Association of serum magnesium and distal symmetric peripheral neuropathy among Filipino patients with Type 2 Diabetes Mellitus

Objective@#This study aims to determine the association of serum magnesium with distal symmetric peripheral neuropathy among persons with type 2 diabetes mellitus (DM).@*Methodology@#A cross-sectional analytical study among adult Filipinos with Type 2 DM. Logistic regression was used to determine the association of serum magnesium with DSPN diagnosed by the Michigan Neuropathy Screening Instrument. The null hypothesis was rejected at 0.05α-level of significance.@*Results@#The average serum magnesium levels were similar between those with versus without DSPN (2.06 ± 0.32 vs 2.05 ± 0.23, p = 0.873); the same was seen for corrected magnesium. There is insufficient evidence to demonstrate a significant statistical difference between those with and without DSPN in relation to glycemic control (HbA1c and FBS). Likewise, there is no significant statistical correlation between serum magnesium levels with HbA1c, FBS, BMI, or duration of diabetes.@*Conclusion@#This present study could not demonstrate any association between DSPN and serum magnesium, even after adjusting for age, sex, and comorbidity.

Magnesium promotes vascularization and osseointegration in diabetic states / 国际口腔科学杂志·英文版

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues. Magnesium has been proved to promote bone healing under normal conditions. Here, we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status. We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised, with significantly decreased angiogenesis. We then developed Mg-coating implants with hydrothermal synthesis. These implants successfully improved the vascularization and osseointegration in diabetic status. Mechanically, Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1 (Keap1) and the nucleation of nuclear factor erythroid 2-related factor 2 (Nrf2) by up-regulating the expression of sestrin 2 (SESN2) in endothelial cells, thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia. Altogether, our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.

The effects of magnesium sulfate added to epidurally administered local anesthetic on postoperative pain: a systematic review

Abstract Background This study evaluated the efficacy of epidurally administered magnesium associated with local anesthetics on postoperative pain control. Methods The study protocol was registered in PROSPERO as CRD42021231910. Literature searches were conducted on Medline, Cochrane, EMBASE, CENTRAL, and Web of Science for randomized controlled trials comparing epidural administration of magnesium added to local anesthetics for postoperative pain in elective surgical adult patients. Primary outcomes were the time to the first Postoperative (PO) Analgesic Request (TFAR), 24-hour postoperative opioid consumption, and Visual Analog Scale (VAS) scores at the first six and 24 postoperative hours. Secondary outcomes included Postoperative Nausea and Vomiting (PONV), pruritus, and shivering. Quality of evidence was assessed using GRADE criteria. Results Seventeen studies comparing epidural were included. Effect estimates are described as weighted Mean Differences (MD) and 95% Confidence Intervals (95% CI) for the main outcomes: TFAR (MD = 72.4 min; 95% CI = 10.22-134.58 min; p < 0.001; I2= 99.8%; GRADE: very low); opioid consumption (MD = -7.2 mg (95% CI = -9.30 - -5.09; p < 0.001; I2= 98%; GRADE: very low). VAS pain scores within the first six PO hours (VAS) (MD = -1.01 cm; 95% CI = -1.40-0.64 cm; p < 0.001; I2= 88%; GRADE: very low), at 24 hours (MD = -0.56 cm; 95% CI = -1.14-0.01 cm; p= 0.05; I2= 97%; GRADE: very low). Conclusions Magnesium sulfate delayed TFAR and decreased 24-hour opioid consumption and early postoperative pain intensity. However, imprecision and inconsistency pervaded meta-analyses, causing very low certainty of effect estimates.

Prevalence of inadequacy and associated indicators with mineral intake in Brazilian adolescents and young adults / Prevalência de inadequação e fatores associados à ingestão adequada de minerais em adolescentes e adultos jovens brasileiros

ABSTRACT Objective To describe the prevalence of inadequate mineral intake and associated factors with calcium, iron, zinc, magnesium, phosphorus, and sodium intakes in individuals aged 15-24.9 years. Methods We analyzed 476 individuals from the Brazilian Study of Nutrition and Health, stratified into two age groups (adolescents aged 15-18.9 years and young adults aged 19-24.9 years). Mineral intake was obtained from two 24-hour Dietary Recalls. The values of the Estimated Average Requirement and the Tolerable Upper Intake Levels were considered to calculate the prevalence of inadequacy. Multiple logistic regression was used to determine associated factors with mineral intake. Results Calcium and magnesium had the highest prevalence of inadequacy (>83%) in both sexes and age groups. Sodium intake was above Tolerable Upper Intake Levels for the majority of the population studied (>68%). The intake of all minerals was different between the sexes for the two age groups (p<0.01), and it was not different between age groups (p>0.05). The associated factors with mineral intake were sex (calcium, iron, phosphorus, and sodium), age group (calcium, magnesium, phosphorus, and sodium), and physical activity (calcium, iron, and magnesium), followed by socioeconomic level (zinc and sodium) and body weight status (iron and sodium). Conclusion The expressive portion of the studied population is at nutritional risk for calcium, magnesium, and sodium. Such data can contribute to the national public policy revision that is related to micronutrient intake and the adoption of healthier habits by adolescents and young adults.

RESUMO Objetivo Descrever as prevalências de inadequação e fatores associados à ingestão de cálcio, ferro, zinco, magnésio, fósforo e sódio em indivíduos dos 15 aos 24,9 anos. Métodos Foram analisados 476 indivíduos do Estudo Brasileiro de Nutrição e Saúde, estratificados em dois grupos etários (adolescentes de 15-18,9 anos e adultos jovens de 19-24,9 anos). A ingestão de minerais foi obtida por meio de dois recordatórios de 24hs. Os valores de Requerimento Médio Estimado e do Limite Superior Tolerável de Ingestão foram considerados para calcular as prevalências de inadequação. Regressão logística múltipla foi utilizada para determinar os fatores associados à ingestão de minerais. Resultados Cálcio e magnésio tiveram elevadas prevalências de inadequação (>83%) em pacientes de ambos os sexos e grupos etários. A ingestão de sódio foi acima Limite Superior Tolerável de Ingestão para a maioria da população estudada (>68%). O consumo de todos os minerais foi diferente entre os sexos para os dois grupos etários (p<0,01) e não foi diferente entre os grupos etários (p>0,05). Os fatores associados à ingestão dos minerais foram sexo (cálcio, ferro, fósforo e sódio), grupo etário (cálcio, magnésio, fósforo e sódio) e atividade física (cálcio, ferro e magnésio), seguidos por nível socioeconômico (zinco e sódio) e estado de peso corporal (ferro e sódio). Conclusão Expressiva parcela da população estudada encontra-se em risco nutricional para cálcio, magnésio e sódio. Esses dados podem contribuir para a revisão de políticas públicas nacionais que se relacionam à ingestão de micronutrientes e à adoção de hábitos mais saudáveis pelos adolescentes e adultos jovens.

