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BMJ Paediatrics Open May 2024To review the efficacy of nebulised magnesium sulfate (MgSO) in acute asthma in children. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To review the efficacy of nebulised magnesium sulfate (MgSO) in acute asthma in children.
METHODS
The authors searched Medline, Embase, Web of Science and Cochrane Library for randomised controlled trials (RCTs) published until 15 December 2023. RCTs were included if they compared the efficacy and safety of nebulised MgSO as a second-line agent in children presenting with acute asthma exacerbation. A random-effects meta-analysis was performed, and the Risk of Bias V.2 tool was used to assess the biases among them.
RESULTS
10 RCTs enrolling 2301 children with acute asthma were included. All trials were placebo controlled and administered nebulised MgSO/placebo and salbutamol (±ipratropium bromide). There was no significant difference in Composite Asthma Severity Score between the two groups (6 RCTs, 1953 participants; standardised mean difference: -0.09; 95% CI: -0.2 to +0.02, I=21%). Children in the MgSO group have significantly better peak expiratory flow rate (% predicted) than the control group (2 RCTs, 145 participants; mean difference: 19.3; 95% CI: 8.9 to 29.8; I=0%). There was no difference in the need for hospitalisation, intensive care unit admission or duration of hospital stay. Adverse events were minor, infrequent (7.3%) and similar among the two groups.
CONCLUSIONS
There is low-certainty evidence that nebulised MgSO as an add-on second-line therapy for acute asthma in children does not reduce asthma severity or a need for hospitalisation. However, it was associated with slightly better lung functions. The current evidence does not support the routine use of nebulised MgSO in paediatric acute asthma management.
PROSPERO REGISTRATION NUMBER
CRD42022373692.
Topics: Humans; Magnesium Sulfate; Asthma; Child; Nebulizers and Vaporizers; Acute Disease; Administration, Inhalation; Bronchodilator Agents; Randomized Controlled Trials as Topic; Anti-Asthmatic Agents
PubMed: 38782483
DOI: 10.1136/bmjpo-2024-002638 -
Minerva Anestesiologica May 2024We assessed the efficiency of intravenous adjuvants in decreasing opioid intake and pain scores after spine fusion surgery. (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Effects of intravenous single-bolus lidocaine infusion versus intravenous single-bolus magnesium sulfate infusion on postoperative pain, emotional status, and quality of life in patients undergoing spine fusion surgery: a randomized study.
BACKGROUND
We assessed the efficiency of intravenous adjuvants in decreasing opioid intake and pain scores after spine fusion surgery.
METHODS
This study included 120 patients aged 18-60 listed for spine fusion surgery under general anesthesia. Patients were randomly assigned to four groups: Group (Lidocaine): received IV lidocaine 4 mg/kg in 50 mL volume over 30 min. Group (Magnesium): received IV magnesium sulfate 30mg/kg in 50 mL volume over 30 min. Group (combined Lidocaine and Magnesium): received IV lidocaine 4 mg/kg in 50 mL volume over 30 min.+IV magnesium sulfate 30mg/kg in 50 mL volume over 30 min. Group (Control): received IV saline 50 mL. The time to the first request analgesia, the postoperative pain score, total analgesic use, patient satisfaction, anxiety, depression, mental state, quality of life, and side effects were measured.
RESULTS
The combined group had more extended time for the first analgesic request and fewer rescue analgesia doses than the other groups. NRS scores at rest or movement were statistically significantly lower in the lidocaine group and the combined group compared to the control group (P1, P3<0.05) at almost all times. This combination reduces anxiety and depression and improves overall health up to three months after a single infusion. The combined group had higher patient satisfaction.
CONCLUSIONS
A synergistic effect of a combination of lidocaine and magnesium sulfate on perioperative pain was found. It reduces analgesic consumption, depression, and anxiety and improves overall health up to three months after a single infusion dose.
Topics: Humans; Magnesium Sulfate; Lidocaine; Male; Female; Pain, Postoperative; Adult; Middle Aged; Quality of Life; Infusions, Intravenous; Spinal Fusion; Anesthetics, Local; Emotions; Young Adult; Adolescent; Double-Blind Method
PubMed: 38771164
DOI: 10.23736/S0375-9393.24.17868-6 -
European Review For Medical and... May 2024Cisplatin is a widely used and potent cytotoxic chemotherapy agent, but its nephrotoxicity is a significant limiting side effect. Various premedication approaches have...
