Incidence and Risk Factors of Hypomagnesemia in Patients With Bone Metastasis From Solid Malignancies Treated With Denosumab: A Retrospective Chart Review.

BACKGROUND: Hypomagnesemia is associated with poor clinical outcomes in cancer patients. Patients with bone metastasis from solid malignancies receiving denosumab (Dmab) to prevent skeletal-related events often receive concurrent antineoplastic agents for cancer treatment. The incidence and risk factors of hypomagnesemia in patients receiving Dmab and the optimal frequency of monitoring serum magnesium (Mg) levels have not been studied in these patient populations. OBJECTIVE: The objective is to investigate the incidence and potential risk factors of hypomagnesemia and the optimal frequency of monitoring serum Mg levels. METHODS: A retrospective chart review identified patients with solid malignancies with bone metastases treated with Dmab at the Loma Linda University Cancer Center between January 2013 and February 2024. The incidence of hypomagnesemia was determined using the number of patients with hypomagnesemia and the total number of patients in the study. Univariate and multivariate logistic regression analyses identified risk factors for hypomagnesemia. RESULTS: Hypomagnesemia was observed in 19% (29/153) of patients, the majority of whom were on concurrent antineoplastic agents with ≥15% hypomagnesemia incidence (high-hypomagnesemic antineoplastics) or nonantineoplastic drugs with documented cases or incidence of hypomagnesemia (hypomagnesemic nonantineoplastics) in addition to high-hypomagnesemic antineoplastics. Multivariate analysis showed increased odds of developing hypomagnesemia with high-hypomagnesemic antineoplastics (odds ratio [OR]: 174.93, 95% confidence interval [CI]: 12.82 to 387.43, P < 0.001); hypomagnesemic nonantineoplastics plus high-hypomagnesemic antineoplastics (OR: 210.09, 95% CI: 11.80 to 3740.12, P < 0.001); and Mg level ≤ 0.85 prior to Dmab administration (OR: 16.79, 95% CI: 2.30 to 122.41, P = 0.005). CONCLUSION AND RELEVANCE: This study describes the incidence and potential risk factors for hypomagnesemia in patients with solid malignancies and metastatic bone disease treated with Dmab. This study's findings provide additional clinical insight into potential risk factors for hypomagnesemia and the need for more frequent serum Mg level monitoring of at-risk patients. Future prospective studies are needed to determine the exact frequencies most appropriate in monitoring serum Mg levels in this group of patients.

Metal-organic frameworks based on unprecedented trinuclear and pentanuclear metal-tetrazole clusters as secondary building units.

Solvothermal reactions of manganese(II) chloride tetrahydrate with a bis-tetrazole ligand, 2,6-di(1H-tetrazol-5-yl)naphthalene (H(2)NDT), in N,N'-dimethylformamide (DMF)/MeOH mixed solvent at two slightly different temperatures, 75 and 100 °C, led to two different metal-organic frameworks (MOFs), [Mn(II)(3)O(HNDT)(2)(NDT)(DMF)(3)] (1) and [Mn(II)(5)O(2)(HNDT)(2)(NDT)(2)(DMF)(8)] (2), with different net topologies. Single-crystal X-ray diffraction studies reveal that 1 is constructed from an unprecedented trinuclear building block, [Mn(II)(3)O(CN(4))(6)], as a 6-connected trigonal prismatic secondary building unit (SBU) of topological D(3h) site symmetry, and that the ligand in the HNDT(-1)/NDT(2-) deprotonation states is a linker, where two tetrazole (CN(4)) groups of the ligand are connected via a rigid naphthyl group. The tetrazole groups in 1 adopt a 1,2-µ-bridging mode with the manganese(II) ions to form a µ(3)-oxo trinuclear SBU. The trigonalprismatic SBU in 1 is connected to six neighboring SBUs to form a three-dimensional MOF of acs net topology. 2 is constructed from an unprecedented pentanuclear building block, [Mn(II)(5)O(2)(CN(4))(8)], as an 8-connected tetragonal prismatic SBU of topological D(4h) site symmetry. The tetrazole groups in 2 adopt monodentate, 1,2-µ- and 2,3-µ-bridging bidentate and 1,2,3-µ-bridging tridentate binding modes with the manganese(II) centers to form a bis-µ(3)-oxo pentanuclear SBU of local C(2) site symmetry. The tetragonal prismatic SBU in 2 is connected to eight neighboring SBUs to form a 3-D MOF of bcu net topology.

