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1.
Medicine (Baltimore) ; 99(2): e18719, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914086

RESUMO

BACKGROUND: Hematoma expansion (HE) is related to clinical deterioration and unfavorable prognosis in intracerebral hemorrhage (ICH). Some studies have revealed that low serum magnesium level is associated with larger hematoma volume at admission, HE, and unfavorable outcomes. However, the conclusions remain unsettled. The purpose of this study is to evaluate the association between low serum magnesium level and HE by meta-analysis. METHODS: We will search the following electronic bibliographic databases: PubMed, Medline, Embase, Web of Science, and The Cochrane Library. Studies will be included if they reported a relationship of low serum magnesium level and HE, mortality or poor outcome. RESULTS: The results of this study will be submitted to a peer-reviewed journal for publication. CONCLUSION: This will be the first systematic review and meta-analysis to evaluate the association of HE following ICH with Hypomagnesemia. We look forward to the results will offer scientific proof to predict HE for ICH patients with low serum magnesium level. PROSPERO REGISTRATION NUMBER: This protocol has been registered in the PROSPERO network with number: CRD42019135995.


Assuntos
Hemorragia Cerebral/patologia , Hematoma/patologia , Magnésio/sangue , Biomarcadores , Deterioração Clínica , Humanos , Prognóstico
2.
Clin Biochem ; 75: 48-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786206

RESUMO

INTRODUCTION: The significance of hypomagnesemia and the need for treatment are under-recognized in clinical practice. Our objective was to design, establish, and test two interventions to screen for patients with hypomagnesemia and increase the rate of treatment of hypomagnesemia in the Emergency Department (ED). MATERIAL AND METHODS: A prospective two-year study was conducted. The Laboratory Information System was set to automatically order plasma magnesium in ED patients with plasma calcium < 7.5 mg/dL (1.9 mmol/L) and/or plasma potassium < 2.5 mEq/L (2.5 mmol/L). We counted the number of identified cases of hypomagnesemia, and calculated the total economic cost per identified patient. The study had three periods "Central lab" "Stat lab" and "Stat lab with comment" according to the availability to measure plasma magnesium levels in the stat laboratory and the inclusion of an automatic comment in the laboratory report in cases of hypomagnesemia. We retrospectively reviewed the medical records of patients with magnesium < 1.5 mg/dL (0.6 mmol/L), to investigate whether they have been appropriately treated. RESULTS: A total of 410 plasma magnesium were measured due to our intervention; 179 due to hypokalemia and 231 due to hypocalcemia. Two hundred thirty (56.1%) of 410 showed hypomagnesemia. Each detected case resulted in reagent cost of 0.7$, when prompted by hypocalcemia, and 0.6$ when prompted by hypokalemia. The rate of patients with hypomagnesemia that were appropriately treated increased from 15% to 75% along the study period. CONCLUSIONS: Our strategies successfully identified patients with hypomagnesemia in the ED at a very affordable cost, and increased the percentage of patients with hypomagnesemia that received treatment.


Assuntos
Sistemas de Informação em Laboratório Clínico , Hipocalcemia/sangue , Hipopotassemia/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/terapia , Magnésio/sangue , Idoso , Idoso de 80 Anos ou mais , Serviço Hospitalar de Emergência , Feminino , Humanos , Deficiência de Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
3.
Ann Otol Rhinol Laryngol ; 129(1): 70-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31510765

RESUMO

OBJECTIVE: Prediction and early intervention for hypocalcemia following parathyroidectomy and total thyroidectomy can decrease hospital cost and prevent severe hypocalcemia-related complications. This study aims to predict the severity of hypocalcemia after parathyroidectomy or thyroidectomy and to stratify patients into groups with different levels of risk for developing severe hypocalcemia, so that higher risk patients may be monitored more closely and receive earlier interventions. METHODS: This was a retrospective cohort study of 100 patients with primary hyperparathyroidism who underwent parathyroidectomy as the primary treatment modality at a tertiary care hospital. Clinical information, including demographic information, perioperative PTH and calcium levels, vitamin D levels, weight of the pathologic glands removed, gland pathology, and re-admission rates, were retrieved. Statistical analysis was performed to analyze the association between collected variables and percentage of calcium drop following parathyroidectomy with statistical significant set at P-values <0.05. RESULTS: Age, sex, and vitamin D level provided very minimal information to quantify risks of postoperative hypocalcemia. The percentage of decrease from preoperative PTH level to the lowest PTH level after the removal of the abnormal gland(s) is the most significant predicting factor for the severity of postoperative hypocalcemia. There is a mathematic regressional correlation between them. A formula was generated to quantify this linear relationship between them, and the nadir calcium can be calculated as Canadir=Capreop*[1-0.35*(PTHpreop-PTHintraop)2PTHpreop2], where Canadir = the lowest postoperative calcium level, and PTHintraop = PTH level 15 minutes after removal of the abnormal gland, with the value of R2 > 0.7. The formula has been tested primarily in our patient population with good reliability. CONCLUSIONS: The highest preoperative, lowest postoperative, and change in PTH level can help us reliably calculate the trend of postoperative calcium level. Decision to pursue early interventions can be made based on the calculated result from the formula we obtained.


