Browsing by Author "Dimitrijevic, Milan (57430798900)"

Background and objectives: induced sputum is used to assess different inflammatory phenotypes in asthma, but is not used routinely. We aimed to determine the proportion of inflammatory asthma phenotypes based on induced sputum, to find biomarkers that can discriminate between phenotypes, and to evaluate biomarkers in patients with and without biological therapy in different inflammatory asthma phenotypes. Materials and Methods: this cross-sectional study investigated clinical characteristics, asthma control tests, skin prick test, impulse oscillometry (IOS), spirometry, induced sputum, biomarkers (IgE, eosinophils, fractional exhaled nitric oxide (FeNO), serum periostin, IL-5, IL-6, IL-8, IL-17A, IL-33) in 80 asthmatics. A total of 17/80 patients were treated with biologics (10 with omalizumab, 7 with benralizumab). Results: a total of 31% of patients had eosinophilic asthma (EA), 30% had mixed granulocytic asthma (MGA), 24% had paucigranulocytic asthma (PGA), and 15% had neutrophilic asthma (NA). The difference was found in blood eosinophils (p = 0.002), the highest observed in EA. The cut-off ≥ 240/μL eosinophils, with 64% sensitivity and 72.7% specificity, identified EA (AUC = 0.743, p = 0.001). A higher IL-8 level was associated with NA (p = 0.025). In 63 non-biologic asthma group, eosinophils were higher in EA than in NA, MGA, and PGA (p = 0.012, p = 0.028, and p = 0.049, respectively). A higher IL-17A was associated with EA without biologics (p = 0.004). A significantly higher IL-5 was found in EA treated with biologics, in comparison with EA without biologics (p = 0.043). The number of leucocytes and neutrophils was higher in MGA without biologics (p = 0.049, p = 0.019), while IL-5, IL-6, and IL-8 levels were higher in MGA treated with biologics (p = 0.012, p = 0.032, p = 0.038, respectively). Conclusions: EA and MGA were the most prevalent asthma phenotypes. Blood eosinophils can identify EA, both in patients with and without biologics. Apart from the clinical profile, a broad spectrum of biomarkers for assessing inflammatory phenotypes is necessary for an adequate therapy approach to patients with asthma. © 2024 by the authors.

Introduction: Previous studies have examined biomarkers of coagulation, inflammation and immunity in chronic spontaneous urticaria (CSU), but no recommended biomarkers for disease activity have been established yet. Aim: To find the relationship between certain laboratory parameters and disease activity in patients with CSU. Material and methods: Serum concentrations of D-dimer, C-reactive protein (CRP), C3, C4, and prothrombin time (PT), activated partial thromboplastin time (aPTT) values were measured in 44 CSU patients and compared with 33 healthy controls. Correlation between biomarkers and urticaria activity score during 7 consecutive days (UAS7) was calculated. Results: Our study included 44 CSU patients (38 females and 6 males), mean age of 50.4 years and the average disease duration of 3.1 years. Based on UAS7, 23 (52.3%) CSU patients had mild urticaria, 8 (18.2%) well-controlled, 7 (15.9%) moderate and 6 (13.6%) severe urticaria. Fourteen (31.8%) patients had elevated CRP, 21 (47.7%) had elevated D-dimer and 14 (13.6%) CSU patients had elevated C4 levels. Patients with CSU had statistically significant elevated D-dimer, CRP and PT as compared with controls (p = 0.007, p = 0.005 and p = 0.029, respectively). There was no correlation between PT, aPTT, D-dimer, CRP, C3 and disease activity. Statistically significant differences in C4 levels between patients with severe and well-controlled, mild, moderate urticaria were determined (p = 0.003). Conclusions: CRP, D-dimer, and PT may be considered as biomarkers for distinguishing patients with CSU from controls. The C4 levels correlate with disease activity and may be useful as a potential biomarker of disease activity. © 2021 Termedia Publishing House Ltd.. All rights reserved.

