Browsing by Author "Jankovic, Jelena (57211575577)"

Tuberculous pleuritis (TP) is one of the most common extra-pulmonary tuberculosis form. Because of tuberculous pleurisy is hard to diagnose due to slow course of disease and lack of specificity in symptoms and diagnostic methods. In that reason, we need multidisciplinary approach and efficient biomarkers. Acid-fast bacilli (AFB) staining, cultures and pathophysiological biopsy finding from the majority of patients are positive only in less than 10%. Löwenstein culture results need time about 6–8 weeks what delays diagnosis. Adenosine deaminase (ADA) is biomarker with high sensitivity and specificity (more than 90%) and considered as gold standard of biomarkers in the diagnosis of TP. It is very hard to distinguish malignant from TP with lymphocyte predomination, but in patient with malignant pleural effusion the level of ADA is decreased, opposite from TP. ADA in pleural punctate is a fast, simple, efficient and economical way for clarification the etiology of the pleural effusion as tuberculous pleurisy. Also, many studies have proved the role of ADA in the response to treatment for tuberculosis at follow up period. © 2023 Sciendo. All rights reserved.

Tuberculous pleuritis (TP) is one of the most common extra-pulmonary tuberculosis form. Because of tuberculous pleurisy is hard to diagnose due to slow course of disease and lack of specificity in symptoms and diagnostic methods. In that reason, we need multidisciplinary approach and efficient biomarkers. Acid-fast bacilli (AFB) staining, cultures and pathophysiological biopsy finding from the majority of patients are positive only in less than 10%. Löwenstein culture results need time about 6–8 weeks what delays diagnosis. Adenosine deaminase (ADA) is biomarker with high sensitivity and specificity (more than 90%) and considered as gold standard of biomarkers in the diagnosis of TP. It is very hard to distinguish malignant from TP with lymphocyte predomination, but in patient with malignant pleural effusion the level of ADA is decreased, opposite from TP. ADA in pleural punctate is a fast, simple, efficient and economical way for clarification the etiology of the pleural effusion as tuberculous pleurisy. Also, many studies have proved the role of ADA in the response to treatment for tuberculosis at follow up period. © 2023 Sciendo. All rights reserved.

