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Journal of Cardiothoracic Surgery Jun 2024Systematic evaluation of the safety of del Nido cardioplegia compared to cold blood cardioplegia in adult cardiac surgery. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Systematic evaluation of the safety of del Nido cardioplegia compared to cold blood cardioplegia in adult cardiac surgery.
METHODS
We systematically searched PubMed, EMbase, The Cochrane Library and ClinicalTrials.gov for randomized clinical trials (published by 14 January 2024) comparing del Nido cardioplegia to cold blood cardioplegia in adult. Our main endpoints were myocardial injury markers and clinical outcomes. We assessed pooled data by use of a random-effects model or a fixed-effects model.
RESULTS
A total of 10 studies were identified, incorporating 889 patients who received del Nido cardioplegia and 907 patients who received cold blood cardioplegia. The meta-analysis results showed that compared with the cold blood cardioplegia, the del Nido cardioplegia had less volume of cardioplegia, higher rate of spontaneous rhythm recovery after cross clamp release, lower levels of postoperative cardiac troponin T and creatinine kinase-myocardial band, all of which were statistically significant. However, there was no statistically significant difference in postoperative troponin I and postoperative left ventricular ejection fraction. The clinical outcomes including mechanical ventilation time, intensive care unit stay time, hospital stay time, postoperative stroke, postoperative new-onset atrial fibrillation, postoperative heart failure requiring intra-aortic balloon pump mechanical circulation support, and in-hospital mortality of both are comparable.
CONCLUSION
Existing evidence suggests that del Nido cardioplegia reduced volume of cardioplegia administration and attempts of defibrillation. The superior postoperative results in CTnT and CK-MB may provide a direction for further research on improvement of the composition of cardioplegia.
Topics: Humans; Heart Arrest, Induced; Randomized Controlled Trials as Topic; Cardiac Surgical Procedures; Cardioplegic Solutions; Adult; Potassium Chloride; Mannitol; Lidocaine; Solutions; Electrolytes; Magnesium Sulfate; Sodium Bicarbonate
PubMed: 38909234
DOI: 10.1186/s13019-024-02846-0 -
Materials (Basel, Switzerland) May 2024The term "desolvation inability" is proposed in order to describe the alteration of the original chemical structure of a solute ("decomposition") prior to the solvent's...
The term "desolvation inability" is proposed in order to describe the alteration of the original chemical structure of a solute ("decomposition") prior to the solvent's full removal upon the heating of the solvate. This behavior has been sporadically reported; however, it is much more frequent, and it is the basis of various, seemingly unrelated, effects/processes, e.g., the vinegar syndrome of cellulose acetate cinematographic films, in thermal energy storage. An explanation and a criterion/index for the prediction of this behavior are provided based on the comparison of the Gibbs free energies of decomposition and desolvation. A new approach for the expression of the Gibbs free energy of desolvation is proposed by reversing the roles of the solute and solvent and by regarding water as the solute rather than as the solvent, while the solute is treated as a solid solvent. This approach results in lower solvation/desolvation Gibbs free energy values. Based on the above, the experimentally observed thermal behavior of three inorganic hydrates is predicted and explained. Theoretically and experimentally, it is supported that decomposition is possible at sub-zero (°C) temperatures and the regarded simultaneous drying and protection of heat-sensitive substances by freeze-drying, at least in some cases, e.g., for the case of gallic acid, is an unverified myth.
PubMed: 38893771
DOI: 10.3390/ma17112508 -
International Journal of Molecular... Jun 2024Biopharmaceutical products, in particular messenger ribonucleic acid (mRNA), have the potential to dramatically improve the quality of life for patients suffering from...
Biopharmaceutical products, in particular messenger ribonucleic acid (mRNA), have the potential to dramatically improve the quality of life for patients suffering from respiratory and infectious diseases, rare genetic disorders, and cancer. However, the quality and safety of such products are particularly critical for patients and require close scrutiny. Key product-related impurities, such as fragments and aggregates, among others, can significantly reduce the efficacy of mRNA therapies. In the present work, the possibilities offered by size exclusion chromatography (SEC) for the characterization of mRNA samples were explored using state-of-the-art ultra-wide pore columns with average pore diameters of 1000 and 2500 Å. Our investigation shows that a column with 1000 Å pores proved to be optimal for the analysis of mRNA products, whatever the size between 500 and 5000 nucleotides (nt). We also studied the influence of mobile phase composition and found that the addition of 10 mM magnesium chloride (MgCl) can be beneficial in improving the resolution and recovery of large size variants for some mRNA samples. We demonstrate that caution should be exercised when increasing column length or decreasing the flow rate. While these adjustments slightly improve resolution, they also lead to an apparent increase in the amount of low-molecular-weight species (LMWS) and monomer peak tailing, which can be attributed to the prolonged residence time inside the column. Finally, our optimal SEC method has been successfully applied to a wide range of mRNA products, ranging from 1000 to 4500 nt in length, as well as mRNA from different suppliers and stressed/unstressed samples.
