Influence of fibrinogen and C-RP on progression of peripheral arterial disease in type 2 diabetes: A preliminary report

BACKGROUND: Limited studies have suggested that inflammatory biomarkers play a role in the initiation and progression of atherosclerosis in diabetic patients. This study assesses the effect of inflammatory biomarkers: fibrinogen and C-reactive protein (C-RP) on the progression of peripheral arterial disease (PAD) in type 2 diabetic (T2D) patients. METHODS: Sixty two patients with T2D and PAD (mean age 60.28 ± 27 years and diabetes duration of 8.58 ± 6.17 years) were enrolled in a cohort prospective study of 36 months. Ankle-brachial index (ABI) was measured in all patients at baseline and after 36 months. Multiple linear regression analysis was used to determine the predictivity of variables for fibrinogen, C-RP, plasma lipid fractions, fasting plasma glucose, Body Mass Index (BMI), duration of diabetes status and the age on changes in ABI value. RESULTS: Linear regression analysis defined F as a predictor for endpoint value of ABI (β = 0.469, p = 0.007). Value of C-RP determinates change of minimal value of ABI (β = 0.449, p = 0.037) and change of mean ABI per year (β = 0.442, p = 0.025). CONCLUSION: Our data indicate that plasma determination of fibrinogen and C-RP might have a clinical implication in defining the process of progression of PAD in T2D population

Radiologic presenaticion of lung complications in COVID-19 patients and their diferentiation

Abstract:Covid-19 is a contagious acute viral disease which mostly affects the lungs. It is caused by the new variety SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was detected for the first time in 2019, while in March 2020 it was declared a pandemic by WHO (World Health Organization). The pandemic lasted for three years.The most common way of transmission is directly by airborne particles through coughing, sneezing, talking and breathing. The clinical image is general signs and symptoms (fatigue, fever, headache, muscle and body aches) as well as specific signs and symptoms such as: throat pain, dry cough, loss of smell/ taste, gastrointestinal implications mostly in children, as well as typical signs and symptoms arising from the above mentioned complications.The first and mostly affected organ in Covid-19 patients is the lungs. Pneumonia, pleuropneumonia, pleuritis and bronchopneumonia are some of the lung complications in Covid-19 patients. The radiological presentation in Covid-19 patients with or without complications is atypical and distinctive. The X-ray is a secondary diagnostic method because of the X-ray exposure, however in the patients with lung complications this is the first and basic choice of differentiation. Keywords:Covid-19, pneumonia, pleuropneumonia, pleuritis

Radiologic presenaticion of lung complications in COVID-19 patients and their diferentiation

Abstract:Covid-19 is a contagious acute viral disease which mostly affects the lungs. It is caused by the new variety SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was detected for the first time in 2019, while in March 2020 it was declared a pandemic by WHO (World Health Organization). The pandemic lasted for three years.The most common way of transmission is directly by airborne particles through coughing, sneezing, talking and breathing. The clinical image is general signs and symptoms (fatigue, fever, headache, muscle and body aches) as well as specific signs and symptoms such as: throat pain, dry cough, loss of smell/ taste, gastrointestinal implications mostly in children, as well as typical signs and symptoms arising from the above mentioned complications.The first and mostly affected organ in Covid-19 patients is the lungs. Pneumonia, pleuropneumonia, pleuritis and bronchopneumonia are some of the lung complications in Covid-19 patients. The radiological presentation in Covid-19 patients with or without complications is atypical and distinctive. The X-ray is a secondary diagnostic method because of the X-ray exposure, however in the patients with lung complications this is the first and basic choice of differentiation. Keywords:Covid-19, pneumonia, pleuropneumonia, pleuritis

Demographic characteristics of COVID-19 patients followed by x-ray in the general hospital in Kochani in the period between 09.2020 - 09.2022

