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Vasiliu A, Köhler N, Altpeter E, Ægisdóttir TR, Amerali M, de Oñate WA, Bakos Á, D'Amato S, Cirillo DM, van Crevel R, Davidaviciene E, Demuth I, Domínguez J, Duarte R, Günther G, Guthmann JP, Hatzianastasiou S, Holm LH, Herrador Z, Hribar U, Huberty C, Ibraim E, Jackson S, Jensenius M, Josefsdottir KS, Koch A, Korzeniewska-Kosela M, Kuksa L, Kunst H, Lienhardt C, Mahler B, Makek MJ, Muylle I, Normark J, Pace-Asciak A, Petrović G, Pieridou D, Russo G, Rzhepishevska O, Salzer HJF, Marques MS, Schmid D, Solovic I, Sukholytka M, Svetina P, Tyufekchieva M, Vasankari T, Viiklepp P, Villand K, Wallenfels J, Wesolowski S, Mandalakas AM, Martinez L, Zenner D, Lange C. Tuberculosis incidence in foreign-born people residing in European countries in 2020. Euro Surveill 2023; 28:2300051. [PMID: 37855907 PMCID: PMC10588305 DOI: 10.2807/1560-7917.es.2023.28.42.2300051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/12/2023] [Indexed: 10/20/2023] Open
Abstract
BackgroundEuropean-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.AimWe aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.MethodsThe Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin.ResultsData on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea.ConclusionsCountry of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.
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Affiliation(s)
- Anca Vasiliu
- Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States
| | - Niklas Köhler
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany
- Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany
| | - Ekkehardt Altpeter
- Swiss Federal Office of Public Health, Division of Communicable Diseases, Bern, Switzerland
| | - Tinna Rán Ægisdóttir
- The National University Hospital of Iceland, Pharmaceutical Services, Reykjavik, Iceland
| | - Marina Amerali
- Tuberculosis Control Office, Department of Respiratory Infections, Directorate for Epidemiological Surveillance & Intervention, National Public Health Organization (NPHO), Athens, Greece
| | - Wouter Arrazola de Oñate
- Belgian Lung and Tuberculosis Association, Brussels, Belgium
- Flemish Association of Respiratory Health and TB Control, Leuven, Belgium
| | - Ágnes Bakos
- Koranyi National Institute for Pulmonology, Budapest, Hungary
| | - Stefania D'Amato
- Prevention of Communicable Diseases and International Prophylaxis, General Direction of Health Prevention, Ministry of Health of Italy, Rome, Italy
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Reinout van Crevel
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Edita Davidaviciene
- Vilnius University hospital Santaros Klinikos, Department of Tuberculosis State information system, Vilnius, Lithuania
| | | | - Jose Domínguez
- Institut d'Investigació Germans Trias i Pujol; Universitat Autònoma de Barcelona; CIBER Enfermedades Respiratorias; INNOVA4TB consortium Badalona, Barcelona, Spain
| | - Raquel Duarte
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto
- ISPUP - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - Gunar Günther
- Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia
| | - Jean-Paul Guthmann
- Division of Infectious Diseases, Santé publique France, Saint-Maurice, France
| | - Sophia Hatzianastasiou
- Tuberculosis Control Office, Department of Respiratory Infections, Directorate for Epidemiological Surveillance & Intervention, National Public Health Organization (NPHO), Athens, Greece
| | - Louise Hedevang Holm
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Zaida Herrador
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Urška Hribar
- Tuberculosis Register of the Republic of Slovenia, University Clinic Golnik, Golnik, Slovenia
| | | | - Elmira Ibraim
- Marius Nasta Institute of Pulmonology, Bucharest, Romania
| | - Sarah Jackson
- Infectious Diseases; Health Service Executive Health Protection Surveillance Centre, Dublin, Ireland
| | - Mogens Jensenius
- Department of Infectious Diseases, Oslo University Hospital, Ullevaal, Norway
| | | | - Anders Koch
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Maria Korzeniewska-Kosela
- Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Liga Kuksa
- Riga East University Hospital, TB and Lung Disease Clinic, Riga, Latvia
| | - Heinke Kunst
- Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Christian Lienhardt
- Unité Unité Mixte Internationale 233 IRD - U1175 INSERM - Université de Montpellier, Institut de Recherche pour le Développement (IRD), Montpellier, France
- Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Beatrice Mahler
- Marius Nasta Institute of Pulmonology, Bucharest, Romania
- Department Cardio-thoracic, Pneumophtisiology II, University of Medicine and Pharmacy "Carol Davila" Bucharest, Romania
| | - Mateja Janković Makek
- University of Zagreb, School of Medicine Zagreb, Croatia
- University Hospital Centre Zagreb, Department for Lung diseases, Zagreb, Croatia
| | - Inge Muylle
- Division of Pneumology, Onze-Lieve-Vrouw Ziekenhuis (OLV) Aalst, Aalst, Belgium
| | - Johan Normark
- Department of Clinical Microbiology, Umeå University, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Sweden
| | - Analita Pace-Asciak
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Superintendence of Public Health, Ministry for Health of Malta, La Valetta, Malta
| | - Goranka Petrović
- Respiratory Diseases and Travel Medicine Department with Vaccination Unit, Infectious Diseases Epidemiology ServiceDepartment, Croatian Institute of Public Health, Zagreb, Croatia
| | - Despo Pieridou
- Cyprus National Reference Laboratory for Mycobacteria, Microbiology Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Giulia Russo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Olena Rzhepishevska
- Department of Chemistry, Department of Clinical Microbiology, Umeå University, Sweden
| | - Helmut J F Salzer
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4- Pneumology, Kepler University Hospital, Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria and Ignaz Semmelweis Institut, Interuniversity Institute for Infection Resarch, Vienna, Austria
| | | | - Daniela Schmid
- Unit for Infectious Diseases Diagnostics and Infectious Diseases Epidemiology, Centre for Pathophysiology, Infectious Diseases and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ivan Solovic
- National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Slovakia
- Catholic University Ruzomberok, Ruzomberok, Slovakia
| | - Mariya Sukholytka
- First Faculty of Medicine and Faculty Thomayer Hospital Prague, Czechia
| | - Petra Svetina
- National TB Program and Tuberculosis Registry of Republic of Slovenia, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Mariya Tyufekchieva
- Health Promotion and Prevention Unit, Directorate Public Health Protection and Health Control, Ministry of Health of Bulgaria, Sofia, Bulgaria
| | - Tuula Vasankari
- University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland
- Finnish Lung Health Association (Filha ry), Helsinki, Finland
| | - Piret Viiklepp
- Estonian Tuberculosis Register, Dept. of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Kersti Villand
- Estonian Tuberculosis Register, Dept. of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Jiri Wallenfels
- National TB Surveillance Unit, University Hospital Bulovka, Prague, Czechia
| | - Stefan Wesolowski
- Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Anna-Maria Mandalakas
- Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
| | - Leonardo Martinez
- Boston University, School of Public Health, Department of Epidemiology, Boston, Massachusetts, United States
| | - Dominik Zenner
- Global Public Health Unit, Wolfson Institute of Population Health Barts
- The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Christoph Lange
- Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany
- Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany
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Rnjak D, Batarilo Hađar M, Pelicarić D, Vukić T, Janković Makek M, Samaržija M, Hećimović A. Nintedanib treatment for bleomycin-induced lung injury - First report. Respir Med Case Rep 2023; 46:101921. [PMID: 37822763 PMCID: PMC10562906 DOI: 10.1016/j.rmcr.2023.101921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 09/07/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023] Open
Abstract
Although the antineoplastic agent bleomycin is known for more than 50 years, its exact pharmacological and side-effect mechanisms remain incompletely understood. The major limitation of bleomycin therapy is the risk of pulmonary toxicity which can be diverse, and potentially fatal in 10% of patients. The optimal treatment for bleomycin lung toxicity has not been established and no clinical trials have been performed. Here we present first successful case report of nintedanib therapy in a patient with bleomycin-induced lung injury (BILI). The prevention, early diagnosis, and management of bleomycin pulmonary toxicities are essential, clinical trials are needed in this area.
