-
Anales de Pediatria Oct 2023In 2016, a protocol was developed in our hospital for the antenatal administration of magnesium sulfate in pregnant women at risk of imminent preterm birth as a method... (Observational Study)
Observational Study
INTRODUCTION
In 2016, a protocol was developed in our hospital for the antenatal administration of magnesium sulfate in pregnant women at risk of imminent preterm birth as a method to reduce the risk of cerebral palsy (CP).
MATERIAL AND METHODS
We conducted a retrospective observational study in a level IIIC hospital with the primary objective of comparing the incidence of CP before and after the implementation of this protocol. Among the secondary outcomes, we ought to highlight the incidence of cognitive deficits and necrotizing enterocolitis and the mortality in both groups. The sample consisted of preterm newborns delivered before 32 weeks of gestation in 2011-2012 (prior to the implementation of the protocol) and in 2016-2018 (after the implementation of the protocol, whose mothers had received magnesium sulfate for neuroprotection). The clinical and epidemiological characteristics of both groups were comparable.
RESULTS
We collected data for a total of 523 patients, 263 and 260 in each group. As regards the primary outcome, we did not find statistically significant differences between groups. We observed a statistically significant reduction in mortality and the risk of severe necrotizing enterocolitis in the group of patients born in the 2016-2018 period and between 26 and 27 weeks of gestation, whose mothers had received magnesium sulfate.
CONCLUSIONS
In our study, the administration of magnesium sulfate to mothers at risk of preterm birth did not decrease the risk of developing CP.
Topics: Female; Humans; Infant; Infant, Newborn; Pregnancy; Cerebral Palsy; Enterocolitis, Necrotizing; Infant, Premature; Magnesium Sulfate; Neuroprotective Agents; Parturition; Premature Birth; Tertiary Care Centers; Retrospective Studies
PubMed: 37741767
DOI: 10.1016/j.anpede.2023.07.007 -
Materials (Basel, Switzerland) Apr 2024Calcium sulfate bone cement (CSC) is extensively used as a bone repair material due to its ability to self-solidify, degradability, and osteogenic ability. However, the...
Calcium sulfate bone cement (CSC) is extensively used as a bone repair material due to its ability to self-solidify, degradability, and osteogenic ability. However, the fast degradation, low mechanical strength, and insufficient biological activity limit its application. This study used magnesium polyphosphate (MPP) and constructed a composite bone cement composed of calcium sulfate (CS), MPP, tricalcium silicate (CS), and plasticizer hydroxypropyl methylcellulose (HPMC). The optimized CS/MPP/CS composite bone cement has a suitable setting time of approximately 15.0 min, a compressive strength of 26.6 MPa, and an injectability of about 93%. The CS/MPP/CS composite bone cement has excellent biocompatibility and osteogenic capabilities; our results showed that cell proliferation is up to 114% compared with the control after 5 days. After 14 days, the expression levels of osteogenic-related genes, including Runx2, BMP2, OCN, OPN, and COL-1, are about 1.8, 2.8, 2.5, 2.2, and 2.2 times higher than those of the control, respectively, while the alkaline phosphatase activity is about 1.7 times higher. Therefore, the CS/MPP/CS composite bone cement overcomes the limitations of CSC and has more effective potential in bone repair.
PubMed: 38673218
DOI: 10.3390/ma17081861 -
Materials (Basel, Switzerland) Nov 2023Large amounts of chloride ions (Cl) and sulfate ions (SO) are present in salt-washing wastewater, making it unsuitable for direct release. Adsorption can be used to...
Large amounts of chloride ions (Cl) and sulfate ions (SO) are present in salt-washing wastewater, making it unsuitable for direct release. Adsorption can be used to eliminate Cl and SO from salt-washing wastewater, and hydrotalcite is an excellent adsorbent with high adsorption properties for these ions because of a layered bimetallic hydroxide structure. The selective extraction of various metals, such as calcium, magnesium, aluminum, and iron, from steel slag via acid leaching facilitates the utilization of steel slag in the preparation of hydrotalcite. In this study, the leaching mechanism of metal in steel slag was investigated using steel slag as a raw material and acetic acid as the reaction medium. The study obtained the optimal leaching mechanism for preparing hydrotalcite. Hydrotalcite was synthesized from the steel slag leaching solution by hydrothermal synthesis, and its structure was characterized. The adsorption performance of Cl and SO in salt-washing wastewater was investigated by solution adsorption experiments. The removal rates of Cl and SO in salt-washing wastewater reached 12.8% and 38.0%, respectively. After multiple adsorption cycles, the removal rates increased to 98.0% for Cl and 96.4% for SO.
