Avaliação metabólica de um dispositivo intravaginal polimérico para a administração de cálcio e magnésio em ruminantes / Metabolic evaluation of a polymer intravaginal device for the administration of calcium and magnesium in ruminants

O objetivo do estudo foi avaliar a disponibilidade de cálcio (Ca2+) a partir de duas formas farmacêuticas (oral e intravaginal) e o seu efeito sobre o metabolismo de ruminantes. O estudo foi realizado na fazenda experimental da Universidade Federal de Pelotas, foram estudadas 24 ovelhas lactantes, divididas de forma randomizada em 4 grupos: dispositivo tratamento (DT); dispositivo controle (DC); oral tratamento (OT); e oral controle (OC). Os animais tratados receberam formiato de cálcio e cloreto de magnésio, as avaliações foram realizadas após a administração dos tratamentos. Foi feita avaliação de cálcio total (CaT), magnésio (Mg), proteínas plasmáticas totais (PPT), aspartato aminotransferase (AST), gama glutamil transpeptidase (GGT), ureia, albumina e pH urinário, e realizado exame clínico em todos os animais. As concentrações séricas de CaT, CaI e Mg diferiram entre os grupos (P≤ 0,05), os animais dos grupos DT e DC, diferiram nas três avaliações, o grupo DT apresentou as maiores médias, sendo significativamente igual ao grupo OT. Não houve diferença nas concentrações séricas de PPT, AST, GGT, Albumina, Ureia e pH urinário. Conclui-se que a disponibilidade sanguínea de CaT, CaI e Mg é igual quando a administração de formiato de cálcio e magnésio é por via intravaginal ou por via oral, sem alterar outros parâmetros metabólicos avaliados.(AU)

The aim of the study was to evaluate the availability of calcium (Ca2+) from two pharmaceutical forms (oral and intravaginal) and its effect on the metabolism of ruminants. The study was carried out at the experimental farm of the Federal University of Pelotas. Twenty-four lactating ewes were randomly divided into 4 groups: treatment device (TD); control device (DC); oral treatment (OT); and oral control (OC). Treated animals received calcium formate and magnesium chloride, evaluations were performed after administration of the treatments. Total calcium (CaT), magnesium (Mg), total plasma proteins (PPT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), urea, albumin and urinary pH, and clinical examination were performed on all animals. Serum CaT, CaI and Mg levels differed between the groups (P≤ 0.05), the animals in the DT and DC groups differed in the three evaluations, the DT group had the highest mean values, being significantly equal to the OT group. There was no difference in the serum concentrations of PPT, AST, GGT, Albumin, Urea and urinary pH. In conclusion, the blood availability of CaT, CaI and Mg is the same when administration of calcium and magnesium formate is intravaginal or orally, without altering other metabolic parameters evaluated.(AU)

The prophylactic effect of intravenous magnesium infusion on postoperative sore throat after thyroid surgery. A randomized clinical trial / Efecto profiláctico de la infusión de magnesio en dolor de garganta postoperatorio luego de una tiroidectomía. Un ensayo clínico aleatorizado

BACKGROUND: The reported incidence of postoperative sore throat (POST) varies widely from 14.4 to 100% with maximum severity at 4th to 6th postoperative hour. Nonetheless, it has increasingly become a common clinical problem particularly in thyroid surgery. Although POST usually resolves spontaneously in few days, it is likely to be the most common complaint. OBJECTIVES: Driven by the increased number of patients with post-intubation sore throat following thyroid surgery, the aim of the present study was to evaluate the effectiveness of perioperative magnesium infusion in attenuating POST after thyroidectomy. METHODS AND MATERIAL: 80 female patients undergoing thyroid surgery, were preoperatively randomized into one of 2 groups. The magnesium group received magnesium sulfate (30 mg/kg) in 100 ml of isotonic saline over 15 min before induction of anesthesia, followed by a continuous magnesium sulfate infusion (10 mg/kg/h) for the duration of the operation. The control group received the same volume and rate of isotonic saline. RESULTS: This study showed that perioperative magnesium infusion had significantly reduced the overall incidence and severity of POST. The incidence of POST at rest (patients who recorded non-zero POST score after thyroid surgery) in the control group was 75% while the incidence of POST in magnesium group was 37.5% which is lower and that was highly significance. Higher sedation scores were encoun tered on arrival to PACU in Magnesium group when compared to controls. CONCLUSIONS: We concluded that perioperative magnesium sulphate infusion effectively decreased overall POST incidence and severity after thyroidectomy with better hemodynamic stability, albeit higher risk of post operative sedation.

