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Cureus Mar 2024In the field of general anesthesia, magnesium sulfate (MgSO4) has become a valuable adjunct because it provides a range of benefits that enhance and optimize... (Review)
Review
In the field of general anesthesia, magnesium sulfate (MgSO4) has become a valuable adjunct because it provides a range of benefits that enhance and optimize conventional aesthetic procedures. This review highlights the various intra-anesthetic benefits of MgSO4 while examining its complex function in the treatment using anesthesia. Magnesium inhibits the release of acetylcholine at the motor endplate and blocks calcium channels at presynaptic nerve terminals. This reduces the amplitude of endplate potential and the excitability of muscle fibers, which increases the potency of a neuromuscular blockade by nondepolarizing neuromuscular blockers. This activity may lessen the need for primary muscle relaxants. Moreover, its capacity to potentially reduce the total amount of main aesthetic agents needed emphasizes its function in maximizing anesthesia dosage, ensuring sufficient depth while perhaps potentially reducing adverse effects linked with increased dosages. MgSO4's adaptable qualities present a viable path for improving anesthetic outcomes, possibly improving patient safety and improving surgical results.
PubMed: 38633961
DOI: 10.7759/cureus.56348 -
PloS One 2024Urban agriculture may be an avenue to help alleviate strain on the global production of staple crops like corn (Zea mays), but significant knowledge gaps exist regarding...
Urban agriculture may be an avenue to help alleviate strain on the global production of staple crops like corn (Zea mays), but significant knowledge gaps exist regarding the optimization of staple crop production in urban settings, and especially in arid urban settings where different challenges exist for crop success. We sought to assess abiotic and biotic factors that impact sweet corn production in six arid urban agricultural plots with varying levels of shade stress, a known inhibitor of corn production. Corn successfully reached maturity in 50% of the studied plots (n = 18). Microbial richness and diversity were uniformly high in all plot soils and not indicated as a hinderance to corn production nor correlated with corn success. Multiple corn success metrics were positively correlated with average daytime light intensity (r = 0.74 to 0.84) and soil organic matter (r = 0.77 to 0.89), suggesting that these factors are critical aspects of successful corn production. In plots that did not receive optimal light exposure, exceptional soil health and morning vs afternoon sun exposure offset at least some degree of shade stress in these arid urban environments. Corn success metrics were negatively correlated with soil calcium, magnesium, sodium and sulfate (r = -0.71 to -0.90), suggesting that minimizing or mitigating the buildup of salt constituents in soils is critical for successful corn production. Optimizing staple crop production in arid urban agricultural settings supports food chain stability and social and economic security of local communities. This work suggests abiotic and biotic drivers of corn success which can be utilized for crop optimization in these environments.
Topics: Zea mays; Agriculture; Soil; Crop Production; Crops, Agricultural
PubMed: 38625854
DOI: 10.1371/journal.pone.0301633 -
Italian Journal of Pediatrics Apr 2024Carnitine palmitoyltransferase II (CPT II) deficiency is a rare inborn error of mitochondrial fatty acid metabolism with autosomal recessive pattern of inheritance. Its...
BACKGROUND
Carnitine palmitoyltransferase II (CPT II) deficiency is a rare inborn error of mitochondrial fatty acid metabolism with autosomal recessive pattern of inheritance. Its phenotype is highly variable (neonatal, infantile, and adult onset) on the base of mutations of the CPT II gene. In affected subjects, long-chain acylcarnitines cannot be subdivided into carnitine and acyl-CoA, leading to their toxic accumulation in different organs. Neonatal form is the most severe, and all the reported patients died within a few days to 6 months after birth. Hereby, we report on a male late-preterm newborn who presented refractory cardiac arrhythmias and acute multiorgan (hepatic, renal, muscular) injury, leading to cerebral hemorrhage, hydrocephalus, cardiovascular failure and early (day 5 of life) to death. Subsequently, extended metabolic screening and target next generation sequencing (NGS) analysis allowed the CPT II deficiency diagnosis.