Assuntos
Hiperparatireoidismo Primário/cirurgia , Hipocalcemia/epidemiologia , Paratireoidectomia , Complicações Pós-Operatórias/epidemiologia , Adenoma/sangue , Adenoma/patologia , Adenoma/cirurgia , Adulto , Fatores Etários , Feminino , Humanos , Hiperparatireoidismo Primário/sangue , Hipocalcemia/sangue , Hipocalcemia/terapia , Período Intraoperatório , Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Hormônio Paratireóideo/sangue , Neoplasias das Paratireoides/sangue , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Complicações Pós-Operatórias/sangue , Período Pós-Operatório , Período Pré-Operatório , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Tireoidectomia , Carga Tumoral , Vitamina D/sangue
4.
Medicine (Baltimore) ; 98(45): e17774, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702629

RESUMO

The impact of magnesium on risk of knee osteoarthritis (KOE) is still under investigation. This meta-analysis evaluated the relationship between magnesium and risk of KOE.A comprehensive search was performed to identify retrospective cohort study or cross-sectional study of the association between magnesium and KOE from the Cochrane library, PubMed, and Embase. The search time limit was from the establishment of the database to December 2018. Two evaluators selected the literature, extracted the data, and evaluated the quality of the literature according to the inclusion and exclusion criteria, independently. Meta-analysis was performed using RevMan 5.3 software and publication bias was assessed using Begg and Egger test and funnel plot.Finally, 6 studies were included with a total of 15,715 participants. Although higher daily intake of magnesium was associated with a significantly reduced risk of fracture in patients with KOE (OR = 0.66, 95%CI: 0.56, 0.78; P < .00001), it was not significant for lowering the risk of KOE (OR = 0.80; 95% CI: 0.61, 1.04; P = .1). Meta-analysis also showed that population with higher serum magnesium levels had significantly lower risk of KOE (odds ratio (OR) = 0.84; 95% confidence interval (CI): 0.72, 0.98; P = .03). Further subgroup analysis showed that the relationship between serum magnesium level and KOE risk was significantly affected by serum magnesium level (P = .006 for quartiles 4 vs 1).Higher level of magnesium intake was not associated with lower risk of KOE. However, higher daily intake of magnesium may be inversely associated with risk of fracture in KOE patients.


Assuntos
Magnésio/uso terapêutico , Osteoartrite do Joelho/epidemiologia , Fraturas por Osteoporose/epidemiologia , Idoso , Estudos Transversais , Feminino , Humanos , Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/sangue , Osteoartrite do Joelho/complicações , Fraturas por Osteoporose/sangue , Estudos Retrospectivos
5.
Mymensingh Med J ; 28(4): 773-778, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599240

RESUMO

This cross-sectional analytical study was carried out to observe serum magnesium in type 2 diabetes mellitus patients and was performed in the department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2016 to December 2016. For this purpose, a total number of 200 subjects of both sexes with age ranged from 30-60 years were selected of whom 100 were type 2 diabetic person and 100 were apparently healthy. Serum magnesium was significantly lower (p<0.0001) in both male and female of the study group in comparison to healthy control group. From this study, it may conclude that type 2 persons are considered to have significant positive relation for formation of hypomagnesaemia. So, prevention of type 2 diabetes mellitus by taking necessary steps like regular physical exercise, intake of healthy diet and behavior therapy may supplementation of magnesium help in prevention of type 2 diabetes mellitus related complication.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Jejum , Magnésio/sangue , Adulto , Bangladesh , Glicemia , Estudos Transversais , Feminino , Glucose , Humanos , Masculino , Pessoa de Meia-Idade
6.
Medicine (Baltimore) ; 98(38): e17069, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567942

RESUMO

Although serum magnesium (Mg) levels are closely associated with the prognosis of heart failure (HF) patients, the clinical significance of sMg levels on the cardiovascular outcomes of HF with preserved ejection fraction (HFpEF) patients is not fully understood. This study was a retrospective, single-center, observational study. We enrolled 452 consecutive HFpEF patients admitted to Kumamoto University Hospital. We defined lower sMg as <2.0 mg/dl (=0.8 mmol/L) based on recent clinical evidence and compared their clinical characteristics and prognosis. There were no significant differences between groups in the use of all medications (loop diuretics, mineralocorticoid receptor antagonists, renin-angiotensin-aldosterone system inhibitors, calcium channel blockers, beta blockers, statins, and Mg preparations). The lower sMg group showed a significantly higher prevalence of diabetes mellitus (DM), uric acid levels, and BNP levels compared with the higher sMg group. Kaplan-Meier curve revealed a significantly higher probability of HF-related events in the lower sMg group compared with the higher sMg group (log-rank test, P = .012). Multivariate Cox-proportional-hazard analysis revealed that the lower sMg group had significantly and independently higher probabilities of HF-related events compared with the higher sMg group (hazard ratio = 2.37, 95% confidence intervals = 1.27-4.41, P = .007). We reclassified the risk of HF-related events after adding the lower sMg to the other prognostic factors (age, previous hospitalization for HF, DM, Ln-BNP); the continuous net reclassification improvement was 29.0% (P = .041). sMg levels might provide important prognostic information in regard to HFpEF.