La incidencia reportada de dolor de garganta postoperatorio (POST) varía ampliamente de 14,4 a 100% con severidad máxima en la 4ta a 6ta hora postoperatoria. Sin embargo, se ha convertido cada vez más en un problema clínico común, particularmente en la cirugía de tiroides. Aunque la POST generalmente se resuelve espontáneamente en pocos días, es probable que sea la queja más común. OBJETIVOS: Impulsado por el mayor número de pacientes con dolor de garganta después de la intubación después de la cirugía de tiroides, el objetivo del presente estudio fue evaluar la efectividad de la infusión perioperatoria de magnesio para atenuar la POST después de la tiroidectomía. MÉTODOS Y METERIAL: 80 pacientes mujeres sometidas a cirugía de tiroides, fueron asignadas al azar preoperatoriamente en uno de los 2 grupos. El grupo de magnesio recibió sulfato de magnesio (30 mg/kg) en 100 ml de solución salina isotónica durante 15 minutos antes de la inducción de la anestesia, seguido de una infusión continua de sulfato de magnesio (10 mg/kg/h) durante la operación. El grupo control recibió el mismo volumen y tasa de solución salina isotónica. RESULTADOS: Este estudio mostró que la infusión perioperatoria de magnesio había reducido significativamente la incidencia general y la gravedad de la POST. La incidencia de POST en reposo (pacientes que registraron una puntuación POST distinta de cero después de la cirugía de tiroides) en el grupo de control fue del 75%, mientras que la incidencia de POST en el grupo de magnesio fue del 37,5%, que es menor y de gran importancia. Se encontraron puntajes de sedación más altos al llegar a la UCPA en el grupo Magnesio en comparación con los controles. CONCLUSIONES: Llegamos a la conclusión de que la infusión perioperatoria de sulfato de magnesio disminuyó efectivamente la incidencia general de POST y la gravedad después de la tiroidectomía con una mejor estabilidad hemodinámica, aunque un mayor riesgo de sedación postoperatoria.

Effects of intraarticular tramadol, magnesium and ketamine on postoperative pain in arthroscopic meniscectomy / Efeitos de tramadol, magnésio e cetamina por via intra-articular sobre a dor pós-operatória em meniscectomia artroscópica

Abstract Objective: Postoperative pain control is important in terms of early recovery and rehabilitation in arthroscopic meniscectomy. For this purpose, we aimed to compare the effects of intraarticular tramadol, magnesium, and ketamine with combinations of pericapsular bupivacaine on postoperative pain and recovery in arthroscopic meniscectomy. Methods: Ninety patients who underwent arthroscopic meniscectomy were enrolled in the study. Group T was given tramadol, Group K was given ketamine, and Group M was given magnesium reconstituted intraarticularly, and all groups received periarticular bupivacaine. Comparisons were made in terms of the patients' postoperative Visual Analogue Scale scores with and without movement, need for additional analgesics, first analgesic time, mobilization times, adverse effects, and satisfaction with the analgesics. Results: The Visual Analogue Scale scores were lowest in Group T at 0 minutes, and were higher in the 15th and 30th minutes and 1st, 2nd, and 6th hours. Visual Analogue Scale values with movement were found to be high in Group M at 0 and 15 minutes, but they were found to be higher in group T in the 30th minute, 1st, 2nd and 6th hour. The groups were similar in terms of postoperative additional analgesic use, number of analgesic use, and satisfaction with analgesics; however, the first analgesic time was earlier in Group M, and the first mobilization time was earlier in Group K. Conclusion: Intraarticular ketamine enables early mobilization and less need for additional analgesics, it also provides a better analgesic effect in comparison with intraarticular tramadol and magnesium.

Resumo Objetivo: O controle da dor pós-operatória é importante para recuperação e reabilitação precoces em meniscectomia artroscópica. Portanto, nosso objetivo foi comparar os efeitos de tramadol, magnésio e cetamina administrados por via intra-articular em associação com bupivacaína pericapsular sobre a dor e a recuperação após meniscectomia artroscópica. Métodos: Noventa pacientes submetidos à meniscectomia artroscópica foram incluídos no estudo. O Grupo T recebeu tramadol, o Grupo K recebeu cetamina e o Grupo M recebeu magnésio em doses reconstituídas por via intra-articular e todos os grupos receberam bupivacaína por via periarticular. As avaliações foram feitas mediante comparação dos escores em escala visual analógica no pós-operatório dos pacientes em movimento e em repouso, necessidade de analgésicos adicionais, tempo até a primeira necessidade de analgésico, tempo de mobilização, efeitos adversos e satisfação com os analgésicos. Resultados: Os escores da escala visual analógica foram menores no minuto zero e maiores nos minutos 15 e 30 e nas horas 1, 2 e 6 no Grupo T. Os escores da escala visual analógica em movimento foram maiores nos minutos zero e 15 no Grupo M e maiores no minuto 30 e nas horas 1, 2 e 6 no Grupo T. Os escores dos grupos foram semelhantes em relação à necessidade de analgésico adicional no pós-operatório, ao consumo de analgésico e à satisfação com os analgésicos, mas os tempos até a primeira necessidade de analgesia e até a primeira mobilização foram mais curtos nos grupos M e K, respectivamente. Conclusão: A administração intra-articular de cetamina permite mobilização precoce e diminui a necessidade de analgésicos adicionais, além de proporcionar um melhor efeito analgésico em comparação com tramadol e magnésio por via intra-articular.

