Bojadjieva, Sonja

Preferred name

Bojadjieva, Sonja

Official Name

Bojadjieva, Sonja

Main Affiliation

sonja.bojadzieva@medf.ukim.edu.mk

Now showing 1 - 10 of 15

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EVALUATION OF PROCALCITONIN AND SERUM ALBUIN LEVELS AS EARLY INFLAMMATORY BIOMARKERS IN NEONATAL SEPSIS
(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020)
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Kimovska M
Prematurity is the leading cause of death globally, and the second largest contributor to all deaths under the age of 5. The aim of this study was to evaluate serum albumin levels and procalcitonin levels for the diagnosis and prognosis of preterm newborns with neonatal sepsis. In this study, we included 100 hospital admitted preterm newborns with the first 24 hours of life, hospitalized at the Intensive Care Unit at the University Children's Hospital-Skopje, for the time period between November 2018 until 30 April 2020. The preterm newborns have been divided into three groups according to albumin levels (>30, 25-30, or <25 g/l). There was a highly significant difference between the discharge diagnosis groups, regarding their serum albumin levels and Procalcitonin (PCT) levels, and there was a significant correlation between serum albumin level and PCT levels in preterm newborns, as well. Lower serum albumin levels might be associated with a poorer prognosis in neonatal sepsis. Serum albumin and procalcitoni levels have been proposed to be an early marker for the diagnosis of neonatal sepsis and a valuable follow-up tool.
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OSTEOMYELITIS OF FEMUR IN A DRUG ADDICTED CHILD
(Macedonian Association of Anatomists, 2021)
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One of the serious complicationsrelated to intravenous drug use is osteomyelitis. We report a13-year-old male child with a history of intravenous heroin abuse, who was admitted to the hospital complaining of abdominal pain and pain in the left leg. Anteroposterior roentgenogram and CT scan of the left thigh and femur,confirmed the diagnosis of osteomyelitis. Pus culture was positive for Staphylococcus aureus. Despite extensive antibiotic and anticoagulant therapy,the patient’sclinical status improved very slowly. Surgical procedure was not undertaken. Femoral osteomyelitis due to injection drug use in childhood is an extremely rare and uncommoncondition. Intravenous drug abuse, late-onset treatment, and secondary bacterial infection can lead to complications which occurred in the case presented.Itis an extremely difficult condition to treat and is a real challenge for physicians. The rapid response and participation of a multidisciplinary team of physiciansis of particularimportance
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DIAGNOSTIC VALUES OF BIOCHEMICAL MARKERSIN ASPHYXED NEWBORNS WITH PROVEN SEPSIS
(Macedonian Association of Anatomists, 2020)
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Elizabeta Shuperliska
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Olivera Jordanova
Introduction: The aim of this study was to investigate the predictive values of biochemical parameters, including Procalcitonin (PCT), as an early diagnostic and prognostic marker for sepsis in asphyxed newborns with proven sepsis. Materials and Methods: This study was designed as a prospective study, where we included 110 (M:F=67:43) newborns with proven sepsis hospitalized in the Intensive Care Unit at the PHI University Children’s Hospital – Skopje.PCT and CRP,WBC one serum blood sample was obtained from each patient at the 24h at admission, as well asday 3 and day 7. Procalcitoninlevels were measured by using an immunoassay system Vidas, based on the Enzyme Linked Fluorescent Assay (ELFA) principles. Results: The newborns with proven sepsis have been divided into two groups. The first group included 50 proven septicpreterm newborns with a positive blood culture and the second group included 50 proven sepsis full-term newborns.We isolated forty two that had two or three bacteria at the same time. The identified bacteria included Staphylococcus aureus (n=56) mecA,Streptococcus (n=6), Acinetobacter baumannii (n=18), Serratia marcescens (n=9) and Entrobacteriaceae (n=31), Candida albicans(n= 1), Candida parapsilosis(n=1).Statistical analysis confirmed significantly different values of PCT in the analyzed time period in preterm newborns with proven sepsis p<0.001.Statistical analysis confirmed significantly different values of PCT in the analyzed time period in newborns with proven sepsis with asphyxia p<0.001. Conclusion: The levels of PCT have important clinical significance in predicting the prognosis of asphyxed newborns with sepsis, to prevent the development of severe sepsis and septic shock.
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INCIDENCE, RISK FACTORS AND OUTCOMES OF ACUTE KIDNEY INJURY IN PRETERM NEWBORNS
(Macedonian Association of Anatomists, 2021)
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Elizabeta Shuperliska
