A phase I/II trial of irinotecan-cisplatin combined with an anti-late-diarrhoeal programme to evaluate the safety and antitumour response of this combination therapy in patients with advanced non-small-cell lung cancer

We conducted a phase I/II study in patients with advanced non-small-cell lung cancer (NSCLC) to increase the therapeutic index of the cisplatin–irinotecan combination by institution of an anti-late-diarrhoeal program (ADP). A total of 77 chemotherapy-naive patients with advanced NSCLC were enrolled. The cisplatin dose was fixed at 60 mg m⁻² (Day 1). Irinotecan was escalated in 5 mg m⁻² increments, starting from 60 mg m⁻² (Days 1 and 8). ADP consisted of oral sodium bicarbonate, magnesium oxide, basic water, and ursodeoxycholic acid, and was administered orally for 4 days with each dose of irinotecan. In the phase I portion, irinotecan pharmacokinetics was also examined. After the recommended dose of irinotecan with ADP was determined, a phase II study was conducted to evaluate the response. Maximum tolerated dose was reached at an irinotecan dose of 80 mg m⁻² (Grade 4 diarrhoea and neutropenia). Pharmacokinetic studies show that the maximum concentration and the area under the curve of both irinotecan and SN38 (active metabolite of irinotecan) tend to increase in the dose-dependent manner of irinotecan. The phase II portion of the study included 48 patients, who were treated with 75 mg m⁻² of irinotecan. Grade 3/4 toxicities included neutropenia in 65%, leucopenia in 33%, and late diarrhoea in 6% of the patients. During this treatment, PS did not change in 65% of patients. At the end of the chemotherapy, PS did not decline in 90% of patients. In the phase II portion, a response occurred in 63% (95% confidential interval (CI), 47–76%) of patients. Median time to progression was 19 weeks (95% CI, 15–22 weeks), and median survival was 52 weeks (95% CI, 39–64 weeks). This regimen of irinotecan and cisplatin with ADP resulted in promising efficacy with acceptable toxicity for patients with advanced NSCLC. This regimen is a candidate for the experimental arm towards future phase III studies.

[The results of application of magnesium-bearing medications and different load doses of vitamins B1 and B2 in volunteers]

Presently is no consensus of opinion of the size of human optimal daily allowance as for thiamine and riboflavin, so for magnesium, what their content in polyvitamin and mineral preparations testify to. The study was conducted in 60 volunteers, who once took oral dosing of magnesium -bearing preparation "Magnerot" (500 mg of magnesium orotat converting to Mg2+ 32,8 Mg) and "Centrum" (100 mg of magnesium oxide converting to Mg2+ - 60,3 Vg) or vitamins B1 and B2 in 10, 20 and 30 mg doses. The received data testify that during the application of both of these preparations, equal concentration of this element takes place, though in case of magnesium oxide it happens later. As for the used vitamin B1 and B2 doses, it is determined that 10 mg is the optimal dose for treating their hypoavitaminosis.

Grass tetany in a herd of beef cows

Five cows in a herd of 15 cattle that had just been turned out onto lush pasture after having over-wintered on poor quality hay died suddenly. Biochemical profiles collected from the cadavers revealed reduced serum levels of magnesium, urea, and beta-hydroxybutycate. Classical grass tetany (hypomagnesemia) was diagnosed on postmortem examination.

Magnesium proteinate is more protective than magnesium oxide in heat-stressed quail

