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Ivanovic ND, Radosavljevic B, Zekovic M, Korcok D, Ignjatovic S, Djordjevic B, Milinkovic N. Effects of short-term magnesium supplementation on ionized, total magnesium and other relevant electrolytes levels. Biometals 2022; 35:267-283. [PMID: 35041150 DOI: 10.1007/s10534-022-00363-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/09/2022] [Indexed: 12/22/2022]
Abstract
This study aimed to investigate the short-term effects of three magnesium (Mg) dietary supplements containing mineral immediately available for absorption on Mg biochemical status indices (ionized and total Mg), as well as their effects on electrolytes levels in healthy female young adults (n = 61). After a 10-days intervention period supplementation with powder/granulate containing Mg oxide led to an increase in both ionized Mg concentration and % in total Mg in comparison with the baseline. Supplementation with Mg citrate was associated with the significant increase in % of ionized fraction and decrease in serum total Mg concentration. By contrast, among participants consuming Mg carbonate in the form of effervescent tablets ionized Mg concentration and % in total Mg decreased, without detectable changes in serum total Mg. In conclusion, after the short-term supplementation period, Mg oxide demonstrated superior bioavailability compared to the other examined Mg supplements without affecting other minerals' levels.
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Affiliation(s)
- Nevena Dj Ivanovic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11000, Belgrade, Serbia.
| | - Branimir Radosavljevic
- Institute of Chemistry in Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Zekovic
- Center of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Davor Korcok
- Faculty of Pharmacy Novi Sad, Business Academy University in Novi Sad, Novi Sad, Serbia
| | - Svetlana Ignjatovic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.,Centar for Medical Biochemistry, Clinical Center of Serbia, Beograd, Serbia
| | - Brizita Djordjevic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11000, Belgrade, Serbia
| | - Neda Milinkovic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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2
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Zhu D, Yang H, Chen X, Chen W, Cai N, Chen Y, Zhang S, Chen H. Temperature-dependent magnesium citrate modified formation of MgO nanoparticles biochar composites with efficient phosphate removal. Chemosphere 2021; 274:129904. [PMID: 33979927 DOI: 10.1016/j.chemosphere.2021.129904] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Nano-MgO biochar composites (nMBCs) have been considered as potential adsorbents for phosphate removal from aqueous solution. It is an effective strategy to improve P removal efficiency that adjustment of the size, distribution and crystallinity of MgO particles embedded into the carbon matrix. Herein, we prepared a highly efficient phosphate adsorbent by co-pyrolysis of lotus seedpod and magnesium citrate and studied its adsorption mechanisms. Results showed that the uniformly dispersed MgO nanoparticle was formed on the surface of nMBCs with the temperature increasing, with the particles size ranging from 3 to 10 nm. Furthermore, high temperature promoted the formation of a large amount of reactive lattice oxygen, which was demonstrated to be the main active adsorption site, thus the phosphate immobilization capacity of nMBCs was greatly improved with the pyrolysis temperature increasing from 450 °C to 750 °C. Besides, some stable CO bonds were formed due to the catalysis of Mg2+, which could bond to HPO42-/H2PO4- by hydrogen bond, enhancing the adsorption performance. The isotherm adsorption experiment showed that MBC-750 achieved an excellent phosphorus adsorption amount of 452.752 mg-P/g. The effectiveness of nMBCs is enhanced and a method for producing an effective nanocomposite adsorbent material for removing phosphate from wastewater is provided.
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Affiliation(s)
- Danchen Zhu
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Haiping Yang
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Xu Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Wei Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Ning Cai
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Yingquan Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Shihong Zhang
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China.