Suplemento de magnesio y ácido málico para fibromialgia / Magnesium and malic acid supplement for fibromyalgia

INTRODUCCIÓN La fibromialgia es una condición reumática no articular caracterizada por distintos síntomas, donde destacan principalmente el dolor, sensibilidad muscular, fatiga, insomnio, rigidez matinal, depresión y disminución de la funcionalidad cotidiana. Aún no existe claridad respecto de su etiología, pero se ha planteado que la deficiencia de elementos tales como el magnesio podría tener un rol tanto en la fisiopatología de la fibromialgia como también contribuir a sus síntomas clínicos. MÉTODOS Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos siete revisiones sistemáticas que en conjunto incluyeron 11 estudios primarios, de los cuales solo uno corresponde a un ensayo aleatorizado. Concluimos que el uso de magnesio y ácido málico en pacientes con fibromialgia tiene poco o nulo impacto en dolor y en los síntomas depresivos.

INTRODUCTION Fibromyalgia is characterized by myalgia and a combination of different symptoms including pain, fatigue, insomnia, morning rigidity, depression and a reduction in every-day functioning. Its aetiology is not clear, but it has been suggested that deficiency in certain minerals such as magnesium may play a role both in the physiopathology and in contributing to the symptoms. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified seven systematic reviews which included 11 primary studies of which one was a randomized trial. Our conclusion is that the use of magnesium and malic acid in patients with fibromyalgia makes little or no difference on pain and on depressive symptoms.

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.

Magnesium: effects on physical and mental performance

Magnesium is a chemical element used by every organ in the body, especially the brain, skeletal muscles and the heart. It functions as a cofactor in approximately 600 enzyme systems that regulate many different biochemical reactions, including aerobic and anaerobic energy production, protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation.1-3 Magnesium is instrumental in combating fatigue and energy loss, and is essential for optimal physical and mental performance

Single-dose lignocaine-based blood cardioplegia in single valve replacement patients

Abstract OBJECTIVE: Myocardial protection is the most important in cardiac surgery. We compared our modified single-dose long-acting lignocaine-based blood cardioplegia with short-acting St Thomas 1 blood cardioplegia in patients undergoing single valve replacement. METHODS: A total of 110 patients who underwent single (aortic or mitral) valve replacement surgery were enrolled. Patients were divided in two groups based on the cardioplegia solution used. In group 1 (56 patients), long-acting lignocaine based-blood cardioplegia solution was administered as a single dose while in group 2 (54 patients), standard St Thomas IB (short-acting blood-based cardioplegia solution) was administered and repeated every 20 minutes. All the patients were compared for preoperative baseline parameters, intraoperative and all the postoperative parameters. RESULTS: We did not find any statistically significant difference in preoperative baseline parameters. Cardiopulmonary bypass time were 73.8±16.5 and 76.4±16.9 minutes (P=0.43) and cross clamp time were 58.9±10.3 and 66.3±11.2 minutes (P=0.23) in group 1 and group 2, respectively. Mean of maximum inotrope score was 6.3±2.52 and 6.1±2.13 (P=0.65) in group 1 and group 2, respectively. We also did not find any statistically significant difference in creatine-phosphokinase-MB (CPK-MB), Troponin-I levels, lactate level and cardiac functions postoperatively. CONCLUSION: This study proves the safety and efficacy of long-acting lignocaine-based single-dose blood cardioplegia compared to the standard short-acting multi-dose blood cardioplegia in patients requiring the single valve replacement. Further studies need to be undertaken to establish this non-inferiority in situations of complex cardiac procedures especially in compromised patients.