PubMed: 38068146
DOI: 10.3390/ma16237402 -
BMC Pregnancy and Childbirth Apr 2024Some studies have compared the efficacy of nifedipine with that of other tocolytic drugs in the treatment of preterm labor, but the reported results are conflicting. (Meta-Analysis)
Meta-Analysis Comparative Study
BACKGROUND
Some studies have compared the efficacy of nifedipine with that of other tocolytic drugs in the treatment of preterm labor, but the reported results are conflicting.
OBJECTIVE
To compare the efficacy of nifedipine with that of ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor.
METHODS
In this systematic review and meta-analysis, PubMed/MEDLINE, Scopus, Clarivate Analytics Web of Science, and Google Scholar were searched until April 3,2024 using predefined keywords. Randomized controlled trials (RCTs) and clinical trials that compared the efficacy of nifedipine with that of ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor were included. Two authors independently reviewed the articles, assessed their quality and extracted the data. The quality of the included RCTs based on the Cochrane Risk of Bias Tool 1 for clinical trial studies. The risk difference (RD) with the associated 95% confidence interval (CI) was calculated. A forest plot diagram was used to show the comparative point estimates of nifedipine and other tocolytic drugs on the prevention of preterm labor and their associated 95% confidence intervals based on the duration of pregnancy prolongation. Study heterogeneity was evaluated by the I index, and publication bias was evaluated by Egger's test.
RESULTS
Forty studies enrolling 4336 women were included. According to our meta-analysis, there was a significant difference in the prolongation of preterm labor within the first 48 h between the nifedipine group and the nitroglycerine group (RD, -0.04; 95% CI, -0.08 to -0.00; I: 32.3%). Additionally, there were significant differences between nifedipine and ritodrine (RD, 0.11; 95% CI, 0.02 to 0.21; I, 51.2%) for more than one week RD, 0.10; 95% CI, 0.03 to 0.19; I, 33.2%) and for 34 weeks and more. The difference between nifedipine and magnesium sulfate was not significant in any of the four time points.
CONCLUSIONS
Considering the superiority of nifedipine over ritodrine and nitroglycerine and its similar efficacy to magnesium sulfate for tocolysis, it seems that the side effects of these options determine the first drug line.
Topics: Humans; Nifedipine; Female; Pregnancy; Obstetric Labor, Premature; Magnesium Sulfate; Ritodrine; Tocolytic Agents; Nitroglycerin; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38664622
DOI: 10.1186/s12884-024-06497-w -
Acta Obstetricia Et Gynecologica... Dec 2023The risk for brain injury manifested as cerebral palsy is higher in very preterm born children than in term. Prenatal administration of magnesium sulfate (MgSO ) has...
INTRODUCTION
The risk for brain injury manifested as cerebral palsy is higher in very preterm born children than in term. Prenatal administration of magnesium sulfate (MgSO ) has been shown to be neuroprotective and reduces the proportion of very preterm born children later diagnosed with cerebral palsy. A Swedish national clinical practice guideline was implemented in March 2020, stipulating the administration of a single intravenous dose of 6 g MgSO 1-24 h prior to delivery before gestational age 32+0, aiming for 90% treatment coverage. The aim of this study was to evaluate the feasibility of this new clinical practice guideline in the first year of its implementation.
MATERIAL AND METHODS
Data on MgSO treatment were collected by reviewing the medical charts of women who gave birth to live born children in gestational age 22+0-31+6 during the period of March 1, 2020 to February 28, 2021, at five Swedish university hospitals. Women with pre-eclampsia, eclampsia, or high elevated liver enzymes low platelets (HELLP) were excluded.
RESULTS
A total of 388 women were eligible and 79% received treatment with MgSO . Of the 21% not receiving treatment, 9% did not receive treatment due to lack of knowledge about the clinical practice guideline, 9% were not possible to treat and 3% had missing data. The proportion treated increased from 72% to 87% from the first to the last 3 months. Of those treated, 81% received the drug within the stipulated timeframe (mean 8.7 h, median 3.4 h).
CONCLUSIONS
There was a positive trend over time in the proportion of women receiving MgSO treatment, but the a priori target of 90% was not reached during the first year of implementation. Our findings indicate that this target could be reached with additional information to clinicians.
Topics: Pregnancy; Child; Infant, Newborn; Female; Humans; Adult; Young Adult; Premature Birth; Magnesium Sulfate; Neuroprotection; Follow-Up Studies; Cerebral Palsy; Feasibility Studies; Prenatal Care; Neuroprotective Agents
PubMed: 37680134
DOI: 10.1111/aogs.14673 -
PloS One 2023The aim of this study is to evaluate the synergistic effect of polyester fiber-reinforced and nanoslica on the technical performance and durability of geopolymer mortar...
