Krstevski, Gregor
Preferred name
Krstevski, Gregor
Official Name
Krstevski, Gregor
Main Affiliation
Email
gregorkrstevski@gmail.com
12 results
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Item type:Publication, Patient-Level, Institutional, and Temporal Variations in Use of Imaging Modalities to Confirm Pulmonary Embolism(Lippincott Williams & Wilkins, 2020-05) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Upper gastrointestinal bleeding from primary aortoesophageal fistula in a patient with aneurism of the thoracoabdominal aorta: Case report and literature review(Wiley, 2024-08); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Management and outcome of major bleeding in patients receiving vitamin K antagonists for venous thromboembolism(Elsevier BV, 2018-11) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Recurrent Severe Hepatitis of Autoimmune Origin(Macedonian Academy of Sciences and Arts / Sciendo, 2021-04-23); ; ; Serafimovski, VladimirThe autoimmune liver disease constituent conditions include autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis and IgG-4 associated cholangitis. They remain a diagnostic challenge to the practicing physician due to their close resemblance in clinical course, and laboratory and imaging findings to the vast array of other etiologies of liver injury. We report a case of recurrent severe hepatitis of autoimmune origin in a female patient. The disease course was marked by initial onset at age 39, followed by nearly four years of remission, and a second flare with a more exaggerated severity. Systemic lupus erythematosus was initially deemed as the culprit, however formal diagnostic criteria were not fulfilled and the serological findings were not reproduced at a later date. With the aim of ascertaining the underlying process, the patient underwent an extensive array of testing with regards to infectious, genetic, systemic and autoimmune disease. Positive anti-dsDNA (double stranded DNA) and an antinuclear antibody titer of 1:160 provided the strongest support for an autoimmune etiology, specifically autoimmune hepatitis or possibly an overlap syndrome. An excellent outcome was achieved via treatment with corticosteroids, ursodeoxycholic acid and plasmapheresis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Nutrition in Advanced Age Population(Consulting and Training Center KEY, 2021-09); Nutritional status of an individual is affected by genetic and environmental factors, access to nutrients, personal preferences, nutritional awareness, comorbidities and daily habits. The number of individuals aged over 65 is increasing globally. This review will look at strategies for nutritional screening and diet therapy in the elderly, taking into account phenomena that influence nutrition and commonly affect this age group. Malnutrition can be assessed via criteria that account for loss of weight, muscle and subcutaneous fat, in combination with decreased energy intake and functional status. Malnutrition and involuntary weight loss are associated with an increased mortality risk, while some studies show that voluntary weight loss reduces this risk. Malnutrition leads to a plethora of negative outcomes, and may signal dire underlying disease such as malignancy. Factors that predispose to malnutrition in the elderly include: anatomical and physiological changes of the gastrointestinal tract, endocrine system and body composition, and impairment of sight, smell and taste. Concomitant illnesses affecting the heart, lungs, liver and kidneys, and depression and dementia also negatively impact nutrition, while socio-economic changes interfere with access to food. Once identified, malnutrition can be mitigated via diet therapy which aims to tailor nutrition to the aforementioned changes, compensate any deficiencies and prevent future recurrence. Special attention should be paid to caloric, protein and fat requirements and diet supplementation with vitamin D, B12, iron and calcium. Focused nutritional assessment can aid in timely detection of malnutrition and its constituent components, which include anorexia, cachexia and sarcopenia. This also provides the opportunity to identify underlying malignancy, and systemic and psychiatric conditions. Diet therapy can then be tailored to accommodate for these conditions and to the changes known to occur in the elderly, potentially mitigating malnutrition and reducing mortality risk. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Frequency of CYP2D6*3 Allele in Macedonian Population - Pilot Study(2011-11); ; Background. The cytochrome P450 enzymes are members of an isoenzyme superfamily that catalyzes the oxidation of many drugs and chemicals. Genetic polymorphisms have been identified for some of the CYP450 enzyme genes that alter enzyme activity. Depending on gene variations, individuals may be intermediate metabolizers (IMs) or poor metabolizers (PMs) or ultra-rapid metabolizers (UMs). CYP2D6 is responsible for the metabolism of environmental chemicals and drugs such as: antiarrhythmics, adenoreceptor antagonists and tricyclic antidepressants. Methods: Thirty-eight volunteers of Macedonian origin previously involved in pahrmacokynetic studies at the institute of Pharmacology and Toxicology were recruited for this study. After signing written consent, DNA was isolated using the phenol-chlorophorm procedure and stored at the human DNA bank (hDNAMKD) at the Institute of Immunobiology and Human Genetics. The exon 5 of the CYP2D6 gene was PCR amplified in order to confirm the presence of the allele # 3 of the 2D6 gene. The resulting product was then digested with the enzyme MspI. Next, electrophoretic separation on the Multiphor II using 12.5% polyacrilamide gel and silver staining was performed. Results: The results indicated that of the 38 samples analyzed with the polyacrylamide gel electrophoresis, 37 portrayed a normal homozygote genotype while only 1 sample showed heterozygous genotypic pattern. Therefore, the frequency of 2D6*3 heterozygotes in the 38 studied samples is 2.6%. This finding is comparable with the other European populations upon which this study has been done. Conclusion: To our knowledge, this is the first study analyzing genetic polymorphism of the CYP2D6 gene in the Macedonian population. In this study we present preliminary results, with the goal to continue and eventualy analyze a representative number of samples which would make comparisons with other European populations possible. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Value of Injection Therapy with Botulinum Toxin in Pain Treatment of Primary Chronic Anal Fissures Compared to Anal Dilation, and Local Nifedipine in Combination with Lidocaine(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Sciendo, 2023-07-01); ; ; ; Introduction: Anal fissure is a longitudinal tear of the mucosa of the anal canal extending from the outer anal orifice in the direction of the dentate line of the inner anal opening. Fissures are divided into primary and secondary, and acute or chronic. Besides minimal rectal bleeding, itching and soiling, primary chronic anal fissures (PCAF) manifest with anal pain as theirs main determinant. It is described as the most troubling symptom. Aim: To compare the effect of injection therapy with botulinum toxin A (ITBT) vs. anal dilation (AD), and local nifedipine with lidocaine (LNL) in pain treatment of PCAF. Materials and Methods: This controlled retrospective prospective longitudinal study covered 94 patients, divided in 3 groups. The first was treated with ITBT, the second with AD and third using LNL (31, 33 and 30 patients respectively). Clostridium botulinum toxin A was used, dissolved with saline to concentration of 200 U/ml. The solution was applied to both sides of PCAF at dose of 40U. Modified technique of AD was done using 3 fingers of a single hand, progressively introduced into the anal canal, followed by gradual lateral distraction during 1 min. LNL therapy was conducted using nifedipine (0.3%) with lidocaine (1.5%) ointment, applied twice daily for 3 weeks. To measure pain, a visual analog scale (VAS) was used. The follow-up period was 12 weeks with checkup at week 4. Results: The median age of participants was 46.6±13.9 years (50 males vs. 44 females). The type of therapy had a significantly different effect on pain at week 4 (p=0.0003). Severe pain was present in only 2 ITBT patients, 16 AD, and 6 LNL patients. Post hoc analyses showed different pain disappearance time by week 12 (p <0.0001). The mean time was shortest in ITBT group (6.1±1.5 weeks). Anal pain intensity significantly differed among the 3 groups (Fisher exact, p=0.002). Namely, 71% in ITBT group rated the pain as weakest (VAS score 1) compared to 18.2% in AD and 30% of patients in LNL group. The overall pain reduction significance was in favor of ITBT, due to the differences between the ITBT and AD groups (p=0.00024) and ITBT compared to LNL group (p=0.018). Conclusion: ITBT is superior to AD and LNL in reducing pain in PCAF. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Crohn's Disease and Ulcerative Colitis - Diferential Diagnosis and Treatment(Macedonian Association of Internal Medicine, 2022-05); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Frequency and prognostic impact of acute kidney injury in patients with acute pulmonary embolism. Data from the RIETE registry(2019)