). Mortality was registered in a total of 9.3% (n ¼ 13) patients with rhabdomyolysis, of which 23.1% (n ¼ 3) had psychotropic intoxication and 76.9% (n ¼ 10) chemical intoxication. The analysis indicated a significantly lower mortality in psychotropic compared to chemical intoxications (p ¼ 0.0001). Mortality in the group of psychotropic intoxications, according to the etiological cause was highest with methadone at 13.3% (n ¼ 2), and neuroleptics at 8.3% (n ¼ 1). In the chemical intoxication group, the prevalence of mortality according to the etiological cause was highest in patients intoxicated with herbicides 50% (n ¼ 1), ethylene glycol 33.3% (n ¼ 1), corrosives 33.3% (n ¼ 4) and organophosphates 26.7% (n ¼ 4). Conclusion: Rhabdomyolysis had no significant effect on the fatal outcome in acutely intoxicated patients with psychotropic and chemical substances. Mortality was significantly lower in patients with rhabdomyolysis intoxicated with psychotropic drugs compared to chemical intoxications. In patients intoxicated with chemical substances, which were mild or moderate rhabdomyolysis, the causes of death were corrosive agents, ethylene glycol, herbicides, and organophosphates. The fatal outcome was due to the toxic effects of these agents and the severe disorders they cause.