Topics: RNA, Messenger; Chromatography, Gel; Humans; Porosity; Molecular Weight; Magnesium Chloride
PubMed: 38892442
DOI: 10.3390/ijms25116254 -
Turkish Journal of Medical Sciences 2024This study investigated serum, vitreous, and anterior chamber fluid electrolyte changes, corneal thickness (CT), corneal volume (CV), anterior chamber volume (ACV), and...
BACKGROUND/AIM
This study investigated serum, vitreous, and anterior chamber fluid electrolyte changes, corneal thickness (CT), corneal volume (CV), anterior chamber volume (ACV), and anterior chamber depth (ACD) as an auxiliary diagnostic method in the identification of drowning in fresh or salt water.
MATERIALS AND METHODS
The study used 35 healthy, adult, male, white New Zealand rabbits, seperated into five groups (control, saltwater drowning (SWD), saltwater immersion (SWI), freshwater drowning (FWD), freshwater immersion (FWI)). CT, CV, ACV, and ACD measurements were made with Pentacam topography at 0, 2, and 4 h in all groups. Magnesium (mg), sodium (Na), and chlorine (Cl) were measured in the blood at 0 and 2 h, and in blood, vitreous fluid, and humor aqueous at 4 h.
RESULTS
It was determined that CT, CV, ACV, and ACD are not of great value in drowning diagnosis and are affected by the fresh or salt water rather than drowning. Vitreous Na, Cl, and Mg levels are ineffective in determining drowning after one h. Anterior chamber fluid may provide valuable information in the differentiation freshwater - saltwater drownings at the 4th h in corpses retrieved from water.
CONCLUSION
Anterior chamber fluid Na and Cl levels, especially in corpses removed from salt water, can be an easily used test that can help diagnose drowning.
Topics: Animals; Rabbits; Drowning; Male; Fresh Water; Vitreous Body; Anterior Chamber; Sodium; Magnesium; Chlorine; Cornea; Seawater; Aqueous Humor; Immersion
PubMed: 38812651
DOI: 10.55730/1300-0144.5764 -
JAMA Network Open May 2024Understanding the effect of antenatal magnesium sulfate (MgSO4) treatment on functional connectivity will help elucidate the mechanism by which it reduces the risk of... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Understanding the effect of antenatal magnesium sulfate (MgSO4) treatment on functional connectivity will help elucidate the mechanism by which it reduces the risk of cerebral palsy and death.
OBJECTIVE
To determine whether MgSO4 administered to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks is associated with increased functional connectivity and measures of functional segregation and integration in infants at term-equivalent age, possibly reflecting a protective mechanism of MgSO4.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study was nested within a randomized placebo-controlled trial performed across 24 tertiary maternity hospitals. Participants included infants born to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks who participated in the MAGENTA (Magnesium Sulphate at 30 to 34 Weeks' Gestational Age) trial and underwent magnetic resonance imaging (MRI) at term-equivalent age. Ineligibility criteria included illness precluding MRI, congenital or genetic disorders likely to affect brain structure, and living more than 1 hour from the MRI center. One hundred and fourteen of 159 eligible infants were excluded due to incomplete or motion-corrupted MRI. Recruitment occurred between October 22, 2014, and October 25, 2017. Participants were followed up to 2 years of age. Analysis was performed from February 1, 2021, to February 27, 2024. Observers were blind to patient groupings during data collection and processing.
EXPOSURES
Women received 4 g of MgSO4 or isotonic sodium chloride solution given intravenously over 30 minutes.
MAIN OUTCOMES AND MEASURES
Prior to data collection, it was hypothesized that infants who were exposed to MgSO4 would show enhanced functional connectivity compared with infants who were not exposed.