The aim of this study is to evaluate the synergistic effect of polyester fiber-reinforced and nanoslica on the technical performance and durability of geopolymer mortar in terms of the chemical resistance. The study examined how the addition of polyester fiber and nanosilica affects the short-term severe durability of geopolymer mortar specimens made with fly ash (type F). The specimens were cured under ambient conditions. Different percentages (0.6%, 1.2%, and 1.8%) of polyester fiber were used, both with and without nanosilica. Additionally, a reference mixture containing only nanosilica was prepared.All mixtures had a liquid to binder ratio of 0.50, and the ratio of NaOH to Na2SiO3 solution was kept at 2.5:1 by weight. The produced mixes, after 28 days of ambient curing, were immersed for another 28 days in solutions containing 3.5%, 5%, and 5% of sodium chloride, magnesium sulphate and sulfuric acid, respectively. For comparison, control specimens which were not exposed to chemical attacks were tested at the same age of 56 days. Moreover, water absorption and sorptivity tests were conducted to explain the durability performance in a more detailed way. The test results express that the combination of both materials showed a synergistic effect and resulted in greater improvements in compressive and flexural strengths. Both materials can reduce the reduction in compressive strength caused by sulfuric acid exposure, but polyester fiber can increase mass loss. The presence of magnesium sulfate and sodium chloride can lead to a reduction in strength, but the addition of both polyester fiber and nanosilica can mitigate these effects. The addition of fibers creates a network of pores that can limit water absorption, and nanosilica can further enhance the microstructure and reduce water absorption. However, using polyester fiber beyond 1.2 percent can adversely affect the rate of water absorption.
Topics: Sulfuric Acids; Coal Ash; Compressive Strength; Magnesium Sulfate; Polyesters; Silicon Dioxide; Sodium Chloride
PubMed: 37751445
DOI: 10.1371/journal.pone.0289497 -
Frontiers in Pediatrics 2023To analyze survival and morbidity among very preterm infants (VPIs) in Shenzhen and explore factors associated with survival without major morbidity.
OBJECTIVE
To analyze survival and morbidity among very preterm infants (VPIs) in Shenzhen and explore factors associated with survival without major morbidity.
METHODS
Between January 2022 and December 2022, 797 infants were admitted to 25 neonatal intensive care units in Shenzhen with gestational age (GA) < 32 weeks, excluded discharged against medical advice, insufficient information, and congenital malformation, 742 VPIs were included. Comparison of maternal and neonate characteristics, morbidities, survival, and survival without major morbidities between groups used Mann Whitney test and test, multivariate logistic regression was used to analyze of risk factors of survival without major morbidities.
RESULTS
The median GA was 29.86 weeks (interquartile range [IQR], 28.0-31.04), and the median birth weight was 1,250 g (IQR, 900-1,500). Of the 797 VPIs, 721 (90.46%) survived, 53.52% (38 of 71) at 25 weeks' or less GA, 86.78% (105 of 121) at 26 to 27 weeks' GA, 91.34% (211 of 230) at 28 to 29 weeks' GA, 97.86% (367 of 375) at 30 to 31 weeks' GA. The incidences of the major morbidities were moderate-to-severe bronchopulmonary dysplasia,16.52% (113 of 671); severe intraventricular hemorrhage and/or periventricular leukomalacia, 2.49% (17 of 671); severe necrotizing enterocolitis, 2.63% (18 of 671); sepsis, 2.34% (16 of 671); and severe retinopathy of prematurity, 4.55% (27 of 593), 65.79% (450 of 671) survived without major morbidities. After adjustment for GA, birth weight, and 5-min Apgar score, antenatal steroid administration (OR = 2.397), antenatal magnesium sulfate administration (OR = 1.554) were the positivity factors to survival without major morbidity of VPIs, however, surfactant therapy (OR = 0.684,), and delivery room resuscitation (OR = 0.626) that were the negativity factors.
CONCLUSIONS
The present results indicate that survival and the incidence of survival without major morbidities increased with GA. Further, antenatal administration of steroids and magnesium sulfate, surfactant therapy, and delivery room resuscitation were pronounced determinants of survival without morbidities.
PubMed: 38464983
DOI: 10.3389/fped.2023.1298173 -
Experimental and Therapeutic Medicine Jul 2024Models of inflammation, oxidative stress, hyperoxia and hypoxia have demonstrated that magnesium sulfate (MgSO), a commonly used drug in obstetrics, has neuroprotective...
