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Introduction. Pulmonary sequestration is a rare congenital anomaly and most intralobar sequestrations were located in lower lobes. Case report. We reported an unusual 28-yearold female patient with intralobar pulmonary sequestration on the left lower lobe, successfully treated with lobectomy. Computed tomography (CT) of the chest with intravenous contrast revealed multiple clustered cystic lesions in the left lower lobe with aberrant artery from descedenting aorta. Additional aortography showed an aberrant artery (3 mm in diameter) arising from the abdominal aorta and flowing into the lesion. Conclusion. Standard therapy regimen for pulmonary sequestration includes surgery. CT scan of thorax with intravenous contrast and aortography represent the gold standard for its diagnosis. Tumor-like shadows seen on the chest radiography or CT scans should not be always suspected on malignant lesions. [ABSTRACT FROM AUTHOR]

Introduction. Bronchobiliary fistula (BBF) is a pathological communication between the bronchial system and the biliary tree that presents with bilioptysis. Many conditions can cause its development. There is still no optimal therapy for BBF. Conservative treatment is rarely indicated, as was published before in a few cases. Case report. We presented a 71-year-old Caucasian Serbin woman with BBF secondary to previous laparotomy due to multiple echinococcus liver cysts. The diagnosis was established by the presence of bilirubin and bile acids in sputum and magnetic resonance cholangiopancreatography (MRCP). A repeat MRCP performed after conservative procedure, did not reveal fistulous communication. Conclusion. We suggest that in small and less severe fistulas between the biliary and the bronchial tract, conservative treatment may be used successfully, and invasive treatment methods are not needed in all patients. [ABSTRACT FROM AUTHOR]

Biological agents, including TNF-alpha antagonists, have been used in treatment of autoimmune diseases for over 20 years. Due to impaired T-cell immunity and blocked effects of TNF-alpha mediator, patients receiving this therapy have increased risk of developing tuberculosis or other non-tuberculous mycobacterial infections. Both tuberculosis and other mycobacterial infections may occur anytime in patients who have ever used these medicines, even after the first injection. Most often we see activation of latent tuberculosis confirmed by screening tests. IGRA tests (QuantiFERON and T-SPOT.TB) are significantly more sensitive and specific for testing population of immunosuppressed patients, in comparison to tuberculosis skin test. There are contemporary recommendations for diagnosing, monitoring, chemoprophylaxis and treatment of latent and active tuberculosis in adults and children in case of planning administration of TNF-alpha antagonists or in cases when these drugs have already been used. Prevention of active tuberculosis via diagnosing LTBI and use of chemoprophylaxis is the crucial component of the strategy of World Health Organization for elimination of TB (End TB Strategy). [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TBC) is a contagious chronic respiratory disease which despite the known cause, Mycobacterium tuberculosis (Mtb), and many decades of successful therapy, remains one of the leading global health problems. Immune responses against Mtb infection involve both of types of immunity, but cellular immunity, in which certain cytokines and Th1 cells play a key role, is crucial. A better understanding of the functions of the cytokine network involved in the state and progression of TBC could identify specific molecular markers for monitoring of disease activity as well as therapy outcomes in TBC patients. Methodology: We investigated expression of TNF-a, IL-6 and IRAK1 genes using an RT-qPCR technique in peripheral blood mononuclear cells of 33 TBC patients and 10 healthy individuals. Results: Comparison between TBC patients and healthy individuals revealed statistically significant differences for all analyzed genes. The levels of expression of TNF-a and IL-6 mRNA were higher, while the level of IRAK1 mRNA was lower in the TBC group compared to controls. Moreover, a strong positive correlation was observed between TNF-a and IL-6 gene expression. When clinical parameters were analyzed, increased levels of TNF-a mRNA were detected in patients with a longer duration of therapy (>2 months) compared to those with a shorter therapy duration (< 2 months), and in patients without anemia. Conclusions: Our results indicate that the inflammatory genes we examined play a crucial role in the pathogenesis of tuberculosis, and that the expression of the TNF-a gene could be a marker for monitoring the clinical effect of the ant-tuberculosis drugs during therapy. [ABSTRACT FROM AUTHOR]

• Molnupiravir and nirmatrelvir/ritonavir are administered to patients with mild COVID-19 to prevent worsening of disease. • Hospitalisation and mortality rates with molnupiravir vs. nirmatrelvir/ritonavir were compared in patients with leukaemia or lymphoma. • No statistically significant differences between treatments for hospitalisation, mortality rates or survival probability. • Results support the use of molnupiravir in patients with haematological malignancies in Europe. • Patients with nirmatrelvir/ritonavir-related contraindications and drug-drug interactions may benefit from molnupiravir treatment. Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections and decrease hospitalisation and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, whereas molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir because it is associated with fewer drug-drug interactions and contraindications. A caveat for molnupiravir is the mode of action induces viral mutations. Mortality rate reduction with molnupiravir was less pronounced than that with nirmatrelvir/ritonavir in patients without haematological malignancy. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, molnupiravir and nirmatrelvir/ritonavir were compared in a cohort of patients with haematological malignancies. Clinical data from patients treated with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and severity of baseline haematological malignancy to controls treated with nirmatrelvir/ritonavir. A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (interquartile range [IQR] 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 56.9% (n=66) of the patients had controlled baseline haematological malignancy, 12.9% (n=15) had stable disease, and 30.2% (n=35) had active disease at COVID-19 onset in each group. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of patients in the two groups were vaccinated (molnupiravir n=77, 66% vs. nirmatrelvir/ritonavir n=87, 75%), more of those treated with nirmatrelvir/ritonavir had received four vaccine doses (n=27, 23%) compared with those treated with molnupiravir (n=5, 4%) (P <0.001). No differences were detected in COVID-19 severity (P =0.39) or hospitalisation (P =1.0). No statistically significant differences were identified in overall mortality rate (P =0.78) or survival probability (d30 P =0.19, d60 P =0.67, d90 P =0.68, last day of follow up P =0.68). Deaths were either attributed to COVID-19, or the infection was judged by the treating physician to have contributed to death. Hospitalisation and mortality rates with molnupiravir were comparable to those with nirmatrelvir/ritonavir in high-risk patients with haematological malignancies and COVID-19. Molnupiravir is a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy. [ABSTRACT FROM AUTHOR]