RESULTS
A total of 45 infants were included in the analysis: 24 receiving MgSO4 treatment and 21 receiving placebo; 23 (51.1%) were female and 22 (48.9%) were male; and the median gestational age at scan was 40.0 (IQR, 39.1-41.1) weeks. Treatment with MgSO4 was associated with greater voxelwise functional connectivity in the temporal and occipital lobes and deep gray matter structures and with significantly greater clustering coefficients (Hedge g, 0.47 [95% CI, -0.13 to 1.07]), transitivity (Hedge g, 0.51 [95% CI, -0.10 to 1.11]), local efficiency (Hedge g, 0.40 [95% CI, -0.20 to 0.99]), and global efficiency (Hedge g, 0.31 [95% CI, -0.29 to 0.90]), representing enhanced functional segregation and integration.
CONCLUSIONS AND RELEVANCE
In this cohort study, infants exposed to MgSO4 had greater voxelwise functional connectivity and functional segregation, consistent with increased brain maturation. Enhanced functional connectivity is a possible mechanism by which MgSO4 protects against cerebral palsy and death.
Topics: Humans; Magnesium Sulfate; Female; Pregnancy; Infant, Newborn; Magnetic Resonance Imaging; Male; Adult; Gestational Age; Cohort Studies; Premature Birth; Infant; Brain; Prenatal Care; Cerebral Palsy
PubMed: 38805222
DOI: 10.1001/jamanetworkopen.2024.13508 -
Materials (Basel, Switzerland) May 2024In this work, the dynamic marine atmospheric corrosion behavior of AZ91 Mg alloy sailing from Yellow Sea to Western Pacific Ocean was studied. The corrosion rates were...
In this work, the dynamic marine atmospheric corrosion behavior of AZ91 Mg alloy sailing from Yellow Sea to Western Pacific Ocean was studied. The corrosion rates were measured using the weight loss method. The microstructure, phase, and chemical composition of corroded samples were investigated by SEM, EDS, XRD, and XPS. The results show that the evolution of corrosion rates of AZ91 Mg alloy was divided into three stages: rapidly increasing during the first 3 months, then remaining stable for the next three months, and finally decreasing after 6 months. The annual corrosion rate of Mg alloy reached 32.50 μm/y after exposure for 12 months in a dynamic marine atmospheric environment, which was several times higher than that of the static field exposure tests. AZ91 magnesium alloy was mainly subjected to localized corrosion with more destructiveness to Mg parts, which is mainly due to the synergistic effect of high relative humidity, the high deposition rate of chloride ion, sulfur dioxide acidic gas produced by fuel combustion, and rapid temperature changes caused by the alternating changes in longitude and latitude during navigation. As the exposure time increased, the corrosion pits gradually increased and deepened. The maximum depth of the corrosion pit was 197 μm after 12 months of exposure, which is almost 6 times the average corrosion depth. This study provides scientific data support for the application of magnesium alloys in shipborne aircraft and electronic equipment. The results could provide guidance for the design of new magnesium alloys and development of anti-corrosion technologies.
PubMed: 38793361
DOI: 10.3390/ma17102294 -
Journal of Chromatography. A Jul 2024A reliable and greener alternative to the usual extraction methods is reported for the determination of pesticide residues in soybeans. This novel approach combines the...
Determination of pesticide residues in soybeans using QuEChERS followed by deep eutectic solvent-based DLLME preconcentration prior to gas chromatography-mass spectrometry analysis.
A reliable and greener alternative to the usual extraction methods is reported for the determination of pesticide residues in soybeans. This novel approach combines the classical QuEChERS extraction method with a DLLME (dispersive liquid-liquid microextraction) step, utilizing a deep eutectic solvent (DES) - camphor: hexanoic acid (1:1 molar ratio) - as the microextraction solvent. This DES has never been employed in pesticide analysis by gas chromatography-mass spectrometry of complex matrices like soybeans. A Plackett-Burman screening design was employed to optimize sample preparation variables of QuEChERS (amount of sodium chloride and magnesium sulfate, and amount of PSA and C18 sorbents) and DLLME (pH of medium, amount of sodium chloride, and volume of microextraction solvent). This design allowed for a systematic evaluation of the impact of each parameter on the method's performance. The optimized method was evaluated using a certified reference material and commercial samples of soybeans. The method exhibited high accuracy and precision for most of the analytes under study, demonstrating its applicability for pesticide residue analysis in soybeans. To assess the greenness and practicality of the developed method, the Analytical Greenness (AGREE) and Blue Applicability Grade Index (BAGI) metric systems were employed, respectively. Overall, the proposed QuEChERS-DLLME method using a DES solvent is a reliable and greener alternative to conventional extraction methods for the determination of pesticide residues in soybeans. Its high performance, coupled with its environmental friendliness, makes it a promising tool for food safety analysis.
