scholarly journals The role of magnesium in the correction of postoperative hypocalcemia

2021 ◽  
pp. 40-44
Author(s):  
D. M. Kvitka ◽  
V. O. Palamarchuk ◽  
S. V. Zemskov ◽  
V. A. Smoliar
Keyword(s):  
Parathyroid Hormone ◽  
Postoperative Period ◽  
Clinical Manifestations ◽  
Main Group ◽  
Ionized Calcium ◽  
Observation Group ◽  
Postoperative Hypoparathyroidism ◽  
Calcium Magnesium ◽  
Calcium And Magnesium

Background. The postoperative hypoparathyroidism remains a specific complication in the thyroid surgery. The incidence of iatrogenic hypoparathyroidism ranges from 3.0 % to 31.5 %. The decrease in the level of parathyroid hormone leads to the launch of a cascade of the electrolyte changes. The standard methods for controlling and correcting hypoparathyroidism do not guarantee the prevention of hypocalcemiacases. The role of calcium and magnesium in the conduction of the nerve impulses along muscle fibers is well known. The study of the role of magnesium will enable further correction of the manifestations of postoperative hypoparathyroidism.Aim — to study a relationship between postoperative hypoparathyroidism, changes in calcium-magnesium metabolism and their clinical manifestations; to analyze the effects of hypomagnesemia on the clinical manifestations of hypocalcemia; to study the possibility of correcting calcium-magnesium metabolism in the postoperative period.Materials and methods. The study involved 145 patients operated for the thyroid diseases. The patients were divided into two groups. The main group (n = 73) included the patients who took magnesium medications in the preoperative period for 10—14 days at a dose of 1500—2000 mg/day. In the observation group (n = 72), the patients did not take the magnesium medications. Parameters of the parathyroid hormone, ionized calcium, and magnesium were measured in all patients in the preoperative period and on the first day of the postoperative period. The parathyroid hormones’levels on the first day of postoperative period were ranged into the “ranges”: 1) parathyroid hormone — ≤ 1 pg/ml, 2) parathyroid hormone — 1—5 pg/ml, 3) parathyroid hormone — 5—10 pg/ml, 4) parathyroid hormone — > 10 pg/ml. The clinical manifestations of hypoparathyroidism were assessed on a scale: not pronounced, poorly pronounced, pronounced, sharply pronounced.Results. The correlations were found between the levels of the postoperative magnesium, ionized calcium and parathyroid hormone. In the main group, the number of the pronounced and sharply pronounced manifestations of hypocalcemia was observed in the parathyroid hormone range — ≤ 1 pg/ml. In the observation group, the largest number of the prono­unced and sharply pronounced clinical manifestations was recorded in the parathyroid hormone range — ≤ 1 pg/ml, parathyroid hormone — 1—5 pg/ml. In the main group, in comparison with the observation group, the total number of the clinical manifestations of hypocalcemia was lower.Conclusions. There were revealed the positive cor­rela­tions in the changes in the levels of the parathyroid hormone, ionized calcium and magnesium. It has been proven that uncorrected hypomagnesemia in the early postoperative period can be a predictor of the clinical manifestations of hypoparathyroidism. The correction of the serum magnesium levels in most patients reduces the clinical manifestations of hypocalcemia.

Role of the fetal parathyroid glands and parathyroid hormone-related protein in the regulation of placental transport of calcium, magnesium and inorganic phosphate

1991 ◽  
Vol 3 (4) ◽  
pp. 447 ◽  
Author(s):  
RJ MacIsaac ◽  
JA Heath ◽  
CP Rodda ◽  
JM Moseley ◽  
AD Care ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Autologous Blood ◽  
Placental Tissue ◽  
Parathyroid Glands ◽  
Related Protein ◽  
Tissue Extracts ◽  
Parathyroid Hormone Related Protein ◽  
Placental Transport ◽  
Calcium Magnesium