Analysis of CNNM2 gene variant in a child with Hypomagnesemia, seizures, and mental retardation syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic etiology of a child with Hypomagnesemia, epilepsy and mental retardation syndrome (HSMR).@*METHODS@#A child who was admitted to the Children's Hospital of Shandong University on July 9, 2021 due to repeated convulsions for 2 months was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and his pedigree members were collected for the extraction of genomic DNA. Whole exome sequencing was carried out, and candidate variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The child, a 1-year-and-7-month-old male, had presented with epilepsy and global developmental delay. Serological testing revealed that he has low serum magnesium. Genetic testing showed that the child has harbored a heterozygous c.1448delT (p.Val483GlyfsTer29) variant of the CNNM2 gene, which was de novo in origin. The variant has caused substitution of the Valine at position 483 by Glycine and formation of a termination codon after 29 amino acids at downstream. As predicted by Swiss-Model online software, the variant may alter the protein structure, resulting in a truncation. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.1448delT (p.Val483GlyfsTer29) was predicted as a pathogenic variant (PVS1+PS2+PM2_Supporting+PP4).@*CONCLUSION@#The heterozygous c.1448delT variant of the CNNM2 gene probably underlay the HSMR in this child. Above finding has enriched the phenotype-genotype spectrum of the CNNM2 gene.

Absorción mineral y retención ósea en ratas normales en crecimiento por el consumo de un yogur experimental reducido en lactosa que contiene galactooligosacáridos (GOS) / Mineral absorption and bone retention in normal growing rats by consumption of an experimental lactose-reduced yogurt containing galactooligosaccharides (GOS)

Introducción: Los GOS son prebióticos naturales presentes en la leche materna que pue-den obtenerse enzimáticamente a partir de la lactosa de leche de vaca durante la fabricación de yogur. El producto lácteo resultante será reducido en lactosa y contendrá prebióticos y bacterias potencialmente probióticas. Sin embargo, mantendrá la baja relación Ca/Pi que aporta la leche de vaca, lo que podría alterar el remodelamiento óseo y la mineralización. Objetivo: comparar si un yogur reducido en lactosa que contiene GOS (YE) ofrece ventajas adicionales respecto de un yogur regular sin GOS (YR) sobre las absorciones (Abs) de Ca y Pi, retención y calidad ósea durante el crecimiento normal. Al destete, ratas machos fueron divididas en 3 grupos alimentados con AIN ́93-G (C), YE o YR durante 28 días. Resultados: YE mostró el mayor aumento de lactobacilos fecales; producción de ácidos grasos de cadena corta especialmente p, profundidad de las criptas colónicas y menor pH cecal. El %AbsCa y %AbsPi aumentó en el siguiente órden: YE> YR> C (p < 0,05). El contenido de Ca y Pi en fémur, la densidad y contenido mineral óseos y los parámetros biomecánicos fueron similares en YE y C, mientras que YR mostró valores significativa-mente menores (p < 0,05). Conclusiones: YE aumentó las Abs y biodisponibilidad de minerales, alcanzando la retención y calidad ósea de C. El aumento en las Abs observado en YR no logró obtener la retención y calidad ósea de C. Conclusión: YE habría contrarrestado el efecto negativo del mayor aporte de Pi de la leche de vaca y sería una buena estrategia para lograr el pico de masa ósea y calidad del hueso adecuados, especialmente en individuos intolerantes a la lactosa. (AU)

Breast milk contains an optimal calcium/phosphate (Ca/Pi) ratio and GOS. These natural prebiotics can be enzymatically produced via cow's milk lactose inyogurt manufacture. This milk product is low in lactose and contains prebiotics and potentially probiotic bacteria but maintains a low Ca/Pi ratio that could alter bone remodeling and mineralization. We evaluated if a lactose-reduced yogurt containing GOS (YE) offers additional advantages over regular yogurt without GOS (YR) on Ca and Pi absorption (Abs), bone retention and quality during normal growth. Weaning male rats were divided into 3 groups fed AIN'93-G (C), YE or YR for 28 days. Results: YE showed the highest increase in fecal lactobacilli; short-chain fatty acids production, especially propionate and butyrate; intestine crypt depth, and the lowest cecal pH. AbsCa% and AbsPi% increased in this order: YE> YR> C (p <0.05). Ca and Pi content in femur, bone density and mineral content, and biomechanical parameters were similar in YE and C, while YR showed the significantly lowest value (p < 0.05). Conclusions: YE increased mineral Abs reaching the retention and bone quality of C. Although YR increased Abs, bone retention and quality did not achieve C values. Seemingly, YE compensated for the negative effect of the higher Pi supply and would be a good strategy to achieve adequate peak bone mass and bone quality, especially in lactose intolerant individuals. (AU)

Alergia a frutos do mar: principais desafios na alimentação e soluções desenvolvidas por alunos do curso de nutrição e gastronomia / Seafood allergy: main challenges in their diet and solutions developed by students of the nutrition and gastronomy course

A alergia alimentar caracteriza-se por uma reação adversa a um determinado alimento, envolvendo um mecanismo imunológico. Uma das alergias mais comuns encontradas atualmente é a alergia a frutos do mar, a qual se baseia em uma hipersensibilidade a animais desse grupo. O objetivo desta pesquisa é identificar os desafios expostos na alimentação de alérgicos a frutos do mar e formular soluções para essa população baseadas em alimentos nutricionalmente substitutos. Sendo realizado em três etapas: investigação inicial, construção de conceitos e planejamento de uma ação com orientações nutricionais. De acordo com as dificuldades encontradas na alimentação dessa parcela populacional, realizaram-se diferentes preparações, com nutrientes como ômega-3, proteínas, vitaminas do complexo B, zinco, ferro, potássio, magnésio, iodo e selênio, os quais também são encontrados nos frutos do mar, a fim de evitar possíveis contaminações cruzadas e garantir seu aporte nutricional em alimentos substitutos. Foi possível concluir que os alérgicos aos frutos do mar não apresentam uma interferência significativa em sua qualidade de vida, tendo um impacto nutricional pequeno, visto que por meio da alimentação existem outras fontes, necessitando somente de alguns cuidados no dia a dia em virtude das consequências de uma possível contaminação.

