Value of proton magnetic resonance spectroscopy of brain to study the cerebral metabolic abnormalities in COPD: Initial experience

Chronic obstructive pulmonary disease [COPD] patients were found to have cerebral metabolic abnormalities. Proton magnetic resonance spectroscopy [1H MRS] is a sensitive technique that detects metabolic changes of the brain. To study the cerebral metabolic changes in COPD patients using 1H MRS. This study was carried-out on twenty symptomatic COPD patients [16 male and 4 female] and age matched group of 20 healthy controls [11 male and 19 female]. Pulmonary function tests, respiratory muscle strength, resting arterial blood gases, and 1H MRS of the brain were carried out on all subjects. The parieto-temporal and occipital regions were localized for 1H MRS. The metabolic ratios of 7V-acetyl aspartate to creatine [NAA/Cr] and choline to creatine [Cho/Cr] were calculated by the single voxel technique. In comparison with healthy control subjects, the mean values of Cho/Cr in COPD patients were lower in parietotemporal and occipital areas [0.99 +/- 0.21 vs. 1.10 +/- 0.31; P = 0.22] [0.81 +/- 0.26 vs. 0.88 +/- 0.21; P = 0.37], respectively while, the mean values of NAA/ Cr in COPD patients were higher in both parieto-temporal and occipital areas of the brain [1.82 +/- 0.35 vs. 1.68 +/- 0.22; P = 0.14] [1.59 +/- 0.31 vs. 1.39 +/- 0.39; P = 0.08], respectively. In COPD patients, significant positive correlations were observed between maximal expiratory pressure [MEP] and NAA/Cr in parieto-temporal area of the brain. The cerebral metabolites, arterial blood gases, respiratory muscle strength, and pulmonary function tests are altered in symptomatic COPD patients. 1H MRS is a non invasive technique that detects cerebral metabolic changes in COPD patients

six-year sleep lab experience in an Egyptian University Hospital

Background: Sleep disorders are common and the gold standard for diagnosis is through polysomnography [PSG] with standard scoring criteria. Published clinical and polysomnographic data reporting sleep disorders among Egyptian patients are lacking

Aim: To study clinical and polysomnographic characteristics in Egyptian patients with suspected sleep disorders

Patients and methods: All patients' polysomnographic records and sleep questionnaires were reviewed from November 2006: November 2012 at the Minoufiya University Hospital Sleep Disorders Unit

Results: 421 patients were recruited among which 229 were males [54.4%]; excessive daytime sleepiness and obesity were major features [ESS = 16, BMI = 33]. Most of the patients were referred by a chest physician [81%]. The most common symptoms were snoring [84.6%], witnessed apneas [78.6%], insomnia [70.9%] while the least was parasomnia [15.4%]. 337 patients were diagnosed as having obstructive sleep apnea OSA [80%] of them, 70 [21%] had mild OSA, 75 [22%] had moderate OSA and 192 [57%] had severe OSA, The most common diseases accompanying OSA were: systemic hypertension [77%], diabetes [63%], COPD [57%], and coronary heart disease [49%]

Conclusions: Sleep medicine in Egypt is still lagging behind the developed world, awareness of sleep disorders among Egyptian physicians should be increased. Diabetes, HTN, IHD and COPD are the commonest predisposing factors for OSA among Egyptians especially snorers, obese and overweight patients