Browsing by Author "Čolić, Nikola (57201737908)"

[No abstract available]

Introduction Laryngeal edema is a rare complication of angina Ludovici. Infections of this region are mostly of dentogenic origin, less often caused by tonsillitis or other infections in the pharynx. We present a case of a patient with laryngeal edema and dyspnea caused by a lower jaw tooth infection and an ipsilateral submandibular abscess. Case outline The clinical picture of our patient progressed rapidly – from toothache, painful swelling of the floor of the oral cavity, submandibular and submental regions, bilaterally, all the way to life-threatening dyspnea. A flexible nasopharyngolaryngoscopy was performed. Swelling of the base of the tongue on the left side was observed, along with pronounced edema of the aryepiglottic fold on the same side, which narrowed the breathing space. Since the breathing space was significantly reduced, the patient was urgently hospitalized. The surgical treatment was carried out in the form of an external incision and drainage of the abscess collection of the left submandibular region, with the use of oxygen support and parenteral therapy, in accordance with the recommendations from the available medical literature. Constant monitoring of saturation levels indicated a significant improvement after just a few hours of medicamentous therapy. Conclusion The goal of our work is to point out a very rare but serious complication, laryngeal edema, which can lead to airway obstruction even in the first few days of the development of the infection, and endanger the life of the patient. © 2023, Serbia Medical Society. All rights reserved.

Background/Objectives: Patients with stage III non-small cell lung cancer represent a very heterogeneous group of patients. In the past, the standard of care for patients with inoperable stage III non-small cell lung cancer was concurrent or sequential radical radiotherapy and chemotherapy. But the progression-free survival was 8 months, and the 5-year overall survival rate was less than 20%. After the results of the PACIFIC study, the standard of care for this group of patients is chemoradiotherapy with durvalumab as consolidation therapy. The aim of our study was to evaluate the efficacy of consolidation durvalumab in a real-world setting after sequential CRT. Methods: We included 24 patients with unresectable stage III non-small cell lung cancer who did not progress after sequential chemoradiotherapy and who received durvalumab consolidation. Results: Median progression-free survival was 16 months, 95% CI (0.5–31.5), and median overall survival was 20 months, 95% CI (13.4–26.6 months). The twelve-month progression-free survival and overall survival rate were 55.1% and 68%, respectively, and the 18-month progression-free survival and overall survival rates were 44.1% and 56.5%, respectively. Conclusions: Durvalumab introduced a new era in the treatment of patients with unresectable stage III non-small cell lung cancer with a significantly prolonged 5-year overall survival rate. Our study is one of the few that investigated the efficacy of durvalumab in a real-world setting after sequential CRT. Our results showed that durvalumab is effective in patients who were treated with sequential CRT. However, the time between radiotherapy termination and the start of durvalumab should be shorter. © 2025 by the authors.

Background/Objectives: Patients with stage III non-small cell lung cancer represent a very heterogeneous group of patients. In the past, the standard of care for patients with inoperable stage III non-small cell lung cancer was concurrent or sequential radical radiotherapy and chemotherapy. But the progression-free survival was 8 months, and the 5-year overall survival rate was less than 20%. After the results of the PACIFIC study, the standard of care for this group of patients is chemoradiotherapy with durvalumab as consolidation therapy. The aim of our study was to evaluate the efficacy of consolidation durvalumab in a real-world setting after sequential CRT. Methods: We included 24 patients with unresectable stage III non-small cell lung cancer who did not progress after sequential chemoradiotherapy and who received durvalumab consolidation. Results: Median progression-free survival was 16 months, 95% CI (0.5–31.5), and median overall survival was 20 months, 95% CI (13.4–26.6 months). The twelve-month progression-free survival and overall survival rate were 55.1% and 68%, respectively, and the 18-month progression-free survival and overall survival rates were 44.1% and 56.5%, respectively. Conclusions: Durvalumab introduced a new era in the treatment of patients with unresectable stage III non-small cell lung cancer with a significantly prolonged 5-year overall survival rate. Our study is one of the few that investigated the efficacy of durvalumab in a real-world setting after sequential CRT. Our results showed that durvalumab is effective in patients who were treated with sequential CRT. However, the time between radiotherapy termination and the start of durvalumab should be shorter. © 2025 by the authors.

