RESUMO
BACKGROUND: Cisplatin-associated electrolyte dysregulation is a prevalent therapy-related adverse effect. There are numerous electrolyte-supplemented hydration regimens that have been evaluated, however these studies focused on the development of nephrotoxicity. The objective of this study was to characterize the impact of magnesium and potassium-supplemented hydration during cisplatin administration on subsequent magnesium and potassium imbalances. METHODS: A single-region retrospective study from central Texas at Baylor Scott & White Cancer Clinics who were treated with two or more cycles of cisplatin were included. Standard hydration for this study was defined as normal saline before and after cisplatin along with potassium chloride 10 mEq and magnesium sulfate 1 g added to the cisplatin bag. RESULTS: A total of 477 patients were included in the study with376 patients receiving the standard hydration. Overall, 17 percent of patients experienced a potassium level below 3.5 mEq/L, but no major depletion was observed. Thirty-three percent of the patients experienced a magnesium level below 1.8 mg/dL, and time to first rescue magnesium supplementation was 4 weeks. CONCLUSION: Our study demonstrated despite routine magnesium and potassium supplementation in hydration, magnesium imbalances were observed. Potassium levels post cisplatin administration were maintained with minimal routine supplementation in hydration.
Assuntos
Cisplatino/efeitos adversos , Magnésio/administração & dosagem , Neoplasias/tratamento farmacológico , Potássio/administração & dosagem , Desequilíbrio Hidroeletrolítico/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/metabolismo , Estudos Retrospectivos , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoRESUMO
The article presents the analysis of the intensive therapy through the correction of persistent hypernatremia in neurosurgical patients after removal of brain tumors. The aim of this work was to evaluate the effectiveness of Sterofundin in the framework of complex therapy of hypernatremia in neurosurgical patients after removal of brain tumors. We analyzed the dynamics of the concentrations of sodium, potassium, chorus of the plasma, anion gap and buffer bases in the postoperative period of these patients. For obtaining reliable results, the patients were divided into groups according to the nature of the treatment: Sterofundin and symptomatic correction of hypotonic solution of sodium chloride, saluretic and Verospiron respectively. In a comparison between the groups, a distinct difference in the speed of regression of hypernatremia and durability of the achieved effect was observed. In case of treatment with Sterofundin there was a significant decrease of hypernatremia by the end of the second day of the postoperative period without tendency to re-raise. The prevalence of hypotonic solutions of sodium chloride and potassium-sparing saluretics in intensive care allowed reducing the sodium concentration non-persistently to the fourth day on the background of significant fluctuations in its concentration. The use of Sterofundin in complex therapy of electrolyte disturbances, particularly of hypernatremia in neurosurgical patients after removal of brain tumors, is reflected in the form of significant regression of increased sodium concentration in plasma compared with the method of use "hypotonic" hemodilution, saluretics and potassium-sparing diuretics.
Assuntos
Adenoma/metabolismo , Neoplasias Encefálicas/metabolismo , Hipernatremia/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Desequilíbrio Ácido-Base/tratamento farmacológico , Desequilíbrio Ácido-Base/etiologia , Adenoma/patologia , Adenoma/cirurgia , Adulto , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Hipernatremia/etiologia , Hipotálamo/patologia , Masculino , Procedimentos Neurocirúrgicos/efeitos adversos , Compostos Orgânicos/uso terapêutico , Hipófise/patologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/etiologiaRESUMO
BACKGROUND: The purpose of this study was to determine the prevalence of hypomagnesemia in patients undergoing thyroidectomy and evaluate the relationship of hypomagnesemia with transient and severe hypocalcemia. MATERIALS AND METHODS: This was a prospective observational study of 50 patients undergoing thyroidectomy. Blood samples were collected pre- and postoperatively for calcium, albumin, magnesium, phosphorous and parathormone (PTH). Signs, symptoms of hypocalcemia and volume of intravenous fluids used perioperatively were documented. The statistical analysis was performed using STATA I/C 10.1. RESULTS: Preoperatively, twelve patients (24 %) had hypomagnesemia and one (2 %) hypocalcemia. On the first postoperative day, hypomagnesemia was seen in 70 % and hypocalcemia in 30 %. A similar trend was observed in the fall and rise of postoperative calcium and magnesium values (p = 0.41). Severe hypocalcemia was present in three patients (6 %). All three patients had a very low postoperative PTH (<2 pg/ml). Among them, two patients (66 %) had hypomagnesemia and their hypocalcemia responded to intravenous magnesium correction. Significant risk factors for postoperative hypocalcemia include a higher volume of fluid used perioperatively and low postoperative PTH (<8 pg/ml) (p = 0.01 and 0.03, respectively). CONCLUSION: Preoperative hypomagnesemia (24 %) was prevalent in this cohort of patients. Postoperative hypomagnesemia is a common event (70 %) following total thyroidectomy, and magnesium levels tend to mimic the calcium levels postoperatively. The cause of hypocalcemia post-thyroidectomy in this study is mainly a factor of parathyroid function and fluid status. Severe hypocalcemia is a rare event, and hypomagnesemia is associated in the majority of these patients. The role of magnesium correction to alleviate severe hypocalcemia needs to be further studied.