OBJECTIVE
Cisplatin is a widely used and potent cytotoxic chemotherapy agent, but its nephrotoxicity is a significant limiting side effect. Various premedication approaches have been implemented to preserve renal function, including magnesium (Mg) preloading. However, the optimal Mg dosage is still unknown. Our study aimed to assess the protective effects of different Mg doses as premedication in cisplatin-based chemoradiotherapy for patients with local/locally advanced cervical and head-neck cancers.
PATIENTS AND METHODS
This retrospective, multicenter study involved premedication with saline infusion containing potassium chloride and magnesium sulfate (MgSO4) for all patients before cisplatin treatment. Patients were divided into two groups: 12 mEq MgSO4 (low-dose Mg preload group, low-Mg) and 24 mEq MgSO4 (high-dose Mg preload group, high-Mg). Renal function was evaluated using serum creatinine (sCr, mg/dl) and estimated glomerular filtration rate (eGFR, ml/min). Acute kidney injury (AKI) was defined per the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Renal outcomes and efficacy were compared between the groups.
RESULTS
In the low-Mg group (n = 159), sCr levels were significantly higher compared to baseline, various weeks during treatment, and at the 1st, 3rd, 6th, and 12th months post-treatment (p < 0.001). In the high-Mg group (n = 128), no significant changes were observed during treatment and at 1st, 3rd, and 12th months post-treatment (p > 0.05). A significant reduction in mean sCr level from baseline to 6 months was noted in the high-Mg group (p < 0.001). eGFR values are generally correlated with sCr levels. AKI occurred in 21 (13.2%) and 22 (17.7%) patients in the low-Mg and high-Mg groups, respectively (p = 0.292). There was no difference in progression-free or overall survival between the groups.
CONCLUSIONS
We clearly demonstrated that saline hydration with 24 mEql MgSO4 supplementation before cisplatin treatment has a better renal protective effect than 12 mEql MgSO4 without reducing efficacy, especially in patients with local/local advanced cervical and head-neck cancer receiving cisplatin with concurrent radiotherapy.
Topics: Cisplatin; Humans; Retrospective Studies; Acute Kidney Injury; Female; Middle Aged; Magnesium Sulfate; Male; Antineoplastic Agents; Glomerular Filtration Rate; Head and Neck Neoplasms; Adult; Magnesium; Dose-Response Relationship, Drug; Aged
PubMed: 38766796
DOI: 10.26355/eurrev_202405_36185 -
Environmental Microbiology May 2024The degradation of freshwater systems by salt pollution is a threat to global freshwater resources. Salinization is commonly identified by increased specific conductance...
The degradation of freshwater systems by salt pollution is a threat to global freshwater resources. Salinization is commonly identified by increased specific conductance (conductivity), a proxy for salt concentrations. However, conductivity fails to account for the diversity of salts entering freshwaters and the potential implications this has on microbial communities and functions. We tested 4 types of salt pollution-MgCl, MgSO, NaCl, and NaSO-on bacterial taxonomic and functional α-, β-diversity of communities originating from streams in two distinct localities (Nebraska [NE] and Ohio [OH], USA). Community responses depended on the site of origin, with NE and OH exhibiting more pronounced decreases in community diversity in response to NaSO and MgCl than other salt amendments. A closer examination of taxonomic and functional diversity metrics suggests that core features of communities are more resistant to induced salt stress and that marginal features at both a population and functional level are more likely to exhibit significant structural shifts based on salt specificity. The lack of uniformity in community response highlights the need to consider the compositional complexities of salinization to accurately identify the ecological consequences of instances of salt pollution.
Topics: Fresh Water; Bacteria; Salinity; Microbiota; Sodium Chloride; Ohio; Sulfates; Biodiversity; Magnesium Sulfate; Magnesium Chloride
PubMed: 38757470
DOI: 10.1111/1462-2920.16628 -
Experimental and Therapeutic Medicine Jun 2024Gestational hypertension (GH) is a common disorder during pregnancy that can cause adverse pregnancy outcomes. In the present study, magnesium sulfate (MgSO) combined...
