We examined whether the COVID-19 pandemic has affected the incidence of
tuberculosis (TB) and influenza in Serbia, a Southeast European country with a
low TB incidence rate and a mandatory BCG ...vaccination at birth. The first case
of COVID-19 was registered on March 6, 2020. Despite the need for a sudden
adaptation of the health care system, routines of mycobacterial laboratories
have never stopped. In 2020, the number of newly diagnosed TB patients was
significantly lower than expected (p = 0.04), but the number of patients with
influenza increased when compared to 2019. Although many patients with influenza
A H1N1 were observed before the beginning of the COVID-19 pandemic, the
increment of cases could also be a consequence of cases of influenza with
COVID-like symptoms detected thereafter. It may also be attributed to
misclassification of clinical cases that were negative for SARS-CoV-2 and
reported as influenza. Difficulties to seek medical attention because of the
COVID-19 pandemic and possible underreporting are considered as reasons for the
decline in the incidence rate of TB. On the other hand, individual and social
measures to prevent the spread of SARS-CoV-2 such as wearing face masks, social
distancing, lockdown, which were strictly applied to COVID-19 patients, health
care staffs and most of the population, could have hindered TB infections more
than the two viral diseases, which appear to be more contagious. The increased
motivation of the population to protect their health during the COVID-19
pandemic provided an opportunity for their effective education. This is crucial
in further combating TB as a preventable disease.
Summary Background Connective tissue diseases (CTD) might be associated with various malignancies, and one of the most frequent is lung cancer (LC). Despite our understanding of pathogenesis, this ...association remains still unclear. The aim of the present study is to describe the clinical characteristics of patients with CTD who developed LC. Methods Of 375 successive patients with CTD followed up to University Hospital between 1995 and 2004, 24 patients were diagnosed with LC: 11 (46%) had systemic sclerosis (SSc), 6 (25%) rheumatoid arthritis (RA), 6 (25%) systemic lupus erythematosus (SLE), and 1 (4%) dermatomyositis. We analyzed LC stage, radiological presentation, histological type, patients’ smoking status, method of diagnosis, treatment applied, and disease outcome. Results Average duration of CTD was 13.95 (range 0–30) years. Non-small cell lung cancer (NSCLC) was significantly more frequent than small-cell lung cancer (SCLC). Among patients with NSCLC, 21 patients (85%) presented with stage III or IV. With regard to treatment, 13% patients underwent surgery, 25% chemotherapy, 4% patients combined chemo- and radiotherapy and 58% patients had only supportive therapy. The median survival was 5 months (range 1–96 months). Conclusion The majority of CTD patients who developed LC were diagnosed at advanced stage and had poor survival. Efforts for early detection of LC in CTD patients’ group are warranted.
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.
How patients relate to the experience of their illness has a direct impact over their behavior
.
We aimed to assess illness perception in patients with pulmonary tuberculosis (TB) by means of the ...Brief Illness Perception Questionnaire (BIPQ) in correlation with patients’ demographic features and clinical TB score.
Our observational questionnaire based study included series of consecutive TB patients enrolled in several countries from October 2008 to January 2011 with 167 valid questionnaires analyzed. Each BIPQ item assessed one dimension of illness perceptions like the consequences, timeline, personal control, treatment control, identity, coherence, emotional representation and concern. An open question referred to the main causes of TB in each patient’s opinion.
The over-all BIPQ score (36.25 ± 11.054) was in concordance with the clinical TB score (p ≤ 0.001). TB patients believed in the treatment (the highest item-related score for treatment control) but were unsure about the illness identity. Illness understanding and the clinical TB score were negatively correlated (p < 0.01). Only 25% of the participants stated bacteria or TB contact as the first ranked cause of the illness.
For routine clinical practice implementation of the BIPQ is convenient for obtaining fast and easy assessment of illness perception with potential utility in intervention design. This time saving effective personalized approach may improve communication with TB patients and contribute to better behavioral strategies in disease control.
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.
Tobacco smoking is major risk factor for development of chronic obstructive
pulmonary disease (COPD), which appears in 15-20% of smokers. Apart from
smoking, exposure to polluted air and various ...noxae, and several genetic
factors influence its development as well. The ABO blood type distribution
varies among populations in the world, but also within subpopulations. A
large number of studies have shown a correlation between blood types and the
pathology of various diseases. These markers, used in population genetic
research, have mainly shown deviations in the representation of blood groups
in different diseases, compared to the general population. The aim of this
study was to determine the ABO blood types distribution in patients with
COPD compared to the general population, and their possible association with
COPD stage, patients? nutritional status and lung function impairment. This
observational, prospective study included 150 patients (68.7% men and 31.3%
women), average age 64.80 ? 8.38 years, diagnosed with COPD. Data were
collected at the Clinical Center of Montenegro in Podgorica and at the
Special Hospital for Lung Diseases Brezovik in Niksic. Determination of
blood types of the ABO system and Rh factors for all subjects was performed
at the Blood Transfusion Center in Podgorica. Apart from patients? tobacco
smoking status (duration of smoking and the number of cigarettes smoked per
day expressed in pack/years for current smokers and former smokers), we also
analyzed their exposure to various other noxae, their body mass index, and
lung function in correlation to ABO blood type and Rh factor, and performed
statistical analysis. We found a significant difference in the distribution
of ABO blood types in patients with COPD compared to the general population.
