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    Insight in the Current Progress in the Largest Clinical Trials for Covid-19 Drug Management (As of January 2021)
    (Macedonian Academy of Sciences and Arts/Sciendo, 2021-04-23)
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    Ridova Nevenka
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    Stojanoska, Tatjana
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    Abstract The outbreak of the COVID-19 pandemic has generated the largest global health crisis of the 21st century, evolving into accelerating socioeconomic disruption. In spite of all rapidly and widely emerging scientific data on epidemiology, diagnosis, prevention and treatment of the COVID-19 disease, severe acute respiratory coronavirus 2 (SARS-CoV-2) is continuing to propagate in lack of definitive and specific therapeutic agents. Current therapeutic strategies are mainly focused on viral inhibition by antiviral drugs and hampering the exuberant immune response of the host by immunomodulatory drugs. In this review, we have studied the reports of the largest clinical trials intended to COVID-19 treatment published during the first year of the pandemics. In general, these results concentrate on seven therapeutic options: remdesivir, chloroguine/hydroxychloroquine, lopinavir-ritonavir combination, corticosteroids, tocilizumab, convalescent plasma and monoclonal antibodies. In line with the reviewed data, as of January 2021, most of the evidence support the use of remdesivir in hospitalized patients with moderate and severe forms of the disease and provide reliable data on the substantial beneficial effect of corticosteroids in patients requiring supplemental oxygen. Moreover, preliminary RECOVERY trial results have demonstrated the efficacy of tociluzumab in the treatment of critically ill patients. The reports presenting the outcomes of the other immune-based therapies under investigation are enthusiastically awaited.
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    Density of truck traffic on residential streets and the impact on asthma and asthma-like symptoms in childhood
    (European Respiratory Soc Journals LTD, 2016-09)
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    Kimovska, Mica
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    Background: Conflicting results have been reported, mostly in developed countries, on the relationship between traffic exposure and asthma. The aim of this study was to examine the impact of truck traffic exposure on childhood asthma in The Republic of Macedonia, as a developing country with a moderate rate of high truck traffic exposure, high dietary antioxidants intake, and previously reported low prevalence of asthma. Methods: Parental-reported data was used, obtained through standardized surveys in winter 2015-16. There were 1945 children aged 5-15 years from randomly selected schools in Skopje, the capital of Macedonia, who took part. The association between truck traffic density on residential streets on weekdays with wheeze 'ever', current wheeze, current exercise-induced wheeze, current dry night cough apart from a cold and doctor-diagnosed asthma was investigated after adjusting for potential confounders using binary multiple logistic regression. Results: Truck traffic density exposure almost the whole day was found to be 9.6%, frequently through the day 30.2%, seldom 47.7% and never 11.9%. The exposure almost the whole day increased the risk of current wheeze (aOR: 2.84; 1.20-6.70; p=0.017), wheeze 'ever' (aOR: 1.55; 0.98-2.45; p=0.061), exercise-induced wheeze (aOR: 4.19; 0.85-20.62; p=0.078) and dry night cough (aOR: 1.78; 0.96-3.33; p=0.068). There was no association with the other investigated variables, including diagnosed asthma. Conclusion: The findings suggest an adverse effect of high truck traffic exposure on asthma-like symptoms, but not on asthma, which support the hypothesis that components of air pollution act as non-specific respiratory irritants.
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    CML-053 Health-Related Quality of Life in Macedonian Patients with Chronic Myeloid Leukemia Treated with Tyrosine Kinase Inhibitors: EQ-5D-5L Assessment
    (Elsevier BV, 2024-09)
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    Popova Labachevska, Marija
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    Stojanovska Jakimovska, Simona
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    Trpkovska Terzieva, Slobodanka
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    Temporal trends in asthma and asthma-like symptom prevalence in Skopje, The Republic of Macedonia
    (European Respiratory Soc Journals LTD, 2016-09)
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    Kimovska, Mica
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    Seckova, Lidija
    Background: There have been differences in temporal trends of asthma prevalence by geographic region. It is important to consider local patterns to plan health care. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of Macedonia as a developing country. Methods: Data was obtained from 3 cross-sectional surveys (2002, 2006 and 2015) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounders. Results: The prevalence of asthma increased although the changes were not statistically significant (2002: 1.7%; 2006: 2.1%; 2015: 2.6%; p=0.13). The prevalence of ever wheeze differed by year (2002: 18.4%; 2006: 15.3%; 2015: 26.4%; p<0.001). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006 and 2015) were observed for current wheeze (8.8%, 7.2% and 5.9%), exercise-induced wheeze (14.2%, 7.9% and 2.1%), and night cough (16.5%, 13.6% and 10.2%). After adjustment for potential confounders, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.35, 95%CI=0.74-2.44; 2015: OR=2.12, 95%CI=1.04-4.35). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results. Conclusion: A significant decrease in asthma symptoms contrary to a slight increase in asthma diagnosis in Skopje during a period of 13 years was established. Improved diagnostics and treatment may explain some of these changes.
