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Huljev Šipoš I, Šipoš K, Steiner J, Grubić Rotkvić P, Ljubičić Đ, Šola AM, Lozo Vukovac E, Kereš T, Plavec D. Validation of the fractional exhaled breath temperature measurement: reference values. J Breath Res 2023; 17. [PMID: 36762826 DOI: 10.1088/1752-7163/acb598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/30/2022] [Indexed: 02/11/2023]
Abstract
Exhaled breath temperature (EBT) is a known biomarker of inflammation and airways blood flow. As opposed to previous studies, we were able to measure temperature of separate fractions of exhaled breath (fEBT) (those from the peripheral and central airways). The aim was to validate the fEBT measurement method to determine the reference values and the influence of endogenous and exogenous factors on fEBT in healthy subjects. This cross-sectional study included 55 healthy adults in whom fEBT was repeatedly measured, two days in a row, using a FractAir®device. Also, basal metabolic rate, level of physical activity, distance from the main road, outdoor and ambient temperature, air pressure and humidity, haematology and inflammation markers, lung function, cumulative EBT and body temperature at characteristic points on the body were measured. The results showed that fEBT from central airways was lower compared to fEBT from the periphery and that fEBTs were not related to body temperature (p> 0.05 for all). We also showed repeatability of fEBT measurements for two consecutive days. All EBT fractions correlated significantly with ambient temperature (<0.01). No associations of fEBT with other personal and external factors were found using multivariate analysis. At room temperature of 22 °C, the physiological temperature values of the first fraction were 23.481 ± 3.150 °C, the second fraction 26.114 ± 4.024 °C and the third fraction 28.216 ± 3.321 °C. The proposed reference values represent the first part of validation of fEBT as the method for the use in clinical practice.
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Affiliation(s)
| | - Kristijan Šipoš
- Department of Cardiology, Clinic for Cardiovascular Diseases Magdalena, Krapinske toplice, Croatia
| | | | | | - Đivo Ljubičić
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | - Ana Marija Šola
- Department of Pulmonology, Special Hospital for Pulmonary Diseases, Zagreb, Croatia
| | | | - Tatjana Kereš
- Department of Intensive Care, University Hospital Dubrava, Zagreb, Croatia
| | - Davor Plavec
- Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
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Vukičević Lazarević V, Marković I, Šola AM. Adolescent and young adult allergic asthma treatment challenges. BMJ Case Rep 2022; 15:15/10/e251244. [PMID: 36316051 PMCID: PMC9628657 DOI: 10.1136/bcr-2022-251244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
The transition from paediatric care to adult care is often difficult, especially in children with chronic diseases like asthma. A significant number of children reach remission throughout puberty; consequently, they are not tracked down for subsequent follow-ups and are not included in transition programmes to adult care. This case report focuses on a young adult with asthma that began in childhood and went into remission during adolescence, only to experience a recurrence when the patient was a young adult. Due to failing to complete the transition process into adult care services, she had poor adherence to therapy and asthma control.Adherence and asthma control significantly improved after a multidisciplinary approach in an adult care setting. In conclusion, appropriate transition and a multidisciplinary approach are critical for the effective management of asthma in young adults.
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Affiliation(s)
- Vesna Vukičević Lazarević
- MSc Allergy, Faculty of Medicine, Imperial College London, London, UK .,Special Hospital for Pulmonary Diseases, Zagreb, Croatia
| | - Ivan Marković
- Special Hospital for Pulmonary Diseases, Zagreb, Croatia
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Vukičević Lazarević V, Šola AM, Vlahović I. Unexpected cause of dyspnoea in a patient with allergic rhinitis. BMJ Case Rep 2021; 14:e244075. [PMID: 34593549 PMCID: PMC8487185 DOI: 10.1136/bcr-2021-244075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A defect in one part of the immune system may affect the whole system. As a result, there may be a myriad of immunological diseases, which are often masked with the one disease that has the most prominent symptoms. This case report presents a patient with long-lasting allergic rhinitis who recently developed dyspnoea in exertion with suspected asthma development. After extensive diagnostic processing, asthma was dismissed, and diagnosis of selective IgA deficiency and coeliac disease with consequential iron deficiency anaemia was established. The patient was treated with parenteral iron and a gluten-free diet, which corrected her anaemia and led to the disappearance of dyspnoea. This paper aims to show the interplay between different immunological disorders and the possible causal connection between them.