The plasma Ca concentration of the fetus is maintained higher than maternal levels by active placental transport. Ca, Mg and PO4 accumulation by the fetus is mainly associated with skeletal growth. The fetal parathyroid glands are essential for maintenance of elevated plasma Ca, which is necessary for the stimulation of fetal osteoblasts and mineralization of cartilage and osteoid. Fetal thyroparathyroidectomy (TxPTx) results in a decreased activity of the placental Ca pump. The presence of a parathyroid hormone-related protein (PTHrP) has been demonstrated in fetal parathyroid glands and placental tissue. Extracts of fetal parathyroid glands and purified PTHrP, as well as recombinant PTHrP (1-84, 1-108 and 1-141), stimulate Ca and Mg but not PO4 transport across the placenta of TxPTx-ized fetuses perfused with autologous blood in the absence of the fetus. Parathyroid hormone (PTH) and the N-terminal region of PTHrP do not stimulate placental Ca and Mg transport. It is concluded that a mid-molecule region of this novel hormone may be required to stimulate placental Ca transfer and contribute to the regulation of fetal Ca homeostasis.

Magnesiuric and calciuric effects of terbutaline in man

1988 ◽  
Vol 74 (6) ◽  
pp. 595-597 ◽  
Author(s):  
W. J. W. Bos ◽  
D. S. Postma ◽  
J. J. van Doormaal
Keyword(s):  
Calcium Phosphate ◽  
Urinary Excretion ◽  
Healthy Volunteers ◽  
Cardiac Disease ◽  
Serum Levels ◽  
Ionized Calcium ◽  
Short Term ◽  
Cyclic Monophosphate ◽  
Calcium Magnesium ◽  
Calcium And Magnesium

1. The effect of terbutaline infusion over 4 h on serum levels of potassium, ionized calcium, phosphate and magnesium and urinary excretion of potassium, calcium, magnesium and adenosine 3′:5′-cyclic monophosphate was studied in six healthy volunteers. 2. Serum levels of potassium, calcium, phosphate and magnesium decreased. Urinary excretion of potassium decreased, whereas those of calcium, magnesium and adenosine 3′:5′-cyclic monophosphate increased. 3. These results indicate that the hypocalcaemic and hypomagnesaemic effects of terbutaline can, at least partly, be explained by enhanced urinary excretion of calcium and magnesium. This may have important implications for the short-term terbutaline treatment of patients with, for example, cardiac disease.

scholarly journals Role Of The PCSF Scale For Patients With Postcovid Syndrome

2021 ◽  
Vol 03 (07) ◽  
pp. 92-98
Author(s):  
Daminov B.T. ◽  
◽  
Muminov D.K. ◽  
Davron Kadirovich Muminov ◽  
◽  
...  
Keyword(s):  
Functional Status ◽  
Daily Activity ◽  
Clinical Manifestations ◽  
Main Group ◽  
Average Score ◽  
Control Group ◽  
Cardiovascular Pathology ◽  
Number Of Patients ◽  
Previous Infection

Purpose of the study. Estimate the functional status of patients using the PCFS (Post-COVID-19 Functional Status) scale. Material and research methods. There were 281 patients under observation, with the presence of clinical manifestations of post covid-19 syndrome. As a control group (CG), 20 patients who had undergone COVID-19 and whose disease ended in full recovery were examined. The assessment of the functional status of patients after suffering COVID-19 was carried out using the PCFS method - Post-COVID-19 Functional Status (https://osf.io/qgpdv/). Research results. In the main group of patients, the average score of the questionnaire was 13.34 ± 0.83 points. Patients who have identified a violation of their functional status at 1 point were 13 patients (4.63%), at 2 points - 90 people (32.03%), at 3 points - 117 people (41.64%), at 4 points - 61 people. (21.71%). In the control group, the patients assessed violations of their functional status at 0 points. The number of patients with extremely severe, severe and moderately severe COVID-19 was significantly higher in the main group than in the control group (30.61% versus 20%, 35.94% versus 30%, 33.45 versus 30%, respectively) In the main group of patients, the average number of background diseases was significantly higher than in the control group (p <0.05). Conclusion. Patients with post covid syndrome have a higher score on the functional status scale (PCFS). Among the patients who scored 3 and 4 points on the PCFS test (significant limitation of daily activity due to symptoms associated with the previous infection and the need for help in self-care), there were more patients with a severe course of COVID-19 and background cardiovascular pathology and obesity.

