Petrushevska marinkovikj, Sanja

Preferred name
Petrushevska marinkovikj, Sanja
Official Name
Petrushevska marinkovikj, Sanja
Translated Name
Petrusevska Marinkovic Sanja
Main Affiliation
Email
sanjapm@yahoo.com
Researcher ID
https://orcid.org/0009-0009-3224-2016

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    Avascular Necrosis of the Hip Joint and Femoral Head Related with Long COVID-19 or Post-COVID-19: Case Report Study
    (Scientific Foundation SPIROSKI, 2024-02-25)
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    Jovanovski, Mario
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    Savin, Tanja
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    Novachkova-Siljanovska, Bojana
    <jats:p>BACKGROUND: Post-COVID conditions can include a wide range of ongoing health problems. As a consequence of long COVID-19 or post-COVID-19 an increase in osteonecrosis has been detected in different series of patients. CASE PRESENTATION: We present two patients diagnosed with COVID-19 and pneumonia, one with moderate and the other with severe clinical picture. They were treated with corticosteroid equivalent to prednisolone 993.5 mg (400–1587 mg) which correlates with steroid dose documented in the literature as causative for avascular necrosis (ANV) in patients with COVID-19. After the mean time of 65 days, due to pain in the groin and difficulty in movement, magnetic resonance imaging (MRI) was performed in both patients and AVN was diagnosed. Compared to our results, the literature records a longer time required for the development of AVN in patients without COVID-19, which is 6–36 months. This indicates the potency of the virus itself to cause disturbances in the microcirculation, and thus the development of AVN. The bone damage correlates with the degree of inflammation and the severity of the clinical picture. CONCLUSION: After a course of COVID-19 as part of a long COVID-19, ANV should be considered a possible complication, especially in patients who have clinical manifestations. Early detection of AVN and diagnosis using MRI on clinical suspicion would help early intervention with bisphosphonate therapy in patients with osteonecrosis of the hip. If the disease is detected in the more advanced stage, it is necessary to perform a surgical intervention and even a possible hip replacement.</jats:p>
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    ANTIPHOSPHOLIPID-LIKE SYNDROME INDUCED BY COVID19: A CASE REPORT STUDY
    (Macedonian Association of Anatomists, 2024)
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    Anastasovski, Ankcia
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    Abstract Many patients with severe COVID-19 present with coagulation abnormalities associated with severe infections, such as disseminated intravascular coagulation or trombotic mycroangiopathy. That’s why is important to pay attention to the differential diagnoses of COVID-19 and other diseases following thrombotic events. Antiphospholipid syndrome is an autoimmune disorder characterized by thrombosis. The diagnosis criteria for antiphospholipid syndrome are based on the detection of abnormal levels of at least one of the most common antiphospholipid antibodies . In this study, we discuss the relationship between COVID-19, antiphospholipid syndrome and antiphospholipid syndrome -like phenomenon, and thrombosis that may occur. We present a 60-year-old woman hospitalized for COVID-19 and pneumonia with a moderately severe clinical picture. During the hospitalization under anticoagulant therapy, she developed coagulation disorders with prolonged active partial thromboplastin time, positive lupus anticoagulant and positive beta-2glycoprotein. The coagulation disorder is in addition to antiphospholipid syndrome, which is associated with the possibility of bleeding in the patient. Elevated levels of the isotypes of antiphospholipid antibodies in COVId-19 patients create antiphospholipid syndrome-like condition. Considering the high rate of mortality due to coagulation abnormalities and thrombosis among COVID-19 patients, it is important to pay attention to the differential diagnoses of COVID-19 and other diseases following thrombotic events, as well as their implication on the therapeutic approach to patients. Current data recommend the use of prophylactic anticoagulation with low molecular weight heparin in hospitalized patients with COVID-19 regardless of the severity of the clinical picture.
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    Pulmonary embolism in a patient with COVID-19 pneumonia despite satisfying anticoagulation status
    (Department of Anesthesia and Reanimation, Faculty of Medicine, "Ss Cyril and Methodius" University, Skopje, R. N. Macedonia, 2022-12)
    Jovanoski M
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    Introduction: COVID-19 disease is a disease related to many complications, some of them are life threatening. Venous thromboembolism is one of the cardiovascular causes (the third in mortality in the group of cardiovascular diseases), which can lead to serious morbidity and even mortality. Aim: To present the fact that a quality anticoagulation therapy is not always a 100 percent safe mechanism of dealing with VTE. Case Report: This case report is about a patient which was presented with a clinical condition related to COVID-19 bilateral bronchopneumonia. As such, she was treated with all the necessary medications, but after a VTE occurred as one of the complications, we had to upgrade the doses of anticoagulation to a therapeutic status. The CT angiography showing lobar and subsegmental pulmonary embolism was the gold standard to confirm the diagnosis. The effect of the LWMH which was used for the VTE was controlled by measuring the anti-Xa blood level. A further correction of the doses and types of antibiotics had to be done because of medications related thrombocytopenia which made the condition even more difficult to fight with. Conclusion: Using the antiXa as a tool to control the anticoagulation status in VTE patients can be a valuable thing to do. However, we must be always thorough in observing the clinical condition of the patient and be aware of the complications which can happen.
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    Analysis of Antibiotic Treatment and Microbiological Findings and Its Implication on Outcome in Patients with Parapneumonic Effusions
    (Scientific Foundation SPIROSKI, 2024-06-02)
    <jats:p>BACKGROUND: Parapneumonic effusion (PPE), as a complication of community-acquired pneumonia, sometimes progresses into complicated PPE (CPPE) and empyema, thus becoming a significant clinical problem. There is a lack of guidelines for antibiotic therapy and reports on local microbiological status and resistance of microorganisms. AIM: Тhe paper is focused on the analysis of antibiotic therapy and microbiological findings that are affecting patient outcomes and length of treatment. METHODS: We analyzed 94 patients, 50 with uncomplicated PPE (UCPPE) and 44 with CPPEs. RESULTS: More patients (59.57%) were male, average age 53.82 ± 17.5 years. Alcoholism was the most common comorbidity in patients with CPPE registered in 25% of patients. A positive pleural punctate culture was present in 31.82% of patients with CPPE. Peptostreptococcus was most often isolated in 28.57%. Blood culture was positive in 12.76% of patients. Most of the patients were treated with combined therapy that also covered anerobes (64.89%). Statistical differences existed in terms of days of hospital treatment with a longer hospital stay for patients with CPPE (p < 0.0001). The average time of hospital treatment in patients with UCPPE was 15 days, and in patients with CPPE, it was 21 days. CONCLUSION: As soon as a pleural infection is noted, patients should receive antibiotic therapy, which should be based on pleural fluid culture. Anerobic coverage is required. In this way, the development of CPPE and empyema will be prevented, and thus, mortality and long hospital stays will be reduced.</jats:p>
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    Prevalence of Rotaviruses in the Etiology of Acute Diarrhea in Young Children, Clinical forms, Extraintestinal Manifestations and Complications
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2020-11-01)
    Stojkovska, Snezana
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    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.