Hypomagnesemia and its relation with chronic low-grade inflammation in obesity / Hipomagnesemia e sua relação com a inflamação crônica de baixo grau na obesidade

Summary Introduction: The accumulation of visceral fat in obesity is associated with excessive production of proinflammatory adipokines, which contributes to low-grade chronic inflammation state. Moreover, the literature has shown that mineral deficiency, in particular of magnesium, has important role in the pathogenesis of this metabolic disorder with relevant clinical repercussions. Objective: To bring updated information about the participation of hypomagnesemia in the manifestation of low-grade chronic inflammation in obese individuals. Method: Articles published in PubMed, SciELO, LILACS and ScienceDirect, using the following keywords: "obesity," "magnesium" and "low grade inflammation." Results: Scientific evidence suggests that magnesium deficiency favors the manifestation of low-grade chronic inflammation in obese subjects. Conclusion: From literature data, it is evident the participation of magnesium through biochemical and metabolic reactions in protecting against this metabolic disorder present in obesity.

Resumo Introdução: O acúmulo de gordura visceral na obesidade está associado à produção excessiva de adipocinas pró-inflamatórias, o que contribui para o estado de inflamação crônica de baixo grau. A literatura também tem mostrado que a deficiência de minerais, em particular do magnésio, possui papel importante na patogênese desse distúrbio metabólico com repercussões clínicas relevantes. Objetivo: Trazer informações atualizadas sobre a participação da hipomagnesemia na inflamação crônica de baixo grau em indivíduos obesos. Método: Bases de dados Pubmed, SciELO, Lilacs e ScienceDirect, utilizando as palavras-chave: "obesity", "magnesium" e "low grade inflammation". Resultados: As evidências científicas sugerem que a deficiência de magnésio favorece a manifestação da inflamação crônica de baixo grau em indivíduos obesos. Conclusão: É evidente a participação do magnésio, por meio de reações bioquímicas e metabólicas, na proteção contra esse distúrbio metabólico presente na obesidade.

Effects of magnesium on cytomorphology and enzyme activities in thyroid of rats.

Till date knowledge regarding the effects of high dietary magnesium on thyroid gland is incomprehensive though certain epidemiological studies reported development of thyroid gland dysfunctions in people with chronic exposure to hard water (especially with high magnesium) despite sufficient iodine consumption. The present study is to explore the effects of chronic high dietary magnesium exposure on thyroid morphology and functional status. Male adult albino Wistar strain rats were treated with graded doses of magnesium sulphate (MgSO4; 0.5, 1.0 and 1.5 g %) for 60 days and changes in different thyroid parameters were investigated. Significantly stimulated thyroid peroxidase and Na+–K+-ATPase and altered idothyronine 5/- deiodinase type I activities, enhanced serum thyroxine (T4) (both total and free), total triiodothyronine (T3) and thyroid stimulating hormone with decreased free T3 levels and T3/T4 ratio (T3:T4) along with enlargement of thyroid with associated histopathological changes were observed in the treated groups. The results clearly confirm that chronic high dietary magnesium exposure causes potential thyroid disruption as reported in earlier epidemiological studies.

Valores de referencia de calcio, vitamina D, fósforo, magnesio y flúor para la población venezolana / Reference values of calcium, vitamin D, phosphorus, magnesium and fluoride for the Venezuelan population.

Se consideraron en conjunto los siguientes micronutrientes por su función en la salud ósea: calcio, vitamina D, fósforo, magnesio y flúor. Calcio: no se tiene suficiente información para cambiar las recomendaciones actuales. En adolescentes y adultos, los escasos datos indican que el consumo a nivel de lo recomendado se relaciona con una masa ósea normal. En adultos mayores, los escasos datos reportan un bajo consumo y un alto índice de fracturas, pero no se tiene información si los valores actuales son adecuados. Vitamina D: los escasos datos reportan alta deficiencia en adultos mayores, la cual está relacionada con osteoporosis. Tomando en cuenta el aumento reciente en las recomendaciones de vitamina D en Norteamérica por su contribución a la salud ósea, se propone aumentar la recomendación poblacional a 400-600 UI/d en Venezuela. Fósforo, Magnesio y Flúor: la falta de datos locales no permite cambiar las últimas recomendaciones. Tal situación evidencia la falta de estudios locales para evaluar las recomendaciones actuales. Se necesitan estudios poblaciones del consumo de estos micronutrientes y evaluar su interacción y su relación con la salud ósea y en general. Se necesita conocer si el nivel de estos nutrientes en leche humana es adecuado para la población infantil. Es preciso implementar un sistema de vigilancia nutricional efectiva e implementar intervenciones que maximicen la salud ósea, incluyendo el diseño e implementación de una política lechera que conlleven al aumento en su producción y consumo por la población.