CASE PRESENTATION
The male proband was born at 36 weeks of gestation by spontaneous vaginal delivery. Parents were healthy and nonconsanguineous, although both coming from Nigeria. Family history was unremarkable. Apgar score was 9/9. At birth, anthropometric measures were as follows: weight 2850 g (47th centile, -0.07 standard deviations, SD), length 50 cm (81st centile, + 0.89 SD) and occipitofrontal circumference (OFC) 35 cm (87th centile, + 1.14 SD). On day 2 of life our newborn showed bradycardia (heart rate around 80 bpm) and hypotonia, and was then transferred to the Neonatal Intensive Care Unit (NICU). There, he subsequently manifested many episodes of ventricular tachycardia, which were treated with pharmacological (magnesium sulfate) and electrical cardioversion. Due to the critical conditions of the baby (hepatic, renal and cardiac dysfunctions) and to guarantee optimal management of the arrythmias, he was transferred to the Pediatric Cardiology Reference Center of our region (Sicily, Italy), where he died 2 days later. Thereafter, the carnitines profile evidenced by the extended metabolic screening resulted compatible with a fatty acid oxidation defect (increased levels of acylcarnitines C and C, and low of C); afterwards, the targeted next generation sequencing (NGS) analysis revealed the known c.680 C > T p. (Pro227Leu) homozygous missense mutation of the CPTII gene, for diagnosis of CPT II deficiency. Genetic investigations have been, then, extended to the baby's parents, who were identified as heterozygous carriers of the same variant. When we meet again the parents for genetic counseling, the mother was within the first trimester of her second pregnancy. Therefore, we offered to the couple and performed the prenatal target NGS analysis on chorionic villi sample, which did not detect any alterations, excluding thus the CPT II deficiency in their second child.
CONCLUSIONS
CPTII deficiency may be suspected in newborns showing cardiac arrhythmias, associated or not with hypertrophic cardiomyopathy, polycystic kidneys, brain malformations, hepatomegaly. Its diagnosis should be even more suspected and investigated in cases of increased plasmatic levels of creatine phosphokinase and acylcarnitines in addition to kidney, heart and liver dysfunctions, as occurred in the present patient. Accurate family history, extended metabolic screening, and multidisciplinary approach are necessary for diagnosis and adequate management of affected subjects. Next generation sequencing (NGS) techniques allow the identification of the CPTII gene mutation, essential to confirm the diagnosis before or after birth, as well as to calculate the recurrence risk for family members. Our report broads the knowledge of the genetic and molecular bases of such rare disease, improving its clinical characterization, and provides useful indications for the treatment of patients.
Topics: Infant, Newborn; Adult; Infant; Child; Female; Pregnancy; Humans; Male; Carnitine O-Palmitoyltransferase; Fatal Outcome; Arrhythmias, Cardiac; Fatty Acids; Sicily; Metabolism, Inborn Errors
PubMed: 38616285
DOI: 10.1186/s13052-024-01632-x -
Clinical and Experimental Emergency... Apr 2024Organophosphorus agents are easily absorbed via respiratory, gastrointestinal, and dermal routes, and inhibit the acetylcholine transferase enzyme (AChE), which is...
Organophosphorus agents are easily absorbed via respiratory, gastrointestinal, and dermal routes, and inhibit the acetylcholine transferase enzyme (AChE), which is responsible for the majority of toxicity caused by organophosphates in the body. A comprehensive search was conducted across three prominent databases, namely Google Scholar, PubMed, and Science Direct, to identify relevant articles published. The search focused on the keywords "MgSO4" or "magnesium sulfate" in conjunction with "organophosphate" or "organophosphate poisoning." Inhibition of AChE results in the accumulation of acetylcholine (ACh) in synapses and stimulation of cholinergic receptors. Considering that several studies have shown the use of magnesium sulfate (MgSO4) in inhibiting the release of ACh in the central and peripheral sympathetic and parasympathetic synapses, this study was conducted to review the role of MgSO4 in the treatment of OP. The intravenous administration of MgSO4 exhibits favorable tolerability and clinical efficacy in alleviating cardiac toxicity associated with OP exposure.
PubMed: 38583865
DOI: 10.15441/ceem.23.179 -
Se Pu = Chinese Journal of... Apr 2024Pesticide residues may be present in olive oil because pesticides are applied to olive trees during their cultivation and growth for pest prevention and some of these...
