Browsing by Author "Pesut, Dragica (55187519500)"

INTRODUCTION: Invasive blastoschizomycosis is an emerging and fatal infection of severely immunocompromised patients. Pneumonia caused by this fungus has been reported as a post mortem diagnosis in a patient with haematologic malignancy. CASE REPORT: A 46-year-old unemployed Caucasian man, smoker, was admitted on emergency in a serious condition, with bilateral pulmonary infiltrates (chest x-ray) and incapsulated mediastinal pleural effusions (computed tomography scans). Blastoschizomyces capitatus (Trichosporon capitatum) has been isolated from two sputum samples and bronchial secretion aspirate obtained by bronchoscopy. CONCLUSION: Pneumonia caused by Blastoschizomyces capitatus can develop in subjects without underlying malignancy but with history of heavy alcohol intake, tobacco smoking and malnutrition and may have favorable disease outcome.

The objective of this study is to estimate the burden of tuberculosis (TB) in Serbia in the period 1992-2002 based on incidence, mortality, and disability adjusted life years (DALY). The average age-adjusted TB incidence rate in the period 1992-2002 was 36.7/100,000 in males and 21.4/100,000 in females. During the period observed, TB incidence levelled of after a long period of decreasing trend during the preceding several decades. The incidence showed slightly increasing tendency in males and decreasing one in females. The average age-adjusted mortality rate was 4.1/100,000 in males and 1.3/100,000 in females. Mortality rates significantly decreased in both males (P = .0001) and females (P = .0001). The burden of TB (DALY) was 0.70/1000 for males and 0.26/1000 for females. DALY rates significantly decreased in both males (P = .009) and females (P = .008). TB incidence and mortality as well as DALY rates increased with aging. © 2006 Association for Professionals in Infection Control and Epidemiology, Inc.

Cigarette smoking is the single most common cause of morbidity and mortality in the world, and the most important risk factor for developing lung cancer (LC). LC is the most frequent form of cancer in men worldwide. Almost half of the adult population in Serbia smokes. The aim of the study was to analyze the incidence rate (IR) and trend of LC in Serbia from 1994 to 2003, with special regard to tobacco smoking status (TSS). Referral annual reports of the Institute of Lung Diseases and Tuberculosis on newly diagnosed cases of LC, categorized by sex and TSS, have been analyzed TSS included three categories: smokers, ex-smokers and non-smokers. LC IR showed an increasing tendency (RR: 0.2859) with 34/100,000 population in 2003, and significant differences among districts (6.3-39.1/100.000). Smokers, ex-smokers, and non-smokers account for 70.3%, 17% and 12.6%, respectively (p < 0.001). An increasing trend of female lung cancer was evident in all three categories, but the most remarkable in smokers. There is a clear and urgent need to inform the population on harmful effects of tobacco smoking on health and risks for lung cancer.

Although tuberculosis (TB) is a curable disease, it continues to be one of the leading infections associated with death in the world. Extra-pulmonary TB (EPTB) occurs in approximately 10% of the total cases, presenting with lymph nodes, pleura, bone and genitourinary tract as the most common locations. Genitourinary tuberculosis, the second most common EPTB, is very difficult to diagnose unless there is a high index of suspicion. Isolated TB orchitis or prostatitis without clinical evidence of renal involvement is a rare entity among genitourinary tuberculosis. We presented the first reported case of TB prostatitis and orchitis associated with pulmonary TB and the presence of an acute massive caseous pneumonia in an immunocompetent man. Despite the anti-TB therapy, the patient presented a rapid progression of disease and deterioration of general conditions taking to death, which occurred four days after TB treatment had started. Disseminated TB is a relatively uncommon cause of acute massive caseous pneumonia; however, there should always be suspicion of the disease, since it is a potentially treatable cause. This rare case supports the assertion that TB should be considered as an important differential diagnosis of genitourinary tumors irrespective of evidence of active TB elsewhere in the body. © 2017, Instituto de Medicina Tropical de Sao Paulo. All rights reserved.