Assuntos
Cálcio/sangue , Hipocalcemia/sangue , Magnésio/sangue , Hormônio Paratireóideo/sangue , Complicações Pós-Operatórias/sangue , Tireoidectomia , Desequilíbrio Hidroeletrolítico/sangue , Administração Intravenosa , Adolescente , Adulto , Idoso , Feminino , Humanos , Hipocalcemia/tratamento farmacológico , Hipocalcemia/epidemiologia , Magnésio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides , Fósforo/sangue , Prevalência , Estudos Prospectivos , Fatores de Risco , Albumina Sérica/metabolismo , Índice de Gravidade de Doença , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/epidemiologia , Adulto JovemRESUMO
Over the past decades, hypomagnesemia (serum Mg(2+) <0.7 mmol/L) has been strongly associated with type 2 diabetes mellitus (T2DM). Patients with hypomagnesemia show a more rapid disease progression and have an increased risk for diabetes complications. Clinical studies demonstrate that T2DM patients with hypomagnesemia have reduced pancreatic ß-cell activity and are more insulin resistant. Moreover, dietary Mg(2+) supplementation for patients with T2DM improves glucose metabolism and insulin sensitivity. Intracellular Mg(2+) regulates glucokinase, KATP channels, and L-type Ca(2+) channels in pancreatic ß-cells, preceding insulin secretion. Moreover, insulin receptor autophosphorylation is dependent on intracellular Mg(2+) concentrations, making Mg(2+) a direct factor in the development of insulin resistance. Conversely, insulin is an important regulator of Mg(2+) homeostasis. In the kidney, insulin activates the renal Mg(2+) channel transient receptor potential melastatin type 6 that determines the final urinary Mg(2+) excretion. Consequently, patients with T2DM and hypomagnesemia enter a vicious circle in which hypomagnesemia causes insulin resistance and insulin resistance reduces serum Mg(2+) concentrations. This Perspective provides a systematic overview of the molecular mechanisms underlying the effects of Mg(2+) on insulin secretion and insulin signaling. In addition to providing a review of current knowledge, we provide novel directions for future research and identify previously neglected contributors to hypomagnesemia in T2DM.
Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Deficiência de Magnésio/metabolismo , Magnésio/metabolismo , Desequilíbrio Hidroeletrolítico/metabolismo , Glicemia/metabolismo , Canais de Cálcio Tipo L/metabolismo , Diabetes Mellitus Tipo 2/complicações , Suplementos Nutricionais , Progressão da Doença , Glucoquinase/metabolismo , Glicogênio/biossíntese , Glicólise , Humanos , Inflamação , Insulina/metabolismo , Resistência à Insulina , Secreção de Insulina , Células Secretoras de Insulina/metabolismo , Canais KATP/metabolismo , Fígado/metabolismo , Magnésio/uso terapêutico , Deficiência de Magnésio/tratamento farmacológico , Obesidade/metabolismo , Canais de Potássio Corretores do Fluxo de Internalização/metabolismo , Simportadores de Cloreto de Sódio/metabolismo , ATPase Trocadora de Sódio-Potássio/metabolismo , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoAssuntos
Antagonistas dos Receptores de Hormônios Antidiuréticos/uso terapêutico , Benzazepinas/uso terapêutico , Endoscopia/métodos , Soluções Hipotônicas/farmacocinética , Adulto , Antagonistas dos Receptores de Hormônios Antidiuréticos/administração & dosagem , Benzazepinas/administração & dosagem , Feminino , Humanos , Concentração Osmolar , Complicações Pós-Operatórias/tratamento farmacológico , Tolvaptan , Água/metabolismo , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoRESUMO
OBJECTIVES: To describe the efficacy of intravenous colistin on clinical and microbiological outcomes in preterm infants with nosocomial sepsis in neonatal intensive care unit (NICU) and define adverse events observed with this treatment. METHODS: The records of preterm infants who received colistin with or without positive cultures in the NICU were retrospectively reviewed. Patients were evaluated for response to therapy and side effects. RESULTS: A total of 21 preterm infants with medians of 28 weeks (23-36) gestational age and 870 g (620-2,650) birth weight were included. The median duration and dose of colistin therapy were 9 days (3-26) and 3 mg/kg/d (2-5). Recovery rate in patients including all with/without positive culture was 81% (17/21). Microbiological clearance by colistin was 69% (9/13). The major side effect observed was acute kidney injury (19%). At least 24% of infants required electrolyte supplementation during the colistin therapy. Magnesium levels were significantly lower at the end of the colistin therapy (p < 0.001). Acute kidney injury and electrolyte disturbances including hypomagnesemia were reversible in all surviving patients. CONCLUSION: We suggest that renal function tests and serum electrolytes should be monitored closely and replaced in case of any need during the colistin therapy in preterm infants.
Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter baumannii , Antibacterianos/uso terapêutico , Colistina/uso terapêutico , Doenças do Prematuro/tratamento farmacológico , Sepse/tratamento farmacológico , Injúria Renal Aguda/induzido quimicamente , Administração Intravenosa , Antibacterianos/efeitos adversos , Colistina/efeitos adversos , Infecção Hospitalar/tratamento farmacológico , Eletrólitos/uso terapêutico , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal , Magnésio/sangue , Masculino , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/induzido quimicamente , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoAssuntos
Aquaporinas/genética , Aquaporinas/fisiologia , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Expressão Gênica/efeitos dos fármacos , Capacidade de Concentração Renal/efeitos dos fármacos , Falência Renal Crônica/metabolismo , Falência Renal Crônica/fisiopatologia , Nefrectomia , Animais , Aquaporina 2 , Aquaporina 3 , Água Corporal/metabolismo , Modelos Animais de Doenças , Progressão da Doença , Homeostase/efeitos dos fármacos , Falência Renal Crônica/prevenção & controle , Túbulos Renais/metabolismo , Medicina Kampo , Proteinúria/tratamento farmacológico , RNA Mensageiro/metabolismo , Ratos , Equilíbrio Hidroeletrolítico/efeitos dos fármacos , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoRESUMO
The article analyzed 60 patients with community-aquired pneumonia from ages 6 to 18 years. The dependences of trace levels of zinc and copper in the serum of these children on the activity of the inflammatory process. Analysis of survey results showed that in children with community-aquired pneumonia was observed imbalance of trace elements Zn, Cu. Severity of such violations depended mainly on severity disease and to a lesser extent on age. Normalization of detected metabolic microelement content in a period of convalescence practically advancing. In children at acute stage of community-aquired pneumonia inflammation was observed with pronounced zinc deficiency (P < 0,001), and its content in blood serum is directly dependent on the acuity and severity of inflammation. Use of the drug, which contains zinc as part of adjuvant therapy in community-aquired pneumonia in children led to more rapid normalization of serum microelement parameters, apparently due to modulating effects on microelement status and immune status. To increase the effectiveness of treatment of community-aquired pneumonia in school-age children, its recommended to use zinc containing drug.