The following micronutrients were considered together for their role in bone health: calcium, vitamin D, phosphorus, magnesium and fluoride. Calcium: not enough is known to change current recommendations. In adolescents and adults, limited data suggest that consuming the recommended level is associated with normal bone mass. In older adults, the limited data reported low consumption and a high rate of fractures but there is no information on whether the current values are adequate. Vitamin D: the limited data reported high deficiency in older adults, which was related to osteoporosis. Given the recent increase in North American recommendation for their contribution to bone health, we proposed to increase the recommendation to 400-600 IU/d for Venezuela. Phosphorus, magnesium and fluoride: the lack of local data does not support changing the latest recommendations. Therefore, it highlights the lack of local studies to assess current recommendations. Studies are needed to estimate the intake of these micronutrients in the population and evaluate their interaction and their relation to bone and overall health. Information of the adequacy of these nutrients in human milk for infants is needed. Alto, it is necessary to implement an effective nutrition surveillance system and implement interventions that maximize bone health from an early stage, including the design and implementation of a dairy policy that leads to an increase in production and consumption by the population.

The effect of acute magnesium loading on the maximal exercise performance of stable chronic obstructive pulmonary disease patients

OBJECTIVE: The potential influence of magnesium on exercise performance is a subject of increasing interest. Magnesium has been shown to have bronchodilatatory properties in asthma and chronic obstructive pulmonary disease patients. The aim of this study was to investigate the effects of acute magnesium IV loading on the aerobic exercise performance of stable chronic obstructive pulmonary disease patients. METHODS: Twenty male chronic obstructive pulmonary disease patients (66.2 + 8.3 years old, FEV1: 49.3+19.8%) received an IV infusion of 2 g of either magnesium sulfate or saline on two randomly assigned occasions approximately two days apart. Spirometry was performed both before and 45 minutes after the infusions. A symptom-limited incremental maximal cardiopulmonary test was performed on a cycle ergometer at approximately 100 minutes after the end of the infusion. ClinicalTrials.gov: NCT00500864 RESULTS: Magnesium infusion was associated with significant reductions in the functional residual capacity (-0.41 l) and residual volume (-0.47 l), the mean arterial blood pressure (-5.6 mmHg) and the cardiac double product (734.8 mmHg.bpm) at rest. Magnesium treatment led to significant increases in the maximal load reached (+8 w) and the respiratory exchange ratio (0.06) at peak exercise. The subgroup of patients who showed increases in the work load equal to or greater than 5 w also exhibited significantly greater improvements in inspiratory capacity (0.29 l). CONCLUSIONS: The acute IV loading of magnesium promotes a reduction in static lung hyperinflation and improves the exercise performance in stable chronic obstructive pulmonary disease patients. Improvements in respiratory mechanics appear to be responsible for the latter finding.

Echinostome Flukes Receovered from Humans in Khammouane Province, Lao PDR

Echinostome eggs were detected in 22 (1.1%) of 2,074 people residing in riparian villages along the Mekong River in Khammouane Province, Lao PDR. In order to recover the adult flukes, 9 persons were treated with praziquantel and purged with magnesium salts. A total of 55 echinostome specimens (4 species) were recovered from the 9 persons. Echinostoma revolutum (8 specimens) was recovered from 3 persons, Artyfechinostomum malayanum (8 specimens) was from 2 persons, Echinochasmus japonicus (33 specimens) was from 7 persons, and Euparyphium sp. (6 specimens) was from 1 person. In Lao PDR, only human infections with E. japonicus were previously known. Therefore, the present study describes human infections with E. revolutum, A. malayanum, and Euparyphium sp. for the first time in Lao PDR. These results indicate that the surveyed villages of Khammouane Province, Lao PDR are low-grade endemic foci of echinostomiasis.

prevalence of hypomagnesaemia in pediatric patients with mitral valve prolapse syndrome and the effect of Mg therapy

A paucity of data exists regarding the prevalence and relationship of hypomagnesaemia with clinical symptoms of mitral valve prolapse [MVP] in pediatric patients. In this study we evaluated the prevalence of magnesium [Mg] deficiency in pediatric patients with MVP syndrome and attempted to clarify the effect of Mg therapy on alleviating their symptoms. The present study was conducted from April 2010 to January 2012, and included 230 patients [90 males and 140 females] with symptoms of mitral valve prolapse and mean age of 11.6 +/- 3.66. Serum magnesium [Mg] level less than 1.5 mg/dl was defined as hypomagnesaemia. Patients with 2 mm leaflet displacement and maximum leaflet thickness of 5 mm in echocardiography were considered to have classic MVP, while those with leaflet thickness less than 5 mm were considered as non-classic MVP. Patients with hypomagnesaemia were orally treated with 4.5 mg/kg/day Mg chloride for 5 weeks followed by re-evaluation of symptoms of chest pain, palpitation, fatigue and dyspnea. Hypomagnesaemia was found in 19 [8.2%] of 230 patients with mitral valve prolapse. The re-evaluation of patients with Hypomagnesaemia after 5 weeks of Mg therapy, showed statistically significant relief of chest pain [P=0.01]. However, no significant changes was detected in regard to palpitation [P=0.06], fatigue [P= 0.5] and dyspnea [P=0.99]. This study revealed that the prevalence of hypomagnesaemia in pediatric patients with mitral valve prolapse is relatively low compared to adults, but treatment with oral Mg in patient with hypomagnesaemia decreases chest pain

