Brezovska Kavrakova, Julijana
Preferred name
Brezovska Kavrakova, Julijana
Official Name
Brezovska Kavrakova, Julijana
Alternative Name
J.Brezovska Kavrakova
J. Brezovska
J. Kavrakova
Brezovska Kavrakova J
Kavrakova J
Brezovska J
Main Affiliation
Email
julijana.brezovska@medf.ukim.edu.mk
60 results
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Item type:Publication, Hyperhomocysteinemia in patients with coronary artery disease(2016-09); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of urinary podocalyxin in early diagnosis of diabetic nephropathy(Sciendo, 2020-08-10); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prevalence of metabolic syndrom in patients with psoriasis(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2019); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The evaluation of some markers of proximal renal tubules damage in patient with psoriatic arthritis(Macedonian Medical Association, 2018); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of Post-Transplant Dysglycemia on Renal Allogrfat Function in Kidney Transplant Recipients on Cyclosporine-Based Immunosuppression(Македонско лекарско друштво / Walter de Gruyter GmbH, 2017-06-01); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Quality management: illuminating the path to ISO 15189 accreditation - A view from the Republic of North Macedonia(Turkish Biochemical Society, 2019); ; ; In the Republic of North Macedonia the work of the diagnostic medical laboratories is regulated by the Law of Health Care. There is an urgent need for better development of an evidence-based, scientific, and sustainable national strategy for the improvement of health laboratory service. Clear indicators of improvement must be established. A key indicator should be the number of laboratories that have achieved, and can maintain accreditation. The Macedonian Society of Medical Biochemistry and Laboratory Medicine (MSMBLM) recommends that the quality system established meet the requirements of the International Standard for medical laboratories (‘Medical laboratories: Requirements for quality and competence ’[EN ISO 15189:2012]), which has been accepted as the fundamental standard for the accreditation of medical laboratories in European countries. EN ISO 15189 was developed as a baseline standard for the Quality Management System (QMS) in medical laboratories and is recognised as the connecting standard for all disciplines in laboratory medicine. With the acceptance of the ISO standard, the need of countries for their own QMS for laboratory medicine no longer existed. In 2013, the Standardisation Institute of the Republic of North Macedonia accepted the standard as the Macedonian norm for quality assessment of medical laboratories (MKS EN ISO 15189:2013). MSMBLM, as the professional society of specialists in medical biochemistry, is responsible for the translation of international guidelines into national guidelines. These guidelines have to be in agreement with the standard EN ISO 15189. For that purpose, cooperation between MSMBLM and the National Accreditation Body (Institute for accreditation of the Republic of North Macedonia), as well as cooperation between international medical laboratory organisations, such as International Federation of Clinical Chemistry (IFCC), European Federation of Laboratory Medicine (EFLM) and international accreditation bodies, such as International Laboratory Accreditation Cooperation (ILAC) is essential. The accreditation of Macedonian medical laboratories is not mandatory; the decision for accreditation is voluntary. Accreditation is accessible to every client submitting an accreditation application to the Institute of Accreditation, which has been a member of ILAC since 2008. In 2013, the first medical biochemistry laboratory was accredited in the country. So far, nine medical laboratories have been accredited according the MKS EN ISO 15189:2013. Four of them are public sector laboratories. Flexible scope is not yet started for the ISO 15189 accreditation process in North Macedonia. The medicalized steps, including test’s selection advice and interpretation of results are not included in accreditation process. Diagnostic laboratories of the Institute of pathology, Medical Faculty-Skopje and Research Center for Genetic Engineering and Biotechnology “Georgi D. Efremov (Macedonian Academy of Sciences and Arts) are also using ISO 17025 as additional standard. The low number of accredited laboratories could be the result of the shortage of financial resources, poor government attention to laboratory service, the shortage of qualified personnel and/or the lack of a national laboratory policy. The experiences of laboratory professionals from accredited laboratories, who have a high level of knowledge, skills, and competence, are crucially important to the process of developing a competent laboratory service