Although Epstein–Barr virus (EBV) reactivation has long been associated with the pathogenesis of systemic lupus erythematosus (SLE), many aspects of this relationship remain unclear. Our objective was to investigate the association between EBV reactivation and the achievement of SLE remission and lupus low disease activity state (LLDAS) over a six-month period. Clinical, laboratory, and virological tests (anti-EBV antibodies and EBV DNA) were performed among 51 patients with the active form of SLE on two occasions six months apart. SLE remission and LLDAS achievement were assessed at the end of the follow-up period. Active EBV infection was detected in 45% of active SLE patients at baseline, and 77% transitioned to latent EBV infection at six months (p < 0.001). Multivariate regression revealed a higher titer of anti-EA(D) IgM-Abs and the presence of anti-EA(D) IgM-Abs as independent predictors of remission and LLDAS in SLE patients with mucocutaneous manifestations (p = 0.042) and rash only (p = 0.023), respectively. Since a higher C3 level was an independent predictor of transition to latent EBV infection (p = 0.027), the estimated cut-off value that could identify active SLE patients who will transition to latent EBV infection after six months was ≥0.780 g/L with a sensitivity of 70.6% and a specificity of 75.0% (AUC = 0.756, p = 0.003). EBV reactivation is common in patients with active SLE, and most of them transition to latent EBV infection after six months. Achieving remission and LLDAS in SLE patients with mucocutaneous manifestations can be predicted by a higher titer, whereas in SLE patients who have only a rash, the presence of anti-EA (D) IgM-Abs was a predictor of remission and LLDAS.

Systemic lupus erythematosus (SLE) is characterized by an imbalance between proinflammatory and anti-inflammatory mediators. Single-nucleotide polymorphisms (SNPs) in genes coding IL10RA, IL10RB, and IL22RA could affect their expression or function and disrupt immune homeostasis. We aimed to analyze the associations of IL10RA, IL10RB, and IL22RA polymorphisms/haplotypes with patients’ susceptibility to and clinical manifestations of SLE. Our study included 103 SLE patients and 99 healthy controls. The genotypes of the selected polymorphisms within IL10RA (rs10892202, rs4252270, rs3135932, rs2228055, rs2229113, and rs9610), IL10RB (rs999788, rs2834167, and rs1058867), and IL22RA (rs3795299 and rs16829204) genes were determined by TaqMan^® Assays. IL10RB rs1058867 G allele carriers were significantly more frequent among the controls than among the SLE patients (76.8% vs. 61.2%; p = 0.017, OR = 0.477, 95% CI: 0.258–0.879). The IL10RB CAA haplotype was more frequent among the SLE patients than in the control group (42.7% vs. 30.7%; p = 0.027). The IL22RA rs3795299 C allele and rs16829204 CC genotype were associated with Hashimoto thyroiditis in the SLE patients (n = 103; p = 0.002 and p = 0.026, respectively), and in all the included participants (n = 202, p < 0.000 and p = 0.007, respectively), and the IL22RA CC haplotype was more frequent in the SLE patients with Hashimoto thyroiditis (p = 0.047) and in the overall participants with Hashimoto thyroiditis (n = 32, p = 0.004). The IL10RA, IL10RB, and IL22RA polymorphisms/haplotypes could be associated with SLE susceptibility and various clinical manifestations, and the IL22RA CC haplotype could be associated with Hashimoto thyroiditis.

Background/Objectives: The COVID-19 pandemic substantially affected both the provision and demand for health services. There are few studies that analyzed factors associated with unmet healthcare needs during the COVID-19 pandemic relative to regular pre-pandemic period, mainly in high-income countries. This study examines the change in the likelihood of reporting unmet healthcare needs as well as individual demographic, socioeconomic, health-related, and geographical characteristics associated with unmet healthcare needs during the COVID-19 pandemic and during the pre-pandemic period in Serbia. Methods: We utilized data from the Survey on Income and Living Conditions in the Republic of Serbia for 2019 and 2021. Multivariable logistic regression analysis was conducted on the pooled sample comprising 21,422 respondents aged 16 years and older from both survey years. Results: Overall, respondents had 1.6 times higher odds of reporting unmet healthcare needs during the COVID-19 pandemic compared with the pre-pandemic period. In the pooled multivariable analysis, older adults (OR = 2.32), individuals reporting poor or very poor self-rated health (OR = 2.16), and those with chronic diseases (OR = 1.46) were more likely to report unmet healthcare needs. In contrast, individuals with higher levels of education (ORs = 0.72 for high school, 0.65 for college, and 0.51 for master’s degree), retired individuals (OR = 0.70), inactive persons (OR = 0.76), and students/pupils (OR = 0.22) had significantly lower odds of unmet needs, compared to their counterparts. Relative to the poorest income quintile, individuals in all higher income quintiles were less likely to report unmet healthcare needs, with the lowest odds observed in the 5th quintile (OR = 0.49). Residents of thinly populated areas had higher odds compared to those in densely populated areas (OR = 1.19). Conclusions: Identified associations with unmet healthcare needs should be used to develop targeted strategies for strengthening healthcare access, particularly in the context of future crises.

