Comparison of the efficacy of oral versus intravascular magnesium in the prevention of hypomagnesemia and arrhythmia after cabg

Abstract Objective: Cardiac arrhythmias are a common challenge following open-heart surgeries. Hypomagnesemia is believed to be correlated with this condition. Prophylactic intravenous magnesium supplementation has been practiced for a long time in patients undergoing CABG. This study was designed in an attempt to compare the efficacy of oral versus intravenous routes in the prevention of hypomagnesemia and arrhythmia. Methods: In this interventional clinical study, 82 patients were randomly assigned to 2 groups. All patients were evaluated for baseline serum magnesium level and arrhythmias. One group received 1,600 mg of oral magnesium hydroxide through nasogastric (NG) tube prior to surgery, while the other group received 2 g of magnesium sulfate during the induction of anesthesia. The serum magnesium level was monitored for 48 hours after the operation. The difference in preoperative hypomagnesemia was non-significant (Sig: 0.576). Results: During the operation, the serum magnesium level peaked around 4 mg/dL, and no hypomagnesemia was detected in any patient. Although the curve of oral group declined parallel and below that of intravenous (IV) group, no significant differences were detected during postoperative monitoring. In addition, a prevalence of arrhythmia of 13.9% and 6.5% was noticed in IV and oral groups, respectively (OR: 0.428). Conclusion: Providing 1,600 mg of oral magnesium supplement to patients is as effective as 2,000 mg of magnesium sulfate IV in preventing hypomagnesemia and arrhythmia after CABG. Thus, the authors introduce this treatment regimen as a promising and cost-effective method.

Efficacy of Magnesium Trihydrate of Ursodeoxycholic Acid and Chenodeoxycholic Acid for Gallstone Dissolution: A Prospective Multicenter Trial

BACKGROUND/AIMS: Cholecystectomy is necessary for the treatment of symptomatic or complicated gallbladder (GB) stones, but oral litholysis with bile acids is an attractive alternative therapeutic option for asymptomatic or mildly symptomatic patients. This study was conducted to evaluate the efficacy of magnesium trihydrate of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) on gallstone dissolution and to investigate improvements in gallstone-related symptoms. METHODS: A prospective, multicenter, phase 4 clinical study to determine the efficacy of orally administered magnesium trihydrate of UDCA and CDCA was performed from January 2011 to June 2013. The inclusion criteria were GB stone diameter or =50%, radiolucency on plain X-ray, and asymptomatic/mildly symptomatic patients. The patients were prescribed one capsule of magnesium trihydrate of UDCA and CDCA at breakfast and two capsules at bedtime for 6 months. The dissolution rate, response rate, and change in symptom score were evaluated. RESULTS: A total of 237 subjects were enrolled, and 195 subjects completed the treatment. The dissolution rate was 45.1% and the response rate was 47.2% (92/195) after 6 months of administration of magnesium trihydrate of UDCA and CDCA. Only the stone diameter was significantly associated with the response rate. Both the symptom score and the number of patients with symptoms significantly decreased regardless of stone dissolution. Adverse events necessitating discontinuation of the drug, surgery, or endoscopic management occurred in 2.5% (6/237) of patients. CONCLUSIONS: Magnesium trihydrate of UDCA and CDCA is a well-tolerated bile acid that showed similar efficacy for gallstone dissolution and improvement of gallstone-related symptoms as that shown in previous studies.

Comparação da efetividade entre polietilenoglicol 4000 sem eletrólitos e hidróxido de magnésio no tratamento da constipação intestinal crônica funcional em crianças / Comparison of the effectiveness of polyethylene glycol 4000 without electrolytes and magnesium hydroxide in the treatment of chronic functional constipation in children

OBJETIVO: Comparar a efetividade de dois medicamentos: hidróxido de magnésio e polietilenoglicol 4000 sem eletrólitos no tratamento da constipação intestinal crônica funcional em crianças. MÉTODOS: Trinta e oito crianças foram divididas, por processo randômico, em dois grupos para uso de polietilenoglicol 4000 sem eletrólitos ou de hidróxido de magnésio. As crianças foram acompanhadas em consultas periódicas até completarem 6 meses de tratamento. Em todas as consultas, foram investigados: consistência das fezes, frequência evacuatória, presença de escape fecal, dor abdominal, esforço evacuatório e aceitação desses fármacos. RESULTADOS: Dezessete crianças fizeram uso de polietilenoglicol, e 21 utilizaram o hidróxido de magnésio. Houve melhora clínica de todas as variáveis nos dois grupos, sem diferenças com significância estatística. Todas as crianças aceitaram o polietilenoglicol, enquanto 42,9 por cento recusaram o hidróxido de magnésio. CONCLUSÃO: Não houve diferença de efetividade no tratamento da constipação intestinal entre esses dois laxantes. Entretanto, a melhor aceitação do polietilenoglicol, por ser inodoro e insípido, torna-o melhor opção no tratamento da constipação intestinal crônica funcional.