Topics: Pesticide Residues; Glycine max; Gas Chromatography-Mass Spectrometry; Liquid Phase Microextraction; Deep Eutectic Solvents; Limit of Detection; Reproducibility of Results
PubMed: 38788403
DOI: 10.1016/j.chroma.2024.464999 -
BMC Ophthalmology May 2024Vitreous humor (VH) is used for postmortem biochemical studies because it is well protected in an uncontaminated state even after death. The goal of this research was to...
PURPOSE
Vitreous humor (VH) is used for postmortem biochemical studies because it is well protected in an uncontaminated state even after death. The goal of this research was to investigate electrolyte concentrations in the VH from human eyes with and without a history of vitrectomy surgery.
METHODS
We analyzed the sodium (Na), potassium (K), chloride (Cl) and magnesium (Mg) concentrations from 34 VH samples from 34 patients. Eleven samples were from eyes with a history of vitrectomy, and the remaining 23 eyes had no history of vitrectomy. The correlations of Na, K, Cl and Mg concentrations with patient age, interval between first and second vitrectomy, and lens status (history of cataract surgery) were also evaluated.
RESULTS
The Na, K, Cl and Mg concentrations in VH from vitrectomized eyes were 134.1 ± 7.9 mmol/L, 3.7 ± 0.2 mmol/L, 99.7 ± 6.7 mmol/L and 0.59 ± 0.09 mmol/L, respectively; all were significantly lower than the corresponding concentrations in VH from control eyes (lower by 5.0%, 11.0%, 11.7%, and 22.6%, respectively). Na, K, Cl and Mg concentrations in VH from vitrectomized eyes did not show significant correlations with patient ages or the interval between their first and second vitrectomies. There were no significant differences in Na, K, Cl and Mg concentrations in VH between phakic eyes and intraocular lens-implanted eyes.
CONCLUSIONS
With the increasing number of vitrectomies being performed, it is necessary to consider the history of vitrectomy when using a subject's VH in forensic examination.
Topics: Humans; Vitrectomy; Vitreous Body; Female; Male; Middle Aged; Aged; Aged, 80 and over; Adult; Electrolytes; Forensic Medicine; Sodium; Potassium; Magnesium
PubMed: 38783230
DOI: 10.1186/s12886-024-03445-2 -
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 -
Heliyon May 2024In this work, the corrosion behavior of pure Mg, Mg3Ag, Mg6Ag, and MgZnYNd alloys in different fixatives (ethyl alcohol (EA), 85 % ethyl alcohol (85 % EA), 10 %...
In this work, the corrosion behavior of pure Mg, Mg3Ag, Mg6Ag, and MgZnYNd alloys in different fixatives (ethyl alcohol (EA), 85 % ethyl alcohol (85 % EA), 10 % neutral buffered formalin (10 % NBF), 4 % glutaric dialdehyde (4 % GD), and 4 % paraformaldehyde (4 % PFA)) was investigated to provide a valuable reference for the selection of fixatives during the histological evaluation of Mg implants. Through the hydrogen evolution test, pH test, and corrosion morphology and product characterization, it was found that corrosion proceeded slowest in the EA and 85 % EA groups, slightly faster in 4 % GD, faster in 10 % NBF, and fastest in 4 % PFA. After corrosion, the EA group surface remained unchanged, while the 85%EA group surface developed minor cracks and warping. The 4%GD fixative formed a dense needle-like protective layer on the Mg substrate. The 10%NBF group initially grew a uniform layer, but later developed irregular pits due to accelerated corrosion. In contrast, the 4%PFA solution caused more severe corrosion attributed to chloride ions. The main corrosion products in the EA and 85%EA groups were MgO and Mg(OH), while the other fixatives containing diverse ions also yielded phosphates like Mg(PO) and MgHPO. In 4 % PFA, AgCl formed on the surface of Mg6Ag alloy after corrosion. Therefore, to minimize Mg alloy corrosion without compromising staining quality, EA or 85 % EA is recommended, while 4 % PFA is not recommended due to its significant impact.
PubMed: 38765150
DOI: 10.1016/j.heliyon.2024.e30286