(1) Background: home-based spirometry, as a form of telemedicine in pulmonology, was previously successfully implemented in clinical practice in developed countries. However, experiences from developing countries are lacking. The aim of this study was to assess the reliability and feasibility of home-based spirometry in patients with interstitial lung diseases from Serbia. (2) Methods: 10 patients were given a personal hand-held spirometer with operating instructions and asked to perform daily domiciliary spirometry for the next 24 weeks. The K-BILD questionnaire was used to assess patients’ quality of life, while the questionnaire designed specifically for this study was used to assess their attitudes toward and satisfaction with domiciliary spirometry. (3) Results: there was a significant positive correlation between office- and home-based spirometry at the beginning (r = 0.946; p < 0.001) and end of the study (r = 0.719; p = 0.019). The compliance rate was nearly 70%. The domiciliary spirometry did not affect patients’ overall quality of life or anxiety levels, as measured via different domains of the K-BILD. Patients expressed positive experiences and high satisfaction with the home spirometry program. (4) Conclusions: home-based spirometry may represent a reliable form of spirometry, exploited in routine clinical practice; however, additional research in developing countries with a larger sample size is required.

Introduction: In October 2022, after almost two years, tuberculosis reclaimed its first place as the world's deadliest infectious disease, replacing COVID-19. Since knowledge is the most powerful tool to combat any disease, the primary goal of our study was to assess patients' knowledge of tuberculosis and its relationship to their socio-demographic status. Methodology: This cross-sectional study included 1,067 respiratory patients who were surveyed between November 2021 and June 2022 at the Institute for Pulmonary Diseases of Vojvodina (Serbia). They completed a questionnaire designed for this study. Results: The majority of patients (53.7%) were female; over two-thirds (70.8%) were ≥ 60 years; every fifth (23.2%) was either with or without primary school; every third (33.3%) was financially poor. Although the majority of patients (97.8%) were aware that tuberculosis is an infectious disease, only 44.2% knew the etiology. Around 3/4 (72.6%) were aware of a tuberculosis vaccine. Hospitalized patients had better knowledge that the vaccine helps prevent tuberculosis than ambulatory patients (p = 0.047). Only 16% of patients in both groups knew that tuberculosis incidence is decreasing in Serbia (p = 0.074). Good knowledge about tuberculosis was reported by 71.5%. Hospitalized patients showed better knowledge than ambulatory patients (p = 0.032). Patients with a higher level of education and higher monthly income were independent predictors of better knowledge of tuberculosis. Conclusions: The study underlines the need to promote knowledge about tuberculosis, particularly among chronic patients, socially vulnerable and refugees, especially in light of the pandemic and emerging economic problems in the region.

While the impact of air pollution on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has been widely studied, its effect on hospitalization outcomes remains less explored. This study examines the influence of short-term air pollution exposure on adverse hospitalization outcomes—mortality, mechanical ventilation use, and prolonged hospitalization—in patients with non-infectious severe AECOPD in Novi Sad, Serbia. Using a five-year time-series analysis, concentrations of selected air pollutants (PM₁₀, PM_2.5, SO₂, and NO₂) and meteorological data were integrated with hospitalization outcomes. Distributed lag non-linear models (DLNMs) revealed significant associations between rising air pollutant levels and some unfavorable outcomes. Exposure to rising PM_2.5 (urban background) and SO₂ (urban traffic) concentrations were linked to higher risks of mechanical ventilation (cumulative OR 21.95 (95% CI 1.07–449.45) and 11.37 (95% CI 1.25–103.27), respectively) and prolonged non-infectious AECOPD hospitalization (cumulative RR 2.27 (95% CI 1.14–4.52) and 2.24 (95% CI 1.38–3.64), respectively). No cumulative lag effects on mortality were observed, though specific patterns emerged in individual lag models. These findings highlight the critical role of improving air quality in reducing some COPD-related hospitalization risks.

Antituberculosis drug-induced liver injury (ATB-DILI) is one of the most significant adverse effects of first-line tuberculosis therapy and a leading cause of treatment discontinuation. Hepatotoxicity associated with isoniazid, rifampicin, and pyrazinamide may substantially impair treatment adherence, prolong treatment duration, and, in severe cases, lead to acute liver failure. This paper provides an overview of contemporary trends in the epidemiology, pathogenesis, diagnosis, and management of ATB-DILI, with particular emphasis on clinically relevant aspects and ongoing controversies. The underlying mechanisms of ATB-DILI origin involve complex interactions between drug metabolism, genetic susceptibility, oxidative stress, mitochondrial dysfunction, and immune-mediated injury, with emerging evidence suggesting a potential role of ferroptosis. Diagnosis relies on biochemical and clinical criteria, the exclusion of alternative causes, and causality assessment tools, such as the Roussel Uclaf Causality Assessment Method – RUCAM scale. Early recognition and timely discontinuation of hepatotoxic agents are of paramount importance, while optimal strategies for treatment reintroduction and the role of hepatoprotective agents are still not fully defined. A better understanding of risk factors and mechanisms, alongside the development of predictive biomarkers and pharmacogenetic approaches, may enable more individualized and safer tuberculosis treatment.

Clostridioides difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea; however, its association with antituberculous therapy (ATT) remains underrecognized. This review examines the risk, mechanisms, and clinical implications of CDI in patients with active tuberculosis (TB). Although ATT is traditionally considered low risk, prolonged exposure, particularly to rifampicin, may lead to cumulative disruption of gut microbiota and loss of colonization resistance. A characteristic feature of CDI in this setting is delayed onset, typically occurring several weeks to months after ATT initiation, which complicates timely diagnosis. Rifampicin plays a dual role, contributing to microbiota alterations and selection of resistant strains, while potentially affecting the pharmacokinetics of co-administered drugs. CDI in TB patients is associated with increased morbidity and mortality, with reported mortality rates up to 9.9%. Fidaxomicin is preferred due to its microbiota-sparing effect and lower recurrence rates, although cost remains a major limitation in high TB-burden settings, since vancomycin is an appropriate alternative. Management requires an individualized approach that balances the risk of CDI recurrence against the necessity of maintaining effective TB therapy.

Introduction: Non-tuberculous mycobacteria (NTM) are a diverse group of environmental microorganisms, most non-pathogenic. Most people come into contact with NTM during their lives. Still, the infection occurs in people with previous lung comorbidities, weakened immune systems, and the elderly. This study aims to analyze the clinical characteristics of patients with NTM. Methodology: The research was conducted in the form of a retrospective study, which included 23 patients with a diagnosis of NTM who were treated at the Clinic for Tuberculosis and Interstitial Lung Diseases of the Institute of Pulmonary Diseases of Vojvodina in Sremska Kamenica from 2014 to 2023. Results: Patients were predominantly male (15, 65.2%). The most common type of NTM was Mycobacterium xenopi in 8 patients (34.8%), as well as the way of establishing the diagnosis in patients who had negative direct microscopy and culture confirmation (12, 52.2%), followed by positive direct microscopy and culture confirmation (10, 43.5%). Smokers were the most frequent (10, 55.6%). The most common comorbidity was chronic obstructive pulmonary disease (10, 43.5%). A statistically significant difference was found in the frequency of the method of proof across different types of non-tuberculous mycobacterium infections (Fisher's exact test = 21.928; p = 0.006). Fatal outcomes were seen in 17.6% of patients. Conclusions: A detailed history, evaluation of clinical features, radiological findings, and microbiological samples are required in patients with suspected NTM infection. Raising suspicion and speeding up diagnostic procedures in these patients is of great importance for the timely initiation of treatment and reduction of mortality.