Sarcoidosis is an inflammatory granulomatous disease that is characterized by diverse organ system manifestations, a variable clinical course, and a predilection for affecting relatively young adults ...worldwide. Abnormalities on chest radiographs are detected in 85% to 95% of patients who have sarcoidosis. Approximately 20% to 50% of patients who have sarcoidosis present with respiratory symptoms, including dyspnea, cough, chest pain, and tightness of the chest. The clinical course and manifestations of pulmonary sarcoidosis are protean: spontaneous remission occurs in approximately two thirds of patients; up to 30% of patients have chronic course of the lung disease, resulting in progressive, (sometimes life-threatening) loss of lung function. Morbidity that correlates to sarcoidosis occurs in 1% to 4% of patients.
Evaluation of the health-related quality of life (HRQoL) in patients with respiratory diseases has been increasingly included into regular clinical studies, and HRQL in sarcoidosis has been evaluated ...since not a long ago. The aim of the study was to evaluate HRQoL in patients with sarcoidosis regarding gender differences, pre and after therapy. We investigated 202 pathohistologically verified sarcoidosis patients (154 female and 48 male) without comorbidities. HRQL was assessed by the disease-specific Sarcoidosis Health Questionnaire (SHQ), which contains 29 items, and cover three domains: everyday functioning, physical activities and emotional state. Total score, as well as the scores for each SHQ domains were calculated. HRQoL was estimated pre and after three months of therapy. At the study start, the lowest score value for the whole group was reported in SHQ emotional state domain (4.24), and the highest in domain of physical functioning (4.7). After three months, the lowest values were reported in domain of everyday activities, while the highest scores were found in emotional domain; all SHQ scores increased, but reached the statistical significance only in the everyday functioning and the physical activities domains. Analyzing mean SHQ scores in male and female sarcoidosis pts before therapy we found high statistically lower emotional and total score in female pts, as well as lower physical score. After the three months therapy we found high statistical difference in physical domain (i.e. women had lower physical score than men). Female sarcoidosis pts showed lower emotional, physical and total score before therapy. After the three-month therapy we found that women had lower physical score than men. SHQ showed good measurement properties both in the cross-sectional and longitudinal assessment of sarcoidosis patients.
Between February and November 2016, 17 tuberculosis (TB) cases were identified among high school students in Novi Pazar, Serbia. The objectives of our study were to describe the outbreak, to identify ...potential risk factors and to evaluate the applied control measures.
The outbreak was described by time, person and place. A retrospective cohort study was conducted. Attack rates, unadjusted relative risks (RR) and 95% confidence intervals (CI) were calculated. Multiple log-binomial regression analysis was performed to calculate adjusted RR.
Sixteen of the total 17 cases occurred among grade 3 students, AR 5.5%. Previous TB family history, (RR = 5.29; 95% CI = 1.63-17.12), spending time with a known TB case at school (RR = 5.38; 95% CI = 1.48-19.55) and exposure to secondhand smoke (RR = 3.37; 95% CI = 1.11-10.29) were all significantly and independently associated with the occurrence of TB.
Delayed diagnosis and reporting resulted in delayed initiation of the contact investigation and non-identification of latent TB cases probably favored the occurrence of this outbreak in a low incidence country. Public health authorities should consider revising the existing guidelines, promoting inter-sectorial collaboration and increasing awareness of public health professionals.
Recently published data indicate that vitamin D abnormalities are common in sarcoidosis patients. The purpose of this study was to compare serum vitamin 25(OH)D levels among sarcoidosis patients with ...different clinical cour - ses of the disease. The study also included the first observations on cognitive functions (i.e. depression and fatigue syndrome) in relation to vitamin D deficiency in sarcoidosis patients. At the Biochemical Laboratory of the Clinical Center of Serbia, Belgrade, vitamin D25(OH)D was measured using the Elecsys® Vitamin D total test. A total of 226 patients with biopsy-positive sarcoidosis were analyzed. The average median value of serum vitamin D was 9.47 mg/L, suggesting severe deficiency. Statistically significant correlation was found in patients with chronic disease and low levels of serum vitamin 25(OH)D (Chi-Square=6.044; df=2; p=0.014). The patient group with vitamin D serum levels higher than 20 mg/L showed higher levels of the mean forced vi tal capacity (FVC) by 380 mL, and forced expiratory volume in one second (FEV1) by 220 mL, when compared to the patient group with lower serum vitamin D. A statistically significant role was established for serum vitamin 25(OH)D levels as the predictor of fatigue (R2=0.878; p=0.038 (b=0.216)) and depression in patients with sarcoidosis (R2=0.80; p=0.000 (b=0.391)). The insufficiency of 25(OH)D seems to be an important factor in predicting the course of chronic disease, significant lung function impairments and cognitive failures such as fatigue and depression. The fact that the majo rity of the analyzed sarcoidosis patients had totally deficient serum 25(OH)D levels made this finding even more notable.