Partial epiglottectomy improves residual apnea-hypopnea index in patients with epiglottis collapse.

Continuous positive airway pressure treatment aggravates airway obstruction in patients with epiglottis collapse. In these patients, partial epiglottectomy can resolve epiglottis collapse by partial excision of the obstructed epiglottis. However, patients with epiglottic collapse usually have simultaneous obstructions on multiple levels, such as the soft palate, base of the tongue, etc. Therefore, sleep apnea cannot be controlled merely by resolving epiglottis collapse. The use of additional continuous positive airway pressure treatment after partial epiglottectomy is considered essential. However, no studies have yet evaluated the effect of partial epiglottectomy on continuous positive airway pressure treatment. In this study, we report on 2 patients with obstructive sleep apnea who underwent partial epiglottectomy. These 2 patients used autotitrating positive airway pressure treatment pre- and postoperatively. The present case report will provide insight into the effects of partial epiglottectomy on the use of positive-pressure devices.

Hearing Results Following Type 1 Tympanoplasty in Elderly Patients.

BACKGROUND/AIM: The outcomes of type 1 tympanoplasty in elderly patients remain controversial. Therefore, more studies are needed to clarify the prognosis of elderly patients after tympanoplasty. The purpose of this study was to evaluate the clinical outcomes of type 1 tympanoplasty in elderly patients. PATIENTS AND METHODS: We retrospectively analyzed data from 116 patients who underwent type 1 tympanoplasty due to chronic otitis media. Seventy-one of the 116 patients were elderly individuals aged 65 years or older (study group). Forty-five patients were younger than 65 years (control group). Due to cochlear intolerance by aging in the study group, we used dexamethasone soaked gelfoam packing in the middle ear and intraoperative dexamethasone injection. To compare the outcomes between groups, we determined the mean hearing levels by averaging the hearing thresholds. The differences in the air-bone gaps before and after tympanoplasty were compared between groups. RESULTS: In the study group, 54 patients had an underlying disease (76%). Hypertension was the most common underlying disease. The postoperative air conduction (AC) and bone conduction (BC) improved in both the study group and the control group. In the control group, postoperative air-bone gap (ABG) was significantly higher than preoperative ABG. Although the postoperative ABG improved in the study group, the improvement was insignificant. CONCLUSION: Although significant improvement of ABG was not achieved, postoperative AC and BC were improved. Intraoperative dexamethasone injection and dexamethasone soaked gelfoam packing in the middle ear was effective to prevent deterioration of BC after operation.

Antioxidant Activities of Functional Beverage Concentrates Containing Herbal Medicine Extracts.

This study investigated the antioxidant activity of functional beverage concentrates containing herbal medicine extracts (FBCH) using various antioxidant assays, such as 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity, and reducing power assay. The total polyphenolic content of FBCH (81.45 mg/100 g) was higher than Ssanghwa tea (SHT, 37.56 mg/100 g). The antioxidant activities of FBCH showed 52.92% DPPH and 55.18% ABTS radical scavenging activities at 100 mg/mL, respectively. FBCH showed significantly higher antioxidant activities compared to the SHT (DPPH, 23.43%; ABTS, 22.21%; reducing power optical density; 0.23, P<0.05). In addition, intracellular reactive oxygen species generation significantly decreased in a concentration-dependent manner following FBCH treatment. These results suggest that the addition of herbal medicine extract contributes to the improved functionality of beverage concentrates.