Food allergy is characterized by an adverse reaction to a given food, involving an immunological mechanism. One of the most common allergies currently found is seafood allergy, which is based on hypersensitivity to animals in this group. The objective of this research is to identify the challenges exposed in the feeding of seafood allergies and formulate solutions for this population based on nutritionally substitute foods. Being carried out in 3 stages, initial investigation, construction of concepts and planning of an action with nutritional guidance. According to the difficulties encountered in feeding this portion of the population, different preparations were carried out, with nutrients such as: ômega-3, proteins, B vitamins, zinc, iron, potassium, magnesium, iodine and selenium. Which are also found in seafood. In order to avoid possible cross-contamination and ensure their nutritional intake in substitute foods. It was possible to conclude that seafood allergies do not present a significant interference in their quality of life, having a small nutritional impact, since through food there are other sources, requiring only some care on a daily basis due to the consequences of possible contamination.

Effects of magnesium supply level on growth, nutrient element absorption and distribution, and quality of Panax quinquefolium / 中国中药杂志

This study aims to investigate the effects of different magnesium supply levels on the growth, nutrient absorption and distribution, and quality of Panax quinquefolium, and to determine the optimum content of exchangeable magnesium in soil. Three-year-old plants of P. quinquefolium were used in this study, and eight magnesium supply gradients(CK, Mg1-Mg7) were designed for indoor pot experiment(cultivation in soil). The plant growth indexes, nutrient element content in soil and plant, and root saponin content were determined at the end of the growth period. The correlation analysis of nutrient element content in aboveground and underground parts of P. quinquefolium showed significantly negative correlations of magnesium-calcium, magnesium-potassium, and magne-sium-manganese. With the increase in magnesium supply level, the biological absorption coefficient of magnesium increased, while that of total nitrogen, potassium, iron, and manganese decreased; the biological transfer coefficient of magnesium decreased, while that of nitrogen, phosphorus, calcium, iron, and manganese increased. The saponin content was analyzed by principal component analysis, which showed the comprehensive score in the order of Mg4(2.537), Mg2(1.001), Mg3(0.600), Mg1(0), Mg7(-0.765), CK(-0.825), Mg6(-0.922), and Mg5(-1.663). The partial least squares-path modeling(PLS-PM) showed that the correlation coefficients of exchangeable magnesium and pH with quality were-0.748 and-0.755, respectively, which were significant. Magnesium-calcium, magnesium-potassium, and magnesium-manganese showed antagonism in the nutritional physiology of P. quinquefolium. Excessive application of magnesium can lead to the imbalance of nutrient elements in P. quinquefolium. The content of exchangeable magnesium in soil suitable for the quality formation of P. quinquefolium was 193.34-293.34 mg·kg~(-1). In addition to exchangeable magnesium, pH was also important to the quality formation of P. quinquefolium. Therefore, exchangeable magnesium and pH could be regarded as monitoring factors for the quality formation of P. quinquefolium.

Magnesio e indicadores bioquímicos óseo-minerales según tasa de filtración glomerular en estudiantes sin enfermedad renal / Magnesium and osseous-mineral biochemical indicators according to glomerular filtration rate testing in students without kidney disease

Introducción: La variación del magnesio y de indicadores bioquímicos del metabolismo óseo-mineral según la tasa de filtración glomerular en jóvenes sin enfermedad renal es poco conocida por lo que es necesario considerarla para delimitar lo no atribuible a enfermedad renal crónica. El papel que desempeña el magnesio está en estudio. En la enfermedad renal crónica hay una alteración progresiva del metabolismo óseo-mineral que comienza tempranamente. Objetivos: Evaluar valores séricos de magnesio, calcio, fósforo, fosfatasa alcalina y parathormona, excreciones urinarias de 24 h y excreción fraccional de estos electrolitos según categoría G de tasa de filtración glomerular estimada por clearance de creatinina: G1 (normal a alta) y G2 (levemente disminuida) en estudiantes sin enfermedad renal crónica. Material y métodos: Estudio analítico y corte transversal con una muestra de 55 estudiantes voluntarios sin enfermedad renal en el periodo 2018 a 2019. Los analitos se determinaron en suero y algunos en orina de 24 h. Resultados: Solamente magnesio sérico y excreción fraccional de magnesio excreción fraccional de magnesio mostraron diferencias significativas según la categoría G (p < 0,05). Los valores de magnesio sérico magnesio sérico estuvieron dentro de los valores de referencia para el método. En G2, magnesio sérico, descendido respecto a G1 y excreción fraccional de magnesio aumentada, inversamente relacionados. El magnesio sérico disminuyó en promedio 0,26 mg/dL por unidad de aumento de excreción fraccional de magnesio (p = 0,0502). Conclusiones: Se observaron diferencias en magnesio sérico y excreción fraccional de magnesio al comparar los resultados en G1 y G2. Los demás indicadores bioquímicos estudiados no mostraron diferencias por categoría G. Diseños de corte longitudinal en muestras mayores pueden confirmar o no estos hallazgos. Tales estudios pueden aportar a la comprensión de cambios bioquímicos del metabolismo óseo-mineral en etapas iniciales de disminución de la tasa de filtración glomerular(AU)