Nedavno objavljena istra`ivanja kod obo - le lih od sarkoidoze govore o ~estim abnormalnim vredno - stima vitamina D. Cilj ove studije bio je da se uporedi nivo vita mina 25(OH)D kod obolelih od sarkoidoze sa razli~itim klini~kim tokom bolesti. Tako|e, ova studija predstavlja prva za pa `anja o vezi izme|u kognitivnih funkcija (odnosno ose - }a ja depresije i zamora) i deficita vitamina D kod obolelih od sarko idoze. U Biohemijskoj laboratoriji Klini~kog centra Srbi - je vitamin D - 25(OH)D meren je kori{}enjem testa Elec sys® Vitamin D. Analizirano je 226 bolesnika sa sarkoidozom potvr|enom biopsijom. Prose~na srednja vrednost vitamina D u serumu bila je 9,47 mg/L, {to ukazuje na ozbiljan ne - dostatak. Statisti~ki zna~ajna korelacija na |e na je kod pa ci - je nata sa hroni~nom formom bolesti i niskim nivoom vitamina 25(OH)D u serumu (Xi-kvad rat=6,044; df=2; p=0,014). Grupa pacijenata sa nivoom vitamina D u serumu ve}im od 20 mg/L pokazuje ve}i nivo srednjeg for siranog vitalnog kapaciteta (FVC) za 380 mL i forsiranog ekspi ratornog volu - mena u prvoj sekundi (FEV1) za 220 mL u od nosu na grupu pacijenata sa ni`im nivoom D vitamina. Utvr|eno je da nivo vitamina 25(OH)D u serumu ima stati sti~ki zna~ajnu ulogu kao prediktor zamora i depresije kod obolelih od sarkoidoze. Insuficijencija 25(OH)D vitamina po kazala se kao va`an faktor u pred vi|anju toka hroni~ne bo le sti, zna ~aj nih o{te}enja plu}ne funkcije i kognitivnih po reme }a ja kao {to su zamor i depresija. ^injenica da ve}ina ana li ziranih bolesnika sa sar - koidozom ima potpuni nedo statak 25(OH)D u serumu u~i - nila je takav nalaz jo{ bitnijim.
Sarcoidosis is a multiorgan, multisystem chronic disease of unknown etiology and unpredictable course. Health status is reduced in sarcoidosis and assessing it is a difficult multitask effort due to ...many faces this disease might have. Recently, a new questionnaire for assessing health status in sarcoidosis was developed by a group of authors from England-King's Sarcoidosis Questionnaire (KSQ). The benefit of KSQ is the ability to develop the best care plan for the patient, as well as to differentiate the efficacy of the administered treatment. The aim of this study was to validate the KSQ in Serbian speaking population of sarcoidosis patients. The test itself is a modular, multi-organ health status measure for patients with sarcoidosis for use in clinic and the evaluation of therapies. The correlation of KSQ with different clinical course of sarcoidosis (acute vs chronic disease) and with the clinical outcome status (COS) in sarcoidosis was also investigated. A total of 159 biopsy positive sarcoidosis patients participated in this study. The average age of the participants was 49.67, majority was female (67.3%) and majority had only pulmonary form of sarcoidosis (71.7%). KSQ - new disease-specific health status instrument, was compared with 5 other already existing instruments already used and validated in sarcoidosis (Saint George Respiratory Questionnaire- SGRQ, Daily Activity List -DAL, Fatigue Assessment Scale- FAS, Medical Research Council dyspnea scale-MRC, Borg Dyspnea Scale and 15D as general questionnaire. KSQ has significant correlation with other quality of life questionnaires already used in sarcoidosis. Translated version of KSQ shows significant internal reliability, similar to the original KSQ. Serbian version of KSQ has significant correlation with different clinical course of sarcoidosis and with COS as well. The translated version of KSQ is reliable sarcoidosis specific instrument for assessing health status in these patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction: Cough is frequent symptom in sarcoidosis and there are no specifi c tools for measurement of its severity in Serbia. Aim: the goal of this study was to translate and validate the ...Serbian version of the Leices-ter Cough Questionnaire (LCQ) in a population of sarcoidosis patients. Methods: After the LCQ forward-backward translation process, in the cross-sectional study in 275 (180 female) sarcoidosis patients Serbian version of the LCQ was administered together with other standardized instruments for measurement of Patient Reported Outcomes (PROs)-symptoms of dyspnea (assessed by MRC and Borg scales) and fatigue (measured by Fatigue Assessment Scale and List of Daily Activities), and patients' health status (assessed by generic tool-15D). Pulmonary function tests (spirometry and diff using capacity for carbon monoxide) were also measured. Results: Serbian LCQ version showed excellent internal consistency (Cronbach's Alpha of its diff erent scores ranged between 0.901 for physical domain and 0.951 for the total score). Concurent validity assessed by correlations of all LCQ scores with other PROs and pulmonary function tests was very good, since all these correlations were statistically signifi cant. Conclusions: Our results confi rmed that the Serbian version of LCQ is a valid instrument to monitor the infl uence of chronic cough on quality of life in sarcoidosis patients.