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Acute kidney injury is a sudden loss of renal function that results indeterioration ofthe renal’s ability to excrete urine in sufficient quantity and adequate composition. The aim of the study was to determine the incidence, risk factors and outcomes of acute kidney injury in pretermnewborns.The study was conducted at theUniversity Clinic of Pediatrics–Skopje.It was a clinical, epidemiological prospective study. In the period of two years, 40preterm newbornshospitalized at the Intensive Care Unit (ICU)with documentedkidney injury were analyzed. Medical data records of hospitalized preterm infants with kidney injury were processed. The material was statistically analyzed using methods of descriptive statistics. We evaluated 40 preterm newbornswith documented acute kidney injury,who at the period of 2 years were treated in the ICU. The prevalence of kidney injury was 6.9%. Most of the involved preterm newbornswere male(72%),and born at 32 to 37 weeks with low birth weight (58%). Prerenal injury was evaluated in 79.5% of the cases.The mortality rate was 36% and it was significantly higher in the group of preterm infants born under 28 weeks,with Extremely Low Birth Weight Newborns ELBW. (P=0.01). Acute kidney injury is a life threatening condition with a still high mortality rate. Appropriate treatment of kidney injury in newbornswith ELBW improves the outcomes and reduces the mortality of the disease.
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RELATIONSHIP OF SERUM PROCALCITONIN LEVELS AND C-REACTIVE PROTEIN LEVELS IN NEWBORNS WITH SEPSIS IN DIFFERENT TYPES OF RESPIRATORY SUPPORT IN INTENSIVE CARE UNIT
(Institute of Public Health of the Republic of North Macedonia, 2021)
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Elizabeta Shuperliska
Sepsis in newborns with RDSy and asphyxia is essential; it is a life-threatening condition and still represents an important cause of mortality and morbidity. The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as an early diagnostic and prognostic biochemical marker for sepsis in newborns with RDS and asphyxia. Material and methods: The study was designed as prospective and we examined 110 newborns with proven sepsis admitted in the Intensive Care Unit at the University Clinic of Pediatrics – Skopje in the period between December 2018 and Јanuary 2021. Procalcitonin levels were measured by using the immunoassay system Vidas based on the ELFA principles. The newborns with proven sepsis were divided into two groups. The first group comprised 55 newborns with RDS and proven sepsis and the second group included 55 newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in first group of newborns with RDS and proven sepsis, p<0.001. The highest average values (40.37±53.79) were measured on admission with a high level of peak compared to the second group of newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in the first group of newborns with RDS and proven sepsis with mechanical ventilation (MV) and bubble continuous positive airway pressure (BCPAP) compared to the second group of newborns with asphyxia and proven sepsis, p<0.001. PCT is a promising sepsis marker in newborns with RDSy, capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection at the time of ICU admission.
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THE ROLE OF RISK OF RENAL FAILURE, INJURY TO THE KIDNEY, FAILURE OF KIDNEY FUNCTION, LOSS OF KIDNEY FUNCTION AND ENDSTAGE RENAL FAILURE (RIFLE) CLASSIFICATION IN IDENTIFICATION AND PREDICTION SEVERITY OF THE KIDNEY INJURY IN NEWBORNS
(SHMSHM / AAMD, 2021)
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Olivera Jordanova
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Elizabeta Shuperliska
Objective: Acute kidney injury is a serious condition with various clinical manifestations ranging from minimal kidneys disordsers to kidney injury requiring substitution therapy. Because of need of timely diagnosis of kidney injury, RIFLE classification could be used. The aim of the study was to determine the role of RIFLE classification in detecting and follow up the progression of kidney injury in newborns. Methods: This study was realized at University Clinic of Pediatrics in Skopje from period of two years. It was analyzed the medical records of 80 newborns (40 with kidney injury and 40 without kidney injury) treated in intensive care unit. The severity of the disease was determined by RIFLE classification. Results: During the study period 6.25% of newborns have developed acute kidney injury acording standard clasification. Most of the newborns analyzed in the study were male (66 and 59%) and term (67% and 61%). RIFLE classification was applied in this study. We reported “risk” in 32%, “injury” in 57% and “failure” in 11% of newborns with AKI. Of these, 69% showed progression to “injury “and 15% to “failure”. In 17% of newborns with verified “injury” the condition progressed to “failure”. Conclusion: By using RIFLE classification we could not only identify kidney injury, but also detected the progression of the disease. Hence the significance of this classification as a solid tool in the diagnosis and follow-up of kidney injury in newborns.
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Psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses.
(SAGE, 2021-05)
Stefanovska Petkovska, Miodraga
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Bojadjiev, Marjan
Addressing the worldwide challenge of shortage of nurses contributes to the national and international efforts to enhance the health and well-being of the global population. The main aim of this research is to investigate the level and the relationship between psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses in public and private practices while accounting for their socio-demographic characteristics. This was a cross sectional study of 173 primary health care nurses. The Oldenburg Burnout Inventory and General Health Questionairre-12 were used to assess burnout and psychological distress among nursing staff. High psychological distress was present in 21.38% of all respondents and was significantly related to intention to quit. The results indicated a mean job satisfaction score of 3.54 with higher job satisfaction among private vs. public sector nurses. Furthermore, nurses with higher burnout levels and lower job satisfaction were more likely to consider leaving the profession compared with those with lower burnout and higher job satisfaction. The study provides valuable insight for managers of general healthcare practice and healthcare policy makers in effectively managing and retaining primary healthcare nurses.