Assuntos
Cobre/sangue , Pneumonia/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Sulfato de Zinco/uso terapêutico , Zinco/sangue , Adolescente , Criança , Infecções Comunitárias Adquiridas , Feminino , Humanos , Masculino , Pneumonia/sangue , Pneumonia/complicações , Índice de Gravidade de Doença , Estudantes , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/complicações , Zinco/deficiência , Sulfato de Zinco/farmacologiaRESUMO
The objective of the study was to evaluate the efficacy of sivelestat, a selective neutrophil elastase inhibitor, on body fluid balance after transthoracic esophagectomy. Esophagectomy with elective lymphadenectomy may induce excessive release of neutrophil elastase, which then promotes vascular permeability and an excessive water shift from the intravascular space to the peripheral compartment. Body fluid imbalance after esophagectomy often leads to circular instability, a decrease of urine output, and a delay in the shift to a diuretic state. The study was designed as a case-control study with a historical control group. A retrospective analysis was performed to examine our hypothesis that sivelestat improves abnormal body fluid retention and prevents subsequent pulmonary complications. To reveal the direct influence of sivelestat on the postoperative course, we avoided using steroids or other diuretic agents. Eighty-eight patients who underwent thoracic esophagectomy with extended lymphadenectomy from 2000 to 2008 were divided into two groups: those treated from 2003 to 2008, who all received postoperative administration of sivelestat (n=60); and those treated from 2000 to 2002, who did not receive sivelestat and were used as the control group (n=28). Both groups received fluid management using the same protocol. The time to reach a diuretic state, time until extubation of the tracheal tube, and development of delayed respiratory dysfunction were compared between the groups using univariate and multivariate analysis. The time until a shift to a diuretic state was significantly shorter after treatment with sivelestat (p<0.0001) and with a shorter operation time (p<0.0001). The tracheal tube was extubated significantly earlier in the sivelestat group (p<0.0001) and the incidence of delayed respiratory dysfunction was also significantly lower (p=0.0028) in this group. Multivariate logistic regression analysis showed that a delay in a shift to a diuretic state was a strong independent risk factor for the time to tracheal extubation (odds ratio 2.539, p=0.0056) and occurrence of delayed respiratory dysfunction (odds ratio 1.989, p=0.0104). Sivelestat treatment was not independently associated with reduced pulmonary complications, but the diuretic state was strongly regulated by sivelestat treatment (odds ratio 0.044, p=0.0003). Thus, administration of sivelestat has a beneficial influence on recovery from body water imbalance through a more rapid return to a diuretic state after esophagectomy, which contributes to prevention of subsequent pulmonary complications.
Assuntos
Esofagectomia/efeitos adversos , Proteínas Secretadas Inibidoras de Proteinases/uso terapêutico , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/etiologia , Idoso , Esofagectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos RetrospectivosRESUMO
Vasopressin is a critical regulator of water homeostasis. There are two major receptors for vasopressin: V1 and V2 receptors. Disturbances in water balance are commonly encountered in clinical practice and can be divided into disorders of urinary dilution and concentration. The major representatives of such disorders are diabetes insipidus and the syndrome of inappropriate secretion of antidiuretic hormone (SI ADH). Recent studies show that genetic forms of nephrogenic diabetes insipidus are due to mutations in the genes coding for the vasopressin V2 receptor (V2R) or aquaporin-2 (AQP2). Identification of the genes involved and analysis of the cellular fate of the V2R and AQP2 mutants are relevant for understanding the functioning of the V2R and AQP2 protein. These developments also have implications for future therapeutic options. The development of nonpeptide vasopressin receptor antagonists (VRAs) offers prospects for the treatment of euvolaemic (SI ADH) or hypervolaemic hyponatraemia (congestive heart failure or cirrhosis). Several nonpeptide VRAs are now in various stages of clinical trials. At present, only conivaptan is registered by the FD A for intravenous treatment of euvolaemic and hypervolaemic hyponatremia. A recent long-term study comparing tolvaptan with placebo in patients with chronic heart failure showed no reduction in risk of death and hospitalisation.