Gestational hypertension (GH) is a common disorder during pregnancy that can cause adverse pregnancy outcomes. In the present study, magnesium sulfate (MgSO) combined with labetalol was used for clinical treatment. Randomized controlled trial was conducted in 100 patients with GH, documented in the Department of Obstetrics and Gynecology (Taicang TCM Hospital) grouped into the experimental (Expt) and control (Ctrl) groups (n=50 cases/group). The Ctrl group was treated with MgSO, whereas the Expt group was treated with MgSO + labetalol. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the Expt group were not significantly different from those in the Ctrl group (P>0.05). By contrast, the SBP and DBP were significantly lower after treatment than those before treatment in both groups (P<0.05). Whole blood viscosity, plasma viscosity and hematocrit were significantly lower in the Expt group compared with those in the Ctrl group after treatment (P<0.05). High mobility group box-1 protein, homocysteine and serum cystatin C levels in the Expt group were also markedly lower than those in the Ctrl group after treatment (P<0.05). In the Expt group, the rate of spontaneous vaginal delivery was much higher, whereas the rates of cesarean section and postpartum hemorrhage were markedly lower than those in the Ctrl group (P<0.05). The occurrence of fetal intrauterine distress, placental abruption, neonatal asphyxia, premature birth and neonatal death were also significantly lower in the Expt group than those in the Ctrl group (P<0.05). In conclusion, MgSO + labetalol could improve inflammatory stress and the hemodynamics of patients with GH, and may have a marked antihypertensive effect. Thus, it may improve pregnancy outcome and reduce perinatal complications.
PubMed: 38756909
DOI: 10.3892/etm.2024.12554 -
Environmental Science and Pollution... May 2024An integrated approach combining water quality indices (WQIs), multivariate data mining, and geographic information system (GIS) was employed to examine the water...
An integrated approach combining water quality indices (WQIs), multivariate data mining, and geographic information system (GIS) was employed to examine the water quality of Bheemasandra Lake, located adjacent to a sewage treatment plant (STP) in Tumakuru city, India. The analysis of 22 lake water samples, examined before and after the monsoons, revealed that the physicochemical parameters namely - electrical conductivity, biochemical oxygen demand, turbidity, total dissolved solids, ammoniacal nitrogen, nitrates, phosphates, magnesium, total hardness, total alkalinity, and calcium - exceeded the acceptable limits stipulated by national and international standards. The Canadian Council of Ministers of the Environment WQI (pre-monsoon: 25.3; post-monsoon: 33.9) and weighted arithmetic WQI (pre-monsoon: 3398; post-monsoon: 2093) designated the water as unsafe for drinking. Irrigation WQIs (sodium adsorption ratio, sodium percentage, residual sodium carbonate, magnesium hazard, permeability index, and potential salinity) implied water's suitability for irrigation. However, electrical conductivity indicated otherwise. Industrial WQIs (Larson-Skold Index, Langelier Index, Aggressive Index, and Puckorius Scaling Index) illustrated scaling propensity and the chloride sulfate mass ratio alluded galvanic corrosion potential. Hierarchical cluster analysis gathered 22 sampling points into two clusters (cluster 1: relatively lower polluted regions; cluster 2: highly polluted regions) for each season based on similarities in water features. Principal component analysis extracted four (79.07% cumulative variance) and six (87.14% cumulative variance) principal components before and after the monsoons, respectively. These components identified the primary pollution sources as urban sewage and natural lithological processes. WQI maps, created using the inverse distance weighted interpolation technique, enhanced the visualization of spatial-temporal variations. This study highlights the dire consequences of urbanization, STP pollution, and sewage management failures, necessitating that concerned authorities should implement policies and measures to curb the negative impacts on the environment and public health.
Topics: India; Water Quality; Environmental Monitoring; Lakes; Geographic Information Systems; Data Mining; Water Pollutants, Chemical
PubMed: 38753236
DOI: 10.1007/s11356-024-33670-7 -
Journal of Clinical Anesthesia Sep 2024Investigating the effect of magnesium sulfate (MS) on emergence agitation (EA) in adult surgical patients following general anesthesia (GA). (Meta-Analysis)
Meta-Analysis
The effect of magnesium sulfate on emergence agitation in surgical adult patients undergoing general anesthesia: A systematic review and meta-analysis of randomized controlled trials.
