Sputum eosinophils might predict response to inhaled corticosteroids (ICS) in patients with advanced chronic obstructive pulmonary disease (COPD). Induction of sputum requires expertise and may not always be successful. Aim was to investigate correlation and predictive relationship between peripheral blood eosinophils (bEo) and sputum eosinophils (sEo), and impact of peripheral blood eosinophilia on outcome of COPD exacerbation. 120 current smokers with COPD (GOLD group C) (57.4 ± 0.92 years, M/F ratio 1.4), with no blood (≥7% or >0.43x109/L) nor sputum (≥3%) eosinophilia, were treated with moderate dose of ICS and long-acting bronchodilatator during stable disease, but systemic corticosteroids and antibiotics during exacerbation. According to sputum eosinophilia (≥4%) during exacerbation, patients were divided into eosinophilic (n=45) and non-eosinophilic group (n=75). In stable disease, bEo and sEo were similar in both groups (p>0.05). During exacerbation, bEo and sEo were significantly higher in eosinophilic group (eosinophilic vs. non-eosinophilic: blood: 1.42 ± 0.39 x109/l vs. 0.23 ± 0.02 x109/l, p<0.001; sputum: 8% (4, 19) vs. 1% (0, 3), p<0.0001), but bEo correlated with sEo in both groups (eosinophilic: r=0.52, p<0.001; non-eosinophilic: r=0.25, p<0.05). Relative bEo predicted sputum eosinophilia (area under the curve=0.71, standard error=0.05; 95% confidence interval [CI] =0.61-0.81; p<0.001) and enabled identification of the presence or absence of sputum eosinophilia in 82% of the cases at a threshold of ≥4% (specificity=83.56%, sensitivity=93.83%, positive likelihood ratio=3.67). Eosinophilic group during exacerbation showed less frequent hospitalisations and shorter exacerbation (eosinophilic vs. non-eosinophilic: hospitalisations: 26.7% vs. 60.0%, p<0.001; duration of exacerbation (days): 8.1±0.35 vs. 10.13±0.31, p<0.0001). In COPD exacerbation, relative peripheral blood eosinophils ≥4% might identify sputum eosinophilia. Blood eosinophilia indicate better outcome of COPD exacerbation. Further investigations are needed to predict eosinophilic exacerbation in COPD patients, with prior absence of sputum or blood eosinophilia.

The development of industry, agriculture, transport and urbanization has resulted in excessive emissions of heavy metals into the environment, which due to their bioaccumulative properties express negative effects on the environment and living organisms as a whole. In this work the presence of heavy metals in the soil samples of the urban area of Lukavac and Kalesija municipality and their effect on the health of the population were studied. Soil samples were collected in October 2017 at five locations in the urban area of Lukavac municipality and two urban locations in Kalesija municipality. Concentrations of chromium (Cr) copper (Cu), cobalt (Co), nickel (Ni), cadmium (Cd), lead (Pb), manganese (Mn), iron (Fe) and zinc (Zn) in the soil samples were determined. The results indicated that in some locations the concentration of heavy metals exceeded the maximum permissible concentration (MPC). MPC value for chromium was exceeded at four locations in the urban area of Lukavac, whereas MPC value for nickel and cadmium was exceeded at all locations. In Kalesija, MPC value was exceeded for chromium and nickel at one location, while cadmium MPC was exceeded at both locations. The negative impact of heavy metals on the health of the population is the cause of many malignant diseases. Statistical analysis of the number of patients with malignant diseases in the area of the Lukavac and Kalesija revealed significantly higher prevalence of malignant diseases of the lungs, breast, skin and cervix in the Lukavac (p<0,05) in comparisson to Kalesija municipality.