The aim of this study was to investigate the differences of Clostridioides difficile infection (CDI) during the COVID-19 pandemic compared to the pre-COVID-19 era. CDI patients treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Serbia during 2017–2019 (n = 304) were compared with COVID-19/CDI patients treated in period September 2021–September 2022 (n = 387). Groups were compared by age, gender, comorbidities, previous medications, laboratory findings, and outcome within 30 days. In the CDI/COVID-19 group, we found: greater percentage of males 59.8% vs. 42.6% (p ≤ 0.001), older age 72.8 ± 9.4 vs. 65.6 ± 11.7 (p ≤ 0.001), higher Charlson comorbidity score (CCS) (3.06 ± 1.54 vs. 2.33 ± 1.34 (p ≤ 0.001), greater percentage of chronic renal failure (33.9% vs. 23.4% (p = 0.003), malignances (24.3% vs. 13.5% (p ≤ 0.001), chronic obstructive pulmonary disease (22.7% vs. 15.5% (p = 0.017), higher usage of macrolide (38.5% vs. 8.6% (p ≤ 0.001), greater percentage of patients with hypoalbuminemia ≤25 g/L (19.6% vs. 12.2% (p ≤ 0.001), lower percentage of patients with elevated creatinine (≥200 mmol/L) (31.5% vs. 43.8%) (p = 0.002), and greater percentage of lethal outcome 29.5% vs. 6.6% (p ≤ 0.001). In the prediction of lethal outcome multivariate regression analysis extracted as an independent predictor, only higher CRP values in the non-COVID-19 group and in the COVID-19 group: older age (p ≤ 0.001), CCS (p = 0.019) and CRP (p = 0.015). COVID-19 changes the disease course of CDI and should be taken into consideration when managing those patients.

Background. The aim of the study was to assess the effect of baricitinib on 28-day all-cause mortality and the progression of respiratory failure in patients needing transfer to the intensive care unit (ICU) with COVID-19 pneumonia treated with high-flow oxygen therapy. Methods. This retrospective study included hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive ventilation receiving standard of care (SOC) or SOC in addition to baricitinib. Data on patients’ characteristics, pro-inflammatory markers, D dimer, and National Early Warning Score 2 (NEWS2) values were collected and compared between groups. The primary endpoint was 28-day all-cause in-hospital mortality and the secondary outcome was transfer to the ICU. Results. The study included 125 patients. The primary outcome was observed in 44.8% of them: 27% in the baricitinib group vs. 62% in the SOC group, p < 0.001. Transfer to the ICU ward was significantly lower in the baricitinib group: 29% vs. 81%, p < 0.001. A significant improvement was observed when the baricitinib group was compared to SOC in procalcitonin, CRP, D-dimer, neutrophil-to-lymphocyte ratio values, and NEWS2. Conclusion. Treatment with baricitinib in addition to SOC was associated with reduced mortality and a lower prevalence of transfer to the ICU in hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive therapy.

Introduction. Left ventricular hypertrophy is defined as an increase in the left ventricular mass. Electrocardiography is a widely used and cost-effective method for the initial screening of the condition, but it has limited sensitivity and specificity. The Sokolow-Lyon and Cornell criteria are still most commonly used in diagnosing the disease; their sensitivity, however, is low. On the contrary, the Romhilt-Estes scoring system incorporates atrial abnormalities and repolarization phases making this scoring system a better diagnostic tool. This study explores the correlation between electrocardiography and echocardiography in the diagnosis of left ventricular hypertrophy. Material and Methods. The study enrolled 30 patients with median age of 62, diagnosed with arterial hyperten­sion, who underwent a 12-lead electrocardiogram and transthoracic echocardiogram. The analysis included the assessment of correlation between the relevant electrocardiographic parameters and the left ventricular mass index, as well as calculation of their diagnostic capability including the area under the ROC curve. Re­sults. Positive correlation of moderate intensity has been observed between the left ventricular mass index and Sokolow-Lyon (ρ=0.479), Cornell index (ρ=0.366), and Cornell product (ρ=0.423). Cornell product had the highest sensitivity (0.82), while the Romhilt-Estes criteria exhibited the highest specificity (0.85). Sokolow-Lyon yielded the highest area under the curve (0.733), followed by Cornell product (0.640), Cornell voltage (0.622), and Romhilt-Estes criteria (0.570). Conclusion. The Sokolow-Lyon criterion exhibited the best balance between sensitivity and specificity, the highest and significant area under the ROC curve and the strongest correlation with the left ventricular mass index.

Introduction. Acute kidney injury is a serious complication in critically ill patients in the intensive care units. The incidence varies from 20% to as high as 80%. Acute kidney injury is associated with expensive supportive therapy, high morbidity and poor outcomes. The aim of this study was to determine the incidence, causes, risk factors, treatment options and treatment outcomes of acute kidney injury in critically ill patients. Material and Methods. The study included 44 patients, with an average age of 67 ? 13.20 years. The data were collected during a three-month prospective study at the Department of Emergency Internal Medicine of the Clinical Center of Vojvodina, Novi Sad. Demographic data were collected from the medical records, as well as data on blood tests, comorbidities, use of nephrotoxic agents, and treatment of these patients. Results. Of the 44 patients who were included in the study, 20% developed acute kidney injury. De novo acute kidney injury was diagnosed in 51.22% and 48.78% of patients had acute-onchronic renal failure. The most common type of acute kidney injury was pre-renal, 80.95%. Comorbidities were present in all patients, most often arterial hypertension, in 52.4% of patients. Complete recovery of kidney function was found in 42.86% of patients and the mortality was 28.57%. Conservative therapy was used in 90.48% of patients, while 9.52% of patients required renal replacement therapy. Conclusion. De novo acute kidney injury was found in approximately half of the critically ill patients in the intensive care unit, mainly older patients with comorbidities. The most common type of acute kidney injury was pre-renal. Older age and comorbidities were associated with poor outcomes and high mortality.

Background / Aim. As an optimal treatment of choice for the patients with the latest stage of chronic renal failure (CKD), renal transplantation is performed. The resistance index (RI)of renal artery is measured by Doppler ultrasonography routinely at certain time intervals to show the condition of the renal graft. The value of RI > 0,75 is considered abnormal. Goal to determine the correlation between the values of the RI index and the function of the transplanted kidney. Methods. in whom the Doppler of renal blood vessels were made in the first month after the renal transplant. In addition to standard demographic data, all patients were analyzed the RI We analyzed retrospectively 63 patients at the Clinic for Nephrology and Clinical Immunology in KC Vojvodina in the period from 2013 to 2017. In the study were included all patients index and its relationship to the function of the transplanted kidney. Results. Out of 63 patients, men were 63.5%, and women 26.5%, with an average age of 47.67 years. +/- 13.62. The primary diseases in patients which led to the terminal CKD stage were hypertension (HTA) at 33.3% and different forms of glomerulonephritis (GN); while other diseases (diabetes mellitus (DM), chronic pyelonephritis (chr PN), eclampsia, polycystic kidneys, kidney agenesia and unknown cause) were present in a smaller percentage. RI 0.75 in 27%. According to the data, there is no statistically significant association between the resistance index and serum creatinine or creatinine clearance at a given time, and there is no connection to gender and length on HD. There is statistically significant association between RI and age of kidney recipient, as well as Tx type. Conclusion. In the observed group of patients, the resistance index of renal arteries did not prove to be a good predictor of the function of the transplanted kidney either in the early or later post-transplant periods. RI might have greater predictive significance if it were determined on or immediately after the transplantation procedure.