Summary Background The objective of this prospective study was to evaluate whether soluble programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) and serum amyloid A1 (SAA1) are potential diagnostic, predictive or prognostic biomarkers in lung cancer. Methods Lung cancer patients (n=115) with advanced metastatic disease, 101 with non-small cell lung cancer, NSCLC (77 EGFR wild-type NSCLC patients on chemotherapy, 15 EGFR mutation positive adenocarcinoma patients, 9 patients with mPD-L1 Expression ≥50% NSCLC – responders to immunotherapy), and 14 patients with small cell lung cancer (SCLC) were examined. ELISA method was used to determine sPD-L1 and SAA1 concentrations in patients’ plasma. Results Significantly higher blood concentrations of sPD-L1 and SAA1 were noted in lung cancer patients compared with a healthy control group. In PD-L1+ NSCLC patients, a significantly higher sPD-L1 level was noticed compared to any other lung cancer subgroup, as well as the highest average SAA1 value compared to other subgroups. Conclusions It seems that sPD-1/PD-L1 might be a potential biomarker, prognostic and/ or predictive, particularly in patients treated with immunotherapy. Serum amyloid A1 has potential to act as a good predictor of patients’ survival, as well as a biomarker of a more advanced disease, with possibly good capability to predict the course of disease measured at different time points.

EBTB was more frequent among men, and among people in their fifties in our country. Detailed bronchoscopic examination, correlated with clinical and laboratory findings, will improve diagnostic rate and provide timely therapy.

SUMMARY – Currently, topical are studies that examine different reasons for delay of tuberculosis (TB) diagnosis and its impact on disease prognosis. The aim was to examine three time periods associated with treatment delay: patient related, health system related and total delay. This retrospective-prospective study included 100 consecutive patients hospitalized at Department of Pulmonology, Clinical Center of Serbia, in the period from March to December 2015. Study results showed median patient delay to be 92.5 days. Total delay was affected by patient related delay. Median healthcare delay was 18.5 days. Patients that reported excessive alcohol consumption were more likely to have prolonged time to seek medical help. Years of alcohol consumption yielded moderate positive correlation with patient related delay (r=0.362, p<0.001). Correlation between the number of cigarettes and patient delay was moderate, positive and statistically significant (r=0.314, p=0.001). Delay in seeking medical help was more likely in patients with negative family history of TB. There was no difference in the effect of the presence of symptoms on patient related delay (p>0.05). Clinical characteristics such as patient TB category and chest radiograph abnormalities were not associated with prolonged patient related delay (p>0.05). Study results point to the importance of health education and/or health intervention in the population group at a high risk of TB.

The presented patient is a rare case of pleural involvement of sarcoidosis with massive effusion, who responded well to the treatment.

In an attempt to meet desires and needs of the patients with pulmonary diseases who plan to travel by air craft, physicians might face complex problems. They are expected to estimate individual risk and need of oxygen supplementation that might be necessary. Sometimes, these patients are a source of infection to other passengers. Some international air travel guidelines offer precise and mandatory conditions, which should be fulfilled during the flight in case such a patient has to travel. Thus, patients with drug resistant tuberculosis are not permitted to travel at all, while all the other patients with pulmonary tuberculosis and other air born infections should not travel during the infectious period. Recent or uncured pneumothorax and hemoptisis are contraindications for travelling. Other patients with pulmonary diseases, especially those with manifested respiratory insufficiency should respect the rules, which include contacting air travel company prior to flight, sharing information about their health condition and asking for details on possibilities of oxygen supplementation while on board, currence voltage, and availability of plugs in the cabin where the devices for respiratory support might be put in, etc. A possibility of hypoxia during the flight is an important individual risk. Methods of hypoxia prediction and possibilities of oxygen supplementation in air craft cabin are in focus of current research.