Three subtypes of achalasia have been defined using esophageal manometry. Several studies have reported that symptoms are experienced differently among men and women, regardless of subtype. All subtypes could have some impact on the appearance of respiratory symptoms and lung complications due to compression of the trachea or aspiration of undigested food. The aim of this research was to analyze the differences in respiratory symptoms and radiographic presentation of lung pathology depending on the diameter and achalasia types. One or more respiratory symptoms were reported in 48% of 114 patients, and all of them had two or more gastrointestinal symptoms. The symptom score (SS) is statistically significant for the prediction of subtype 1 (area under the curve = 0.318; p < 0.001, cut-off score of 6.5 had 95.2% sensitivity) and subtype 2 (area under the curve = 0.626; p = 0.020, cut-off score of 7.5 had 93.1% sensitivity). The most common type was subtype 2 (50.8%), and although only 14 patients had subtype 3, they had the largest esophageal diameter (mean 5.8 cm). The difference in esophageal diameter was significant between subtype 1 and 3 (p = 0.011), subtype 2 and subtype 3 (p = 0.011). Nine patients (6%) had mega-esophagus (four patients in type 1, three in type 2 and two in type 3). More than half of all patients (51.7%) had at least one parenchymal lung change on CT scan. Recurrent micro-aspirations led to changes in the structure of the airways and lung parenchyma such as ground glass (GGO) and nodular changes (12%) and fibrosis (14.5%), and they had higher esophageal diameters (p < 0.001). Patients with chronic lung CT changes had significantly higher esophageal diameter than with acute changes (p < 0.001). Awareness of the association of achalasia and lung disorders is important in early diagnosis and treatment. More than half (57.5%) of patients with achalasia had some clinical and/or structural pulmonary abnormalities. All three subtypes had similar respiratory symptoms, meaning they cannot be used to predict the subtype of achalasia; on the contrary, SS can predict the first two subtypes. A higher diameter of the esophagus is associated with chronic structural lung changes. Although unexpected, the pathological radiological findings and diameter were significantly different in subtype 3 patients, but those parameters cannot lead us to a specified subtype.

Malignant pleural mesothelioma (MPM) is a very aggressive tumor. The prognostic value of PD-L1 and BAP1 expression has been investigated in many studies. A retrospective study was conducted that analyzed PD-L1 and BAP1 expression as prognostic biomarkers in patients with MPM. The study included 53 patients with MPM. PD-L1 expression ≥ 1% was found in 39.6%, and BAP1 loss was found in 81.1% of patients. The median overall survival (mOS) was 11 months. Subtype of MPM (p = 0.045), early tumor stage (p = 0.049), therapy (p = 0.002), and good PS (0–1) (p = 0.012) were associated with better survival. Expression of PD-L1 and BAP1 did not show statistical significance regarding OS, but OS was numerically shorter in patients with PD-L1 ≥ 10% (5 vs. 12 months) and longer in patients with BAP1 loss (12 vs. 4 months). In patients with PD-L1 ≥ 1% and BAP1 loss, the median progression-free survival (mPFS) was numerically longer (10 vs. 7 months) but in patients with PD-L1 ≥ 1% and BAP1 positivity, PFS was statistically significantly shorter (1 vs. 7 months, p = 0.048). Our results did not show that PD-L1 and BAP1 are prognostic biomarkers for MPM, but positive PD-L1 expression and BAP1 loss were associated with worse survival in patients with MPM.

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.

Introduction/Objective. Since tibial shaft is a common location of opened and closed tibial fractures, it is very important to determine the best method of treating these fractures. Our objective was to assess whether the Ilizarov technique is appropriate in terms of complications, outcomes, and pain reduction in treatment of patients with tibial shaft fracture. Methods. Retrospective analysis included all consecutive patients with tibial shaft fracture treated with the Ilizarov technique in the period from January 2013 to June 2017 at the Banjica Institute for Orthopaedic Surgery, Belgrade, Serbia. Demographic and clinical data on patients were collected. Pain was assessed using visual analogue scale of pain. Two models of uni- and multi-variate linear regression analysis were performed. Results. The study showed that the overall rate of complications was low, and that hypertension, administration of antibiotics, and reoperation prolonged fixation. Also, severe fractures and longer procedure time delay mobilization. Significant reduction of pain was observed. Conclusion. The Ilizarov technique is a safe and reliable method in the treatment of patients with tibial shaft fractures and is followed by pain reduction, overall improvement of functioning, good outcomes, and is not commonly associated with complications.

Background/Objectives: A significant breakthrough in non-small-cell lung cancer (NSCLC) treatment has occurred with the introduction of targeted therapies and immunotherapy. However, not all patients treated with these therapies would respond to treatment, and patients who respond to treatment would acquire resistance at some time point. This is why we need new biomarkers that can predict response to therapy. The aim of this study was to investigate whether soluble programmed cell death-ligand 1 (sPD-L1) could be a predictive biomarker in patients with epidermal growth factor receptor (EGFR)-positive NSCLC. Materials and Methods: Blood samples from 35 patients with EGFR-mutated (EGFRmut) adenocarcinoma who achieved disease control with EGFR tyrosine kinase inhibitor (EGFR TKI) therapy were collected for sPD-L1 analysis. We analyzed sPD-L1 concentrations in 30 healthy middle-aged subjects, as a control population, to determine the reference range. Adenocarcinoma patients were divided into two groups, i.e., a group with low sPD-L1 (≤182.5 ng/L) and a group with high sPD-L1 (>182.5 ng/L). Results: We found that progression-free survival (PFS) was 18 months, 95% CI (11.1–24.9), for patients with low sPD-L1 and 25 months, 95% CI (8.3–41.7), for patients with high sPD-L1. There was no statistically significant difference in PFS between the groups (p = 0.100). Overall survival (OS) was 34.4 months, 95% CI (26.6–42.2), for patients with low sPD-L1 and 84.1 months, 95% CI (50.6–117.6), for patients with high sPD-L1; there was also no statistically significant difference between the groups (p = 0.114). Conclusion: In our study, we found that patients with high sPD-L1 had numerically better PFS and OS, but this has no statistical significance. Further studies with a larger number of patients are needed to evaluate the role of sPD-L1 as a predictive biomarker in patients with EGFRmut NSCLC.

Introduction: Lung cancer remains the leading cause of cancer death among all cancers. The discovery of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations led to an increased survival rate in patients with locally advanced and metastatic non-small cell lung cancer (NSCLC). Results of the ALTA 1L study showed superior outcomes for patients treated with brigatinib compared to patients treated with crizotinib. Background: We conducted research including 23 patients with ALK-positive lung adenocarcinoma who were treated with brigatinib in first or further lines of therapy. The median follow-up was 22 months (4–66 months). Results: There were no significant differences in patient population between the first and further lines of treatment regarding sex distribution (p = 0.692), smoking status (p = 0.554), ECOG performance status (p = 1.000), and baseline presence of brain metastases (p = 0.862). The response rate was 47.8%, and disease control was 95.6%. The 12-month progression-free survival (PFS) and overall survival (OS) rates were 85.3% and 86.5%, respectively, while the 60-month PFS rate was not reached, and the 60-month OS rate was 27.1%. The mPFS and mOS were 32 months. Conclusions: The results of this analysis are promising, as our patients experienced better outcomes compared to those in the ALTA 1L study, which may be attributed to the small sample size. However, the effectiveness of brigatinib has been confirmed in our clinical practice.