Severova Andreevska, Galina
Preferred name
Severova Andreevska, Galina
Official Name
Severova Andreevska, Galina
Main Affiliation
30 results
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Item type:Publication, COVID 19 Pneumonia and a Rare Form of Fungal Peritonitis in a Patient Survivor on Peritoneal Dialysis(Walter de Gruyter GmbH / Macedonian Academy of Sciences and Arts, 2021-12-30); ; ; ; Peritoneal dialysis (PD) related peritonitis is usually caused by bacteria, but viruses and fungi could also affect the peritoneal membrane and cause cloudy effluent with negative bacterial cultures. We present a case of a PD patient who survived fungal peritonitis caused by Geotrichum klebahnii (March 2015) and COVID-19 pneumonia (April 2021) with peritonitis probably caused by the SARS-CoV-2 virus. The fungal peritonitis followed one episode of exit-site infection and two episodes of bacterial peritonitis treated with a wide-spectrum antibiotic. The patient's PD catheter was removed immediately upon the diagnosis of fungal peritonitis, and an antifungal treatment was continued for 3 weeks after catheter removal. The new peritoneal catheter was reinserted 8 weeks after complete resolution of peritonitis, and the patient continued treatment with PD. The patient developed severe Covid-19 pneumonia with a sudden appearance of cloudy peritoneal effluent. There was no bacterial or fungal growth on the effluent culture. A PCR test for SARS-CoV-2 in peritoneal effluent was not performed. The peritoneal effluent became transparent with the resolution of the severe symptoms of Covid-19 pneumonia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, KIDNEY FUNCTION DECLINE AND MORTALITY IN DONORS WITH EXPANDED CRITERIA - FIVE YEARS FOLLOW UP STUDY(Macedonian Association of Anatomists and Morphologists, 2024); ; ; ; Kidney donors are considered healthy, but with a need for continued medical follow up and encouragement for continued healthy lifestyle, especially when expanded criteria for donation are applied. This study aims to analyse the five years follow up of kidney donors after explanation, encountering risks of kidney function decline and donors’ mortality. In a retrospective study we evaluated a donor cohort with 5 years of follow up. Demographic characteristics as age, gender and the presence comorbidities as diabetes, hypertension, hyperlipidemia and Body Mass Index (BMI) >30kg/m2 were analyzed. Estimated glomerular filtration rate (eGFR) by CKD EPI formula was notified prior donation, and annually afterwards. Consultations with nephrologist or other specialists were notified. In a multivariate regression analysis, the reduction ratio (RR) of eGFR was explored as dependent variable. Cox regression analysis exploited mortality; Kaplan Meier survival curve was applied in respect of BMI. Seventy-five donors with average age above 55 years were predominantly women (69%), nearly every nineth patient had diabetes or obesity (9%). Proportion of donors referred to nephrologist at the 12 months, declined up to 58% at the fifth year, ignoring medical checks showed ascending trend to 16% at the end of second and third year and 12% at the end of observational period. The univariate regression analysis found diabetes, hyperlipidemia and hypertension, the presence of multiple comorbidities, gender and age as insignificant predictors of eGFR 12 months reduction ratio. The nephrologist referral showed borderline significance (β = - 0.103, p=0.076). Only BMI over 30kg/m2 worsened the kidney function (β = 0.600, p=0.001). Five years mortality rate was 6.7%. The diseased donors were significantly older, more frequently had diabetes and obesity also they had significantly lower eGFR pre-donation, at the end of the first year but also and more step decline of it after 12 months. In the multivariate analysis BMI>30kg/m2 emerged as most powerful predictor of mortality (HR 40.02; CI: [4.11-389), p=0.0001). Survival of obese patients was significantly shorter when compared with patients with lower body weight (43.28 ± 7.51 vs. 59.33±0.65, Log rank p=0.000), respectively. Our study demonstrates that the mortality and declination of renal function after donation are associated with nephrologist referral and other potentially modifiable factors, especially obesity. Improved protocols for pre-donation information, education and adequate after-donation follow up is mandatory to achieve better longevity and kidney function survival in these frail and precious individuals. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Decreased nitric oxide in women with essential hypertension in prehypertensive phase(Medicinska naklada - Zagreb, 2005-12); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Percutaneous Nephrostomy as a Procedure in the Treatment of Urinary Tract Obstruction - Experiences in the University Clinic of Urology in Skopje(Macedonian Academy of Sciences and Arts, 2024-04); ; Obstructive uropathy encompasses various urinary tract obstructions, leading to changes in urine flow, kidney pressure, and impaired kidney function. Predicting renal recovery from obstructive uropathy, can be challenging and necessitates treatment, as in percutaneous nephrostomy (PNS) drainage. The choice of drainage method depends on patient-specific factors and local expertise. According to the data for the Republic of North Macedonia, in the register of the European Renal Association, in the last few years, there has been an increase in the percentage of patients with obstructive nephropathy from 7.6% to 8.9% who end up on a chronic hemodialysis program. Prompt relief from urinary tract obstruction is essential to preserve renal function and prevent complications. The aim of this study is to present our initial data analysis of recent experience in the use of nephrostomies as a method for temporary or long-term resolution of obstructive nephropathy, in terms of safety and success in preserving kidney function and reducing the number of patients on hemodialysis. - Some of the metrics are blocked by yourconsent settings
