Nikolovska, Emilija
Preferred name
Nikolovska, Emilija
Official Name
Nikolovska, Emilija
Main Affiliation
Email
emilija.nikolovska@medf.ukim.edu.mk
17 results
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Item type:Publication, The role of the connection between intestinal microbiota and brain in the pathogenesis of functional gastrointestinal disorders(Centre for Evaluation in Education and Science (CEON/CEES), 2023)<jats:p>The relation between the intestinal microbiota and the brain is an important field of research in the pathophysiology of functional gastrointestinal disorders (FGIDs). This group of diseases includes more than 40% of the population and is one of the most common reasons for the need of consulting a gastroenterologist. The interaction between the gut microbiota and the brain is a new terminology for defining functional gastrointestinal disorders, based on certain diagnostic criteria. The ROMA IV classification of diagnostic criteria divides functional gastrointestinal diseases into five anatomical regions including the esophagus, gastroduodenal tract, intestine, biliary tract, and anorectal region. Symptoms are usually based on gastrointestinal dysfunction such as gastroesophageal reflux disease (GERD), functional dysphagia, functional dyspepsia, gastroparesis, irritable bowel syndrome (IBS), functional constipation, diarrhea, and fecal incontinence. In this study, we observe at the mechanisms of interaction between gut microbes and brain function. Enteric microbiota (nonpathological microorganisms) has numerous synergistic actions with the human body. The microbiota can change and is different in each individual, as each individual has their own specific microbiome. From digesting food to protecting against pathogens, the intestinal microbiota plays an important role in maintaining immunity and homeostasis. Recently, studies have shown that one of the main impeler of the interaction between the gut and the brain is precisely the microbiome, and so the new term was created "axis of intestinal microbiota-brain". In the future, the general approach to the treatment of functional gastrointestinal disorders tends to be personalized, not only based on symptoms, but also on the underlying pathophysiology and psychology. Various mechanisms, including metabolic pathways, immune system, neural pathways, are involved in the relationship between the gut microbiota axis and the brain. We also discuss some future challenges in modifying the intestinal microbiota with probiotics, prebiotics and nutrition, precisely through this new relationship. Awareness of the relationship between intestinal bacteria and their hosts is crucial in the development of modern therapeutic strategies based on good microorganisms (pre/probiotics) for functional gastrointestinal disorders.</jats:p> - 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, Biologic Therapy in Inflammatory Bowel Disease - Results from a Single Tertiary Care Center in North Macedonia(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH, 2023-07-01); ; ; ; Medical therapies used for Inflammatory Bowel Disease (IBD) include conventional (e.g. 5-aminosalicylates, steroids, immunomodulators) and biologic (e.g. inhibitors of tumor necrosis factor - alpha, integrin inhibitors, interleukin inhibitors) medications. Biologics, due to their high cost, were unfortunately not covered by the public health insurance system in North Macedonia until 2019 and, therefore, not widely utilized for our IBD patients. In 2019, the University Clinic of Gastroenterology and Hepatology in Skopje developed a biologic therapy supply, provided by the National Health Insurance Fund, making this therapy available for a larger number of patients. This report presents the initial results of our prospective, single tertiary-care center study on the effects of biologic therapy in patients with IBD in North Macedonia. The study is focused on the evaluation of clinical outcomes after anti-tumor necrosis factor alpha (anti TNF-alpha) therapy in IBD patients with prior inadequate response to conventional medications. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Management of an adolescent with familial adenomatous polyposis: report of a case(2019); ; ; ; Ana Karadzova Dzambaz - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rare presentation of gastric schwannoma: a case report.(2016); ; ; Mishevski JSchwannomas or neurilemmomas are well-defined benign tumors arising from neural crest cells and surrounding the nerve sheath. These neoplasm’s are rare among the spindle cell mesenchymal tumors of the gastrointestinal tract, and develop most commonly in the stomach representing 0.2% of all gastric tumors. We present a case of 53-years-old female with a history of upper abdominal pain. The physical examination revealed palpable epigastric mass; serum biochemistry and tumor markers were in normal range. Abdominal ultrasound as a first imaging procedure detected 5 cm cystic tumor located between the body and the tail of the pancreas, while upper endoscopy showed sub mucosal mass in the region of cardia. Diagnostic dilemma was resolved by the means of endoscopic ultrasound (EUS), which defined the exact place of the tumor in the gastric wall. Since EUS biopsy was not available procedure, percutaneous biopsy was performed. Histological and immuno-histochemical findings of the biopsy specimen and surgically resected tumor were identical, establishing the diagnosis of schwannoma. Complete surgical resection of the tumor is the treatment of choice, and the prognosis after tumor resection is excellent. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gastrointestinal Lymphoma in Tertiary Gastroenterology Center: Epidemiological, Clinical and Endoscopic Features(Македонско лекарско друштво /Macedonian Medical Association, 2017-06-01); ; ; ; Introduction. Within the heterogeneous group of extra-nodal lymphoma, the gastrointestinal tract is the most frequently involved extranodal site accounting for 30-50% of all extranodal cases. Gastrointestinal involvement most oftenoccurs secondarily, while the primary gastrointestinal lymphomasare relatively rare accounting for 30%-45% of all extranodal lymphomas and 0.9% of all gastrointestinal tumors. Within the gastrointestinal tract, lymphoma can arise in any region but the stomach is the most commonly involved organ being affected in 50-70% of all the gastrointestinal lymphomas, followed by the small intestine and ileocecal region. The aim of the study was to analyze and present data regarding the endoscopic aspects and clinical presentation of patients with gastrointestinal lymphoma. Methods. We retrospectively reviewed the medical records of patients with primary or secondary gastrointestinal lymphoma diagnosed at our Clinic over a fifteen-year period (January 1, 1999 to December 31, 2013). We analyzed the demographic data, clinical presentation, anatomic distribution, endoscopic aspect of the lesion, extension of the neoplastic process and occurrence of different histological subtypes. Results. We discovered 18 patients with gastrointestinal lymphoma (7 males and 11 females). Fourteen patients (77.7%) were considered primary, while 4 patients (22.2%) were considered secondary gastrointestinal lymphoma. The stomach was affected in 14 cases (11 primary and 3 secondary), there were 2 duodenal lymphomas, 1 lymphoma of the terminal ileum and 1 peritoneal lymphoma. In most patients (10) massive and diffuse gastrointestinal infiltration was diagnosed, 5 patients had ulcerated lesions in the stomach and 3 patients presented with polyploid mass. Six patients presented with upper gastrointestinal bleeding, 1 patient with biliary tract obstruction, one patient with protein losing enteropathy, malabsorption and consecutive bowel perforation and one patient presented only with ascites and pleural effusion. All the malignant lymphomas were Non-Hodgkin type and among them we registered only one T-cell lymphoma. Being diagnosed in 6 patients (33.33%), diffuse large B-cell lymphoma was the most prevalent histological type. The lymphoma was limited to the gastrointestinal tract in 6 patients, 7 patients had regional nodal involvement, in 2 patients there was an intra-abdominal spread and in 3 patients there was an extra-abdominal dissemination. Most patients received chemotherapy and only 2 patients were treated surgically. Two patients had rapidly progressive clinical course and lethal outcome shortly after the diagnosis was established and before chemotherapy was administered. Conclusion. The gastrointestinal lymphoma has a variable clinical presentation and endoscopic aspect that often makes the diagnosis challenging. Substantial level of diagnostic awareness and comprehensive clinical approach are necessary in order to establish the correct diagnosis, provide appropriate treatment and prolong survival. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, PARACENTESIS-INDUCED ABDOMINAL WALL HEMATOMA: CASE REPORT AND REVIEW OF LITERATURE(Македонско лекарско друштво = Macedonian medical association, 2019); ; ; ; Despite the well-known coagulopathy-associated compli-cations, paracentesis is considered a relatively safe procedure when performed inpatients with liver cirrho-sis. We present a case of a large abdominal wall hema-toma after paracentesisin a 72-years-old male with de-compensated cirrhosis, portal hypertension, refractory ascites and moderately prolonged prothrombin time. Several hours after therapeutic paracentesis wasperfor-med at the usual point, in the left lower abdominal quad-rant, the patient was admitted with severe abdominal pain, circulatory instability and significant blood loss. Ultrasound of the abdominal wall revealed a 10 cm intra-mural hematoma at the puncture site.In addition to the usual resuscitative measures, the patient required fresh frozen plasma and five units of cryoprecipitate for defi-nitive stabilization. Paracentesis-associated abdominal wall hematoma is a potentially serious, life-threatening complication requiring invasive therapeutic interven-tion in most cases. In some caseshowever the conser-vative treatment with cryoprecipitate and fresh frozen plasma can also be quite effective. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Immunohistochemical Expression of Epidermal Growth Factor Receptor in Hepatocellular Carcinoma(Macedonian Academy of Sciences and Arts/Sciendo, 2018-12-01); ; ; Epidermal growth factor receptor (EGFR) signaling plays an important role in various cancers, including hepatocellular carcinoma (HCC). We aimed to evaluate immunoexpression of EGFR in HCC and surrounding non-tumor liver tissue and to correlate it to multiple clinicopathologic data. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Degree of Fibrous Stroma in Pancreatic Ductal Adenocarcinoma Does Not Serve as A Reliable Marker for Survival: A Case Study(United Prime Publications, 2024-07-16); ; ; ; 1. Introduction: The fibrous stroma (FS) in pancreatic ductal adenocarcinoma develops due to chronic injury during tumor invasion, yet emerging evidence indicates its crucial role in tumor invasion. 2. Aims: This study aims to assess the fibrous stroma percentage (FSP) in pancreatic ductal adenocarcinoma (PDAC) tissue and its corelation with various factors including gender, tumor size, lymphatic and vascular invasion, distant metastases, tumor grade, disease stage and overall survival. 3. Materials and Methods: We enrolled 62 patients categorized into two groups based on FSP percentage in tumor tissue: group with FSP ≤ 50% and group with FSP > 50%. FSP was determined using the Prika method, modified to fit two-tiered system of low and high degree of FS. Correlations between FSP and gender, tumor size, lymphatic and vascular invasion, distant metastases, stage, grade, and survival were assessed. 4. Results: FSP in tumor tissue exceeding 50% was observed more in females compared to males. FSP more than 50% was prevalent in larger tumors, and in tumors infiltrating the celiac plexus. While FSP in stage III tumors was slightly higher, no statistically significant difference was found. Interestingly, FSP below 50% was more common in patients with distant metastases. 5. Conclusions: Although higher FSP correlated with larger tumors, poorer differentiation, more advanced stage, and presence of lymphatic invasion, patients with FSP below and above 50% did not significantly differ in terms of survival time.