We evaluated the effects of dietary supplementation with Mg-oxide and Mg-proteinate on performance; nutrient digestibilities; malondialdehyde (MDA) concentrations in serum, liver, and thigh meat; and serum cholesterol and triacylglycerol concentrations in Japanese quail (Coturnix coturnix japonica) exposed to high ambient temperature. The birds (n = 360; 10 d old) were randomly assigned to 12 treatment groups consisting of 6 replicates of 5 birds each in a 2 x 2 x 3 factorial arrangement (temperature, Mg source, Mg level). Birds were maintained in temperature-controlled rooms at 22 degrees C for 24 h/d or 34 degrees C for 8 h/d (0900-1700 h) and fed a basal diet or that diet supplemented with 1 or 2 g Mg-oxide or Mg-proteinate/kg of diet. Heat exposure decreased (P = 0.0001) live weight gain, feed intake, feed efficiency, and carcass weight in quail fed the basal diet. A linear increase in feed intake (P = 0.008) and body weight (P = 0.001), and improvements in feed efficiency (P = 0.001), carcass weight (P < 0.0001), digestibility of dry matter, organic matter, crude protein, and ether extract were found in Mg-supplemented, heat-stressed quail. The effects of Mg-proteinate were greater than those of Mg-oxide (P < or = 0.0001). Serum Mg (P = 0.001) concentration increased, whereas the concentration of MDA in serum (P = 0.0001), liver (P = 0.04), and thigh meat (P = 0.0001) and serum triglyceride and cholesterol concentrations decreased linearly (P = 0.001) with the level of Mg in the diet. Interactions between dietary Mg source, temperature, and level of supplementation (P < or = 0.05) were found for several variables. Results of the present study suggest that supplementation with Mg-proteinate is more protective than Mg-oxide in reducing the negative effects of heat stress in quail.

Management of constipation in residents with dementia: sorbitol effectiveness and cost

OBJECTIVE

The objective of this report is to describe a cost-effective strategy for management of constipation in nursing home residents with dementia.

DESIGN

We conducted a prospective observational quality improvement study of 41 residents with chronic constipation and receiving an osmotic laxative. Sorbitol was substituted for lactulose.

SETTING

The study was conducted at a dementia special care unit at a Veterans Administration hospital.

MEASUREMENT

We measured the number and amount of laxative use over a period of 4 weeks that were required to maintain regular bowel function.

RESULTS

There was no difference in efficacy of lactulose and sorbitol. Use of additional laxatives was infrequent: Milk of Magnesia on approximately 10% of days/patient, bisacodyl suppository on 2% to 4% of days/patient, and Fleet enema only on 3 occasions. The cost of constipation management using routine administration of sorbitol and as-needed use of other laxatives was 27% to 55% lower than the cost of other constipation management strategies reported in the literature.

CONCLUSION

Substitution of sorbitol for lactulose does not change efficacy of the treatment and decreases cost. Regular use of an osmotic laxative avoids the costs and discomforts of rectal laxatives.

Weekly administration of irinotecan (CPT-11) plus cisplatin for refractory or relapsed small cell lung cancer

PURPOSE

Weekly administrations of CPT-11 plus cisplatin together with an anti-diarrheal program, the Oral Alkalization and Control of Defecation [Int J Cancer 1999;83:491; Int J Cancer 2001;92:269; Cancer Res 2002;62:179], were evaluated in this phase II study for patients with refractory or relapsed small cell lung cancer.

METHODS

Patients were treated by weekly administrations of 60 mg/m(2) CPT-11 plus 30 mg/m(2) cisplatin on Days 1, 8 and 15 over 4 weeks. Coinciding with the infusions and for 4 days thereafter, the anti-diarrheal program was practiced using orally administered sodium bicarbonate, magnesium oxide and basic water.

RESULTS

Twenty-five patients who had prior treatments of etoposide and platinum containing regimens (16 refractory patients and nine relapsed patients) were entered. The mean dose-intensities of CPT-11 and cisplatin were 154.8 and 77.4 mg/m(2) per course, respectively. Therefore, 86% of the planned dose was delivered. There were 20 partial responses and an overall response rate of 80% (95% confidence interval, 62-96%) was obtained. The median time to progression and the median survival after starting this regimen were 3.6 and 7.9 months, respectively. The major toxicity was myelosuppression. Grades 3 and 4 neutropenia occurred in 24 and 12% of patients, respectively. One patient with febrile neutropenia was experienced, and Grade 3 diarrhea was observed in 8%. But there was no treatment death.

