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    THE RELEVANCE OF PREDICTING RHEUMATOID ARTHRITISSEVERITY: FACILITATING EARLY TREATMENT IN POOR PROGNOSISAND PROGNOSTIC LABORATORY MARKERS OF JOINT DAMAGE
    (Macedonian Association of Anatomists, 2021-07-26)
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    Simultaneous testing especially of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF), which are reversible measures of inflammation, together with clinical variables of inflammatory synovitis are recommended for evaluation of disease activity. In this study 35 patients (pts) with early RA were included, while 35 pts were in the healthy control group. Pts were treated with Methotrexate at an average dose of 10 mg once weekly. RA was evaluated following the dynamics of changes of the mean values of ESR, CRP and RF. Statistical analysis showed statistically significant differences among mean values of ESR in the four time intervals (p= 0.00002). Regarding CRP, there were statistically significant differences among mean values in all four time intervals (p= 0.0428)(standard deviations were with great variations). There were no statistically significant differences of RF in the four time intervals (p= 0.573). We found high values of CRP and RF in most of the patients. In spite of the therapy with Methotrexate, disease progression continues especially in patients with elevated values of ESR, CRP and RF, which are shown as predictors for aggressive course of disease. This enables selection of high risk groups of patients for aggressive course of disease and points to the need of early and aggressive treatment.
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    Myocardial Infarction in Systemic Lupus Erythematosus - the Sex Specific Risk Profile
    (Bentham Science Publishers Ltd., 2020-12-09)
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    Pop-Gjorceva, Daniela
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    Accelerated atherosclerosis is widely present in patients with systemic lupus erythematosus.
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    99mTc-MIBI GATED-SPECT Myocardial Perfusion Scintigraphy in Asimptomatic patients with Systemic Lupus Erythematosus.
    (Medical Facilty, Ss Cyril and Methodius University, Skopje, R. Macedonia, 2018)
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    Tanevska, B
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    Sandevski, A
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    Myocardial Perfusion Abnormalities in Young and Premenopausal Women with Systemic Lupus Erythematosus, Detected with 99MTC MIBI Myocardial Perfusion Scintigraphy - Prevalence and Correlation with Proatherogenic Factors
    (Walter de Gruyter GmbH/Macedonian Academy of Sciences and Arts, 2018-12-01)
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    Pop-Gjorcheva, Daniela
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    Sandevski, Aleksandar
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    Atherosclerosis in young and premenopausal women with systemic lupus erythematosus (SLE) is frequent, premature and progressive. Although asymptomatic or with atypical clinical presentation, the patients are at high risk of cardiac events. Aim of this study is to estimate the risk profile for atherogenesis and the prevalence of myocardial perfusion abnormalities with 99mTc myocardial perfusion scintigraphy (MPS) in young and premenopausal women.
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    Severe Complicated secondary antiphospholipid syndrome conjointly with lupus erythematosus -case report
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2025-01)
    Vidinikj, Sonja
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    Antova, Dubravka
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    Guchev, Filip
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    Antiphospholipid syndrome (APS), is an autoimmune systemic disorder known to manifest with thrombosis in almost all vessels throughout the body, can also be accompanied by pregnancy morbidity, and is persistent with the presence of antiphospholipid antibodies, including lupus anticoagulant antibodies, or relatively high titers of anticardiolipin, or anti-β2Glycoprotein I antibodies. APS can occur alone or in association with other diseases, more commonly systemic lupus erythematous. In patients with both underlying diseases episodes of arthritis, skin changes in the form of livedo reticularis, thrombocytopenia and leucopenia were more common. Cardiac manifestations have also been reported. Here we present a complicated case of a young female patient with antiphospholipid syndrome and an underlying systemic lupus erythematosus.
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    Satisfaction Level of Rheumatoid Arthritis Patients Enrolled in the Treatment with Subcutaneous Tocilizumab. Journal of Autoimmune Diseases and Rheumatology
    (Karachi: Synergy Publishers, 2020)
    Filip Guchev
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    D. Antova
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    B. Osmani
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    M. Nikolovska Kotevska
    Background: The introduction of biological-Disease Modifying Agents (bDMARDs) has allowed serious improvement in the treatment of patients with rheumatoid arthritis (RA) by providing a better quality of life (QoL). Such improvements have been shown in patients using subcutaneous form of Tocilizumab SC (TCZ-SC), a humanized monoclonal antibody against IL-6 receptor. Objective: To assess the subcutaneous treatment satisfaction level and to evaluate the epidemiological profile of RA patients treated with TCZ-SC in North Macedonian Patients with RA. Methods: An observational study was conducted at the University Rheumatology Clinic in Skopje between October 1st and December 15th 2018, including 48 patients who have received TCZ-SC. In order to obtain patient’s satisfaction level and to evaluate the epidemiological characteristics of the patients, a standardized questionnaire was developed. Results: The mean age of the patient’s cohort was 50.9 years and 88.5% of the patients were females. More than half of the patients (58%) had high disease activity with mean disease duration of 5.35 years. Eighty three percent of the patients were entitled to receive subcutaneous TCZ because of the insufficient efficacy of previous treatment, All patients enrolled in the treatment with TCZ-SC, reported to be satisfied or very satisfied with the subcutaneous application of TCZ. They were also very satisfied with the previous education and the opportunity to receive the treatment at home. Conclusions: Tocilizumab as an efficient and well tolerated bDMARD is becoming a standard of care in the treatment of patients suffering from RA, offering unprecedented benefits for QoL improvement and satisfying the patients’ needs for modern and effective treatment.
