Title Novosti u dijagnostici i liječenju bronhiektazija
Title (english) New developments in the diagnosis and treatment of bronchiectasis
Author Tena Lusavec
Mentor Andrea Vukić Dugac (mentor)
Committee member Miroslav Samaržija (predsjednik povjerenstva)
Committee member Marko Jakopović (član povjerenstva)
Committee member Andrea Vukić Dugac (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Internal Medicine) Zagreb
Defense date and country 2020-09-11, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract Bronhiektazije su kronična progresivna bolest donjeg respiratornog trakta koju karakterizira trajno, abnormalno proširenje bronha. Značajan su socioekonomski teret jer povećavaju troškove zdravstvene skrbi i nepovoljno utječu na kvalitetu života. Epidemiološki podaci o bronhiektazijama nisu dovoljno jasni, ali uočen je porast prevalencije i stope hospitalizacija. Danas se puno više zna o patogenezi i etiologiji bronhiektazija. Mehanizam nastanka je složen, a objašnjava se hipotezom začaranog kruga koja se temelji na međusobnom podržavanju upale, strukturnog oštećenja, poremećaja mukocilijarnog aparata i kronične
infekcije. Najčešći patogeni organizmi u nastanku infekcije su H. influenzae i P. aeruginosa. Kronična infekcija P. aeruginosa rizični je čimbenik za lošiji klinički ishod. Etiologija bronhiektazija je heterogena. Prepoznati su brojni mogući uzroci, iako je i dalje
visok udio bronhiektazija nepoznatog uzroka. Podležeći uzroci mogu biti postinfektivni, imunodeficijentna stanja, alergijske i upalne bolesti, i dr. Najčešća klinička prezentacija bolesti uključuje kronični kašalj s obilnim iskašljavanjem i ponavljajuće respiratorne infekcije. Nedavno izdane smjernice jasno definiraju dijagnostičke postupke. Dijagnoza se postavlja klinički, a potvrđuje radiološki HRCT uređajem. Zahvaljujući spoznajama o liječenju bronhiektazija u CF-u i studijama o bronhiektazijama bez CF-a, po prvi su puta izdane jasne i sistematizirane preporuke za liječenje. Cilj liječenja je zaustavljanje patogenetskog začaranog kruga i prevencija egzacerbacija. Također, važno je liječiti podležeći uzrok. Za procjenu težine i prognoze bronhiektazija koriste se sustavi BSI, FACED i BACI.
Abstract (english) Bronchiectasis is a chronic progressive disease of the lower respiratory tract characterized by permanent, abnormal bronchial dilatation. It presents a large socioeconomic burden because it increases the cost of healthcare and has a negative impact on quality of life. Epidemiological data about bronchiectasis is unclear, but an increase in prevalence and
rate of hospitalization has been observed. Nowadays there is more knowledge about the pathogenesis and etiology of
bronchiectasis. The mechanism of occurrence is complex and is explained using the vicious cycle hypothesis which is based on the mutual support of inflammation, structural damage, impaired mucociliary clearance and chronic infection. The most common pathogens that contribute to the infection are H. influenzae and P. aeruginosa. Chronic P. aeruginosa infection is a risk factor for a worse clinical outcome. The etiology of bronchiectasis is heterogeneous. Many potential causes have been identified, even though there is still a large percentage of bronchiectasis with an unknown cause. The underlying causes can be postinfectious, immunodeficient states, allergic and inflammatory diseases, etc. The most common clinical presentation of the disease includes chronic cough with copious expectoration and recurrent respiratory infections. Recently published guidelines clearly define the diagnostic workup. The diagnosis is set clinically and confirmed
radiologically using HRCT. Thanks to discoveries in treatment of bronchiectasis in CF and studies about bronchiectasis without CF, for the first time clear and systematized treatment guidelines have been published. The goal of treatment is to break the pathogenic vicious circle and to prevent exacerbations. Also, treatment of the underlying cause is important.
Bronchiectasis severity and prognosis is estimated using the BSI, FACED and BACI systems.
Keywords
bronhiektazije
dijagnostika
liječenje
makrolidi
inhalacijski antibiotici
Keywords (english)
bronchiectasis
diagnosis
treatment
macrolides
inhaled antibiotics
Language croatian
URN:NBN urn:nbn:hr:105:393304
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2021-03-26 11:26:52