CONCLUSION

Weekly administrations of CPT-11 plus cisplatin together with Oral Alkalization and Control of Defecation provide a practical and well tolerated regimen that was active for refractory or relapsed small cell lung cancer.

Changes in urinary parameters after oral administration of potassium-sodium citrate and magnesium oxide to prevent urolithiasis

OBJECTIVES

To examine urinary parameters among normal individuals and patients with calcium oxalate (CaOx) stones after oral administration of potassium-sodium citrate (KNa-Cit) and magnesium oxide (MgO). Urinary citrate and magnesium have been known as the inhibitors of CaOx stone formation. Supplementation with potassium-magnesium citrate prevents the recurrence of CaOx stones.

METHODS

Twenty-five male volunteers aged 21 to 42 years without a history of urinary stones were given either KNa-Cit or MgO, or both. Fourteen patients with recurrent CaOx stones were also given both supplements, and 24-hour urine samples were collected to determine the urinary parameters.

RESULTS

The administration of both KNa-Cit and MgO to the normal individuals increased the excretion of citrate, magnesium, and potassium by 70.0%, 44.2%, and 50.0%, respectively. These parameters increased less when KNa-Cit or MgO was administered individually. After administration of both supplements to the patients with stones, the citrate, magnesium, and potassium levels increased by 62.1%, 63.3%, and 25.3%, respectively, and oxalate decreased by 66.5%. In both normal individuals and patients, the ion activity product index of CaOx decreased significantly more after administration of the combination than with either compound alone or before administration.

CONCLUSION

The combination of KNa-Cit and MgO is more effective than either supplement alone in inhibiting the crystallization of CaOx stones. The combination may improve the urinary parameters of patients with stones accompanied by hypocitraturia and/or hypomagnesuria.

[Two cases of encrusted cystitis]

Encrusted cystitis is a type of severe cystitis, which progresses chronically and is characterized by excessively alkaline urine and calcifications within the bladder wall. We report two cases of encrusted cystitis. Both cases were high aged and had severe anemia with chronic cystitis. They complained of gross hematuria, voiding frequency and pain upon urination. Urine pH was 8-9, and urine cytology was negative. Urine culture contained Corynebacterium Group D2. Abdominal computed tomography and transurethral resection revealed wall bladder wall calcification and inflammatory change. We diagnosed it as encrusted cystitis. The patients underwent excision of plaques of calcified encrustation, adapted antibiotic therapy and acidification of urine. It is essential to diagnose encrusted cystitis early and to provide adequate treatment promptly.

Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial

OBJECTIVE

To assess whether, in children, oral magnesium oxide reduces migrainous headache frequency, severity, and associated features compared to placebo.

BACKGROUND

There is no single, safe, widely well-tolerated, and effective prophylactic treatment for all children and adolescents with frequent migrainous headache.

DESIGN

Randomized, double-blind, placebo-controlled, parallel-group trial.

METHODS

This study was conducted between June 1997 and January 2000 using 7 selected Northern California Kaiser Permanente sites. We recruited children of ages 3 to 17 years who reported a 4-week history of at least weekly, moderate-to-severe headache with a throbbing or pulsatile quality, associated anorexia/nausea, vomiting, photophobia, sonophobia, or relief with sleep, but no fever or evidence of infection. Subjects were randomly assigned to receive either magnesium oxide (9 mg/kg per day by mouth divided 3 times a day with food) (n = 58) or matching placebo (n = 60) for 16 weeks. The number of headache days (days with at least one headache) during each of eight 2-week intervals was chosen to be the primary outcome variable.

