Asthma and chronic bronchitis symptoms among adult population of Belgrade.

INTRODUCTION: Over the last three decades the prevalence of respiratory diseases has been increasing worldwide thus increasing economic burden on the healthcare system. Recent studies have shown that the prevalence of asthma in West European countries ranges from 6-9%, while of chronic obstructive pulmonary diseases (COPD) is 8.0% worldwide. OBJECTIVE: The aim of the study was to estimate the prevalence of respiratory symptoms and smoking habits, and to assess the prevalence of asthma and chronic bronchitis among adults in Belgrade, Serbia. METHODS: To collect data we used a questionnaire based on the European Community Respiratory Health Survey (ECRHS) protocol, which was mailed to 10,208 randomly selected subjects. RESULTS: There were 58.3% of responders to our questionnaire. We noted a higher prevalence of respiratory symptoms in subjects who responded promptly. The majority of the respondents were current or former smokers (37.5% and 17.5% respectively) and 79.9% of them reported respiratory symptoms. The most frequent symptoms were longstanding cough (32.2%), sputum production (30.4%) and wheezing (30.3%). Asthma attacks were reported in 4.4% of cases and 5.6% of subjects were using asthma medications. The prevalence of respiratory symptoms increased with age. Women reported coughing, attacks of breathlessness and coughing, chest tightness by night, allergic rhinitis and chronic coughing, more frequently than men. Productive cough was more frequent in men. The prevalence of almost all symptoms was higher in smokers compared to nonsmokers. CONCLUSION: In Serbia there is a high prevalence of respiratory symptoms, asthma and chronic bronchitis smoking addiction.

[Benign solitary fibrous pleural tumour and hypoglycaemia].

INTRODUCTION: Solitary fibrous tumours of the pleura are uncommon and discovered fortuitously or in patients with non-specific respiratory symptoms. When associated with hypoglycaemia, they are commonly referred to as Doege-Potter syndrome. CASE OUTLINE: A 68-year old woman presented with a large pleural mass. She had a long history of headache and decreased consciousness with one-year worsening dyspnoea and right-sided chest pain. The chest X-ray revealed an enormous opacity occupying almost the entire right hemithorax. Endocrine tests showed an extremely reduced glucose level and blood concentration of insulin, C-peptide, glucagon, growth hormone and catecholamines within normal range. After fine-needle aspiration, by histological and immunohistochemical analysis, a benign solitary fibrous pleural tumour was diagnosed. Although surgical resection of such a huge tumour with hypoglycaemia is usually curative, our patient declined surgery and opted for conservative treatment with intravenous glucose. CONCLUSION: Clinicians should be aware of this rare, but important cause of hypoglycaemia and exclude a fibrous pleural tumour in the assessment of their patients.

Evaluation of magnesium in serum and urine in patients with pulmonary diseases.

We evaluated magnesium (Mg) in serum and 24-hour urine in patients with acute and chronic pulmonary diseases. Mg was determined in 114 patients, 56 with acute pulmonary diseases (group I) and 58 patients with acute exacerbation of chronic obstructive pulmonary disease (group II), at the start (To) and at the end of hospital treatment (T1). In group I, in period To, there were disturbances of Mg in serum in 14 patients (25%) which decreased in period T1 and persisted in 4 patients (7.1%) (p < 0.05). In group II the distribution of normal, decreased and increased Mg in serum was similar in periods To and T1 (p > 0.05). Hypomagnesemia was found in 9 patients (16.1%) in group I at the start of treatment (To), with accompanying increased Mg in 24-hour urine in only 4 patients (7.2%). Extrarenal elimination of Mg or transcellular distribution was a possibility. In group II in period To there was a proportional ratio between hypomagnesemia (12-20.7% patients) and increased concentration of Mg in 24-hour urine (20 - 34.5% patients) probably due to renal loss. Simultaneous determination and follow-up of Mg in serum and in 24-hour urine can give information about electrolyte disturbances in acute and chronic pulmonary diseases.