scholarly journals Role of the 2018 American Thyroid Association statement on postoperative hypoparathyroidism: a 5-year retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuxuan Qiu ◽  
Zhichao Xing ◽  
Yuan Fei ◽  
Yuanfan Qian ◽  
Yan Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Parathyroid Hormone ◽  
Independent Risk Factor ◽  
Tumor Location ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Postoperative Hypoparathyroidism ◽  
Independent Risk Factors

Abstract Background Definitions of postoperative hypoparathyroidism (hypoPT) have never reached consent until the American Thyroid Association (ATA) statement was released, with new characteristics and challenges. Methods Patients with papillary thyroid carcinoma who underwent primary total thyroidectomy between January 2013 and June 2018 were retrospectively enrolled. Symptoms of hypocalcemia and their frequency were stringently followed. Patients were divided into groups according to the ATA statement. Incidence of postoperative hypoPT and serum parathyroid hormone levels accompanied by calcium levels, from 1-day to at least 24-month follow-up. Results A total of 1749 patients were included: 458 (26.2%) had transient and 63 (3.6%) had permanent hypoPT. Transient hypoPT was found in 363 (20.7%) patients with biochemical hypoPT, 72 (4.1%) with clinical hypoPT, and 23 (1.3%) with relative hypoPT; permanent hypoPT was detected in 8 (0.5%) patients with biochemical hypoPT, 55 (3.1%) with clinical hypoPT, and none with relative hypoPT. Female sex, age ≥ 55 years, unintentional parathyroid gland resection, and autotransplantation of ≥ 2 parathyroid glands were independent risk factors for transient biochemical hypoPT. Age ≥ 55 years, bilateral central neck dissection, and isthmus tumor location were independent risk factors for transient clinical hypoPT. A postoperative 1-day percentage of parathyroid hormone (PTH) reduction of > 51.1% was an independent risk factor for relative hypoPT (odds ratio, 4.892; 95% confidence interval, 1.653–14.480; P = 0.004). No independent risk factor for permanent hypoPT was found. Conclusion ATA diagnostic criteria for postoperative hypoPT are of great value in differentiating patients by hypocalcemia symptoms and choosing corresponding clinical assistance; however, they may underestimate the actual incidence.

The role of divalent ions in cariogenic biofilm formation

2020 ◽  
Author(s):  
Monika Astasov-Frauenhoffer ◽  
Elena Steiger ◽  
Julia Muelli ◽  
Olivier Braissant ◽  
Tuomas Waltimo
Keyword(s):  
Biofilm Formation ◽  
Type Strain ◽  
Laser Scanning ◽  
Laser Scanning Microscopy ◽  
Titration Calorimetry ◽  
Confocal Laser ◽  
Calcium Magnesium ◽  
Calcium And Magnesium ◽  
Cariogenic Biofilm

&lt;p&gt;The aim of the study was to investigate the effect of calcium, magnesium, and zinc on cariogenic biofilm formation and their interaction with bacterial EPS. This was evaluated using two &lt;em&gt;S. mutans&lt;/em&gt; strains and different carbohydrates (glucose, sucrose and fructose).&lt;/p&gt; &lt;p&gt;Different combinations of carbohydrates and ions were investigated for their effect on the biofilm formation on hydroxyapatite disks by confocal laser scanning microscopy. Moreover, exopolysaccharides were purified and their affinity to the ions was measured by isothermal titration calorimetry.&lt;/p&gt; &lt;p&gt;The biofilm formation of &lt;em&gt;S. mutans &lt;/em&gt;clinical isolate was almost eliminated in the presence of Zn&lt;sup&gt;2+&lt;/sup&gt; and promoted by Ca&lt;sup&gt;2+&lt;/sup&gt;, while adhesion seems to be more inhibited by Ca&lt;sup&gt;2+&lt;/sup&gt; and Mg&lt;sup&gt;2+&lt;/sup&gt; for &lt;em&gt;S. mutans&lt;/em&gt; type strain. The EPS of cilincal isolate had a higher binding affinity towards calcium and magnesium than the type strain.&lt;/p&gt; &lt;p&gt;There seems to be a fine balance between these ions that needs to be maintained as excessive concentrations of one or another destroy the balance between the three.&lt;/p&gt;

