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47 result(s) for "Maric, Nikola"
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King’s Sarcoidosis Questionnaire (KSQ) – Validation study in Serbian speaking population of sarcoidosis patients
Introduction Sarcoidosis is a multiorgan, multisystem chronic disease of unknown etiology and unpredictable course. Health status is reduced in sarcoidosis and assessing it is a difficult multitask effort due to many faces this disease might have. Recently, a new questionnaire for assessing health status in sarcoidosis was developed by a group of authors from England-King's Sarcoidosis Questionnaire (KSQ). The benefit of KSQ is the ability to develop the best care plan for the patient, as well as to differentiate the efficacy of the administered treatment. Objective The aim of this study was to validate the KSQ in Serbian speaking population of sarcoidosis patients. The test itself is a modular, multi-organ health status measure for patients with sarcoidosis for use in clinic and the evaluation of therapies. The correlation of KSQ with different clinical course of sarcoidosis (acute vs chronic disease) and with the clinical outcome status (COS) in sarcoidosis was also investigated. Methods A total of 159 biopsy positive sarcoidosis patients participated in this study. The average age of the participants was 49.67, majority was female (67.3%) and majority had only pulmonary form of sarcoidosis (71.7%). KSQ - new disease-specific health status instrument, was compared with 5 other already existing instruments already used and validated in sarcoidosis (Saint George Respiratory Questionnaire- SGRQ, Daily Activity List -DAL, Fatigue Assessment Scale- FAS, Medical Research Council dyspnea scale-MRC, Borg Dyspnea Scale and 15D as general questionnaire. Results KSQ has significant correlation with other quality of life questionnaires already used in sarcoidosis. Translated version of KSQ shows significant internal reliability, similar to the original KSQ. Serbian version of KSQ has significant correlation with different clinical course of sarcoidosis and with COS as well. The translated version of KSQ is reliable sarcoidosis specific instrument for assessing health status in these patients.
Clinical Characteristics and Survival of Patients with Idiopathic Pulmonary Fibrosis: Analysis of the Serbian Cohort from the EMPIRE Registry
Background/Objectives: Idiopathic pulmonary fibrosis (IPF) registries are established to enhance understanding of its natural history. Methods: Serbia (RS) participated in the EMPIRE (European Multi-Partner IPF Registry) from June 2015 to October 2022, involving four centers. The registry included patients over 18 diagnosed with IPF based on the 2011 international criteria. We aimed to gather key clinical, functional, and survival data, along with treatment information for IPF patients in RS, using a centralized electronic case report for consistency. Results: 188 RS patients participated (median age at diagnosis 65, 63.8% male, 51% smoking history, 56% radiological usual interstitial pneumonia (UIP) pattern). At the diagnosis, median forced vital capacity (FVC) was 73.7% and diffusion capacity for carbon monoxide (DLCO) was 38%. At initiation of antifibrotic therapy, median FVC was 73.2% (71.5% for deceased, 75.8% for survivors (p = 0.455), and DLCO was 33.8% (19.9% for deceased, and 35.6% for survivors (p = 0.046)). The median long-term survival from diagnosis was 29.4 months (95% CI: 22.6–36.2 months), and 9.4 months (95% CI: 5.9–12.9 months) from the initiation of therapy, with no difference in the duration of antifibrotic treatment between survivors and deceased (p = 0.598). Conclusions: The RS EMPIRE cohort represents a younger, less comorbid population with fewer smokers and more probable UIP, factors linked to a favorable prognosis. Nevertheless, survival was poorer than expected, mainly due to advanced disease severity at the time of antifibrotic initiation, as indicated by lower DLCO. These findings highlight the importance of earlier diagnosis and treatment before significant physiological decline to improve outcomes.
Evaluating Tuberculosis and Drug Resistance in Serbia: A Ten-Year Experience from a Tertiary Center
Background: Tuberculosis (TB) remains a leading cause of mortality worldwide, particularly in low- and middle-income countries. The rise of multidrug-resistant TB (MDR-TB) poses significant challenges to global health. This study reviews the experience of the largest pulmonology center in Serbia, a country with low MDR-TB incidence, focusing on TB prevalence, resistance detection, and treatment strategies between 2012 and 2021. Methods: We retrospectively analyzed a total of 1239 patients who were diagnosed and treated for TB in the period from 2012 to 2021 at University Clinical Center of Serbia. Results: Drug resistance was identified in 21 patients (1.7%), with the highest resistance to rifampicin (1.4%) and isoniazid (1.3%). Pyrazinamide and streptomycin resistance were detected in only a few cases. Patients with resistant TB were younger on average, though the difference was not statistically significant (46.4 ± 19.1 vs. 53.6 ± 18.4, p = 0.079). Prior TB history was more frequent in the resistant group, almost reaching statistical significance (4 vs. 82, p = 0.052). Conclusions: These findings underscore the critical importance of sustained surveillance, particularly of latent and drug-resistant TB forms, in alignment with the World Health Organization’s (WHO) TB control strategy to preserve Serbia’s low-incidence status. Moreover, given Serbia’s strategic location on a major migration route, there is an elevated risk of new TB cases emerging and potential shifts in TB-drug-resistance patterns developing in the future.