| | - Hanping Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074, Wuhan, China
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Koc B, Kizildag S, Hosgorler F, Gumus H, Kandis S, Ates M, Uysal N. Magnesium Citrate Increases Pain Threshold and Reduces TLR4 Concentration in the Brain. Biol Trace Elem Res 2021; 199:1954-1966. [PMID: 32989649 DOI: 10.1007/s12011-020-02384-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
Magnesium is being investigated in various clinical conditions and has shown to be effective in some chronic pain models. However, it is not clear if oral magnesium use affects pain perception in acute pain. TLR4's (toll-like receptor) role in pain perception has emerged through its role in immune pathways and ion channels. The aim of this study is to investigate the effect of a single oral dose of magnesium citrate on pain conduction and whether with magnesium, the expression of TLR4 changes in the acute phase. Following a single dose of 66-mg/kg magnesium citrate administration to male Balb-c mice, pain perception (via hot-plate test), motor conduction (via electrophysiological recording, forelimb grip strength, rotarod and open-field tests), and emotional state (via elevated plus maze and forced swim test) were evaluated. In behavioral experiments, the control group was compared with applied magnesium for three different time groups (4, 8, 24 h). TLR4 expression was measured in four groups: control, magnesium (Mg), hot plate (HP), and Mg + HP. Hot plate latency was prolonged in the magnesium group (p < 0.0001) and electrophysiological recordings (p < 0.001) and forelimb grip strength measurement (p < 0.001) determined motor latency. Compared with the untreated hot plate group, TLR4 levels was lower in the brain (p = 0.023) and higher in the sciatic nerve (p = 0.001) in the magnesium-treated hot plate group. Consequently, the study indicated a single dose of magnesium citrate appeared to cause weakening in the transmission and perception of nociceptive pain. TLR4 may act as a regulator in magnesium's effects on pain perception.
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Affiliation(s)
- Basar Koc
- Department of Physiology, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Servet Kizildag
- College of Vocational School of Health Services, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ferda Hosgorler
- Department of Physiology, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Hikmet Gumus
- Department of Sports Medicine, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sevim Kandis
- Department of Physiology, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Mehmet Ates
- College of Vocational School of Health Services, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Nazan Uysal
- Department of Physiology, School of Medicine, Dokuz Eylül University, Izmir, Turkey.
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Zhu D, Yang H, Chen Y, Chen X, Zou J, Zhang S, Chen H. Synergetic effect of magnesium citrate and temperature on the product characteristics of waste lotus seedpod pyrolysis. Bioresour Technol 2020; 305:123079. [PMID: 32131040 DOI: 10.1016/j.biortech.2020.123079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 06/10/2023]
Abstract
To understand the synergetic effect of magnesium citrate (MC) and temperature on biomass pyrolysis, co-pyrolysis of lotus seedpod (LS) and MC was carried out in a fixed bed reactor. With the addition of MC, CO2 become the dominate composition in gas (55.83-90.75 vol%). And with temperature increasing, the main components in bio-oil converted from carboxylic acid to phenols and aromatics. Meanwhile, the mesoporous carbon was formed, with the BET specific surface area up to 514.66 m2/g, and pore diameter mainly focused at 3-8 nm. For the catalytic effect, the secondary cracking of pyrolytic volatiles (acetic acid and anhydrosugar) was inhibited, therefore the gas releasing was inhibited below 550 °C. However, at higher temperature, MgO catalysts favored the reduction of acids and deoxygenation via ketonization and aldol condensation reactions. The formed MgO as a template and the catalysis of MgO during co-pyrolysis contributed to the mesoporous structure of solid char.
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Affiliation(s)
- Danchen Zhu
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Haiping Yang
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Yingquan Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Xu Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Jun Zou
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China.
