Danilovski, Dragan

Preferred name

Danilovski, Dragan

Official Name

Danilovski, Dragan

Main Affiliation

danilovski_d@yahoo.com

Now showing 1 - 10 of 16

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Evaluation of the value of p53 protein expression in the extra-capsular extension of prostate cancer
(2011)
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Georgiev, V
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Penev, M
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The objective of this study is to identify the nuclear expression of the p53 protein in prostate cancer and to determine its relationship with clinico-pathological variables.
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Comorbid Conditions in a Cohort of Inpatients with SARS-CoV-2 and their Association with In-Hospital Mortality During the Early Phases of the Pandemic
(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2023-12-01)
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Cibrev, Dragan
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Chamurovski, Nikola
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Introduction: Studies determined that age and associated comorbidities are associated with worse outcomes for COVID-19 patients. The aim of the present study is to examine previous electronic health records of SARS-CoV-2 patients to identify which chronic conditions are associated with in-hospital mortality in a nationally representative sample. Materials and Methods: The actual study is a cross-sectional analysis of SARS-CoV-2 infected patients who were treated in repurposed hospitals. The study includes a cohort of patients treated from 06-11-2020 to 15-03-2021 for COVID-19 associated pneumonia. To examine the presence of comorbidities, electronic health records were examined and analyzed. Results: A total of 1486 in-patients were treated in the specified period, out of which 1237 met the criteria for case. The median age of the sample was 65 years. The overall in-hospital mortality in the sample was 25.5%, while the median length of stay was 11 days. From whole sample, 16.0% of the patients did not have established diagnoses in their electronic records, while the most prevalent coexisting condition was arterial hypertension (62.7%), followed by diabetes mellitus (27.3%). The factors of age, male gender, and the number of diagnoses showed a statistically significant increase in odds ratio (OR) for in-hospital mortality. The presence of chronic kidney injury was associated with the highest increase of OR (by 3.37) for in-hospital mortality in our sample. Conclusion: The study reaffirms the findings that age, male gender, and the presence of comorbidities are associated with in-hospital mortality in COVID-19 treated and unvaccinated patients. Our study suggests that chronic kidney injury showed strongest association with the outcome, when adjusted for age, gender, and coexisting comorbidities.
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Childhood craniopharyngioma in Macedonia: incidence and outcome after subtotal resection and cranial irradiation
(Springer International Publ., 2011-02)
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Ugrinovski, Jovica
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Nastova, Vesna
Craniopharyngioma is a frequent tumor in children with challenging surgical, endocrine, and visual consequences. We evaluated our experience in treating craniopharyngioma and its incidence in Macedonia.
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NEURO DEVELOPMENTAL CONSEQUENCES OF NEONATAL HYPOGLYCEMIA
(Macedonian Academy of Sciences and Arts / Sciendo, 2020-09)
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Valentina Dukovska
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Neonatal hypoglycemia (HG) can cause neurologic damage, epilepsy, mental retardation, behavioral and personality disorders and death. The longest the HG lasts and the greatest the glucose nadir the consequences are more pronounced. Comorbidities are rather important in development of neurological damage. Hypoxemia and ischemia can cause permanent brain damage. Small for gestational age (SGA), large for gestational age (LGA), intrauterine growth restriction, gestational age bellow the 37th week, low Apgar score, sepsis, children whose mothers have toxemia, diabetes or chorioamnionitis are all newborns with increased HG risk. Comparing 34 patients with NH and 34 children without NH with similar GA, BW, BL, the Apgar score, we found statistically significant differences in motor and mental development using the Griffith scale. Children with neonatal HG fared significantly worse than those without neonatal HG. Therefore, CBG measurements and early recognition of neonatal HG is of significant importance in preventing motor and mental damage in children. A larger and well-balanced cohort of patients followed for a longer period is also necessary to clarify and discern in detail the importance of neonatal HG and other perinatal factors in neurodevelopmental damage.
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NEONATAL HYPOGLYCEMIA: RISK FACTORS AND OUTCOMES
(Macedonian Academy of Sciences and Arts / Sciendo, 2017-03)
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Elizabeta Petkovska