within the national health system. The implementation of the Laboratory Quality Management system (LQMS) requires support of laboratories by the MSMBLM and close collaboration between specialists in laboratory medicine (medical biochemistry), technical assessors, and consultants. Each of them will give a different perspective on what should be prioritised. Implementation of a QMS should be a stepwise process but it is necessary to start with changes that can be easily accomplished and have the biggest impact. All quality essentials must be addressed. Appropriate laboratory facilities, infrastructure, and equipment for each laboratory tier level are essential to enable safely and efficient performance. Strong programs supporting quality assurance, quality control, and quality improvement should exist. They are fundamental for the establishment, maintenance and improvement of laboratory quality systems. SOPs must be well-written, understood, and implemented; laboratory personnel should routinely perform IQCs; and laboratories must be required to participate in EQA or proficiency testing (PT) programmes. Future directions: The globalisation of markets and migration of health professionals requires improving the laboratory diagnostic process. A quality laboratory system is the foundation of a strong national health system. Laboratory workforce, infrastructure, and quality management system are vital for the delivery of quality laboratory services. Coordination with the Ministries of Education and Health is essential for maintaining standards of education and levels of knowledge. The competency of laboratory professionals has to be maintained through mandatory participation in continuous medical education (CME). For Government, Ministry of Health, professional association(s) and stakeholders, accreditation of medical laboratories according to ISO 15189:2012 should be a high priority. They should act together and undertake coordinated efforts to integrate accreditation programs into national health policy, planning, and health development programmes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Hyperhomocysteinemia and the Methylenetetrahydrofolate Reductase (C677T) Genetic Polymorphism in Patients with Deep Vein Thrombosis(ScopeMed Publishing, 2013); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Lipoprotein(a) - Link between Atherogenesis and Thrombosis(Charles University in Prague, Karolinum Press, 2019); ; ; Lipoprotein(a) - Lp(a) - is an independent risk factor for cardiovascular disease (CVD). Indeed, individuals with plasma concentrations of Lp(a) > 200 mg/l carry an increased risk of developing CVD. Circulating levels of Lp(a) are remarkably resistant to common lipid lowering therapies, currently available treatment for reduction of Lp(a) is plasma apheresis, which is costly and labour intensive. The Lp(a) molecule is composed of two parts: LDL/apoB-100 core and glycoprotein, apolipoprotein(a) - Apo(a), both of them can interact with components of the coagulation cascade, inflammatory pathways and blood vessel cells (smooth muscle cells and endothelial cells). Therefore, it is very important to determine the molecular pathways by which Lp(a) affect the vascular system in order to design therapeutics for targeting the Lp(a) cellular effects. This paper summarises the cellular effects and molecular mechanisms by which Lp(a) participate in atherogenesis, thrombogenesis, inflammation and development of cardiovascular diseases. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ACUTE PANCREATITIS AS ADVERSE REACTION ТО PERINDOPRIL THERAPY(2019); ; ; Many drugs and drug classes have been reported to be associated with acute pancreatitis. Angiotensin-converting enzyme inhibitors are one of the most commonly prescribed classes of medications, as they are used in hypertension, heart failure and proteinuria. Although well tolerated, acute pancreatitis has been reported in a few subjects treated with drugs from this group. We present a rare case of pancreatitis occurring as an adverse reaction to therapeutic doses of perindopril with good outcome. Case report: We report а case of a 63 year-old-woman presented with clinical signs of acute pancreatitis, 2 months after administration of perindopril 4 mg once daily for treatment of hypertension and reduction of proteinuria. The patient has had a 3-year-history of diabetes treated with metformin 2 x 850 mg daily, which is also classified as a possible drug that causes pancreatitis. Other causes of the disease were ruled out. After cessation of perindopril her clinical status improved and pancreatic enzymes level decreased. Conclusion: Because perindopril has a widespread clinical use, we wish to alert clinicians and urge close monitoring for pancreatitis as well as other adverse effects. Discontinuation of the drug leads to an improvement in the clinical condition.