Cancer stem cells (CSCs) significantly contribute to heterogeneity, malignancy, and therapy resistance in ovarian cancer. Recent studies emphasize the role of the vitamin D receptor (VDR) in regulating cell differentiation and stemness in various types of cancer. This study aims to determine the expression levels of CD44, CD133, and VDR in epithelial ovarian tumors (EOTs) and to compare these levels across different tumor types, including benign, atypical proliferative tumors, and five types of malignant phenotypes, in order to evaluate their potential as diagnostic tools for malignancy. Tissue samples from 218 patients diagnosed with EOT were analyzed. Clinical and histopathologic parameters were recorded. Quantitative immunohistochemical tissue microarray analysis was used to assess the expression levels of CD44, CD133, and VDR using two different scoring systems. Comparisons were made between benign tumors (n = 45), atypical proliferative tumors (n = 42), and ovarian carcinomas (n = 131), including high-grade serous (HGSC) and non-HGSC subtypes. Ovarian cancer, especially HGSC, showed a significantly higher expression of CD44 and VDR (p < 0.05) compared to atypical proliferative tumors and benign tumors. The expression of CD133 was highest in atypical proliferative tumors (p < 0.05). A moderate positive correlation was found between CD44, CD133, and VDR in all groups, with significant correlations with tumor grade and FIGO stage in ovarian cancer (p < 0.05). The increased expression of CD44 and VDR in aggressive ovarian cancer, along with elevated CD133 levels in atypical proliferative tumors, highlights the complexity of tumor biology. These markers may serve as valuable targets for the diagnosis of ovarian cancer.

Background: Non-ST-segment elevation acute myocardial infarction (NSTEMI) represents a heterogeneous patient population with varying risks of adverse outcomes. The RISK-PCI score, initially developed for ST-segment elevation myocardial infarction (STEMI) patients, was evaluated for its prognostic value in NSTEMI patients undergoing percutaneous coronary intervention (PCI). Methods: A retrospective observational study of 242 NSTEMI patients treated with PCI at the Clinical Center of Serbia from June 2011 to June 2016 was conducted. The RISK-PCI score, incorporating clinical, echocardiographic, and angiographic variables, was calculated for each patient. The primary outcome was 30-day major adverse cardiovascular events (MACE). Secondary outcomes included individual components of MACE. Statistical analyses were performed to assess the predictive value of the RISK-PCI score. Results: The primary outcome of 30-day MACE occurred in 9.9% of patients. Independent predictors of 30-day MACE included age > 75 years, glucose ≥ 6.6 mmol/L, creatinine clearance < 60 mL/min, and post-procedural TIMI flow < 3. The RISK-PCI score demonstrated good discrimination for 30-day MACE (AUC = 0.725). Patients stratified into the very high-risk group (RISK-PCI score ≥ 7) had significantly higher risks of 30-day MACE (29.4%). Conclusions: The RISK-PCI score effectively stratifies NSTEMI patients by their risk of 30-day MACE, identifying a very high-risk subgroup that may benefit from closer monitoring and tailored interventions. External validation on larger cohorts is recommended to confirm these findings.

Background: Immune checkpoint inhibitors (ICIs) are effective against melanoma, but are often limited by adverse events (AEs). We aimed to characterise the incidence, characteristics and predictors of AEs. Methods: This ambispective study included 141 patients with melanoma (165 ICI treatment episodes) treated between March 2017 and April 2026. Predictors of AE occurrence, seriousness and severity were analysed per treatment episode and per AE using generalised estimating equations. Results: We recorded 206 AEs in 95 patients (67.4%). At least one AE occurred in 59.8% of pembrolizumab, 59.5% of nivolumab and 81.0% of nivolumab/ipilimumab episodes. Most AEs were Grade 1–2 (88.3%); skin disorders were the most frequent (29.1%) and endocrine AEs had the lowest resolution rate (3.2%). Time to first AE was shortest with nivolumab/ipilimumab (p < 0.001). Per episode, nivolumab/ipilimumab was associated with more serious AEs than nivolumab (p = 0.042) and, borderline, than pembrolizumab (p = 0.051), and with Grade 3–4 AEs (p = 0.001); the lower odds of AE with monotherapy were not significant (p = 0.063, 0.242). Systemic treatment for unresectable disease was associated with AE occurrence (p = 0.029), serious (p = 0.009) and Grade 3–4 AEs (p = 0.016), and BRAF mutation with AE occurrence (p = 0.029). Conclusions: Patients receiving combination immunotherapy and those treated for unresectable disease may warrant closer monitoring.