The Effect of Intravenous Magnesium Sulphate as an Adjuvant in the Treatment of Acute Exacerbations of COPD in the Emergency Department: A Double-Blind Randomized Clinical Trial

BackgroundAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) are serious complications that often require immediate intervention in an emergency department (ED). The aim of this study was to investigate the effect of intravenous magnesium sulphate as an adjuvant in the treatment of AECOPD in the ED.MethodsIn a double-blind, randomized clinical trial, a total of 60 patients with AECOPD presenting to the ED of Imam Khomeini Hospital in Sari, Iran, were included. The study was conducted between September 2016 and February 2018. Eligible patients were randomly allocated into two groups of intervention and control. Patients in the intervention and control groups received intravenous infusion of magnesium sulfate (2 gr) or normal saline over 30 minutes, respectively. For all patients, Borgdyspnea score, forced expiratory volume in one second (FEV1) result and clinical variables of interest were evaluated before the beginning of the intervention, and also 45 minutes and 6 hours after the commencement of intervention.ResultsRegardless of time of evaluation, pulse rate (PR), respiratory rate (RR) and Borg score in intervention group was lower than control group. Also, FEV1 and SPO2 were greater in intervention group compared to control group. However, these differences were not statistically significant (between-subject differences or group effect) (p<0.001). The trends of FEV1, SPO2, PR, RR and Borg score were similar between two groups of study (no interaction effect; P>0.05).ConclusionAccording to the results of this study, it seems that using intravenous magnesium sulfate has no significant effect on SPO2, FEV1, RR, and PR of patients with AECOPD who presented to ED.     

Grafted human chorionic stem cells restore motor function and preclude cerebellar neurodegeneration in rat model of cerebellar ataxia

Metabolic Brain Disease - Cerebellar ataxia (CA) is a form of ataxia that adversely affects the cerebellum. Cell replacement therapy (CRT) has been considered as a potential treatment for...     

B0 field inhomogeneity considerations in pseudo-continuous arterial spin labeling (pCASL): effects on tagging efficiency and correction strategy

Pseudo-continuous arterial spin labeling (pCASL) is a very powerful technique to measure cerebral perfusion, which circumvents the problems affecting other continuous arterial spin labeling schemes, such as magnetization transfer and duty cycle. However, some variability in the tagging efficiency of the pCASL technique has been reported. This article investigates the effect of B(0) field inhomogeneity on the tagging efficiency of the pCASL pulse sequence as a possible cause of this variability. Both theory and simulated data predict that the efficiency of pseudo-continuous labeling pulses can be degraded in the presence of off-resonance effects. These findings are corroborated by human in vivo measurements of tagging efficiency. On the basis of this theoretical framework, a method utilizing B(0) field map information is proposed to correct for the possible loss in tagging efficiency of the pCASL pulse sequence. The efficiency of the proposed correction method is evaluated using numerical simulations and in vivo implementation. The data show that the proposed method can effectively recover the lost tagging efficiency and signal-to-noise ratio of pCASL caused by off-resonance effects.     

The bone scan in disseminated BCGitis

Despite the long history of worldwide use of bacillus Calmette-Guerin (BCG) vaccine, a wide spectrum of adverse reactions has been observed in a small proportion of immunized infants. The most severe complication is disseminated BCGitis, often fatal but extremely rare and considered to be a result of host immunodeficiency. At present, polymerase chain reaction test, CT scan, ultrasound, X-rays and bone marrow aspirations are the investigations used to diagnose this disease. We report a case report of a 6 months old female infant with disseminated BCGitis. This paper aims to highlight the advantages of using bone (99m)Tc-MDP imaging and it's findings in supporting the diagnosis of disseminated BCGitis.     

