Neuroinvasive flaviviruses such as tick-borne encephalitis virus (TBEV) and West Nile virus (WNV) are widely distributed in continental Croatian regions. We analyzed clinical characteristics, laboratory parameters, and molecular epidemiology of neuroinvasive flavivirus infections in eastern Croatia. A total of 43 patients with confirmed flavivirus infection hospitalized from 2017 to 2023 were included in the study. Reverse-transcription polymerase chain reaction (RT-qPCR) was used to detect flavivirus RNA in clinical samples (cerebrospinal fluid; CSF, urine). ELISA was used for IgM and IgG antibody detection in serum and CSF with confirmation of cross-reactive samples by virus neutralization test. WNV was detected more frequently (74.4%) than TBEV (25.6%). A statistically significant age difference was found between WNV patients (median 65 years) and TBEV patients (median 36 years). Comorbidities were more frequently detected in WNV patients (hypertension 56.3 vs. 18.2%; diabetes 31.3 vs. 0%). Meningitis was the most common clinical presentation in both TBE and WNV neuroinvasive disease (WNND; 63.6 and 59.4%, respectively). In addition, some rare clinical presentations of WNND were also detected (cerebellitis, polyradiculoneuritis). No significant differences in the frequency of clinical symptoms were observed between WNV and TBEV-infected patients (fever 93.7 vs. 100%; malaise 78.1 vs. 100%; headache 75.0 vs. 100%; nausea 50.0 vs. 63.6%; vomiting 34.4 vs. 54.6%). Comparative analysis of total and differential leukocyte blood count showed similar results. However, CSF pleocytosis was higher in TBE patients, with a significant difference in the neutrophil and lymphocyte count (WNND median 48.5% and 51.5%; TBE median 10.0 and 90.0%, respectively). The length of hospital stay was 12 days for WNND and 9 days for TBE. Phylogenetic analysis of detected WNV strains revealed the presence of WNV lineage 2 in eastern Croatia.

Measuring quality of life (QoL) in patients with early-stage lung cancer is an important aspect of treatment success. This study assessed QoL in the early postoperative period in patients with lung cancer, with regard to the type of cancer. This single-center study was conducted on 64 patients who underwent surgery for non-small cell (NSCLC) and small cell (SCLC) lung cancer. Quality of life questionnaires (QLQs) of the European Organization for Research and Treatment of Cancer (EORTC) were used. The EORTC QLQ-C30 questionnaire assesses the quality of life of cancer patients, and the EORTC QLQ-LC13 questionnaire is a lung cancer module. In the group of patients with NSCLC, the general health status (p < 0.001), physical functioning (p = 0.004), emotional functioning (p = 0.005) and total functional scale (p = 0.01) were significantly better assessed, fatigue was less pronounced (p = 0.005), nausea/vomiting (p = 0.04), pain (p = 0.004), breathing difficulties were less pronounced (p = 0.03), loss of appetite was less pronounced (p = 0.005), and the symptom scale was significantly less pronounced (p = 0.002) compared to patients with SCLC. In the QLQ-LC13 symptom scale, SCLC patients had more cough (p = 0.02), dyspnea (p = 0.03), dysphagia (p = 0.005), peripheral neuropathy (p = 0.04), chest pain (p < 0.001), arm or shoulder pain (p < 0.001), and pain in other parts of the body (p = 0.005) compared to NSCLC patients. Patients with NSCLC evaluated the functioning scales better and had less pronounced symptoms on the symptom scale, while patients with SCLC evaluated the treatment symptoms worse on the symptom scale, especially the symptom of pain, which had an impact on the quality of life of the patients. The results of this study could contribute to raising public awareness about the quality of life of lung cancer patients.