Browsing by Author "Pesut, Dragica P. (55187519500)"

Adult Langerhans Cell Histiocytosis (LCH) is a quite rare and tobacco smoking related disease. We report on a case of pulmonary LCH, diagnosed at the Teaching Hospital of Lung Disease, Clinical Centre of Serbia in Belgrade. On admission, a 45-year-old mechanician, smoker (30 pack/years) had severe dyspnea, fatigue and massive pretibial/ ankle oedema due to right-heart failure. Since the age of 19 years, he suffered from recurrent pneumothorax, and the first radiographic changes (bilateral micronodular shadows) were present at the age of 39 together with obstructive disturbance of ventilation and respiratory failure. At the patient's age of 40 years, open lung biopsy led to diagnosis of LCH. Investigation was completed with computed tomography scans, hemodynamic investigation (heart catheterization and pneumoangiography), echocardiography, skeletal scintigraphy, and additional lung function testing. Treatment included methylprednisolon, sildenafil, and diuretics. The patient is being followed up and severe pulmonary arterial hypertension is usually considered a poor prognosis.

The asthma mortality pattern differs among countries. No published evidence is currently available on asthma mortality in a European low-middle-income country in socioeconomic transition. We analyzed the trend of asthma mortality rate in Serbia during the period 1980 2009. a descriptive study; source of data: Republic of Serbia Institute of Statistics Death Registry. We analyzed asthma mortality data in the total population, including gender specific analysis, and in the selected >5 34 year age group. The International Classification of Diseases codes for asthma 493 (1980 1996) and J45+J46 (1997 2009) were included. Population estimates were based on 1991 and 2002 census data, with extrapolation. The over-all average mortality rate was 7.27±2.14/100,000 inhabitants. The mortality rate peaked in 1981 at 11.3/100,000 but was 4.45/100,000 in the last year of analysis. While both overall mortality rate, as well as gender specific rates, showed clear decreases over the observed 30-year period (average absolute annual decrease of 0.195/100,000 inhabitants, 0.241/100,000 men and 0.149/100,000 women; p <0.001) with corresponding relative annual decreases of 2.9 for the whole population, 3.0 for men and 2.8 for women, a stable trend of the rate was found in the age group >5-34 years. Male-to-female ratio was 1.59±0.186, on average and it showed a stable trend over the observed period. Although the failure of the health care system during the socioeconomic crisis of the 1990s might have transiently affected asthma mortality rates, the overall mortality rate for the disease shows a favorable decreasing trend. © 2011 Elsevier Ltd. All rights reserved.

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Introduction: Despite the prevalence and importance of anxiety and depressive symptoms in chronic obstructive pulmonary disease (COPD) patients, procedures for routine screening in therapeutic protocols are not commonly used. Objective: to assess the symptoms of anxiety and depression in COPD patients and to evaluate their relation to patients' demographic parameters and clinical characteristics. Methods: The research included 40 COPD patients, treated at the Institute of Lung Diseases and Tuberculosis, Clinical Centre Serbia in Belgrade, from November 2010 to February 2011. Study data were assessed by the questionnaire designed for the purposes of the present study together with Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS). Results: Mean HARS score was 10.7 (SD=6.5) (22.5% subjects scored≤17) and mean HDRS score was 10.7 (SD=8.2) (20.0% subjects scored ≤17). Depression was significantly higher in women (Z=-1.971: p=0.049). Lower value of forced expiratory volume in one second (FEV1) correlated with higher HDRS score (ρ=-0.321; p=0.042). The incidence of anxiety and depression symptoms is higher in patients with more hospitalizations and longer hospital stay. Conclusion: The prevalence and importance of anxiety and depressive symptoms in COPD patients require implementation of a specific questionnaire as the procedure for routine screening in order to detect affective symptoms early and to prevent the progression.