Calcium-Regulating Hormones and Minerals From Birth to 18 Months of Age: A Cros-Sectional Study. II. Effects of Sex, Race, Age, Season, and Diet on Serum Minerals, Parathyroid Hormone, and Calcitonin

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 891-896
Author(s):  
B. L. Specker] ◽  
P. Lichtenstein ◽  
F. Mimouni ◽  
C. Gormley ◽  
R. C. Tsang
Keyword(s):  
Parathyroid Hormone ◽  
Human Milk ◽  
Normative Data ◽  
Serum Phosphorus ◽  
Ionized Calcium ◽  
Milk Formula ◽  
Serum Minerals ◽  
Calcium Magnesium ◽  
Serum Ionized Calcium ◽  
Phosphorus Levels

The influence of sex, race, age, season, and diet (cow's milk formula v human milk) on serum minerals and calcium-regulating hormones in infants less than 18 months of age is described in this study of 198 infants. No sex differences were observed in calcium, magnesium, phosphorus, parathyroid hormone, or calcitonin concentrations. Black infants had decreased serum phosphorus concentrations compared with white infants. There was a decrease in serum ionized calcium and phosphorus levels with age. During winter, there were significant increases in serum calcium and magnesium and decreases in serum phosphorus, parathyroid hormone, and calcitonin levels. Formula-fed infants had increased serum phosphorus and decreased ionized calcium concentrations compared with infants fed human milk. Thus, race, age, season, and diet appear to exert significant effects on serum minerals and calcium-regulating hormones in infancy. Interpretation of these mineral and hormone concentrations in normal or diseased states should be based on normative data specific to race, age, season, and diet.

DIENOGEST IN POST OPERATIVE MANAGEMENT’S OF PATIENT’S WITH ENDOMETRIOSIS

2020 ◽  
pp. 22-26
Author(s):  
Porsukova B.D. ◽  
Dzhumagulova D.D.
Keyword(s):  
Surgical Treatment ◽  
Combination Treatment ◽  
Postoperative Period ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Hormonal Treatment ◽  
Early Postoperative Period ◽  
Main Group ◽  
Uterine Ligaments ◽  
Severity Of The Disease

To assess the effectiveness of using dienogest in combination with postoperative interventions in patients with endometriosis. There were enrolled 102 patients with signs of external endometriosis underwent examination and surgical treatment, subdivided into 2 groups: 67 – main group (after surgical treatment, received dienogest 2 mg/day for 6 months), 35 – comparison group received no hormone therapy in the postoperative period. Surgical treatment included removal of endometrioid ovarian cysts, endometriosis foci on the pelvic peritoneum and sacral uterine ligaments. Course of the early postoperative period (up to 1 month after the intervention) as well as the long-term dynamics of the disease manifestations (3, 6, 12 and 15 months later) were assessed. Dienogest was administered after surgical treatment due to endometriosis that reduced the severity of dyspareunia and intensity of chronic pelvic pain by 3.5- and 2-fold, respectively. The probability of achieving control over uterine bleeding 6 month after the onset of treatment due to endometriosis manifested with metrorrhagia showed that combination treatment (consisting of dienogest) was 3.19-fold higher compared to surgical treatment alone (OR = 3.19; 95 % CI = 1.70–11,0; p < 0,05). Recovery of normal menstrual cycle in 63 (94.0%) women of the main group was established 1.5–2 months after completing of hormonal treatment, while in the comparison group pain and dysmenorrhea relapsed in some patients at the 6-month follow-up. Decreased libido as a side effect in patients who treated with dienogest was observed in 2 (3.0 %) women. Dienogest was highly effective in the combination treatment of patients with verified endometriosis that resulted in reduced severity of pain and metrorrhagia. The drug was featured by low level of side effects. Thus, a combination treatment of endometriosis containing dienogest at a dose of 2 mg/day applied during postoperative period allows to reduce the severity of the disease clinical manifestations and improve treatment outcome.

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