Hypomagnesemia: a clinical perspective Pham, Phuong-Chi; Pham, Phuong Anh; Pham, Son ...
International journal of nephrology and renovascular disease,
01/2014, Letnik:
7, Številka:
default
Journal Article
Recenzirano
Odprti dostop
Although magnesium is involved in a wide spectrum of vital functions in normal human physiology, the significance of hypomagnesemia and necessity for its treatment are under-recognized and ...underappreciated in clinical practice. In the current review, we first present an overview of the clinical significance of hypomagnesemia and normal magnesium metabolism, with a focus on renal magnesium handling. Subsequently, we review the literature for both congenital and acquired hypomagnesemic conditions that affect the various steps in normal magnesium metabolism. Finally, we present an approach to the routine evaluation and suggested management of hypomagnesemia.
Background
Osmotic demyelination syndrome (ODS) is a complication generally associated with overly rapid correction of hyponatremia. Traditionally, nephrologists have been trained to focus solely on ...limiting the correction rate. However, there is accumulating evidence to suggest that the prevention of ODS is beyond achieving slow correction rates.
Methods
We (1) reviewed the literature for glial intracellular protective alterations during hyperosmolar stress, a state presumed equivalent to the rapid correction of hyponatremia, and (2) analyzed all available hyponatremia-associated ODS cases from PubMed for possible contributing factors including correction rates and concurrent metabolic disturbances involving hypokalemia, hypophosphatemia, hypomagnesemia, and/or hypoglycemia.
Results
In response to acute hyperosmolar stress, glial cells undergo immediate extracellular free water shift, followed by active intracellular Na
+
, K
+
and amino acid uptake, and eventual idiogenic osmoles synthesis. At minimum, protective mechanisms require K
+
, Mg
2+
, phosphate, amino acids, and glucose. There were 158 cases of hyponatremia-associated ODS where both correction rates and other metabolic factors were documented. Compared with the rapid correction group (>0.5 mmol/L/h), the slow correction group (≤0.5 mmol/L/h) had a greater number of cases with concurrent hypokalemia (49.4 vs. 33.3 %,
p
= 0.04), and a greater number of cases with any concurrent metabolic derangements (55.8 vs. 38.3 %,
p
= 0.03).
Conclusion
Glial cell minimizes volume changes and injury in response to hyperosmolar stress via mobilization and/or utilization of various electrolytes and metabolic factors. The prevention of ODS likely requires both minimization of correction rate and optimization of intracellular response during the correction phase when a sufficient supply of various factors is necessary.
Hypomagnesemia in patients with type 2 diabetes Pham, Phuong-Chi T; Pham, Phuong-Mai T; Pham, Son V ...
Clinical journal of the American Society of Nephrology
2, Številka:
2
Journal Article
Recenzirano
Hypomagnesemia has been reported to occur at an increased frequency among patients with type 2 diabetes compared with their counterparts without diabetes. Despite numerous reports linking ...hypomagnesemia to chronic diabetic complications, attention to this issue is poor among clinicians. This article reviews the literature on the metabolism of magnesium, incidence of hypomagnesemia in patients with type 2 diabetes, implicated contributing factors, and associated complications. Hypomagnesemia occurs at an incidence of 13.5 to 47.7% among patients with type 2 diabetes. Poor dietary intake, autonomic dysfunction, altered insulin metabolism, glomerular hyperfiltration, osmotic diuresis, recurrent metabolic acidosis, hypophosphatemia, and hypokalemia may be contributory. Hypomagnesemia has been linked to poor glycemic control, coronary artery diseases, hypertension, diabetic retinopathy, nephropathy, neuropathy, and foot ulcerations. The increased incidence of hypomagnesemia among patients with type 2 diabetes presumably is multifactorial. Because current data suggest adverse outcomes in association with hypomagnesemia, it is prudent to monitor magnesium routinely in this patient population and treat the condition whenever possible.
A grand family of two-dimensional (2D) materials and their heterostructures have been discovered through the extensive experimental and theoretical efforts of chemists, material scientists, ...physicists, and technologists. These pioneering works contribute to realizing the fundamental platforms to explore and analyze new physical/chemical properties and technological phenomena at the micro–nano–pico scales. Engineering 2D van der Waals (vdW) materials and their heterostructures via chemical and physical methods with a suitable choice of stacking order, thickness, and interlayer interactions enable exotic carrier dynamics, showing potential in high-frequency electronics, broadband optoelectronics, low-power neuromorphic computing, and ubiquitous electronics. This comprehensive review addresses recent advances in terms of representative 2D materials, the general fabrication methods, and characterization techniques and the vital role of the physical parameters affecting the quality of 2D heterostructures. The main emphasis is on 2D heterostructures and 3D-bulk (3D) hybrid systems exhibiting intrinsic quantum mechanical responses in the optical, valley, and topological states. Finally, we discuss the universality of 2D heterostructures with representative applications and trends for future electronics and optoelectronics (FEO) under the challenges and opportunities from physical, nanotechnological, and material synthesis perspectives.
The prevalence of pain has been reported to be >60–70% among patients with advanced and end-stage kidney disease. Although the underlying etiologies of pain may vary, pain per se has been linked to ...lower quality of life and depression. The latter is of great concern given its known association with reduced survival among patients with end-stage kidney disease. We herein discuss and update the management of pain in patients with chronic kidney disease with and without requirement for renal replacement therapy with the focus on optimizing pain control while minimizing therapy-induced complications.