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Affiliation(s)
- Vesna Vukičević Lazarević
- Imperial College London Faculty of Medicine, London, UK
- Special Hospital for Pulmonary Diseases, Zagreb, Croatia
| | | | - Ivan Vlahović
- Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex, UK
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Glodić G, Samaržija M, Sabol I, Bulat Kardum L, Carević Vladić V, Džubur F, Jakopović M, Kuhtić I, Marušić A, Mihelčić D, Popović Grle S, Strelec D, Šklebar T, Šola AM, Žmak L, van Ingen J, Janković Makek M. Risk factors for nontuberculous mycobacterial pulmonary disease (NTM-PD) in Croatia. Wien Klin Wochenschr 2021; 133:1195-1200. [PMID: 34402990 DOI: 10.1007/s00508-021-01923-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence, geographical distribution and clinical relevance of different nontuberculous mycobacteria (NTM) in Croatia are well described. There are few data on the risk factors for developing NTM pulmonary disease (NTM-PD) in this setting. METHODS We conducted a retrospective cohort study on all Croatian residents with NTM isolated from respiratory samples in the period from 2006 to 2015 with follow-up to 2018. The American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines were used to establish NTM-PD diagnosis. Clinical, radiological and treatment data were collected from hospital records. RESULTS Risk analysis calculations were made on the 439 isolation episodes that were classified as definitive NTM-PD (n = 137) or no disease (n = 302). Female gender, presence of bronchiectasis, low BMI and long-term systemic corticosteroid treatment were independent risk factors associated with NTM-PD. Hemoptysis and malaise were presenting symptoms independently associated with NTM-PD. Chronic obstructive pulmonary disease (COPD) and low/moderate dose inhaled corticosteroid (ICS) treatment were not associated with NTM-PD. High dose ICS treatment was a significant risk factor for developing NTM-PD (aOR = 4.73, CI 1.69-13.23 p = 0.003). CONCLUSION The NTM-PD patients in Croatia are similar to those in other published cohorts in terms of their characteristics and risk factors. The significant dose-dependent association between ICS use and NTM-PD adds to the body of evidence suggesting that high dose ICS use is associated with NTM-PD.
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Affiliation(s)
- Goran Glodić
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Miroslav Samaržija
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Sabol
- Division of Molecular Medicine, Laboratory od Molecular Virology and Bacteriology, Ruder Boskovic Institute, Zagreb, Croatia
| | - Ljiljana Bulat Kardum
- Department for Respiratory Diseases, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | | | - Feđa Džubur
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Jakopović
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Kuhtić
- Clinic for Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ante Marušić
- Clinic for Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dina Mihelčić
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sanja Popović Grle
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Dražen Strelec
- Hospital for pulmonary disease and TBC Klenovnik, Klenovnik, Croatia
| | | | - Ana Marija Šola
- Special Hospital for Respiratory Diseases Rockefellerova, Zagreb, Croatia
| | - Ljiljana Žmak
- School of Medicine, University of Zagreb, Zagreb, Croatia
- National Mycobacteria Reference Laboratory, Croatian Institute of Public Health, Zagreb, Croatia
| | - Jakko van Ingen
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmengen, The Netherlands
| | - Mateja Janković Makek
- Clinic for Respiratory diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Glodić G, Sabol I, Zmak L, Šola AM, Marušić A, Hećimović A, Džubur F, Jakopović M, Kardum Bulat L, Pavliša G, Samaržija M, Čivljak A, Dakić A, Janković Makek M. Clinical relevance of differentiation between Mycobacterium avium and M. intracellulare in M. avium complex pulmonary disease in Croatia. Tuberculosis (Edinb) 2019. [DOI: 10.1183/13993003.congress-2019.pa3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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