| | - Shihong Zhang
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Hanping Chen
- State Key Laboratory of Coal Combustion, School of Power and Energy Engineering, Huazhong University of Science and Technology, 430074 Wuhan, China
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Jerkovic D, Tadin A, Gavic L, Vladislavic NZ, Grgic N, Macan D. Effect of orally administered magnesium on postoperative pain level and trismus after surgical removal of the lower third molars: a randomized, double-blind, placebo-controlled trial. Clin Oral Investig 2020; 24:4649-4659. [PMID: 32436160 DOI: 10.1007/s00784-020-03335-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/08/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Pain and trismus are the most common postoperative complications following a surgical removal of the lower third molar. This randomized, double-blind, placebo-controlled clinical trial evaluated the effect of orally administrated magnesium on postoperative pain and trismus after surgical removal of the lower third molars. MATERIALS AND METHODS The study was conducted on 80 participants who were divided into two groups. Each group took different oral forms of magnesium citrate. Participants in both groups had their two lower molars surgically removed. For one randomly selected third molar, participants received either magnesium citrate tablets or lozenges. For the surgical removal of the lower third molar of the opposite side, the participants received either placebo tablets or lozenges. The data were analyzed using the Wilcoxon signed-ranked test, the Mann-Whitney U test, and the Spearman rank-order correlation with the level of significance set at p < 0.05. This manuscript was written in accordance with the Consort recommendation. RESULTS The results show a statistically significant lower pain level at all tested times (24 h, 48 h, and 72 h postoperatively) for participants who used magnesium preparations in lozenges (p = 0.012, p = 0.013, and p ≤ 0.001) as well as in tablet form (p ≤ 0.001) compared to placebo. The results also show a statistically significant greater mouth opening ability at all tested times (24 h, 48 h, and 72 h postoperatively) between magnesium preparations and the placebo (p ≤ 0.001). CONCLUSION Orally administered magnesium (either lozenges or tablets) before and after a lower third molar surgical removal significantly reduces pain intensity and the degree of trismus in the postoperative period. CLINICAL RELEVANCE Based on the results of the study, oral magnesium could be used in the oral and maxillofacial surgery to reduce postoperative complications after surgical removal of the lower third molars. TRIAL REGISTRATION This study is registered on http:clinicaltrials.gov under protocol no. NCT03398382.
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Affiliation(s)
- Daniel Jerkovic
- Department of Maxillofacial Surgery, Study of Dental Medicine, School of Medicine, Clinical Hospital Centre, University of Split, Spinciceva 1, 21000, Split, Croatia.
| | - Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Lidia Gavic
- Department for Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | | | - Nino Grgic
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Darko Macan
- Department of Maxillofacial and Oral Surgery, School of Dental Medicine, University of Zagreb, University Hospital Dubrava, Zagreb, Croatia
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Ates M, Kizildag S, Yuksel O, Hosgorler F, Yuce Z, Guvendi G, Kandis S, Karakilic A, Koc B, Uysal N. Dose-Dependent Absorption Profile of Different Magnesium Compounds. Biol Trace Elem Res 2019; 192:244-251. [PMID: 30761462 DOI: 10.1007/s12011-019-01663-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/04/2019] [Indexed: 02/07/2023]
Abstract
Magnesium, one of the basic elements for the human body, is necessary for many physiological functions. Magnesium deficiency is widely observed as a result of the reduced nutrient content of foods, over-cooking, diseases, drugs, alcohol, and caffeine consumption. Taking a dietary supplement is necessary magnesium deficiency. It has been demonstrated that absorption of organic magnesium compounds is better than absorption of inorganic compounds. The aim of this study is to investigate transitions to tissues of different organic magnesium compounds in different doses and whether there is a difference in the organic acid-bounded compounds (magnesium citrate and magnesium malate) and the amino acid-bounded compounds (magnesium acetyl taurate and magnesium glycinate), associated with transition and bioavailability. In addition, the effects of split dosages of high doses in a high volume of solvent on tissue magnesium levels are being investigated, because galenic formulation problems are regarded to prepare convenient dosage that can be taken once a day. All magnesium compounds were administered as three different doses, 45, 135, and 405 mg/70 kg elemental magnesium, were given per orally to Balbc mice. In a second set of experiments, 405 mg/70 kg high dose was divided into two doses of 202.5 mg/70 kg each and administered every 12 h. Brain, muscle tissues, and serum magnesium levels measured in all experimental groups and control 24 h later. Brain magnesium levels were found increased in all magnesium acetyl taurate administered subjects. Magnesium citrate increased muscle and brain magnesium levels in a dose-independent manner. We showed that dividing high doses of daily administered magnesium compounds did not sufficiently increase tissue magnesium levels. Although passive paracellular mechanism by solvent drag is the main mechanism of Mg absorption, other factors (electrochemical gradient effects, transcellular transporter mechanisms, magnesium status) should be effective on our results. It is necessary for further research on long-term administration of different magnesium compounds and their effect on other tissues.
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Affiliation(s)
- Mehmet Ates
- College of Vocational School of Health Services, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Servet Kizildag
- College of Vocational School of Health Services, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Oguz Yuksel
- Department of Sports Medicine, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Ferda Hosgorler
- Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Zeynep Yuce
- Department of Medical Biology and Genetics, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Guven Guvendi
- Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Sevim Kandis
- Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Aslı Karakilic
- Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Basar Koc
- Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Nazan Uysal
- Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey.