RESULTS

Of those enrolled, 86 (73%) completed the study (42 received magnesium oxide and 44 placebo); 74 of 192 eligible subjects declined to participate. Baseline information on demographic factors, health status, and headache history was similar comparing the 2 groups. By intention-to-treat analysis, we found a statistically significant decrease over time in headache frequency in the magnesium oxide group (P =.0037) but not in the placebo group (P =.086), although the slopes of these 2 lines were not statistically significantly different from each other (P =.88). The group treated with magnesium oxide had significantly lower headache severity (P =.0029) relative to the placebo group.

CONCLUSIONS

This study does not unequivocally determine whether oral magnesium oxide is or is not superior to placebo in preventing frequent migrainous headache in children, but treatment with the active agent did lead to a significant reduction in headache days. Larger trials involving this safe, appealing complementary therapy are needed.

The incidence and control of hypocalcaemia in pasture-based systems

A large emphasis on precalving magnesium supplementation has substantially reduced the incidence of clinical hypocalaemia in pasture-based systems. Survey data in the major pasture-based systems suggest a 2 to 4% incidence of parturient paresis, although this can vary considerably between farms. Detailed blood measurements under research conditions suggests that approximately 5% of cows are clinically hypocalcaemic (blood calcium < 1.4 mmol/l) and between 30 and 40% of cows are subclinically hypocalcaemic (plasma calcium < 2.0 mmol/l). Systems of control have traditionally been based on preventing the paretic cow, with more emphasis of late being placed on preventing hypocalcaemia. Preventative measures vary, but largely involve either supplementation with magnesium oxide pre-calving, supplementation with calcium carbonate during the colostrum period or a combination of magnesium supplementation precalving and calcium supplementation post-calving. In New Zealand, the use of commercial products that bind calcium is increasing precalving, but is still only practiced by a small percentage of farmers. The dietary cation-anion difference (DCAD) of pasture is so high and so variable that changes in DCAD sufficient to change blood pH are not practical and very difficult to achieve with consistency. The use of magnesium chloride and magnesium sulphate in preference to magnesium oxide, as precalving magnesium supplements, is increasing.

[A case of urolithiasis associated with short bowel syndrome]

We report a case of urolithiasis associated with short bowel syndrome. A 56-year-old woman was admitted to our hospital for asymptomatic bilateral renal stones. She had received extensive resection of small intestine due to strangulating obstructive ileus 7 years ago (residual intestine, only 20 cm). Subsequently, she was in a state of short bowel syndrome. Plain film of kidney, uteter, bladder and computed tomography revealed bilateral renal stones (right 4 mm, left 10 mm). The left renal stone was successfully treated by extracorporeal shock wave lithotripsy. Since the right renal stone was small, no treatment was performed. The stone fragments were composed of calcium oxalate and calcium phosphate, and excessive urinary excretion of oxalate (103.8 mg/day) was observed. In this patient, urolithiasis was diagnosed to be due to enteric hyperoxaluria caused by short bowel syndrome. To prevent the recurrence of stone formation, she was treated with oral administration of calcium lactate, sodium/potassium citrate and magnesium oxide. We review the Japanese literatures on urolithiasis with short bowel syndrome.

[A case-control study of prevention of irinotecan-induced diarrhea: the reducing side effects of irinotecan by oral alkalization combined with control of defecation]

Irinotecan and its active metabolite, SN-38, were reported to have the absorption characteristics of weakly basic drugs. Moreover, stasis of these compounds is thought to induce damage to the intestinal mucous membrane. The purpose of this report was to examine whether oral alkalization (OA) combined with control of defecation (CD) might prevent irinotecan-induced side effects. From day one of irinotecan infusion to day four, OA & CD were practiced using orally administered sodium bicarbonate, magnesium oxide, basic water, and ursodeoxycholic acid. Thirty-two lung cancer patients were treated with irinotecan in combination with cisplatin in the absence of OA & CD (Group A). Thirty-seven patients matched for background characteristics were treated with the same regimen in the presence of OA & CD (Group B). Group B had a reduced incidence of delayed diarrhea (Grade 2 < or = Group A 32.3% vs. Group B 9.4%), nausea, vomiting, and myelotoxicity, especially granulocytopenia compared with Group A. In addition, dose intensification was well-tolerated in Group B. Tumor response rates for non-small cell lung cancer were 59.3% (16/27 patients) in Group B against 38.5% (10/26 patients) in Group A. OA & CD appears to reduce the irinotecan-induced side effects, especially delayed diarrhea. Risk factors statistically associated with delayed diarrhea include advanced age and the use of irinotecan without OA & CD.