OBJECTIVE: To compare the effectiveness of two drugs, polyethylene glycol 4000 without electrolytes and magnesium hydroxide, in the treatment of chronic functional constipation in children. METHODS: Thirty-eight children were randomly assigned to either of two groups, polyethylene glycol 4000 without electrolytes or magnesium hydroxide. The children were followed through periodic appointments until they reached 6 months of treatment. In each medical appointment the following aspects were evaluated: stool consistency, frequency of bowel movements, fecal incontinence, abdominal pain, straining and acceptance of the drugs. RESULTS: Seventeen children made use of polyethylene glycol and twenty-one received magnesium hydroxide. All variables analyzed improved for both groups, with no statistically significant differences. All children accepted polyethylene glycol, while 42.9 percent refused magnesium hydroxide. CONCLUSION: The two laxatives showed no difference in effectiveness for the treatment of constipation. However, due to its better acceptance, because it is odorless and tasteless, polyethylene glycol proved to be a better option for treating chronic functional constipation.

Effects of different neutralizing agents on succinate production by Actinobacillus succinogenes NJ113 / 生物工程学报

Different neutralizing agents were used as pH controller to investigate their effects on the growth and succinic acid production of Actinobacillus succinogenes NJ113. The fermentation results showed that Ca(OH)2, CaCO3 and NH4OH were not suitable for succinic acid production by A. succinogenes NJ113 because of their negative effects on cell growth. When Na-base was used, cells would flocculate and lump, and due to the sodium ion concentration reaching to a high level, OD660 dropped sharply after 12 h of fermentation. Mg-base was better because there was no significant inhibition by magnesium ion. Two combined neutralizing agents were used to maintain pH level, one with NaOH and Mg(OH)2 while the other with Na2CO3 and Mg(OH)2. The optimum ratios of the combined neutralizing agents were both 1:1 (g:g) when using 100 g/L glucose. When NaOH and Mg(OH)2 were chosen with the ratio of 1:1(g:g), 69.8 g/L of the succinic acid and 74.5% of the yield was obtained.

Effect of Combination Pretreatment of Polyethylene Glycol Solution and Magnesium Hydroxide for Colonoscopy / 대한소화기학회지

No abstract available.

Effect of Combination Pretreatment of Polyethylene Glycol Solution and Magnesium Hydroxide for Colonoscopy / 대한소화기학회지

BACKGROUND/AIMS: This study was designed to compare the efficacy and patient tolerance between standard bowel preparation using 4 liters of polyethylene glycol (PEG) solution and 4 liters of PEG preceded by the osmotic laxative, magnesium hydroxide in constipation and non-constipation group. METHODS: 173 outpatient colonoscopy, except for three patients who were not taking magnesium, were divided into constipation and non-constipation group. Then, the patients were randomly assigned to receive 4-liter of PEG solution or 4-liter of PEG plus magnesium hydroxide. The quality of bowel preparation was assessed using Ottawa scale, and satisfaction score was assessed using questionnaires. Solid stool, cecal intubation time, compliance, and side effects were assessed. RESULTS: Non-constipation group showed no significant differences between two groups. In constipation group, 4-liter PEG solution plus magnesium hydroxide induced the more effective colonic preparation (Ottawa scale 2.47+/-0.99 vs. 5.92+/-2.39, p<0.05), and less solid stool (0.67+/-0.72 vs. 1.38+/-0.65, p<0.05) compared with 4-liter PEG solution. CONCLUSIONS: Bowel preparation with magnesium hydroxide and 4 liters of PEG solution might reduce solid stool in constipation group, but could not improve preparation quality.