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Uysal N, Kizildag S, Yuce Z, Guvendi G, Kandis S, Koc B, Karakilic A, Camsari UM, Ates M. Timeline (Bioavailability) of Magnesium Compounds in Hours: Which Magnesium Compound Works Best? Biol Trace Elem Res 2019; 187:128-136. [PMID: 29679349 DOI: 10.1007/s12011-018-1351-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/13/2018] [Indexed: 11/29/2022]
Abstract
Magnesium is an element of great importance functioning because of its association with many cellular physiological functions. The magnesium content of foods is gradually decreasing due to food processing, and magnesium supplementation for healthy living has become increasingly popular. However, data is very limited on the bioavailability of various magnesium preparations. The aim of this study is to investigate the bioavailability of five different magnesium compounds (magnesium sulfate, magnesium oxide, magnesium acetyl taurate, magnesium citrate, and magnesium malate) in different tissues. Following a single dose 400 mg/70 kg magnesium administration to Sprague Dawley rats, bioavailability was evaluated by examining time-dependent absorption, tissue penetration, and the effects on the behavior of the animals. Pharmacokinetically, the area under the curve calculation is highest in the magnesium malate. The magnesium acetyl taurate was found to have the second highest area under the curve calculation. Magnesium acetyl taurate was rapidly absorbed, able to pass through to the brain easily, had the highest tissue concentration level in the brain, and was found to be associated with decreased anxiety indicators. Magnesium malate levels remained high for an extended period of time in the serum. The commonly prescribed dietary supplements magnesium oxide and magnesium citrate had the lowest bioavailability when compared to our control group. More research is needed to investigate the bioavailability of magnesium malate and acetyl taurate compounds and their effects in specific tissues and on behavior.
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Affiliation(s)
- Nazan Uysal
- Medical Faculty, Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey.
- College of Vocational School of Health Services, School of Medicine Izmir, Dokuz Eylul University, İzmir, Turkey.
| | - Servet Kizildag
- College of Vocational School of Health Services, School of Medicine Izmir, Dokuz Eylul University, İzmir, Turkey
| | - Zeynep Yuce
- Department of Medical Biology and Genetics, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Guven Guvendi
- Medical Faculty, Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Sevim Kandis
- Medical Faculty, Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Basar Koc
- Medical Faculty, Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Aslı Karakilic
- Medical Faculty, Department of Physiology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Ulas M Camsari
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mehmet Ates
- College of Vocational School of Health Services, School of Medicine Izmir, Dokuz Eylul University, İzmir, Turkey
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Seo SI, Kang JG, Kim HS, Jang MK, Kim HY, Shin WG. Efficacy and tolerability of 2-L polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate: a randomized controlled trial. Int J Colorectal Dis 2018; 33:541-548. [PMID: 29497812 DOI: 10.1007/s00384-018-2989-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIM Previous studies comparing 2-L polyethylene glycol (PEG)-based solution with ascorbic acid (PEG/Asc) with sodium picosulfate/magnesium citrate (SP/MC) drew inconclusive results. This study aimed to compare a 2-L-PEG/Asc with SP/MC by split method in bowel cleansing efficacy, tolerability, and safety and to identify factors influencing inadequate bowel preparation. METHOD We performed a prospective randomized, endoscopist-blinded, single-center, controlled trial. The Aronchick scale and Ottawa bowel preparation scale (OBPS) were used to evaluate the bowel cleansing efficacy, and patients' tolerability and preferences were assessed by questionnaire. RESULTS In total, 223 patients were randomized to receive 2-L-PEG/Asc (n = 109) or SP/MC (n = 114). There was no significant difference in overall bowel cleansing efficacy between the two groups; however, when analyzing by individual segment, mean bowel cleansing efficacy of right colon showed a trend in favor of SP/MC group than in PEG/Asc group (OBPS; 1.55 ± 0.66 vs. 1.74 ± 0.88, P = 0.08). Furthermore, SP/MC was better tolerated than PEG/Asc based on ease of consumption and preference to receive the agents again in the future. Total adverse events were significantly lower in SP/MC group than PEG/Asc group (47.4 vs. 62.4%, P = 0.031). In multivariate analysis, later colonoscopic starting time was the only independent factor predicting inadequate bowel preparation (OR 1.39, 95% CI 1.156-1.692, P = 0.001). CONCLUSIONS There was no significant difference in overall bowel cleansing efficacy between PEG/Asc and SP/MC; however, SP/MC showed better tolerability and safety profile than PEG/Asc. The independent factor for inadequate bowel preparation was later colonoscopic starting time when applied split method.
