Pemovska, Gordana
Preferred name
Pemovska, Gordana
Official Name
Pemovska, Gordana
Main Affiliation
Email
gordana.pemovska@medf.ukim.edu.mk
31 results
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Item type:Publication, A case of ACTH producing oat cell carcinoma cause of ectopic Cushing's syndrome and life threatening hypokalaemia(Bioscientifica, 2013-04-01); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Lower limb perfusion scintigraphy with 99mTc-MIBI scintigraphy and determination of endothelin in diabetic and nondiabetic patients(National Library of Serbia, 2020); ; ; ; Pop Gjorceva, Daniela - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Hypercalcaemia in patient with primary hyperparathyroidism and acromegaly(Bioscientifica, 2015-05); ; Introduction: Hypercalcaemia in acromegaly can be a result of several pathophysiological mechanisms. Multiple endocrine neoplasia type 1 (MEN1) syndrome, mitogenic effect of hyperactivated GH–parathyroid gland axis, i.e. primary hyperparathyroidism and hypercalcaemia mediated by elevated 1,25-dihydroxyvitamin D should be considered. Case report: We describe a case of acromegaly associated with primary hyperparathyroidism. A 52-year-old female was diagnosed with acromegaly due to GH secreting pituitary microadenoma. Evaluation at diagnosis showed normal levels of hormones other than GH and IGF1, and presence of hypertension and multinodular goiter (volume 80 mm3). Because the patient denied surgery, treatment with cabergoline was administrated and a biochemical control was accomplished. Within 1 year of the diagnosis laboratory data showed hypercalcaemia (serum calcium 1.51 mmol/l (1.10–1.40)) in the setting of elevated parathormone (PTH) levels (158 pg/ml (15–65)) and low levels of vitamin D (5.6 nmol/l (>25)). Bone densitometry detected osteoporosis limited to the right radius (T score value −4.0 S.D.). Analysis of 24-h urine showed normal calcium and phosphate excretion. This findings were consistent with diagnosis of primary hyperparathyroidism. Imaging and radioisotope studies identified enlarged thyroid gland, predominantly the left lobe with consequent tracheal compression, and higher radioisotope uptake in the lower pole of the left thyroid lobe. Surgical excision of left lower parathyroid gland and subtotal thyroidectomy was done. Histopathological examination confirmed hyperplasia of parathyroid and thyroid gland. After surgery, serum calcium normalised, PTH levels significantly reduced to 73.2 pg/ml. Vitamin D remained low (17.8 nmol/l) and TSH levels elevated to 27 mU/l (0.4–4) for which vitamin D and levothyroxine substitution was started. Conclusion: The approach to hypercalcaemia in the course of acromegaly implies evaluation for several potential pathophysiological mechanisms, which in turn dictates the treatment strategy – parathyroidectomy vs biochemical control of acromegaly. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Maternal 75 g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus(Bioscientifica, 2013-04-01); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Malnutrition cause of Secondary Osteoporosis after surgical operation of Glucagonoma(Bioscientifica, 2013-04-01); ; Dimitrovski, CedomirIntroduction: Glucagonoma is a rare condition with annual incidence 1 in 20 million, associated with diabetes mellitus, dermatitis, deep vein trombosis and depression. Case report: A 55-year-old woman patient was hospitalized at our department because of intense discomfort of the skin lesions that were pruritic and painful, erythematous area of skin with blisters that breach after a few days, red tongue, cracks on the mouth corners. She had a constant weight loss accompanied with bloody diarrhea. Her weight was 36 kg, height 150 cm and her BMI was 16. We made 75 g OGTT and it was normal. She was misdiagnosed like contact dermatitis magnum et pedum, stomatitis protetica, erythema exsudativum multiforme, colitis. On the examination she had cheilitis angularis, atrophic glossitis, stomatitis, normochromic normocytic anemia and the Hct was 0.27, SE 70/100. She had dermatological changes – erythematous patch, blisters centrally, erodes, crusts, heals with hyperpigmentation. We made a lab test and we got that her glucagonemia was increased twice than normal. The normal values are 200 ng/l and she had 400 ng/l. We made a CT scan where a round form of a tumor was noticed in the pancreas with dimensions 5 cm width and 8 cm length. After that, she underwent a surgical operation and the surgeon made a distal splenopancreatectomy to remove the tumor. The tumor immunohistochemistry was positive of glucagon, synaptophysin and chromogranin-A. After the operation, she suffered from malnutrition and she came again at our department to check herself for osteoporosis. We made a DXA scan and we saw that she had a generalized secondary osteoporosis caused due to malnutrition after operation (T score=−4.0 on the spin, T score=−3.8 on the right hip and T score=−3.6 on the left hip). Conclusion: Long-term misdiagnosed glucagonoma explain appearance of other co-morbidites such as osteoporosis and anemia. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Metformin improves menstrual patterns, endocrine and metabolic profile in obese hyperinsulinemic women with a polycystic ovary syndrome(Macedonian Academy of Sciences and Arts, 2006-07); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The beneficial effect of L-thyroxine on lipid parameters in mild form of subclinical hypothyroidism(Bioscientifica, 2016-05-13); ; ; Introduction: Overt hypothyroidism and severe subclinical hypothyroidism (ScH) are associated with dyslipidaemia, and its condition is reversible after thyroid replacement therapy. We investigated the effect of levothyroxine therapy on lipid parameters in patients with mild form of subclinical hypothyroidism (ScH). Material and methods: Fifty-seven patients with newly diagnosed ScH with TSH levels below 10 mU/l and 30 age and sex-matched healthy subjects were included in the study. Lipid parameters were evaluated at the first visit in both groups, and after 6 months euthyroid stage in patients with ScH. Results: Average value of TSH in patients with ScH was 8.1 mU/l. At the baseline, ScH patients has a significantly higher total cholesterol and LDL-C levels, and lower HDL-C, than the control group (5.6±0.9 vs. 4.8±1.1, 3.4±1.0 vs. 2.9±0.8, and 1.5±0.5 vs. 1.7±0.9, mmol/L, P<0.05, respectively). Thyroid substitution therapy in ScH group, significantly decreased total cholesterol and LDL-C, and increased HDL-C (5.6±0.9 vs. 5.3±1.1, 3.4±1.0 vs. 3.2±1.1, 1.5±0.5 vs. 1.6±0.5, mmol/L, P<0.05 respectively). Also, TSH positively correlated with total cholesterol (r=0.147, P<0.05). Conclusion: Mild form of ScH is associated with hipercholesterolemia, which is reversible after levothyroxine treatment. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effect of L-thyroxine on left ventricular function in subclinical hypothyroidism(Bioscientifica, 2015-05-01); ; Introduction: Thyroid hormone deficiency can lead to the impairment of cardiac function. Whether subclinical hypothyroidism (ScH) is a risk factor for left ventricular (LV) dysfunction is controversial. Aim of the study was to assess whether ScH is associated with LV systolic and diastolic dysfunction and it’s reversibility after treatment with L-thyroxine. Material and methods: Twenty-seven consecutive patients with newly diagnosed ScH underwent laboratory analyses (TSH, fT4, fT3, anti-TPO, and anti-Tg antibodies), and a complete two-dimensional echocardiography study. Results: Analysed patients has the following characteristics: age 41±12 years, TSH 8.5±2.7 mU/l before treatment, and TSH 2.07±0.9 mU/l after an average follow-up period of 7.2±1.9 months. Compared to baseline measurements, after 5 months euthyroid stage the duration of the A wave was shorter (112.18±17.2 ms vs 112.18±17.2 ms, P<0.01), and the longitudinal global strain was higher (−19.55±2.3% vs −20.07±2.7%, P<0.05). Free T4 positively correlated with E/A ratio (r=0.42, P<0.05) and fT3 negatively correlated with DT (r=−0.50, P<0.05). Univariant regression analysis showed a statistically significant independent effect of TSH on the E/e’ lat, E/e’ average, LVED vol, LA, and LA area. Conclusion: Subclinical hypothyroidism is associated with systolic and diastolic LV dysfunction, as well as reducing global longitudinal LV systolic function. These alterations may be reversed by L-thyroxine. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Carotid ultrasound, blood lipids and waist determination can predict a future coronary revascularisation in the type 2 diabetic cohort(Macedonian Academy of Science and Art (MANU), 2007-12-28); ; ; The aim of the study was to identify incremental values of carotid ultrasound measurements (carotid plaques and stenosis) on the prediction of future coronary revascularization among type 2 diabetic patients. The second objective was to determine the predictive value of the assessment of blood lipids, BMI, abdominal obesity and the ankle-brachial index (ABI). Three hundred and thirty three (333) patients with type 2 diabetes and manifested coronary artery disease were randomly selected in a cohort prospective study. Univariate and multivariate logistic regression analyses were conducted to identify variables predictive of the need for future revascularization: percutaneus coronary interventions (PCI) or coronary bypass surgery (CABG) followed 24 months after the study starting point. The presence of arterial hypertension, hyperlipidemia, physical inactivity, intermittent claudication, the value of systolic pressure, BMI, waist and hip measurement, glycemia and blood lipid fraction (total cholesterol, HDL, LDL, non-HDL, triglycerides) were entered in a model. Ultrasound measurements: carotid IMT, presence of carotid plaques and stenosis, and ABI were also included in the analysis. Based on the univariate and multivariate findings, the presence of internal carotid artery (ICA) stenosis (OR 4,562, 95% CI 1,327-15,687), carotid plaque (OR 1,465, 95% CI 0,829-2,591), and increased waist measurement (OR 1,371, 95% CI 0,757-2,483) were found as significant independent predictors of future PCI. LDL and non HDL cholesterol were found to be factors independently associated with the need for future CABG by univariate analysis, which was not confirmed by multivariate analysis. In conclusion, the current study has provided an identification of predisposing factors for the future need of coronary revascularization among type 2 diabetic patients that permits risk stratification and may facilitate improved patient selection or optimization.