Although renal transplantation ameliorates cardiovascular risk factors by restoring renal function, it introduces new cardiovascular risks including impaired glucose tolerance or diabetes mellitus, ...hypertension, and dyslipidemia that are derived, in part, from immunosuppressive medications such as calcineurin inhibitors, corticosteroids, or mammalian target of rapamycin inhibitors. New onset diabetes mellitus after transplantation (NODAT) is a serious and common complication following solid organ transplantation. NODAT has been reported to occur in 2% to 53% of all solid organ transplants. Kidney transplant recipients who develop NODAT have variably been reported to be at increased risk of fatal and nonfatal cardiovascular events and other adverse outcomes including infection, reduced patient survival, graft rejection, and accelerated graft loss compared with those who do not develop diabetes. Identification of high-risk patients and implementation of measures to reduce the development of NODAT may improve long-term patient and graft outcome. The following article presents an overview of the literature on the current diagnostic criteria for NODAT, its incidence after solid organ transplantation, suggested risk factors and potential pathogenic mechanisms. The impact of NODAT on patient and allograft outcomes and suggested guidelines for early identification and management of NODAT will also be discussed.
The manganese-promoted cobalt supported on gamma alumina was prepared following the incipient wetness impregnation method and employed as a catalyst for carbon dioxide reforming of methane. The ...addition of manganese has changed the physicochemical properties of the original material. The Co
3
O
4
crystallite size was decreased from 12.14 to 8.66 nm, suggesting a higher metal dispersion. The activation of the catalyst precursor was more effective with less energy required. Notably, the carbon dioxide adsorption over the catalyst surface was greatly enhanced in the presence of 1 wt% manganese. Taken all together, the manganese-promoted catalyst showed an outperformance with higher activity and stability in comparison with the pristine. At 973 K, 1 atm, CH
4
/CO
2
ratio of 1, the addition of 1 wt% Mn into 5Co/Al
2
O
3
led to notable increases in CH
4
(15.2%) and CO
2
(17.68%) conversions. Also, the stability of Mn-promoted was much higher compared to pristine catalyst with only 0.3 wt% of undesirable coke formed. Meanwhile, it was 4.94 wt% in the case of 5Co/Al
2
O
3
at the same operating condition. Furthermore, the role of carbon dioxide adsorption in carbon dioxide reforming of methane was investigated. At a proper combination of carbon dioxide activation and methane dissociation, the catalytic activity can be significantly enhanced with much lower activation energies for the feedstock gases. Nevertheless, when the adsorption of carbon dioxide was dominant, catalytic activity was much lower and the deactivation occurred rapidly.
The current outbreak of Ebola in eastern DR Congo, beginning in 2018, emerged in a complex and violent political and security environment. Community-level prevention and outbreak control measures ...appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. We aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of Ebola virus disease (EVD).
We surveyed 961 adults between Sept 1 and Sept 16, 2018. We used a multistage sampling design in Beni and Butembo in North Kivu, DR Congo. Of 412 avenues and cells (the lowest administrative structures; 99 in Beni and 313 in Butembo), we randomly selected 30 in each city. In each avenue or cell, 16 households were selected using the WHO Expanded Programme on Immunization's random walk approach. In each household, one adult (aged ≥18 years) was randomly selected for interview. Standardised questionnaires were administered by experienced interviewers. We used multivariate models to examine the intermediate variables of interest, including institutional trust and belief in selected misinformation, with outcomes of interest related to EVD prevention behaviours.
Among 961 respondents, 349 (31·9%, 95% CI 27·4–36·9) trusted that local authorities represent their interest. Belief in misinformation was widespread, with 230 (25·5%, 21·7–29·6) respondents believing that the Ebola outbreak was not real. Low institutional trust and belief in misinformation were associated with a decreased likelihood of adopting preventive behaviours, including acceptance of Ebola vaccines (odds ratio 0·22, 95% CI 0·21–0·22, and 1·40, 1·39–1·42) and seeking formal health care (0·06, 0·05–0·06, and 1·16, 1·15–1·17).
The findings underscore the practical implications of mistrust and misinformation for outbreak control. These factors are associated with low compliance with messages of social and behavioural change and refusal to seek formal medical care or accept vaccines, which in turn increases the risk of spread of EVD.
The Harvard Humanitarian Initiative Innovation Fund.
Syngas, a mixture of carbon monoxide and hydrogen, is widely used in electricity, synthetic chemicals, and fuels productions. Syngas can be obtained from a chemical reaction between methane and ...carbon dioxide that are commonly found in biogas. In this study, a simulated mixture of biogas containing CH
4
:CO
2
= 1:1 (mol/mol) was used as the feedstock. Different nickel-based catalysts supported on TiO
2
, MgO, KIT-6, and Al
2
O
3
have been prepared through the dry impregnation method with a fixed Ni dosage of 10 wt%. All samples were characterized by modern techniques including XRD, BET, H
2
-TPR, CO
2
-TPD, TPO, and TEM. It was found that the metal-support interaction played a critical role in metal dispersibility and reducibility of catalyst precursors. During the methane dry reforming, catalyst basicity is a crucial factor facilitating the adsorption and activation of carbon dioxide. The highest activity was achieved over 10Ni/Al
2
O
3
with the methane conversion of 73.2% and carbon dioxide conversion of 86.9%. Furthermore, the effects of support properties on the catalyst stability were studied. Nature of support especially basicity plays an important role on the deposition of carbon over the active sites. The Ni/Al
2
O
3
with good nickel dispersibility, affordable metal-support interaction, reasonable basicity was reported the most stable without any significant deactivation after 6 h reaction. Finally, the catalyst design strategy for the DRM was proposed.
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