Introduction: Not much is known about the variation in magnesium and biochemical indicators of the osseous-mineral metabolism according to glomerular filtration rate testing in young people without kidney disease. This variation should therefore be considered to delimit whatever is not attributable to chronic kidney disease. The role played by magnesium is currently under study. In chronic kidney disease a progressive alteration of the osseous-mineral metabolism starts early. Objectives: Evaluate serum values of magnesium, calcium, phosphorus, alkaline phosphatase and parathormone, 24-hour urinary excretion and fractional excretion of these electrolytes according to category G of the glomerular filtration rate estimated by creatinine clearance: G1 (normal to high) and G2 (slightly reduced) in students without chronic kidney disease. Methods: An analytical cross-sectional study was conducted of a sample of 55 student volunteers without kidney disease in the period 2018-2019. The analytes were determined in serum and some in 24-hour urine. Results: Only serum magnesium and magnesium fractional excretion displayed significant differences according to category G (p < 0.05). Serum magnesium values were within the reference values for the method. In G2, serum magnesium was lower than in G1, whereas magnesium fractional excretion was higher, i.e. an inverse relation is observed. Serum magnesium reduction averaged 0.26 mg/dl per unit of magnesium fractional excretion increase (p = 0.0502). Conclusions: Comparison of G1 and G2 results revealed differences in serum magnesium and magnesium fractional excretion. The remaining biochemical indicators studied did not show any differences in category G. Longitudinal studies with larger samples may or may not confirm these findings, thus contributing to a better understanding of the biochemical changes in osseous-mineral metabolism occurring in the initial stages of glomerular filtration rate reduction(AU)

Insuficiencia respiratoria asociada con la hipomagnesemia extrema en un paciente con colitis ulcerativa. Reporte de caso y revisión de la literatura / Ventilatory failure associated with extreme hypomagnesemia in a patient with ulcerative colitis: case report and literatura review

RESUMEN La hipomagnesemia es un trastorno electrolítico asociado con la disminución de los aportes nutricionales, las pérdidas gastrointestinales y la depuración renal del magnesio, un catión divalente que, al tener una mayor concentración a nivel intracelular, dificulta el análisis de su déficit absoluto y el establecimiento de una adecuada corrección que supla las pérdidas y los requerimientos diarios que son aproximadamente 360 mg por día. Es por esto que el conocimiento de las etiologías de la hipomagnesemia, al igual que el cálculo de la fracción excretada de magnesio y la medición de la magnesiuria en 24 horas, son herramientas útiles para establecer pautas adecuadas de corrección continua de magnesio con el fin de evitar las complicaciones asociadas con su toxicidad o una corrección deficiente que perpetúe dicho trastorno electrolítico, lo cual puede generar una sintomatología tan grave como la tetania o la insuficiencia respiratoria. La paciente descrita, en ausencia de estado de choque o trastorno ácido base, requirió ingreso a la unidad de cuidados intensivos para ventilación mecánica invasiva y corrección de sus trastornos electrolíticos asociados con la colitis ulcerativa (hipocalcemia, hipocalemia e hipomagnesemia).

SUMMARY Hypomagnesemia is an electrolyte disorder associated with decreased nutritional intake, gastrointestinal losses, and renal clearance of magnesium, a divalent cation that, having a higher concentration at the intracellular level, makes it difficult to analyze its absolute deficit and establish an adequate correction that supplies daily losses and requirements; For this reason, knowledge of the etiologies of hypomagnesemia, as well as the calculation of the excreted fraction of magnesium and measurement of magnesiuria in 24 hours, are useful tools to establish adequate guidelines for continuous magnesium correction, in order to avoid complications associated with its toxicity or poor correction that perpetuates this electrolyte disorder, and generates the appearance of symptoms as severe as tetany and ventilatory failure. These severe manifestations were present in the patient described, who, in the absence of shock or base acid disorder, required admission to the intensive care unit for invasive mechanical ventilation and correction of their electrolyte disorders associated with ulcerative colitis (hypocalcemia, hypokalemia, and hypomagnesemia).

Excess Calcium, Magnesium and Phosphorus Deposition in the Epigastric Artery of Dialysis Patients Undergoing Renal Transplantation

ABSTRACT Objective: Vascular calcification contributes to cardiovascular disease on dialysis patients. Arterial mineral content is modified but not well defined. We aim to define what is the concentration of calcium, magnesium and phosphorus in the epigastric artery of adult dialysis patients undergoing renal transplantation. Methods: All renal allograft recipients who underwent surgery at our centre between May 2003 and December 2005 and consented to be taken small samples of epigastric artery were included in our cross-sectional study. Histological, radiological and spectrometric methods were used to measure vascular calcification, deposits and concentrations of calcium, phosphorus and magnesium in epigastric artery, which were correlated with clinical and biochemical characteristics. Mineral vascular content was compared with corresponding samples from cadaveric renal donors free from renal disease (control group). Results: Calcium and magnesium concentrations in epigastric artery were much higher in recipients (n = 100) than in donors (n = 30). Histologically confirmed calcifications were more frequent in recipients. Calcium and magnesium content in epigastric artery were correlated directly with recipient age, pre-transplant serum P and Ca × P product. A high content of calcium and magnesium in this artery was observed in recipients with media and intimal calcification. Multivariate logistic regression showed that dialysis vintage > 3.5 years and calcium concentration in epigastric artery ≥ 4500 mg/kg wet weight were independent predictors of histological calcification. Conclusion: Excess mineral deposition is observed in the epigastric artery of dialysis patients, where the recipient's age, serum P, Ca × P product and time on dialysis play a decisive role.

Serum Magnesium and High-sensitive C-reactive Proteins in Hypertensive, Obese Female School Learners

ABSTRACT Objective: To examine the relationship of serum magnesium and high-sensitive C-reactive proteins (hsCRPs) with overweight/obesity, and its association with hypertension in lean versus overweight/obese (O/O), female, adolescent school learners living in Mthatha, Eastern Cape, South Africa. Methods: A case-control study was conducted involving age-matched, non-pregnant and nonlactating lean and O/O females aged 13-17 years. Relevant data on demography, anthropometry (height, weight, and waist and hip circumferences), blood pressure and venous blood samples were collected. Results: A significant inverse correlation was observed between serum magnesium and waist circumference (WC) (r = −0.3153; 95% CI = −3.843, −0.8681; p = 0.0022). Serum hsCRP levels were significantly higher in O/O participants. Participants with a WC > 80 cm had significantly higher mean systolic blood pressure and mean diastolic blood pressure (MDBP). A hip circumference (HC) > 94 cm was associated with higher mean systolic blood pressure (MSBP) and MDBP (120 ± 2 vs 113 ± 2, p = 0.009 and 73 ± 2 vs 68 ± 1, p = 0.003). Both WC and HC were found to be positively correlated with both MSBP (r = 0.2691; 95% CI = 0.042, 0.457; p = 0.018 and r = 0.2758; 95% CI = 0.03184, 0.3001; p = 0.0159) and MDBP (r = 0.2686; 95% CI = 0.0286, 0.320; p = 0.19 and r = 0.2836; 95% CI = 0.05382, 0.4455; p = 0.013), respectively. Conclusion: In our study, low-grade inflammation and early-onset hypertension in O/O adolescent females were consistent with evidence that support the beneficial effect of maintaining lean body habitus. There is an urgent need to prevent overweight/obesity among adolescents.