Assuntos
Insuficiência Cardíaca/mortalidade , Magnésio/sangue , Volume Sistólico , Idoso , Ecocardiografia , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Japão , Masculino , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida
7.
Cochrane Database Syst Rev ; 9: CD011358, 2019 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-31498421

RESUMO

BACKGROUND: Sickle cell disease is an autosomal recessive inherited haemoglobinopathy which causes painful vaso-occlusive crises due to sickle red blood cell dehydration. Vaso-occlusive crises are common painful events responsible for a variety of clinical complications; overall mortality is increased and life expectancy decreased compared to the general population. Experimental studies suggest that intravenous magnesium has proven to be well-tolerated in individuals hospitalised for the immediate relief of acute (sudden onset) painful crisis and has the potential to decrease the length of hospital stay. Some in vitro studies and open studies of long-term oral magnesium showed promising effect on pain relief but failed to show its efficacy. The studies show that oral magnesium therapy may prevent sickle red blood cell dehydration and prevent recurrent painful episodes. There is a need to access evidence for the impact of oral and intravenous magnesium effect on frequency of pain, length of hospital stay and quality of life. This is an updated version of the review. OBJECTIVES: To evaluate the effects of short-term intravenous magnesium on the length of hospital stay and quality of life in children and adults with sickle cell disease. To determine the effects of long-term oral magnesium therapy on the frequency of painful crises and the quality of life in children and adults with sickle cell disease. SEARCH METHODS: We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register: 03 February 2019.Date of last search of other resources (clinical trials registries): 04 April 2019. SELECTION CRITERIA: We searched for published and unpublished randomized controlled studies of oral or intravenous magnesium compared to placebo or no magnesium. DATA COLLECTION AND ANALYSIS: Authors independently assessed the study quality and extracted the data using standard Cochrane methodologies. MAIN RESULTS: We included five randomized placebo-controlled studies with a total of 386 participants (aged three to 53 years). Of these, two shorter parallel studies (n = 306) compared intravenous magnesium sulphate to placebo (normal saline) for admission to hospital due to a vaso-occlusive crisis, for which we were able to analyse data. The quality of evidence was moderate for studies in this comparison, mainly due to limitations due to risk of bias and imprecision. Two of the three longer-term studies comparing oral magnesium pidolate to placebo had a cross-over design. The third was a parallel factorial study which compared hydroxyurea and oral magnesium to each other and to placebo over a longer period of time; we only present the comparison of oral magnesium to placebo from this study. The quality of evidence was very low with uncertainty of the estimation.The eight-hourly dose levels in the two studies of intravenous magnesium were different; one used 100 mg/kg while the second used 40 mg/kg. Only one of these studies (n = 104) reported the mean daily pain score while hospitalised (a non-significant difference between groups, moderate quality evidence). The second study (n = 202) reported a number of child- and parent-reported quality of life scores. None of the scores showed any difference between treatment groups (low quality evidence). Data from one study (n = 106) showed no difference in length of stay in hospital between groups (low quality evidence). Both studies reported on adverse events, but not defined by severity as we had planned. One study showed significantly more participants receiving intravenous magnesium experienced warmth at infusion site compared to placebo; there were no differences between groups for other adverse events (low quality evidence).Three studies (n = 80) compared oral magnesium pidolate to placebo. None of them reported data which we were able to analyse. One study (n = 24) reported on the number of painful days and stated there was no difference between two groups (low quality evidence). None of the studies reported on quality of life or length of hospital stay. Two studies (n = 68) reported there were no differences in levels of magnesium in either plasma or red blood cells (moderate quality evidence). Two studies (n = 56) reported adverse events. One reported episodes of mild diarrhoea and headache, all of which resolved without stopping treatment. The second study reported adverse events as gastrointestinal disorders, headache or migraine, upper respiratory infections and rash; which were all evenly distributed across treatment groups (moderate quality evidence). AUTHORS' CONCLUSIONS: Moderate to low quality evidence showed neither intravenous magnesium and oral magnesium therapy has an effect on reducing painful crisis, length of hospital stay and changing quality of life in treating sickle cell disease. Therefore, no definitive conclusions can be made regarding its clinical benefit. Further randomized controlled studies, perhaps multicentre, are necessary to establish whether intravenous and oral magnesium therapies have any effect on improving the health of people with sickle cell disease.


