Life-Threatening Hemoptysis Leading to Suffocation.

Hemoptysis represents a symptom or sign that typically causes anxiety for patients and draws the attention of the physician because it can be caused by various conditions, ranging from benign to malignant. Depending on the amount of coughed-up blood, hemoptysis can be a life-threatening condition. We present the case of a female patient with a life-threatening hemoptysis that was caused by underlying bronchiectasis and antiplatelet and anticoagulant treatments. A large blood clot was extracted from the patient's airways using a rigid bronchoscope. Hemoptysis is a significant symptom that should be taken seriously, regardless of its size. Massive hemoptysis is an emergency condition in respiratory medicine, which requires immediate management in adequately equipped centers.

The training type influence on male elite athletes' ventilatory function.

BACKGROUND/AIM: To assess and compare measured ventilatory volumes (forced expiratory volume in 1 s (FEV1), peak expirium flow (PEF) and maximal voluntary ventilation (MVV)), ventilatory function capacities (forced vital capacity (FVC) and vital capacity (VC)) and FEV1/VC ratio in a sample of power and endurance elite athletes and their age-matched and sex-matched sedentary control group. METHODS: A cross-sectional study was applied on male elite athletes (n=470) who were classified according to the type of the predominantly performed exercise in the following way: group 1: endurance group (EG=270), group 2: power athletes group (SG=200) and group 3: sedentary control group (CG=100). The lung VC, FVC, FEV1, FEV1/FVC ratio, PEF and MVV were measured in all of the observed subjects, who were also classified with regard to body mass index (BMI) and the percentage of the body fat (BF%). RESULTS: The CG had the highest BF% value, while the endurance group had the lowest BMI and BF% value, which is significantly different from the other two groups (p<0.05). The observed values of VC, FVC and FEV1 in the EG were significantly higher than those from the other two groups (p<0.05). There were no differences concerning the observed FEV1/FVC ratio. CONCLUSIONS: A continued endurance physical activity leads to adaptive changes in spirometric parameters (VC, FVC and FEV1), highlighting the fact that there is a need for specific consideration of different respiratory 'pattern' development in different types of sport, which also has to be further evaluated.

Differentiation between progression and pseudoprogresion by arterial spin labeling MRI in patients with glioblastoma multiforme.

PURPOSE: To compare arterial spin labeling (ASL) perfusion technique with the clinically established dynamic susceptibility contrast-enhanced (DSC) perfusion weighted-imaging (PWI), and to determine its value in routine MRI evaluation of disease progression in patients with glioblastoma multiforme (GBM). METHODS: A prospective intraindividual study was performed in 31 patients with histologically proven GBM who had clinical and/or radiological deterioration after treatment, including surgery, radiotherapy and therapy with temozolomide. Conventional brain protocol with ASL and DSC techniques was performed on 3T MRI unit. Cerebral blood flow (CBF) and cerebral blood volume (CBV) maps were analyzed by means of regions of interest (ROI). Each ROI average value was normalized to the contralateral normal brain parenchyma ROI value. Neuroradiologists analyzed CBF and CBV maps separately, and classified patients into progression or pseudoprogression group. Radiological diagnosis was confirmed by clinical-radiological follow-up for at least three months after patient deterioration. RESULTS: High linear correlation existed between DSC-PWI and ASL in the tumor ROI (r=0.733; p<0.001). 92% of ASL CBF maps were informative. ASL detected all lesions as well as DSC MRI. Both techniques provided perfusion values closely correlated. CONCLUSION: ASL allows distinction between GBM progression and pseudoprogression, and it can be used as reliable alternative to DSC-PWI.

Adaptation and validation of the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire for use in Serbia.

Rheumatoid arthritis (RA) is one of the most prevalent inflammatory rheumatic diseases. As it is a chronic and a lifelong destructive disease, the aim of the treatment is to reduce disability and improve quality of life. The Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire is a patient-reported outcome measure, specific to RA. To adapt and validate the RAQoL for use in Serbia, two translation panels were involved to produce the Serbian RAQoL. After successful translation, face and content validity was determined via cognitive debriefing interviews. The psychometric properties of the questionnaire were examined, including reliability and construct validity, by using the Nottingham Health Profile (NHP) as a comparator scale. The RAQoL was translated successfully and rated as applicable, relevant and comprehensive by respondents. The questionnaire had high internal consistency (alpha = 0.94 at both time points) and test-retest reliability (r = 0.92). Moderately high correlations were found between the RAQoL and physical mobility, pain and energy level sections of the NHP, providing evidence of convergent validity. The RAQoL was able to distinguish between patients grouped by perceived general health, incidence of flare-up and disease severity. The Serbian language version of the RAQoL showed strong evidence of reliability and validity and is recommended for use in clinical trials and routine general practice in RA.

Insights into body composition adaptation: should we reconsider the use of Body Mass Index in some sports?

BACKGROUND: The purposes of this study were to indentify the under/overweight/obese frequencies by Body Mass Index (BMI) and body fat percentage (BF%) in athletes within groups of sport and to investigate the accuracy of the BMI as a measure of BF%. METHODS: Cross-sectional design study on elite male athletes (N.=2234, aged 22±4 years) from 51 sports disciplines who were classified according to two different sport classifications: predominant characteristic of training (four group model) and type and intensity of exercise (nine group model). All athletes underwent full anthropometric testing. RESULTS: After stratification, the majority of athletes were in normal weight category. According to 4 group model, BMI is showed as statistically significant, reliable and independent predictor of BF% in all groups of sports. In nine groups model all correlated parameters were positive for athletes being statistically significant (P<0.001) with exception of group LSMD, MSMD and HSMD (P>0.05). The highest positive correlation between BMI and BF% was in group MSLD (r=0.53; P<0.001) and in power sports group (r=0.24; P<0.001). CONCLUSIONS: BMI could be an accurate predictor of BF% in athletes but that depends on group of sport. Our results suggest the BMI could use only in power and MSLD groups of sport.