Milenkovikj, Zvonko
Preferred name
Milenkovikj, Zvonko
Official Name
Milenkovikj, Zvonko
Main Affiliation
Email
zvonko.milenkovikj@medf.ukim.edu.mk
80 results
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Item type:Publication, Procalcitonin values as prognostic marker in patients with sepsis and septic shock.(Македонско лекарско друштво = Macedonian Medical Association, 2018); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of Size of the Tumour, Persistence of Estrogen Receptors, Progesterone Receptors, HER2Neu Receptors and Ki67 Values on Positivity of Axillary Lymph Nodes in Patients with Early Breast Cancer with Clinically Negative Axillary Examination(2017-12-15); ; ; ; The study aimed to identify factors that influence the positivity of axillary lymph nodes in patients with early breast cancer and clinically negative axillary lymph nodes, who were subjected for modified radical mastectomy and axillary lymphadenectomy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Seasonal influenza-factors associated with a severe clinical form of the illness.(Македонско лекарско друштво = Macedonian Medical Association, 2016); ; ; ; Kirova Urosevic V - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Pneumonia impact on the flow and the outcome at patients with seasonal influenza(European Respiratory Society, 2020-09); ; ; ; Abstract Seasonal influenza complications are the cause of development of severe clinical picture as well as death. The most common are the respiratory ones, and the leading one that stands out is the secondary bacterial pneumonia. The aim of this study is determining the pneumonia impact on the severity of the clinical picture as well as the outcome for the patients with influenza. The research is prospectively compared in groups, carried out at University Clinic for Infectious Diseases during a 3-year period. 122 adult patients with clinical and laboratory confirmed influenza have been analyzed. Based on the severity of the clinical picture, patients were divided into two groups, a severe (n=87) and a mild (n=35) form of the disease. During the study demographic, general data, clinical symptoms and signs as well as complications have been recorded. Out of 122 patients with influenza, there were registered complications at 108 (88.52%), with significant appearance in the group with severe influenza 93.1% vs 77.14% (p=0.012). The most common one in percentage is pneumonia 98(80.33%) which also significantly influenced the severity of the disease (p=0.002). Complications such as ABI 8(6.56%), ARDS 7(5.74%), sepsis 5(4.1%), DIC 4(3.28%), and otitis 2(1.64%) have been registered only in the group with severe influenza. At 5(4.1%) patients acute meningoencephalitis has been registered, gastroenterocolitis at 3(2.46%), an hepatic damage at 14(11.47%) of the patients. Pneumonia as the most common complication for patients with severe influenza has significant impact on the clinical flow ant the outcome of the disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Epidemiology of Community-Acquired Sepsis in Adult Patients: A Six Year Observational Study(Macedonian Academy of Sciences and Arts/Sciendo, 2018-07-01); ; ; ; Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection and it is a major cause of morbidity and mortality worldwide. The aim of this study is to describe epidemiology of community-acquired sepsis in the Intensive care unit (ICU) of the Macedonian tertiary care University Clinic for Infectious Diseases. A prospective observational study was conducted over a 6-year period from January, 2011 to December, 2016. All consecutive adults with community-acquired sepsis or septic shock were included in the study. Variables measured were incidence of sepsis, age, gender, comorbidities, season, source of infection, complications, interventions, severity indexes, length of stay, laboratory findings, blood cultures, 28-day and in hospital mortality. Of 1348 admissions, 277 (20.5%) had sepsis and septic shock. The most common chronic condition was heart failure (26.4%), and the most frequent site of infection was the respiratory tract (57.4%). Median Simplified Acute Physiology Score (SAPS II) was 50.0, and median Sequential Organ Failure Assessment (SOFA) score was 8.0. Blood cultures were positive in 22% of the cases. Gram-positive bacteria were isolated in 13% and Gram-negatives in 9.7% of patients with sepsis. The overall 28-day and in hospital mortality was 50.5% and 56.3% respectively. The presence of chronic heart failure, occurrence of ARDS, septic shock and the winter period may influence an unfavorable outcome. Mortality compared to previous years is unchanged but patients that we have been treating these last 6 years have had more severe illnesses. Better adherence to the Surviving Sepsis guidelines will reduce mortality in this group of severely ill patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of VITEK-2 yeast susceptibility test for antifungal susceptibility testing of Candida species to fluconazole(Македонско лекарско друштво = Macedonian Medical Association, 2011); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Characteristics of pleural fluid in patients with parapneumonic effusions(SHMSHM - AAMD, 2016); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Identification of risk factors for lethal outcome in patients with severe community-acquired pneumonia(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prevalence of Rotaviruses in the Etiology