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PROMISING DIAGNSOTIC MARKER AT NICU AND PICU-NEW APPROACHES FOR DIAGNOSTIC AND TREATMENT
(Macedonian Association of Anatomists, 2019)
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Mica Kimovska-Hristova
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Tamara Voinovska
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The aim of this study is evaluate the initial PCT levels on the outcome of patients in pediatric intensive care units and find out if these biomarker can be used to predict sepsis. The study was designed as a prospective, clinical, investigation conducted in the period sixth months, which included 45 (M:F=25:20) newborns with two or three clinical signs of sepsis hospitalized in the Intensive Care Unit at the PHI University Clinic for Children Diseases. The patient have been divided into two groups: I group included 31 septic newborns with negative blood culture and II group - 14 septic newborns with positive blood cultures. Results of blood count (WBC), CRP and PCT, were recorded. Procalcitonin PCT levels at first 24 hours of the admission were increased in all 45 newborns (≥2 ng/mL). The values of C-reactive protein gradually increase after 12-36 hours at admission. The second measurement, after 3 days usage of an adequate antibiotic treatment, the levels of PCT is decreased,regardless of whether blood culture is positive or negative, except 5 patients develop severe sepsis, and three patients develop septic shock. After the third measurement the levels of PCT and CRP is decreased. NIV was used in 39.8% patients and Invasive MV was used in 29.8% patients.Sensitivity of procalcitonin 83.5%, Specificity of procalcitonin 81.3%. Procalcitonin value is a early prognostic factor for sepsis and it is a reliable parameter whether an appropriate antibiotic for the treatment is used,thus increasing newborns safety,and reducing costs .
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POST COVID-19 NEUROLOGICAL SYNDROME (PCNS) IN AN 11 YEARS OLD BOY,A CASE REPORT
(2021)
Learta Alili Ademi
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Blerim Ademi
By now more than 92.6[1] persons have been reported to be infected with COVID-19, of which significant part are children. Although children experience milder symptoms compared with adults at the time of the infection, cases of post-covid-19 complications have been reported (2, 3, 4, and 5). Complications might also include the CNS, in our case with cerebellar ataxia-like and polyneuritislike signs and symptoms. A 13 year old boy was presented in our clinic with signs of ataxia, occasional vomiting, impaired gait, impaired patellar reflexes on the right leg, incomplete Babinski reflex on the right leg, paresis of the left facial nerve and mild hypertension. Based on the clinical appearance and the parameters that showed past COVID-19 infection, a diagnosis of Post-COVID19 Cerebellar Ataxia-like and Polyneuritis-like was made, meaning a Post Covid-19 Neurological Syndrome (PCNS). Treatment was conducted with antibiotics and immunoglobulins resulting in significant improvement in the following days. There are few reported cases about neurological complications caused by COVID-19 in children and adolescents, without any other symptoms of the virus. This is one of the first cases of Post- COVID19 Cerebellar Ataxia and Polyneuritis in a child as a result of COVID-19 and the first case in our country.
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EARLY DIAGNOSTIC OF SEPSIS IN NEWBORNS WITH RESPIRATORY DISTRESS SYNDROME
(SHMSHM / AAMD, 2020)
Elizabeta Shuperliska
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Avdi Murtezani
Objective: Early diagnosis of sepsis in newborns with RDS is essential for life-threatening condition, for reducing severe sepsis and septic shock in the Intensive care Unit at the University Children’s Hospital in Skopje.Methods: In this prospective study, we included 100 (M:F=59:41) newborns with Respiratory distress syndrome (RDS) suspected for sepsis admitted in the Intensive Care Unit in period of December 2019 till 31 May 2020 y. Procalcitonin levels were measured by using a immunoassay system Vidas based on the ELFA principles. Results: The newborns with RDS suspected for sepsis have been divided into two groups The first group included 50 newborns with RDS and positive blood culture and the second group included 50 newborns with RDS and negative blood culture. Тhe average gestational age of the newborn with RDS and positive blood culture was 36,01± 3,1 weeks and the newborn with RDS and negative blood culture 36,26± 3,2 weeks. Preterm newborns in both groups dominated (64,2% and 58,2%). Тhe average birth weight of the newborn with RDS and positive blood culture was 2490,5 ±791,6 grams, and the newborn with RDS and negative blood culture was 2690,2±788,5grams. There is statistically significant difference in average PCT between the two groups overtime (p<0.05). There is statistically significant difference in average PCT between the two groups overtime procedure (MV , BCPAP, OXYGEN MASK) (p<0.05).Conclusions: PCT is promising sepsis markers in newborns with RDS, capable of complementing clinical signs and routine lab parameters suggestive of severe infection at the time of ICU admission

Bojadjieva, Sonja

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