Assuntos
Receptores de Vasopressinas/uso terapêutico , Vasopressinas/fisiologia , Equilíbrio Hidroeletrolítico/fisiologia , Desequilíbrio Hidroeletrolítico/fisiopatologia , Água/metabolismo , Antagonistas dos Receptores de Hormônios Antidiuréticos , Diabetes Insípido Nefrogênico/tratamento farmacológico , Diabetes Insípido Nefrogênico/genética , Diabetes Insípido Nefrogênico/fisiopatologia , Humanos , Síndrome de Secreção Inadequada de HAD/tratamento farmacológico , Síndrome de Secreção Inadequada de HAD/genética , Síndrome de Secreção Inadequada de HAD/fisiopatologia , Mutação , Receptores de Vasopressinas/genética , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/genéticaRESUMO
We describe a case of a patient with cisplatin-induced hypomagnesemia who suffered brief asystole during an episode of gastroenteritis. Structural heart disease was excluded. The patient achieved complete clinical recovery after short-term administration of intravenous magnesium supplementation. Cisplatin should be considered a cause of hypomagnesemic-related cardiac dysrhythmia. Magnesium deficit may increase myocardial electrical instability and thus, the risk of life-threatening arrhythmias and sudden death. Long-term serum electrolyte measurement and appropriate replacement of magnesium are recommended.
Assuntos
Cisplatino/efeitos adversos , Parada Cardíaca/induzido quimicamente , Magnésio , Desequilíbrio Hidroeletrolítico/induzido quimicamente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bleomicina/administração & dosagem , Bleomicina/efeitos adversos , Neoplasias Ósseas/complicações , Neoplasias Ósseas/terapia , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Dactinomicina/administração & dosagem , Dactinomicina/efeitos adversos , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Feminino , Gastroenterite/tratamento farmacológico , Gastroenterite/etiologia , Parada Cardíaca/tratamento farmacológico , Humanos , Magnésio/administração & dosagem , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Osteossarcoma/complicações , Osteossarcoma/terapia , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoRESUMO
Electrolyte and fluid imbalances are disorders frequently observed in critical care patients. In many instances patients are asymptomatic, but they may also present with neurological alterations, severe muscle weakness, nausea and vomiting or cardiovascular emergencies. Therefore, a pathophysiological understanding of these disorders is necessary for initiating an appropriate therapy. After a precise history-including drug prescriptions-has been obtained from the patient or his/her relatives, determination of the hydration status of the patient and measurement of acid-base status, plasma and urine osmolality and electrolytes are the first steps in the assessment of the disease. Once a diagnosis has been established, great attention has to be paid to the rate at which the disorder is corrected because this-if inappropriate-may cause more severe damage to the patient than the disease itself. This chapter addresses the initial diagnostic and therapeutic steps of the most common electrolyte emergencies.
Assuntos
Eletrólitos/sangue , Emergências , Desequilíbrio Hidroeletrolítico/diagnóstico , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Cálcio/sangue , Diagnóstico Diferencial , Tratamento de Emergência , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/tratamento farmacológico , Hipernatremia/diagnóstico , Hipernatremia/tratamento farmacológico , Hipocalcemia/diagnóstico , Hipocalcemia/tratamento farmacológico , Hipopotassemia/diagnóstico , Hipopotassemia/tratamento farmacológico , Hiponatremia/diagnóstico , Hiponatremia/tratamento farmacológico , Magnésio/sangue , Fósforo/sangue , Potássio/sangue , Sódio/sangue , Desequilíbrio Hidroeletrolítico/sangueRESUMO
OBJECTIVE: Aminophylline has not been studied as an adjunct diuretic in critically ill children. Our purpose was to evaluate its use in the treatment of fluid overload in these patients. DESIGN: Open, controlled clinical trial. SETTING: Pediatric intensive care unit. PATIENTS: Study subjects ranged from 2-46 months of age, were fluid overloaded, and were receiving a continuous infusion of furosemide (> or =6 mg/kg/day). Patients with hemodynamic instability or liver dysfunction were excluded. INTERVENTIONS: A single dose of aminophylline (6 mg/kg) was given after establishing baseline values. There were no additional diuretics or changes in vasoactive agents during the study. MEASUREMENTS AND MAIN RESULTS: Urine output, creatinine clearance, and sodium and potassium excretion were measured before and after administration of the aminophylline bolus. Heart rate and mean arterial pressure (mm Hg) were recorded hourly. Urine output increased by >80% (p < .01) during the first 2 hrs after administration of the aminophylline bolus and then returned to baseline by 4 to 6 hrs. The change in urine output is consistent with the pharmacokinetics of aminophylline. Heart rate and mean arterial pressure exhibited a change of <10% from baseline. CONCLUSIONS: These results suggest that aminophylline is an effective adjunct to furosemide in increasing diuresis in critically ill children with fluid overload. The increased diuresis can be accomplished without increased risk if drug levels are adequately monitored.