Biological behavior of magnesium-substituted hydroxyapatite during bone repair / Comportamento biológico de hidroxiapatita substituída com magnésio durante o reparo ósseo

Abstract The aim of this study was to analyze the biological behavior and osteogenic potential of magnesium (Mg) substituted hydroxyapatite (HA) microspheres, implanted in a critical bone defect, considering that this ion is of great clinical interest, since it is closely associated with homeostasis and bone mineralization. For the purpose of this study, 30 rats were used to compose three experimental groups: GI - bone defect filled with HA microspheres; GII - bone defect filled with HA microspheres replaced with Mg; GIII - empty bone defect; evaluated at biological points of 15 and 45 days. The histological results, at 15 days, showed, in all the groups, a discrete chronic inflammatory infiltrate; biomaterials intact and surrounded by connective tissue; and bone neoformation restricted to the borders. At 45 days, in the GI and GII groups, an inflammatory response of discrete granulomatous chronic type was observed, and in the GIII there was a scarce presence of mononuclear inflammatory cells; in GI and GII, the microspheres were seen to be either intact or fragmented, surrounded by fibrous connective tissue rich in blood vessels; and discrete bone neoformation near the edges and surrounding some microspheres. In GIII, the mineralization was limited to the borders and the remaining area was filled by fibrous connective tissue. It was concluded that the biomaterials were biocompatible and osteoconductive, and the percentage of Mg used as replacement ion in the HA did not favor a greater bone neoformation in relation to the HA without the metal.

Resumo O objetivo deste estudo foi analisar o comportamento biológico de microesferas de hidroxiapatita (HA) substituída com magnésio (Mg) durante o reparo de defeito ósseo crítico, tendo em vista que este íon é de grande interesse clínico, pois está intimamente associado à homeostasia e à mineralização óssea. Para tanto, utilizou-se 30 ratos para compor três grupos experimentais: GI - defeito ósseo preenchido com microesferas de HA; GII - defeito ósseo preenchido com microesferas de HA substituída com Mg; GIII (controle) - defeito ósseo vazio; avaliados nos pontos biológicos de 15 e 45 dias. Os resultados histológicos evidenciaram, aos 15 dias, discreto infiltrado inflamatório crônico e neoformação óssea restrita às bordas, em todos os grupos. Nos grupos GI e GII, os biomateriais mantiveram-se íntegros e circundados por tecido conjuntivo frouxo. Aos 45 dias, notou-se resposta inflamatória do tipo crônica granulomatosa discreta nos grupos GI e GII, e no GIII presença escassa de células inflamatórias mononucleares. As microesferas implantadas no GI e GII mantiveram-se, em sua maioria, íntegras e envolvidas por tecido conjuntivo fibroso. Notou-se discreta neoformação óssea próxima às bordas e circunjacente a algumas microesferas. No GIII, a mineralização limitou-se às bordas e a área remanescente foi preenchida por tecido conjuntivo fibroso. Conclui-se que os biomateriais foram biocompatíveis, bioativos, osteocondutores e apresentaram biodegradação lenta, indicando seu grande potencial para em aplicações clínica como biomaterial de preenchimento.

Hypomagnesemia in beef cattle / Hipomagnesemia em bovinos de corte

Hypomagnesemia is a major cause of death in grazing beef cows in countries of the Southern Hemisphere such as Argentina, Australia and New Zealand. Here we review the literature on hypomagnesemia in beef cattle and describe an outbreak in Uruguay. The disease occurred in late autumn, affecting 6 to 11-year-old Aberdeen Angus and Hereford x Aberdeen Angus lactating multiparous cows in good body condition, grazing on natural grasslands that had been improved by fertilization and sowing of seeds of ryegrass and oat. Approximately 40 out of 225 cows were affected and 24 (10.7%) died. A presumptive diagnosis of hypomagnesemia was established based on sudden death, acute neuromuscular clinical signs, epidemiological data, and the response to Mg administration. The diagnosis was confirmed by detecting low Mg concentrations in serum (0.47-0.57mmol/L), vitreous humor (0.47-0.80mmol/L), aqueous humor (0.66mmol/L) and cerebrospinal fluid (0.59mmol/L). The largest component of the diet corresponding to fast-growing and exuberant forages of ryegrass and oat had high concentrations of K (3.48%), N (4.38%) and P (0.94%), suggesting secondary hypomagnesemia. In addition, the K/(Ca+Mg) ratio was 2.38 in forages of ryegrass and oat (reference value: 2.2), and 0.15 in the soil (reference value: 0.09), which represent risk factors for hypomagnesemia. In conclusion, hypomagnesemia is an important cause of mortality in beef cattle grazing improved natural grasslands in Uruguay and it can be easily prevented by correct seasonal Mg supplementation.(AU)