Efeito da calagem e da correção dos teores de Ca e Mg do solo sobre o crescimento de mudas de angelim-pedra (Dinizia excelsa Ducke) / Liming effect and correction of the Ca and Mg contents of the soil on angelim-pedra (Dinizia excelsa Ducke) seedling growth

O conhecimento dos requerimentos nutricionais das espécies e de suas respostas à correção do substrato é fundamental para a produção de mudas de qualidade. O objetivo deste trabalho foi avaliar o efeito de diferentes tipos de calcário e da correção da deficiência de Ca e Mg sobre o desenvolvimento de mudas de angelim-pedra (D. excelsa) em casa de vegetação, utilizando-se como substrato Latossolo Amarelo. Foram testados três tipos de calcário e fornecimento de Ca e Mg por meio de fontes não-corretivas da acidez em três relações Ca:Mg. Os tratamentos consistiram de T0 & testemunha; T1 & calcário dolomítico; T2 & calcário magnesiano; T3 & calcário calcítico; T4 & Ca e Mg na relação 3:1; T5 & Ca e Mg na relação 9:1; e T6 & Ca e Mg na relação 15:1. O delineamento experimental foi de blocos ao acaso, com cinco repetições, totalizando 35 parcelas, cada uma delas com 3 mudas. O substrato foi adubado com doses equivalentes a 100-250-150 e 15 kg ha-1 de N, P2O5, K2O e S, respectivamente e com solução de micronutrientes (3 mL de Chelamix L-1 de água destilada). Foram avaliadas: a altura da planta, o diâmetro do colo, matéria seca da parte aérea, matéria seca da raiz, matéria seca total, relação raiz/parte aérea e conteúdos de nutrientes da parte aérea das plantas. De modo geral, a aplicação de calcário favoreceu o crescimento de D. excelsa, sendo os melhores resultados obtidos com a aplicação de calcário magnesiano na relação 9:1.

Knowledge of nutritional requirements of the species and their answers to correcting the substratum is fundamental for the production of quality seedlings. In this work, we aimed to evaluate the effect of different limestone types and the correction of Ca and Mg deficiency on the development of angelim-pedra (Dinizia excelsa) seedlings, under glasshouse conditions. We tested three types of limestone and three types of Ca:Mg provisioning on a Yellow Oxisol (with non-corrective acidity sources): T0 & control; T1 & soil limed with dolomitic lime (3:1); T2 & soil limed with magnesium lime (9:1); T3 & soil limed with calcitic lime (15:1); T4 & a mixture of calcium and magnesium, in the 3:1 proportion; T5 & calcium and magnesium, in the 9:1 proportion; and T6 & calcium and magnesium, in the 15:1 proportion. The experimental design was of random blocks, with 5 repetitions, totaling 35 parcels with 3 seedlings each. The substratum was fertilized with doses equivalent to 100-250-150 and 15 k ha-1 of N, P2O5, K2O and S respectively, and micronutrient solution (3 mL of Chelamix L-1 of distilled water). We evaluated the height, diameter of the stem, dry biomass of the aerial part, dry biomass of the root, dry biomass of the drought, aerial part/root relation and nutrient contents of the aerial part of the plants. The limestone application affected positively the height, the diameter, the matter total biomass and the absorption of Ca of the D. excelsa seedlings (p<0,05). The application of magnesium lime with Ca:Mg 9:1 proportion showed the best results.

