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Malinowska J, Małecka-Giełdowska M, Pietrucha K, Górska G, Kogut D, Ciepiela O. Massive Transfusion Increases Serum Magnesium Concentration. J Clin Med 2023; 12:5157. [PMID: 37568557 PMCID: PMC10419839 DOI: 10.3390/jcm12155157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The massive transfusion of packed red blood cells (RBCs) is a lifesaving procedure, but it is associated with complications, e.g., dysmagnesemia. Since magnesium is an intracellular ion, the transfused RBCs can significantly influence the magnesium concentration in the recipient's blood. (2) Methods: A retrospective study was performed among 49 patients hospitalized in the Central Clinical Hospital of the Medical University of Warsaw who received a massive blood transfusion (≥4 units/h). Data on laboratory results and patient history were collected from the hospital database. The intracellular RBCs magnesium concentration was measured in 231 samples using the colorimetric method. (3) Results: There were statistically significant changes in the mean serum magnesium concentration preoperatively and 24 h postoperatively (0.87 ± 0.13 vs. 1.03 ± 0.14, p < 0.00001) and 48 h postoperatively (0.87 ± 0.13 vs. 1.06 ± 0.15, p < 0.00001). Patients who died had significantly higher serum magnesium concentrations (p < 0.05). The median intracellular magnesium concentration in RBCs was 0.91 (0.55-1.8) mmol/L, which is below the reference values of 1.65-2.65 mmol/L. (4) Conclusions: Transfused RBCs significantly increased the serum magnesium concentration 24 h and 48 h postoperatively. It could be a result of mild hemolysis, as the median intracellular magnesium concentration in RBCs was below the reference values.
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Affiliation(s)
- Justyna Malinowska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Milena Małecka-Giełdowska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Katarzyna Pietrucha
- Students Scientific Group of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Gabriela Górska
- Students Scientific Group of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Dagmara Kogut
- Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Olga Ciepiela
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland
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Bredell MG, Ernst J, El-Kochairi I, Dahlem Y, Ikenberg K, Schumann DM. Current relevance of hypoxia in head and neck cancer. Oncotarget 2016; 7:50781-50804. [PMID: 27434126 PMCID: PMC5226620 DOI: 10.18632/oncotarget.9549] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 04/28/2016] [Indexed: 01/23/2023] Open
Abstract
Head and Neck cancer (HNC) is a complex mix of cancers and one of the more common cancers with a relatively poor prognosis. One of the factors that may assist us in predicting survival and allow us to adjust our treatment strategies is the presence of tumor hypoxia. In this overview we aim to evaluate the current evidence and potential clinical relevance of tumor hypoxia in head and neck cancer according to an extensive search of current literature.An abundance of evidence and often contradictory evidence is found in the literature. Even the contradictory evidence and comparisons are difficult to judge as criteria and methodologies differ greatly, furthermore few prospective observational studies exist for verification of the pre-clinical studies. Despite these discrepancies there is clear evidence of associations between prognosis and poor tumor oxygenation biomarkers such as HIF-1α, GLUT-1 and lactate, though these associations are not exclusive. The use of genetic markers is expanding and will probably lead to significantly more and complex evidence. The lack of oxygenation in head and neck tumors is of paramount importance for the prediction of treatment outcomes and prognosis. Despite the wide array of conflicting evidence, the drive towards non-invasive prediction of tumor hypoxia should continue.
