1.Clinical and radiological manifestations of primary tracheobronchial tumours: a single centre experience.
Ruza STEVIC ; Branislava MILENKOVIC ; Jelena STOJSIC ; Dragica PESUT ; Maja ERCEGOVAC ; Dragana JOVANOVIC
Annals of the Academy of Medicine, Singapore 2012;41(5):205-211
INTRODUCTIONTracheobronchial tumours usually cause an airway obstruction and secondary pulmonary infections. Although rare, they are an important differential diagnosis as they may mimic other conditions and diseases. This paper aims to analyse clinical, radiological and histological characteristics of the patients with tracheobronchial tumours diagnosed for a period of 7 years.
MATERIALS AND METHODSIn this retrospective, observational study, we carefully reviewed 65 patients who were diagnosed with tracheal and endobronchial tumours, and performed statistical analysis on the results.
RESULTSAmong these 65 patients (36 men and 29 women) with a mean age of 48.8 years (range, 15 to 75), 50 had malignant tumours while 15 had benign ones. The most common symptoms were cough, chest pain and haemoptysis. Cough was a more frequent symptom in patients with benign tumours (P <0.0014). Only 2 patients were asymptomatic. Tumours were predominantly localised in the large airways (46 in large bronchi and 2 in trachea). The most common radiological manifestation of malignant tumours was tumour mass (46%) followed by atelectasis. One third benign tumour caused atelectasis, while tumour mass and consolidation were found in 3 patients each. Computerised tomography revealed endoluminal tumour mass in 29.2% of the cases, which was more frequently found in benign than malignant tumours (47% vs 24%, respectively). On bronchoscopy, tumours were visible in 73% and 70% benign and malignant cases respectively.
CONCLUSIONTracheobronchial tumours should be ruled as a possible diagnosis in patients with cough, haemoptysis, dyspnoea and chest pain. The imaging techniques and histological examination of the tissue would subsequently lead to correct diagnosis and proper treatment can be administered.
Adolescent ; Adult ; Aged ; Airway Obstruction ; diagnosis ; Bronchial Neoplasms ; complications ; diagnosis ; diagnostic imaging ; Bronchoscopy ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Atelectasis ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tracheal Neoplasms ; complications ; diagnosis ; diagnostic imaging
2.Parameters of Calcium Metabolism Fluctuated during Initiation or Changing of Antipsychotic Drugs.
Dragan R MILOVANOVIC ; Marijana STANOJEVIC PIRKOVIC ; Snezana ZIVANCEVIC SIMONOVIC ; Milovan MATOVIC ; Slavica DJUKIC DEJANOVIC ; Slobodan M JANKOVIC ; Dragan RAVANIC ; Milan PETRONIJEVIC ; Dragana IGNJATOVIC RISTIC ; Violeta MLADENOVIC ; Mirjana JOVANOVIC ; Sandra NIKOLIC LABOVIC ; Marina PAJOVIC ; Danijela DJOKOVIC ; Dusan PETROVIC ; Vladimir JANJIC
Psychiatry Investigation 2016;13(1):89-101
OBJECTIVE: Serum parameters of calcium homeostasis were measured based on previously published evidence linking osteoporotic fractures and/or bone/mineral loss with antipsychotics. METHODS: Prospective, four-week, time-series trial was conducted and study population consisted of patients of both genders, aged 35-85 years, admitted within the routine practice, with acute psychotic symptoms, to whom an antipsychotic drug was either introduced or substituted. Serial measurements of serum calcium, phosphorous, magnesium, 25(OH)D, parathyroid hormone, calcitonin, osteocalcin and C-telopeptide were made from patient venous blood samples. RESULTS: Calcium serum concentrations significantly decreased from baseline to the fourth week (2.42+/-0.12 vs. 2.33+/-0.16 mmol/L, p=0.022, n=25). The mean of all calcemia changes from the baseline was -2.6+/-5.7% (-24.1 to 7.7) with more decreases than increases (78 vs. 49, p=0.010) and more patents having negative sum of calcemia changes from baseline (n=28) than positive ones (n=10) (p=0.004). There were simultaneous falls of calcium and magnesium from baseline (63/15 vs. 23/26, p<0.001; OR=4.75, 95% CI 2.14-10.51), phosphorous (45/33 vs. 9/40, p<0.001; 6.06, 2.59-14.20) and 25(OH)D concentrations (57/21 vs. 13/35, p<0.001; 7.31, 3.25-16.42), respectively. Calcemia positively correlated with magnesemia, phosphatemia and 25(OH)D values. Parathyroid hormone and C-telopeptide showed only subtle oscillations of their absolute concentrations or changes from baseline; calcitonin and osteocalcin did not change. Adjustment of final calcemia trend (depletion/accumulation) for relevant risk factors, generally, did not change the results. CONCLUSION: In patients with psychotic disorders and several risks for bone metabolism disturbances antipsychotic treatment was associated with the decrease of calcemia and changes in levels of the associated ions.
Antipsychotic Agents*
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Blood Chemical Analysis
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Bone and Bones
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Calcitonin
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Calcium*
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Homeostasis
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Humans
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Ions
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Magnesium
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Metabolism*
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Minerals
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Osteocalcin
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Osteoporotic Fractures
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Parathyroid Hormone
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Prospective Studies
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Psychotic Disorders
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Risk Factors