Severe COVID infection is most often presented as bilateral pneumonia and, according to current knowledge, can be explained by cytokine storm, hypercoagulability and microvascular thromboses. ...Patients at risk of poor outcome include obese middle-aged men and persons with cardiovascular and pulmonary comorbidities and diabetes. One of specific traits of COVID 19 pneumonias is frequent discrepancy between clinical presentation, radiographic findings and oxygen saturation. Regular monitoring and use of early warning scores improve survival and decrease rates of emergency admissions to intensive care units. Corner-stone of treatment of critically ill patients include oxygen, anti-inflammatory and anticoagulant therapy. Best results are obtained through administering high flow oxygen and non-invasive mechanical ventilation.
Genetic variation plays a significant role in the etiology of sarcoidosis. However, only a small fraction of its heritability has been explained so far.
To define further genetic risk loci for ...sarcoidosis, we used the Immunochip for a candidate gene association study of immune-associated loci.
Altogether the study population comprised over 19,000 individuals. In a two-stage design, 1,726 German sarcoidosis cases and 5,482 control subjects were genotyped for 128,705 single-nucleotide polymorphisms using the Illumina Immunochip for the screening step. The remaining 3,955 cases, 7,514 control subjects, and 684 parents of affected offspring were used for validation and replication of 44 candidate and two established risk single-nucleotide polymorphisms.
Four novel susceptibility loci were identified with genome-wide significance in the European case-control populations, located on chromosomes 12q24.12 (rs653178; ATXN2/SH2B3), 5q33.3 (rs4921492; IL12B), 4q24 (rs223498; MANBA/NFKB1), and 2q33.2 (rs6748088; FAM117B). We further defined three independent association signals in the HLA region with genome-wide significance, peaking in the BTNL2 promoter region (rs5007259), at HLA-B (rs4143332/HLA-B*0801) and at HLA-DPB1 (rs9277542), and found another novel independent signal near IL23R (rs12069782) on chromosome 1p31.3.
Functional predictions and protein network analyses suggest a prominent role of the drug-targetable IL23/Th17 signaling pathway in the genetic etiology of sarcoidosis. Our findings reveal a substantial genetic overlap of sarcoidosis with diverse immune-mediated inflammatory disorders, which could be of relevance for the clinical application of modern therapeutics.
FDG PET/CT in bone sarcoidosis Grozdic Milojevic, Isidora; Sobic-Saranovic, Dragana; Videnovic-Ivanov, Jelica ...
Sarcoidosis, vasculitis, and diffuse lung diseases,
2016-Mar-29, Letnik:
33, Številka:
1
Journal Article
Recenzirano
Bone sarcoidosis is rare manifestation of disease usually accompanied with pulmonary involvement. Until today, exact prevalence of bone sarcoidosis is not known, since reported prevalence varies ...widely depending on the studied population and the used diagnostic techniques.
To determine the prevalence of bone involvement and distribution pattern in active chronic sarcoidosis by using FDG PET/CT.
Between January 2010 and December 2011, 98 patients with chronic sarcoidosis and presence of prolonged symptoms or other findings suggestive of active disease were referred to FDG PET/CT examination. Active disease was found in 82 patients, and they all were screened for presence of bone sarcoidosis on FDG PET/CT. All patients also underwent MDCT and assessment of serum ACE level.
Bone sarcoidosis was present in 18/82 patients with active sarcoidosis. FDG uptake in bones was focal in 8 (44.4%), diffuse in 6 (33.3%) and both diffuse and focal in 4 (22.2%) patients. CT indicated bone abnormalities only in 5% patients. Osseous involvement was present in: pelvis (61.1%), vertebrae (44.4%), ribs (27.8%) and bone marrow (16.7%). Some patients had two or more locations of disease. Follow-up FDG PET/CT showed normal findings in two patients, same localization of active disease in four patients and progression of disease in one.
In patients with active chronic sarcoidosis 22% of patients had osseous abnormalities on FDG PET/CT that mostly were not detected on CT.
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