STUDY OBJECTIVE
Investigating the effect of magnesium sulfate (MS) on emergence agitation (EA) in adult surgical patients following general anesthesia (GA).
DESIGN
Systematic literature review and meta-analysis (PROSPERO number: CRD42023461988).
SETTING
Review of published literature.
PATIENTS
Adults undergoing GA.
INTERVENTIONS
Intravenous administration of MS.
MEASUREMENTS
We searched PubMed/MEDLINE, EMBASE, the Cochrane Library, Scopus, and Web of Science for publications until September 14, 2023. The primary outcome was the incidence of EA, while the secondary outcomes included the impact of MS on postoperative agitation score (PAS), emergence variables and adverse events. Relative risk (RR) with 95% confidence interval (CI) measured dichotomous outcome, while standardized mean difference (SMD) or mean difference (MD) with 95% CI measured continuous outcomes.
MAIN RESULTS
Meta-analysis of five randomized controlled trials (RCTs) indicated that MS was associated with a lower incidence of EA at various time points (0 min: RR = 0.62, 95% CI [0.41, 0.95]; p = 0.183, I = 43.6%; 5 min: RR = 0.29, 95% CI [0.16, 0.52]; p = 0.211, I = 36%; 10 min: RR = 0.14, 95% CI [0.06, 0.32]; p = 0.449, I = 0%; 15 min: RR = 0.11, 95% CI [0.02, 0.55]; p = 0.265, I = 19.5%; 30 min: RR = 0.05, 95% CI [0.00, 0.91]; the postoperative period: RR = 0.21, 95% CI [0.09, 0.49]; p = 0.724, I = 0%;). Additionally, MS was associated with a reduced PAS at various time points except for 0 min. However, no significant differences were observed in extubation time, the length of stay in the post-anesthesia care unit, postoperative nausea and vomiting or total complications.
CONCLUSIONS
Limited available evidence suggests that MS was associated with a lower incidence of EA. Nevertheless, further high-quality studies are warranted to strengthen and validate the effect of MS in preventing EA in adult surgical patients.
Topics: Humans; Anesthesia, General; Magnesium Sulfate; Randomized Controlled Trials as Topic; Emergence Delirium; Anesthesia Recovery Period; Adult; Incidence
PubMed: 38749290
DOI: 10.1016/j.jclinane.2024.111499 -
The Journal of Arthroplasty May 2024We compared the efficacy and safety of a modified cocktail for postoperative analgesia and early functional rehabilitation in patients undergoing total hip arthroplasty...
BACKGROUND
We compared the efficacy and safety of a modified cocktail for postoperative analgesia and early functional rehabilitation in patients undergoing total hip arthroplasty (THA).
METHODS
Magnesium sulfate and sodium bicarbonate were added to a cocktail of ropivacaine, epinephrine, and dexamethasone. Primary outcome measures were visual analog scale (VAS) pain scores at various intervals after surgery, morphine consumption for rescue analgesia after surgery, and time to first rescue analgesia. Secondary outcomes were hip function after surgery, daily walking distance, quadriceps muscle strength, and the incidence of postoperative adverse reactions.
RESULTS
Morphine consumption was significantly lower in the modified cocktail group than in the control group in the first 24 hours after surgery (6.2 ± 6.0 versus 14.2 ± 6.4 mg, P < .001), as was total morphine consumption (10.0 ± 8.6 versus 19.2 ± 10.1 mg, P < .001). The duration of the first rescue analgesia was significantly prolonged (23.7 ± 10.3 versus 11.9 ± 5.8 mg, P < .001). Morphine consumption was also reduced in the magnesium sulfate and sodium bicarbonate groups over a 24-hour period compared to the control group (P < .001). The modified cocktail group had significantly lower resting VAS pain scores than the control group within 24 hours after surgery (P < .050). The VAS pain scores during movement within 12 hours after surgery were also lower (P < .050). The experimental groups showed better hip range of motion (P < .050) and longer walking distance (P < .050) on the first postoperative day, and levels of inflammatory markers were significantly reduced. The incidence of postoperative adverse reactions was similar among the 4 groups.
CONCLUSIONS
The modified cocktail with a new adjuvant can prolong the duration of postoperative analgesia, reduce the dosage of rescue analgesics, and accelerate early postoperative functional recovery in patients undergoing THA.