study of the effect of magnesium hydroxide on the wound healing process in rats

Wound healing is the restoration of physical integrity to internal and external structures and involves intricate interactions between the cells and numerous other factors. Appropriate treatment and care are essential for acceleration of the healing process, prevention of infection and chronicity of the wound and different means and approaches have thus far been used to this end. The aim of this study was to evaluate the effect of magnesium hydroxide that was used for prevention of bed sores erstwhile on the wound healing process. The effect of magnesium hydroxide on the healing process in two models of skin wound; length wounds of 15 mm full-thickness and round wounds of 5 mm in diameter full thickness incision were created in the paravertebral area, 1.5 mm from midline on the back of rats was evaluated through measuring the length and area of the healed region and process pathological on different days, and conducting tensiometry experiments after complete wound healing. The percentage of wound healing on days 3, 6, 9, 12 and 15 in control group of length wounds changed in the group treated with magnesium hydroxide from 10.13%, 31.88%, 52.46%, 78.75% and 100% to 11.63%, 49.75% [p<0.05], 94% [p<0.01], 100% and 100% respectively; also the percentage of wound healing on days 3, 6, 9, 12, 15 and 18 in control group of round wounds changed in the group treated with magnesium hydroxide from 9.88%, 21.25%, 52.13%, 69.63%, 88.21% and 100% to 12.25%, 37.25% [p<0.05], 60.5%, 76%, 93.4% and 100% respectively. Stress [maximum tensile force causing skin rupture] changed from 13.19 Newton [N] in the control group of length wound to 20.87 N, also from 11.78 N [p<0.05] in the control group of round wound to 16.9 N [p<0.05] in group treated with magnesium hydroxide. Strain [tissue length under maximum strain] changed from 9.98mm in the control group of length wound to 15.43mm [p<0.05], also from 10.53 mm in the control group of round wound to 17mm [p<0.05] in group treated with magnesium hydroxide. The result of pathological samples of view histological [wound healing and cell aggregative] accelerated in magnesium groups on length and round wounds partition to control groups. Our findings suggest that magnesium hydroxide may have accelerated the skin wound healing process in rat and increased tissue strength through stimulating collagen formation

Cephradine antacids interaction studies

The present work comprises of interaction studies of cephradine with antacids. Cephradine is included among the first generation cephalosporin, which is active against a wide range of Gram positive and Gram-negative bacteria including penicillinase-producing staphylococci. Since the presence of complexing ligand may affect the bioavailability of a drug in blood or tissue, therefore, in order to study the probable interaction of cephradine with antacids all the reaction conditions were simulated to natural environments. Antacids are commonly used in patients complaining of GI irritations. The behavior of cephradine in presence of seven antacids i.e., simethicone, magaldrate, magnesium carbonate, magnesium hydroxide, magnesium trisilicate, sodium bicarbonate and aluminium hydroxide was studied by using standard dissolution apparatus. Cephradine was monitored both by UV and by high performance liquid chromatography. The results revealed that antacids containing polyvalent cations retarded the in vitro availability of cephradine. Moreover, these studies indicated that cephradine was strongly adsorbed on antacids; magnesium trisilicate and simeco tablets [powdered] exhibited relatively higher adsorption capacities

Effects of Oral Administration of Citrate, Thiazide, Allopurinol and Magnesium on Renal Calcium Oxalate Crystal Formation and Osteopontin Expression in a Rat Urolithiasis Model / 대한비뇨기과학회지

PURPOSE: It has previously been reported that citrate, thiazide, allopurinol and magnesium (CTAM) have inhibitory effects on calcium oxalate crystallization, but the effects of CTAM on the matrix proteins of stones in vivo has not been studied. Using an ethylene glycol-induced urolithiasis model, we investigated the effects of CTAM on renal crystallization and the expression of osteopontin (OPN), which is an important stone matrix protein. MATERIALS AND METHODS: Adult Sprague-Dawley rats (200-250gm) were divided randomly into 6 groups of 10 rats. Group 1 was left untreated, and served as a control. Group 2 (CID group) was fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in drinking water for 4 weeks. Groups 3, 4, 5 and 6 (CTAM groups) were fed the same CID as group 2, but were also treated with either potassium citrate or hydrochlorothiazide or allopurinol or magnesium hydroxide, for 4 weeks, respectively. We biochemically analyzed the 24-hour urine and serum samples. The renal calcium content was measured by atomic absorption. The kidneys were histologically examined for crystal deposit with HandE staining, and for OPN expression with immunohistochemical staining. RESULTS: The grade of calcium oxalate crystal deposits, and renal calcium content, were significantly decreased in the CTAM groups compared to the CID group, which also correlated with the decreased expression of OPN proteins in the kidneys of the CTAM-treated rats. CTAM were all effective in preventing calcium oxalate crystal formation, and decreasing the expression of OPN in rat kidneys. CONCLUSIONS: Our results suggest that CTAM are effective in preventing calcium oxalate stone formation, and that OPN plays an important role in calcium oxalate nephrolithiasis.

Antiulcer activity and the mechanism of action of magaldrate in gastric ulceration models of rat.