Before the introduction of targeted therapy and immunotherapy, patients with metastatic non-small-cell lung cancer (NSCLC) had a 5-year overall survival (OS) rate of up to 10%. After the positive results of KEYNOTE-024, pembrolizumab was approved in a first-line setting for patients with metastatic NSCLC and PD-L1 ≥ 50%. A small number of patients had a durable response to immunotherapy, and so far it has not been discovered who will benefit. The aim of this study was to investigate the efficacy of first-line pembrolizumab in patients with locally advanced and metastatic NSCLC with high PD-L1 expression in a real-world setting. We enrolled 35 patients with locally advanced and metastatic NSCLC who had PD-L1 ≥ 50%. Progression-free survival was 9 months, 95% CI (2.6–15.4). Overall survival was 14 months, 95% CI (0–28.5). Five-year OS rate for the whole group of patients was 20%, and the six-year OS rate was 17.2%. Immunotherapy was a revolution in the treatment of NSCLC. We still do not know which patients will benefit from immunotherapy, but patients who do respond may experience long-term outcomes. © 2025 by the authors.

Introduction Surgery of the primary tumor following extended course of chemoimmunotherapy has only recently been recognized as a feasible and safe option for selected groups of patients with initially unresectable non-small cell lung cancer. Case outline Here we report a case of a 49-year-old female patient, who never smoked, that was diagnosed with metastatic non-small cell lung cancer. Lesions were evident in both lungs and the brain. She underwent stereotactic radiosurgery for brain metastases and combination therapy of chemotherapy, atezolizumab and bevacizumab. Response to therapy was both remarkable and durable. Ten cycles into treatment, magnetic resonance imaging of the brain revealed no metastatic lesions. Positron emission tomography / computed tomography revealed a single lesion in the right upper lobe 22 × 23 mm in diameter. The patient underwent a right upper lobectomy. Pathohistological evaluation of the specimen revealed complete pathologic response. The patient recovered from surgery and continued chemoimmunotherapy. Four months post-surgery she is disease free and of excellent performance status. Conclusion Primary tumor surgery following extensive chemoimmunotherapy regiment is feasible and could be considered as a treatment option. Further research is warranted to define a patient population that stands to benefit the most from this modality. © 2024, Serbia Medical Society. All rights reserved.

Introduction The systemic autoimmune diseases (SAD) can cause a variety of pulmonary and pleural abnormalities. The aim of this paper is to review clinical and radiological characteristics of a series of patients with a systemic autoimmune disease hospitalized at a tertiary level facility. Methods In this retrospective study, we reviewed the clinical and imaging findings in patients diagnosed with SAD at the Teaching Hospital of Pulmonology during a nine-year period. Results An 84-patient group (mean age of 53.8 years) consisted of 64 women and 20 men. Fifty-eight out of 84 patients suffered from collagen vascular disease (CVD) and 26/84 had systemic vasculitis. Fatigue was the dominant symptom (75.8% in CVD, and 69.2% in vasculitis). Cough, hemoptysis, and fever were more frequent in patients with vasculitis. Fibrosis was the most common radiological manifestation of CVD (26/58), followed by pleural effusion (18/58) and consolidation (10/58). Irregular opacities were dominant radiologic finding in vasculitis (10/26), followed by nodules (8/26). Histological confirmation of systemic autoimmune disease was obtained in 28.6% patients, in 58/84 patients the diagnosis was based on a positive serologic test and clinico-radiological manifestations, in two cases on clinical and radiological features according to defined criteria. Conclusion Pleuropulmonary manifestations of SAD are usually expressed in the sixth decade of life, predominantly in women. Clinical findings and positive serologic tests suggest diagnosis of SAD. Fibrosis is the most common radiologic pattern found in almost one half of the patients with CVD and irregular opacities are the most common findings in vasculitis. © 2020, Serbia Medical Society. All rights reserved.