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Affiliation(s)
- Seung In Seo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jin Gu Kang
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyoung Su Kim
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Myoung Kuk Jang
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hak Yang Kim
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
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9
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Kojecky V, Matous J, Keil R, Dastych M, Kroupa R, Zadorova Z, Varga M, Dolina J, Kment M, Hep A. A head-to-head comparison of 4-L polyethylene glycol and low-volume solutions before colonoscopy: which is the best? A multicentre, randomized trial. Int J Colorectal Dis 2017; 32:1763-6. [PMID: 28944412 DOI: 10.1007/s00384-017-2901-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE The purpose of this study is to compare the efficacy and tolerability of polyethylene glycol (PEG) to sodium picosulfate/magnesium citrate (SPMC) and low-volume polyethylene glycol/ascorbic acid (PEGA) in a single- or split-dose regimen for colonoscopy bowel preparation. METHODS This was a prospective, randomized, endoscopist-blinded, multicentre study. Outpatients received either PEG or SPMC or PEGA in a single or a split dose before the colonoscopy. Quality and tolerability of the preparation and complaints during preparation were recorded. RESULTS Nine hundred seventy-three patients were analysed. Satisfactory bowel cleansing (Aronchick score 1 + 2) was more frequent when a split dose was used irrespective of the solution type (PEG 90.1 vs 68.8%, PEGA 86.0 vs 71.6%, SPMC 84.3 vs 60.2%, p < 0.001). SPMC was the best tolerated followed by PEGA (p < 0.006) and PEG as the worst (p < 0.001). Tolerability did not correlate with the regimen and amount of the solution used. Female gender is associated with a higher incidence of nausea, vomiting and pain (p < 0.029). CONCLUSIONS Both PEG, PEGA and SPMC are fully comparable in terms of colonic cleansing when used in similar regimens. The split-dose preparation is more effective in all agents. SPMC and PEGA are better tolerated than PEG. The preparation regimen and/or the volume do not affect tolerability.
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10
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Ze EY, Choi CH, Kim JW. Acute Gastric Injury Caused by Undissolved Sodium Picosulfate/ Magnesium Citrate Powder. Clin Endosc 2016; 50:87-90. [PMID: 27732774 PMCID: PMC5299977 DOI: 10.5946/ce.2016.081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/30/2016] [Accepted: 09/06/2016] [Indexed: 01/07/2023] Open
Abstract
Sodium picosulfate/magnesium citrate (SPMC) is a widely used oral bowel cleansing agent considered to be relatively safe. However, partially dissolved or undissolved SPMC powder may cause severe injuries of the esophagus and stomach. We report a very rare case of acute gastric injury without esophageal damage caused by the ingestion of undissolved SPMC powder. A 69-year-old man experienced epigastric pain after swallowing SPMC powder without dissolving it in water in preparation for a screening colonoscopy. He realized his mistake immediately and subsequently drank 2 L of water. The esophagogastroduodenoscopy conducted after 12 hours indicated an acute gastric ulceration without injury of the esophagus or duodenum. The endoscopy conducted after 6 weeks of oral proton pump inhibitor treatment showed healing of the gastric injury. This suggested that drinking large amounts of water after ingesting partially dissolved or undissolved SPMC powder can prevent serious esophageal injury, but offers no preventive benefit for acute gastric injury.
