Browsing by Author "Trboljevac, Nikola (57722831100)"

Endobronchial tuberculosis is a rare form of tuberculosis that is characterized by the presence of tuberculous granuloma within the respiratory tract, usually in the trachea or main bronchi. Multiple key notes regarding this form make it difficult to detect and treat, which can lead to prolonged, lifelong even, problems that lead to a significant loss in quality of life. Even if the conventional treatment for tuberculosis is started on time, endobronchial tuberculosis can still develop. In those cases, a bronchoscopy should be performed to objectify the type of endobronchial tuberculosis and treat it in order to prevent permanent airway stenosis. In this paper, we will note the main characteristics of endobronchial tuberculosis, as well as bronchoscopy procedures used for its treatment such as balloon dilatation, laser, argon plasma coagulation, cryotherapy, and implementation of the stent. The main goal is to raise awareness of endobronchial tuberculosis to reduce the risk of complications of its mistreatment. Copyright © 2025 Popevic et al.

Legionella pneumophila is a rarely diagnosed microorganism in Serbia. It causes legionellosis, usually a mild respiratory infection. However, in some cases it can be severe and even life threatening. In June 2020, during the COVID-19 pandemic, a patient with symptoms of the aforesaid infection, namely severe pneumonia and acute respiratory distress syndrome, was admitted to the hospital. The multiplex polymerase chain reaction (PCR) test (The BioFire FilmArray Pneumonia Panel plus) detected the presence of L. pneumophila in the patient’s bronchial secretions. The specific culture for the detection of that organism, however, remained sterile. The patient’s paired sera had been sent for serology and the results in both of them came back positive for Legionella spp. 1–6, while the assays specific for each one of the 10 serogroups detected more than a fourfold increase of antibody titers in an uncommon serogroup 2 only. The patient was treated with moxifloxacin; he recovered well and was discharged after 26 days of hospitalization. Having being diagnosed with the L. pneumophila infection correctly through the multiplex PCR test, the patient was given the right therapy with moxifloxacin. The serologic assays corroborated this result and revealed the uncommon group 2, thus confirming the necessity of carrying out all the tests available to attain the exact diagnosis of legionellosis. © The Author(s) 2022.

Legionella pneumophila is a rarely diagnosed microorganism in Serbia. It causes legionellosis, usually a mild respiratory infection. However, in some cases it can be severe and even life threatening. In June 2020, during the COVID-19 pandemic, a patient with symptoms of the aforesaid infection, namely severe pneumonia and acute respiratory distress syndrome, was admitted to the hospital. The multiplex polymerase chain reaction (PCR) test (The BioFire FilmArray Pneumonia Panel plus) detected the presence of L. pneumophila in the patient’s bronchial secretions. The specific culture for the detection of that organism, however, remained sterile. The patient’s paired sera had been sent for serology and the results in both of them came back positive for Legionella spp. 1–6, while the assays specific for each one of the 10 serogroups detected more than a fourfold increase of antibody titers in an uncommon serogroup 2 only. The patient was treated with moxifloxacin; he recovered well and was discharged after 26 days of hospitalization. Having being diagnosed with the L. pneumophila infection correctly through the multiplex PCR test, the patient was given the right therapy with moxifloxacin. The serologic assays corroborated this result and revealed the uncommon group 2, thus confirming the necessity of carrying out all the tests available to attain the exact diagnosis of legionellosis. © The Author(s) 2022.

Introduction: The aim of the study was to determine the survival probability of critically ill patients with COVID-19 infection who needed mechanical ventilation and to determine the efficacy of Tocilizumab use. Methodology: The study was designed as a retrospective analysis of consecutive patients older than 18 years, treated in an intensive care unit. The criteria for admission to the intensive care unit was severe respiratory failure requiring mechanical ventilation. All patients received corticosteroid therapy (methylprednisolone 1-2 mg/kg). Tocilizumab was used at a dose of 8 mg/kg in patients with a severe form of the disease (onset, or developed ARDS), followed by cytokine storm (IL-6 ≥ 40 ng/L and CRP ≥ 50 mg/L). Results: 88 patients were included in the study. Intrahospital mortality was 48.86%. No statistically significant difference was observed between patients with and without tocilizumab therapy. In the group of patients in whom this therapy was applied, the values of intrahospital survival were 45.7%, while in the group without this therapy the probability of intrahospital survival was only 0.93%. The probability of survival in the group with noninvasive mechanical ventilation (NIV) was 94.7%, while in the group with invasive mechanical ventilation (IMV) 0.78%. The duration of symptoms before hospitalization (RR-1.088 CI 1.025-1.155, p < 0.05), as well as the duration of IMV (RR-0.906 CI 0.841-0.976, p < 0.05), were shown to be an independent predictor of poor outcome. Conclusions: The mortality of patients with the most severe form of respiratory failure caused by COVID-19 infection remains high. Independent predictors of poor outcomes were needed for invasive mechanical ventilation and the duration of symptoms before hospitalization or late initiation of appropriate therapy. Copyright © 2022 Stojanović et al.

Introduction: The aim of the study was to determine the survival probability of critically ill patients with COVID-19 infection who needed mechanical ventilation and to determine the efficacy of Tocilizumab use. Methodology: The study was designed as a retrospective analysis of consecutive patients older than 18 years, treated in an intensive care unit. The criteria for admission to the intensive care unit was severe respiratory failure requiring mechanical ventilation. All patients received corticosteroid therapy (methylprednisolone 1-2 mg/kg). Tocilizumab was used at a dose of 8 mg/kg in patients with a severe form of the disease (onset, or developed ARDS), followed by cytokine storm (IL-6 ≥ 40 ng/L and CRP ≥ 50 mg/L). Results: 88 patients were included in the study. Intrahospital mortality was 48.86%. No statistically significant difference was observed between patients with and without tocilizumab therapy. In the group of patients in whom this therapy was applied, the values of intrahospital survival were 45.7%, while in the group without this therapy the probability of intrahospital survival was only 0.93%. The probability of survival in the group with noninvasive mechanical ventilation (NIV) was 94.7%, while in the group with invasive mechanical ventilation (IMV) 0.78%. The duration of symptoms before hospitalization (RR-1.088 CI 1.025-1.155, p < 0.05), as well as the duration of IMV (RR-0.906 CI 0.841-0.976, p < 0.05), were shown to be an independent predictor of poor outcome. Conclusions: The mortality of patients with the most severe form of respiratory failure caused by COVID-19 infection remains high. Independent predictors of poor outcomes were needed for invasive mechanical ventilation and the duration of symptoms before hospitalization or late initiation of appropriate therapy. Copyright © 2022 Stojanović et al.

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.