Introduction Primary malignant tumors of the sternum are rare, with chondrosarcoma being the most common primary malignant tumor of the chest. The gold standard in treatment is surgical treatment with wide resection margins, where the rigidity of the chest wall must be ensured, with protection of internal organs with satisfactory lung function. Case outline We present a 67-year-old patient in whom previous computed tomography and magnetic resonance imaging examinations confirmed a tumor mass involving the sternum with the associated ribs, with involvement of the soft tissues above. First, sternum resection was performed with partial resection of the associated ribs and soft tissues. Reconstruction and stabilization of the chest wall were achieved with two layers of polypropylene mesh and methyl methacrylate bone cement with antibiotics. We reconstructed the primary soft tissue defect with a combination of a large local fasciocutaneous flap raised from the abdomen and a smaller sliding flap from the chest. The secondary defect was reconstructed by wide undermining of the skin in the area of the anterior abdominal wall and a small Thiersch-type free skin graft. In the postoperative period, the flaps were vital, but there was necrosis of the free skin graft. That defect was closed secondary thanks to bandaging. Respiratory function was preserved. Conclusion Surgical treatment is the main treatment for sternal chondrosarcoma. With an adequate preoperative and intraoperative approach, it is necessary to enable good postoperative oncological outcomes with the achievement of chest rigidity and satisfactory respiratory status. © 2024, Serbia Medical Society. All rights reserved.

Introduction/Objective Since tibial shaft is a common location of opened and closed tibial fractures, it is very important to determine the best method of treating these fractures. Our objective was to assess whether the Ilizarov technique is appropriate in terms of complications, outcomes, and pain reduction in treatment of patients with tibial shaft fracture. Methods Retrospective analysis included all consecutive patients with tibial shaft fracture treated with the Ilizarov technique in the period from January 2013 to June 2017 at the Banjica Institute for Orthopaedic Surgery, Belgrade, Serbia. Demographic and clinical data on patients were collected. Pain was assessed using visual analogue scale of pain. Two models of uni-and multi-variate linear regression analysis were performed. Results The study showed that the overall rate of complications was low, and that hypertension, administration of antibiotics, and reoperation prolonged fixation. Also, severe fractures and longer procedure time delay mobilization. Significant reduction of pain was observed. Conclusion The Ilizarov technique is a safe and reliable method in the treatment of patients with tibial shaft fractures and is followed by pain reduction, overall improvement of functioning, good outcomes, and is not commonly associated with complications. © 2020, Serbia Medical Society. All rights reserved.

Background/Objectives: A significant breakthrough in non-small-cell lung cancer (NSCLC) treatment has occurred with the introduction of targeted therapies and immunotherapy. However, not all patients treated with these therapies would respond to treatment, and patients who respond to treatment would acquire resistance at some time point. This is why we need new biomarkers that can predict response to therapy. The aim of this study was to investigate whether soluble programmed cell death-ligand 1 (sPD-L1) could be a predictive biomarker in patients with epidermal growth factor receptor (EGFR)-positive NSCLC. Materials and Methods: Blood samples from 35 patients with EGFR-mutated (EGFRmut) adenocarcinoma who achieved disease control with EGFR tyrosine kinase inhibitor (EGFR TKI) therapy were collected for sPD-L1 analysis. We analyzed sPD-L1 concentrations in 30 healthy middle-aged subjects, as a control population, to determine the reference range. Adenocarcinoma patients were divided into two groups, i.e., a group with low sPD-L1 (≤182.5 ng/L) and a group with high sPD-L1 (>182.5 ng/L). Results: We found that progression-free survival (PFS) was 18 months, 95% CI (11.1–24.9), for patients with low sPD-L1 and 25 months, 95% CI (8.3–41.7), for patients with high sPD-L1. There was no statistically significant difference in PFS between the groups (p = 0.100). Overall survival (OS) was 34.4 months, 95% CI (26.6–42.2), for patients with low sPD-L1 and 84.1 months, 95% CI (50.6–117.6), for patients with high sPD-L1; there was also no statistically significant difference between the groups (p = 0.114). Conclusion: In our study, we found that patients with high sPD-L1 had numerically better PFS and OS, but this has no statistical significance. Further studies with a larger number of patients are needed to evaluate the role of sPD-L1 as a predictive biomarker in patients with EGFRmut NSCLC. © 2025 by the authors.