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    ASSESSMENT OF ENZYMURIA FROM PROXIMAL RENAL TUBULE IN INFLAMMATORY SERONEGATIVE RHEUMATOID ARTHRITIS
    (Macedonian Medical Association/De Gruyter, 2022)
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    Ana Vasilevska
    Introduction. To determine the effects of non-treated seronegative rheumatoid arthritis (RA) on proximal renal tubule, sensitivity of alanine aminopeptidase (AAP), -glutamyltransferase (--GT), β2 microglobulin in urine β2M), as well as to determine the relation with rheu-matoid factor (RF) and C-reactive protein (CRP), DAS 28 - disease activity score. Methods. RF was determined by agglutination test (latex RF test, while kinetic methods were used for determination of alanine aminopeptidase (AAP) and -glutamyltransferase (-GT), as well as MEIA (micro-particle enzyme immunoassay) to determine β2 micro-globulin in urine. Samples (serum and urine) of 70 participants were examined (35 RA not treated, 35 healthy control group of patients). Results. In 35 RF negative RA, AAP enzymuria was present in 12 (34.28%) patients, -GT was present in 7 patients (20%), while β2 microglobulin was present in 3 patients (8.57%). In the healthy control group, 4 patients showed AAP positivity (11.42%), 2 patients -GT positivity (5.71%) and 1 patient showed presence of 2 microglobulin in urine (2.85). RF was not detected in any patient (0%). Conclusion. AAP has a higher sensitivity of -GT and β2 microglobulin in the detection of asymptomatic renal lesions in non-treated seronegative RA.
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    The utility of dual-energy X-ray absorptiometry (DXA) in the assessment of fracture risk in women with early undifferentiated psoriatic arthropathy sine psoriasis vulgaris with or without joint inflammation
    (Sievert Association, 2021-09)
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    Psoriatic arthritis (PsA) is associated with decreased bone mineral density (BMD) and increased fracture risk. The association between BMD and fracture risk in PsA is not well elucidated. We aimed to assess BMD in an PsA cohort of patients with active disease and patients in remission, and to assess the predictive value of BMD on incidence of fractures.
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    DIAGNOSTIC UTILITY OF ANTI-CCP ASSAY IN PATIENTS WITH RHEUMATOID ARTHRITIS
    (Macedonian Association of Anatomists and Morphologists, 2021-12)
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    Krstevska Balkanov, Svetlana
    Introduction: The purpose of this research was to compare the diagnostic values of laboratory variables, to present quantitative evaluations of the diagnostic test with reference value for anti-cyclic citrullinated peptide (anti-CCP2) antibodies, rheumatoid factor (RF), Creactive protein (CRP), and DAS 28 index in early diagnosis of untreated rheumatoid arthritis (RA). Material and methods: Using the ELISA method of DIA-STAT™ Anti CCP (Axis-Shield Diagnostics), sera of 70 participants were examined (35 untreated patients with RA and 35 subjects from the healthy control group). RF and CRP were determined with the agglutination test (Latex test) in the same participants. At the same time, we determined the sensitivity, specificity, predictive value for positive and negative test and accuracy. Results: Presence of anti-CCP 2 antibodies was 65.71%, 23/35 patients, while RF was present in 17/35 (48.57%). Twelve patients were anti-CCP2 and RF positive, 11 were antiCCP2 positive, but RF negative. Five patients were anti-CCP2 negative and RF positive. In the healthy control group, one patient was anti-CCP2 positive, while 2 patients were RF positive. Conclusion: Anti-CCP2 antibodies have higher sensitivity and specificity than RF in early RA
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    C-REACTIVE PROTEIN - THE MOST USEFUL REACTANT OF ACUTE PHASE IN RHEUMATOID ARTHRITIS
    (Macedonian Association of Anatomists, 2023)
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    Ljindita Djemaili Jakupi
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    Ana Vasilevska
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    Abstract The aim of the study was to determine the most useful biochemical marker of the acute phase reactants for the evaluation of disease activity in rheumatoid arthritis (RA). Sixty patients with RA were included, 27 of whom were treated with non-steroid antiinflammatory drugs (NSAIDs) and methotrexate (MTH). The control group consisted of 33 patients treated only with NSAIDs due to irregular control. In the first group, disease activity was evaluated at four-week intervals and in the control group at threeweek intervals, following the scores of the articular indices, complete blood count (CBC), elevated sedimentation rate (ESR), and C-reactive protein (CRP) in every patient. In the first group of patients, decreased activity of RA was found in every subsequent control, with a consecutive decrease in the mean values of the scores of the articular indices and statistically significant differences in the four-time intervals. Considering laboratory parameters, there were statistically significant differences in the mean values of haemoglobin (Hb), erythrocytes (Er), platelets (Plt), and ESR (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). The mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (the standard deviation also increased). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of the articular indices, with increases in every subsequent control (in favor ofdisease progression). There were no statistically significant differences considering CBC, ESR, and CRP (in favor of a permanently active disease). CRP is the most useful marker in the prospective evaluation of patients with rheumatoid arthritis.