Background: The increasing prevalence of allergic rhinitis (AR) is reported worldwide. Illness perception (IP) assessment is warranted in current routine clinical practice to assist communication between patients and medical staff, and improve adherence to treatment and disease outcome. Objective: To investigate a group of patients with AR in terms of their IP by the Brief Illness Perception Questionnaire (BIPQ) and to correlate the findings with demographic and clinical features. Methods: In this observational questionnaire-based study, a successive series of patients treated for AR at the Allergology and Immunology Teaching Hospital, Clinical Centre of Serbia in Belgrade, were enrolled from September 2010 to January 2011, and 93 valid questionnaires were analyzed. Each item of the BIPQ assessed one dimension of IP like the consequences, timeline, personal control, treatment control, identity, coherence, emotional representation and concern. Results: The patients' average age: 35.25±12.42; male/female ratio: 0.79; the overall BIPQ score=34.69±11.89. The highest item-related scores were found for treatment control (8.17±2.28), illness understanding (7.34±2.96) and emotional representation (6.30±3.45), and the lowest for identity (4.8±2.78) and affection (4.83±2.65). Women compared with men perceive AR as a significantly more threatening disease (P=0.04). No significant correlation between the BIPQ total or item-related scores was found for any other demographic or clinical feature. Conclusion: The BIPQ, which allows rapid assessment of IP and reveals gender differences in AR, is a convenient tool for use in routine clinical practice. Further investigation is needed to demonstrate how IP may influence patients' behavior in AR, treatment adherence and disease outcome. © 2013 John Wiley & Sons Ltd.

In this observational study based on an original questionnaire, we investigated a group of health care workers--smokers employees of a teaching hospital in terms of basic features of tobacco smoking. A total of 137 smokers were asked to answer the questions on voluntary basis and anonymously. Response rate was 70%: a total of 96 participants with valid questionnaires consisted of 93% women, predominantly nurses (71%); mean age 40.5 (range 19-58 years). They started smoking at the age of 20 years on average; 83% started smoking before the age of 23. The mean smoking duration was 19.1 +/- 9.378 years and the average number of the cigarettes smoked per day was 17 +/- 7.90. They smoke 18 +/- 13.55 pack/year; 25% smoke 7.42 pack/year, 25% smoke > 27.5 pack/year. Some 59% had tried and failed to stop smoking while 61% intend to stop smoking (married significantly more intend to quit than singles). The most important reasons for smoking, in a rank order, were: a) habit (35.36%), b) nervousness (12.13%) and c) pleasure (11.11%); boredom and desire were rarely mentioned; only 7 (7.3%) stated addiction. There is an urgent need of continuous medical education on tobacco smoking as an addictive disease, its primary prevention and cure, including professional assistance in smoking cessation.

Aim Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. Methods TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. Results 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. Conclusion Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop. © 2017 Elsevier Ltd

A cross-sectional study on pulmonary TB diagnosis delay in an intermediate TB incidence setting showed average patient's delay of 44±61.65days and total delay of 103±148days. Alcoholism, lack of TB cases in family, diabetes mellitus, relapse, cough or tachycardia (p<0.01), absence of hemoptysis, dyspnea and anemia (p<0.01), age ≥40 (p<0.05), negative auscultation and positive sputum smear findings (p<0.05) were significantly associated with patient's delay >30 days. Age <40 years, negative auscultation and sputum smear findings (p<0.01), female sex, city as residence (p<0.05), absence of cough, sputum, weight loss, fever, excavation (p<0.01), and night sweats (p<0.05) were significantly associated with total delay > 103 days. Further population education and continual medical education are waranted.

Background: Population's knowledge on tuberculosis (TB) is crucial in early seeking of medical care. Delay in diagnosis for any reason contributes to advanced forms and TB transmission in the community. Knowledge about TB in general population of Serbia is poor, including vulnerable groups. Aim: to assess knowledge about TB in a group of non medical students in University of Belgrade, their attitudes towards TB patients, sources of medical information they use or desire. Methods:- observational, questionnaire based study. University students of the Faculty of Organizational Science and Faculty of Geography completed the 27-item questionnaires voluntarily and anonymously. The questions related to TB etiology, way of transmission, risk factors and the source of health information students preffer. Statistical analysis was performed. Results: All the participants (69 students aged 20±0.777 years, 69.7% male, 30.3% female) previously heard about TB, mostly describing it as pulmonary disease. Only 22 (31.88%) selected bacillus as the only cause of TB, and 20% selected answer "I do not know". TB is curable (95%). One third does not know about TB symptoms and 45/69 (65%) think that TB is an infectious disease. Majority (78.3%) would pay visit to TB patient, 1/2 with fear of infection that is in positive correlation with knowledge on infectiousness (p=0.041). Television is the most common used source of health information. Students have the greatest confidence in doctors' information. Conclusion: Students' knowledge on TB is inadequate, especially on its cause and way of transmission. More effort is needed in university students' health education.