Background and objectives: The purpose of this study is to investigate the differences in the degree of the anxiety and comorbidity levels in patients with different chronic pulmonary diseases such as chronic obstructive bronchitis (COPD) without emphysema phenotype, pulmonary emphysema, bronchial asthma and lung cancer. Materials and Methods: The prospective clinical study included 272 patients that were diagnosed and treated of pulmonary pathology. COPD (without emphysema phenotype) (Group-1), pulmonary emphysema (Group-2), bronchial asthma (Group-3) and lung cancer (Group-4) were assessed. For the evaluation of the anxiety degree, we used Hamilton Anxiety Rating Scale (HAM-A). Results: The degree of cardiovascular symptoms was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p = 0.001) and Group-4 (p = 0.013), and significantly higher in Group-4 versus Group-2 (p = 0.046). The degree of respiratory symptoms was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p <0.001) and Group-4 (p = 0.002), and significantly higher in Group-4 versus Group-2 (p = 0.013) and versus Group-3 (p = 0.023). For gastrointestinal symptoms, the degree of one was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.017). Somatic subscale values were significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p <0.001) and Group-4 (p = 0.015), and significantly higher in Group-4 versus Group-2 (p = 0.024). Total HAM-A score was significantly higher in Group-1 versus Group-2 (p = 0.002) and Group-3 (p = 0.007). Conclusions: Patients with COPD (without emphysema phenotype) followed by the lung cancer are at elevated risk of being more mentally challenged in terms of increased anxiety. Furthermore, patients with exacerbation of evaluated pulmonary pathologies have various levels of comorbidities degrees. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Background: Achalasia is a rare esophageal motility disorder of unknown etiology, which leads to changes in the pressure and relaxation of the lower esophageal sphincter (LES), affecting peristalsis and contraction of the esophageal body. Dysphagia can impact individuals of any age, it is frequent in the elderly. Non-specific gastrointestinal symptoms are delayed and can give false diagnoses. The aim of this study is to compare clinical presentation and pulmonary complications in younger (Group I) and elderly patients (Group II). Methods: 108 patients with achalasia were separated into two groups - young and elderly patients. Demographic, clinical, radiological and manometric data, smoking status, and symptom score were compared between these groups. Results: There was no significant difference in gender, duration of symptoms, body mass index (BMI), or diameter of esophagus between the two patient groups. There was a statistically significant difference between frequencies of comorbidity between groups (p = 0.009). Even though there were no differences in chest tomography scan (CT) findings and diameter, there were statistical differences in diffusion capacity (p = 0.041). Respiratory symptoms occurred in 38 (48.7%) patients in Group I and in 20 (66.7%) in Group II (p = 0.011). Cough was dominant in the younger group, but fatigue and chest pain were statistically significant and frequent in elderly group patients with achalasia. There was no significant difference in Eskardt symptom score (ESS), but there was the difference in the frequency of individual symptoms. Vomitus and regurgitation were statistically higher frequent in Group I, but dysphagia and weight loss in Group II. Subtype 1 was dominant in the younger group, and subtype 2 in a group with older patients. Conclusion: The younger achalasia population group was found to be associated with decreased diffusion capacity, type 1 achalasia, cough, and gastrointestinal symptoms such as vomitus and regurgitation. Geriatric status was found to be associated with frequent comorbidities, subtype 2, frequent respiratory symptoms, dysphagia, and weight loss. Our findings demonstrated an association between esophageal motility abnormalities and characteristics of geriatric population. © 2024 Jankovic, Milenkovic, Simic, Ivanovic, Skrobic, licensee HBKU Press.

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. © 2024 by the authors.

Background and Objectives: Lung cancer is the second most common form of cancer in the world for both men and women as well as the most common cause of cancer-related deaths worldwide. The aim of this study is to summarize the radiological characteristics between primary lung adenocarcinoma subtypes and to correlate them with FDG uptake on PET-CT. Materials and Methods: This retrospective study included 102 patients with pathohistologically confirmed lung adenocarcinoma. A PET-CT examination was performed on some of the patients and the values of SUVmax were also correlated with the histological and morphological characteristics of the masses in the lungs. Results: The results of this analysis showed that the mean size of AIS-MIA (adenocarcinoma in situ and minimally invasive adenocarcinoma) cancer was significantly lower than for all other cancer types, while the mean size of the acinar cancer was smaller than in the solid type of cancer. Metastases were significantly more frequent in solid adenocarcinoma than in acinar, lepidic, and AIS-MIA cancer subtypes. The maximum standardized FDG uptake was significantly lower in AIS-MIA than in all other cancer types and in the acinar predominant subtype compared to solid cancer. Papillary predominant adenocarcinoma had higher odds of developing contralateral lymph node involvement compared to other types. Solid adenocarcinoma was associated with higher odds of having metastases and with higher SUVmax. AIS-MIA was associated with lower odds of one unit increase in tumor size and ipsilateral lymph node involvement. Conclusions: The correlation between histopathological and radiological findings is crucial for accurate diagnosis and staging. By integrating both sets of data, clinicians can enhance diagnostic accuracy and determine the optimal treatment plan. © 2024 by the authors.

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. Copyright © 2024 Belic et al.

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. Copyright © 2024 Belic et al.