Models of inflammation, oxidative stress, hyperoxia and hypoxia have demonstrated that magnesium sulfate (MgSO), a commonly used drug in obstetrics, has neuroprotective potential. In the present study, the effects of MgSO treatment on inflammation, oxidative stress and fetal brain histopathology were evaluated in an experimental rat model following sevoflurane (Sv) exposure during the mid-gestational period. Rats were randomly divided into groups: C (control; no injections or anesthesia), Sv (exposure to 2.5% Sv for 2 h), MgSO (administered 270 mg/kg MgSO intraperitoneally) and Sv + MgSO (Sv administered 30 min after MgSO injection). Inflammatory and oxidative stress markers were measured in the serum and neurotoxicity was investigated histopathologically in fetal brain tissue. Short-term mid-gestational exposure to a 1.1 minimum alveolar concentration of Sv did not significantly increase the levels of any of the measured biochemical markers, except for TNF-α. Histopathological evaluations demonstrated no findings suggestive of pathological apoptosis, neuroinflammation or oxidative stress-induced cell damage. MgSO injection prior to anesthesia caused no significant differences in biochemical or histopathological marker levels compared to the C and Sv groups. The present study indicated that short-term exposure to Sv could potentially be considered a harmless external stimulus to the fetal brain.
PubMed: 38827470
DOI: 10.3892/etm.2024.12574 -
The Journal of Physical Chemistry. C,... Mar 2024Mg nanoparticles are an emerging plasmonic material due to Mg's abundance and ability to sustain size- and shape-dependent localized surface plasmon resonances across a...
Mg nanoparticles are an emerging plasmonic material due to Mg's abundance and ability to sustain size- and shape-dependent localized surface plasmon resonances across a broad range of wavelengths from the ultraviolet to the near infrared. However, Mg nanoparticles are colloidally unstable due to their tendency to aggregate and sediment. Nanoparticle aggregation can be inhibited by the addition of capping agents that impart surface charges or steric repulsion. Here, we report that the common capping agents poly(vinyl) pyrrolidone (PVP), polyethylene glycol (PEG), cetyltrimethylammonium bromide (CTAB), and sodium dodecyl sulfate (SDS) interact differently and have varied effects on the aggregation and colloidal stability of Mg nanoparticles. Nanoparticles synthesized in the presence of PVP showed improvements in colloidal stability and reduced aggregation, as observed by electron microscopy and optical spectroscopy. The binding of PVP was confirmed through infrared and X-ray photoelectron spectroscopy. The influence of PVP on the reduction of di--butyl magnesium was evaluated through analysis of particle size distribution and Mg yield as a function of reaction time, reducing agent, and temperature. Furthermore, the presence of PVP drastically changes the growth pattern of metallic Mg structures obtained from the reduction of the Grignard reagents butylmagnesium chloride and phenylmagnesium chloride by lithium naphthalenide: large polycrystalline aggregates and well-separated faceted nanoparticles grow without and with PVP, respectively. This study provides new synthetic routes that generate colloidally stable and well-dispersed Mg nanoparticles for plasmonic and other applications.
PubMed: 38533241
DOI: 10.1021/acs.jpcc.4c00366 -
Critical Care and Resuscitation :... Mar 2022The pharmacokinetics and haemodynamic effect of continuous magnesium infusion in non-cardiac intensive care unit (ICU) patients are poorly understood. We aimed to...
The pharmacokinetics and haemodynamic effect of continuous magnesium infusion in non-cardiac intensive care unit (ICU) patients are poorly understood. We aimed to measure serum and urine magnesium levels during bolus and continuous infusion in critically ill adults, compare serum levels with those of a control population, and assess its haemodynamic effect. Pharmacokinetic study A single tertiary adult ICU. Mechanically ventilated adults requiring vasopressor support. A 10 mmol bolus of magnesium sulfate followed by 1.5-3 mmol/h infusion for 24 hours. The primary outcome was the change in total serum magnesium concentration. The main secondary outcome was mean arterial pressure (MAP)- adjusted vasopressor dose. We matched 31 treated patients with 93 controls. Serum total magnesium concentration increased from a median 0.94 mmol/L (interquartile range [IQR], 0.83-1.10 mmol/L) to 1.38 mmol/L (IQR, 1.25-1.69 mmol/L; < 0.001) and stabilised between a median 1.64 mmol/L (IQR, 1.38-1.88 mmol/L) at 7 hours and 1.77 mmol/L (IQR, 1.53-1.85 mmol/L) at 25 hours. This was significantly greater than in the control group ( < 0.001). The MAP-adjusted vasopressor dose decreased during magnesium infusion ( < 0.001). In critically ill patients, a magnesium sulfate bolus followed by continuous infusion achieved moderately elevated levels of total serum magnesium with a decrease in MAP-adjusted vasopressor dose. ACTRN12619000925145.
PubMed: 38046838
DOI: 10.51893/2022.1.OA4