Aim: Tuberculosis (TB) continues to be an important health problem in Serbia, as a country with numerous socioeconomic problems. Health care workers, especially medical and dental students could be key persons to engage in prevention of TB. The aim of our study was to compare the knowledge level and awareness of TB among medical and dental students. Methods: Cross-sectional study was conducted at the School of Medicine and the School of Dentistry, University of Belgrade, Serbia. A sample of 350 students was selected by stratified sampling.Data about knowledge and awareness of TB was collected through the anonymous (self-administered) questionnaire. Results: 300 questionnaires were returned; response rate was 85.7%. Medical students gave significantlyhigher correct responses about modes of transmission of TB (p<0.001). Significantly higher proportion of medical students (p=0.003) knew that age above 65 years is risk period of life for getting TB, but only 6.5% of them noted that the age of puberty is the risk period too. High proportion of both groups agreed that alcoholism and AIDS are the conditions, which can increase risk for getting TB. Medical students have better knowledge about therapy of TB, but there were no differences concerning questions about diagnosis. Conclusion: In spite of valid basic awareness of TB, there were some gaps in the knowledge, more frequently among dental then medical students. This study suggests that students need more training and more practice.

Background: Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy. Method: Design: A cross-sectional survey. Setting: 13 tuberculosis clinics within different European countries and the USA. Population/sample: All patients with tuberculosis seen at these clinics for a period > 1 year. Instrument: Questionnaire survey based on continuous data collection. Main outcome measures: number and proportion of women with tuberculosis who were pregnant; timing of diagnosis in relation to pregnancy, including those who were pregnant or delivered in the 3 months prior to the diagnosis of TB and those who developed TB within 3 months after delivery. Results: Pregnancy occurred in 224 (1.5 %) of 15,217 TB patients and followed the expected rate predicted from the crude birth rate for the clinic populations. TB was diagnosed more commonly in the 3 months after delivery (n = 103) than during pregnancy (n = 68; χ 2 = 25.1, P < 0.001). Conclusions: TB is diagnosed more frequently after delivery, despite variations in local TB incidence and healthcare systems. © 2016 The Author(s).

This paper is a review of current approaches on pulmonary rehabilitation (PR) in chronic pulmonary diseases. Pulmonary rehabilitation is the most accepted method of non-pharmacological treatment in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma, bronchiectasis, cystic fibrosis, interstitial lung disease, neuromuscular degenerative disease and post-tuberculosis lung sequelae. Throughout its components, especially oxygen therapy, it is the most important intervention in chronic respiratory failure in order to improve exercise tolerance, lung function and self-management. Enrolling patients in pulmonary rehabilitation programmes is a consistent help to a better control of their illness and a step forward to the international standards of treating COPD and non-COPD chronic respiratory diseases. It is evidence-based that PR is effective in reducing dyspnoea, improving health-related quality of life, reducing the number of hospital days and the utilisation of costly healthcare resources; there are also psychosocial benefits from comprehensive PR programmes in patients with COPD. PR is currently considered as effective in patients with COPD and in some patients with chronic respiratory diseases other than COPD.

[No abstract available]

Recurrent pleural effusion of unrevealed etiology is important problem in clinical practice. Yellow nail syndrome (YNS) is a rare disorder, which consists of the triad of deformed yellow nails, lymphedema and respiratory disorder. It is often accompanied with bronchiectasis, pleural effusion and/or chronic rhinosinusitis. Frequently, only two of three features are present. The exact mechanism of YNS remains unknown. However, it is thought to reflect functional defects in the lymphatic vasculature. We report on a case of yellow nail syndrome in a 75-year old man, heavy smoker, treated for exacerbation of chronic obstructive pulmonary disease and chronic hypercapnic respiratory failure. He had characteristic nail changes and recurrent pleural effusion of the unknown etiology until the exudation was put into connection with YNS.