Background: The COVID-19 pandemic caused global medical, economic and social problems. High infection rates, heterogeneous presentation, lack of previous data, and lack of standardized treatment led to a need for further analysis to prepare for potential new pandemics. We analyzed any possible correlation between gender, laboratory findings, disease severity and the need for oxygen or mechanical ventilation support. Methods: 99 patients with confirmed SARS-CoV-2 virus infection enrolled. Baseline characteristics that included age, sex, smoking history, BMI, oxygen therapy or mechanical ventilation support needs were recorded. Type and severity of radiological findings determined by chest CT scan. Results: The majority of our patients were over 61 years old (58.6%), male (57.6%), and had severe radiological findings (bilateral pneumonia 29.3%, ARDS 35.4%), with only 20.2% had not required any oxygen supplementation. Regarding gender and laboratory findings, men have shown statistically significant higher values of CRP, lymphocytes, LDH and ferritin (96.4 vs 87.1, p=0.014; 1.17 vs 0.84, p=0.048; 674.8 vs 609.1, p=0.031; 1263 vs 578.4, p=0.001, respectfully). Severe radiological findings showed a positive correlation with the need for HFNC and/or (N)IMV (p=0.021 and p=0.032. respectfully), as well as with higher values of WBC, LDH and ferritin (p=0.042, p=0.035 and p=0.017, respectively). Conclusions: There is a difference between the presentation of the disease and analyzed laboratory markers between sexes. The difference is most likely multifactorial and should require further research in order to discover other risk and prognostic factors. © 2025 Society of Medical Biochemists of Serbia. All rights reserved.

Background: The COVID-19 pandemic caused global medical, economic and social problems. High infection rates, heterogeneous presentation, lack of previous data, and lack of standardized treatment led to a need for further analysis to prepare for potential new pandemics. We analyzed any possible correlation between gender, laboratory findings, disease severity and the need for oxygen or mechanical ventilation support. Methods: 99 patients with confirmed SARS-CoV-2 virus infection enrolled. Baseline characteristics that included age, sex, smoking history, BMI, oxygen therapy or mechanical ventilation support needs were recorded. Type and severity of radiological findings determined by chest CT scan. Results: The majority of our patients were over 61 years old (58.6%), male (57.6%), and had severe radiological findings (bilateral pneumonia 29.3%, ARDS 35.4%), with only 20.2% had not required any oxygen supplementation. Regarding gender and laboratory findings, men have shown statistically significant higher values of CRP, lymphocytes, LDH and ferritin (96.4 vs 87.1, p=0.014; 1.17 vs 0.84, p=0.048; 674.8 vs 609.1, p=0.031; 1263 vs 578.4, p=0.001, respectfully). Severe radiological findings showed a positive correlation with the need for HFNC and/or (N)IMV (p=0.021 and p=0.032. respectfully), as well as with higher values of WBC, LDH and ferritin (p=0.042, p=0.035 and p=0.017, respectively). Conclusions: There is a difference between the presentation of the disease and analyzed laboratory markers between sexes. The difference is most likely multifactorial and should require further research in order to discover other risk and prognostic factors. © 2025 Society of Medical Biochemists of Serbia. All rights reserved.