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Snezana Jancevska
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Background and aims: Severe neonatal hypoglycemia (HG) leads to neurologic damage, mental retardation, epilepsy, personality disorders, impaired cardiac performance and muscle weakness. We aimed to assess the clinical characteristics of children with hypoglycemia in a random population of newborns. Patients, methods and results: We investigated 84 patients (M:F=35:48) born at the University Clinic for Gynecology and Obstetrics in Skopje (hospitalized in the NICU) who were found to have hypoglycemia. In total 89.25% of the babies were premature. The mean birth weight was 1795.95 +/596.08 grams, the mean birth length was 41.92+/- 4.62 cm, while the mean gestational age was 33.05±3.19 weeks. 32 children (38.08%) were very low birth weight (<1500g), 38 (45.22%) were low birth weight (1500-2500g), while there were 8 children (9.52%) appropriate for age BW and no high BW for age patients (>4000 g). HG duration was 2.42+/-2.41 hours. In the group as a whole, hypoxic-ischemic encephalopathy (HIE) was found in 3 children (3.57%), infections in 22 (26.18%), respiratory distress syndrome (RDS) in 9 patients (10.62%), intracranial haemorrhage in 2 patients (2.38%). There were no inborn errors of metabolism. There were two deaths (2.38%). Conclusion: Neonatal HG is a significant factor in the overall neonatal mortality. HG can also cause severe invalidity. We found that infections, LBW and low gestational age were most commonly associated with neonatal HG. However the Spearman test showed weak direct correlation, without statistical significance. Neonatal HG requires complex and team interaction of prenatal and postnatal approaches to reduce the incidence of seizures, their consequences and the overall mortality. Special consideration is to be taken in measures that avoid neonatal infections, HIE, LBW and low gestational age. Further studies on a larger population are needed to fully understand and prevent the phenomenon of HG in newborns.
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Hypoglycaemia in the newborn
(Macedonian Academy of Sciences and Arts / Sciendo, 2017-09)
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Elizabeta Petkovska
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Sanja Ivanovska
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Snezana Jancevska
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Aim: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. Patients and methods: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU). 1416 babies were treated in the same period in NICU, and HG was observed in 52.18%. The birth weight was dominated by children with low birth weight: very low birth weight (VLBW)(<1500g) 253 children, (34,23%), low birth weight (1500-2500g) 402 (54.39%), appropriate for gestational age (AGA) 78(10.55%), and high birth weight (>4000g) 6 babies (0.81%). The gestational age was also dominated by children with low gestational age: gestational week (GW) 20-25 four children (0.54%), 26-30 GW 133 babies (17.99%), 31-35 GW472 (63.87%), and 36-40 GW130 neonates (17.59 %). 241 mothers (32.61%) have had an infection during pregnancy, 82 preeclampsia or eclampsia (11.09%), 20 diabetes mellitus (2.70%), 78 placental situations (placenta previa, abruption) (10.55%). In this study 47 babies (6.35%) with HG and co-morbidities died. There was a significant positive correlation between HG birth weight (p<0.01), gestational age (p<0.05), and the lowest Apgar score (p<0.01). Neonatal deaths were significantly correlated with GA (р>0,01), co-morbidities of the mothers (р>0,05) but not with the birth weight (р>0,05). In contrast, a significant positive correlation was found between convulsions and body weight (р<0.05). The lowest Apgar score was positively correlated with the gestational age (0.01), but not with the birth weight (0.05). Conclusion: Low birth weight, low gestational age, maternal risk factors, hypoxic-ischemic encephalopathy and neonatal infections are associated with HG and are a significant factor in overall neonatal mortality. Those results indicate that diminishing the frequency of the neonatal HG and the rates of neonatal mortality requires complex interaction of prenatal and postnatal interventions.
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РИЗИК ФАКТОРИ НА СКВАМОЗНИТЕ КЛЕТОЧНИ АБНОРМАЛНОСТИ НА ГРЛОТО НА МАТКАТА
(SHMSHM / AAMD, 2017)
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Duvlis, Sotirija
Вовед: Целта на нашата студија беше да ги детектираме најчестите ризик фактори на сквамозните интраепителни лезии и сквамозниот инвазивен карцином на грлото на матката. Материјал и методи: Case-control студија, работена на 192 сексуално активни жени, на возраст од 20 до 59 години, поделени во две групи: испитувана и контролна, на Универзитетските клиники за гинекологија и акушерство и радиотерапија и онкологија во Скопје и на Институтот за јавно здравје на Република Македонија, во периодот од Јануари 2016 година до Јуни 2017 година. Кај сите жени се направи: анкета со специфичен прашалник, ХПВ ДНК тестирање, Nugent-ов скор систем, а по индикација, кај сите жени од испитуваната група и колпоскопска цервикална биопсија со ендоцервикална киретажа за хистопатолошка анализа. Резултати: Анализата на податоците