The highest frequency of blood type A was found in patients with COPD. We
also found the lowest average values of spirometry parameters in that group,
which represented majority of those patients with respiratory insufficiency
having the most severe stage of the disease. Combined blood types A, B and
were significantly more common in patients with COPD in comparison to
blood type O, which is the least represented (23.3%). The least obstructive
disturbance of pulmonary ventilation was found in the patients with B type.
Respiratory insufficiency showed differences in gender representation, found
in 40.4% of women, and in 25.2% of men with terminal phase of COPD. The
prevalence of AB, higher than expected, decreases with the severity of the
disease.
Tuberculous (TB) synovitis is a rare, treatable, potentially lethal form of extrapulmonary TB resulting from massive lymphohematogenous dissemination of Mycobacterium tuberculosis (M. tuberculosis). ...We presented a case of TB synovitis of the knee in a Caucasian HIV-negative man from Romania, a high TB incidence country.
A 65-year old man presented with cough, high fever, mild wheezing, and swelling of the left knee. Chest radiography was normal. Sputum smears were Acid Fast Bacilli negative and Lowenstein-Jensen (L-J) culture negative for M. tuberculosis. Tuberculin skin test was negative. Respiratory symptoms disappeared in a week under antibiotics. Positive L-J cultures of knee punctation and favourable treatment outcome following standardized antituberculous treatment regimen confirmed the diagnosis of specific synovitis, which was also demonstrated by Magnetic Resonance Imaging (MRI).
Tuberculous synovitis is important differencial diagnosis in patients with arthropathies and risk factors for TB in all the countries and all patients' ages even when tuberculin skin test is negative.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Increased incidence of extrapulmonary tuberculosis (XPTB) is reported worldwide. Serbia is a country in socio-economic transition period with low-middle HIV prevalence and intermediate-to-low ...tuberculosis (TB) incidence rate, 100% directly observed treatment (DOT) coverage, and mandatory BCGC vaccination at birth. The aim of the study was to examine the incidence trend and clinical features of XPTB in Serbia during a 15-year period.
This retrospective observational study included XPTB cases diagnosed in the period between 1st January 1993 and 31st Decembre 2007, according to the reports of the National Referral Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data.
While the overall TB incidence rate showed a slight, not significant decreasing trend (p = 0.535), a significant increase was found for XPTB (y = 1.7996 + 0.089x; R2 = 0.4141; p = 0.01). A total of 2,858 XPTB cases (newly diagnosed and 10% relapses) gave an average age specific incidence rate of 2.51/100,000 population (95% confidence interval, SD = 0.6182) with 8.9% annual increase. The male-to-female ratio was 0.54. Lymph nodes were most frequently affected site (48.5%) followed by genitourinary (20.5%), pleural (12%), and osseo-arthicular (10.3%) TB. Treatment outcome was successful in 88.29% of patients (cured and completed), 3.64% died, 5.18% interrupted, 0.57% displaced, and 2.3% unknown.
Increasing trend of XPTB incidence rate may be a result of increased morbidity due to still present risk factors, possible higher detection rate in Serbia and better notification. A high coverage of newborns with BCG vaccination at birth might contribute to a decreased number and rare XPTB cases in children.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. The aim of the study was to determine are there significant differences in clinical manifestations, radiographic and lung ...function findings and therapeutic approach in menopausal female sarcoidosis pa-tients compared to premenopausal ones.
Seventy seven Caucasian women (average age 43.71 years, range 38-54) with sarcoidosis diagnosed at the University Hospital from January to October 2006, were included in the study. They were divided into two groups according to their menstrual period status. The group I included 42 women with normal menstrual cycle, while the group II included 35 menopausal women (either spontaneous or after hysterectomy). The patients were not under hormonal therapy.
We found significantly higher proportion of the first radiographic stage (66.7% vs 34.2%, p < 0.05) and acute form of sarcoidosis (57.2% vs 17.1%; p < 0.01) in the group I in relation to the group II. Extrapulmonary sarcoidosis was more frequent in the group II than in the group I (p < 0.01). Disturbances of lung ventilation were registered in 50.8% of all the patients, and decrease of one or both of diffusion parameters was found in 63.6%, but without significant differences between the groups (p > 0.05). Hypercalciuria was found in 19.1% of the patients in the group I and 42.8% of the patient in the group II (p < 0.05). A difference in the therapy approach was also found to be significant with methotrexate more frequently applied in the group II than in the group I (p < 0.01).
Menopausal women with sarcoidosis may represent a group of patients that requires special attention in diagnostic procedure, therapeutic approach and follow-up, to prevent unfavourable course of the disease. Attention should be particularly focused on the detection of extrapulmonary sites involvement in this group of the patients. Further prospective studies are needed to reveal the role of hormones, and especially plasma estrogen level in sarcoidosis appearance.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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