Assuntos
Anemia Falciforme/tratamento farmacológico , Antidrepanocíticos/uso terapêutico , Magnésio/uso terapêutico , Adolescente , Adulto , Anemia Falciforme/sangue , Criança , Pré-Escolar , Feminino , Humanos , Hidroxiureia/uso terapêutico , Magnésio/sangue , Sulfato de Magnésio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
8.
Psychiatr Danub ; 31(Suppl 3): 221-226, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488730

RESUMO

BACKGROUND: Both Vitamin D deficiency and magnesium deficiency have an increased prevalence and have been associated with an increased risk of and increased severity of symptoms in both depression and schizophrenia (Boerman 2016, Tarleton & Littenberg 2015). This effect appears more pronounced in younger populations and is often apparent from the time of initial diagnosis and is present with adjustment for confounding factors. Thus, the evidence suggests that Vitamin D and magnesium deficiency reflects not only dietary or somatic aspects of health but also may have a role in the pathophysiology of depression and schizophrenia. SUBJECTS AND METHODS: A single site audit of serum Vitamin D and magnesium levels in patients at an Acute Day Treatment Unit was carried out. Blood tests were performed on admission and analysed in house. Data were collected between April - June 2019 and was analysed subsequently, as described below (n=73). RESULTS: Our data show that our psychiatric day treatment unit cohort (n=73) had a higher proportion of vitamin D deficiency (52%) than the general population (40%), although due to the limited sample size this was not significant (p=0.22, Chi-squared test). The percentage of patients who were magnesium deficient was 78.6% (n=22/28). However, the F60 subgroup of patients with personality disorders showed a high prevalence of vit D deficiency (p=0.07), highlighting a trend towards significance despite the limited size of this subgroup. CONCLUSIONS: We carried out a single-site audit of serum vitamin D and magnesium levels in a psychiatric day unit population in order to assess the extent of vitamin deficiency in such patients. These data indicate that that the proportion of patients with vitamin D deficiency is higher than in the general population. Further larger analysis is needed to establish the statistical significance of these data and whether treatment with vitamin D supplementation improves outcomes.


Assuntos
Magnésio/sangue , Transtornos Mentais/sangue , Vitamina D/sangue , Estudos de Coortes , Humanos , Deficiência de Magnésio/sangue , Deficiência de Vitamina D/sangue
9.
J Therm Biol ; 84: 176-184, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31466751

RESUMO

AIM: The aim of this survey was to ascertain the difference in the levels of Magnesium (Mg) and Phosphorus (P) after an exercise test in normothermia and hyperthermia before and after heat acclimation in comparison to their respective pre-test values. METHODS: Twenty-nine male university students were divided into an Experimental Group (EG) (n = 15) and a Control Group (CG) (n = 14). All of them voluntarily participated in this investigation. Both groups performed an incremental test until exhaustion on a cycloergometer in normothermia (22 °C) and hyperthermia (42 °C). EG underwent 9 sessions of heat acclimation (100 °C) in a sauna (Harvia C105S Logix Combi Control; 3-15 W; Finland). Once the experimental period was completed, all initial measurements were carried out again under identical conditions. Urine and blood samples were obtained before and after each trial. Sweat samples were collected at the end of every test performed in hyperthermia. The samples were frozen at -80 °C until further analysis by ICP-MS. RESULTS: Lower seric Mg levels were observed in both groups at the end of pre-acclimation tests. After acclimation, only EG experimented a decrease of Mg in serum after testing (p < .01). The urinary excretion was unaffected in the pre-acclimated period, but EG experimented an increase in Mg after trials in the post-acclimation evaluation (p < .01). Mg sweat loss decreased significantly after heat acclimation (p < .05). P did not undergo changes, except in its urinary excretion, which was elevated after the normothermia trial in the post-acclimation period (p < .05). CONCLUSIONS: It seems that exercise in hyperthermia altered Mg status but not P homeostasis. Additionally, heat acclimation reduces Mg losses in sweat while increasing its loss in urine. Thus, Mg supplementation should be considered in unacclimated and acclimated subjects if physical exercise is going to be performed in hyperthermic conditions.


Assuntos
Exercício/fisiologia , Temperatura Alta/efeitos adversos , Magnésio/metabolismo , Fósforo/metabolismo , Adulto , Temperatura Corporal , Fadiga/metabolismo , Humanos , Magnésio/sangue , Magnésio/urina , Masculino , Fósforo/sangue , Fósforo/urina , Suor/metabolismo , Adulto Jovem
10.
Nutrients ; 11(7)2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31330811

RESUMO

Despite the presumption of the beneficial effects of magnesium supplementation, little is known about the pharmacokinetics of different magnesium formulations. We aimed to investigate the value of two in vitro approaches to predict bioavailability of magnesium and to validate this in subsequent in vivo testing. In vitro assessment of 15 commercially available magnesium formulations was performed by means of a Simulator of the Human Intestinal Microbial Ecosystem (SHIME®) and by dissolution tests. Two magnesium formulations with contrasting bioavailability prediction from both in vitro tests (best vs. worst) were selected for in vivo testing in 30 subjects. In vivo bioavailability was compared following one acute ingestion by monitoring blood magnesium concentrations up to 6 h following intake. The in vitro tests showed a very wide variation in absorption and dissolution of the 15 magnesium products. In the in vivo testing, a significant different serum magnesium absorption profile was found up to 4 h following supplement ingestion for the two supplements with opposing in vitro test results. Moreover, maximal serum magnesium increase and total area under the curve were significantly different for both supplements (+6.2% vs. +4.6% and 6.87 vs. 0.31 mM.min, respectively). Collectively, poor bioaccessibility and bioavailability in the SHIME model clearly translated into poor dissolution and poor bioavailability in vivo. This provides a valid methodology for the prediction of in vivo bioavailability and effectiveness of micronutrients by specific in vitro approaches.