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Affiliation(s)
- Marius G. Bredell
- Department of Cranio-, Maxillofacial and Oral Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Jutta Ernst
- Department of Cranio-, Maxillofacial and Oral Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Ilhem El-Kochairi
- Department of Cranio-, Maxillofacial and Oral Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Yuliya Dahlem
- Department of Cranio-, Maxillofacial and Oral Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Kristian Ikenberg
- Department of Pathology, University Hospital of Zürich, Zürich, Switzerland
| | - Desiree M. Schumann
- Department of Cranio-, Maxillofacial and Oral Surgery, University Hospital Zürich, Zürich, Switzerland
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Affiliation(s)
- W.-C. Tsoi
- Hong Kong Red Cross Blood Transfusion Service; Hong Kong China
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Effects of packed red blood cell storage duration on post-transfusion clinical outcomes: a meta-analysis and systematic review. Intensive Care Med 2015; 41:2087-97. [DOI: 10.1007/s00134-015-4078-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/22/2015] [Indexed: 12/31/2022]
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Pottel L, Lycke M, Boterberg T, Pottel H, Goethals L, Duprez F, Maes A, Goemaere S, Rottey S, Foubert I, Debruyne PR. Echium oil is not protective against weight loss in head and neck cancer patients undergoing curative radio(chemo)therapy: a randomised-controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:382. [PMID: 25293388 PMCID: PMC4200132 DOI: 10.1186/1472-6882-14-382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/26/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Therapy-induced mucositis and dysphagia puts head and neck (H&N) cancer patients at increased risk for developing cachexia. Omega-3 fatty acids (n-3 FA) have been suggested to protect against cachexia. We aimed to examine if echium oil, a plant source of n-3 FA, could reduce weight loss in H&N cancer patients undergoing radio(chemo)therapy with curative intent. METHODS In a double-blind trial, patients were randomly assigned to echium oil (intervention (I) group; 7.5 ml bis in die (b.i.d.), 235 mg/ml α-linolenic acid (ALA) + 95 mg/ml stearidonic acid (SDA) + 79 mg/ml γ-linolenic acid (GLA)) or n-3 FA deficient sunflower oil high oleic (control (C) group; 7.5 ml b.i.d.) additional to standard nutritional support during treatment. Differences in percentage weight loss between both groups were analysed according to the intention-to-treat principle. Erythrocyte FA profile, body composition, nutritional status and quality of life were collected. RESULTS Ninety-one eligible patients were randomised, of whom 83 were evaluable. Dietary supplement adherence was comparable in both groups (median, I: 87%, C: 81%). At week 4, the I group showed significantly increased values of erythrocyte n-3 eicosapentanoic acid (EPA, 14% vs -5%) and n-6 GLA (42% vs -20%) compared to the C group, without a significant change in n-6 arachidonic acid (AA, 2% vs -1%). Intention-to-treat analysis could not reveal a significant reduction in weight loss related to echium oil consumption (median weight loss, I: 8.9%, C: 7.6%). Also, no significant improvement was observed in the other evaluated anthropometric parameters. CONCLUSIONS Echium oil effectively increased erythrocyte EPA and GLA FAs in H&N cancer patients. It failed however to protect against weight loss, or improve nutritional parameters. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01596933.
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Affiliation(s)
- Lies Pottel
- />Cancer Centre, General Hospital Groeninge, Loofstraat 43, B-8500 Kortrijk, Belgium
- />Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
- />Ageing and Cancer Research Cluster, Centre for Positive Ageing, University of Greenwich, London, UK
| | - Michelle Lycke
- />Cancer Centre, General Hospital Groeninge, Loofstraat 43, B-8500 Kortrijk, Belgium
- />Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
- />Ageing and Cancer Research Cluster, Centre for Positive Ageing, University of Greenwich, London, UK
| | - Tom Boterberg
- />Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
- />Ageing and Cancer Research Cluster, Centre for Positive Ageing, University of Greenwich, London, UK
| | - Hans Pottel
- />Department of Public Health and Primary Care, Catholic University Leuven Kulak, Kortrijk, Belgium
| | - Laurence Goethals
- />Cancer Centre, General Hospital Groeninge, Loofstraat 43, B-8500 Kortrijk, Belgium
| | - Fréderic Duprez
- />Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Alex Maes
- />Department of Nuclear Medicine, General Hospital Groeninge, Kortrijk, Belgium
| | - Stefan Goemaere
- />Department of Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Sylvie Rottey
- />Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Imogen Foubert
- />Department of Microbial and Molecular Systems, Food Science and Nutrition Research Centre (LForCe), Catholic University Leuven Kulak, Kortrijk, Belgium
| | - Philip R Debruyne
- />Cancer Centre, General Hospital Groeninge, Loofstraat 43, B-8500 Kortrijk, Belgium
- />Ageing and Cancer Research Cluster, Centre for Positive Ageing, University of Greenwich, London, UK
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Cholesterol and the "Cycle of Violence" in attempted suicide. Psychiatry Res 2014; 215:646-50. [PMID: 24503286 DOI: 10.1016/j.psychres.2014.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 12/06/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022]
Abstract
An association between low levels of serum cholesterol and violent or suicidal behaviour has frequently been reported. However the role of serum cholesterol in the cycle of violence (Widom, 1989) has not been studied. The aim of this study was to investigate association between exposure to violence during childhood and used adult violence in suicide attempters with low and high serum cholesterol levels. 81 suicide attempters were assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6 and 14 years of age) and during adult life (15 years or older). We used median split to dichotomise groups below and above median serum cholesterol. In patients with serum cholesterol below median, the correlation between exposure to violence as a child and used adult violence was significant (rho=0.52, p=0.002), while in patients with serum cholesterol above median, the correlation between exposure to violence as a child and expressed violent behaviour as an adult was not significant (rho=0.25, p=0.2). Comorbid substance abuse predicted violent behaviour as an adult only in patients with serum cholesterol above median. Serum cholesterol may modify the effect of the "Cycle of Violence".