A hipomagnesemia é uma das principais causas de morte em vacas de corte em pastagem em países do Hemisfério Sul, como Argentina, Austrália e Nova Zelândia. Aqui, revisamos a literatura sobre hipomagnesemia em bovinos de corte e descrevemos um surto no Uruguai. A doença ocorreu no final do outono, afetando vacas Aberdeen Angus e Aberdeen Angus x Hereford de 6-11 anos de idade em boas condições corporais, lactantes, multíparas e pastando em campos naturais que foram melhorados com fertilização e plantio de azevém e aveia. Aproximadamente 40 de 225 vacas foram afetadas e 24 (10,7%) morreram. O diagnóstico presuntivo de hipomagnesemia foi estabelecido com base na morte súbita, sinais clínicos neuromusculares agudos, dados epidemiológicos e a resposta à administração de Mg. O diagnóstico foi confirmado pela detecção de baixos níveis de Mg no soro (0,47-0,57mmol/L), humor vítreo (0,47-0,80mmol/L), humor aquoso (0,66mmol/L) e líquido cefalorraquidiano (0,59mmol/L). O componente mais importante da dieta correspondia a pastagens de azevém e aveia de rápido crescimento, as quais apresentaram altas concentrações de K (3,48%), N (4,38%) e P (0,94%), que sugerem hipomagnesemia secundária. Além disso, a relação K/(Ca+Mg) foi de 2,38 em forragens de azevém e aveia (valor de referência: 2,2) e 0,15 no solo (valor de referência: 0,09), que representam fatores de risco para hipomagnesemia. Em conclusão, a hipomagnesemia é uma causa importante de mortalidade em gado de corte em pastagens naturais melhoradas no Uruguai e pode ser facilmente prevenida pela correta suplementação sazonal de Mg.(AU)

Vitamina D, magnesio y parámetros seleccionados de laboratorio en hombres uruguayos / Vitamin D, magnesium, and selected laboratory parameters in Uruguayan men / Vitamina D, magnésio e parâmetros selecionados de laboratório em homens uruguaios

Resumen: Introducción: los niveles de vitamina D (VD) plasmática se han investigado sobre todo en mujeres, no obstante también son relevantes en hombres, y no sólo en relación al estado de salud ósea. Un estudio previo realizado hace dos décadas en una pequeña muestra de hombres y mujeres uruguayos reveló serias deficiencias de VD. Por otra parte, el magnesio posee importantes efectos no solo relacionados a los niveles de VD, también afecta el hueso directa e indirectamente. Objetivos: analizar posibles interrelaciones entre valores de VD plasmática, testosterona plasmática, densitometría ósea, y otros parámetros en una población de jóvenes varones uruguayos. Métodos: durante julio-agosto de 2015, cien hombres uruguayos afiliados al sistema prepago de salud fueron invitados a participar en nuestra Unidad de Metabolismo Fosfocálcico, para ser estudiados con técnicas de antropometría, laboratorio y densitométricas. Los datos colectados fueron analizados estadísticamente. Resultados: los hombres estudiados mostraron bajos niveles de VD plasmática (96% insuficientes-deficientes), que no mostraron correlaciones significativas con ninguno de los parámetros estudiados. El magnesio plasmático se correlacionó significativa e inversamente con los z-scores densitométricos, lo que fue más intenso en hombres con sobrepeso y con VD ≥15 ng/ml. Conclusiones: a pesar de lo pequeño de la muestra, los resultados confirman la presencia de bajos niveles de VD en hombres aparentemente saludables. Los hallazgos dan razones para pensar en posibles recomendaciones para mejorar el espectro preventivo enfocado en osteoporosis y cáncer colorrectal.

Summary: Background: serum vitamin D (VD) levels have been mainly studied in women, but they are relevant also among men, not only regarding bone health status. A previous small-size study performed two decades ago in Uruguayan women and men revealed serious deficiencies of VD. On the other hand, magnesium has important effects not only related to vitamin D levels but directly and indirectly affect bone. Purpose: to analyze possible interrelationships among values of serum VD, magnesium, testosterone, bone densitometry and other parameters in young Uruguayan male population. Methods: during July-August 2015, one hundred Uruguayan men affiliated to the prepaid healthcare system, invited to participate by our Unit of Bone Metabolism, were studied with anthropometry, laboratory and, densitometry techniques. Collected data were statistically analyzed. Results: the studied men showed low serum VD levels (96% insufficient-deficient), which did not show significant correlations with any of the studied parameters. Serum magnesium was significantly and inversely correlated with densitometric z-scores, even stronger among men with overweight and with VD≥15 ng/ml. Conclusions: despite the sample size, results confirm the presence of low serum VD levels in apparently healthy men. Findings give reasons to think about possible recommendations to improve the preventive scope regarding osteoporosis and colorectal cancer.

Resumo: Introdução: os níveis plasmáticos de vitamina D (DV) têm sido investigados principalmente em mulheres, porém também são relevantes em homens, e não apenas em relação à saúde óssea. Um estudo anterior realizado há duas décadas em uma pequena amostra de homens e mulheres uruguaios revelou graves deficiências de VD. Por outro lado, o magnésio tem efeitos importantes não apenas relacionados aos níveis de VD, mas também afeta o osso direta e indiretamente. Objetivos: analisar as possíveis relações entre os valores plasmáticos de VD, testosterona plasmática, densitometria óssea e outros parâmetros em uma população de jovens uruguaios. Métodos: durante o período de julho a agosto de 2015, cem uruguaios filiados ao sistema de saúde pré-pago foram convidados a participar de nossa Unidade de Metabolismo Fosfocálcico, para serem estudados com técnicas antropométricas, laboratoriais e densitométricas. Os dados coletados foram analisados estatisticamente. Resultados: os homens estudados apresentaram baixos níveis de VD plasmático (96% insuficiente-deficiente), que não apresentou correlações significativas com nenhum dos parâmetros estudados. O magnésio plasmático foi significativa e inversamente correlacionado com os escores z densitométricos, que foi mais intenso em homens com sobrepeso e VR ≥15 ng / ml. Conclusões: porém, na pequena amostra, os resultados confirmam a presença de baixos níveis de VD em homens aparentemente saudáveis. Estes achados propõem pensar sobre possíveis recomendações para melhorar o espectro preventivo com foco na osteoporose e no câncer colorretal.