Assuntos
Aminofilina/uso terapêutico , Cardiotônicos/uso terapêutico , Cuidados Críticos , Diuréticos/uso terapêutico , Furosemida/uso terapêutico , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Adjuvantes Farmacêuticos , Aminofilina/farmacocinética , Cardiotônicos/farmacocinética , Pré-Escolar , Creatinina/metabolismo , Diuréticos/administração & dosagem , Furosemida/administração & dosagem , Hemodinâmica/efeitos dos fármacos , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Potássio/sangue , Potássio/urina , Sódio/sangue , Sódio/urinaRESUMO
We investigated the effect of a daily supplement of 200 mg of magnesium (as MgO) for two menstrual cycles on the severity of premenstrual symptoms in a randomized, double-blind, placebo-controlled, crossover study. A daily supplement of 200 mg of Mg (as MgO) or placebo was administered for two menstrual cycles to each volunteer, who kept a daily record of her symptoms, using a 4-point scale in a menstrual diary of 22 items. Symptoms were grouped into six categories: PMS-A (anxiety), PMS-C (craving), PMS-D (depression), PMS-H (hydration), PMS-O (other), and PMS-T (total overall symptoms). Urinary Mg output/24 hours was estimated from spot samples using the Mg/creatinine ratio. Analysis of variance for 38 women showed no effect of Mg supplementation compared with placebo in any category in the first month of supplementation. In the second month there was a greater reduction (p = 0.009) of symptoms of PMS-H (weight gain, swelling of extremities, breast tenderness, abdominal bloating) with Mg supplementation compared with placebo. Compliance to supplementation was confirmed by the greater mean estimated 24-hour urinary output of Mg (p = 0.013) during Mg supplementation (100.8 mg) compared with placebo (74.1 mg). A daily supplement of 200 mg of Mg (as MgO) reduced mild premenstrual symptoms of fluid retention in the second cycle of administration.
Assuntos
Óxido de Magnésio/uso terapêutico , Síndrome Pré-Menstrual/complicações , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/etiologia , Adolescente , Adulto , Estudos Cross-Over , Monitoramento de Medicamentos , Feminino , Humanos , Magnésio/urina , Índice de Gravidade de Doença , Inquéritos e Questionários , Desequilíbrio Hidroeletrolítico/urinaRESUMO
Bilateral subdiaphragmatic vagotomy in rats leads to hepatic and small intestinal water metabolic disorders appeared as higher levels of total water, longer spin-grid (T1) and spin-spin (T2) relaxation and impaired correlation between T1 and T2. The time course of changes in water metabolism in the liver is one-sided (maximum after 7 days) at the same time in the small intestine is two-sided (maximum after 7 and 30 days). The antihypoxant tomerzole and the antioxidant dibunol produce a partial normalizing effect on water metabolism in the studied viscera of the animals vagotomized (at day 30), the highest efficiency was demonstrated by dibunol whose pharmacological activity is the greatest in the small intestine.