[Determination of 222 pesticide residues in olive oil by fully automatic QuEChERS pre-treatment instrument coupled with gas chromatography-quadrupole-time-of-flight mass spectrometry].
Pesticide residues may be present in olive oil because pesticides are applied to olive trees during their cultivation and growth for pest prevention and some of these pesticides are not easily degraded. Studies on pesticide residues in olive oil have mainly focused on the detection of single types of pesticide residues, and reports on the simultaneous detection of multiple pesticide residues are limited. At present, hundreds of pesticides with different polarities and chemical properties are used in practice. In this study, an analytical method based on fully automatic QuEChERS pretreatment instrument coupled with gas chromatography-quadrupole time-of-flight mass spectrometry (GC-QTOF-MS) was established for the rapid determination of 222 pesticide residues in olive oil. The effects of acetonitrile acidification concentration, -hexane volume, oscillation time, centrifugation temperature, and purification agent on the determination of the 222 pesticide residues were investigated. First, ions with good responses and no obvious interference were selected for quantification and characterization. The purification process was then developed by setting the parameters of the fully automatic QuEChERS pretreatment instrument to optimal values. The sample was extracted with acetonitrile containing 2% formic acid, and the supernatant was purified by centrifugation in a centrifuge tube containing 400 mg -propylethylenediamine (PSA), 400 mg octadecylsilane-bonded silica gel (C18), and 1200 mg anhydrous magnesium sulfate. The purified solution was blown dry with nitrogen and then fixed with ethyl acetate for instrumental analysis. Finally, a matrix standard solution was used for quantification. The method was validated in terms of matrix effects, linear ranges, limits of detection (LODs) and quantification (LOQs), accuracies, and precisions. The results showed that 86.04% of the 222 pesticides had linear ranges of 0.02-2.00 μg/mL, 10.81% had linear ranges of 0.10-2.00 μg/mL, and 3.15% had linear ranges of 0.20-2.00 μg/mL. The pesticide residues showed good relationships within their respective linear ranges, and the correlation coefficients () were greater than 0.99. The LODs of all tested pesticides ranged from 0.002 to 0.050 mg/kg, and their LOQs ranged from 0.007 to 0.167 mg/kg. Among the 222 pesticides determined, 170 pesticides had LOQs of 0.007 mg/kg while 21 pesticides had LOQs of 0.017 mg/kg. At the three spiked levels of 0.2, 0.5, and 0.8 mg/kg, 79.58% of all tested pesticides had average recoveries of 70%-120% while 65.92% had average recoveries of 80%-110%. In addition, 93.54% of all tested pesticides had relative standard deviations (RSDs, =6)<10% while 98.35% had RSDs (=6)<20%. The method was applied to 14 commercially available olive oil samples, and seven pesticides were detected in the range of 0.0044-0.0490 mg/kg. The residues of fenbuconazole, chlorpyrifos, and methoprene did not exceed the maximum limits stated in GB 2763-2021. The maximum residual limits of molinate, monolinuron, benalaxyl, and thiobencarb have not been established. The method utilizes the high mass resolution capability of TOF-MS, which can improve the detection throughput while ensuring good sensitivity. In addition, high-resolution and accurate mass measurements render the screening results more reliable, which is necessary for the high-throughput detection of pesticide residues. The use of a fully automatic QuEChERS instrument in the pretreatment step reduces personnel errors and labor costs, especially when a large number of samples must be processed, thereby offering significant advantages over other approaches. Moreover, the method is simple, rapid, sensitive, highly automatable, accurate, and precise. Thus, it meets requirements for the high-throughput detection of pesticide residues in olive oil and provides a reference for the development of detection methods for pesticide residues in other types of oils as well as the automatic pretreatment of complex matrices.
Topics: Pesticide Residues; Olive Oil; Tandem Mass Spectrometry; Gas Chromatography-Mass Spectrometry; Pesticides; Acetonitriles
PubMed: 38566426
DOI: 10.3724/SP.J.1123.2023.09010 -
Drug Design, Development and Therapy 2024Magnesium sulfate, an intravenous adjuvant, has recently attracted immense attention in multimodal analgesia. Previous studies confirmed the crucial role of magnesium... (Randomized Controlled Trial)
Randomized Controlled Trial Clinical Trial
Effect of Magnesium Sulfate Infusion on Postoperative Quality of Recovery in Patients Undergoing Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial.