The present study was undertaken to investigate the mechanism of cytoprotective effects of magaldrate in aspirin plus pylorus-ligation model and ethanol-induced gastric ulcer model in rats. Magaldrate (60 mg/kg, p.o.) produced a significant reduction in the ulcer index and significant increase in mucus content in ethanol-induced gastric ulceration in rats. In aspirin plus pylorus-ligation model magaldrate produced significant decrease in ulcer index, total acidity and protein content (PR). It did not produce any significant change in volume of gastric secretion. However, it produced significant increase in total carbohydrate (TC) level but not in ratio between TC and proteins. It also produced a significant decrease in lipid peroxidation (as expressed by thiobarbituric acid reactive substance). Our data suggests the cytoprotective action of magaldrate on gastric mucosal cells which may be due to protection of gastric mucosa from lipid peroxidation.

Heterogeneous decomposition of H2O2 over Mn-doped Mg [OH] 2 prepared by co-precipitation

H2O2 over Mn-doped Mg [OH]2 was precipitated from a common salt solution containing Mn2+ and Mg2+ ions by the addition of alkali; final solids contained 1.36, 0.36, 0.23 and 0.088 wt% of Mn. Kinetic curves were determined at varying contents of Mn, weight of carrier, initial H2O2 concentrations and temperatures. First-order reaction law equations were applied satisfactorily in the full-range of decomposition curves. A wide spectrum of differently active catalysts were obtained, depending above all on the Mn-content per weight unit. Experiments with H2O2 concentrations of 0.27-1.20 M showed variable t50 and t90 values. However, the overall rate constant [K0] showed no definite pattern. Decomposition over 2 catalysts was associated with Ea-41.1 and 44.2 Kj mol-1. A satisfactory linear log-log correlation holds between Ko and t90

Evaluación de tratamientos en la prevención de las lesiones agudas gástricas en el stress, en ratas / Evaluation of the treatments in the prevention of acute gastric lesions in stress, in rats

Se estudiaron en grupos de ratas Wistar, en stress por inmovilización más inmersión en agua a 18C, las groseras lesiones agudas gástricas sangrantes y su prevención con drogas citoprotectoras gástricas como: sucralfato, HOAI y Mg, magaldrato, hidrotalcita y misoprostol; asimismo, drogas antisecretoras gástricas como misoprostol (dosis antisecretora), somatostatina (octeotride), ranitidina, omeprazol y lanzoprazol. En otra experiencia, se estudió la secreción gástrica ácida en ratas con ligadura de píloro, donde fueron tratadas con las mismas drogas y dosis que en la experiencia anterior. Se comprobó que el modelo de stress 6 hs. dió una zona lesional gástrica de un 80 por ciento; el sucralfato, como droga citoprotectora, dio una protección parcial de la mucosa gástrica; en cambio, los bloqueantes de la bomba de protones, omeprazol y lanzoprazol dieron una zona gástrica cercana al 0 por ciento y por ende, postulamos su uso en terapia intensiva en la profilaxis de las lesiones agudas gástricas sangrantes en el stress.

Hidrotalcita en la sintomatología de la enfermedad ácido péptica: estudio fase IV de farmacovigilancia / Hidrotalcite in the symptomatology of acid peptic diseade: phase IV study in drug surveillance

Con el objeto de valorar la seguridad y eficacia de hidrotalcita tabletas 500 mg en el tratamiento de la sintomatología en la enfermedad ácido péptica, se realizó en México el presente estudio de farmacovigilancia durante seis meses. Mediante una hoja de recolección de datos se obtuvo información de 1971 pacientes, de los cuales 79 por ciento presentó gastritis como diagnóstico principal. Los síntomas observados antes del tratamiento fueron: dolor gástrico en 1352 pacientes (68.7 porciento), ardor gástrico en 1595 pacientes (81 porciento), reflujo en 872 (44.3 porciento), nausea o vómito en 600 (30.6 porciento), meteorismo o flatulencia en 745 (37.9 porciento) y eructos en 710 (36.2 porciento). Los resultados a los siete días de tratamiento fueron mejoría en 90.1 porciento con dolor gástrico, de 93.3 porciento con ardor gástrico, de 86.6 con reflujo, de 90.8 por ciento con náusea, 86.6 porciento con eructo, y 78.8 por ciento con meteorismo. Los efectos secundarios fueron leves y observados en el 4.1 porciento del total de los casos. La posología que con mayor frecuencia se registró fue de tres a cuatro tabletas diarias. De 117 pacientes que suspendieron el tratamiento, 85 lo hicieron por sentir mejoría antes de los siete días de tratamiento. Los resultados demuestran que la hidrotalcita a las dosis empleadas, es un fármaco con altos índices de mejoría, bien tolerado y eficaz para el tratamiento de enfermedad ácido péptica.