In March 2020, The World Health Organization - WHO declared COVID 19 pandemics (Coronavirus disease 2019) caused by the virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). WHO declared the end of the pandemics on May 5, 2023 with a total of 765 222 932 infected people in the whole world and almost 7 million deaths. In PHI General Hospital with Extended Activity - Kochani, as one of the COVID-19 centers, the patients from the east of the country (Kochani, Vinica, M. Kamenica, Delchevo, Berovo, Pehchevo, Zrnovci and the municipality of Chesinovo-Obleshevo) were followed roentgenologically. The pathogenesis of SARS-CoV-2 on the lung parenchyma is the main factor in the roentgenological presentation of the disease. The main goal of the research is the analysis of comparison of the demographic characteristics of COVID-19 patients and those of patients with other lung diseases which were also followed in the hospital in Kochani. Subject: retrospective-prospective study of roentgenograms (taken in the hospital) of lungs in one projection divided in three groups (group A, group B and control group O). Methods: statistical analysis of the demographic data of COVID-19 patients and patients with non-COVID-19 lung diseases in the hospital in Kochani. The number of people infected with COVID-19 is higher in the urban environment, also there is a difference in the male-female percentage among the A, B and O group and in all three groups in which the research was conducted it was noticed that the highest number of infected people is of the age group between 60-70 years old. Key words: COVID-19, roentgenogram, statistical demographic analysis

Effect of Covid-19 pandemic on influenza burden

Flu or influenza is a contagious viral disease that most often occurs in the autumn and winter months with symptoms that are typical for infections of the upper and lower respiratory tract. According to the World Health Organization, lower respiratory tract infections are the fourth leading cause of death in the world. Due to the huge mortality (about 290 000 to 650 000 annually), especially among vulnerable populations with acute heart failure, chronic pulmonary disease, diabetes etc; as well as the increased incidence of acute complications: myocarditis, encephalitis, myositis, respiratory and kidney failure; and worsened long-term medical conditions, information regarding the burden with respiratory viruses, in the direction of public health protection are very important. There are several types of influenza viruses (A, B, C and D), of which the most common in humans are viruses type A (H3N2, H1Npdm09), known as a cause of outbreaks and pandemic, and type B (B/Yamagata or B/Victoria lineage). During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, a significant global decrease in influenza cases was recorded. It is believed that the restrictive measures taken to reduce the transmission of SARS-CoV-2, such as: social distancing, wearing masks and increased hygiene measures, as well as restrictions on travel and movement, are the main factors that caused a decrease in the influenza burden and probably had a huge impact in preventing the spread of influenza and other respiratory pathogens The aim of this research is to make a retrospective analysis of detected influenza virus before, during and after the SARS-CoV-2 pandemic, and to determine the impact of SARS-CoV-2 on the burden and occurrence of influenza in the R. N Macedonia. The analysis is conducted on reported influenza cases and samples tested with Reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2, influenza type A and B at the Institute of Public Health in the period January 201 - June 2023. Out of 129,114, total reported cases from 2016 – 2023, 15 379 cases were reported during the SARS-CoV-2 pandemic seasons with the lower number of 1127 reported cases in the 2020/21 season and 3690 in the 2021/22. Lower number of samples tested (only 35) and the smallest positivity rate for influenza of 5,71% was observed 2020/2021, in comparison with positivity rate before pandemic from 37,21 – 50,29%. Different serotypes dominate during the analysed seasons. Influenza e A(H3N2) is dominantly detected in 3 seasons (2016/17, 2018.19 and 2021/22), although there are seasons with domination of A(H1N1) pdm09. From the analyzed seasons, a decreased number of reported influenza cases during the period of highest SARS-CoV-2 activity and adherence to restrictive measures is observed

