Browsing by Author "Janković, Jelena (57211575577)"

Background: Achalasia is a primary esophageal motility disorder, predominantly presenting with dysphagia. With disease progression, the esophagus becomes tortuous and dilated, resulting in a condition known as “megaesophagus.” Tracheal compression with acute respiratory failure due to esophageal dilation is a rare but potentially fatal complication of achalasia. Case report: A 52-year-old male patient presented with acute respiratory failure and a history of prior dysphagia, regurgitation, and pneumonia. Further diagnostic tests revealed an extremely dilated esophagus compressing the trachea and lung parenchyma. Results: Laparoscopic Heller myotomy and fundoplication were performed, which alleviated the patient’s symptoms. Conclusion: Early recognition of this condition is crucial for patient survival, as is initial decompression of the dilated esophagus, relieving the patient of acute, life-threating symptoms. © The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2025.

Background: The SNP rs855791 has been linked to increased hepcidin levels, variations in serum iron, transferrin saturation and red blood cell indices. Our goal was to determine the prevalence of this polymorphism among COPD patients and to assess its impact on iron status parameters in patients with stable COPD. Methods: We analysed iron status parameters and genetic data from 29 COPD patients with wild-type genotype (WT group) and 65 COPD patients with either homozygous or heterozygous genotype (HH group). Additionally, the prevalence of SNP rs855791 was assessed in 192 volunteers. Results: The frequency distribution of SNP rs855791 was comparable between the COPD patients and control subjects (p=0.791). Iron status parameters were within their respective reference values and showed neither statistically nor clinically significant difference between the WT and HH group of COPD patients. However, after excluding patients with (sub)clinical vitamin B12 deficiency and/or hypoxemia, WT group of patients exhibited significantly lower erythropoietin levels (p=0.015). The area under the curve for erythropoietin was 0.688 (95% CI: 0.545–0.830, p=0.015), with an optimal cut-off of 9.74, sensitivity of 61.2% (95% CI: 58.1–64.3) and specificity of 65.0% (95% CI: 61.8–68.3). Conclusions: Iron status parameters do not differ between WT and HH groups of stable COPD patients. Statistical but not clinical difference in EPO levels was observed in a subgroup of patients. In addition to promoting erythropoiesis, EPO may regulate hepcidin levels and thus influence the development of iron deficiency and/or anaemia. Also, EPO’s direct effect on immune cells and down-regulation of inflammatory reactions should be considered in this context. © 2025 Society of Medical Biochemists of Serbia. All rights reserved.

Background: The SNP rs855791 has been linked to increased hepcidin levels, variations in serum iron, transferrin saturation and red blood cell indices. Our goal was to determine the prevalence of this polymorphism among COPD patients and to assess its impact on iron status parameters in patients with stable COPD. Methods: We analysed iron status parameters and genetic data from 29 COPD patients with wild-type genotype (WT group) and 65 COPD patients with either homozygous or heterozygous genotype (HH group). Additionally, the prevalence of SNP rs855791 was assessed in 192 volunteers. Results: The frequency distribution of SNP rs855791 was comparable between the COPD patients and control subjects (p=0.791). Iron status parameters were within their respective reference values and showed neither statistically nor clinically significant difference between the WT and HH group of COPD patients. However, after excluding patients with (sub)clinical vitamin B12 deficiency and/or hypoxemia, WT group of patients exhibited significantly lower erythropoietin levels (p=0.015). The area under the curve for erythropoietin was 0.688 (95% CI: 0.545–0.830, p=0.015), with an optimal cut-off of 9.74, sensitivity of 61.2% (95% CI: 58.1–64.3) and specificity of 65.0% (95% CI: 61.8–68.3). Conclusions: Iron status parameters do not differ between WT and HH groups of stable COPD patients. Statistical but not clinical difference in EPO levels was observed in a subgroup of patients. In addition to promoting erythropoiesis, EPO may regulate hepcidin levels and thus influence the development of iron deficiency and/or anaemia. Also, EPO’s direct effect on immune cells and down-regulation of inflammatory reactions should be considered in this context. © 2025 Society of Medical Biochemists of Serbia. All rights reserved.

Introduction: Erythrocyte indices LHD and Maf are complementary parameters to complete blood count and have been shown as reliable iron deficiency markers in different clinical settings. The aim of the study was to assess diagnostic performances of LHD and Maf in detecting iron deficiency in nonanaemic stable COPD patients. Methods: A total of 93 nonanaemic stable COPD patients were classified as either iron deficient (ID, N = 15) or non-iron deficient (non-ID, N = 78). Iron deficiency was defined as a ferritin level < 100 μg/L with a transferrin saturation (TSAT) <20%. A complete blood count, including LHD and Maf as well as other relevant inflammation and iron status parameters were obtained for all participants. Results: Both LHD and Maf have shown significant differences between the ID and non-ID group with p =.003 and p =.007 respectively. The AUC for LHD was.744 (95% CI:.626–.863, p =.003) with the best cut-off of 5.85 and sensitivity of 80% (95% CI: 76.0–84.0) and specificity of 61.5% (95% CI: 58.4–64.6). The AUC for Maf was.707 with optimal cut-off value 12.65 and sensitivity of 83.3% (95% CI: 79.1–87.5) and specificity of 60.0% (95% CI: 57.0–63.0). Furthermore, LHD performance was not affected by vitamin B12 status. Conclusion: LHD and Maf are useful for iron deficiency diagnosis in stable COPD patients. LHD was shown to be resistant to vitamin B12 deficiency, which is of substantial importance in specific patient subpopulations. Both parameters are not technology-dependant and do not require additional sample and/or reagent volume, which makes them cost-effective and convenient for everyday use. © 2023 John Wiley & Sons Ltd.