Use of cisapride with magnesium oxide in chronic pediatric constipation

Functional constipation in children is a common problem in daily practice, however there is currently no accepted optimal treatment of choice. This study investigated the effect of cisapride in the treatment of pediatric constipation when combined with magnesium oxide (MgO). This prospective study enrolled children with chronic constipation. They were randomly assigned to either MgO (125 mg three times a day for patients weighing less than 20 kg or 250 mg three times a day for those weighing more than 20 kg), or cisapride 0.2 mg/kg (max 5mg/dose) plus MgO for 4 weeks. Twenty-one doctors in 19 major medical centers or hospitals in Taiwan with well- established pediatric departments participated in this study from October 1999 to March 2000. 84 children (51 males, 33 females, 1-7 years of age) with fewer than 2 spontaneous bowel movements per week for at least one month completed the study. After 1 week of therapy, a good response, defined as 3 or more bowel movements per week, was achieved in 30 (68.2%) of children treated with cisapride and MgO compared with 23 (57.5%) children treated with MgO alone (p=n.s.). At the end of the 4-week treatment period, 90.9% of the children in cisapride group compared with 67.5% of the children in MgO group achieved a good response (p=0.013). There was no statistical difference between the two groups in terms of the side effects and stool characteristics. In conclusion, it appears that cisapride in combination with MgO may have a synergistic effect and improves the frequency of stool passage in pediatric functional constipation.

Physicochemical characterization and evaluation of buccal adhesive tablets containing omeprazole

The objective of this study was to develop an effective omeprazole buccal adhesive tablet with excellent bioadhesive force and good drug stability in human saliva. The omeprazole buccal adhesive tablets were prepared with various bioadhesive polymers, alkali materials, and croscarmellose sodium. Their physicochemical properties, such as bioadhesive force and drug stability in human saliva, were investigated. The release and bioavailability of omeprazole delivered by the buccal adhesive tablets were studied. As bioadhesive additives for the omeprazole tablet, a mixture of sodium alginate and hydroxypropylmethylcellulose (HPMC) was selected. The omeprazole tablets prepared with bioadhesive polymers alone had bioadhesive forces suitable for a buccal adhesive tablet, but the stability of omeprazole in human saliva was not satisfactory. Among alkali materials, only magnesium oxide could be an alkali stabilizerfor omeprazole buccal adhesive tablets due to its strong waterproofing effect. Croscarmellose sodium enhanced the release of omeprazole from the tablets; however, it decreased the bioadhesive forces and stability of omeprazole tablets in human saliva. The tablet composed of omeprazole/sodium alginate/HPMC/magnesium oxide/croscarmellose sodium (20/24/6/50/10 mg) could be attached on the human cheek without disintegration, and it enhanced the stability of omeprazole in human saliva for at least 4 h and gave fast release of omeprazole. The plasma concentration of omeprazole in hamsters increased to a maximum of 370 ng/ml at 45 min after buccal administration and continuously maintained a high level of 146-366 ng/ml until 6 h. The buccal bioavailability of omeprazole in hamsters was 13.7% +/- 3.2%. These results demonstrate that the omeprazole buccal adhesive tablet would be useful for delivery of an omeprazole that degrades very rapidly in acidic aqueous medium and undergoes hepatic first-pass metabolism after oral administration.

Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart disease patients

The use of magnesium in the treatment of acute myocardial infarction remains controversial despite preliminary experimental evidence that magnesium plays a beneficial role as a regulator of thrombosis. The aim of our study was to determine whether oral magnesium treatment inhibits platelet-dependent thrombosis (PDT) in stable patients with coronary artery disease (CAD). In a randomized prospective, double-blind, cross-over and placebo controlled study, 42 patients with stable CAD (37 men, 5 women, mean age 68 +/- 9 years) on aspirin received either magnesium oxide tablets (800-1,200 mg/day) or placebo for 3 months (Phase 1) followed by a 4-week washout period, and the cross-over treatment for 3 months (Phase 2). PDT, platelet aggregation, platelet P-selectin flow-cytometry, monocyte tissue factor procoagulant activity (TF-PCA) and adhesion molecules density were assessed before and after each phase. PDT was evaluated by an ex-vivo perfusion model using the Badimon chamber. Median PDT was significantly reduced by 35 percent in patients who received magnesium versus placebo (D change from baseline: -24 vs. 26 microm2/mm; p = 0.02, respectively). There was no significant effect of magnesium treatment on platelet aggregation, P-selectin expression, monocyte TF-PCA or adhesion molecules. Oral magnesium treatment inhibits PDT in patients with stable CAD. This effect appears to be independent of platelet aggregation or P-selectin expression, and is evident despite aspirin therapy. These findings suggest a potential mechanism whereby magnesium may beneficially alter outcomes in patients with CAD.

Effect of oral magnesium supplementation on blood pressure, platelet aggregation and calcium handling in deoxycorticosterone acetate induced hypertension in rats

OBJECTIVE

To study the effect of oral magnesium supplementation on blood pressure, platelet aggregation and platelet calcium handling in deoxycorticosterone acetate (DOCA)-induced hypertension in rats.

DESIGN AND METHODS

Rats were divided into four groups of 20 each. Drug treatments were given for a 6-week period. Control rats were vehicle treated. In the second group, DOCA, 15 mg/kg, was injected subcutaneously twice weekly with 1% NaCl used instead of drinking water. The third group was given magnesium oxide (MgO), 1 g/kg daily, orally by gavage. The fourth group was given MgO along with DOCA and 1% NaCl. Blood pressure and heart rate were measured weekly. Platelet aggregation, intracellular calcium, calcium uptake and calcium efflux studies were performed at the end of sixth week. Serum magnesium concentration, plasma levels of reactive nitrogen intermediates (RNI) and citrulline were also measured

RESULTS

There was a significant rise in blood pressure in the DOCA-treated rats. Magnesium prevented the gradual rise in blood pressure when given along with DOCA, but had no effect in normotensive rats. Heart rate did not show any significant change. Platelet aggregation was significantly reduced in all the treatment groups compared to the control group. DOCA treatment produced a significant increase in the intracellular calcium concentration as well as the calcium uptake compared to the control group. Magnesium supplementation inhibited the increased intracellular calcium concentration and calcium uptake in DOCA-treated rats. RNI and citrulline levels were elevated in all the treatment groups. Serum magnesium levels were significantly higher in the magnesium-treated and DOCA plus magnesium-treated rats.

CONCLUSIONS

Magnesium supplementation prevents blood pressure elevation in DOCA hypertensive rats. These effects are associated with inhibition of platelet calcium uptake and decreased intracellular free calcium concentration.

Oral magnesium supplementation inhibits platelet-dependent thrombosis in patients with coronary artery disease