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Affiliation(s)
- Dina Rnjak
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
| | - Martina Batarilo Hađar
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
| | - Dubravka Pelicarić
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
| | - Tea Vukić
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
| | - Mateja Janković Makek
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
- University of Zagreb, School of Medicine, Šalata 2, Zagreb, Croatia
| | - Miroslav Samaržija
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
- University of Zagreb, School of Medicine, Šalata 2, Zagreb, Croatia
| | - Ana Hećimović
- University Hospital Zagreb, Clinical Center for Pulmonary Diseases Jordanovac, Jordanovac 104, Zagreb, Croatia
- University of Zagreb, School of Medicine, Šalata 2, Zagreb, Croatia
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Makek MJ, Tiberi S, Felker I, Amorim GGC. Literature Highlights. Int J Tuberc Lung Dis 2023; 27:429-431. [PMID: 37231605 DOI: 10.5588/ijtld.23.9906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Literature Highlights is a digest of notable papers recently published in the leading respiratory journals. Coverage includes clinical trials to investigate the diagnostic and clinical effect of trial of antibiotics on TB; a Phase 3 trial to assess if glucocorticoids decrease mortality among patients with pneumonia; a Phase 2 trial on pretomanid use for treating drug-susceptible TB; contact investigation for TB in China; and post-TB sequelae after TB treatment in children.
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Affiliation(s)
- M J Makek
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - S Tiberi
- Blizard Institute, Queen Mary University, London, UK
| | - I Felker
- Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russian Federation
| | - G G C Amorim
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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Markanović M, Makek MJ, Glodić G, Kuliš T, Mareković I. Evaluation and clinical impact of MALDI Biotyper Mycobacteria Library v6.0 for identification of nontuberculous mycobacteria by MALDI-TOF mass spectrometry. J Mass Spectrom 2023; 58:e4915. [PMID: 37010443 DOI: 10.1002/jms.4915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/03/2023] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
Major challenges in the identification of non-tuberculous mycobacteria (NTM) by MALDI-TOF MS include protein extraction protocol and updating of the NTM database. The aim of this study was to evaluate MALDI Biotyper Mycobacteria Library v6.0 (Bruker Daltonics GmbH, Bremen, Germany) for identification of clinical NTM isolates and its impact on clinical management. NTM isolates cultivated from clinical samples in 101 patients were identified simultaneously by PCR-reverse hybridization (Hain Lifescience GmbH, Nehren, Germany) as a routinely used reference molecular method and using MALDI Biotyper Microflex LT/SH after protein extraction. Each isolate was applied to eight spots, and mean scores were used in analysis. MALDI-TOF MS obtained correct identification to the species level for 95 (94.06%) NTM isolates. The majority of correctly identified isolates (92/95; 96.84%) were identified with high-confidence score of ≥1.80 and only 3.16% (3/95) with a score of <1.80. Mean value ± SD of RGM NTM isolates (2.127 ± 0.172) was statistically significant higher in comparison to SGM NTM isolates (2.027 ± 0.142) with a p value of 0.007. In comparison to PCR-reverse hybridization, discordant identification results by MALDI-TOF MS were found in six (6/101; 5.94%) NTM isolates for which clinical data were analyzed. We demonstrated a high confidence NTM identifications using Mycobacterium Library v 6.0 on routine clinical isolates. This is the first study that analyzed MALDI-TOF MS identification results of NTM isolates in the context of clinical data, and it showed that MALDI-TOF MS with its updated databases could help clarify the epidemiology, clinical characteristics, and course of infections caused by less frequent NTM species.