Knowledge is the most powerful tool in the fight against tuberculosis
Introduction: In October 2022, after almost two years, tuberculosis reclaimed its first place as the world's deadliest infectious disease, replacing COVID-19. Since knowledge is the most powerful tool to combat any disease, the primary goal of our study was to assess patients' knowledge of tuberculosis and its relationship to their socio-demographic status. Methodology: This cross-sectional study included 1,067 respiratory patients who were surveyed between November 2021 and June 2022 at the Institute for Pulmonary Diseases of Vojvodina (Serbia). They completed a questionnaire designed for this study. Results: The majority of patients (53.7%) were female; over two-thirds (70.8%) were ≥ 60 years; every fifth (23.2%) was either with or without primary school; every third (33.3%) was financially poor. Although the majority of patients (97.8%) were aware that tuberculosis is an infectious disease, only 44.2% knew the etiology. Around 3/4 (72.6%) were aware of a tuberculosis vaccine. Hospitalized patients had better knowledge that the vaccine helps prevent tuberculosis than ambulatory patients (p = 0.047). Only 16% of patients in both groups knew that tuberculosis incidence is decreasing in Serbia (p = 0.074). Good knowledge about tuberculosis was reported by 71.5%. Hospitalized patients showed better knowledge than ambulatory patients (p = 0.032). Patients with a higher level of education and higher monthly income were independent predictors of better knowledge of tuberculosis. Conclusions: The study underlines the need to promote knowledge about tuberculosis, particularly among chronic patients, socially vulnerable and refugees, especially in light of the pandemic and emerging economic problems in the region.
Correlation of the severity of the clinical presentation of SARS-CoV-2 pneumonia with respiratory function parameters in the post-COVID period
Introduction: Since COVID-19 first surfaced in 2019, it has seriously threatened public health. The most prevalent symptoms are respiratory ones. This study aimed to present the correlation between the severity of the clinical presentation of the disease and the results of respiratory function tests conducted within 6 months after hospital discharge. Methodology: This retrospective study included 99 patients with confirmed SARS-CoV-2 virus infection. Of all patients 24.2% had accentuated bronchovascular pattern, 9.1% had unilateral, and 29.3% had bilateral pneumonia. In comparison, 35.4% patients had diffuse changes, which were described as acute respiratory distress syndrome (ARDS) on computed tomography (CT). Results: Patients with unilateral, bilateral pneumonia or diffuse lung damage had significantly lower forced vital capacity (FVC) values. They were treated with non-invasive mechanical ventilation (NIV) or invasive mechanical ventilation (MV) and had lower FVC values (0.039). A negative, weak correlation existed between CT findings during the infection and Diffusing capacity for carbon monoxide (DLCO) measured after the infection (0.003). A negative, weak correlation was found between oxygen therapy, the use of NIV, and MV findings during the infection with DLCO. A negative correlation was noted between leukocyte values during the infection and forced expiratory volume in the first second (FEV1) and FVC after the infection. Conclusions: Patients with COVID-19 infection who need oxygen support and MV continue to suffer from loss of respiratory function after the resolution of COVID-19 infection. These findings highlight the negative predictive value of pulmonary tests in the long-term follow-up for the development of PC-ILD as well as decreased pulmonary capacity.
Hyperglycemia and Lung Cancer—A Possible Relationship
Glucose is the main source of energy in human cells. Elevated levels of glucose are one of the most common metabolic disorders, and it has been shown to have a significant, mostly negative, effect on multiple chronic and acute diseases. Lung cancer remains one of the biggest challenges for treatment in modern medicine, with a high prevalence, incidence and mortality. Hyperglycemia is not uncommon in patients with lung cancer; however, it is usually overlooked. Patients with unregulated glycemia and lung cancer have been shown to have worse outcomes, reduced therapeutic effect and more complications during treatment. Studies have identified multiple molecular pathways common in both hyperglycemia and lung cancer; however, no clear correlation has been identified. By understanding these signaling pathways, we can influence the outcome therapeutically and thereby improve the survival of patients with lung cancer.
