Vesna Kuruc

The Serbian version of the Epworth Sleepiness Scale

PurposeThe Epworth Sleepiness Scale (ESS) is extensively used for evaluating daytime sleepiness in patients with sleep apnea–hypopnea syndrome (SAHS). The aim of this study was to translate and validate the ESS in the Serbian language.MethodsThe Serbian version of the ESS (ESSs) was administered to 112 patients with symptoms of sleep disorder breathing referred to Sleep Center of the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia and 111 healthy controls. Test–retest reliability was tested in 19 healthy subjects.ResultsPatients referred to the Sleep center had significantly higher ESS scores compared to controls (9 vs. 4, p < 0.001). The difference was also present for each item separately, excluding item 5. The ESSs scores were significantly higher in patients with severe (median, 13.5; interquartile range (IQR), 10.3–17.8) compared to moderate (median, 9; IQR, 7.3–9.5; p = 0.005) and mild SAHS (median, 8; IQR, 5.5–9.7; p < 0.001). Item analysis demonstrated good internal consistency of the scale (Cronbach’s alpha 0.88 in patients and 0.72 in healthy controls). Test–retest Spearman’s correlation coefficient was 0.68 (p = 0.001).ConclusionThe Serbian version of the ESS demonstrated good internal consistency and test–retest reliability. The ESSs could be used for both clinical practice and research in Serbian population.

Autofluorescence videobronchoscopy (AFI) for the assessment of tumor extension in lung cancer.

The major objective of our study was to determine the specificity and sensitivity of AFI videobronchoscopy vs. white light videobronchoscopy, in the assessment of lung cancer extent. Secondary objective was to investigate whether or not AFI can reveal greater extension of the tumor, and can it influence therapy making decision. Autofluorescence videobronchoscopy systems are new technology for visualization of bronchial mucosa, and the proper indications for such systems will be determined in the near future. In this prospective trial we have enrolled 27 patients with suspected lung cancer in whom we performed 108 diagnostic biopsies and 54 control biopsies. All patients underwent WL videobronchoscopy followed by Auto Fluorescence Imaging (AFI) examination of tracheobronchial tree. We were using videobronchoscope BF-F260 and EVIS LUCERA SPECTRUM processor unit. Overall specificity for AFI in the diagnostics of lung cancer was found to be 85%, sensitivity was 90%, positive predictive value (PPV) 78%, and negative predictive value (NPV) 94%. Specificity, sensitivity, PPV, and NPV for WL videobronchoscopy in lung cancer diagnostics were 54%, 64%, 51%, and 69%, respectively. Relative sensitivity ratio of AFI over WL videobronchoscopy, which is calculated to be 1.41, confirmed superiority of AFI in lung cancer diagnostics. We confirmed significant correlation between the greater extension of the tumor (assessed with AFI) and the therapeutical decision in lung cancer treatment (p = 0.01). Influence of AFI on therapeutical decision was significant (p = 0.034). AFI videobronchoscopy system yields significantly higher sensitivity and specificity for the assessment of lung cancer extent than WLB videobronchoscopy alone. It had shown to be able to influence therapeutic option for lung cancer treatment. Further studies are needed to evaluate and validate these results.

Relation of functional characteristics and serum alpha-1-antitrypsin (AAT) concentration in patients with PiMM phenotype and chronic obstructive pulmonary disease (COPD)

INTRODUCTION The relation of AAT phenotype and COPD still raises lots of controversy. In this study we aimed to investigate relation lung function characteristics, AAT serum level and COPD in smoking and non smoking population. PATIENTS AND METHODS This was a prospective non-randomized study in which we evaluated 45 patients with severe (stage IV) COPD. In all patients we determined AAT phenotype, serum AAT levels and lung function tests. We correlated findings in relation to the smoking status. RESULTS All patients were MM type homozygotes. Serum AAT concentrations were within the reference values, amounting to 1.66g/l in smokers and 1.80g/l in nonsmokers. There was no significant correlation between serum AAT concentrations and lung function parameters. We have observed the higher mean values of ITGV, RV, TLC and RV/TLC in smokers and a statistically significant difference only in ITGV. CONCLUSION All of the investigated patients with severe COPD were MM type homozygotes with normal plasma level of AAT. There was no significant correlation between the phenotype and severity of COPD. We did not find significant relation of plasma AAT level and lung function impairment.

Tuberculosis in a developing country - how much patients know about disease

IntroductionKnowledge of tuberculosis among patients with the disease is crucial for early disease recognition, patients’ full cooperation during the treatment, and prevention of future relapses. Our major aim was to evaluate knowledge about tuberculosis among patients and its correlation to their socioeconomic status (education level, employment status, monthly income, living conditions).Patients and methodsIn this prospective study we interviewed 200 adult patients with newly diagnosed, active pulmonary tuberculosis treated at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia (July, 2006–June, 2008). The information for analysis was obtained from two questionnaires and patients’ medical records.ResultsThe majority of the patients, 158 (79%), were male, with a mean age of 49 years (±15.4). Most of the patients knew that tuberculosis is an infectious disease (n=188, 92%), but they were unaware of the cause (n=84, 42%). The patients with a higher education level (61.2% vs. 90%, p=0.03), satisfactory living conditions (88.7% vs. 63.2%, p=0.02), and higher economic status (78.4% vs. 100%, p=0.04) demonstrated more knowledge about the disease. Half of the patients (n=98, 49%) believed that concomitant diseases (HIV, tumors) might contribute to the genesis of tuberculosis.ConclusionsPatients with tuberculosis demonstrated good knowledge of their disease. Patients with higher socioeconomic status and education level were more knowledgeable about their disease.