Assuntos
Antioxidantes/uso terapêutico , Intestino Delgado/efeitos dos fármacos , Fígado/efeitos dos fármacos , Peptídeos/uso terapêutico , Vagotomia/efeitos adversos , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Animais , Intestino Delgado/metabolismo , Fígado/metabolismo , Masculino , RatosRESUMO
It has been suggested that under hypokinesia (reduced number of steps/day) and intensive physical exercise, the intensification of fluid excretion in men is apparently caused as a result of the inability of the body to retain optimum amounts of water. Thus, to evaluate this hypothesis, studies were performed with the use of fluid and sodium chloride (NaCl) supplements on 12 highly trained physically healthy male volunteers aged 19-24 years under 364 days of hypokinesis (HK) and a set of intensive physical exercises (PE). They were divided into two groups with 6 volunteers per group. The first group of subjects were submitted to HK and took daily fluid and salt supplements in very small doses and the second group of volunteers were subjected to intensive PE and fluid-salt supplements. For the simulation of the hypokinetic effect, both groups of subjects were kept under an average of 4000 steps/day. During the prehypokinetic period of 60 days and under the hypokinetic period of 364 days water consumed and eliminated in urine by the men, water content in blood, plasma volume, rate of glomerular filtration, renal blood flow, osmotic concentration of urine and blood were measured. Under HK, the rate of renal excretion of water increased considerably in both groups. The additional fluid and salt intake failed to normalize water balance adequately under HK and PE. It was concluded that negative water balance evidently resulted not from shortage of water in the diet but from the inability of the body to retain optimum amounts of fluid under HK and a set of intensive PEs.
Assuntos
Exercício Físico/fisiologia , Hidratação , Hipocinesia/metabolismo , Cloreto de Sódio/uso terapêutico , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Água/metabolismo , Adulto , Peso Corporal , Desidratação , Ingestão de Líquidos , Ingestão de Energia , Taxa de Filtração Glomerular , Humanos , Masculino , Circulação Renal , Urina , Redução de PesoRESUMO
The treatment of a patient with hypocalcemic tetany secondary to sodium phosphate enemas is reported. The patient presented with a serum calcium level of 5.2 mg/dL and a phosphate level of 17.5 mg/dL. Physical manifestations included tetanic contraction of the muscles of the legs and arms. There was rapid symptomatic resolution with IV calcium. The electrolyte imbalance normalized over the next two days with oral calcium supplementation.
Assuntos
Enema/efeitos adversos , Hipocalcemia/complicações , Fosfatos/efeitos adversos , Tetania/etiologia , Gluconato de Cálcio/uso terapêutico , Pré-Escolar , Emergências , Humanos , Hipocalcemia/induzido quimicamente , Hipocalcemia/tratamento farmacológico , Masculino , Tetania/tratamento farmacológico , Tetania/fisiopatologia , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/tratamento farmacológicoAssuntos
Medicina Tradicional Chinesa , Medicina Tradicional do Leste Asiático , Plantas Medicinais , Doença Cardiopulmonar/tratamento farmacológico , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Adulto , Idoso , Gasometria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Extratos Vegetais/uso terapêutico , Doença Cardiopulmonar/complicações , Desequilíbrio Hidroeletrolítico/etiologiaRESUMO
Muzolimine, the new sulphonamide-free loop-diuretic with both high ceiling and long-lasting activities, was tested in 21 adult patients with chronic renal failure (CRF) (creatinine clearance ranging from 30 to 5 ml/min) and acute fluid overload. Low-protein diet and individual drug therapy were unchanged throughout the study. All patients received a single oral dose of 240 mg of muzolimine for 4 or 6 consecutive days depending on individual response. Clinical status, diuresis, body weight, blood and urine chemistry were recorded daily. In 19 out of 21 patients muzolimine treatment induced reversal of edema and congestive heart failure and a satisfactory fluid balance was achieved. Only two patients did not respond to diuretic treatment and required dialysis to control fluid balance and azotemia. In responsive patients diuresis increased by 50-100% and no rebound antidiuresis was observed after drug withdrawal. Body weight decreased meanly by 9%. No significant change occurred in serum concentration of K throughout the study, even in the 11 patients on digoxin. Except for a slight decrease of serum Cl by the end of treatment, no significant change in serum electrolytes was recorded. No effect was observed on blood glucose, urea and creatinine clearance whereas a slight increase of serum uric acid was recorded. Urinary lysozyme and gamma-GT were similar before and after the trial. Apart from a single case of muscle cramps, no significant side-effects were recorded. In conclusion, the present results indicate that short-term, high-dose oral muzolimine treatment is effective and safe in most patients with advanced CRF and acute fluid retention.