Introduction: Regular physical activity (PA) has a beneficial effect on joint pain, stiffness, strength, flexibility, and aerobic capacity in patients with rheumatoid arthritis (RA). Objective: The aim of this study was to assess the level of PA in patients with rheumatoid arthritis and to identify potential barriers to this activity. Material and Methods: The study involved 132 patients with RA. Participants completed the International Physical Activity Questionnaire (IPAQ), the Functional Assessment of Chronic Illness Therapy—Fatigue Scale (FACIT-F), the Tampa Scale for kinesiophobia (TSK), Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling questionnaire (SARC-F) for sarcopenia assessment, and the Patient Health Questionnaire-9 (PHQ-9) for depression. Basic socio-epidemiological data, disease activity score in 28 joints (DAS₂₈), duration of disease, and therapy information were retrieved from electronic patient records. Latent class analysis (LCA) was used to identify subpopulations of patients. Results: The study included 109 women (82.6%) and 23 men (17.4%). Low levels of PA were observed in 16 patients (12%), moderate levels in 70 patients (53%), and high levels in 42 patients (35%). Symptoms of pronounced fatigue were significantly associated with low PA (28.5 ± 11.3 vs. 37 ± 7 vs. 37 ± 10; p = 0.002). The risk of sarcopenia was significantly higher in RA patients with low PA (p = 0.05). Kinesiophobia was present in all three groups (65.2%). LCA identified two classes. In the first class, patients were more likely to be non-exercisers compared to the second class. Patients in the first class were characterized by a higher probability of being female, obese, with lower education levels. Patients in the first class had pronounced fatigue, kinesiophobia and more frequent symptoms of depression. The second class (65% of the total population) included patients who exercised moderately to frequently (93%) and were middle-aged. They were less obese, highly educated, employed, and majority of them achieved low disease activity or remission. In addition, they had lower risks for sarcopenia, depression, fatigue, and kinesiophobia. Conclusions: This study showed that RA patients with moderate and high levels of PA have better disease control, fewer symptoms of fatigue and depression, and a lower risk of sarcopenia. However, kinesiophobia was significantly present in all three groups, indicating a need for further promotion of this non-pharmacological treatment.

Introduction: To evaluate physical activity (PA) levels in patients with psoriatic arthritis (PsA) and their associations with cardiovascular (CV) risk factors, psychosocial parameters, and functional status, and to identify distinct patient subgroups using latent class analysis. Material and methods: In this cross-sectional study, 62 adults with PsA fulfilling Classification Criteria for Psoriatic Arthritis (CASPAR) were consecutively recruited from the Institute of Rheumatology. Phy­sical activity was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorized as low, moderate, or high. Cardiovascular risk factors, fatigue (Functional Assessment of Chronic Illness Therapy Fatigue Scale – FACIT-F), functional status (Health Assessment Questionnaire Disability Index – HAQ-DI), depression (Patient Health Questionnaire-9 – PHQ-9), an­xiety (Beck Anxiety Inventory – BAI), kinesiophobia (Tampa Scale for Kinesiophobia – TSK), and sarcopenia risk (SARC-F) were evaluated. Disease activity was measured using the clinical Disease Activity Index for Psoriatic Arthritis (cDAPsA). Latent class analysis was applied to identify patient subgroups based on PA, comorbidities, and psychosocial variables. Results: Mean age was 44.5 ±10.3 years; 52% were female. Physical activity was low in 19.4%, mode­rate in 67.7%, and high in 12.9%. Lower PA was associated with older age (p = 0.04), higher fatigue (FACIT-F 29 ±7 vs. 43 ±6.4, p = 0.01), and greater disability (HAQ-DI 0.9 vs. 0.1, p = 0.03). The prevalence of obesity was 51.6% (n = 32), hypertension (HT) 23% (n = 16), dyslipidemia 30% (n = 19), and diabetes mellitus type 2 12.9% (n = 8). Latent class analysis identified two classes: class I – younger, predominantly female (56%), higher education (82%), moderate PA (75%), lower cardiometabolic burden (obesity 46%, HT 14%, dyslipidemia 10%), and lower psychosocial impact; class II – broader age range, male predominance (54%), lower PA (30% low, 60% moderate), higher cardiometabolic burden (HT 86%, obesity 56%, dyslipidemia 35%), greater kinesiophobia (74%), and sarcopenia risk (19%). Conclusions: In PsA, low PA is associated with higher fatigue, functional impairment, and cardiometabolic and psychosocial burden. Latent class analysis revealed distinct subgroups, suggesting the need for personalized, multidisciplinary interventions targeting physical and psychological barriers. Integrating tailored PA promotion alongside pharmacological control may improve both joint and CV outcomes.

