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  • Previous studies have assessed the protective effect of nebulized magnesium sulfate on bronchial hyperreactivity. Intravenous and inhaled magnesium sulfate have successfully been used in the treatment of acute asthma. In the present study we investigated the effect of histamine challenge on intracellular (erythrocytes) and extracellular (plasma) levels of magnesium (Mg) and the possible relationship between degree of bronchial hyperreactivity and levels of Mg in plasma and erythrocytes. We studied 42 asthmatic patients (all males, mean age 21±0.3 yrs, FEV1 91±2% pred, 10 on inhaled steroids) and 20 healthy subjects (all male, mean age 22±0.4 yrs, FEV1 93±1% pred). Histamine challenge was performed using Bronchoscreen Jaeger 6021. PD20 was calculated at the time when a 20% fall of baseline FEV1 was observed. Mg levels in plasma and erythrocytes were measured both at baseline and when the PD20 had occurred. Our results showed that magnesium levels in plasma did not significantly change after histamine challenge (from 2.06±0.02 mg/dl to 2.08±0.02 mg/dl respectively). On the other hand there was a statistically significant difference in magnesium levels in erythrocytes (from 5.16±0.07 mg/dl to 4.9±0.07 mg/dl p<0.0001). There was no correlation between PD20, the difference of both magnesium concentrations (baseline-PD20 time) as well as the initial values of magnesium levels in erythrocytes and serum. In conclusion, these data show that histamine challenge significantly affects the magnesium levels in erythrocytes while at the same time serum levels remain unchangeable. This statistical difference is not correlated with the degree of bronchial hyperreactivity (PD20). Pneumon 1999, 12 (3): 182-188
     
  • SUMMARY We investigated inhaled citric acid-induced cough and bronchial obstruction in 15 smokers without chronic airflow limitation, 13 occasional smokers and 9 non smokers. Cough threshold was significantly higher in occasional smokers in comparison to smokers and non smokers. Citric acid-induced bronchial obstruction had a similar pattern in smokers and occasionaI smokers: the maximal fall of FEV1 took place at 5 seconds post-inhalation of citric acid and maximal fall of FEV1 was statistically significant between the two groups. In non smokers, the maximal fall of FEV1 was significantly less than in smokers and occasional smokers. In smokers, the degree of tobacco consumption seems to influence the percent fall of FEV1 (r = 0.48, p < 0.10). It is concluded that cough and bronchial obstruction to noxious agents such as citric acid are based upon different physiological mechanisms and they depend on smoking history of the subject. Pneumon 1999, 12 (3): 189-195
     
  • We reviewed the records of 120 cases of tuberculous pleural effusion seen during the period 1979-94. These cases constituted 24.3% of all diseases due to Mycobacterium Tuberculosis and 37% of all exudative pleural eflusions. The mean age of the patients was 44 years and 27.5% of them was over 60 years of age. Ten per cent of the total cases were accompanied by roentgenographic pulmonary parenchymal infiltrates. As for the elderly group we found in 79% of the cases the pleural effusion as the only roentgenographic abnormality. Eighteen per cent of the cases had M. Tuberculosis cultured in sputum while the 66% of this subgroup had no parenchymal infiltrates. Tuberculous pleural effusion was diagnosed if the patient had positive pleural biopsy and M. Tuberculosis cultured in pleural fluid or sputum. In the absence of a positive culture, the diagnosis was based upon an undiagnosed lymphocytic exudative pleural effusion, increased ADA in pleural fluid and pleural lysozyme /serum lysozyme ratio as well as clinical and roentgenographic abnormalities resolution following antimycobacterial chemotherapy. We conclude that the age of patients with pleural effusion appears to be increasing. Sputum cultures in addition to other specimens cultures increase the diagnostic yield even in cases without roentgenographic parenchymal infiltrates. Pneumon 1999, 12 (3): 196-202
     
  • A patient suffering from severe hypercapnia secondary to hypothyreoidism is presented. Replacement therapy with thyroid hormones was instituted. After a period of two months the patient showed a remarkable improvement of his functional respiratory parameters, blood gases, PImax, PEmax, Pdimax and of his overall clinical status and laboratory tests. The literature is briefly reviewed and correlated to this case. Pneumon 1999, 12 (3): 203-206
     
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