Padronização de modelo de coração isolado "working heart" com circulação parabiótica / Development of isolated swine "working heart model" with parabiotic circulation

OBJETIVO: Desenvolver modelo de coração isolado de suíno "working heart" sob suporte por circulação parabiótica e verificar se o mesmo é estável e se possibilitou de forma efetiva a mensuração dos dados propostos. MÉTODOS: O modelo foi padronizado durante preparação para estudo de associação de agente à solução cardioplégica. Foram realizados 18 experimentos com um animal suporte e um animal doador em cada. O coração do animal doador foi perfundido como coração isolado pelo animal suporte em modo de execução de trabalho ("coração ejetante"). O coração isolado foi submetido à isquemia regional por pinçamento da artéria interventricular anterior seguido de isquemia global. Durante reperfusão, com o coração ejetante (em modo "working heart"), aos 30, 60 e 90 minutos foram medidos parâmetros hemodinâmicos de contratilidade e metabólicos, obtendo-se assim a elastância máxima (Emáx), o trabalho sistólico pré-recrutável (PRSW), rigidez do ventrículo (EDPRV), fluxo coronariano, consumo de oxigênio e dosagens de lactato e glicose. RESULTADOS: Os animais suporte ficaram estáveis durante todo o experimento. O pH, a pressão parcial de oxigênio e o hematócrito foram mantidos estáveis e dentro da faixa fisiológica. O coração isolado foi perfundido de forma adequada durante todo o experimento. Os dados hemodinâmicos e metabólicos propostos puderam ser mensurados adequadamente e sempre com o coração ejetante, em modo de execução de trabalho ("working heart"). CONCLUSÃO: O modelo de coração isolado desenvolvido tipo "working heart" se manteve estável durante todo o experimento, sem a administração de drogas cardiotônicas e possibilitou a mensuração de todos os dados propostos de forma efetiva com o coração executando trabalho.

OBJECTIVE: To develop an isolated working heart model with parabiotic circulaton in swines and verify its stability and possibility to allow effective measurements of hemodinamic and metabolic data. METHODS: This model was developed during study of association of agents to cardiolegia. There were performed 18 experiments, each with a support animal and a donor animal. Donor animal heart was perfused as isolated working heart with parabiotic circulation from support animal. Isolated heart underwent regional ischemia by interventricular artery clamping, followed by global ischemia. During reperfusion in working heart state mode at 30, 60 and 90 minutes, contractility indices such as elastance, preload recruitable stroke work index and metabolic data were acquired. RESULTS: Support animals were kept stable throughout the procedures without use of blood transfusions or vasoactive drugs. pH, oxygen partial pressure and hematocrit were kept stable and within physiologic ranges. Isolated heart was perfused adequately throughout the experiment. All hemodinamic and metabolic data proposed were adequately measured in working heart state mode. CONCLUSION: This swine isolated "working heart" model was kept stable throughout the experiments with no administration of vasoactive drugs and it allowed adequate measurements of metabolic and hemodinamic data.

Analgesic requirements for patients undergoing lower extremity orthopedic surgery: the effect of combined spinal and epidural magnesium

Polypharmacological approach is the most common practice to treat perioperative pain, as no single agent has yet been identified to specifically inhibit nociception without associated side effects[1]. Opioids such as Fentanyl is commonly added to local anesthetics to produce spinal and epidural anesthesia. However, significant adverse effects, such as pruritus, respiratory depression, hemodynamic instability and occasionally severe nausea and vomiting, may limit their use[3, 4, 5]. Our present study was designed to assess the effectiveness of using combined intrathecal and epidural magnesium [Mg] in reducing intra-and postoperative analgesic requirements and improving the quality of analgesia. Eighty patients ASA I, II, III who scheduled for lower extremity orthopedic surgery were included in the study. Patients were randomly allocated to one of two groups, 40 patients each. The Control Group: patients received intrathecal 10 mg of Bupivacaine 0.5% [2 ml], plus 25 micro g of Fentanyl [0.5 ml], plus 0.9% NaCl solution [1 ml] and an epidural infusion of 0.9% NaCl at a rate of 5 ml/hr. The Magnesium Group: patients received intrathecal 10 mg of Bupivacaine 0.5% [2 ml], plus 25 micro g of Fentanyl [0.5 ml], plus 50 mg of 5% Mg [1 ml] and an epidural infusion of 2% Mg at a rate of 100 mg/hr [5 ml/hr]. Intrathecal Mg prolonged fentanyl analgesia as indicated by increased duration of anesthesia in the Mg group, and thus improving the quality of spinal anesthesia. The effectiveness of the postoperative analgesia was confirmed by markedly lower perioperative analgesic requirements [38.3% less than the Control group], the patient's low VAS score, the longer time for the patients first requirements of post-operative analgesia in the Mg group. For lower extremity orthopedic procedure, supplementation of spinal anesthesia with combined intrathecally injected and epidurally infused Mg, considerably reduced the perioperative analgesic requirements without any side effects

Role of intravenous magnesium therapy in short term risk factors of acute myocardial infarction