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Affiliation(s)
- Eun Young Ze
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Chang Hwan Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jeong Wook Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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Abstract
Background and Objectives: Mechanical bowel preparation (MBP) has been used prior to total laparoscopic hysterectomy (TLH), but evidence for its use is lacking. Our study seeks to assess whether or not completion of preoperative MBP prior to TLH improves visualization of the surgical field, bowel handling, or overall ease of the operation. Methods: Women aged 18–65 years undergoing TLH for benign indications at a level 1 trauma center were randomized to a bowel preparation (BP; n = 39) or non–bowel preparation (NP; n = 39) regimen. After each operation, the surgeon completed a survey about intraoperative visualization of the surgical field, bowel handling, and the overall ease of the operation. The surgeon was also asked whether or not he thought the patient had completed MBP. The patient completed a survey about pre- and postoperative gastrointestinal discomfort. The surgeon was blinded to whether MBP was completed before the operation. Results: There was no difference in intraoperative visualization, bowel handling, or overall ease of the operation between the BP and NP groups. Comfort levels before and after surgery were not significantly different between the two groups. The surgeon was able to correctly predict whether the patient performed MBP in 59% of cases. Conclusion: The routine use of MBP before TLH does not improve intraoperative visualization, bowel handling, or overall ease of performing the procedure. It also has no significant effect on patient comfort levels. MBP is not indicated before TLH for benign indications.
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Affiliation(s)
- Nicholas A Ryan
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Vicki Sue-Mei Ng
- Department of Obstetrics and Gynecology, St. Luke's Women's Center, San Francisco, California
| | | | - Xiaoming Guan
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
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12
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Sahebally SM, Burke JP, Chu S, Mabadeje O, Geoghegan J. A randomized controlled trial comparing polyethylene glycol + ascorbic acid with sodium picosulphate + magnesium citrate solution for bowel cleansing prior to colonoscopy. Ir J Med Sci 2014; 184:819-23. [PMID: 25156179 DOI: 10.1007/s11845-014-1182-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/09/2014] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Adequate bowel cleansing which is acceptable to the patient is a prerequisite for safe and effective colonoscopy. A 2-L polyethylene glycol solution containing ascorbic acid and electrolytes (PEG-Asc) is an alternative to sodium picosulphate + magnesium citrate (SPS-Mg) for bowel preparation. The aim of the current study is to compare PEG-Asc to SPS-Mg in terms of tolerability and efficacy. METHODS This was a single blind, randomized controlled trial. A blinded assessment of bowel cleansing was made by the attending endoscopist. Patients completed a questionnaire on the acceptability of the preparation. RESULTS One hundred and thirty (130) consecutive patients attending for day case colonoscopy were randomly allocated to bowel preparation with PEG-Asc (n = 66) or SPS-Mg (n = 64). More patients found PEG-Asc to taste unpleasant (37.9 vs. 10.9%, P < 0.001) and more patients found PEG-Asc to be a more distressing preparation than SPS-Mg (15.1 vs. 4.7%, P = 0.043). However, there was no difference in the proportion of patients being able to complete bowel preparation (PEG-Asc vs. SPS-Mg, 92.4 vs. 93.8%, P = 0.520). There was no detectable difference between PEG-Asc and SPS-Mg in the quality of cleansing with a good or very good preparation being reported by the endoscopist in 46.9 and 54.5% of cases, respectively (P = 0.242). CONCLUSIONS More patients find PEG-Asc to taste unpleasant and to be a more distressing preparation than SPS-Mg. However, there was no detectable difference between PEG-Asc and SPS-Mg in bowel cleansing prior to colonoscopy.
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Affiliation(s)
- S M Sahebally
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland.
| | - J P Burke
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland.
| | - S Chu
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland
| | - O Mabadeje
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland
| | - J Geoghegan
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland
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13
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Uchiyama C, Kato T, Tomida K, Suzuki R, Nakata K, Hamanaka M, Kanemura T, Izumi M, Tamura S. Fatal hypermagnesemia induced by preoperative colon preparation in an elderly woman: report of a case. Clin J Gastroenterol 2013; 6:105-10. [PMID: 26181446 DOI: 10.1007/s12328-012-0353-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 12/19/2012] [Indexed: 12/15/2022]
Abstract
An 85-year-old woman with rectal carcinoma was referred to our hospital for surgical treatment. She had a history of constipation treated with oral magnesium oxide. She received 34 g of magnesium citrate (Magcolol P(®)) orally for 2 days as a mechanical bowel preparation prior to the operation. Just before the operation, she suddenly developed nausea, vomiting, and cyanosis and went into cardiac arrest. Despite support by mechanical ventilation, dopamine, dobutamine, and norepinephrine, she exhibited repeated bradycardia that was nearly fatal and required temporary pacing. The following day, her laboratory tests revealed marked hypermagnesemia (14.3 mg/dL). After a hemodialysis session, she recovered dramatically and all vasopressors were withdrawn. We conclude that preoperative mechanical bowel preparation with magnesium-containing cathartics can cause fatal hypermagnesemia in elderly patients even if their renal function is normal.
