The Clinic for Granulomatous and Interstitial Lung Diseases
Primary activities of the Clinic are diagnosis and treatment of interstitial (most frequently idiopathic pulmonary fibrosis) and granulomatous (sarcoidosis and tuberculosis) lung diseases. Nowadays, tuberculosis takes about 15% of the Clinic’s capacity, due to a reduced incidence rate of tuberculosis in Vojvodina (14/100,000 persons) over the last 12-year period.
The Clinic employs nine physicians – one specialist in pulmonology and internal medicine respectively, four pneumophthysiologists, one physician specialising in internal medicine, and two clinicians. Three of the physicians have a PhD title, one and two of whom are a full and associate professors respectively. Twenty-three nurses work in the Clinic, including a head nurse, four section nurses, three therapists, and 15 shift nurses.
The Clinic for Granulamatous and Interstitial Lung Diseases has the capacity of 62 beds, distributed in 17 patient rooms (seven six-bed and two ten-bed rooms). Each room has its own bathroom and is equipped with a central oxygen supply and an air conditioner. In 2016, there were 1,159 patients treated in the Clinic, who made the total of 19,483 hospital days, with the mean treatment duration of 17 days.
Infectious TB Isolation Section including three patient rooms with the total capacity of nine patients was opened in October, 2014. The Section is physically separated from the rest of the Clinic and it entirely applies TB infection control measures in compliance with standard operative procedures.
“TB Control in Serbia”, a ten-year project, was being carried out until 1st April, 2015. All physicians of the Clinic participated in this project as the expert team members, supervisors, or educators. Education of all staff profiles of the Clinic has been carried out according to the plan and programme of education. Special attention has been paid to education on the measures for prevention and control of the TB bacillus-induced nosocomial infection immediately before opening the Isolation Section of the Clinic, which also included other health professional and assisting staff outside the Clinic who come in contact with the Section during their regular work practice (food serving staff, technical staff, laboratory technicians), as well as the patients themselves and their family members.
Upon termination of the TB Control in Serbia project, the physicians of the Clinic still have a leading role in the control of the disease in Vojvodina through educational seminars, workshops, supervision visits to TB treatment centres, as well as consultation services given by the Commission for Granulomatous and Interstitial Diseases at the Clinic.
The quantiFERON test (QTF) has been applied in the Institute for Pulmonary Diseases of Vojvodina since 1st January, 2015. It is used to detect a latent TB infection (LTB). Unlike the tuberculin skin test (TST), the QFT is positive only when a TB infection is chiefly induced by M. tuberculosis, but not when BCG vaccination is applied. The test is performed in the Immunology Laboratory of the Institute. The advantage of this LTB-confirming method over tuberculin skin test (TST) is in that it requires just a single visit to the laboratory unlike theTST, which requires two visits in 72 hours.
Although the Clinic has been primarily intended for diagnosis and treatment of tuberculosis, current declining trends in the number of TB patients in Serbia and Vojvodina have resulted in the Clinic’s growing orientation to the diagnosis and treatment of sarcoidosis and disorders of the lung parenchyma. The name of the Clinic itself has been accordingly amended. Significant advances in the diagnosis and treatment of these diseases have been achieved in the last decade, so the physicians of the Clinic have been increasingly interested in these fields, constantly improving their knowledge about them.
Consequently, a multidisciplinary approach in the diagnosis and treatment of interstitial lung diseases has been recognized and the Commission for granulomatous and interstitial diseases founded, which includes clinicians (pulmonologists/pneumophthysiologists) from the Clinic, a radiologist and a pathologist. The Commission makes a final decision about the diagnosis and treatment of active and latent tuberculosis, sarcoidosis and other granulomatous and interstitial lung diseases. It considers the cases of both in- and out-patients, the latter referred by a regional pulmonologist or another specialist dealing with systemic diseases which may affect the lung interstitium (immunologist, rheumatologist, etc). The Commission works on Tuesdays and Thursdays from 11 o’clock. Appointments are made by phone at the Control Examination Unit (+381 21 48 05 114).
All medical staff members of the Clinic have been permanently improving in their fields of interest through education courses, professional meetings and conferences in the country and abroad in which they take an active part, organising seminars and symposia, giving introductory lectures, oral and poster presentations.