покажа асоцијација помеѓу ХПВ ДНК инфекцијата (хи квадрат тест=4.8204, p=0.028125, p<0.05), бактериската вагиноза (хи квадрат тест=4.1906, p=0.040649, p<0.05) и сквамозните клеточни абнормалности на грлото на матката. Нашата студија покажа дека пониското ниво на едукација за 2,29 пати (OR=2.29; 95%CI: 1.093-4.797) го зголемува ризикот за појава на сквамозни клеточни абнормалности на грлото на матката. Релативниот ризик за сквамозни клеточни абнормалности на грлото на матката, кај пациентките со понизок социјален статус беше 2,59 (OR=2.59; 95%CI: 1.137-5.503). Нашата студија покажа дека пушењето цигари за 2,45 пати го зголемува ризикот за појава на сквамозни клеточни абнормалности на грлото на матката (OR=2.45; 95%CI=1.3165-4.5762). Релативниот ризик за сквамозни клеточни абнормалности на грлото на матката, кај пациентките кои употребувале орални хормонски контрацептивни средства подолго од 5 години беше 3,00. Нашата студија покажа дека раниот прв сексуален однос пред 17 година од животот за 2,14 пати го зголемува ризикот за појава на сквамозните интраепителни лезии и сквамозниот инвазивен карцином на грлото на матката (OR=2.14; 95%CI: 1.0723-4.2821). Анализата на податоците од нашата студија покажа и асоцијација помеѓу сквамозните клеточни абнормалности на грлото на матката и диеталната исхрана (OR=2.11; 95%CI=1.0218-4.3832). Заклучок: Анализата на податоците на нашата студија покажа асоцијација помеѓу сквамозните клеточни абнормалности на грлото на матката и ХПВ ДНК инфекцијата, бактериската вагиноза, нередовните гинеколошки контроли, честиот вагинален исцедок, раниот прв сексуален однос, пушењето цигари, долготрајната употреба на хормонски орални контрацептивни средства и диеталната исхрана. Introduction: The purpose of our study was to detect the most common risk factors for squamous cell abnormalities of the uterine cervix. Material and methods: Case-control study, performed on 192 sexually active women aged 20 to 59, divided into two groups: examination and control, at the University Clinics of Gynecology and Obstetrics and Radiotherapy and Oncology in Skopje and the Institute for Public Health of the Republic of Macedonia, in the period from January 2016 to June 2017. All women were made: a questionnaire, HPV DNA testing, Nugent score system, and by indication, in all women in the study group and colposcopic cervical biopsy with endocervical curettage for histopathological analysis. Results: The analysis of the data showed an association between the presence of HPV DNA infection (chi-square test = 4.8204, p = 0.028125, p <0.05), bacterial vaginosis (chi-square test = 4.1906, p = 0.040649, p <0.05) and the occurrence of squamous intraepithelial lesions and squamous invasive carcinoma of the uterine cervix. Our study showed that the lower level of education for 2.29 times (OR = 2.29; 95% CI: 1.093-4.797) increased the risk of squamous cell abnormalities of the uterine cervix. The relative risk of squamous cell cervical abnormalities in patients with lower social status was 2.59 (OR = 2.59; 95% CI: 1.137-5.503). Our study showed that smoking cigarettes by 2.45 times increases the risk of squamous cell abnormalities of the uterine cervix (OR = 2.45; 95% CI: 1.3165-4.5762). The relative risk of squamous cell cervical abnormalities in patients who used oral hormone contraceptives for more than 5 years was 3.00. Our study showed that the first sexual intercourse before the age of 17 years of life for 2.14 times increases the risk of squamous intraepithelial lesions and squamous invasive cervical cancer (OR = 2.14; 95% CI: 1.0723-4.2821). The analysis of the data from our study also showed an association between squamous intraepithelial lesions and squamous invasive cervical cancer and dietary nutrition (OR = 2.11; 95% CI: 1.0218-4.3832). Conclusion: The analysis of the data of our study showed an association between squamous intraepithelial lesions and squamous invasive cervix cancer and HPV DNA infection, bacterial vaginosis, irregular gynecological controls, frequent vaginal discharge, early first sexual intercourse, cigarette smoking, long-term use of hormonal oral contraceptives and dietary nutrition.
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Tissue Detection and Typisation of Human Papillomavirus in Women with Squamous Intraepithelial Lesions and Squamous Invasive Carcinoma of the Cervix
(Македонско лекарско друштво = Macedonian medical association, 2015-06-01)
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Popovska, Zora
Introduction. The most common risk factor for intraepithelial lesions and cervical carcinoma is infection with human papillomavirus (HPV), especially with high-risk HPV genotypes. Only persistent, high-risk HPV infections represent a major risk factor for intraepithelial lesions and cervical cancer. The aims of the study were: detection and typisation of HPV genotypes, which are the most common causes of intraepithelial lesions and cervical cancer, determination of the correlation between HPV infection and histopathological diagnosis, and the correlation between the grade of lesion of the cervix and oncogenic potential of the virus as well as determination of the most affected age group of patients. Methods. This cross-sectional study included 100 sexually active patients with an abnormal Pap test at the age from 20 to 69 