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Affiliation(s)
| | - Takeshi Kato
- Department of Surgery, Kansai Rousai Hospital, Hyogo, Japan.
| | - Kodo Tomida
- Department of Internal Medicine, Kansai Rousai Hospital, Hyogo, Japan
| | - Rei Suzuki
- Department of Surgery, Kansai Rousai Hospital, Hyogo, Japan
| | - Ken Nakata
- Department of Surgery, Kansai Rousai Hospital, Hyogo, Japan
| | | | | | - Masaaki Izumi
- Department of Internal Medicine, Kansai Rousai Hospital, Hyogo, Japan
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14
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Choi YS, Suh JP, Kim JK, Lee IT, Youk EG, Lee DS, Kim DS, Lee DH. Magnesium citrate with a single dose of sodium phosphate for colonoscopy bowel preparation. World J Gastroenterol 2011; 17:242-8. [PMID: 21245999 PMCID: PMC3020380 DOI: 10.3748/wjg.v17.i2.242] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 08/17/2010] [Accepted: 08/24/2010] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the efficacy and acceptability of magnesium citrate and a single dose of oral sodium phosphate (45 mL) solution for morning colonoscopy bowel preparation.
METHODS: A total of 159 patients were randomly assigned to receive two split doses of 90 mg of sodium phosphate (Group I, n = 79) or magnesium citrate (250 mL, the day before the procedure) followed by 45 mL of sodium phosphate (the day of procedure, Group II, n = 80). The quality of bowel cleansing and the acceptability of each regimen were compared, including the satisfaction, taste, willing to repeat and adverse effects of each regimen.
RESULTS: The quality of bowel cleansing of Group II was as good as that of Group I (An Aronchick scale score of good or excellent: 70.9% vs 81.0%, respectively, P = 0.34; the Ottawa system score: 4.4 ± 2.6 vs 3.8 ± 3.0, respectively, P = 0.76). There was no statistically significant difference between both groups with regard to acceptability, including the satisfaction, taste and willingness to repeat the regimen. A significantly greater number of older patients (over 65 years old) in Group II graded the overall satisfaction as satisfactory (48.1% vs 78.1%, respectively; Group I vs Group II, P = 0.01). There were no significant adverse reactions.
CONCLUSION: Magnesium citrate and a single dose of sodium phosphate was as effective and tolerable as the conventional sodium phosphate regimen and is a satisfactory option.
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Vradelis S, Kalaitzakis E, Sharifi Y, Buchel O, Keshav S, Chapman RW, Braden B. Addition of senna improves quality of colonoscopy preparation with magnesium citrate. World J Gastroenterol 2009; 15:1759-63. [PMID: 19360920 PMCID: PMC2668782 DOI: 10.3748/wjg.15.1759] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To prospectively investigate the effectiveness and patient’s tolerance of two low-cost bowel cleansing preparation protocols based on magnesium citrate only or the combination of magnesium citrate and senna.
METHODS: A total of 342 patients who were referred for colonoscopy underwent a colon cleansing protocol with magnesium citrate alone (n = 160) or magnesium citrate and senna granules (n = 182). The colonoscopist rated the overall efficacy of colon cleansing using an established score on a 4-point scale. Patients were questioned before undergoing colonoscopy for side effects and symptoms during bowel preparation.
RESULTS: The percentage of procedures rescheduled because of insufficient colon cleansing was 7% in the magnesium citrate group and 4% in the magnesium citrate/senna group (P = 0.44). Adequate visualization of the colonic mucosa was rated superior under the citramag/senna regimen (P = 0.004). Both regimens were well tolerated, and did not significantly differ in the occurrence of nausea, bloating or headache. However, abdominal cramps were observed more often under the senna protocol (29.2%) compared to the magnesium citrate only protocol (9.9%, P < 0.0003).
CONCLUSION: The addition of senna to the bowel preparation protocol with magnesium citrate significantly improves the cleansing outcome.
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