BACKGROUND
Magnesium sulfate, an intravenous adjuvant, has recently attracted immense attention in multimodal analgesia. Previous studies confirmed the crucial role of magnesium sulfate in postoperative pain and nociceptive hypersensitivity. However, the effect of magnesium sulfate in multimodal analgesia on the quality of recovery (QoR) for elderly patients has not been thoroughly studied. Therefore, the present experiment aimed to investigate the effect of continuous intravenous magnesium sulfate on the quality of postoperative recovery in elderly patients undergoing total knee arthroplasty (TKA).
PATIENTS AND METHODS
In this study, a total of 148 patients scheduled to undergo unilateral total knee arthroplasty were randomized into a magnesium sulfate group (Group M, n=68) and a control group (Group C, n=66) using a double-blind, randomized controlled trial. Before induction of anesthesia, Group M received intravenous magnesium sulfate (40 mg/kg) for 15 min, followed by a continuous infusion (15 mg/kg) until the end of the procedure. In the same manner, Group C received an infusion of the same amount of isotonic saline using the same method as the Group M.
RESULTS
Compared with Group C, Group M had significantly better QoR-15 scores on postoperative day 1(POD) than Group C ( <0.05). Analysis of the dimensions of QoR-15 scores indicated that Group M exhibited notably reduced levels of pain, and higher levels of emotional state and physical comfort than Group C ( <0.05). Furthermore, Group C had significantly higher numerical rating scale (NRS) scores at POD than Group M ( <0.05).
CONCLUSION
For elderly patients undergoing knee arthroplasty, magnesium sulfate can be used as an adjuvant in a multimodal analgesic regimen to reduce early postoperative pain and improve the quality of early postoperative recovery.
Topics: Humans; Aged; Magnesium Sulfate; Arthroplasty, Replacement, Knee; Prospective Studies; Analgesics; Pain, Postoperative; Double-Blind Method; Analgesics, Opioid
PubMed: 38560523
DOI: 10.2147/DDDT.S444896 -
Biological & Pharmaceutical Bulletin 2024Hypomagnesemia is a characteristic adverse event of cetuximab in patients with head and neck cancer (HNC). However, there is limited information about its prevalence,...
Hypomagnesemia is a characteristic adverse event of cetuximab in patients with head and neck cancer (HNC). However, there is limited information about its prevalence, risk factors, and preventive strategies. This study aimed to investigate the risk factors of hypomagnesemia and examine the preventive effects of prophylactic magnesium (Mg) administration. We initially investigated HNC patients treated with cetuximab between 2013 and 2019. Our institute started prophylactic Mg treatment (20-mEq Mg sulfate administration before cetuximab) in practice during this period. We retrospectively assess the preventive efficacy by comparing patients before and after its implementation. In total, 109 patients were included. In 60 patients without prophylaxis, all-grade and grade ≥2 hypomagnesemia at 3 months occurred in 61.7 and 15.0% of patients. The incidence of hypomagnesemia was not affected by regimens and concomitant medications. In 49 patients treated with prophylactic Mg treatment, there was no significant decrease in the cumulative incidence of hypomagnesemia. However, the preventive Mg treatment eliminated the need for additional Mg repletion to maintain Mg levels in patients treated with paclitaxel + cetuximab. A risk factor in patients without prophylaxis was a low Mg level at pre-treatment (≤2.0 mg/dL) (odds ratio: 6.03, 95% confidence interval: 1.78-20.4, p = 0.004), whereas that in patients with prophylaxis was the number of cetuximab doses (≥10) (odds ratio: 5.50, 95% confidence interval: 1.52-19.87, p = 0.009). In conclusion, a low pre-treatment Mg level was the only risk factor that could be avoided by prophylactic Mg administration. This preventive intervention is recommended for managing cetuximab-induced hypomagnesemia.
Topics: Humans; Cetuximab; Retrospective Studies; Magnesium; Antibodies, Monoclonal, Humanized; Head and Neck Neoplasms; Risk Factors
PubMed: 38556358
DOI: 10.1248/bpb.b23-00714 -
Bioengineering (Basel, Switzerland) Feb 2024Critical care physicians are commonly faced with patients exhibiting atrial fibrillation (AF), a cardiac arrhythmia with multifaceted origins. Recent investigations shed...