Introduction: Erythrocyte indices LHD and Maf are complementary parameters to complete blood count and have been shown as reliable iron deficiency markers in different clinical settings. The aim of the study was to assess diagnostic performances of LHD and Maf in detecting iron deficiency in nonanaemic stable COPD patients. Methods: A total of 93 nonanaemic stable COPD patients were classified as either iron deficient (ID, N = 15) or non-iron deficient (non-ID, N = 78). Iron deficiency was defined as a ferritin level < 100 μg/L with a transferrin saturation (TSAT) <20%. A complete blood count, including LHD and Maf as well as other relevant inflammation and iron status parameters were obtained for all participants. Results: Both LHD and Maf have shown significant differences between the ID and non-ID group with p =.003 and p =.007 respectively. The AUC for LHD was.744 (95% CI:.626–.863, p =.003) with the best cut-off of 5.85 and sensitivity of 80% (95% CI: 76.0–84.0) and specificity of 61.5% (95% CI: 58.4–64.6). The AUC for Maf was.707 with optimal cut-off value 12.65 and sensitivity of 83.3% (95% CI: 79.1–87.5) and specificity of 60.0% (95% CI: 57.0–63.0). Furthermore, LHD performance was not affected by vitamin B12 status. Conclusion: LHD and Maf are useful for iron deficiency diagnosis in stable COPD patients. LHD was shown to be resistant to vitamin B12 deficiency, which is of substantial importance in specific patient subpopulations. Both parameters are not technology-dependant and do not require additional sample and/or reagent volume, which makes them cost-effective and convenient for everyday use. © 2023 John Wiley & Sons Ltd.

Introduction: Sphingomonas paucimobilis can be found in air, water systems, dialysis fluid, nebulizers and laboratory instruments in hospitals. Despite its low pathogenicity, it can cause severe infections. Case report: A 54-year-old man presented with fever, cough and pain in the right hemithorax. The laboratory results showed elevated inflammatory parameters. Chest radiography showed right upper lobe pneumonia. Empiric antibiotic therapy (cephalosporin) was prescribed. On control examination chest radiography showed incomplete regression. Chest computer tomography (CT) finding was bronchopneumonia in the right upper lobe. Bacteriological examination of fiberaspirate revealed Sphingomonas paucimobils. Trimethoprim-sulfamethoxazole was prescribed based on the antibiogram. After two weeks the control laboratory analysis was normal. The patient was fully recovered. Conclusions: Our patient had no comorbidities or malignancies, and no hospitalization in the recent past. He had a dental intervention 5 days prior to the onset of symptoms. We propose that it was an infection after the dental intervention. Copyright © 2023 Janković et al.

Introduction: Sphingomonas paucimobilis can be found in air, water systems, dialysis fluid, nebulizers and laboratory instruments in hospitals. Despite its low pathogenicity, it can cause severe infections. Case report: A 54-year-old man presented with fever, cough and pain in the right hemithorax. The laboratory results showed elevated inflammatory parameters. Chest radiography showed right upper lobe pneumonia. Empiric antibiotic therapy (cephalosporin) was prescribed. On control examination chest radiography showed incomplete regression. Chest computer tomography (CT) finding was bronchopneumonia in the right upper lobe. Bacteriological examination of fiberaspirate revealed Sphingomonas paucimobils. Trimethoprim-sulfamethoxazole was prescribed based on the antibiogram. After two weeks the control laboratory analysis was normal. The patient was fully recovered. Conclusions: Our patient had no comorbidities or malignancies, and no hospitalization in the recent past. He had a dental intervention 5 days prior to the onset of symptoms. We propose that it was an infection after the dental intervention. Copyright © 2023 Janković et al.

Introduction Unilateral absence of pulmonary artery is a rare vascular malformation. Because of this anomaly, the lungs are supplied by the system of collateral arteries. Case outline We present a case of the right pulmonary artery agenesis in a female patient. She was admitted to the hospital because of hemoptysis. A computed tomography scan revealed a congenital malformation – the right lung was smaller in size, the right principal pulmonary artery had not been developed along with aberrant tortuous blood vessels. Conclusion Symptomatic therapy was applied in the case of our patient. There was no need for any surgical treatment. However, in case of massive hemoptysis embolisation or lobectomy/ pneumonectomy will probably be applied. © 2019, Serbia Medical Society. All rights reserved.

Background/Aim. The Chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a simple and reliable tool designed to measure overall COPD related health status and complement physician assessment in routine clinical practice. Objective of this study was to evaluate the validity of the Serbian version of CAT. Methods. Study included 140 outpatients in the stable COPD, recruited from two centres: Clinic for Pulmonology, Clinical Center of Serbia, Belgrade, and Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica. All patients completed pulmonary function testing - spirometry, the CAT and the modified Medical Research Council (mMRC) dyspnea scale at baseline visit. The CAT test-retest reliability was tested in 20 patients by the same investigator (physician). Results. We demonstrated that Serbian version of CAT had high internal consistency with Cronbach's alpha 0.88. Test-retest analysis showed good correlation between CAT scores in two time points (Spearman's ρ = 0.681, p < 0.01). In our study the CAT correlated moderately to mMRC scale (ρ = +0.57), weakly to FEV1 (ρ -0.214), was positively related to number of exacerbations, but did not showed exact regularity with change in the Global Initiative for Chronic Obstructive lung disease (GOLD) stage. Conclusion. The Serbian version of CAT is a reliable, simple and easy-to-use tool that can be used in everyday clinical practice to assess the health status of COPD patients in Serbia. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.