Assuntos
Magnésio/farmacocinética , Adolescente , Adulto , Disponibilidade Biológica , Suplementos Nutricionais , Formas de Dosagem , Liberação Controlada de Fármacos , Feminino , Humanos , Magnésio/sangue , Magnésio/química , Magnésio/urina , Masculino , Adulto Jovem
11.
Diabetes Metab Syndr ; 13(2): 1087-1091, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336449

RESUMO

BACKGROUND: Diabetic Peripheral neuropathy (DPN) is the most distressing complication of diabetic population leading to loss of sensation, pain, and amputation. Low-level laser therapy (LLLT) has been used to manage nerve injuries as it holds the potential to induce a biostimulatory effect with no side effects. Hence we planned to study the biochemical effect and therapeutic outcomes of LLLT on patients with painful diabetic peripheral neuropathy as a preliminary work. MATERIALS AND METHODS: Pre-posttest analysis was done on 40 patients diagnosed with DPN confirmed using 10 g Monofilament test and Michigan Neuropathy Screening Instrument (MNSI). Vibration sensation and pain measured by Vibration perception threshold (VPT) and Numeric pain rating scale (NPRS). All patients were given LLLT (3.1 J/cm2) on plantar and dorsal of the foot for 10 days. Serum samples were collected at baseline and 4 weeks after LLLT to estimate Vitamin D and Magnesium and compared the results. RESULTS: There was a significant increase in Vitamin D and Magnesium levels after LLLT. We observed a considerable improvement in the quality of life after LLLT demonstrated by a decrease in VPT and MNSI and a reduction in NPRS in DPN patients. CONCLUSION: In this study, we found that LLLT improved the QL and hence may be a useful therapeutic option in treating peripheral neuropathic pain in type 2 diabetic patients. The progress in the serum Magnesium and Vit. D levels were proportional to the QL and may be a good indicator of the prognosis of DPN after LLLT.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Magnésio/sangue , Qualidade de Vida , Vitamina D/sangue , Adulto , Idoso , Neuropatias Diabéticas/sangue , Neuropatias Diabéticas/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prognóstico , Estudos Prospectivos , Vitaminas/sangue
12.
Nutrients ; 11(7)2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31261707

RESUMO

Depression is common, places a large burden on the patient, their family and community, and is often difficult to treat. Magnesium supplementation is associated with improved depressive symptoms, but because the mechanism is unknown, it is unclear whether serum magnesium levels act as a biological predictor of the treatment outcome. Therefore, we sought to describe the relationship between serum magnesium and the Patient Health Questionnaire (PHQ, a measure of depression) scores. A cross-sectional analysis of medical records from 3604 adults (mean age 62 years; 42% men) seen in primary care clinics between 2015 and 2018, with at least one completed PHQ were included. The relationship between serum magnesium and depression using univariate analyses showed a significant effect when measured by the PHQ-2 (-0.19 points/mg/dL; 95% CI -0.31, -0.07; P = 0.001) and the PHQ-9 (-0.93 points/mg/dL; 95% CI -1.81, -0.06; P = 0.037). This relationship was strengthened after adjusting for covariates (age, gender, race, time between serum magnesium and PHQ tests, and presence of diabetes and chronic kidney disease) (PHQ-2: -0.25 points/mg/dL; 95% CI -3.33, -0.09; P < 0.001 and PHQ-9: -1.09 95% CI -1.96 -0.21; P = 0.015). For adults seen in primary care, lower serum magnesium levels are associated with depressive symptoms, supporting the use of supplemental magnesium as therapy. Serum magnesium may help identify the biological mechanism of depressive symptoms and identify patients likely to respond to magnesium supplementation.


Assuntos
Afeto , Depressão/sangue , Deficiência de Magnésio/sangue , Magnésio/sangue , Atenção Primária à Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Depressão/diagnóstico , Depressão/psicologia , Registros Eletrônicos de Saúde , Feminino , Humanos , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/psicologia , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Medição de Risco , Fatores de Risco , Adulto Jovem
13.
Vopr Pitan ; 88(3): 78-83, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31265778

RESUMO

Insufficiency or deficiency of some micronutrients may be additional modifying factors that influence the pathogenesis of the disease and the effectiveness of standard pharmacotherapy. The aim of the study - to evaluate the level of magnesium and vitamin B2 in blood serum of patients with bronchial asthma and obesity in order to develop methods for individual correction of deficiency. Material and methods. The study included 51 children aged 12-17 years. The first group included 23 patients (12 girls and 11 boys) with asthma with comorbidities (obesity), and the second group consisted of 28 children (10 girls and 18 boys) with obesity. The concentration of magnesium in blood serum was determined by a colorimetric method without deproteinization, and vitamin B2 - by an immunological microbiological method. Results and discussion. When analyzing the concentration of magnesium in blood serum of the examined children, it was found that in patients with bronchial asthma and obesity, a reduced content of this mineral was observed in 15 (65.2%) patients. The average magnesium concentration was 0.66±0.02 mmol/l at a rate of 0.7-1.2 mmol/l. A statistically significant decrease in the magnesium level in children suffering from asthma and obesity was noted, compared with the level in children with obesity (0.66 [0.57; 0.73] vs 0.71 [0.67; 0.73] mmol/l, р<0.05). Low serum magnesium levels in obese patients were detected more rarely (р<0.05) - only in 6 (21.4%) children, mostly in patients with grade III obesity. The remaining 22 (78.6%) children had magnesium level within the normal range. Patients with low serum magnesium levels showed increased irritability, sleep disturbance, loss of memory and concentration. Vitamin B2 levels in all examined children were within the normal range (137-370 ng/ml). Conclusion. The results indicate a decrease in the concentration of magnesium and normal levels of vitamin B2 in serum in patients with bronchial asthma and obesity. Low serum magnesium levels were observed in children with low bronchial asthma control. To increase the effectiveness of therapy and control the symptoms of bronchial asthma, especially when combined with obesity, correction of the accompanying magnesium deficiency is necessary.


