SHubeska stratrova, Slavica
Preferred name
SHubeska stratrova, Slavica
Official Name
SHubeska stratrova, Slavica
Main Affiliation
Email
slavica.shubeska.stratrova@medf.ukim.edu.mk
80 results
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Item type:Publication, Type 1 Diabetes and Long-Term Continuous Subcutaneous Insulin Infusion Therapy: A 10-Year Experience from Macedonia(Mary Ann Liebert Inc, 2017-12); ; ; Todorova Jovanovska, BiljanaBackground: Subcutaneous insulin infusion (CSII) therapy is a challenge for both patients and healthcare providers. The long-term CSII use is scarce. The aim of this study is to describe the impact of CSII therapy for 10 years of use at our center. Methods: This single-center retrospective study includes 162 type 1 diabetes patients using CSII for >3 years during October 2004 until October 2014. Data were collected through the electronic medical record system, cross-sectional analysis (telephone, e-mail, or social media), and CSII reports generated by Carelink Therapy Management Software (Medtronic, Northridge, CA). Results: Patients were analyzed in three age groups: 12–18, 19–24, and >25 years. All patients were treated with CSII for >3 years. Total daily dose of insulin was >0.9 U/(kg$day) in age group 12–18 years old, which was significantly higher than other two age groups (P < 0.05). Basal ratio was lower in younger age (<40%) and showed trend of increasing with age and longer diabetes duration (up to 44%). Younger patients used bolus wizard on regular basis (>75%), which was significantly higher than other age groups (P < 0.05). More than 50% of patients achieved glycated hemoglobin (HbA1c) <7.0% and >70% of patients achieved HbA1c <7.5%. HbA1c level significantly changed from baseline in all groups (P < 0.05). Conclusion: Our study shows improved glucose control in long-term CSII users. A reduction of HbA1c levels by -1.1% was maintained during the study period. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Менопауза, липиден профил и кардиоваскуларни болести(MACEDONIAN ASSOCIATION OF ANATOMISTS AND MORPHOLOGISTS, 2008); ; ; Mishevska, Petranka - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; ; ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of Hormone Replacement Therapy on Insulin Resistance in Postmenopausal Diabetic Women(ID Design 2012/Scientific Foundation SPIROSKI, 2016-03-15); ; ; Insulin resistance (IR) is closely associated with diabetes mellitus. On the other hand, increased visceral fat in menopause is also associated with IR, which makes postmenopausal diabetic women in a big risk for cardiovascular diseases. There are conflicting reports about the effects on hormone replacement therapy (HRT) on IR. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RARE CASE OF OVARIAN STEROID CELL TUMOR NOT OTHERWISE SPECIFIED IN A POSTMENOPAUSAL WOMAN(Macedonian Association of Anatomists, 2022-08-31); ; ; Todorova, BiljanaOvarian steroid cell tumors, not otherwise specified(NOS), are rare ovarian sex cord–stromal tumors with malignant potential.They represent less than 0.1% of all ovarian neoplasms.Little is known about this tumor, it is rare, and only a small number of case reports are available in the literature. This type of tumor can produce testosterone, leading to hyperandrogenism,virilizationand amenorrhea.Postmenopausal occurrences are rare.We present a 60-year-old woman with onset of virilization,worsening alopecia and excessive growth of hair onabdominal and genital parts of the body.She haselevated levelsof adrenal androgens.Radiologic studies were consistent with left sided ovarian changes. A diagnostic and therapeutic bilateral salpingo-oophorectomy confirmed steroid cell tumor NOS in bothovaries. Post-operatively, the patient had complete resolutionof her symptoms and normalization of testosterone levels. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Social media and diabetes: can Facebook and Skype improve glucose control in patients with type 1 diabetes on pump therapy? One-year experience(American Diabetes Association, 2015-04); ; The aims of the study were to evaluate results from social media (Skype and Facebook) and CareLink software as tools to improve diabetes control in patients with type 1 diabetes using insulin pumps with glucose sensors. To our knowledge, this is the first study where Facebook is used as treatment alternative to regular clinic visits. A total of 56 children and adolescents with type 1 diabetes, ages 14–23, were randomized in two groups: Regular group and Internet group. The Regular group is composed of 29 patients who were treated using standard medical protocol with regular visits at clinic. Data were uploaded at the clinic and interventions (pump settings, basal bolus insulin, and education) were given to the patient by health care professionals. The Internet group was composed of 27 patients who were treated using CareLink software (Medtronic Diabetes). Data were uploaded by the patient at home and interventions (same as Regular group) were given via Facebook (chats) and Skype (sound and video). Both groups had improved A1C at 12 months (Regular group: 7.7 6 1.6% [61 6 17.5 mmol/mol] at baseline vs. 6.6 6 1.5% [49 6 16.4 mmol/mol] at 12 months; Internet group: 7.8 6 1.9% [62 6 20.8 mmol/mol] at baseline vs. 6.4 6 1.6% [46 6 17.5 mmol/mol] at 12 months, P , 0.05 at 12 months) (Table 1). Internet visits were performed with Facebook (54%), Skype (12%), and both Facebook and Skype (34%). Improvement occurred in the first 6 months and was maintained for 6 additional months. There were no differences in acute complications (diabetic ketoacidosis and severe hypoglycemia events), total daily dose of insulin, and weight change in both groups at 12 months. Personalization, presentation, and participation in social media and health care (5) can be tailored to the priorities of the patient Every Internet visit was personalized with patient needs (appointment date and time) and used active patient participation in the decision-making process of diabetes management. We found that social media use allows patients to gain diabetes knowledge and information and interact in their daily insulin adjustments. Moreover, it could help patients cope better with their daily life. This brief trial suggests that patients prefer to communicate with their health care providers using social media. Facebook and Skype can improve diabetes control similar to regular clinic visits. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The influence on coagulation of transdermal estrogen hormone replacement therapy as a preoperative preparation of the tissue before vaginal hysterectomy(Macedonian Academy of Sciences and Arts, 2004); ; ; ; Kiprovska, GordanaIn 32 postmenopausal patients who underwent vaginal hysterectomy due to the presence of uterine prolapse at the Department of Uro-gynaecology and Pelvic Floor Disorders in the Clinic of Gynaecology and Obstetrics, Medical School, Skopje in the period from 1st January 2002 to 1st January 2003, and who were preoperatively treated with transdermal estradiol 50 microg/day during 14 days the following parameters of the coagulating status were estimated: prothrombin time (PT) that is expressed in: absolute value, percentage and INR; activated partial thromboplastin time (aPTT Pathrombin SL); thrombin time and platelets number before and after hormone replacement therapy. After 14-day transdermal estrogen therapy, the parameters: PT, PT%, PT INR, aPTT Pathrombin SL didn't expressed significant changes, the thrombin time expressed significant extension, and the platelets expressed a significant decrease. According to our results, the transdermal estrogens might not have any influence on the hepatic synthesis of coagulating factors till the step of prothrombin formation. They might have an essential influence on the step of prothrombin transformation into thrombin, as well as on the process of megacaryocytes segregation into platelets. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Trunk/Legs Dual Energy X-Ray Absorptiometric Index Of Abdominal Obesity In Diagnosing Visceral Obesity In Cushing’s And Obese Women(2020); ; ; Maja DimitrovskaObjectives: Obesity and especially central body fat distribution (BFD) are known risk factors for cardiovascular and metabolic diseases. Android obesity in Cushing’s syndrome (CS) and in non CS abdominally obese women with the metabolic syndrome, which is predominantly visceral, intra-abdominal, is more predictive of adipose-related comorbidities than gynecoid obesity, which has a relatively peripheral (gluteal) distribution. Determination of dual-energy x-ray absorptiometric (DXA) indexes cut-off point values of abdominal obesity is very important to discover obese women with abdominal obesity. The aim of this study was to determine cut-off point values of DXA indexes of