years (39±10.77), and was conducted at the University Clinic of Gynecology and Obstetrics in Skopje and University Clinic of Radiotherapy and Oncology in Skopje in the period from January 2014 to August 2014. In all patients colposcopic cervical biopsy was made with endocervical curettage for histopathological analysis and cervical biopsy for detection and HPV typisation. HPV detection and typisation were done using polymerase chain reaction (PCR) and reverse hybridization. Results. HPV DNA was detected in 81.0% (81/100) of the examined women. The relationship between the prevalence of high-risk and low-risk HPV DNA genotypes was 72.0%:9.0%. The frequency of high-risk HPV DNA genotypes ranged from: 54.5% (12/22) in productive HPV infection-mild dysplasia, 86.4% (19/22) with moderate dysplasia, 91.2% (21/23) in severe dysplasia to 100% of squamous cell carcinoma in situ (6/6) and invasive squamous cell carcinoma (5/5). Mixed HPV infection was detected in 19.0% (19/100) of all patients, in 23.5% (19/81) of HPV DNA positive patients. The most common HPV DNA genotypes, in descending order, were HPV 16 (43.2%), HPV 31 (28.4%), HPV 18 (14.8%), etc. The highest frequency of HPV infection was found in patients under 30 years of age. Conclusion. There was an association between HPV infection and squamous intraepithelial lesions and squamous invasive carcinoma of the cervix. There was a correlation between the grade of cervical lesion and the oncogenic potential of the virus. The results of this study may be useful for building a national strategy in the fight against cervical cancer.
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Correlation between cytopathology and histopathology in women with squamous cell abnormalities of the uterine cervix
(Macedonian Association of Pathology, 2016-09)
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Objective: The objective of our study was to investigate the correlation between cytology and cervical biopsy findings in women with squamous cell abnormalities on cervical cytology. Material and Methods: A comparative retrospective study was conducted in the period from September 2015 to March 2016 in a series of 184 sexually active women, aged from 20 to 60 years, with squamous cell abnormalities in the liquid-based cytology test. In all women, cervical biopsy with endocervical curettage was performed colposcopically for histopathological analysis. Results: Cytologically, there were 118 (64.13%) atypical squamous cells of undetermined significance (ASC-US), 22 (11.96%) low-grade squamous intraepithelial lesions (LSIL), 38 (20.65%) high-grade squamous intraepithelial lesions (HSIL) and 6 (3.26%) invasive squamous cell carcinoma cases. According to the histopathological findings in the cervical biopsy and/or endocervical curettage material in 108 (58.70%) women only nonneoplastic lesions were diagnosed. Twenty-four (13.04%) women had histologically confirmed LSIL, 42 (22.83%) had HSIL and in 10 (5.43%) cases invasive SCC was confirmed. For all squamous cell abnormalities, the sensitivity of the liquid-based cytology test in LSIL and higher grade lesions was 58.70% (108/184) and false positivity was 41.30% (76/184). Excluding ASC-US lesions, the sensitivity of the liquid-based cytology test was 78.80% (52/66) and the false positivity was 21.21% (14/66). The positive predictive value was 100% (6/6) for invasive SCC, 68.42% (26/38) for HSIL and 31.82% (7/22) for LSIL. Conclusions: The high sensitivity of the liquid-based cytology test for HSILs shows that it is an effective screening test for cervical cancer and its precursor lesions.
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THE CRIB II (CLINICAL RISK INDEX FOR BABIES II) SCORE IN PREDICTION OF NEONATAL MORTALITY
(Macedonian Academy of Sciences and Arts / Sciendo, 2020-12)
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Predicting the outcome of neonatal critical patients remains elusive. The multiple factors of maternal state of health (infections, diabetes, gestosis), the placental situation (premature rupture of membranes) as well as multiple factors from the baby (small for gestational age, low Apgar score, low birth infections, mechanical ventilation, hypoglycaemia hyperglycamiea) render the approach to treatment of each patient individual and the outcome uncertain. Several approaches and scales are developed in order to assess the mortality risk in those rather complicated situations. We used the CRIB-II scale to assess the mortality risk in 80 patients delivered in a large tertiary level hospital with more than 4,000 deliveries yearly. The patients were stratified according to all the neonatal risk factors and comorbidities. The CRIB-II scale identified well the mortality rates, but not the outcomes. A large and well-balanced cohort of patients followed for a longer period is required to discern in detail the importance of CRIB-II scale in predicting outcomes in high-risk new-borns. This could serve as an assistance to personalized approach to severely sick children. In addition, it is a valuable method in comparing outcomes in different NICUs and outcomes in different times in the same NICU, thus rendering possible improvements in the same unit and among several NICU departments.

Danilovski, Dragan

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