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    Effectiveness of Ropeginterferon Alfa-2B in High-Risk Patients with Philadelphia Chromosome Negative Myeloproliferative Neoplasms- Evaluation of Clinicohaematologic Response, and Safety Profile: Single Centre Experience
    (Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH, 2023-12-01)
    Popova-Labachevska, Marija
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    Stojanovska-Jakimovska, Simona
    Background: Treatment of Philadelphia chromosome negative myeloproliferative neoplasms (Ph - MPNs) requires individualized approach depending on multiple factors. Novel pegylated Interferon (IFN) formulations have become an attractive therapeutic option in young Ph- MPN patients associated with better patient compliance. Methods: In this retrospective observational study a total of 16 high-risk Ph- MPN patients treated off-label with ropeginterferon alfa-2b given twice monthly, were included. Median follow-up was 24 months. High-risk patients were defined using the IPSET score. Response to treatment was evaluated using ELN, IWG-MET EUMNET standardized criteria and occurrence of side effects was documented. Results: 11 patients were female (68.8%) and 5 male (31.2%); average age at diagnosis was 36 years (17-51); 12 patients (75%) had ET, one (6.2%) PV and three (18.8%) hypercellular phase of PMF. JAK2V617F mutation was detected in 10 patients (62.5%), CALR in three (18.8%), and three (18.7%) were triple-negative cases. In 7 patients (43.7%), ropeginterferon alfa-2b was used in first-line, and 9 (56.3%) were previously treated with HU and/or standard IFN. Among initially ropeginterferon alfa-2b treated patients, complete haematological response was observed in 4/7 (57.1%), partial in 2/7 (28.6%) and suboptimal in one (14.3%). Complete haematological response was observed in 8/9 (88.9%) among previously treated patients. Average time to blood count normalization was 8 weeks, at a dose ranging between 100mcg and 300mcg. Side effects were observed in one patient (6.2%). Conclusion: Our experience is in support of previous studies regarding ropeginterferon alfa-2b efficacy and safety profile in the treatment of young patients with Ph- MPNs.
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    Long-Term Efficacy of Treatment in Elderly Patients With Hodgkin Lymphoma: A Retrospective Analysis
    (Elsevier BV, 2024-09)
    Terzieva, Slobodanka Trpkovska
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    AUTOIMMUNE HEMOLITYC ANEMIA IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA: SINGLE CENTER EXPERIENCE
    (Macedonian Association of Anatomists, 2024)
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    Popova-Labacevska, Marija
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    Haploidentical Stem Cell Transplantation in Patients with Myelodysplastic Syndrome: Case Report First Experience
    (Scientific Foundation SPIROSKI, 2021-11-23)
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    Popova-Labachevska, Marija
    <jats:p>  BACKGROUND: Allogeneic stem cell transplantation (ASCT) is a potentially curative therapeutic approach in patients with intermediate and high-risk myelodysplastic syndrome (MDS). If a family sibling or unrelated donor is not available mismatched donors are viable option for young patients with no comorbidities. The aim of this case presentation was to evaluate our first experience with haploidentical transplantation for this indication. CASE PRESENTATION: We present a case of 50 years male patient with myelodysplastic syndrome (MDS) diagnosed at University Clinic for hematology, Skopje, North Macedonia. Patient was scored in IPSS -R as high risk patient. He was referred for HLA DNA typing of family siblings and since he didn’t have identical sibling and unrelated donor, he was referred to continue treatment with haploidentical stem cell transplantation. He received Flu Bu conditioning and PTCY, cyclosporine and MMF for GVHD prophylaxis. Peripheral blood stem cells (PBSC) from his mismatched brother were infused in the amount of CD34=5.8x106/kg. He experienced prolonged engraftment, severe infective bacterial infections and CMV reactivation with clinical manifestation of CMV colitis. He was successfully treated with antiviral drug and completely resolved. His bone marrow analysis showed complete remission and chimerism evaluation revealed high donor engraftment. Patient is now +34 months post transplant in complete remission. CONCLUSION: The use of a mismatched donor increases the risk of NRM, but there is also evidence to suggest that an haploidentical donor is a valid choice, as general outcome appears to be at least similar to MUD.</jats:p>
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    Poster: MM-326: Visceral Leishmaniasis Mimicking Multiple Myeloma
    (Elsevier BV, 2021-09)
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    Stojanovska, Simona
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