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Kuliaviene I, Gulbinas A, Cremers J, Pundzius J, Kupcinskas L, Dambrauskas Z, Jansen E. Fatty acids of erythrocyte membrane in acute pancreatitis patients. World J Gastroenterol 2013; 19:5678-5684. [PMID: 24039361 PMCID: PMC3769905 DOI: 10.3748/wjg.v19.i34.5678] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/03/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate changes in the fatty acid composition of erythrocyte membrane phospholipids during severe and mild acute pancreatitis (AP) of alcoholic and nonalcoholic etiology.
METHODS: All consecutive patients with a diagnosis of AP and onset of the disease within the last 72 h admitted to the Hospital of Lithuanian University of Health Sciences between June and December 2007 were included. According to the Acute Physiology and Chronic Health Evaluation (APACHE II) scale, the patients were subdivided into the mild (APACHE II score < 7, n = 22) and severe (APACHE II score ≥ 7, n = 17) AP groups. Healthy individuals (n = 26) were enrolled as controls. Blood samples were collected from patients on admission to the hospital. Fatty acids (FAs) were extracted from erythrocyte phospholipids and expressed as percentages of the total FAs present in the chromatogram. The concentrations of superoxide dismutase and glutathione peroxidase were measured in erythrocytes.
RESULTS: We found an increase in the percentages of saturated and monounsaturated FAs, a decrease in the percentages of total polyunsaturated FAs (PUFAs) and n-3 PUFAs in erythrocyte membrane phospholipids of AP patients compared with healthy controls. Palmitic (C16:0), palmitoleic (C16:1n7cis), arachidonic (C20:4n6), docosahexaenoic (DHA, C22:6n3), and docosapentaenoic (DPA, C22:5n3) acids were the major contributing factors. A decrease in the peroxidation and unsaturation indexes in AP patients as well as the severe and mild AP groups as compared with controls was observed. The concentrations of antioxidant enzymes in the mild AP group were lower than in the control group. In severe AP of nonalcoholic etiology, the percentages of arachidic (C20:0) and arachidonic (C20:4n6) acids were decreased as compared with the control group. The patients with mild AP of nonalcoholic etiology had the increased percentages of total saturated FAs and gama linoleic acid (C18:3n6) and the decreased percentages of elaidic (C18:1n9t), eicosapentaenoic acid (EPA, C20:5n3), DPA (C22:5n3), DHA (C22:6n3) as well as total and n-3 PUFAs in erythrocyte membrane phospholipids.
CONCLUSION: The composition of FAs in erythrocyte membranes is altered during AP. These changes are likely to be associated with alcohol consumption, inflammatory processes, and oxidative stress.