Background: Drug desensitization allows for safe administration of a drug to a patient with a previous hypersensitivity reaction. Successful desensitization protocols have been described for different medications, including protocols for oncology patients. Few cases of desensitization to sorafenib and imatinib have been described in the literature so far. Objective: The objective of this paper is to describe the process of the sorafenib and imatinib drug hypersensitivity diagnosis and desensitization process in two patients. Methods: Two oncology patients who experienced non-immediate hypersensitivity reactions to sorafenib and imatinib underwent desensitization to these drugs. We designed a protocol for the first patient and used a modified protocol from the literature for the second patient. Results: By using a slow desensitization technique and gradual tapering of corticosteroids and antihistamines, both patients reached the target dose of the incriminated drug. Conclusions: Desensitization to sorafenib and imatinib can be an effective therapeutic option in patients with hypersensitivity to those medications, without alternative treatment options. © 2024 by the authors.

Background: Drug desensitization allows for safe administration of a drug to a patient with a previous hypersensitivity reaction. Successful desensitization protocols have been described for different medications, including protocols for oncology patients. Few cases of desensitization to sorafenib and imatinib have been described in the literature so far. Objective: The objective of this paper is to describe the process of the sorafenib and imatinib drug hypersensitivity diagnosis and desensitization process in two patients. Methods: Two oncology patients who experienced non-immediate hypersensitivity reactions to sorafenib and imatinib underwent desensitization to these drugs. We designed a protocol for the first patient and used a modified protocol from the literature for the second patient. Results: By using a slow desensitization technique and gradual tapering of corticosteroids and antihistamines, both patients reached the target dose of the incriminated drug. Conclusions: Desensitization to sorafenib and imatinib can be an effective therapeutic option in patients with hypersensitivity to those medications, without alternative treatment options. © 2024 by the authors.

Background: Because of the COVID-19 pandemic, people were recommended to implement new health behaviors into their daily routines to prevent the viral spread. The aim of this study was to investigate whether specific health behaviors, such as wearing face masks, taking immunity boosters and visiting risky places were associated with a higher level of stress due to COVID-19 in the general adult population. Method: This cross-sectional study was conducted from September 1, 2020 to October 1, 2021 in eight randomly chosen cities of two Serbian speaking countries (Republic of Serbia and Republic of Srpska - Bosnia and Herzegovina). Participants filled a socio-epidemiologic questionnaire, COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Results: The study included 2,301 participants with an average age of 36.72 ± 13.82 years of whom 54.9% were female (p = 0.001). Most participants were healthy, highly educated, employed, married, non-smokers and consumed alcohol. The mean total CSS score was 32.7 ± 23.8 out of 144, suggesting a relatively low stress due to COVID-19. The mean PSS was 19.43 ± 5.05 out of 40 indicating slightly increased level of general stress. Participants who reported higher CSS scores were more likely to wear face masks, use immunity boosters, go to cafes and clubs, have chronic illnesses, have suspicious, but not proven contact with COVID-19 positive people, and use multiple sources of information about COVID-19. Conclusion: Few participants experienced high levels of stress due to COVID-19. People who used face masks, immunity boosters and visited risky places reported a higher level of stress during the pandemic. © The Author(s) 2025.

Background: Because of the COVID-19 pandemic, people were recommended to implement new health behaviors into their daily routines to prevent the viral spread. The aim of this study was to investigate whether specific health behaviors, such as wearing face masks, taking immunity boosters and visiting risky places were associated with a higher level of stress due to COVID-19 in the general adult population. Method: This cross-sectional study was conducted from September 1, 2020 to October 1, 2021 in eight randomly chosen cities of two Serbian speaking countries (Republic of Serbia and Republic of Srpska - Bosnia and Herzegovina). Participants filled a socio-epidemiologic questionnaire, COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Results: The study included 2,301 participants with an average age of 36.72 ± 13.82 years of whom 54.9% were female (p = 0.001). Most participants were healthy, highly educated, employed, married, non-smokers and consumed alcohol. The mean total CSS score was 32.7 ± 23.8 out of 144, suggesting a relatively low stress due to COVID-19. The mean PSS was 19.43 ± 5.05 out of 40 indicating slightly increased level of general stress. Participants who reported higher CSS scores were more likely to wear face masks, use immunity boosters, go to cafes and clubs, have chronic illnesses, have suspicious, but not proven contact with COVID-19 positive people, and use multiple sources of information about COVID-19. Conclusion: Few participants experienced high levels of stress due to COVID-19. People who used face masks, immunity boosters and visited risky places reported a higher level of stress during the pandemic. © The Author(s) 2025.