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Affiliation(s)
- Manda Markanović
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, 10 000, Croatia
| | - Mateja Janković Makek
- School of Medicine, University of Zagreb, Zagreb, 10 000, Croatia
- Department of Respiratory Diseases, University Hospital Centre Zagreb, Zagreb, 10 000, Croatia
| | - Goran Glodić
- Department of Respiratory Diseases, University Hospital Centre Zagreb, Zagreb, 10 000, Croatia
| | - Tomislav Kuliš
- Department of Urology, University Hospital Centre Zagreb, Zagreb, 10 000, Croatia
| | - Ivana Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, 10 000, Croatia
- School of Medicine, University of Zagreb, Zagreb, 10 000, Croatia
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5
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Varda-Brkić D, Makek MJ, Kuliš T, Mareković I. Increasing trend of non-tuberculous mycobacteria in a Croatian hospital, 2012-2019. Int J Tuberc Lung Dis 2023; 27:166-168. [PMID: 36853099 DOI: 10.5588/ijtld.22.0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- D Varda-Brkić
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - M J Makek
- Department of Respiratory Diseases, University Hospital Centre Zagreb, Zagreb, Croatia, University of Zagreb School of Medicine, Zagreb, Croatia
| | - T Kuliš
- Department of Urology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - I Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia, University of Zagreb School of Medicine, Zagreb, Croatia
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Badovinac S, Glodić G, Sabol I, Džubur F, Makek MJ, Baričević D, Koršić M, Popović F, Srdić D, Samaržija M. Tranexamic Acid vs Adrenaline for Controlling Iatrogenic Bleeding During Flexible Bronchoscopy: A Double-Blind Randomized Controlled Trial. Chest 2022; 163:985-993. [PMID: 36273651 DOI: 10.1016/j.chest.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The most commonly used topical hemostatic agents during flexible bronchoscopy (FB) are cold saline and adrenaline. Data on use of other agents such as tranexamic acid (TXA) for this purpose are limited. RESEARCH QUESTION Is TXA effective and safe in controlling iatrogenic bleeding during FB compared with adrenaline? STUDY DESIGN AND METHODS We conducted a cluster-randomized, double-blind, single-center trial in a tertiary teaching hospital. Patients were randomized in weekly clusters to receive up to three applications of TXA (100 mg, 2 mL) or adrenaline (0.2 mg, 2 mL, 1:10000) after hemostasis failure after three applications of cold saline (4 ° C, 5 mL). Crossover was allowed (for up to three further applications) before proceeding with other interventions. Bleeding severity was graded by the bronchoscopist using a visual analog scale (VAS; 1 = very mild, 10 = severe). RESULTS A total of 2,033 FBs were performed and 130 patients were randomized successfully to adrenaline (n = 65) or TXA (n = 65), whereas 12 patients had to be excluded for protocol violations (two patients from the adrenaline arm and 10 patients from TXA arm). Bleeding was stopped in 83.1% of patients (54/65) in both groups (P = 1). The severity of bleeding and number of applications needed for bleeding control were similar in both groups (adrenaline: mean VAS score, 4.9 ± 1.3 [n = 1.8 ± 0.8]; TXA: mean VAS score, 5.3 ± 1.4 [n = 1.8 ± 0.8]). Both adrenaline and TXA were more successful in controlling moderate bleeding (86.7% and 88.7%, respectively) than severe bleeding (40% and 58.3%, respectively; P = .008 and P = .012, respectively) and required more applications for severe bleeding (3.0 ± 0 and 2.4 ± 0.5, respectively) than moderate bleeding (1.7 ± 0.8 and 1.7 ± 0.8, respectively) control (P = .006 and P = .002, respectively). We observed no drug-related adverse events in either group. INTERPRETATION We found no significant difference between adrenaline and TXA for controlling noncatastrophic iatrogenic endobronchial bleeding after cold saline failure, adding to the body of evidence that TXA can be used safely and effectively during FB. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT04771923; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Sonja Badovinac
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Goran Glodić
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Ivan Sabol