Assuntos
Asma/sangue , Deficiência de Magnésio/sangue , Magnésio/sangue , Obesidade/sangue , Riboflavina/sangue , Adolescente , Criança , Feminino , Humanos , Masculino
14.
Int J Chron Obstruct Pulmon Dis ; 14: 1053-1061, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31190790

RESUMO

Objectives: COPD is the fourth-leading cause of mortality worldwide. Prolonged QTc has been found to be a long-term negative prognostic factor in ambulatory COPD patients. The aim of this study was to evaluate the extent of prolonged-QTc syndrome in COPD patients upon admission to an internal medicine department, its relationship to hypomagnesemia, hypokalemia, and hypocalcemia, and the effect of COPD treatment on mortality during hospital stay. Methods: This prospective cohort study evaluated COPD patients hospitalized in an internal medicine department. The study evaluated QTc, electrolyte levels, and known risk factors during hospitalization of COPD patients. Results: A total of 67 patients were recruited. The median QTc interval was 0.441 seconds and 0.434 seconds on days 0 and 3, respectively. Prolonged QTc was noted in 35.8% of patients on admission and 37.3% on day 3 of hospitalization. The median QTc in the prolonged-QTc group on admission was 0.471 seconds and in the normal-QTc group 0.430 seconds. There was no significant difference in age, sex, electrolyte levels, renal function tests, or blood gases on admission between the two groups. Mortality during the hospital stay was significantly higher in the prolonged-QTc group (3 deaths, 12%) than in the normal QTc group (no deaths) (P=0.04). A subanalysis was performed, removing known causes for prolonged QTc. We found no differences in age, electrolytes, or renal functions. There was a small but significant difference in bicarbonate levels. Conclusion: Our findings demonstrated that there was no correlation between QTc prolongation in hospitalized COPD patients and electrolyte levels, comorbidities, or relevant medications. A higher rate of mortality was noted in patients with prolonged QTc in comparison to normal QTc. As such, it is suggested that prolonged QTc could serve as a negative prognostic factor for mortality during hospitalization in COPD patients.


Assuntos
Hospitalização , Síndrome do QT Longo/mortalidade , Doença Pulmonar Obstrutiva Crônica/mortalidade , Desequilíbrio Hidroeletrolítico/mortalidade , Potenciais de Ação , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Cálcio/sangue , Causas de Morte , Progressão da Doença , Feminino , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca , Mortalidade Hospitalar , Humanos , Hipocalcemia/sangue , Hipocalcemia/mortalidade , Hipopotassemia/sangue , Hipopotassemia/mortalidade , Síndrome do QT Longo/diagnóstico , Síndrome do QT Longo/fisiopatologia , Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Prognóstico , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Medição de Risco , Fatores de Risco , Fatores de Tempo , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/diagnóstico
15.
Kidney Blood Press Res ; 44(3): 354-361, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31189174

RESUMO

BACKGROUND/AIMS: As shown in the China Health and Nutrition Survey, serum magnesium is associated with anemia. However, the roles of magnesium in anemia and erythropoietin (EPO) responsiveness remain unclear in maintenance hemodialysis (MHD) patients. This study aims to investigate the level of serum magnesium and its relationship with EPO responsiveness in MHD patients. METHODS: A total of 307 MHD patients were recruited for this survey. Laboratory data and anthropometrics were collected. EPO responsiveness was evaluated by the erythropoietin resistance index (ERI). The subjects were divided into 3 groups according to serum magnesium concentrations (group A, the lowest tertile; group B, the middle tertiles; and group C, the highest tertile). Multivariate logistic regressions were conducted to evaluate the factors that may be associated with EPO responsiveness. RESULTS: The mean serum magnesium level was significantly higher than normal levels in MHD patients, while no hypomagnesemia was observed. A multivariate logistic regression model revealed that high-sensitivity C-reactive protein, intact parathyroid hormone, serum albumin, and magnesium levels were correlated with a high ERI. The OR of a high ERI was found to be 2.57 (95% CI 1.330-4.975, p = 0.005) for group A and 1.66 (95% CI 0.878--3.140, p > 0.05) for group B compared with the OR for group C. CONCLUSION: Serum magnesium levels were higher than normal levels in MHD patients. A high serum magnesium level was correlated with good EPO responsiveness and was therefore suggested to be a protective factor for EPO hyporesponsiveness.


