BACKGROUND:High blood cholesterol is part of metabolic syndrome and can be caused by medical conditions or bad dietary habits.AIM:The aim of the study was to investigate the prevalence of hypercholesterolemia in privies diagnosed patients with the severe and very severe stage of COPD, which were stable.MATERIAL AND METHODS:We investigated 100 subjects, all of them smokers, with smoking status >10 years, stratified into two groups: with severe and very severe stage of the disease. It was clinical, randomized, cross-sectional study. Besides demographic parameters and functional parameters, body mass index, cholesterol, LDL, and HDL were investigated.RESULTS:In the group of patients with very severe COPD were recorded significantly higher average values of cholesterol (6.16 ± 1.5 vs. 5.61 ± 1.1, p = 0.039). As independent significant factors influencing cholesterol in the group with a very severe COPD were confirmed the age of the patients (p = 0.005), LDL (p = 0.004) and HDL (p = 0.002). In the group with severe COPD, only LDL was confirmed as an independent significant factor that has an impact on cholesterol (p < 0.0001).CONCLUSION:The results of our survey demonstrated a high level of blood cholesterol and LDL, and low level of blood HDL in both investigated group’s patients with COPD.

AIM:The aim of the study was to investigate the prevalence of diabetes mellitus in privies diagnosed chronic obstructive pulmonary disease (COPD) patients with severe and very severe disease, which ware stable.METHODS:We investigated 100 subjects, all of them smokers, with smoking status >10 years. They were stratified in two groups. It was clinical, randomized, cross sectional study. Besides demographic parameters, functional parameters, BMI, cholesterol, LDL and HDL, and the level of blood sugar was measured.RESULTS:The prevalence of diabetes mellitus in our survey in total number of COPD patients with severe and very severe stage was 21%. In the very severe group were recorded significantly higher average values of glycaemia compared with severe group (7.67 ± 3.7 vs. 5.62 ± 0.9, p = 0.018). In the group with severe COPD, it was not confirmed any factor with significant predictive effect on the values of glycaemia. As independent significant factors that affect blood glucose in a group of very severe COPD were confirmed cholesterol (p <0.0001) and HDL (p = 0.018).CONCLUSION:These results suggest that the presence of the COPD in patients itself is a factor that results in the clinical presentation of diabetes mellitus Type 2.

BACKGROUND:Goodpasture syndrome was originally described as an association of alveolar haemorrhage and glomerulonephritis. It occurs when the immune system attacks and destroys healthy body tissue.AIM:We are presenting a patient with a clinical picture of pulmonary haemorrhage and glomerulonephritis, which is diagnosed by renal biopsy.CASE PRESENTATION:His illness began a year and a half before being diagnosed. In that period he had occasional exacerbations. He was received at our Clinic in extremely serious condition, and after stabilisation of his medical condition, there was made a biopsy of the kidney. The p-ANCA was 8.93 U/ml (neg < 3, poz > 5 U/ml). Histopathological diagnosis of biopsy of the kidney was: Glomerulonephritis extra capillaries focalis, segmentalis et globalis. Based on this he was diagnosed with Goodpasture syndrome. He received corticosteroid therapy and cyclophosphamide, with good response to treatment, and he is currently in a stable condition, receiving only corticosteroid therapy.CONCLUSION:Goodpasture syndrome is a severe illness caused by the formation of antibodies to the glomerular basement membrane and alveolus with consequential damage to renal and pulmonary function. With current therapy, long-term survival is more than 50%.

SARS-CoV-2 sometime is associated with potential life-threatening rare complication, more specifically, pneumomediastinum, pneumatocelеs, cyst formations, and very often pulmonary fibrosis.Our patient was 35 years old with main complaints: dry cough. chest pain, fatigue. She experienced a severe form of COVID 19, which resulted in complications of pneumomediastinum, pneumatocell, and pulmonary fibrosis. During the treatment of six months there is an almost complete withdrawal of the complications. She now feels well, able to work, and is still under our control.Physicians should be aware and careful in COVID 19 patients with severe clinical form given ventilator support, that such complications are possible and before a discharge from the hospital to do an X-ray or CT scan of the lungs. Especially when advising procedures such as postural drainage.

A large number of hospitalized COVID-19 survivors show that persistent symptoms, radiographic abnormalities and physiological impairments exist months after the initial illness. Persistent chest imaging abnormalities and histopathological findings of lung fibrosis were also found in a majority of survivors of the SARS-CoV-1 suggesting that the SARS viruses may lead to a worse fibroproliferative response than other pneumonias.Our patient had a severe COVID-19 pneumonia, followed by massive infiltrative changes in both lungs in addition to massive pulmonary fibrosis. After the initial treatment in one of the COVID-19 centers in the Clinical Center in Skopje, the patient with post-COVID-19 (more precisely pulmonary fibrous changes of the lungs) was referred for further treatment to the University Clinic for Pulmonology in a severe clinical condition, where he was treated at an outpatient basis in the period of several months. During that time the condition improved, with a significant withdrawal of the X-ray finding of the lungs, which was registered on CT from 5.5.2021. He is still under observation.The robust responses of corticosteroid therapy in our case presenting a radiological pattern of organizing pneumonia allowed the patient to return to his baseline clinical condition. But due to the persistence of X-ray residual changes he is under our regular observation.