Background: The aim of this study was to establish whether non-atopic patients with cough variant asthma (CVA) have different pattern of response to direct bronchoconstrictors than non-atopic patients with classic asthma (CA). Method: A total of 170 patients of both sexes with stable CVA and CA were screened for the study and 153 were included. Patients with proven atopy were not included and 17 patients with worsening of their condition or with verified bronchial obstruction during screening were excluded. All included patients performed spirometry and underwent a bronchial challenge with histamine according to long-standing protocol in our laboratory. Results: Significantly higher frequency of bronchial hyper-responsiveness (BHR) was found in patients with CA than in patients with CVA (63.9% vs. 44.9%, respectively; p < 0.05). Sensitivity was significantly lower in patients with CVA (p < 0.05), while no significant difference was found in maximal response and responsiveness. Only patients with positive challenge tests were included in the analysis. Conclusion: Adult non-atopic patients with CVA and CA have a pattern of response to non-specific bronchial stimuli similar to atopic patients with same conditions, with the exception of similar maximal response, which may reflect the efficacy of previous treatment. We believe that further studies are needed to clarify the mechanisms involved in airway response to non-specific stimuli in CVA and CA, especially in non-atopic patients. Further studies should also clarify whether this response pattern has any implications on clinical presentation or on treatment options. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Introduction: Bronchiectasis is a chronic progressive respiratory disease characterized by permanent dilatation of the bronchi. It is a complex condition with numerous different etiologies, co-morbidities, and a heterogeneous presentation. As we know, there is a lack of studies that describe the differences and compare the characteristics between focal and multifocal bronchiectasis. The aim of this study is to identify differences in clinical characteristics presentation, severity or distribution in focal and multifocal bronchiectasis, and prognostic implications. Methods: 126 patients with computed tomography (CT)-verified bronchiectasis were enrolled. Baseline characteristics that included age, sex, smoking history, and respiratory symptoms were recorded, with special attention paid to hemoptysis appearance, body mass index, and comorbidities. The type of bronchiectasis determined by CT scan and the modified Reiff scores indicating radiological severity were recorded. Patients were divided in two groups (I is focal and II is multifocal). Results: There were no statistically significant differences in age, smoking status, comorbidity, and BMI between the two groups. Multifocality was associated with a significantly higher proportion of females (p = 0.014), the rate of hemoptysis (p = 0.023), and the number of hospitalizations, but not of exacerbations and prevalence of immunodeficiency (p = 0.049). Significantly, a high number of subjects with multifocality had bronchiectasis of moderate severity, and post-infective and asthma-associated phenotypes were the dominant in this group. Unexpectedly, the cystic and varicose radiological phenotype (which need more time to develop) were more dominant in the focal group. The cylindrical phenotype was equally observed in the multifocal and focal groups. Conclusions: Our study suggests that multifocality is not related to age, number of exacerbations, or radiological phenotype, but it seems to be associated with the clinical post-infective phenotype, immunodeficiency, frequent hospitalizations, and severity. Thus, the presence of multifocal bronchiectasis may act as a biomarker of severity and poor outcomes in these patients. © 2024 by the authors.

Problem considered: Having cardiovascular, pulmonary and metabolic illnesses increases the likelihood of developing critical COVID-19. As the global population is aging, people with chronic illnesses may have high demands for health care, including critical care, in future health crises. The purpose of this research was to examine whether presence of different pre-existing chronic illnesses were associated with the onset of respiratory failure among patients who were treated and discharged from the intensive care unit. Methods: A retrospective cohort study was conducted at the University Hospital “Dr Dragiša Mišović-Dedinje” in Belgrade (Serbia) during the January–March 2021 epidemic wave, which had the highest mortality rate in Serbia. The study included COVID-19 patients who were treated and discharged from the intensive care unit (ICU). Data on chronic illnesses and clinical parameters regarding COVID-19 were retrieved from the electronic medical records. Results: Of 299 surviving ICU-treated patients during the study period, 47.5 % required mechanical ventilation. The adjusted logistic regression models adjusted for body mass index (BMI), platelet count, C-reactive protein, interleukin-6, lactate dehydrogenase, urea, oxygen saturation on admission and CT score showed that diabetes, neurological disorders (predominantly stroke), and recent injuries/fractures were independently associated with the onset of respiratory failure. Patients who had respiratory failure also had a higher BMI, laboratory parameters, and CT severity scores on admission. Conclusion: People with pre-existing diabetes, neurological disorders (especially stroke), and recent injuries/fractures are at higher risk of respiratory failure in COVID-19 and should strictly adhere to COVID-19 prevention measures to minimize the risk of getting infected. © 2024 The Authors