Consequências do Mercúrio na Saúde Humana e no Meio Ambiente / Consequences of Mercury on Health Human and Environment

Uma das coisas mais bonitas em nossa cultura Munduruku e que nos foi passada por nossos ancestrais é de que nós fazemos parte do mundo e o mundo faz parte de cada um de nós. Tudo foi criado a partir da voz mágica de Karusakaibo usando os corpos dos nossos parentes-seres para fazer nascer todos os nossos alimentos, nossos remédios, nossas curas, nossas sabedorias. Em contrapartida, nós temos que nos esforçar para cuidar do mundo que ele nos deixou e no qual ele continua atuando. Enquanto continuarmos cuidando deste mundo, estaremos honrando a criação e o esforço de nossos avós que sempre lutaram com grande força para nos deixar este mundo bonito. O que se quer dizer com este livro é que nós fazemos parte da natureza e que é importante conhecer para entender quem somos e o que somos. A vida do planeta é a nossa própria vida. Devemos conhecer o mundo que a gente vive e cuidar dele, protegê-lo, pois é tão importante para nós a beleza de tudo que se encontra no ambiente e que está ao nosso redor. O valor da vida é primordial. Essa leitura é para nossas crianças, jovens e adultos para que apreciem e aprendam como se relacionar de forma saudável com a natureza, a fim de que se encantem com o passeio pelo mundo em que vivemos. Assim, imaginar como funciona o meio ambiente, a natureza, o seu ecossistema, assimilando o nosso modo de viver e como tudo está relacionado à nossa volta. Procuramos proporcionar uma leitura fácil, utilizando linguagem simples e acessível para que todos possamos entender o ciclo da vida e como nós nos encaixamos nele. Para compreender melhor, será preciso entrar e caminhar através da leitura. Vamos nos conscientizar, imaginar, olhar com uma visão mais humana, quão rico é ter respeito pelo que temos, que é a terra, uma herança de nosso criador Karusakaibo que entregou em nossas mãos um presente valiosíssimo, tão precioso para cuidarmos com muito carinho. Então, cabe a nós preservar o nosso território para que não seja destruído por nossas ações e pelas ações de pessoas que não conseguem entender nosso modo de vida. Somos responsáveis por cuidar, mas também ensinar aos outros que somos partes do mundo e não seus donos. Desejamos que esta leitura possa lhes ensinar a cuidar do mundo cuidando de si mesmos e das pessoas com quem convivem. Este material é a forma de dizermos NÃO à invasão de nossos territórios e NÃO ao uso de agrotóxicos e mercúrio em nosso alimento e em nossas águas. É nosso jeito de dizer SIM ao respeito ao espírito da natureza e ao bem-estar das futuras gerações. Desejamos a todos uma boa leitura e que ela seja capaz de lembrar a cada um de vocês que cada coisa que está na natureza também está dentro de nós; que a natureza é cíclica e que nós também somos; que alterar o ciclo da natureza afeta a nossa própria vida e empobrece nossa cultura porque mexe com nosso alimento, nossas crenças e nosso espírito.

Urolithiasis and sleeve gastrectomy: a prospective assessment of urinary biochemical variables / Urolitíase e gastrectomia vertical: uma avaliação prospectiva das variáveis bioquímicas urinárias

ABSTRACT Introduction: to evaluate urinary biochemical alterations related to urolithogenesis processes after sleeve gastrectomy (SG). Materials and methods : prospective study with 32 individuals without previous diagnosis of urolithiasis who underwent SG. A 24-h urine test was collected seven days prior to surgery and at 6-month follow-up. The studied variables were urine volume, urinary pH, oxalate, calcium, citrate, and magnesium and calcium oxalate super saturation (CaOx SS). Results: patients were mainly women (81.2%), with mean age of 40.6 years. Mean pre- and postoperative BMI were 47.1 ± 8.3 Kg/m2 and 35.5 ± 6.1 Kg/m2, respectively (p<0.001). Urine volume was significantly lower at the postoperative evaluation in absolute values (2,242.50 ± 798.26 mL x 1,240.94 ± 352.39 mL, p<0.001) and adjusted to body weight (18.58 ± 6.92 mL/kg x 13.92 ± 4.65 mL/kg, p<0.001). CaOx SS increased significantly after SG (0.11 ± 0.10 x 0.24 ± 0.18, p<0.001). Moreover, uric acid levels were significantly lower at the postoperative evaluation (482.34 ± 195.80 mg x 434.75 ± 158.38 mg, p=0.027). Urinary pH, oxalate, calcium, citrate, and magnesium did not present significant variations between the pre- and postoperative periods. Conclusion: SG may lead to important alterations in the urinary profile. However, it occurs in a much milder way than that of RYGB.

RESUMO Introdução: avaliar as alterações bioquímicas urinárias relacionadas aos processos de litíase urinária após gastrectomia vertical (GV). Método: estudo prospectivo, com 32 indivíduos submetidos a GV, sem diagnóstico prévio de urolitíase. Foi coletada urina de 24 horas, sete dias antes da operação e no retorno de 6 meses. As variáveis estudadas foram volume de urina, pH urinário, oxalato, cálcio, citrato e super saturação de oxalato e cálcio (SS CaOx). Resultados: os pacientes foram em sua maioria mulheres (81,2%), com idade média de 40,6 anos. O IMC médio pré e pós-operatório foi 47,1 ± 8,3 Kg/m2 e 35,5 ± 6,1 Kg/m2, respectivamente (p<0,001). O volume de urina foi significativamente baixo na avaliação pós-operatória em valores absolutos (2.242,50 ± 798,26 mL versus 1.240,94 ± 352,39 mL, p<0,001) e ajustado ao peso corporal (18,58 ± 6,92 mL/kg versus 13,92 ± 4,65 mL/kg, p<0,001). A SS CaOx aumentou significativamente após a GV (0,11 ± 0,10 versus 0,24 ± 0,18, p<0,001). Além disso, os níveis de ácido úrico apresentaram-se significativamente baixos na avaliação pós-operatória (482,34 ± 195,80 mg versus 434,75 ± 158,38 mg, p=0,027). PH urinário, oxalato, cálcio, citrato e magnésio não apresentaram variações significativas entre os períodos pré e pós-operatório. Conclusão: a GV pode levar a alterações importantes no perfil urinário. Entretanto, essas ocorrem de forma muito mais leve que na derivação gástrica em Y de Roux.