PubMed: 38735542
DOI: 10.1016/j.arth.2024.05.019 -
Applied Microbiology and Biotechnology May 2024This study was conducted to investigate the effects of Ca(HPO) and MgSO on the bacterial community and nitrogen metabolism genes in the aerobic composting of pig manure....
This study was conducted to investigate the effects of Ca(HPO) and MgSO on the bacterial community and nitrogen metabolism genes in the aerobic composting of pig manure. The experimental treatments were set up as control (C), 1% Ca(HPO) + 2% MgSO (CaPM1), and 1.5% Ca(HPO) + 3% MgSO (CaPM2), which were used at the end of composting for potting trials. The results showed that Ca(HPO) and MgSO played an excellent role in retaining nitrogen and increasing the alkali-hydrolyzed nitrogen (AN), available phosphorus (AP), and available potassium (AK) contents of the composts. Adding Ca(HPO) and MgSO changed the microbial community structure of the compost. The microorganisms associated with nitrogen retention were activated. The complexity of the microbial network was enhanced. Genetic prediction analysis showed that the addition of Ca(HPO) and MgSO reduced the accumulation of nitroso-nitrogen and the process of denitrification. At the same time, despite the reduction of genes related to nitrogen fixation, the conversion of ammonia to nitrogenous organic compounds was promoted and the stability of nitrogen was increased. Mantel test analysis showed that Ca(HPO) and MgSO can affect nitrogen transformation-related bacteria and thus indirectly affect nitrogen metabolism genes by influencing the temperature, pH, and organic matter (OM) of the compost and also directly affected nitrogen metabolism genes through PO and Mg. The pot experiment showed that composting with 1.5% Ca(HPO) + 3% MgSO produced the compost product that improved the growth yield and nutrient content of cilantro and increased the fertility of the soil. In conclusion, Ca(HPO) and MgSO reduces the loss of nitrogen from compost, activates nitrogen-related bacteria and genes in the thermophilic phase of composting, and improves the fertilizer efficiency of compost products. KEY POINTS: • Ca(HPO) and MgSO reduced the nitrogen loss and improved the compost effect • Activated nitrogen-related bacteria and altered nitrogen metabolism genes • Improved the yield and quality of cilantro and fertility of soil.
Topics: Nitrogen; Manure; Animals; Swine; Bacteria; Magnesium Sulfate; Composting; Phosphorus; Soil Microbiology; Hydrogen-Ion Concentration; Temperature; Potassium; Calcium Phosphates; Nitrogen Fixation
PubMed: 38734749
DOI: 10.1007/s00253-024-13167-6 -
Molecules (Basel, Switzerland) Apr 2024It is a valid path to realize the zero discharge of coal chemical wastewater by using the fractional crystallization method to recycle the miscellaneous salt in...
Influence of Organic Impurities on Fractional Crystallization of NaCl and NaSO from High-Salinity Coal Chemical Wastewater: Thermodynamics and Nucleation Kinetics Analysis.
It is a valid path to realize the zero discharge of coal chemical wastewater by using the fractional crystallization method to recycle the miscellaneous salt in high-salinity wastewater. In this study, the thermodynamics and nucleation kinetics of sodium chloride (NaCl) and sodium sulfate (NaSO) crystallization in coal chemical wastewater were systematically studied. Through analyses of solubility, metastable zone width, and induction period, it was found that the impurity dimethoxymethane would increase the solid-liquid interface energy and critical crystal size during the nucleation of NaSO. Ternary phase diagrams of the pseudo-ternary NaSO-NaCl-HO systems in simulated wastewater were plotted in the temperature range of 303.15 to 333.15 K, indicating that a co-ionization effect existed between NaCl and NaSO, and NaCl had a strong salting out effect on NaSO. Finally, the nucleation rate and growth rate of NaSO crystals under simulated wastewater conditions were determined by the intermittent dynamic method, and the crystallization kinetic models of NaSO were established. The crystallization nucleation of NaSO crystals was found to be secondary nucleation controlled by surface reactions. The basic theoretical research of crystallization in this study is expected to fundamentally promote the application of fractional crystallization to realize the resource utilization of high-salinity wastewater in the coal chemical industry.
PubMed: 38731419
DOI: 10.3390/molecules29091928