Title TEMPERATURA IZDAHA KAO MOGUĆI NEINVAZIVNI MARKER OSJETLJIVOSTI NA DUHANSKI DIM
Title (english) Breath temperature as a possible non-invasive marker of susceptibility to a cigarette smoke
Author Marina Labor
Mentor Davor Plavec (mentor)
Committee member Neven Tudorić (predsjednik povjerenstva)
Granter Josip Juraj Strossmayer University of Osijek Faculty of Medicine Osijek Osijek
Defense date and country 2016, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Universal decimal classification (UDC ) 61 - Medical sciences
Abstract Cilj istraživanja: Glavni cilj je bio utvrditi dijagnostičku vrijednost temperature izdaha kao mogućeg neinvazivnog markera u dijagnostici osoba osjetljivih na duhanski dim. Nacrt studije: Doktorski rad je učinjen u sklopu multicentrične prospektivne studije praćenja kohorte ispitanika s rizikom za razvoj KOPB-a. U prvoj fazi istraživanja kroz ordinacije liječnika obiteljske medicine uključeni su ispitanici s rizikom za razvoj KOPB-a, a koji su nakon 2-4 tjedna prema dijagnostičkom protokolu pregledani od pulmologa kako bi se isključila ili potvrdila dijagnoza i stadij KOPB-a prema GOLD smjernicama. U drugu fazu praćenja tijekom 2 godine uključeni su ispitanici bez postavljene dijagnoze KOPB-a te oni u stupnju GOLD 0 i GOLD I. Ispitanici i metode: Prema kriterijima, uključeno je 333 ispitanika aktivnih pušača. Ispitanicima je uzeta anamneza i učinjen klinički pregled, potom su samostalno ispunili 3 samoocjenska upitnika - upitnik Studije europske zajednice o plućnom zdravlju II, upitnik bolnice St. George o problemima s disanjem i test za ocjenu KOPB-a, nakon čega je učinjena laboratorijska obrada, testovi plućne funkcije (plućna funkcija s COPD6, spirometrija s bronhodilatacijskim testom, 6-minutni test hoda) te se izmjerila temperatura izdahnutnog zraka prije i nakon popušene cigarete. Ispitanici koji su završili drugu fazu (n=146) procijenjeni su nakon 2 godine vezano uz dijagnozu i stadij KOPB-a. Rezultati: Za potvrđivanje novodijagnosticiranog KOPB-a promjena temperature izdaha nakon popušene cigarete u početnoj procjeni uz graničnu vrijednost promjene od 0.2°C imala je osjetljivost 62.5%, specifičnost 73.7%, PPV 13.9% i NPV 96.7%, a za razlikovanje progresije bolesti osjetljivost 63.6%, specifičnost 73.7%, PPV 18.4% i NPV 95.6%. U ispitanika s progresijom bolesti promjena temperature izdaha nakon popušene cigarete statistički značajno je razlikovala sve kategorije progresije bolesti (novodijagnosticirani KOPB; novodijagnosticirani KOPB+pogoršanje stupnja težine KOPB-a; gubitak postbronhodilatatorne vrijednosti FEV1 >50 ml/god) nakon 2 godine praćenja, a temperatura izdaha prije popušene cigarete statistički značajno je razlikovala novodijagnosticirani KOPB te novodijagnosticirani KOPB+progresiju bolesti. Gubitak plućne funkcije nakon 2 godine je bio najveći u skupini bolesnika s KOPB GOLD I. Zaključak: Temperatura izdahnutog zraka može poslužiti kao jedan od markera ranog otkrivanja KOPB-a u pušača pod rizikom.
Abstract (english) Aim: The main goal of the study was to determine the diagnostic value of exhaled breath temperature as a possible non-invasive marker of susceptibility to a cigarette smoke in smokers. Study design: The study was conducted as a part of a multicenter prospective cohort study in active smokers at risk for developing COPD. In the first phase subjects at risk for developing COPD were recruited through primary care. Recruited subjects were reviewed by a pulmonologist after 2-4 weeks according to the diagnostic protocol to rule out or confirm the diagnosis and the severity of COPD according to GOLD guidelines. In the second phase subjects without a diagnosis of COPD and those in GOLD stage 0 and I were reassessed after 2 years of follow-up. Subjects and methods: According to the inclusion criteria 333 active smokers were included and underwent a diagnostic workup: medical history along with comorbidities, physical examination, after which subjects filled The European Community Respiratory Health Survey II, St. George Respiratory Questionnaire and COPD Assessment Test, followed by laboratory tests, pulmonary function tests (screening spirometry using COPD6, spirometry with bronchodilation test, 6-minute walk test) and measurement of exhaled breath temperature before and after smoking a cigarette. Subjects (n=146) without a diagnosis of COPD and those in GOLD stage 0 and I were reassessed by a pulmonologist for the diagnosis and the severity of COPD after 2 years of follow-up. Results: Change in exhaled breath temperature after smoking a cigarette at initial assessment with a threshold value change of 0.2 °C had a sensitivity of 62.5%, specificity of 73.7%, PPV of 13.9% and NPV of 96.7% for differentiating subjects with a newly diagnosed COPD after 2 years of follow-up, and a sensitivity of 63.6 %, specificity of 73.7%, PPV of 18.4% and NPV of 95.6% for for differentiating subjects with a progression of disease. Change in exhaled breath temperature after smoking a cigarette was significantly different in all three categories of disease progression (newly diagnosed COPD; newly diagnosed COPD+severity progression; loss of postbronchodilator FEV1 >50 ml/yr) after 2 years of follow-up, and exhaled breath temperature before smoking was significantly different for two categories of disease progression (newly diagnosed COPD; newly diagnosed COPD+severity progression). The loss of lung function after 2 years was the largest in the group of patients with COPD GOLD I stage. Conclusion: Exhaled breath temperature could be used as one of the early markers of COPD in smokers at risk.
Keywords
biološki markeri
kronična opstruktivna plućna bolest
osjetljivost
pušenje
temperatura izdaha
upala
Keywords (english)
biological markers
chronic obstructive pulmonary disease (COPD)
disease susceptibility
cigarette smoking
exhaled breath temperature
inflammation
Language croatian
URN:NBN urn:nbn:hr:152:551135
Promotion 2021
Study programme Title: University Postgraduate Study Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Repository Repository of the Faculty of Medicine Osijek
Created on 2021-07-19 09:16:24