Critical care physicians are commonly faced with patients exhibiting atrial fibrillation (AF), a cardiac arrhythmia with multifaceted origins. Recent investigations shed light on the heterogeneity among AF patients by uncovering unique AF phenotypes, characterized by differing treatment strategies and clinical outcomes. In this retrospective study encompassing 9401 AF patients in an intensive care cohort, we sought to identify differences in average treatment effects (ATEs) across different patient groups. We extract data from the MIMIC-III database, use hierarchical agglomerative clustering to identify patients' phenotypes, and assign them to treatment groups based on their initial drug administration during AF episodes. The treatment options examined included beta blockers (BBs), potassium channel blockers (PCBs), calcium channel blockers (CCBs), and magnesium sulfate (MgS). Utilizing multiple imputation and inverse probability of treatment weighting, we estimate ATEs related to rhythm control, rate control, and mortality, approximated as hourly and daily rates (%/h, %/d). Our analysis unveiled four distinctive AF phenotypes: (1) postoperative hypertensive, (2) non-cardiovascular mutlimorbid, (3) cardiovascular multimorbid, and (4) valvulopathy atrial dilation. PCBs showed the highest cardioversion rates across phenotypes, ranging from 11.6%/h (9.35-13.3) to 7.69%/h (5.80-9.22). While CCBs demonstrated the highest effectiveness in controlling ventricular rates within the overall patient cohort, PCBs and MgS outperformed them in specific phenotypes. PCBs exhibited the most favorable mortality outcomes overall, except for the non-cardiovascular multimorbid cluster, where BBs displayed a lower mortality rate of 1.33%/d [1.04-1.93] compared to PCBs' 1.68%/d [1.10-2.24]. The results of this study underscore the significant diversity in ATEs among individuals with AF and suggest that phenotype-based classification could be a valuable tool for physicians, providing personalized insights to inform clinical decision making.
PubMed: 38534473
DOI: 10.3390/bioengineering11030199 -
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 -
ACS Environmental Au Mar 2024Nitrogen in wastewater has negative environmental, human health, and economic impacts but can be recovered to reduce the costs and environmental impacts of wastewater...
Nitrogen in wastewater has negative environmental, human health, and economic impacts but can be recovered to reduce the costs and environmental impacts of wastewater treatment and chemical production. To recover ammonia/ammonium (total ammonia nitrogen, TAN) from urine, we operated electrochemical stripping (ECS) for over a month, achieving 83.4 ± 1.5% TAN removal and 73.0 ± 2.9% TAN recovery. With two reactors, we recovered sixteen 500-mL batches (8 L total) of ammonium sulfate (20.9 g/L TAN) approaching commercial fertilizer concentrations (28.4 g/L TAN) and often having >95% purity. While evaluating the operation and maintenance needs, we identified pH, full-cell voltage, product volume, and water flux into the product as informative process monitoring parameters that can be inexpensively and rapidly measured. Characterization of fouled cation exchange and omniphobic membranes informs cleaning and reactor modifications to reduce fouling with organics and calcium/magnesium salts. To evaluate the impact of urine collection and storage on ECS, we conducted experiments with urine at different levels of dilution with flush water, extents of divalent cation precipitation, and degrees of hydrolysis. ECS effectively treated urine under all conditions, but minimizing flush water and ensuring storage until complete hydrolysis would enable energy-efficient TAN recovery. Our experimental results and cost analysis motivate a multifaceted approach to improving ECS's technical and economic viability by extending component lifetimes, decreasing component costs, and reducing energy consumption through material, reactor, and process engineering. In summary, we demonstrated urine treatment as a foothold for electrochemical nutrient recovery from wastewater while supporting the applicability of ECS to seven other wastewaters with widely varying characteristics. Our findings will facilitate the scale-up and deployment of electrochemical nutrient recovery technologies, enabling a circular nitrogen economy that fosters sanitation provision, efficient chemical production, and water resource protection.
PubMed: 38525023
DOI: 10.1021/acsenvironau.3c00058