Pavleska kuzmanoska, Svetlana
Preferred name
Pavleska kuzmanoska, Svetlana
Official Name
Pavleska kuzmanoska, Svetlana
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Item type:Publication, Challenging Case of Multisystem Inflammatory Syndrome in a 19- Year Old Female: A Case Report(Macedonian Society of Nephrology, Dialysis, Transplantation and Artifical Organs, Department of Nephrology, 2022); ; Introduction. In comparison to older adults, SARSCoV-2, leads to a mild illness in children and young adults typically manifested with fever, cough and gastrointestinal symptoms. However, the multisystem inflammatory syndrome in children and young adults (MISC) emerged during the coronavirus disease in 2019 pandemic. Case report. We report a challenging case of a 19- year old female patient with signs and symptoms of multisystem inflammatory syndrome and SARS-CoV2 infection, most probably as a post infectious disease with onset between 2 to 4 weeks after the infection. Its clinical symptoms may have overlaped with classical Kawasaki disease (systemic vasculitis) or Kawasakilike syndrome (atypical) with fever, gastrointestinal symptoms, rash, conjunctival injection, hypotension, sore throat, mucosal changes with a relative lack of severe respiratory disease, myocarditis, hypoalbuminemia and elevated inflammatory markers. And indeed, the clinical presentation of COVID-19 in young adults resembles Kawasaki disease with gastrointestinal manifestations to severe inflammation with myocarditis. Conclusion. Timely diagnosis and proper treatment of the multisystem inflammatory syndrome and SARSCoV-2 infection are real challenge requiring multidisciplinary approach and tertiary resources. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Emphysematous pyelonephritis and sepsis in a diabetic female patient caused by extended-spectrum beta-lactamase-producing Escherichia coli – case report(Slovenian Medical Association, 2023-07-13); ; ; ; <jats:p>Emphysematous pyelonephritis (EPN) is a rare, severe, spontaneous gas-forming infection of renal parenchyma and its surrounding areas. EPN was detected in diabetic patients. A 49-year-old female with type I diabetes mellitus presented with severe thrombocytopenia, acute kidney injury (AKI) and was in need of haemodialysis treatment. She had impaired liver function tests, with active urine sediment, indicating severe upper urinary tract infection with suspected sepsis. The contrast enhanced CT scan of the abdomen showed multiple areas of air density in renal parenchyma and perirenal regions, suggestive of left-side EPN. The blood and urine cultures reported growth of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli. The final diagnosis of emphysematous pyelonephritis complicated with severe sepsis and AKI was established. The patient was managed conservatively with wide-spectrum antibiotics, fluid resuscitation, consistent blood sugar control, and haemodialysis treatment. Percutaneous drainage techniques (PCD) and nephrectomy were postponed because of the initial clinical response to the antibiotics treatment. However, the patient experienced sudden clinical deterioration and died only a few hours after the established diagnosis. An autopsy was not performed upon the patient’s family’s request. EPN should be highly suspected in poorly controlled diabetic patients with urinary tract infection and should be promptly recognized and aggressively treated. The patients with multiple risk factors had high mortality, even with timely diagnosis and combined (conservative and surgical) treatment.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Diabetes and arterial stiffness, our experiences(Македонско лекарско друштво = Macedonian medical association, 2021); ; Introduction. The incidence and prevalence of diabetes mellitus (DM) has increased worldwide but also in the Republic of Macedonia, Diabetes is a high-ranking a cause of death, primarily as a cause of cardiovascular death. In the United States, 42% of diabetic patients have diabetic nephropathy, with a 20-fold increased risk of cardiovascular mortality. Arterial rigidity is another independent risk factor for CV death, which is a degenerative process of remodeling the large arteries wall. There is increased arterial rigidity in both: diabetic patients and in patients with arterial hypertension, but studies that address these issues do not have consistency in the results, which was our motive for this study. Methods. This was a cross-sectional study that comprised 62 patients with diabetes mellitus type 2, aged over 38 years, followed at the University Clinic for Nephrology for diagnosis of, or already diagnosed hypertension. The control group consisted of 22 healthy subjects who had not been diagnosed with either DM type 2 or arterial hypertension. We examined pulse wave velocity, and analyzed hypertension with data obtained from 24-hour ambulatory blood pressure monitoring. The obtained data were statistically processed. Results. The results were displayed in tables. Conclusion. Arterial stiffness (measured by PWV) was higher in patients with DM compared to the control group of healthy subjects. In our study HgA1c had impact on PWV which can serve as a tool for assessing CV risk and arterial rigidity. Keywords: diabetes mellitus, arterial hypertension, arterial rigidity, pulse wave velocity - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Some Aspects of Women’s Health in Republic of Macedonia(Scientific Foundation SPIROSKI, 2022-10-12); ; ; ; INTRODUCTION: Sex and gender “matters” in terms of the health status as well as a result of both biological and gender-related differences. Thus, sex must be considered in all aspects and all levels of biomedical research.AIM: This study aims to analyze sex- and gender-based differences in Republic of Macedonia through analysis of some aspects of mortality, the knowledge, and attitudes related to women’s health.METHODS: Analysis of the general and age-standardized mortality patterns and computer-assisted personal interview composed on different topics including women’s health for the period of 2017–2020 were used.RESULTS: Age-standardized mortality rates (all-causes of death, circulatory and respiratory diseases, and neoplasms) are prevalent and higher in the male population in Republic of Macedonia. A significantly higher all-cause mortality trend for both sexes was found in 2020 making this year hardly comparable with the previous years. A decreasing trend of malignant neoplasms rate of female genital organs and an increasing trend of breast cancer mortality is observed. The majority of the respondents (50.6%) rated their current health status as excellent with a statistically significant difference between the age and ethnical groups. One-third of the respondents reported regular physical activity, mostly on a daily basis. The majority (39.3%) are overweight and 27.5% belongs to the obesity Class I without a significant difference in terms of ethnicity. Respondents (27%) reported that have high blood pressure, 20.2% vaginal infections, 19.9% allergies, heart issues 15.1%, anemia 11.7%, while diabetes and cancer 8.5% and 2.5%, respectively. The youngest and oldest age groups of Albanian women are the least informed about the early detection procedures of malignant compared to Macedonian women and other ethnic groups.CONCLUSIONS: Analyzing some aspects of women’s health in Republic of Macedonia through the mortality and knowledge and attitudes of Macedonian women, we provide some further evidence for the development and implementation of targeted interventions and policies aimed to reduce the sex- and gender-based health inequalities in the country.