Simonovska, Natasha
Preferred name
Simonovska, Natasha
Official Name
Simonovska, Natasha
Translated Name
Симоновска Наташа
Alternative Name
Велјановска Н.
Н.Велјановска
Natasha Simonovska
Natasha K. Simonovska
Simonovska N.
Natasha Simonovska, PhD
Simonovska Natasha
Natasa Simonovska
Dr. Natasha Simonovska
Симовска Н.
Симоновска Наташа
Наташа Симоновска
Симоновска Н.
Н.Симоновска
Велјановска Наташа
Наташа Велјановска
Main Affiliation
Email
natasha.simonovska@medf.ukim.edu.mk
64 results
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Item type:Publication, Malignancy in patients with opioid use disorder: A late diagnosis in patient on maintenance treatment with Buprenorphine, with lethal effect: a case report(Merit Research Journals, 2016-03); Antonio GligorievskiHeroin dependents might be at a higher risk of death from cancer than the general population. A 31-year-old male on maintenance treatment with Buprenorphine, came to our Clinic with paralysis of his legs. He also complained on spinal pains. He couldn’t walk and he was in forced position. The biochemical analysis showed high values of SE, LDH, globulins, CRP, D-dimer, Tu markers: beta HCG, CYFRA 21-1, presence of paraproteins. The other investigations showed enlarged lymph nodes in the abdomen and small pelvis, thrombosis of v.cava inf and right v. iliaca. The histological finding from the biopsy of the sacrum showed a metastatic process on the skeletal muscles. The patient was treated with buprenorphine, antibiotic therapy, Carbamazepine, anticoagulant therapy and other symtomatic therapy. Despite numerous investigations and treatment, bleeding and abscesses in the cerebrum occurred. The patient immediately underwent surgery and his recovery was well. He was discharged on his request, but his condition was deteriorated sharply at home and he died in a short time. There are few studies on malignant diseases found in heroin dependents. It is a challenge to monitor and also to compare the incidence of malignancy between heroin dependents and healthy population. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CLINICAL AND BIOCHEMICAL FINDINGS OF RHABDOMYOLYSIS IN ACUTE INTOXICATIONS WITH PSYCHOACTIVE AND CHEMICAL SUBSTANCES(2020); ; ; ; The aim of the study is to identify possible differences in demographic, laboratory and clinical characteristics between patients with rhabdomyolysis due to intoxication with psychoactive and chemical substances. The study is a cross-sectional study conducted between 1 January and 30 June 2019. All the patients included during this period were treated due to intoxication (outpatient or hospitalized) at the University Clinic of Toxicology in Skopje. The patients with rhabdomyolysis were divided in two groups according to the nature of the substance used for intoxication: a) psychoactive substances and b) a chemical substance. Rhabdomyolysis was determined with a value of CPK (creatinine phosphate kinase) >250 U/L. Patients with rhabdomyolysis due to intoxication with chemical substances were significantly older than patients with rhabdomyolysis due to intoxication with psychoactive substances. There is a significant difference between the two groups of patients with rhabdomyolysis in terms of CPK, urea, hemoglobin values during the first day with regards to significantly higher values in the group where intoxication occurred with psychoactive substances. Five patients with rhabdomyolysis due to intoxication with psychoactive substances experienced muscle pain (10.9%), and one patient (3.8%) of those with rhabdomyolysis due to intoxication with chemicals, without any significant association between muscle pain and type of intoxication (Fisher exact test: p=0.3003). Muscle weakness and pigmented urine were identified consequently in six patients (13.0%) vs. five (10.9%) of patients with psychoactive intoxication and none with chemical. Rhabdomyolysis caused by psychoactive and chemical substances is associated with clinical manifestations and biochemical abnormalities. The values of CPK, myoglobin, AST, ALT, LDH, urea and creatinine were higher in favor of the group of intoxicated patients with rhabdomyolysis with psychoactive substances. The clinical symptoms of rhabdomyolysis are not present in all intoxicated patients, but are more present in the group intoxicated with psychoactive substances. Biochemical findings are crucial in establishing the diagnosis of rhabdomyolysis. Abnormalities of biochemical findings need to be identified in order to initiate appropriate treatment immediately to prevent mortality and morbidity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, АСОЦИРАНОСТ НА СЕРУМСКИОТ ЛИПИДЕН СТАТУС СО НАЧИНОТ НА АПЛИКАЦИЈА НА ХЕРОИНОТ КАЈ ОПИЈАТНА ЗАВИСНОСТ(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2010); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Artificial Nutrition in Therapeutic Approach of Acute Caustic Poisonings(ID Design 2012/DOOEL Skopje, 2010-06); Acutes corrosive poisonings can cause serious chemical injuries of the upper gastrointestinal tract, and they are localized most frequently in the esophagus and the stomach because the poison remains there a long time. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, corticosteroids, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery.The damaged mucosa, submucosa and muscle layer regenerate with great difficulty because of the surrounding inflammation, necrosis and secondary complications. Tissue fibrosis, adhesions or circular stenosis appear, which greatly disturb the normal functioning (impeded peristaltic, impeded passage). All these complicate the entire general condition of the patient, including inadequate normal food intake, loss of body weight, prostration, cachexia. These patients are also into a severe general condition due to hypercatabolic state and negative alkali balance. Therefore, early nutritional support is of substantial importance in treatment of these patients. Nutritional support can be given by parenteral way in peripheral or central vein and by enteral way through specially designed tubes inserted in the stomach or intestines, prepyloric or postpyloric.The type of artificial nutritional support will depend on the grade of esophageal or gastric damage determined by endoscopy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Program of the University Clinic of Toxicology, Skopje, Republic of Macedonia in treatment of drug addiction (buprenorfin treatment protocol)(ScopeMed Publishing, 2011); ; ; Irena JurukovThe program of our Clinic includes, not only treatment of acute intoxication with opioids and other drugs, but also comprehends clinical investigations and treatment of the somatic complications of this population. For the first time in our country our Clinic offers to this population the alternative way of treatment with Buprenorfin. The Clinic started with this protocol on August 1, 2009. During a period of two years, the treatment with Buprenorfine has been initiated in 353 patients, of which 211 regularly attend the medical check ups. This model is used according to the national clinical guidelines and procedures for the use of buprenorfine in the treatment of opioid dependence The dose of this medicament depends on the evolution of the withdrawal symptoms. We have used the objective and subjective opioid withdrawal scale for the observation of these symptoms (OOWS ; SOWS - Handelsman et al 1987). This protocol starts with a complete clinical investigations, (i.e. where all patients undergo the inclusion and exclusion criteria with a written consent). Afterwards, the patients are hospitalized and start with a Buprenorfin teratment. After period of 7-10 days hospitalization they come to our Clinic, like outpatients for a regular controls. We have precise evidence for every patient who comes for control (e.g. medical record with all biochemical and toxicological screenings). All patients are recommended a tight cooperation with psychiatrists who are specialized to treat the problematic drug addictions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ТЕРАПИСКИ ПРИСТАП СО БУПРЕНОРФИН ОДНОСНО МЕТАДОН КАЈ ЗАВИСНИЦИ ОД ХЕРОИН(2015); ; ; Oвој труд има за цел да ги спореди искуствата од терапискиот пристап со бупренорфин односно метадон при зависност од хероин. Maтеријал и методи: Истражувањето е проспективно рандомизирано, контролирано. Спроведено е на Универзитетската Клиника за Токсикологија и Центарот за зависности. Со истражувањето се опфатени вкупно 140 зависници од хероин поделени во две групи од по 70 испитаници кои минимум три месеци пред почетокот на истражувањето биле доброволно вклучени на супституционен третман со бупренорфин (испитувана група) односно метадон (контролна група). Во двете групи следена е: просечната доза на одржување како и влијанието на времетраењето на зависноста од хероин врз висината на просечната доза на одржување. Резултати: Постои сигнификантна разлика од две години (t-test<0,05), во однос на просечното времетраење на злоупотребата на хероин помеѓу испитуваната (5,9±2,3) и контролната група (7,8±2,4). Согледана е позитивни, односно директни корелација помеѓу просечното времетраење на користење на хероин и просечната доза на одржување на бупренорфин односно метадон при третман на хероински зависници. Заклучок: Соодветната доза на бупренорфинот и метадон во индукционата фаза е критичниот фактор за успешноста во лекувањето на хероинските зависници. Ниските дози на бупренорфин