Facing of Family Doctor with Hantavirus Infection

BACKGROUND: Hantavirus infection is manifested as an urgent, severe and life-threatening disease caused by Hantavirus. The virus affects human endothelial cells. The natural reservoir of the Hantaviruses is chronically infected rodents. Human infection is accidental. Occurs by intake of contaminated food or inhalation of contaminated secretion from infected rodents' excretions have an increased risk of contamination. The most affected persons are people who work in nature. The virus causes haemorrhages, fever and acute renal failure. The disease appears more frequently in endemic regions with the lethality of 6-15%. The disease can surprise doctors with severity, urgency and undefined clinical picture. Fast clinical evaluation, proper and urgent diagnosis and treatment can improve the safe life of these patients. CASE REPORT: We report a case of 45 -year-old male patient worked as a shepherd on mountain Babuna near the city of Veles in the Republic of Macedonia at the end of the summer in the year 2017, presented with prolonged hemorrhagic fever with renal syndrome. The clinical presentation and lab findings support the diagnosis of Hantavirus infection with acute renal failure. CONCLUSION: It is necessary to raise the awareness of the family doctors for the hantavirus disease, especially in countries with sporadic cases, as in our country. It needs for prompt and timely diagnosis, timely hospitalisation and initiation of therapy

Excess Mortality in a Nephrology Clinic during First Months of Coronavirus Disease-19 Pandemic: A Pragmatic Approach

BACKGROUND: Excess mortality is defined as mortality above what would be expected based on the non-crisis mortality rate in the population of interest. AIM: In this study, we aimed to access weather the coronavirus disease (COVID)-19 pandemic had impact on the in-hospital mortality during the first 6 months of the year and compare it with the data from the previous years. METHODS: A retroprospective study was conducted at the University Clinic of Nephrology Skopje, Republic of Macedonia. In-hospital mortality rates were calculated for the first half of the year (01.01–30.06) from 2015 until 2020, as monthly number of dead patients divided by the number of non-elective hospitalized patents in the same period. The excess mortality rate (p-score) was calculated as ratio or percentage of excess deaths relative to expected average deaths: (Observed mortality rate–expected average death rate)/expected average death rate *100%. RESULTS: The expected (average) overall death mortality rate for the period 2015–2019 was 8.9% and for 2020 was 15.3%. The calculated overall excess mortality in 2020 was 72% (pscore 0.72). CONCLUSION: In this pragmatic study, we have provided clear evidence of high excess mortality at our nephrology clinic during the 1st months of the COVID-19 pandemic. The delayed referral of patients due to the patient and health care system-related factors might partially explain the excess mortality during pandemic crises. Further analysis is needed to estimate unrecognized probable COVID-19 deaths

European survey on laboratory preparedness, response and diagnostic capacity for crimean-congo haemorrhagic fever, 2012

Crimean-Congo haemorrhagic fever (CCHF) is an infectious viral disease that has (re-)emerged in the last decade in south-eastern Europe, and there is a risk for further geographical expansion to western Europe. Here we report the results of a survey covering 28 countries, conducted in 2012 among the member laboratories of the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD) to assess laboratory preparedness and response capacities for CCHF. The answers of 31 laboratories of the European region regarding CCHF case definition, training necessity, biosafety, quality assurance and diagnostic tests are presented. In addition, we identifi

Setting a baseline for global urban virome surveillance in sewage

The rapid development of megacities, and their growing connectedness across the world is becoming a distinct driver for emerging disease outbreaks. Early detection of unusual disease emergence and spread should therefore include such cities as part of risk-based surveillance. A catch-all metagenomic sequencing approach of urban sewage could potentially provide an unbiased insight into the dynamics of viral pathogens circulating in a community irrespective of access to care, a potential which already has been proven for the surveillance of poliovirus. Here, we present a detailed characterization of sewage viromes from a snapshot of 81 high density urban areas across the globe, including in-depth assessment of potential biases, as a proof of concept for catch-all viral pathogen surveillance. We show the ability to detect a wide range of viruses and geographical and seasonal differences for specific viral groups. Our findings offer a cross-sectional baseline for further research in viral surveillance from urban sewage samples and place previous studies in a global perspective