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, Hypercalcemia and Renal Affection: An Unusual Initial Presentation of Sarcoidosis(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2025-03-01); ; ; ; Sarcoidosis is a chronic, multisystem, inflammatory granulomatous disease that affects multiple organs in the body, but mostly the lungs and the lymph glands. Hypercalcemia and renal affection are rarely initial presenting features, and in the absence of pulmonary symptoms, the diagnosis of sarcoidosis in those patients could be a diagnostic challenge. A case-patient with sarcoidosis presented with elevated serum calcium and creatinine levels. Renal biopsy showed nephrocalcinosis with chronic fibrosing interstitial nephritis. The extensive mediastinal, abdominal, axillar, and neck lymphadenopathy was presented on the computer tomography scan of the patient's chest and abdomen. The neck lymph node surgical biopsy showed confluent, non-caseating, epithelioid granulomas consistent with sarcoidosis. The serum angiotensin-converting enzyme level was elevated. Treatment with oral prednisolone was started, and improvement of renal function and normalization of serum calcium was noted. Sarcoidosis should be considered in the differential diagnoses in patients with renal impairment and non-parathyroid hormone (non-PTH) dependent hypercalcemia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, INFLUENCE OF DAILY SODIUM INTAKE ON MORTALITY IN HD PATIENTS(Macedonian Association of Anatomists, 2022); ; ; The aim of our study was to assess the influence of daily sodium intake (DSI) on the cardiovascular mortality in dialysis patients (pts). In prospective, observational study, 156 pts on hemodialysis (HD) were followed for 36 months,until death or kidney transplantation. Cardiovascular (CV) mortality was defined as death resulting from coronary heart disease, sudden death, stroke or complicated peripheral vascular disease and was notified from the patients’ medical history at baseline. Estimated DSI, as a major predictor for CV mortality, was calculated using formula European Best Practice Guidelines (EBPG) on Nutrition. In respect of median DSI (11.7 ± 2.87 g/day) pts were stratified in two groups: Group 1 – pts with low DSI (<11.7 g/day) and Group 2 – patients with high DSI (> 11.7 g/day). The prevalence of CV comorbidities was not significantly different between two groups at baseline. At the end of the study, 41 pts (26.3%) died, among which 24 pts (60%) died from CV diseases. Kaplan-Mayer survival log rank test demonstrated that there was no difference in the cardiovascular survival between HD pts with high DSI and HD pts with low DSI(p>0.05).Serum levels of C-reactive protein (CRP) and mean age were significantly higher in pts diseased from CV disease compared to survived pts. Our results showed that HD pts may be particularly susceptible to non-osmotic sodium accumulation in skin and muscles. This study have shown that there was no significant influence of baseline DSI on the CV mortality of the pts included in the study. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, First Experience in Management of Coronavirus Disease 2019 (COVID-19) in Kidney Transplant Patient – Case Report(Scientific Foundation SPIROSKI, 2020-08-18); ; ; ; Cana, Fadil<jats:p>BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently emerged in the world. There are limited data describing the clinical progression of COVID-19 in transplanted patients. In the general population, clinical presentation ranges from asymptomatic infection to severe pneumonia and may also develop renal failure. In kidney transplant (KT) patients, management of these patients was mainly based on anecdotal experience. CASE REPORT: We report our first experience of KT patients with COVID-19. A 49-year-old male with KT in 2017 presented on March 20, 2020, with fever, weakness, smell loss, chest pain, and caught. On chest X-ray, he presented ground-glass opacities and bilateral pneumonia. There was a slight progression to acute hypoxic respiratory failure. We reduced immunosuppression therapy and since we suspected seasonal flu, we applied available antiviral oseltamivir till confirmation of RNA sequence of the SARS-CoV-2 virus. Moreover, we applied azithromycin and broad spectrum of antibiotics as well as an anticoagulant therapy. Graft function remained stable during 14 days of hospitalization. The patient clinically improved with decreasing oxygen requirements and manifested clinical recovery. After two negative PCR test, he was discharged and immunosuppression therapy was returned to previous. CONCLUSION: This case highlights the importance of earlier outpatient hospitalization and testing which may improve COVID-19 outcomes among transplanted patients.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Quality of Health Care and Mortality - Three Years of Experience(Macedonian Association of Anatomists and Morphologists, 2018); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COLLAPSING GLOMERULOPATHY-RARE VARIANT OF FOCAL SEGMENTAL GLOMERULOSCLEROSIS-CASE REPORT(Македонско лекарско друштво = Macedonian medical association, 2021); ; ; ; Focal segmental glomerulosclerosis (FSGS) is classified into five variants, with the collapsing variant being the most rare one. However, the number of idiopathic cases is increasing and the presentation becoming more routine. We report the case of a 77-year-old female patient, with nephrotic syndrome and histopathologic features of glomerular capillary collapse. She presented with chronic renal failure with serum creatinine-126…154…174 μmol/L. Nephrotic syndrome with feet and ankles edema, progressively extended, at first failed to respond to diuretic therapy. The level of total serum protein fraction was 54g/l, albumin-29…24…28g/L. Urinalysis demonstrated proteinuria 7.8 g/l… 6.15g/L and 12.3 g/24 h. Presence of 25-30 erythrocytes and 2-3 leukocytes in urine sediment was also noticed. Renal biopsy was performed to determinate the presence of glomerular disease. The histopathological analysis showed fibrously thickened Bowman’s membrane, with discretely thickened glomerular basal membrane and collapsed vascular lumen on TEM analysis. The treatment of the patient included corticosteroids, angiotensin-converting enzyme inhibitor and lipid lowering agents, which resulted in lowering of the proteinuria, followed by withdrawal of the edema.
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