Velikj stefanovska, Vesna
Preferred name
Velikj stefanovska, Vesna
Official Name
Velikj stefanovska, Vesna
Main Affiliation
Email
vesnavelikjstefanovska@medf.ukim.edu.mk
36 results
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Item type:Publication, Prognostic factors in thyroid carcinomas: a 17-year outcome study(Archives of Endocrinology and Metabolism, 2019-09-30); ; ; ; The aim of our study was to evaluate the survival rate of all thyroid carcinomas (TCs) diagnosed in the 1999-2015 period in the Republic of North Macedonia and to analyze the prognostic influence of several characteristics on development of distant metastases, as well as to analyze the prognostic effect of seven clinical and constitutional features on mortality. - 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, 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, Evaluation of the Effects of Gastro Protect as an Alternative Medicine on Gastritis and Other Gastrointestinal Symptoms(Macedonian Academy of Sciences and Arts, 2024-03-01); ; ; ; Introduction: The use of herbal medicine as a part of the Complementary and Alternative Medicine is increasing worldwide. Herbal remedies are used to better different conditions including gastritis. Material and Methods: We conducted a prospective randomized control clinical trial on a total sample of 72 patients with gastritis in order to examine the effects of the commercial herbal product Gastro Protect. After 6 weeks of conventional therapy the patients were divided into two groups with 36 patients each. As a continuation of the treatment, Group 1 received conventional therapy + Gastro Protect and Group 2 received conventional therapy + Placebo. We analyzed 14 selected gastrointestinal symptoms, five related to digestive problems, and nine related to stool and bowel problems. For assessing the selected symptoms we used seven point gastrointestinal symptom rating scale (GSRS). Results: The Gastro Protect group had a significantly lower GSRS score (better condition) compared to the Placebo group related to all five selected symptoms of digestive problems as: abdominal pain (p=0.0250), hunger pain (p=0.0276), nausea (p=0.0019), heartburn (p=0.00001), and acid reflux (p=0.0017). The Gastro Protect group, also had a significantly lower GSRS score (better condition) compared to the Placebo group related to three out of nine selected bowel symptoms: rumbling (p=0.0022), abdominal distension (p=0.0029), and gas or flatus (p=0.0039). Conclusion: Gastro protect was effective in treating gastritis and other gastrointestinal symptoms. It was safe for usage and showed almost no side effects. In our study, Gastro Protect reduced the examined gastric symptoms and related examined intestinal symptoms. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ultrasound features and preoperative accuracy of the fine needle aspiration biopsy in detection of thyroid carcinomas(Wiley, 2022-09-21); ; ; Objective To analyze the ultrasound (US) characteristics and fine needle biopsy (FNAB) of thyroid carcinomas (TCs) prior to surgery and compare with postoperative histopathology and to determine FNAB sensitivity and specificity. Material and Methods Retrospective analysis of the US data during 1999–2015 was performed, as well as analysis of FNAB results and using histopathology report as “gold standard” the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this method was evaluated. Results Data revealed that tumors >51 mm were declining by 50% in the period 2011–2015 compared to 2005–2010 or by 18% 2011–2015 compared to 1999–2004 and significant increase was detected in diagnosis of multicentric tumors. The analysis revealed that FNAB has sensitivity = 65.7% CI (0.59% - 0.71%) and specificity = 50% CI (0.43%–0.56%), PPV = 56.9% and NPV = 59.2%. Conclusion We found increasing detection of smaller TCs, as well as more frequent detection of multicentricity of the neoplastic foci. FNAB results in our study revealed low sensitivity and specificity. Major limitation of the study was inability to exactly separate US guided from non US guided FNAB in evaluation of the sensitivity and specificity, due to retrospective nature of the analysis. Further studies evaluating only US guided FNAB should be performed. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Overweight/obesity and childhood asthma(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2018); ; Childhood asthma and obesity have been increasing in recent decades worldwide. Many studies have reported an increased risk of development of asthma in overweight/obese adults and children. The complex association of overweight/obesity with asthma might be explain by the influence of genetic and epigenetic factors, external factors and mechanical factors with impaired lung function and GERD. Obesity affects lung function in obese asthmatics with decrease in FRC and ERV. In obese children a significantly decreased ratio of FEV1/FVC has been documented. Obesity is associated with low-grade systemic inflammation, giving rise to this idea obesity is a “proinflammatory state”. Adipose tissue secretes leptin, adiponectin, IL-6 and TNF-α, which may have significant effects in development of systemic and airway inflammation. AHR is also present in obese adults suffering from asthma, but data in children are inconsistent. In conclusion, there is evidence to associate asthma with obesity in children, but the data are still conflicting. Pediatric obese asthma is a distinct asthma phenotype, characterized by more severe form, steroid resistance, which requires a specialized treatment plan. As the number of obese children is expected to increase in the next decades, research on pathogenetic mechanisms, will improve the management of this chronic diseases. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Non-Opioid Substances Acute Poisonings with Suicidal Intent in Patients with Opioid Use Disorder(2020-03-31); ; Introduction: Several epidemiological studies have evaluated the role of illicit drug use in suicide behaviour. Aim: To assess patients with opioid use disorder and suicidal intent related to behavior, severity of acute poisoning and the most commonly used non-opioid substances. Materials and methods: This cross sectional study included 67 patients diagnosed with opioid use disorder. The study was conducted at the University Clinic of Toxicology in Skopje over a 5-year period (2013-2017). The following variables were examined: gender, age, duration and route of opioid administration, duration of hospitalization, and types of substances used in acute poisoning. Assessment of patients’ behavior and severity of poisoning was made by using the Suicide Behaviours Questionnaire-Revised and the Poison severity score. Results: The majority of patients were male (88.1%). The mean age of patients was 30±6.1 years. The average duration of opioid use disorder was 8.5±3.9. A single poisoning was found in 62.7%, double poisoning in 25.4%, and triple poisoning in 11.9% of participants. Benzodiazepines were most commonly used by the patients (55.2%). The largest number of patients (32.8%) had minor Poison severity score (PSS), and only 17.9% had severe PSS. None of the patients had a fatal suicide attempt. 86.6% of patients had a score of ≥7 indicating a high risk of repeat suicide attempts. Conclusion: Benzodiazepines were most commonly used as a single or combined substance in patients with opioid use disorder. PSS indicated that most of the participants were with minor PSS and with high risk of a repeat suicide attempt. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses.(SAGE, 2021-05); ; Bojadjiev, MarjanAddressing 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Distribution of histopathological types of thyroid tumors in 1999-2015 compared to 1966-1988 year period(National Library of Serbia, 2020); ;