Sulfato de magnésio: principais utilizações na obstetrícia contemporânea / Magnesium sulphate: main uses in contemporary obstetrics

O sulfato de magnésio tem sido utilizado em obstetrícia por décadas e milhares de mulheres já foram incluídas em ensaios clínicos que estudaram sua eficácia em uma variedade de condições gestacionais. Os principais usos do medicamento na atual prática obstétrica incluem prevenção e tratamento de convulsões eclâmpticas, prolongamento da gravidez para administração antenatal de corticosteroides e neuroproteção fetal na iminência de interrupção prematura da gravidez. Em função da alta qualidade e da consistência dos resultados de importantes ensaios clínicos, a indicação do sulfato de magnésio para profilaxia e terapia das convulsões eclâmpticas está bem estabelecida. Entretanto, tal unanimidade não ocorre com relação ao seu emprego como tocolítico, tanto pela discussão sobre sua efetividade quanto pelas doses mais altas usualmente utilizadas para esse fim. Em relação à importância do sulfato de magnésio como agente neuroprotetor fetal, a paralisia cerebral é a causa mais comum de deficiência motora na infância e tem como fator de risco mais importante a prematuridade, cuja incidência tem aumentado significativamente. Diretrizes nacionais e internacionais mais recentes, baseadas em resultados de ensaios clínicos randomizados e metanálises de boa qualidade, mostraram que a administração antenatal de sulfato de magnésio na iminência de parto pré-termo precoce é uma intervenção eficiente, viável, segura, com boa relação custo-benefício e pode contribuir para a melhoria dos desfechos neurológicos neonatais.

Magnesium sulfate has been used in obstetrics for decades and thousands of women have already been included in clinical trials that have studied its effectiveness in a variety of gestational conditions. The main uses of the drug in current obstetrical practice include prevention and treatment of eclamptic seizures, prolongation of pregnancy for antenatal administration of corticosteroids, and fetal neuroprotection in the imminence of premature termination of pregnancy. Because of the high quality and consistency of the results of important clinical trials, the indication of magnesium sulfate for prophylaxis and therapy of eclamptic seizures is well established. However, such unanimity does not occur regarding its use as tocolytic, either by the discussion of its effectiveness or by the higher doses usually used for this purpose. Regarding the importance of magnesium sulfate as a fetal neuroprotective agent, cerebral palsy is the most common cause of motor deficits in childhood and has a significantly higher incidence of prematurity as a major risk factor. More recent national and international guidelines, based on results from randomized controlled trials and good quality meta-analyzes, have shown that the antenatal administration of magnesium sulfate at the imminence of early preterm delivery is a cost-effective, viable, efficient intervention and safe and can contribute to the improvement of neonatal neurological outcomes.

Dosagem do magnésio eritrocitário: Qual é o seu real valor? / Measurement of erythrocyte magnesium: What is its real value?

O magnésio é um cátion de localização predominantemente intracelular e de grande importância em várias funções metabólicas. É possível que tenha uma participação importante em processos álgicos e inflamatórios. Sua dosagem sérica possivelmente não representa a realidade de sua concentração corporal. A mensuração do magnésio eritrocitário talvez possa representar um avanço na sua melhor avaliação

Magnesium is a cation with location predominantly intracellular and of great importance in several metabolic functions. It is possible that it plays an important role in pain and inflammatory processes. It's serum dosage possibly does not represent the reality of it's body concentration. The measurement of erythrocyte magnesium may represent an advance in its better evaluation.

Características clínicas de la hipomagnesemia en pacientes adultos / Clinical characteristics of hypomagnesemia in adult patients

Introducción: Las causas de hipomagnesemia son diversas: disminución de la ingesta, redistribución o translocación de Mg extracelular al intracelular, pérdida gastrointestinal y pérdida renal. El objetivo fue determinar las características clínicas de la hipomagnesemia en pacientes internados en el Departamento de Medicina Interna del Hospital Nacional (Itauguá, Paraguay) en el periodo 2018 - 2019. Materiales y métodos: Se aplicó un diseño observacional, descriptivo, retrospectivo. Se incluyeron pacientes adultos con Mg sérico ≤ 1,5 mg/dL. Se midieron variables demográficas, manifestaciones clínicas neuromusculares, metabólicas y electrocardiográficas. La investigación fue aprobada por el Comité de Ética de la Universidad Nacional de Itapúa (Paraguay). Resultados: Se detectó hipomagnesemia en 8,2% de los pacientes. La edad media de los mismos fue 55 años y 53% eran del sexo masculino. Las comorbilidades más frecuentes fueron hipertensión arterial (63%), diabetes mellitus (30%) y enfermedad renal crónica (16%). La hipomagnesemia se presentó con vómitos (34%), diarreas (13%), uso de omeprazol (97%), furosemida (31%) y corticoides (24%). Los síntomas predominantes fueron ansiedad (9%) y espasmos musculares (8%). Las alteraciones electrocardiográficas comunes fueron fibrilación auricular (11%), trastornos de la repolarización (18%) y prolongación del complejo QRS (9%). Conclusión: La hipomagnesemia se detectó en 8,2% de los pacientes y se presentó con vómitos (34%), diarreas (13%), uso de omeprazol (97%), furosemida (31%) y corticoides (24%).

Introduction: The causes of hypomagnesemia are diverse: decreased intake, redistribution or translocation of extracellular to intracellular magnesium, gastrointestinal loss and kidney loss. The objective was to determine the clinical characteristics of hypomagnesemia in patients admitted to the Internal Medicine Department of the National Hospital (Itauguá, Paraguay) in the period 2018 - 2019. Materials and methods: We conducted an observational, descriptive, retrospective design. We included adult patients with serum Mg ≤ 1.5 mg / dL. We measured demographic variables, neuromuscular, metabolic and electrocardiographic clinical manifestations. The research was approved by the Ethics Committee of the National University of Itapúa (Paraguay). Results: Hypomagnesemia was detected in 8.2% of the patients. Their mean age was 55 years and 53% were male. The most frequent comorbidities were hypertension (63%), diabetes mellitus (30%) and chronic kidney disease (16%). Hypomagnesemia was presented with vomiting (34%), diarrhea (13%), and use of omeprazole (97%), furosemide (31%) and corticosteroids (24%). The predominant symptoms were anxiety (9%) and muscle spasms (8%). Common electrocardiographic abnormalities were atrial fibrillation (11%), repolarization disorders (18%) and prolongation of the QRS complex (9%). Conclusion: We detected hypomagnesemia in 8.2% of patients and was presented with vomiting (34%), diarrhea (13%), use of omeprazole (97%), furosemide (31%) and corticosteroids (24%).