Introduction: Bronchiectasis is a chronic progressive respiratory disease characterized by permanent dilatation of the bronchi. It is a complex condition with numerous different etiologies, co-morbidities, and a heterogeneous presentation. As we know, there is a lack of studies that describe the differences and compare the characteristics between focal and multifocal bronchiectasis. The aim of this study is to identify differences in clinical characteristics presentation, severity or distribution in focal and multifocal bronchiectasis, and prognostic implications. Methods: 126 patients with computed tomography (CT)-verified bronchiectasis were enrolled. Baseline characteristics that included age, sex, smoking history, and respiratory symptoms were recorded, with special attention paid to hemoptysis appearance, body mass index, and comorbidities. The type of bronchiectasis determined by CT scan and the modified Reiff scores indicating radiological severity were recorded. Patients were divided in two groups (I is focal and II is multifocal). Results: There were no statistically significant differences in age, smoking status, comorbidity, and BMI between the two groups. Multifocality was associated with a significantly higher proportion of females (p = 0.014), the rate of hemoptysis (p = 0.023), and the number of hospitalizations, but not of exacerbations and prevalence of immunodeficiency (p = 0.049). Significantly, a high number of subjects with multifocality had bronchiectasis of moderate severity, and post-infective and asthma-associated phenotypes were the dominant in this group. Unexpectedly, the cystic and varicose radiological phenotype (which need more time to develop) were more dominant in the focal group. The cylindrical phenotype was equally observed in the multifocal and focal groups. Conclusions: Our study suggests that multifocality is not related to age, number of exacerbations, or radiological phenotype, but it seems to be associated with the clinical post-infective phenotype, immunodeficiency, frequent hospitalizations, and severity. Thus, the presence of multifocal bronchiectasis may act as a biomarker of severity and poor outcomes in these patients.

Background/Objectives: Idiopathic pulmonary fibrosis (IPF) registries are established to enhance understanding of its natural history. Methods: Serbia (RS) participated in the EMPIRE (European Multi-Partner IPF Registry) from June 2015 to October 2022, involving four centers. The registry included patients over 18 diagnosed with IPF based on the 2011 international criteria. We aimed to gather key clinical, functional, and survival data, along with treatment information for IPF patients in RS, using a centralized electronic case report for consistency. Results: 188 RS patients participated (median age at diagnosis 65, 63.8% male, 51% smoking history, 56% radiological usual interstitial pneumonia (UIP) pattern). At the diagnosis, median forced vital capacity (FVC) was 73.7% and diffusion capacity for carbon monoxide (DL_CO) was 38%. At initiation of antifibrotic therapy, median FVC was 73.2% (71.5% for deceased, 75.8% for survivors (p = 0.455), and DL_CO was 33.8% (19.9% for deceased, and 35.6% for survivors (p = 0.046)). The median long-term survival from diagnosis was 29.4 months (95% CI: 22.6–36.2 months), and 9.4 months (95% CI: 5.9–12.9 months) from the initiation of therapy, with no difference in the duration of antifibrotic treatment between survivors and deceased (p = 0.598). Conclusions: The RS EMPIRE cohort represents a younger, less comorbid population with fewer smokers and more probable UIP, factors linked to a favorable prognosis. Nevertheless, survival was poorer than expected, mainly due to advanced disease severity at the time of antifibrotic initiation, as indicated by lower DL_CO. These findings highlight the importance of earlier diagnosis and treatment before significant physiological decline to improve outcomes.