и метадон во фазата на оджување ја зголемуваат “гладта“ за хероин, со што се објаснува зголемениот процент на рецидиви. Постои позитивна корелација помеѓу историјата на просечното времетраење на користење на хероин и просечната доза на одржување на бупренорфин односно метадон при третман на хероински зависници - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Influence of Duration of Heroin Dependence on Humoral Immunologic Indicators(American Society of Addiction Medicine, 2016-11); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Corrosive poisonings in adults(ScopeMed Publishing, 2012); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Severe mushroom poisoning in one Macedonian family(SAGE, 2015-09-05); ; ; Miletic, MilenaBACKGROUND: Collecting and consuming wild mushrooms is a historical tradition in many European countries, including The Republic of Macedonia. This activity is predominantly performed in the period between June and October, when the weather is warm and humidity in the air and soil is at higher levels.The Amanita genus consists of 500 different species of mushrooms; among these, Amanita phaloides, Amanita virosa and Amanita verna are most commonly found in oak forests in our country. These species are highly poisonous and because they can be similar to some edible mushrooms, they have often been misidentified. Their consumption causes severe intoxication. PURPOSE: The aim of this case series report is to demonstrate a severe poisoning with Amanita mushrooms (A. verna) that occurred in 8 patients, all from 1 Macedonian family. RESULTS: We show the differences in the clinical appearance and status of these patients, the wide spectrum of symptoms as well as the treatment and outcome of this rare poisoning. One patient, an 8-month-old baby, was excluded from the study because the infant was immediately transferred to the pediatric clinic after admission to our clinic. CONCLUSIONS: Despite modern therapy, poisoning due to ingestion of Amanita mushrooms is a serious clinical and health problem that may even be potentially lethal. The most efficient way for the general public to protect itself against potential poisoning is to avoid ingesting mushrooms that may not be edible. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Presence of Some Humoral Immunologic Indicators and Clinical Manifestations in Cryoglobulin Positive Heroin Addicts without Evidence of Hepatitis Virus Infection(2015-05); ; SUMMARY Introduction Cryoglobulins are single or mixed immunoglobulins that are subject to reversible precipitation at low temperatures. Objective The aims of this paper were: 1. Comparison of cryoglobulin positive (CP), cryoglobulin negative (CN) heroin addicts and the control group (CG) in terms of serum immunoglobulins IgG, IgA and IgM and complement components C3 and C4; 2. Comparison of CP and CN heroin addicts in terms of rheumatoid factor (RF) and circulating immune complexes (CIC); 3. Assessment of clinical manifestations in CP heroin addicts. Methods This is a comparative study of cases (outpatients) treated at the University Clinic of Toxicology in Skopje over 3.5 years, from January 2009 to June 2012. In this study 140 heroin addicts without HbsAg were examined, seronegative for HCV and HIV infections. They were divided into 2 groups: 70 CP and 70 CN heroin addicts. A previously designed self-administered questionnaire was used as a data source on participants. All heroin addicts underwent the following analyses: urea and creatinine in serum; creatinine in urine; proteinuria; 24-hour proteinuria; IgM, IgG, IgA, C3, C4 ; RF; CIC; creatinine clearance; ECG; toxicological analyses for opioids in a urine sample; cryoglobulins. In addition to these 2 groups, IgG, IgA, IgM, C3 and C4 were also examined in 70 healthy subjects (CG). Results The study showed that there was no statistically significant difference between CP, CN heroin addicts and CG regarding the concentration of IgA, IgG, IgM, C3 and C4, and between CP and CN regarding the concentration of CIC. There was significant difference between CP and CN regarding the concentration of RF. The following conditions were significantly more frequently manifested in CP than in CN heroin addicts: arthralgia, Raynaud’s phenomenon, respiratory difficulties, neurological disorders, manifested skin changes, hematuria, 24-hour proteinuria levels, and decreased renal clearance. Conclusion There were no differences in concentrations of IgG, IgA, IgM, C3, C4 and CIC, while there was a difference in concentration of RF between CP and CN heroin addicts. Clinical manifestations (arthralgias, Raynaud’s phenomenon, respiratory, neurologic, renal disorders and skin changes) were more common in CP heroin addicts.