- Ruđer Bošković Institute, Zagreb, Croatia
| | - Feđa Džubur
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
| | - Mateja Janković Makek
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
| | - Denis Baričević
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marta Koršić
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Filip Popović
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dražena Srdić
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miroslav Samaržija
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
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Banić M, Janković Makek M, Samaržija M, Muršić D, Boras Z, Trkeš V, Baričević D, Koršić M, Basara L, Jalušić T, Glunčić, Vukić Dugac A. Risk factors and severity of functional impairment in long COVID: a single-center experience in Croatia. Croat Med J 2022. [PMID: 35230003 PMCID: PMC8895334 DOI: 10.3325/cmj.2022.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim To determine the frequency of common symptoms in long COVID and their effect on the quality of life, and to determine the factors contributing to a more severe long COVID. Methods The study enrolled 266 patients who were either referred to long-COVID outpatient clinic or were inpatients undergoing rehabilitation. The data were collected between December 2020 and May 2021. We evaluated the symptoms experienced during acute and long COVID and comorbidities. Functional status was assessed with Post Covid Functional Status (PCFS). Results The final sample consisted of 261 patients. After acute COVID-19 period (>4 weeks), almost 80% of patients had impaired functional status. Only 21.5% reported no functional impairment (0 on PCFS scale). A higher PCFS score was associated with female sex (P < 0.001) and oxygen therapy requirement during acute disease (P = 0.001). However, it was not associated with having a pre-existing lung disease (P = 0.749). Disease severity did not pose a risk for developing a more severe long COVID. Conclusion Women were at greater risk for developing greater functional impairment in long COVID, although we have no explanation why. Malignant disease and hypertension also presented a risk factor for greater functional impairment. More studies are warranted to determine if patients with certain lung disease are more susceptible to long COVID.
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Glodić G, Samaržija M, Sabol I, Bulat Kardum L, Carević Vladić V, Džubur F, Jakopović M, Kuhtić I, Marušić A, Mihelčić D, Popović Grle S, Strelec D, Šklebar T, Šola AM, Žmak L, van Ingen J, Janković Makek M. Risk factors for nontuberculous mycobacterial pulmonary disease (NTM-PD) in Croatia. Wien Klin Wochenschr 2021; 133:1195-1200. [PMID: 34402990 DOI: 10.1007/s00508-021-01923-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence, geographical distribution and clinical relevance of different nontuberculous mycobacteria (NTM) in Croatia are well described. There are few data on the risk factors for developing NTM pulmonary disease (NTM-PD) in this setting. METHODS We conducted a retrospective cohort study on all Croatian residents with NTM isolated from respiratory samples in the period from 2006 to 2015 with follow-up to 2018. The American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines were used to establish NTM-PD diagnosis. Clinical, radiological and treatment data were collected from hospital records. RESULTS Risk analysis calculations were made on the 439 isolation episodes that were classified as definitive NTM-PD (n = 137) or no disease (n = 302). Female gender, presence of bronchiectasis, low BMI and long-term systemic corticosteroid treatment were independent risk factors associated with NTM-PD. Hemoptysis and malaise were presenting symptoms independently associated with NTM-PD. Chronic obstructive pulmonary disease (COPD) and low/moderate dose inhaled corticosteroid (ICS) treatment were not associated with NTM-PD. High dose ICS treatment was a significant risk factor for developing NTM-PD (aOR = 4.73, CI 1.69-13.23 p = 0.003). CONCLUSION The NTM-PD patients in Croatia are similar to those in other published cohorts in terms of their characteristics and risk factors. The significant dose-dependent association between ICS use and NTM-PD adds to the body of evidence suggesting that high dose ICS use is associated with NTM-PD.
