Simeonova krstevska, Slagjana

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Simeonova krstevska, Slagjana

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Association of Inflammatory Markers with Disease Severity and Outcome in Covid-19 Patients
(Macedonian Academy of Sciences and Arts, 2023-03-01)
Gjuzelova Aleksoska, Aleksandra
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Nakova Velkoska, Valentina
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Metodieva, Marija
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Stojkoska Jorganovic, Aleksandra
Objectives: The coronavirus pandemic was associated with a high mortality rate in the Republic of North Macedonia. Finding early markers of the disease's severity may predict outcomes and guide the treatment of the disease. The aim of our study was to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. Methods: The study included 104 PCR-confirmed COVID-19 patients who underwent hospital treatment at the Institute of Lung Diseases and Tuberculosis in Skopje, North Macedonia, between November 2020 and May 2021. Inflammatory markers were assessed in all patients and correlated with the disease severity and outcome in terms of survival or death. Results: IL-6 and LDH at admission were significantly elevated in patients with a severe or critical form of the disease and among non-survivors. In addition, IL-6 showed 87.9% of sensitivity and 61.8% of specificity for distinguishing non-survivors from survivors with a cut-off value of 21.7 pg/ml in the receiver operator curve (ROC). Procalcitonin was significantly increased in non-survivors. Parallel to the increase of disease severity, the values of CRP and LDH increased significantly during hospitalization. Conclusion: The results of the study indicate that a significant association exists between the highly increased levels of CRP, LDH, IL-6 and procalcitonin and the severity of the disease and mortality in COVID-19 patients. Their measurements and follow-up during the course of the disease could be used as predictors for prognosis and outcome but also as a subject for targeted therapy.
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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)
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Velkovska-Nakova, Valentina
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Jovanoska, Biljana
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Objective: Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods: The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients' ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results: From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels). Conclusion: Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies.
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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)
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Dimitrovski, Chedomir
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Misevska, Sasha
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Dimova, Zaneta
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Antiphospholipid syndrome and pregnancy
(MedCrave Group, LLC, 2021-10-15)
Jasovic-Siveska, Emilija
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Milkovski, Daniel
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Maternal Lipids May Predict Fetal Growth in Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus Pregnancies
(Macedonian Academy of Sciences and Arts/De Gruyter, 2016-11-01)
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Nakova, Valentina Velkoska
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Serafimoski, Vladimir
During diabetic pregnancy, complex metabolic changes occur in the lipid profile. The aim of the study was to determine the predictive values of maternal serum lipid levels on large-for-gestational age newborns during the third trimester in pregnancies of women with type 2 diabetes mellitus (DM2) and gestational diabetes mellitus (GDM).
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A rare case of pleomorphic dermal sarcoma presented during pregnancy, a case report
(John Wiley & Sons, Inc., 2024)
Milkovski, Daniel
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Gjirevski, Vlatko
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Kijajova, Ivana
Soft tissue sarcomas are rare tumors arising in mesenchymal tissues and can occur almost anywhere in the body. They are rarely diagnosed during pregnancy. Pleomorphic dermal sarcoma (PDS) are dermal-based malignant tumors that usually present on sun-exposed sites of elderly patients and are morphologically similar to atypical fibroxanthoma (AFX). PDS is considered an aggressive cancer and likely to metastasize and reappear. Early detection and aggressive treatment improve outcomes.
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Acute appendicitis in the third trimester of a pregnancy finished with spontaneous vaginal delivery
(Asclepius, 2018)
Milkovski, Daniel
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Acute appendicitis is the most common surgical problem occurring during pregnancy. Its incidence is more common in the second trimester and is confirmed in 1/1000 pregnancies. Clinical manifestations of acute appendicitis in pregnant patients are generally very similar to non- pregnant patients. We present, here, the case of a 29-year-old pregnant patient at 35+4 weeks of gestation with the signs of acute appendicitis. The patient underwent a successful open appendectomy of her perforated appendix, without performing a cesarean section (CS) at the same time. 5 weeks postoperatively, at term, labor was induced with vaginal prostaglandins and the patient delivered a healthy female baby without any complications. Immediate diagnosis of acute appendicitis during pregnancy is recommended and management with the suitable surgical intervention should not be delayed for >24 h as it increases the risk of perforation with its subsequent critical complications. The treatment of acute appendicitis is always surgical, with an appendectomy and perioperative broad-spectrum antibiotics. Except in cases of high maternal and fetal mortality, a CS should not be done simultaneously with the appendectomy in cases of a perforated appendix with diffuse peritonitis, due to the very high risk of dehiscence of the uterus.
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Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019
(Elsevier BV, 2021-07)
D'Antonio, Francesco
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Sen, Cihat
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Mascio, Daniele Di
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Galindo, Alberto
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Villalain, Cecilia
It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. OBJECTIVE This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. RESULTS A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03–2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07–2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41–3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42–4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19–5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15–2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02–1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90–5.11; P<.001) were independently associated with adverse maternal outcomes. CONCLUSION High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.
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Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus
(Sociedade Brasileira de Endocrinologia e Metabologia, 2016-02)
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Valentina, Velkoska Nakova
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Objective Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients’ ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels). Conclusion Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies.
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Evaluation of HOMA IR in perimenopause patients with abnormal uterine bleeding
(MSD Publications India Pvt Ltd., 2024-02-25)
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<jats:p>Introduction: Perimenopause as a clinical entity is characterized by a series of symptoms that occur due to estrogen deficiency in multiple organs and systems. Obesity is a risk factor that favors all these changes, especially hyperplasia. Glucose homeostasis is often impaired in these patients, insulin levels are increased, and HOMA IR is increased. Goals: to detect hyperplasia in obese perimenopausal patients with abnormal uterine bleeding to determine insulin levels, HOMA IR, to determine the association between hyperplasia and HOMA IR. Material and Methods: This was a prospective cohort study, performed at the OB/GYN Clinic, over 1 year. 100 patients with abnormal uterine bleeding during the perimenopause were involved, aged 45–50, divided into two groups based on BMI. 1-patients with a BMI above 30, 2-patients with a BMI under 30, and the control group consisted of 40 asymptomatic patients. Results: The average value of glycemia in the first group was higher and was 5.7 mmol/l, the cut-off value was 5,5. The average value of the HOMA-IR insulin resistance index in the first group was highest - 2.8 (the cut-off value was 1.8). Endometrial hyperplasia was registered in the first group at 40.9%. Discussion: The first group registered a significant association between HOMA IR and hyperplasia, the risk of endometrial hyperplasia occurring was eight times higher. The first group registered a significant association between glycemia and endometrial hyperplasia. High levels of glycemia increase the risk of endometrial hyperplasia occurring three times. Conclusion: In menopausal transition patients with abnormal uterine bleeding there is an increased incidence of endometrial hyperplasia, hyperglycemia, and increased HOMA IR. There is a strong association between these changes and the risk of cardiovascular disease increases. Menopause is a period in a woman’s life that requires a multidisciplinary approach to diagnostics and treatment. Keywords: HOMA IR, perimenopause, abnormal bleeding, hyperplasia.</jats:p>

Simeonova krstevska, Slagjana

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