Background/Objectives: A significant breakthrough in non-small-cell lung cancer (NSCLC) treatment has occurred with the introduction of targeted therapies and immunotherapy. However, not all patients treated with these therapies would respond to treatment, and patients who respond to treatment would acquire resistance at some time point. This is why we need new biomarkers that can predict response to therapy. The aim of this study was to investigate whether soluble programmed cell death-ligand 1 (sPD-L1) could be a predictive biomarker in patients with epidermal growth factor receptor (EGFR)-positive NSCLC. Materials and Methods: Blood samples from 35 patients with EGFR-mutated (EGFRmut) adenocarcinoma who achieved disease control with EGFR tyrosine kinase inhibitor (EGFR TKI) therapy were collected for sPD-L1 analysis. We analyzed sPD-L1 concentrations in 30 healthy middle-aged subjects, as a control population, to determine the reference range. Adenocarcinoma patients were divided into two groups, i.e., a group with low sPD-L1 (≤182.5 ng/L) and a group with high sPD-L1 (>182.5 ng/L). Results: We found that progression-free survival (PFS) was 18 months, 95% CI (11.1–24.9), for patients with low sPD-L1 and 25 months, 95% CI (8.3–41.7), for patients with high sPD-L1. There was no statistically significant difference in PFS between the groups (p = 0.100). Overall survival (OS) was 34.4 months, 95% CI (26.6–42.2), for patients with low sPD-L1 and 84.1 months, 95% CI (50.6–117.6), for patients with high sPD-L1; there was also no statistically significant difference between the groups (p = 0.114). Conclusion: In our study, we found that patients with high sPD-L1 had numerically better PFS and OS, but this has no statistical significance. Further studies with a larger number of patients are needed to evaluate the role of sPD-L1 as a predictive biomarker in patients with EGFRmut NSCLC. © 2025 by the authors.

Introduction Extremely rarely, the evolution of abdominal aortic aneurysm (AAA) includes the phase when extravasations of the blood from a ruptured aneurysm is contained by the surrounding tissue, referred to as chronic (contained) rupture of the AAA. Our aim was to call attention to this life-threatening condition, which is always challenging for diagnosis. Case outline A 58-year-old man reported to the Emergency Center for significant abdominal pain. Ultrasound examination showed an infrarenal aneurysm of the abdominal aorta. A computed tomography scan of the thorax, abdomen, and pelvis with iodine contrast in arterial phase was performed. A free gas collection was observed between the liver and the anterior abdominal wall that is traced to a ruptured inflamed diverticulum on the transversal colon. Immediately distal to the branching sites of the renal arteries, the abdominal aorta extended forward and aneurismatically expanded. Posterior left, along the psoas muscle, a rupture of the aortic wall was seen, with an organized hematoma that accompanied the muscle. Between the hematoma and the aortic aneurysm, erosions of the anterior and lateral part of the vertebral bodies L2 and L3 were discovered. The patient underwent endovascular AAA repair (EVAR) and recovered well. Conclusion Multidetector computed tomography angiography is a reliable, non-invasive, and necessary examination for localization and evaluation of the size of the AAA form, its chronic rupture, and complications such as vertebral body erosion. © 2019, Serbia Medical Society. All rights reserved.