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Teubert A, Thome J, Büttner A, Richter J, Irmisch G. Elevated oleic acid serum concentrations in patients suffering from alcohol dependence. J Mol Psychiatry 2013; 1:13. [PMID: 25408906 PMCID: PMC4224011 DOI: 10.1186/2049-9256-1-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/09/2013] [Indexed: 01/20/2023] Open
Abstract
Background Alcohol-induced damages such as brain atrophy and fatty liver are closely related to a disturbed lipid metabolism. In animal models, a linkage between chronic alcohol consumption and changes in fatty acid (FA) composition in various organs and cells is well known and there is some indication that this phenomenon could be linked to behavioural alterations associated with alcohol addiction such as craving. However, the influence of ethanol on secretory FA has not been investigated so far. In this study, we therefore aimed at investigating whether there is a significant change of serum FA composition in patients suffering from alcohol dependence. We compared patients before and after treatment (detoxication) with control individuals who did not suffer from addiction. The roles of age, the duration and intensity of alcohol use and lifestyles were considered. Methods Serum FA was measured in 73 male ethanol dependent patients before and after alcohol withdrawal in an in-patient setting. Additionally, of this group, 45 patients were matched with 45 healthy male volunteers as controls. Results We found significant differences in the FA composition before and after detoxication as well as between patients and controls. After detoxication, the values changed towards the ones in healthy controls. The main finding during acute alcohol use was an increased oleic acid concentration above the level of the linoleic acid concentration. Conclusions An elevated oleic/linoleic acid ratio seems to be a state marker for acute alcohol use and may be a relevant trait marker during detoxification and possibly the subsequent therapeutic measures. The results of this pilot study need to be replicated in a larger study also including female patients. Further, the specificity of this potential biomarker needs to be determined.
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Affiliation(s)
- Annekatrin Teubert
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Rostock, Gehlsheimerstr. 20, 18147 Rostock, Germany ; Department of Forensic Medicine, University of Rostock, St.-Georg-Str. 108, 18055 Rostock, Germany
| | - Johannes Thome
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Rostock, Gehlsheimerstr. 20, 18147 Rostock, Germany ; College of Medicine, Swansea University, Singleton Park, Swansea, SA2 8PP UK
| | - Andreas Büttner
- Department of Forensic Medicine, University of Rostock, St.-Georg-Str. 108, 18055 Rostock, Germany
| | - Jörg Richter
- Norway Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, P.O. Box 4623, Oslo, 0405 Norway
| | - Gisela Irmisch
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Rostock, Gehlsheimerstr. 20, 18147 Rostock, Germany
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Time to revisit red blood cell additive solutions and storage conditions: a role for "omics" analyses. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2012; 10 Suppl 2:s7-11. [PMID: 22890271 DOI: 10.2450/2012.003s] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Esteban-Pretel G, Marín MP, Romero AM, Timoneda J, Ponsoda X, Ballestín R, Renau-Piqueras J. Polyphosphoinositide metabolism and Golgi complex morphology in hippocampal neurons in primary culture is altered by chronic ethanol exposure. Alcohol Alcohol 2012; 48:15-27. [PMID: 23118092 DOI: 10.1093/alcalc/ags117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
AIMS Ethanol affects not only the cytoskeletal organization and activity, but also intracellular trafficking in neurons in the primary culture. Polyphosphoinositide (PPIn) are essential regulators of many important cell functions, including those mentioned, cytoskeleton integrity and intracellular vesicle trafficking. Since information about the effect of chronic ethanol exposure on PPIn metabolism in neurons is scarce, this study analysed the effect of this treatment on three of these phospholipids. METHODS Phosphatidylinositol (PtdIns) levels as well as the activity and/or levels of enzymes involved in their metabolism were analysed in neurons chronically exposed to ethanol. The levels of phospholipases C and D, and phosphatidylethanol formation were also assessed. The consequence of the possible alterations in the levels of PtdIns on the Golgi complex (GC) was also analysed. RESULTS We show that phosphatidylinositol (4,5)-bisphosphate and phosphatidylinositol (3,4,5)-trisphosphate levels, both involved in the control of intracellular trafficking and cytoskeleton organization, decrease in ethanol-exposed hippocampal neurons. In contrast, several kinases that participate in the metabolism of these phospholipids, and the level and/or activity of phospholipases C and D, increase in cells after ethanol exposure. Ethanol also promotes phosphatidylethanol formation in neurons, which can result in the suppression of phosphatidic acid synthesis and, therefore, in PPIn biosynthesis. This treatment also lowers the phosphatidylinositol 4-phosphate levels, the main PPIn in the GC, with alterations in their morphology and in the levels of some of the proteins involved in structure maintenance. CONCLUSIONS The deregulation of the metabolism of PtdIns may underlie the ethanol-induced alterations on different neuronal processes, including intracellular trafficking and cytoskeletal integrity.
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Affiliation(s)
- Guillermo Esteban-Pretel
- Corresponding author: Sección de Biología y Patología Celular, Centro de Investigación, Hospital Universitario La Fe, Avda. Campanar 21, Valencia, Spain.
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