Sarcoidosis is a granulomatous disease of unknown etiology that can affect almost any organ. Although the acute form can have spontaneous regression, a certain number of patients can have a chronic form, which leads to an increase in mortality and a decrease in the quality of life. Considering that the risk factors are still unknown, we wanted to compare the characteristics of patients with acute and chronic forms of sarcoidosis in Serbia in order to determine significant differences between them with hopes of contributing to everyday clinical practice. A total of 2380 patients treated in our clinic were enrolled in this study. They were separated into the following two groups: 1126 patients with acute form and 1254 patients with chronic form. They were further compared by gender, smoking status, radiological status, exposition, biomarkers for sarcoidosis, organ involvement, and other comorbidities; the distribution of patients according to regions of Serbia was also noted. Statistical significance was found in radiological findings (p < 0.001), biomarkers (calcium in 24 h urine p < 0.001; chitotriosidase p = 0.001), and the affliction of organs (p < 0.001). The differences noted in this paper could help improve our understanding of this disease.

Background: Low-dose computed tomography (LDCT) lung cancer screening (LCS) frequently identifies emphysema in high-risk smokers. However, the extent to which CT-detected emphysema reflects underlying physiological impairment remains uncertain. We evaluated whether spirometry can detect functional abnormalities in this population beyond structural imaging findings. Methods: This cross-sectional study included 323 individuals with LDCT- detected emphysema and no lung cancer or prior chronic respiratory diseases within a screening cohort (n = 3076). Participants underwent pre-bronchodilator spirometry and symptom assessments (COPD Assessment test (CAT) and Modified Medical Research Council (mMRC) Dyspnea Scale). Pre-bronchodilator airflow limitation was defined as forced expiratory volume in one second to forced vital capacity ratio (FEV₁/FVC) < 0.70. Small airways dysfunction was defined by ≥2 reduced mid-expiratory flow parameters (<60% predicted). Flow–volume curve morphology was assessed qualitatively. Results: Pre-bronchodilator airflow limitation was observed in 45.2% of participants, predominantly mild. Small-airway dysfunction was present in 52%, and an abnormal flow–volume curve morphology in 67.5%. Notably, functional abnormalities were frequently observed despite preserved FEV₁. Symptom burden was low, with only 7.7% of participants reporting clinically significant symptoms. Functional impairments often overlapped and were common in minimally symptomatic individuals. Conclusions: In a lung cancer screening (LCS) cohort with CT-detected emphysema, functional abnormalities are frequently observed, including in individuals with preserved FEV₁ and minimal symptoms. Spirometry provides additional physiological insight beyond structural imaging; however, these findings are descriptive and should not be interpreted as diagnostic of COPD. Further studies are needed to determine their clinical relevance.

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive condition and a leading cause of morbidity and mortality worldwide. The rate of forced expiratory volume in one second (FEV1) decline is a key prognostic marker. This study aimed to evaluate the impact of demographic, clinical, and therapeutic factors, including respiratory muscle strength and inhaled corticosteroid (ICS) use, on FEV1 decline.Methods: A prospective study was conducted in 2019 at the Clinic for Pulmonology, Clinical Center of Serbia. Fifty patients with stable COPD underwent spirometry, body plethysmography, respiratory muscle strength testing, and laboratory analyses. Demo-graphic and clinical data were collected via questionnaire. All assessments were repeated after six months of regular inhalation therapy.Results: Significant reductions were observed in FEV1, FVC, TLC, PImax, and PEmax. Lower baseline respiratory muscle strength predicted a faster FEV1 decline. Patients in GOLD stage 2 and those with greater hyperinflation exhibited accelerated functional deterioration. Therapy type affected selected parameters: LABA/ICS and LAMA/LABA/ICS regimens significantly reduced residual volume, but not the rate of FEV1 decline. Higher eosinophil counts were associated with a slower reduction in FEV1, suggesting a potential protective effect of ICS.Conclusion: Respiratory muscle strength, hyperinflation, and eosinophil count represent important predictors of COPD progression. Incorporating these parameters into diagnostic and therapeutic algorithms may improve early risk stratification and support indi-vidualized treatment strategies.