Estudo in vitro da inibiçäo do crescimento de bactérias pelo hidróxido de magnésio / In vitro study of magnesium hydroxide inhibition of bacterial growth

Estudou-se a açäo "in vitro" do hidróxido de magnésio como inibidor do crescimento de algumas bactérias que säo comumente encontradas em feridas operatórias infectadas. Utilizou-se culturas de Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus pyogenes e Streptococcus faecalis, que foram colocadas em tubos com diferentes diluiçöes de suspensäo de Mg (OH)2 a 8%, a saber: 1, 1/2, 1/4, 1/8 e 1/16. Esses tubos foram incubados por 24 horas e entäo deles retirou-se amostras que foram colocadas em placas de ágar-sangue com e sem filtraçäo em membraa Millipore e em meio de cultura BHI. Os resultados demonstraram que a suspensäo de Mg (OH)2 a 8% até a diluiçäo de 1/4 foi faecalis. Os dados encontrados neste estudo abrem novas perspectivas de pesquisa utilizando o Mg (OH)2, seja em laboratório seja em atividade clínica no tratamento de feridas operatórias infectadas ou em outros ferimentos supurativos

Constipación intestinal crónica: diagnóstico y tratamiento

Se analizó el comportamiento clínico y los factores relacionados con Constipación Intestinal Crónica (CIC) en 35 niños que consultaron a la Clínica de Gastroenterología Pediátrica del Hospital General San Juan De Dios. En 44% de casos la CIC se inició en el primer año de vida, 35% en el primer mes de vida. El síntoma más frecuentemente asociado a esta entidad fue dolor abdominal, siendo este el principal motivo de consulta en algunos pacientes. Se observó un intervalo de tiempo importante entre el inicio del cuadro y la primera consulta al servicio (1 año 10 meses en promedio). Los pacientes recibieron tratamiento según un protocolo de manejo integral, que incluye orientación alimenticia, administración de laxantes, reacondicionamiento esfinteriano y orientación psicológica. Los resultados evidencian que el 91% de pacientes respondió al esquema terapéutico; la mayor parte (59%) en el primer mes de tratamiento lo cual indica que el Protocolo de Manejo propuesto es funcional, efectivo y aplicable en nuestro medio

Evaluación in vivo del efecto de los antiácidos y bloqueadores H2 sobre el pH intragástrico en la úlcera gástrica y duodenal / In vivo evaluation of the effect of antacids and H2 receptor blockaders on the intragastric pH in gastric and duodenal ulcer

El objetivo del presente estudio, fue evaluar "in vivo" la acción de los antiácidos y de los antagonistas de los receptores H2, sobre el pH gástrico, en pacientes portadores de ulceras gástricas y duodenales, con el fin de establecer cual es la medicación más efectiva. Se estudiaron 16 pacientes ulcerosos: nueve eran portadores de Ulcera Duodenal, dos tenían Ulcera Gástrica y cinco presentaban Ulcera Gástrica y Duodenal. En cada paciente se obtuvo el contenido gástrico por aspiración mediante una sonda nasogástrica, en forma horaria desde la hora 8 a la hora 20; midiéndose la secreción nocturna por aspiración a la hora 8 del día siguiente, estando el paciente en ayunas y sin medicación. El mismo procedimiento se repitó en cada paciente administrando Cimetidina (a la dosis de 1 g. por día), Ranitidina (a la dosis de 300 mg. por día), Hidróxido de Aluminio y Magnesio (a la dosis de 150 ml por día) y finalmente se repitió el procedimiento asociando la Ranitidina con el Hidróxido de Aluminio y Magnesio en las dosis anteriormente mencionadas. Se realizó un análisis estadístico de los resultados, calculándose la ordenada media de pH. El efecto medio del tratamiento se obtuvo promediando las diferencias individuales (pH tratamiento - pH sin tratamiento). El mismo procedimiento se empleó para la comparación de los diferentes fármacos entre sí. Se realizaron pruebas de Student para muestras dependientes con un nivel de significación de alfa = 5%. La capacidad de neutralización se midió por la proporción del total de muestras con un pH igual o mayor a 4, obtenidos en cada tratamiento y en el total de pacientes, comparándose con los resultados hallados sin medicación. Se utilizó el x2 con corrección de Yates. Todas las medicaciones fueron eficaces (aunque en diferente grado) para neutralizar la acidez gástrica. La combinación del antiácido con la Ranitidina apareció como lo más eficaz, mostrando diferencias estadísticamente significativas con la Cimetidina y el Hidróxido de Aluminio, y Magnesio, no así con la Ranitidina sola