King's Sarcoidosis Questionnaire
Sarcoidosis is a multiorgan, multisystem chronic disease of unknown etiology and unpredictable course. Health status is reduced in sarcoidosis and assessing it is a difficult multitask effort due to many faces this disease might have. Recently, a new questionnaire for assessing health status in sarcoidosis was developed by a group of authors from England-King's Sarcoidosis Questionnaire (KSQ). The benefit of KSQ is the ability to develop the best care plan for the patient, as well as to differentiate the efficacy of the administered treatment. The aim of this study was to validate the KSQ in Serbian speaking population of sarcoidosis patients. The test itself is a modular, multi-organ health status measure for patients with sarcoidosis for use in clinic and the evaluation of therapies. The correlation of KSQ with different clinical course of sarcoidosis (acute vs chronic disease) and with the clinical outcome status (COS) in sarcoidosis was also investigated. A total of 159 biopsy positive sarcoidosis patients participated in this study. The average age of the participants was 49.67, majority was female (67.3%) and majority had only pulmonary form of sarcoidosis (71.7%). KSQ - new disease-specific health status instrument, was compared with 5 other already existing instruments already used and validated in sarcoidosis (Saint George Respiratory Questionnaire- SGRQ, Daily Activity List -DAL, Fatigue Assessment Scale- FAS, Medical Research Council dyspnea scale-MRC, Borg Dyspnea Scale and 15D as general questionnaire. KSQ has significant correlation with other quality of life questionnaires already used in sarcoidosis. Translated version of KSQ shows significant internal reliability, similar to the original KSQ. Serbian version of KSQ has significant correlation with different clinical course of sarcoidosis and with COS as well. The translated version of KSQ is reliable sarcoidosis specific instrument for assessing health status in these patients.
Characteristics of Patients with Sarcoidosis with Emphasis on Acute vs. Chronic Forms—A Single Center Experience
Sarcoidosis is a granulomatous disease of unknown etiology that can affect almost any organ. Although the acute form can have spontaneous regression, a certain number of patients can have a chronic form, which leads to an increase in mortality and a decrease in the quality of life. Considering that the risk factors are still unknown, we wanted to compare the characteristics of patients with acute and chronic forms of sarcoidosis in Serbia in order to determine significant differences between them with hopes of contributing to everyday clinical practice. A total of 2380 patients treated in our clinic were enrolled in this study. They were separated into the following two groups: 1126 patients with acute form and 1254 patients with chronic form. They were further compared by gender, smoking status, radiological status, exposition, biomarkers for sarcoidosis, organ involvement, and other comorbidities; the distribution of patients according to regions of Serbia was also noted. Statistical significance was found in radiological findings (p < 0.001), biomarkers (calcium in 24 h urine p < 0.001; chitotriosidase p = 0.001), and the affliction of organs (p < 0.001). The differences noted in this paper could help improve our understanding of this disease.
Hipoteza zamišljenog kontakta: Uloga radnog pamćenja
Prema hipotezi zamišljenog kontakta dovoljna je samo vizualizacija socijalnog kontakta pozitivnog tona prema vanjskoj grupi kako bi došlo do promjene u negativnim stavovima. U ovom je istraživanju ispitivana uloga kapaciteta radnog pamćenja u zamišljenom kontaktu. Provedene su dvije studije. U prvoj je, kvazieksperimentalnoj studiji, pokazano da osobe koje imaju manji kapacitet radnog pamćenja imaju negativnije opise zamišljenog kontakta i negativnije stavove prema vanj skoj grupi u odnosu na osobe većeg kapaciteta radnog pamćenja. Druga, eksperimentalna studija, proširila je nalaze prve studije te je pokazano da su osobe koje su neposredno pred zamišljanje kontakta s članom vanjske grupe imale dodatno opterećenje radnog pamćenja posljedično imale negativnije opise zamišljenog kontakta i negativnije stavove prema članovima vanjske grupe nego skupina ispitanika koja nije imala dodatno opterećenje radnog pamćenja. Medijacijska analiza potvrdila je hipotezu da je (ne)mogućnost održavanja pozitivnog tona zamišljene interakcije mehanizam koji uvjetuje uspješnost zamišljenog kontakta na smanjenje negativnih stavova. Nalazi obiju studija upućuju na to da je kapacitet radnog pamćenja jedan od faktora koji uvjetuje uspješnost intervencije zamišljenim kontaktom. Dobiveni rezultati otvaraju nova pitanja o efikasnosti zamišljenog kontakta u promjenama stava.
Bronchoscopy procedures in diagnostics and treatment of endobronchial tuberculosis
Endobronchial tuberculosis is a rare form of tuberculosis that is characterized by the presence of tuberculous granuloma within the respiratory tract, usually in the trachea or main bronchi. Multiple key notes regarding this form make it difficult to detect and treat, which can lead to prolonged, lifelong even, problems that lead to a significant loss in quality of life. Even if the conventional treatment for tuberculosis is started on time, endobronchial tuberculosis can still develop. In those cases, a bronchoscopy should be performed to objectify the type of endobronchial tuberculosis and treat it in order to prevent permanent airway stenosis. In this paper, we will note the main characteristics of endobronchial tuberculosis, as well as bronchoscopy procedures used for its treatment such as balloon dilatation, laser, argon plasma coagulation, cryotherapy, and implementation of the stent. The main goal is to raise awareness of endobronchial tuberculosis to reduce the risk of complications of its mistreatment.