The use of magnesium in the treatment of acute myocardial infarction remains controversial despite preliminary experimental evidence that magnesium plays a beneficial role as a regulator of thrombosis. This study examines whether oral magnesium treatment inhibits platelet-dependent thrombosis (PDT) in patients with coronary artery disease (CAD). In a randomized prospective, double-blind, crossover, and placebo-controlled study, 42 patients with CAD (37 men, 5 women, mean age 68 +/- 9 years) on aspirin received either magnesium oxide tablets (800 to 1,200 mg/day) or placebo for 3 months (phase 1) followed by a 4-week wash-out period, and the crossover treatment for 3 months (phase 2). PDT, platelet aggregation, platelet P-selectin flow cytometry, monocyte tissue factor procoagulant activity (TF-PCA), and adhesion molecule density were assessed before and after each phase. PDT was evaluated by an ex vivo perfusion model using the Badimon chamber. Median PDT was significantly reduced by 35% in patients who received magnesium versus placebo (delta change from baseline -24 vs 26 mm2/mm; p = 0.02, respectively). There was no significant effect of magnesium treatment on platelet aggregation, P-selectin expression, monocyte TF-PCA, or adhesion molecules. Oral magnesium treatment inhibited PDT in patients with stable CAD. This effect appears to be independent of platelet aggregation or P-selectin expression, and is evident despite aspirin therapy. These findings suggest a potential mechanism whereby magnesium may beneficially alter outcomes in patients with CAD.

Percutaneous chemolysis--an important tool in the treatment of urolithiasis

Persistent residual calculi after therapy, i.e. extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolitholapaxy (PNL), as well as pyelo- and nephrolithotomy are big problems in the treatment of urolithiasis. Furthermore, the therapy of stones is problematic in patients with inadequate drainage, impaired kidney function, or with high risks against anaesthetics. Between 1991 and 1997 percutaneous antegrade chemolysis was carried out in eleven patients. In nine of them complete dissolution of stones was achieved. In two further cases, in which calcium oxalate was the main component of the stones, chemolysis was unsuccessful. Through our own cases and under consideration of the literature, we will show that percutaneous chemolysis in these cases is useful and effective in the treatment of urolithiasis.

Primary hypomagnesemia caused by isolated magnesium malabsorption: atypical case in adult

Isolated magnesium malabsorption is a rare disorder, which bas been described in no more than 30 patients worldwide. Patients with this disorder typically present with convulsion and diarrhea in early infancy. Hypomagnesemia and hypocalcemia were found in a 35-year-old man with muscle cramps, who bad been diagnosed as primary hypoparathyroidism. Oral magnesium therapy corrected the low serum calcium, magnesium and parathyroid hormone levels. We report an atypical case of isolated magnesium malabsorption in an adult.

[Antitoxic features of magnesium oxide under combined radiation and thermal injury]

Male Wistar rats were exposed to 7.5 Gy total body gamma radiation followed to the additional full-thickness thermal bum. It was shown, that single administration of magnesium oxide in 1 hour after combined injury significantly corrected the early signs of endogenous intoxication. The level of bacterial endotoxemia decreased as well as serum concentration of toxic oligopeptides; general blood serum toxicity has been reduced too. Four-fold magnesium oxide's using as an enterosorbent in combination with antibiotics (doxycyclini, gentamicini or ciprofloxacin) has ensured 73-100% rats survival. All untreated animals dead within 30 days after combined injury.

High-dose pyridoxine and magnesium administration in children with autistic disorder: an absence of salutary effects in a double-blind, placebo-controlled study

Several reports have described salutary effects such as decreased physical aggression and improved social responsiveness being associated with the administration of high doses of pyridoxine and magnesium (HDPM) in open-labeled and controlled studies of patients with autism. Despite this fact, this intervention remains controversial. A 10-week double-blind, placebo-controlled trial was undertaken to examine both the efficacy and safety of HDPM in autism. Twelve patients were enrolled, and 10 patients (mean age 6 years 3 months) were able to complete the study. HDPM at an average dose of 638.9 mg of pyridoxine and 216.3 mg of magnesium oxide was ineffective in ameliorating autistic behaviors as assessed by the Children's Psychiatric Rating Scale (CPRS), the Clinical Global Impression Scale, and the NIMH Global Obsessive Compulsive Scale. Furthermore, no clinically significant side effects were noted during HDPM administration. A trend for a transient change on the CPRS was found that was possibly due to a placebo response. This study raises doubts about the clinical effectiveness of HDPM in autistic disorder.