Assuntos
Eritropoetina/farmacologia , Falência Renal Crônica/sangue , Magnésio/sangue , Adulto , Idoso , Anemia/sangue , Anemia/etiologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Diálise Renal
16.
Medicentro (Villa Clara) ; 23(2): 84-93, abr.-jun. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1002571

RESUMO

RESUMEN Introducción: la hipertensión, al igual que la obesidad, es un problema de salud a nivel mundial. En los últimos años esta situación ha aumentado en la edad infantil. Existe una estrecha relación inversa entre la ingestión del magnesio en la dieta, o en su suplementación, y los niveles de presión sanguínea. En la hipertensión hay presencia de las especies reactivas del oxígeno y las defensas antioxidantes pudieran estar afectadas. Objetivos: evaluar el comportamiento de las concentraciones del magnesio en niños pre-hipertensos, hipertensos y obesos en edad escolar. Métodos: se realizó un estudio descriptivo transversal. La muestra estuvo constituida por 501 infantes (8-11 años), los cuales se clasificaron según: los valores de presión arterial en reposo, sexo, color de la piel e índice de masa corporal. Las determinaciones del magnesio se realizaron por el método de absorción atómica con llama. Se utilizaron las pruebas: T student y U de Mann-Whinney, en la comparación de los grupos con un nivel de significación p< 0,05. Resultados: en el grupo total de niños no hubo diferencias en las concentraciones del magnesio. Los niños pre-hipertensos e hipertensos, del sexo femenino y piel blanca, de 9 años, presentaron disminución significativa de las concentraciones de magnesio. Los varones hipertensos normopesos presentaron diferencia significativa del magnesio en relación con los normotensos. No se encontró diferencia significativa en las concentraciones de magnesio al estudiar el índice de masa corporal. Conclusiones: las concentraciones de magnesio estuvieron disminuidas en los niños pre-hipertensos, hipertensos u obesos para determinados grupos de edad, sexo y color de la piel.


ABSTRACT Introduction: hypertension as obesity is considered a health problem worldwide. In recent years, this situation has increased in childhood. There is a close inverse correlation between the dietary intake of magnesium, or in its supplementation, and blood pressure levels. In hypertension, there is a presence of reactive oxygen species, as well as, antioxidant defenses may be affected. Objectives: to evaluate the manifestation of magnesium concentrations in pre-hypertensive, hypertensive and obese school-age children. Methods: a cross-sectional descriptive study was carried out. The sample consisted of 501 infants (8-11 years old), which were classified according to: blood pressure values at rest, gender, skin color and body mass index. The determinations of magnesium were made using flame atomic absorption spectrometry. Mann-Whitney U and Student's T Tests were used to compare groups with a significance level of p <0.05. Results: there were no differences in magnesium concentrations in the total group of children. Female pre-hypertensive and hypertensive white children aged 9 years showed a significant decrease in magnesium concentrations. Normal-weight hypertensive males had a significant difference in magnesium concentrations in relation to normotensive ones. No significant difference in magnesium concentrations was found when studying the body mass index. Conclusions: magnesium concentrations were decreased in pre-hypertensive, hypertensive or obese children for certain age groups, gender and skin color.


Assuntos
Obesidade Pediátrica/prevenção & controle , Magnésio/sangue
17.
J Vet Intern Med ; 33(4): 1822-1832, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31059164

RESUMO

BACKGROUND: The plasma ionized calcium concentration (cCa2+ ) represents the biologically active form of calcium and is the preferred method for evaluating calcium status in animals. Different pH-corrective equations have been developed for human plasma, but the validity of the equations for bovine plasma is unknown. HYPOTHESIS: We hypothesized that pH-corrective equations for bovine plasma would be similar to those used for human plasma; cCa2+ was dependent on the plasma concentrations of total calcium (cTCa), chloride (cCl), L-lactate (cLactate), and albumin (cAlbumin); and the in vitro and in vivo cCa2+ -pH relationships would differ. ANIMALS: Ten healthy calves (in vitro study), 1426 critically ill calves. METHODS: The in vitro plasma log10 (cCa2+ )-pH relationship was determined by CO2 tonometry of 465 plasma samples. Plasma cCl was altered by equivolume dilution of plasma with 3 electrolyte solutions of different cCl. The in vivo plasma cCa2+ -pH relationship was investigated and validated using clinicopathologic data extracted from the medical records of 950 (model development) and 476 (model validation) critically ill calves. RESULTS: pH-corrective equations for bovine plasma were similar to those used for human plasma. Plasma cCa2+ increased in vitro with increases in plasma cCl. Plasma cCa2+ in critically ill calves was associated with plasma cTCa, blood pH, plasma cCl, serum cMg, and cL-lactate (R2 = 0.69) but not plasma cAlbumin. CONCLUSIONS AND CLINICAL IMPORTANCE: Calculation of cCa2+ from cTCa in calf plasma or serum requires adjustment for at least pH and cCl when 1 or both are outside the reference range.