Purpose: The Phenotypes of COPD in Central and Eastern Europe (POPE) study assessed the prevalence and clinical characteristics of four clinical COPD phenotypes, but not mortality. This retrospective analysis of the POPE study (RETRO-POPE) investigated the relationship between all-cause mortality and patient characteristics using two grouping methods: clinical phenotyping (as in POPE) and Burgel clustering, to better identify high-risk patients. Patients and Methods: The two largest POPE study patient cohorts (Czech Republic and Serbia) were categorized into one of four clinical phenotypes (acute exacerbators [with/without chronic bronchitis], non-exacerbators, asthma–COPD overlap), and one of five Burgel clusters based on comorbidities, lung function, age, body mass index (BMI) and dyspnea (very severe comorbid, very severe respiratory, moderate-to-severe respiratory, moderate-to-severe comorbid/obese, and mild respiratory). Patients were followed-up for approximately 7 years for survival status. Results: Overall, 801 of 1,003 screened patients had sufficient data for analysis. Of these, 440 patients (54.9%) were alive and 361 (45.1%) had died at the end of follow-up. Analysis of survival by clinical phenotype showed no significant differences between the phenotypes (P=0.211). However, Burgel clustering demonstrated significant differences in survival between clusters (P>0.001), with patients in the “very severe comorbid” and “very severe respiratory” clusters most likely to die. Overall survival was not significantly different between Serbia and the Czech Republic after adjustment for age, BMI, comorbidities and forced expiratory volume in 1 second (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.65–0.99; P=0.036 [unadjusted]; HR 0.88, 95% CI 0.7–1.1; P=0.257 [adjusted]). The most common causes of death were respiratory-related (36.8%), followed by cardiovascular (25.2%) then neoplasm (15.2%). Conclusion: Patient clusters based on comorbidities, lung function, age, BMI and dyspnea were more likely to show differences in COPD mortality risk than phenotypes defined by exacerbation history and presence/absence of chronic bronchitis and/or asthmatic features. © 2023, Dove Medical Press Ltd. All rights reserved.

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is an irreversible disease and has influence on patients’ quality of life. The aim is to investigate the influence of gender on the illness perception in COPD patients. MATERIALS AND METHODS: This prospective study enrolled 151 COPD patients. For the evaluation of illness perception, we used Brief Illness Perception Questionnaire (BIPQ). RESULTS: Average FEV1 values were significantly different (p = 0.007) in favor of woman compared to men. There was a higher proportion of GOLD stage 3 and less stage 4 in women. We found a significant difference in total BIPQ scores between female and male patients (p = 0.008). Women gave a significantly higher score on question 6 and 8 (p = 0.003). We found a significant difference in total BIPQ scores between female and male patients. Women perceive COPD as a significantly more threatening disease and accept chronic course and long-term treatment. CONCLUSION: COPD is no longer a disease that predominantly affects men. BIPQ is a convenient tool for fast assessment of illness perception for COPD. Patients’ perceptions of COPD is in correlation with gender and GOLD stadium. The results of this study have potential benefits in terms of health promotion and improvement of the quality of life and outcome (Fig. 4, Ref. 21). Text in PDF www.elis.sk © (2023). All rights reserved.

Background: Inflammation, oxidative stress and an imbalance between proteases and protease inhibitors are recognized pathophysiological features of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate serum levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with COPD and to assess their relationship with lung function, symptom severity scores and recent acute exacerbations. Methods: In this observational cohort study, serum levels of MMP-9 and TIMP-1 and the MMP-9/TIMP-1 ratio in the peripheral blood of COPD patients with stable disease and healthy controls were determined, and their association with lung function (postbronchodilator spirometry, body plethysmography, single breath diffusion capacity for carbon monoxide), symptom severity scores (mMRC and CAT) and exacerbation history were assessed. Results: COPD patients (n = 98) had significantly higher levels of serum MMP-9 and TIMP-1 and a higher MMP-9/TIMP-1 ratio than healthy controls (n = 47) (p ≤ 0.001). The areas under the receiver operating characteristic curve for MMP-9, TIMP-1 and the MMP-9/TIMP-1 ratio for COPD diagnosis were 0.974, 0.961 and 0.910, respectively (all p < 0.05). MMP-9 and the MMP-9/TIMP-1 ratio were both negatively correlated with FVC, FEV1, FEV1/FVC, VC, and IC (all p < 0.05). For MMP-9, a positive correlation was found with RV/TLC% (p = 0.005), and a positive correlation was found for the MMP-9/TIMP-1 ratio with RV% and RV/TLC% (p = 0.013 and 0.002, respectively). Patients with COPD GOLD 3 and 4 presented greater MMP-9 levels and a greater MMP-9/TIMP-1 ratio compared to GOLD 1 and 2 patients (p ≤ 0.001). No correlation between diffusion capacity for carbon monoxide and number of acute exacerbations in the previous year was found. Conclusions: COPD patients have elevated serum levels of MMP-9 and TIMP-1 and MMP-9/TIMP-1 ratio. COPD patients have an imbalance between MMP-9 and TIMP-1 in favor of a pro-proteolytic environment, which overall indicates the importance of the MMP-9/TIMP-1 ratio as a potential biomarker for COPD diagnosis and severity. © 2023, The Author(s).