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Affiliation(s)
- Goran Glodić
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Miroslav Samaržija
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Sabol
- Division of Molecular Medicine, Laboratory od Molecular Virology and Bacteriology, Ruder Boskovic Institute, Zagreb, Croatia
| | - Ljiljana Bulat Kardum
- Department for Respiratory Diseases, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | | | - Feđa Džubur
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Jakopović
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Kuhtić
- Clinic for Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ante Marušić
- Clinic for Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dina Mihelčić
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sanja Popović Grle
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Dražen Strelec
- Hospital for pulmonary disease and TBC Klenovnik, Klenovnik, Croatia
| | | | - Ana Marija Šola
- Special Hospital for Respiratory Diseases Rockefellerova, Zagreb, Croatia
| | - Ljiljana Žmak
- School of Medicine, University of Zagreb, Zagreb, Croatia
- National Mycobacteria Reference Laboratory, Croatian Institute of Public Health, Zagreb, Croatia
| | - Jakko van Ingen
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmengen, The Netherlands
| | - Mateja Janković Makek
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Rnjak D, Basara L, Banić M, Baričević D, Džubur F, Hećimović A, Jalušić Glunčić T, Juričić Kursan M, Pavliša G, Popović-Grle S, Samaržija M, Tolić E, Trkeš V, Vukić Dugac A, Janković Makek M. Does Smoking Status Impact the Severity of Acute COVID-19? Psychiatr Danub 2021; 33:252-253. [PMID: 34185760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Dina Rnjak
- University Hospital Zagreb, Clinic for Pulmonary Diseases, Jordanovac, Zagreb, Croatia,
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Jalušić Glunčić T, Muršić D, Basara L, Vranić L, Moćan A, Janković Makek M, Samaržija M. Overview of Symptoms of Ongoing Symptomatic and Post-COVID-19 Patients Who Were Reffered to Pulmonary Rehabilitation - First Single-Centre Experience in Croatia. Psychiatr Danub 2021; 33:565-571. [PMID: 34718282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Coronavirus-2 pandemic has changed the functioning of health systems worldwide. It is not yet fully known which symptoms of the disease are most commonly presented in patients referred for pulmonary rehabilitation. Our aim was to investigate the profile of patients referred for pulmonary rehabilitation; what symptoms they had during the acute phase of the disease and what symptoms were still present at the start of pulmonary rehabilitation. SUBJECTS AND METHODS Study included ongoing symptomatic and post-COVID patients who attended standard, in person pulmonary rehabilitation program. Patients had COVID-19 disease at least four weeks before attending pulmonary rehabilitation. Patients completed questionnaires of self-reported somatic deficits during acute and post-COVID-19 stage as well as questionnaires regarding their psychological symptoms. Pulmonary function test, expiratory and inspiratory muscle strenght, hand grip strenght and six-minute walk test was performed prior and after pulmonary rehabilitation. RESULTS Study included 63 patients (32 male, 31 female), with mean age of 52.9 years. During acute COVID-19, majority of patients complained of fatigue, cough, dyspnea, myalgia and headache. More than 85% of patients reported pulmonary deficits during ongoing symptomatic and post-COVID-19 stage. Emotional distress and anxiety levels were significantly elevated in acute stage, while depression, anger and the need for help was not significantly elevated. All reported symptoms were significantly reduced in post-COVID-19 stage. There was statistically significant difference in six-minute walk distance, inspiratory and expiratory muscle strenght and hand grip strenght between first and final testing. CONCLUSIONS Results of our study are similar with previous studies, the most common symptoms during acute phase were fatigue, cough and dyspnea and fatigue and respiratory problems during ongoing symptomatic and post-COVID stage. Emotional distress diminishes signifiacantly in post-COVID stage. Further larger studies are needed to clarify which acute disease symptoms are predominant in patients referred to pulmonary rehabilitation and cause prolongued discomfort.
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Affiliation(s)
- Tajana Jalušić Glunčić
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Jordanovac 104, 10000, Zagreb, Croatia, E-mail:
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Glodić G, Sabol I, Zmak L, Šola AM, Marušić A, Hećimović A, Džubur F, Jakopović M, Kardum Bulat L, Pavliša G, Samaržija M, Čivljak A, Dakić A, Janković Makek M. Clinical relevance of differentiation between Mycobacterium avium and M. intracellulare in M. avium complex pulmonary disease in Croatia. Tuberculosis (Edinb) 2019. [DOI: 10.1183/13993003.congress-2019.pa3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Janković Makek M, Glodic G, Sabol I, Zmak L, Sola AM, Marusic A, Marekovic I, Hecimovic A, Vukic Dugac A, Dzubur F, Jakopovic M, Ticac B, Kardum Bulat L, Popovic Grle S, Barisic B, Carevic Vladic V, Strelec D, Pavlisa G, Samarzija M. Cure rates in nontuberculous mycobacterial pulmonary disease. Tuberculosis (Edinb) 2019. [DOI: 10.1183/13993003.congress-2019.pa4645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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