central, abdominal obesity determined as a ratio of trunk to legs tissue and fat mass and their percentages that best differentiate CS and O and confirm central, abdominal obesity. Material and Methods: DXA assessment of body composition and BFD was performed in two groups of women, each consisting of 21 subjects: 1st group of CS with clinically confirmed CS with Body Mass Index (BMI) (30.03±6.49 kg/m2 ) and age of 42.98±13.27 years and 2nd group of obese women (O), matched with CS according to their BMI (29.91±6.12 kg/m2 ) and age (41.04±12.85 years). Trunk/Legs tissue mass ratio (Tr/L-T), trunk/legs fat mass ratio (Tr/L-F), trunk/legs tissue % fat mass ratio (Tr/L-T%f) and trunk/legs fat mass % ratio (Tr/L-F%) were determined as indexes of central, ab - dominal obesity and their cut-off point values that best differentiate CS women from O were also determined. Sensitivity (S), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and DG (diagnostic accuracy) of these idexes were determined. Results: Tr/L-T values in CS were 2.05±0.44, significantly higher compared to 1.42±0.28 in O, and Tr/L-F values in CS 2.33±0.55 were also significantly higher compared to O (1.39±0.66) (p<0.0001). Tr/L-T%f values in CS were 1.15±0.14, significantly higher compared to 0.94±0.22 in O, as well as Tr/L-F% values of 1.18±0.12 in CS were significantly higher compared to O (0.94±0.68) (p<0.0001). Tr/L-T cut-off point value of 1.6 best differentiated CS from O for DG of 88.89% and Tr/L-F cut-off point value of 1.8 best differentiated CS from O for DG of 88.89%. Tr/L-T%f value of 1.0 differentiated CS from O for DG of 72.22% and Tr/L-F % value of 1.1 differentiated CS and O for DG of 77.78%. Tr/L-T and Tr/L-F differentiated CS and O with higher diagnostic accuracy. Tr/L-T with higher sensitivity of 94.44% and NPV value of 93.75% differentiated CS from O compared to the Tr/L-F correspondent values 83.33% and 85%. Conclusion: Tr/L-T and Tr/L-F DXA indexes cut-off point values of 1.6 and 1.8 best differentiated CS women from matched O women with high diagnostic accuracy. They confirmed abdominal, visceral obesity in CS with significantly higher values in CS compared to obese women and could be used as diagnostic indexes of abdominal obesity. Tr/L-T%f and Tr/L-F% indexes differeniated the two examined groups with lower diagnostic accuracy and are not useful in diagnosing abdominal obesity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ANTHROPOMETRIC INDEXES OF VISCERAL OBESITY RELATIONS TO DYSLIPIDEMIC PROFILE IN METABOLIC SYNDROME(2019); ; Zivkovic, MarijaIntroduction: Visceral obesity and dyslipidemia are the main characteristics of the metabolic syndrome. Objective: The relationship of abdominal sagittal diameter to thigh circumference ratio (SD/T) with anthropometric indexes of visceral obesity waist circumference (WC) and waist hip ratio (WHR) was determined as well as their association with lipid levels. Material and methods: Triglyceride (TG), cholesterol (C), HDL and LDL levels, LDL/HDL, C/HDL as well as WC, WHR and SD/T were determined in 250 healthy women divided into 3 groups according to body fat distribution by their WHR values: 1stgr WHR<0.85; 2ndgr WHR (0.85-1.0) and 3rdgr WHR>1.0. Results: SD/T correlated significantly positively with TG and C (p<0.0001), LDL (p<0.006), LDL/HDL and C/HDL (p<0.0001), also with WC and WHR (p<0.0001), and negatively with HDL (p<0.001). WC and SD/T levels were significantly higher in the 3rd gr (125.16±15.26cm; 0.49±0.38) compared to the 2nd gr (109±14cm; 0.39±0.43) and the 1stgr (88±17cm; 0.32±0.37)(p<0.0001). TG levels in the 3rd gr (1.87±0.69ng/ml) were significantly higher compared to the 1st gr (1.03±0.42ng/ml) and the 2ndgr (1.69±0.92ng/ml) (p<0.0001). HDL in the 3 rd gr was (0.95±0.23ng/ml), significantly lower compared to the 1stgr. (1.24±0.27ng/ml) (p<0.001) and 2n dgr (1.07±0.39ng/ml) (p<0.028). LDL, C/HDL, LDL/HDL and C levels were also significantly higher in the 3rdgr. Conclusion: Visceral obesity was characterized with increased values of WHR, WC and SD/T, which were positively related to dyslipidemic profile. Positive relation of SD/T with atherogenic lipids, atherogenic indexes, WHR and WC, and negative relation with HDL, confirmed it as an important anthropometric diagnostic parameter of visceral obesity in metabolic syndrome. - Some of the metrics are blocked by yourconsent settings
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