Shoulder magnetic resonance imaging findings in manual wheelchair users with spinal cord injury

Objective: To investigate the prevalence of rotator cuff and long head of the biceps pathologies in manual wheelchair (MWC) users with spinal cord injury (SCI).Design: Cross-sectional study.Setting: Outpatient clinic at a tertiary medical center.Participants: Forty-four adult MWC users with SCI (36 men and 8 women) with an average age (SD) of 42 (13) years. SCI levels ranged from C6 to L1; complete and incomplete SCI.Outcome Measures: Participants’ demographic and anthropometric information, presence of shoulder pain, Wheelchair User’s Pain Index (WUSPI) scores, and magnetic resonance imaging findings of shoulder pathologies including tendinopathy, tendon tears, and muscle atrophy.Results: Fifty-nine percent of the participants reported some shoulder pain. The prevalence of any tendinopathy across the rotator cuff and the long head of biceps tendon was 98%. The prevalence of tendinopathy in the supraspinatus was 86%, infraspinatus was 91%, subscapularis was 75%, and biceps was 57%. The majority of tendinopathies had mild or moderate severity. The prevalence of any tears was 68%. The prevalence of tendon tears in the supraspinatus was 48%, infraspinatus was 36%, subscapularis was 43%, and biceps was 12%. The majority of the tears were partial-thickness tears. Participants without tendon tears were significantly younger (P < 0.001) and had been wheelchair user for a significantly shorter time (P = 0.005) than those with tendon tears.Conclusion: Mild and moderate shoulder tendinopathy and partial-thickness tendon tears were highly prevalent in MWC users with SCI. Additionally, the findings of this study suggest that strategies for monitoring shoulder pathologies in this population should not be overly reliant on patient-reported pain, but perhaps more concerned with years of wheelchair use and age.     

Work-related respiratory symptoms and pulmonary function tests in northeast iranian (the city of Mashhad) carpenters

OBJECTIVE:

To assess the respiratory symptoms and pulmonary function of carpenters from the city of Mashhad (northeast Iran).

METHODS:

The frequency of respiratory symptoms was retrospectively estimated in a sample of 66 carpenters in the city of Mashhad in northeast Iran using a questionnaire including questions on work‐related respiratory symptoms in the past year, allergy, type of irritant chemicals that induce respiratory symptoms, smoking habits, and working periods as a carpenter. PFT values were also measured in all participants, and the age and smoking habits matched those of a sample of men from the general population as a control group.

RESULTS:

Thirty‐five carpenters (53%) reported work‐related respiratory symptoms. Cough (34.4%) and sputum (33.3%) were the most common symptoms, and only 15.15% of carpenters reported wheezing during work. All respiratory symptoms were higher in carpenters than in controls, which was statistically significant for cough and sputum (p<0.001 in both cases). Most allergic symptoms were also significantly greater among the carpenters than in the control group (p<0.05 for both itchy eyes and sneezing). Most respiratory and allergic symptoms in the carpenters increased during work compared to rest period which was statistically significant only for cough (p<0.05). PFT values were significantly lower in the carpenters than in control subjects (p<0.05 to p<0.001).

CONCLUSIONS:

Carpentry work was associated with a high frequency of respiratory symptoms, particularly after exposure to irritating chemicals during work. PFT values were also significantly reduced among carpenters compared to controls.     

Real‐time functional MRI using pseudo‐continuous arterial spin labeling

The first implementation of real‐time acquisition and analysis of arterial spin labeling‐based functional magnetic resonance imaging time series is presented in this article. The implementation uses a pseudo‐continuous labeling scheme followed by a spiral k‐space acquisition trajectory. Real‐time reconstruction of the images, preprocessing, and regression analysis of the functional magnetic resonance imaging data were implemented on a laptop computer interfaced with the MRI scanner. The method allows the user to track the current raw data, subtraction images, and the cumulative t‐statistic map overlaid on a cumulative subtraction image. The user is also able to track the time course of individual time courses and interactively selects a region of interest as a nuisance covariate. The pulse sequence allows the user to adjust acquisition and labeling parameters while observing their effect on the image within two successive pulse repetition times. This method is demonstrated by two functional imaging experiments: a simultaneous finger‐tapping and visual stimulation paradigm, and a bimanual finger‐tapping task. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.