Assuntos
Cálcio/sangue , Doenças dos Bovinos/sangue , Concentração de Íons de Hidrogênio , Animais , Dióxido de Carbono/sangue , Bovinos , Cloretos/sangue , Estado Terminal , Feminino , Ácido Láctico/sangue , Magnésio/sangue , Masculino , Albumina Sérica/análise
18.
Expert Rev Cardiovasc Ther ; 17(5): 345-351, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31092056

RESUMO

Introduction: Magnesium is the third most common intracellular ion after potassium and calcium and is an important element in the functions of the body, since it participates in more than 300 enzyme systems. It also, plays a significant role in the transport of calcium and potassium across the cell membranes and protects against cardiac arrhythmias and is useful for their treatment due to hypomagnesemia induced from the proton pump inhibitors (PPIs). Areas covered: PPIs are used for the treatment of peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD), but have been associated with hypomagnesemia with serious cardiac arrhythmias including torsades de pointes (TdP). To better understand the magnitude of this problem, a Medline search of the English language literature was conducted from 2010 to 2018 and 35 papers with pertinent information were selected. Expert commentary: The review of these papers suggests that PPIs cause hypomagnesemia, which could be associated with serious cardiac arrhythmias including TdP. However, its incidence is not very common considering the millions of people taking PPIs, but the FDA has advised the physicians to be watchful about this serious adverse effect of PPIs and check the magnesium levels before initiation of PPI treatment.


Assuntos
Arritmias Cardíacas/induzido quimicamente , Magnésio/sangue , Inibidores da Bomba de Prótons/efeitos adversos , Cálcio/metabolismo , Humanos , Torsades de Pointes/induzido quimicamente
19.
J Ayub Med Coll Abbottabad ; 31(2): 226-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31094121

RESUMO

BACKGROUND: Magnesium serves as a cofactor for various oxidation reactions in the body and helps in glucose transport across cell membrane. Deficiency of magnesium is a common electrolyte abnormality in type 2 diabetic patients and is linked to development of various diabetic complications. This study was conducted to determine the association between low serum magnesium level and type 2 diabetes mellitus presenting at Medical B ward, BBS Hospital Abbottabad. METHODS: This descriptive study was conducted over a period of 6 months starting July 1, 2017. One hundred & eighty diagnosed diabetic patients aged at least 40 years, were included in the study. Their serum magnesium level was checked after withdrawing blood under strict aseptic conditions. Fasting & random blood glucose and the level of glycosylated haemoglobin were measured and age, gender, duration of illness were recorded on a proforma. RESULTS: Sixty-one patients (33.89%) had hypomagnesemia. There was no significant association between hypomagnesemia and age and sex of patients (p>0.05). However, hypomagnesemia was found to be significantly associated with the duration of diabetes mellitus among study population (p=0.02). CONCLUSIONS: Hypomagnesemia is frequently present in patients with diabetes mellitus and it appears that its prevalence increases with the duration of diabetes mellitus.


Assuntos
Diabetes Mellitus Tipo 2 , Deficiência de Magnésio , Magnésio/sangue , Adulto , Glicemia/análise , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Masculino , Paquistão/epidemiologia
20.
Wei Sheng Yan Jiu ; 48(2): 238-243, 2019 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-31133101

RESUMO

OBJECTIVE: To investigate the distribution and changes of blood copper, zinc, calcium, magnesium and iron in Chinese rural children aged 6 to 12 years in 2002 and 2012. METHODS: A total of 3420 blood samples were randomly selected from the China Nutrition and Health Survey 2002 and 2012. Metal concentrations in whole blood were determined by inductively coupled mass spectrometry(ICP-MS) after the dilution of 0. 5%(V/V) HNO_3 and 0. 05%(V/V) Triton-X-100. The changes between 2002 and 2012 of blood five elements concentration in children of 6-12 years in rural China were compared. RESULTS: The median of blood levels of copper, zinc, calcium, magnesium and iron in 2002 were 1. 02(95% CI 0. 79-1. 32), 4. 88(95% CI 3. 17-6. 77), 58. 59(95% CI 44. 97-74. 24), 41. 56(95% CI 33. 01-52. 28) and 423. 21(95% CI 338. 83-540. 69) mg/L, respectively. And in 2012, the median values were 1. 00(95% CI 0. 75-1. 31), 5. 12(95% CI 3. 17-7. 37), 63. 36(95% CI 41. 14-79. 16), 41. 78(95% CI 30. 89-52. 53) and 422. 06(95% CI 297. 83-522. 56) mg/L, respectively. There were significant differences in blood copper, zinc, calcium and iron levels in general, gender and age. There were also significant area differences in the distribution of copper, zinc, calcium, magnesium and iron, but the changes were opposite. CONCLUSION: In 2002 and 2012, there were differences in the blood distribution of Cu, Zn, Ca, Mg and Fe of children aged 6-12 in rural China in terms of general, gender, age and area.


Assuntos
Cálcio/sangue , Cobre/sangue , Ferro/sangue , Magnésio/sangue , Zinco/sangue , Criança , China , Feminino , Hemoglobinas/metabolismo , Humanos , Masculino , Espectrofotometria Atômica , Oligoelementos
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