Association of chronic inflammation with cardiovascular risk in chronic obstructive pulmonary disease-A cross-sectional study.

Background And Aims: COPD is progressive lung disease with known higher cardiovascular (CV) risk, mainly attributed to smoking of cigarettes as the main etiological factor of disease. The aim of this study was to compare CV risk in patients with COPD to control groups of smokers and non-COPD and to investigate the relation of lung function variables, COPD severity, and smoking with Systemic Coronary Risk Estimation (SCORE) risk calculation, arterial stiffness (AS) values, and biological systemic inflammatory markers.

Methods: A total of 208 subjects were included in this study: 61 subjects diagnosed with COPD, 83 smokers without COPD, and 64 nonsmokers without COPD.

Recommendations for COPD management in Central and Eastern Europe.

Introduction: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy report provides guidance on effective management of chronic obstructive pulmonary disease (COPD) according to local healthcare systems. However, COPD is a heterogenous disease and certain aspects, including prevalence, disease-time course and phenotype distribution, can differ between countries. Moreover, features of clinical practice and healthcare systems for patients with COPD can vary widely, even in geographically close and economically similar countries.

COVID-19: The Impact on Cardiovascular System.

SARS-CoV-2 has been circulating in population worldwide for the past year and a half, and thus a vast amount of scientific literature has been produced in order to study the biology of the virus and the pathophysiology of COVID-19, as well as to determine the best way to prevent infection, treat the patients and eliminate the virus. SARS-CoV-2 binding to the ACE2 receptor is the key initiator of COVID-19. The ability of SARS-CoV-2 to infect various types of cells requires special attention to be given to the cardiovascular system, as it is commonly affected.

Attitudes of Croatian pulmonologists concerning obstacles to earlier, more appropriate use of biologics in severe asthma: Survey results.

Aims: Biologics have been proven efficacious for patients with severe asthma (SA). It is essential to diagnose such individuals correctly. This study was designed to survey pulmonologists to identify barriers to early diagnosis and subsequent appropriate use of biologics for SA in Croatia.

Mepolizumab as a glucocorticoid-sparing agent in eosinophilic granulomatosis with polyangiitis (EGPA): is a lower dose sufficient?

Introduction: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of small-vessel vasculitis characterized by asthma, hyper-eosinophilia, and progressive multiorgan involvement. EGPA is traditionally treated using glucocorticoids, either alone or in combination with conventional immunosuppressants. Mepolizumab, a novel anti-interleukin (IL)-5 agent, has been approved as an add-on therapy for adult patients with EGPA.

Easy to Perform Physical Performance Tests to Identify COPD Patients with Low Physical Activity in Clinical Practice.

Background: The study investigates which physical performance or muscle function/mass tests significantly correlate with objectively measured physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) and could potentially serve to identify physically inactive COPD patients in routine clinical practice.

Methods: A cross-sectional, observational study was conducted in outpatients with moderate to very severe COPD. PA was measured during one week with the StepWatch Activity Monitor, an ankle-worn accelerometer, and expressed in steps per day.

Determinants of CAT (COPD Assessment Test) scores in a population of patients with COPD in central and Eastern Europe: The POPE study.

Background: The COPD Assessment Test (CAT) has been proposed to help guide therapy in chronic obstructive pulmonary disease (COPD). It is important to understand the distribution of scores in different COPD populations and their determinants.

Methods: The POPE study is an international, observational cross-sectional study of COPD subjects in 11 Central and Eastern European countries aimed at characterizing COPD phenotypes.

A Retrospective Study of Ultrasound Characteristics and Macroscopic Findings in Confirmed Malignant Pleural Effusion.

Background: A definitive diagnosis of malignant pleural effusion (MPE) is reached by cytological or histological assessment, but thorough analysis of the ultrasound features of the effusion as well as pleural thickening or nodularity can also be of significant diagnostic help.

Objective: To assess the relationship of specific ultrasound characterisctics and macroscopic features of confirmed malignant pleural effusion, thus increasing the diagnostic potential of thoracic ultrasound.

Methods: The findings of thoracic ultrasonography performed prior to initial thoracentesis in 104 patients with subsequently confirmed malignant pleural effusion were analyzed with regard to the macroscopic features of the pleural effusion.

Inhaled therapies in patients with moderate COPD in clinical practice: current thinking.

COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations.

Nutritional Status of Patients with Chronic Obstructive Pulmonary Disease in Relation to their Physical Performance.

Nutritional abnormalities and physical inactivity are highly prevalent in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to determine the association between nutritional status/body composition and physical performance in patients with COPD. A cross-sectional observational study was conducted in outpatients with clinically stable, moderate to very severe COPD.

Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study.

Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region.Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria.

[INITIAL RESULTS OF DIAGNOSTIC APPLICATION OF ENDOBRONCHIAL ULTRASOUND IN CLINICAL HOSPITAL DUBRAVA].

Endobronchial ultrasound (EBUS) enables visualization of mediastinal and hilar lymph nodes as well as, in case of clinical indication, its transbronchial needle aspiration (TBNA). Simultaneous application of color doppler gives the additional prospects to investigate the blood vessels. The primary indication for EBUS is radiographic finding of mediastinal and/or hilar lymph nodes enlargement as well as the staging of non-small cell lung cancer (NSCLC).

POPE study: rationale and methodology of a study to phenotype patients with COPD in Central and Eastern Europe.

Introduction: Chronic obstructive pulmonary disease (COPD) constitutes a major health challenge in Central and Eastern European (CEE) countries. However, clinical phenotypes, symptom load, and treatment habits of patients with COPD in CEE countries remain largely unknown. This paper provides a rationale for phenotyping COPD and describes the methodology of a large study in CEE.

Intraregional differences in asthma prevalence and risk factors for asthma among adolescents in Split-Dalmatia County, Croatia.

Background: Our aim was to assess the differences in intraregional prevalence of asthma in adolescents in Split-Dalmatia County to determine asthma risk factors in our population and estimate the specificity and sensitivity of the questionnaire used.

Material/methods: We conducted the study using the European Community Respiratory Health Survey II short questionnaire supplemented by some questions from the International Study of Asthma in Childhood questionnaire. The participants suspected to have asthma were invited for examination by an asthma specialist who established the final diagnosis of asthma according to the medical history, physical examination, skin-prick tests, and peak flow measurements.

Churg-Strauss syndrome with myopericardial involvement.

Churg-Strauss syndrome (CSS) is a small-vessel necrotizing vasculitis typically characterized by asthma, lung infiltrates, extravascular necrotizing granulomas and hypereosinophilia. Cardiac disease is a major contributor to disease-related death in CSS. We describe a 38-year-old man with late-onset asthma, allergic rhinosinusitis, and high extravascular and peripheral blood eosinophilia, who presented with migratory pulmonary infiltrates and acute myopericarditis.

[The treatment of asthma exacerbations in adults].

Asthma exacerbation is characterized by a rapid and progressive worsening of symptoms, mainly dyspnea, cough, wheezing and chest tightness. The intensity of an exacerbation may vary form a mild, transient worsening marked by a cough and moderate shortness of breath to a very severe and life-threatening condition. The clinical features of asthma include increased rate of breathing, cough, and prolonged and difficult expiration.

Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis.

The study was designed to investigate efficacy and safety of Astragalus membranaceus (AM) in the treatment of patients with seasonal allergic rhinitis (SAR). AM is an active component in the herbal and mineral complex (HMC) registered in Croatia as a food supplement Lectranal. The study was designed as a 6-weeks, double-blind, placebo-controlled clinical trial and conducted in 48 adult patients with a moderate to severe SAR.

Fatal toxic epidermal necrolysis and severe granulocytopenia following therapy with cefuroxime.

Toxic epidermal necrolysis (TEN) is one of the most threatening adverse reactions to various drugs. No case of concomitant occurrence TEN and severe granulocytopenia following the treatment with cefuroxime has been reported to date. Herein we present a case of TEN that developed eighteen days of the initiation of cefuroxime axetil therapy for urinary tract infection in a 73-year-old woman with chronic renal failure and no previous history of allergic diathesis.

[Guidelines for diagnosis and management of asthma in adults of the Croatian Respiratory Society].

The global use of guidelines for proper diagnosis and management of asthma was worldwide aimed toward obtaining effective control of asthma. Until now, the most often used guidelines in Croatia were the ones issued by the Global Initiative for Asthma (GINA). Their implementation significantly improved and uniformed the diagnosis and management of asthma at different levels of the national health system.

Effect of educational programs on asthma control and quality of life in adult asthma patients.

This study investigated the effectiveness of different educational programs in obtaining better asthma control and asthma-related quality of life (QoL). In 60 adult patients with moderate persistent asthma we tested the benefit of individual verbal instructions (IVI), written information ("asthma booklet", B), and integrated asthma classes ("asthma school", AS). At the enrollment and at the end of the study, all participants completed the questionnaires regarding their asthma-related knowledge (ArK) and QoL.

[Bronchial reactivity in patients with seasonal allergic rhinitis].

The allergic rhinitis (AR) is an important risk factor for the development of asthma. In significant number of patients with AR, the non-specific bronchial hyperresponsiveness (BHR) could be demonstrated. It has been anticipated that these patients were at the greater risk for asthma.