of Acute Diarrhea in Young Children, Clinical forms, Extraintestinal Manifestations and Complications(Macedonian Academy of Sciences and Arts/Sciendo, 2020-12-08); ; ; ; Rotavirus is highly contagious factor with dominant feces-oral transmission. Because it is stable in external environment, transmission clusters are possible by close contact, ingestion of contaminated water or food or contact with contaminated surfaces. It survives within hours and days on hands and contaminated surfaces. This makes it the most common enteric and nosocomial pathogen in the world, especially in early childhood. In addition to the rapid dehydration with pronounced electrolyte disturbances, numerous extraintestinal possibilities have been recorded in the clinical picture, which emphasizes the need for prevention of this disease.In the period from 1.02.2018 to 31.01.2020 at the Clinic for Infectious diseases were treated 1060 patients with diarrheal disease, of which 502 children (47.36%). Rotavirus etiology was confirmed in 23.30% of the children. According to the protocols, laboratory and biochemical investigations were done to all 117 children, with tracking parameters and their dynamics of admission and discharge from the hospital. Most of the children, 84 (82.0 6%) are from urban areas, with a more confirmed epidemiological survey of 59 (42.00%). The average age of the children was 8 months, with a small percentage of children on maternal food (breastfed 25, i.e. 21.37%), with high febrile admission in 99% of children with an average temperature of 38.5oC and an average febrile duration of 4 days, with an average of 7 (+ 2.49) of stools and 5 (+ 2.12) of vomiting. There was a significant difference in hematocrit, leukocyte, electrolyte, glycaemia, and CRP values on admission and discharge. There was predominant isonatremic dehydration, and the compensatory mechanisms followed by the values of the electrolytes ABS, Ph, BE showed a tendency to maintain within the physiological limits. The clinical picture of extraintestinal manifestations included bronchitis, mesenteric lymphadenitis, upper respiratory infections and rash.Rotavirus infection is a serious health and economic problem in our country, so it needs continuous prevention and monitoring in order to reduce the incidence, and thus the need for hospitalization and cure of rotavirus disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza(Macedonian Academy of Sciences and Arts/Sciendo, 2016-11-01); ; ; Cvetanovski, VlatkoIntroduction: Clinical manifestations of influenza range from relatively mild and self-limiting respiratory infections to severe clinical manifestations with significant morbidity and mortality. The awareness of predictive indicators for the lethal outcome of influenza is of particular significance in making timely and exact decision for adequate treatment. The aim of this study was to identify the factors in patients with a severe form of influenza, resulting in lethal outcome. Materials and methods: The investigation was a prospective group comparison conducted at the University Clinic for Infectious Diseases in Skopje, R. Macedonia in the period from January 01, 2012 to January 01, 2015. The study included adult patients with a severe form of influenza who were further categorized into a group of either survived patients or a group of deceased patients. Demographic, clinical and biochemical data were noted in all patients included in the study on admission. The variables of the univariate analysis that showed a significant difference in terms of the outcome were used for creating multivariate logistic and regression analysis of the outcome as dependent factors. The independent predictors for lethal outcome in severe cases of influenza were identified by using logistic regression. Results: The study included 87 patients with a severe form of clinical and laboratory confirmed influenza. The patients were divided in two groups: survived (n = 75) and deceased (n = 75). The overall mortality was 13.79%. Multivariate analysis conducted on admission to hospital identified cardiovascular comorbid diseases (p = 0.014), urea values higher than 8.3 U/L (p = 0.045) and SAPS score (p = 0.048) as independent predictors of the outcome in patients with severe form of influenza. Influenza patients with cardiovascular diseases had 2.024 times greater risk of death from influenza in comparison to the patients having influenza without history of such a disease (OR = 2.024 95% CI 1.842-17.337). Patients with serum urea values higher than 8.3 U/L had 1.89 times higher chance of death compared to patients with normal values (OR = 1.89 95% CI 1.091-11.432). The increase of the SAPS score in one point increased the chance of death in patients with influenza by 1.2% (OR = 1.12 95% CI 1.01-2.976). The ROC analysis indicated that cardiovascular diseases, increased urea values and SAPS score in combination act as a good prognostic model for the fatal outcome. The global authenticity of this predictive model to foresee lethal outcome amounts to 80%, sensitivity being 82%, and specificity 70%. Conclusion: Cardiovascular diseases, increased values of urea over 8.3 mmol/l and SAPS score are independent predictive indicators for lethal outcome in severe influenza. Early identification of the outcome predictors in patients with severe influenza will allow implementation of adequate medical treatment and will contribute to decreasing of mortality in patients with severe form of influenza.