Acute Myocardial Infarction [AMI] continues to be a major health problem in the developed and underdeveloped countries. A deficient intake of magnesium [Mg[++]] is suspected to be involved in the pathogenesis of ischaemic heart disease and sudden death. A large proportion of deaths among patients with myocardial infarction occur within the first 24 hours due to arrhythmias, re-infarction and sudden cardiac death. The aim of study was to evaluate the role of intravenous magnesium therapy in the short term risk factors of AMI i.e. arrhythmias, re-infarction and sudden cardiac death within first 24 hours of the incidence of AMI. The study was conducted in Punjab Institute of Cardiology, Lahore. The study group [comprising 75 patients of AMI] was given intravenous magnesium in standard doses along with conventional therapy of AMI. The control group [comprising 75 patients of AMI] was given only conventional therapy. Both groups were compared for occurrence of short term risk factors of AMI during the next 24 hours of their stay in the hospital. The results indicated that patients getting magnesium therapy along with conventional treatment of AMI, only 02 patients [2.67%] developed complications i.e. arrhythmias [1.33%], sudden cardiac death [1.33%], while those patients who were not given intravenous magnesium[control group]. 12 out of 75 patients [16%] developed complications i.e. arrhythmias [10.67%], and sudden cardiac deaths [5.33%]. The number of patients who developed post-infarct short term complications in the control group was statistically significant. In conclusion, it seems that intravenous magnesium therapy may have anti-arrhythmic effects and may prevent re-infarction and sudden cardiac death

Changes in erythrocyte contents of potassium, sodium and magnesium and Na, K-pump activity after the administration of potassium and magnesium salts.

Low potassium and magnesium status and decreased Na, K-pump activity is an endemic condition among rural Northeast Thais. The authors examined the effect of supplementing potassium and magnesium on erythrocyte potassium, sodium and magnesium content and on Na, K-pump activity. Rural Northeast Thai renal stone patients (62) were recruited, divided into four groups and supplemented for one month with potassium chloride (Group1, n = 16), potassium-sodium citrate (Group2, n = 15), chelated magnesium (Group 3, n =16) and potassium-magnesium citrate (Group 4, n =15) in order to achieve 40 mmol potassium, 10 mmol magnesium and 60 mmol citrate daily. After supplementation with potassium (Groups 1, 2 and 4), plasma potassium and Na, K-pump activity rose significantly in Groups 1, 2 and 4, but erythrocyte potassium rose only in Groups 2 and 4. When supplementing elemental magnesium (Groups 3 and 4), the chelated magnesium caused a significant increase in plasma potassium, erythrocyte potassium, sodium and magnesium without a significant increase in Na, K-pump activity. By contrast, potassium-magnesium citrate caused a significant increase in erythrocyte potassium and magnesium and Na, K-pump activity, but depressed erythrocyte sodium. These results suggest the forms of potassium and /or magnesium salts being supplemented should be considered because they affect erythrocyte potassium, sodium and magnesium content and Na, K-pump activity differently.

Effect of oral magnesium supplementation on the lipid profile and blood glucose of patients with type 2 diabetes mellitus.

BACKGROUND AND OBJECTIVES: Controversial reports are available regarding the effect of magnesium (Mg) on lipid profile and glycaemic control in diabetic patients. The present study was designed on 1) compare serum Mg levels in diabetic patients with those of non-diabetic controls and 2) to assess the effect of oral Mg supplementation on lipid profile and blood glucose of these patients. METHODS: The study included 40 patients of type 2 diabetes mellitus (DM) and 54 age and sex matched non-diabetic controls. After the baseline investigations of all the subjects (n=94) including blood glucose, serum lipid and magnesium, the diabetic patients (study group) were supplemented with 600 mg of Mg oxide daily for 12 weeks. They were followed up every four weeks (for a total duration of twelve weeks) and investigated for the above parameters. RESULTS: Mean serum magnesium at baseline in the diabetic patients was significantly lower than that in controls (1.44 +/- 0.48 mg/dl Vs 2.29 +/- 0.33 mg/dl; p < 0.001). A significant fall in serum total cholesterol, LDL cholesterol and triglycerides and a rise in HDL cholesterol levels was observed 4 to 8 weeks after initiation of magnesium supplementation and continued till the end of the study i.e. 12 weeks. Fasting and post-prandial blood glucose levels did not show any significant change after twelve weeks of magnesium supplementation when compared with baseline. CONCLUSIONS: A significant hypomagnesemia was observed in diabetic patients as compared to controls and Mg supplementation resulted in a beneficial effect on the lipid profile of these patients with no significant effect on blood glucose levels.