Introduction: The Neutrophil-to-Lymphocyte Ratio (NLR) has been utilized to predict clinical outcomes in cardiovascular diseases, infectious diseases, and solid tumors and it has a potential association with the severity of Chronic Obstructive Pulmonary Disease (COPD). This study aimed to determine whether NLR is a possible predictor of inflammation severity and mortality in COPD. Methodology: A prospective analysis of NLR in 70 COPD patients, and its relation with biochemical, lung function parameters, and mortality was assessed. Results: NLR was negatively associated with oxygen saturation (p < 0.05) and positively related to C-reactive protein (CRP) (p < 0.05), matrix metalloproteinase-9 (MMP-9) (p ≤ 0.001), tissue inhibitor of metalloproteinase-1 (TIMP-1) (p < 0.05), MMP-9/TIMP-1 ratio (p < 0.05), and the modified Medical Research Council dyspnea scale (mMRC) score (p < 0.05). Deceased patients had significantly higher NLR (p < 0.05). Older age and lower levels of saturation were independently associated with higher mortality in COPD patients (p < 0.05). Conclusions: NLR in COPD correlates with inflammation and protease/antiprotease balance, with elevated NLR detected in deceased patients. These findings suggest that NLR can be a helpful clinical marker in COPD. Copyright © 2025 Dimic-Janjic et al.

Background: Depressive symptoms are frequent in sarcoidosis. We assessed the impact of sarcoidosis symptoms, pulmonary function, fatigue, radiographic findings, comorbidities, treatment, and serum levels of 25-hydroxyvitamin D (25(OH)D) on depressive symptoms in sarcoidosis patients. Methods: In a cross-sectional study, we measured depressive symptoms using the Center for Epidemiologic Studies – Depression Scale (CES-D) and fatigue using the Fatigue Assessment Scale (FAS). Presence of depressive symptoms was defined with CES-D scores ≥16 and ≥20, respectively. Fatigue was defined as having an FAS score of ≥22. Results: A total of 400 patients were included in the study. CES-D score ≥16 had 128 patients, while CES-D score ≥20 had 86 patients. In a multivariate binomial logistic regression model, the following independent predictors of CES-D score ≥16 were identified: female gender (odds ratio, OR 1.983), chronic sarcoidosis (OR 2.311), serum levels of 25(OH)D ≤20 ng/mL (OR 2.326), persistent dry cough (OR 2.173), FAS Scores ≥22 (OR 9.243), and chest X-ray stage 3 (8.851). Five variables were independent predictors of CES-D score ≥20: diplopia (OR 4.411), FEV1 <80% predicted associated with FVC <80% predicted (OR 2.311), serum levels of 25(OH)D ≤20 ng/mL (OR 2.278), persistent dry cough (OR 3.001), and FAS Scores ≥22 (OR 7.611). Conclusions: Measuring the contribution of low serum 25-hydroxyvitamin D and the impact of persistent dry cough on depressive symptoms in patients with sarcoidosis may be crucial in deciding whether to use vitamin D3 alone or with antitussive therapy before the psychiatric diagnosis of depression with antidepressant therapy initiation. © 2025 Society of Medical Biochemists of Serbia. All rights reserved.