Introduction: After the Serbian community hospitals had reached their full capacity during the pandemic, new institutions were enrolled into the coronavirus disease 2019 (COVID-19) system as temporary COVID hospitals (TCH). These hospitals usually had no intensive care units (ICU) and no possibility to treat severely ill patients. The aim of this study was to identify risk factors at the time of triage that could help identify patients that will require ICU treatment and cannot be treated in a TCH. Methodology: In this retrospective study, a total of 158 patients with COVID-19 infection were enrolled. The demographic information, underlying comorbidities, laboratory findings, chest X-rays, computed tomography scans, and clinical outcomes were obtained from medical records. Deterioration of a patient’s condition was regarded as a need for further transfer to ICU. Results: During the hospitalization 15.2% of patients required transfer to ICU. Patients with deterioration were significantly older and there was no difference between genders. We observed a higher prevalence of hypertension, other cardiovascular diseases, lower lymphocyte and platelet counts, and higher IL-6 and troponin T in patients with deterioration. The multivariate logistical regression model showed that only age was an independent risk factor for deterioration and with each year of age, the risk for poor outcome increased by 8%. Conclusions: Patients with cardiovascular risk factors, low lymphocyte and platelet counts, high IL-6 and troponin T and, especially, increased age should not be treated in a TCH because of the high possibility for deterioration and need for transfer to an ICU.

Introduction: Coreceptor tropism is the ability of human immunodeficiency virus (HIV) to use CCR5 or CXCR4 coreceptor to enter the host cell. Tropism depends on the structure of the surface glycoprotein, involved in binding molecules to receptor and coreceptor. Viruses that CCR5use are named R5, viruses that CXCR4 use are X4-tropic, and dual/mixed (DM) viruses use either of the two. During early stages of HIV infection,R5 strains are usually present and with the progression of HIV disease, frequency of X4 occurs. Aim: The aim of the study was to analyze the coreceptor tropism in newly diagnosed HIV infected patients. Material and methods: The study group included 26 patients with newly diagnosed HIV infection, in the hospital care from 2010 to 2012 at the Clinic for Infectious and Tropical diseases of the Clinical Center of Serbia. Upon RNA isolation from plasma, PCR amplification and DNA sequencing of the V3 loop of the env gene were performed. The sequences were used for prediction of the coreceptor tropism, using the Geno2pheno bioinformatics algorithms. Results: R5 and X4 tropism were detected in 21/26 (81%) and 5/26 (19%) patients, respectively. Five out of twenty-six patients (19.2%) were in the C3 clinical stadium of the disease, and all of them were infected with R5-tropic virus. Fourteen out of twenty-five patients (56%) were late presenters of HIV infection, where 12 (86%) of them were infected with R5-tropic virus. Conclusion: Our results imply that the majority of HIV strains in patients, with newly diagnosed infection in Serbia, are characterized by R5 tropism. However, the prevalence of X4 strains is not negligible, indicating late presentation of newly diagnosed patients, but also possibly implying increased virulence of the circulating strains. Considering that CCR5 antagonists would not be effective in 19% of studied patients, the prediction of coreceptor tropism is undoubtedly very important.

Introduction/Objective Patients with ankylosing spondylitis (AS) often experience chronic musculoskeletal pain, fatigue, and stiffness, which may contribute to psychological distress and sexual dysfunction. This study aims to assess prevalence of erectile dysfunction (ED) in patients with AS and identify potential associations between clinical parameters related to AS with the presence of ED. Methods Forty consecutive male patients with AS (mean age 42.8 ? 8.9 years) and 60 healthy men (mean age 38.9 ? 10.9 years) were included. All subjects filled out the International Index of Erectile Function (IIEF) questionnaire, as well as the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI). In patients with AS disease activity was evaluated using the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functionality using the Bath Ankylosing Spondylitis Functional Index (BASFI), and quality of life using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. Results ED was significantly more frequent in patients with AS compared to controls (52.5%: 25%, p = 0.049). AS patients with ED had more severe symptoms of depression, than AS patients without ED (p = 0.034). According to ASQoL scores, patients with AS and ED had a worse quality of life, compared to patients with AS without ED (p = 0.022). The increase in one unit of ASQoL increased the odds of having ED for 17.5% (p = 0.035). Conclusion ASQoL score, as a measure of quality of life, was the only independently associated parameter with the presence of ED. It is necessary to raise awareness of ED in patients with AS.