Introduction/Aim: Bronchiectasis is a chronic respiratory condition characterized by permanent dilatation of the bronchi with chronic respiratory symptoms. Some studies have found association between malnutrition and bronchiectasis. However, research on obesity remains insufficient and further studies are needed. The aim was to evaluate the association between BMI (body mass index) and phenotypes, endotypes, clinico-radiological presentation and severity. Methods: A retrospective study included 120 patients with bronchiectasis. The socio-epidemiological, clinical, radiographic and laboratory characteristics were compared using statistical analyzes, depending on BMI. Results: The mean age was 61.3 ± 7.6 years. Underweight, normal, overweight, and obese accounted for 6.7%, 48.3%, 27.5%, and 17.5% of all patients. There were statistically significant differences in BACI score (p = 0.01), normal sputum finding (p = 0.03), lower hemoglobin level (p = 0.02) in the underweight group and eosinophil endotype in all groups except underweight (p = 0.04). The mean BACI (Bronchiectasis Aetiology and Co-morbidity Index) score had a rising trend from overweight and obese patients to normal weight the followed by the underweight category. Chronical colonization of Haemophilus was dominant in the underweight whereas Pseudomonas predominated in the overweight and obese. Asthma was most common in overweight and obese patients. We did not find differences between the groups in spirometry findings (but, the majority of all study patients with restriction belonged to the underweight group), Reiff score and radiological phenotype. Conclusion: Underweight patients were females and they were younger than overweight patients, they had lower diffusion capacity, systemic inflammation and higher BACI score, post-infective phenotype and predominantly normal sputum bacterial analysis for colonization screening. On the other hand, overweight and obese patients had chronic colonization by P. aeruginosa, asthma comorbidity, and eosinophil endotype. Those differences are very important for future specific treatment.

Introduction and objective: Community-acquired pneumonia pneumonia is acute respiratory infection of the lung parenchyma and alveolar apparatus caused by respiratory viruses, bacteria and fungi present at all ages. It can be lobar or multilobar, unilateral or bilateral. The aim of the research is to examine the difference in disease severity and laboratory analyzes in patients with lobar and multilobar pneumonia. Methods: The retrospective study included 80 patients with symptoms and signs of acute respiratory infection who were initially examined in the Emergency Department and then treated in the hospital at the Clinic for Pulmonology, UKCS due to radiographically verified lobar or multilobar pneumonia. Demographic characteristics of patients, PCR respiratory panel of nasopharyngeal swab, radiographic topography of pneumonia, length of hospitalization, laboratory tests, therapy and pneumonia severity score (CURB65) were analyzed. Results: The average age of the patients was 67.21±69.5 years, and 43(53%) were male and 37(47%) were female. Out of the total number of patients, 24(30%) were non-smokers, the other 56(70%) were active or former smokers. The most common comorbidities are: arterial hypertension 49(61%), diabetes mellitus 15(18%), COPD 14(17%), malignancy 13(16%), cardiomyopathy 4(5%). PCR respiratory panel of nasopharyngeal swab revealed the following pathogens: Streptococcus pneumoniae 41(51%), Influenza A 25(31%), influenza virus H1N1 14(18%), Moraxella catarrhalis 8(10%), SarsCov-2 virus 6(7%). Lobar pneumonia in 39(48%) patients, more common in males 22(56%), radiographically most commonly affected lower right lobe 18(46%), average length of hospitalization 12.48±10 days, most often caused by Streptococcus Pneumoniae 20(51%) , Influenza A 13(33%), Metapneumovirus and Moraxella catharralis 3(7%) with an average inflammation marker 148.05±136, procalcitonin 13.83±0.44 and mean CURB65 values 2.15. Multilobar pneumonia in 41(52%) patients, more common in men 21(53%), average length of hospitalization 12.53±10 days, most often caused by Streptococcus Pneumoniae 22(56%), Influenza A 9(21%), SarsCov-2 virus 6(14%) with average inflammation marker 162.35±136, procalcitonin 7.25±0.44 and mean CURB65 values 2.43. 22 patients(17%) were treated in the intensive care unit with an average CURB65 score of 2.5. Fatal outcomes occurred in 16(20%) patients with an average CURB65 score of 3. CURB65 score 4-5, which indicates a high degree of mortality in the next 30 days, was present in 9(11%) patients. Conclusion: The test results are in favor of a more frequent presence of multilobar pneumonia in males, caused by the bacterium Streptococcus Pnuemoniae with higher inflammation parameters and CURB65 values, a more severe clinical picture.