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Prevalence of electrolyte and nutritional deficiencies in Chinese bariatric surgery candidates.
Wang, C, Guan, B, Yang, W, Yang, J, Cao, G, Lee, S
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2016;(3):629-634
Abstract
BACKGROUND Electrolyte and nutritional deficiencies have been reported in Western populations seeking bariatric surgery. However, data are scarce for Chinese patients. OBJECTIVES To investigate the prevalence of electrolyte and nutritional deficiencies in Chinese bariatric surgery candidates and to explore their associations with patients' demographic data. SETTING University hospital, China. METHODS Demographical data of 211 patients presenting for bariatric surgery were collected on gender, age, body mass index (BMI) and waist circumference (WC). Blood biochemical data were collected on some nutrients (hemoglobin, albumin, globulin, folate, vitamin B12, calcium, phosphorus, iron, ferritin, magnesium, parathyroid hormone [PTH], and vitamin D) and some electrolytes (potassium, sodium, and chloride). RESULTS Deficiencies were found for hemoglobin (2.8%), albumin (11.8%), globulin (1.4%), folate (32.2%), vitamin B12 (4.7%), corrected calcium (13.7%), phosphorus (10.4%), iron (9.0%), ferritin (1.9%), vitamin D (80.0%), potassium (5.7%), sodium (7.6%), and chloride (15.6%). Secondary hyperparathyroidism was found in 17.3%; no hypomagnesemia was encountered. A significant correlation was observed between age and folate, corrected calcium and PTH levels (r = .257, -.206, and .273, respectively; P<.05). Greater BMI was associated with lower albumin and folate (r = -.338 and -.370, respectively) and with higher globulin and phosphorus levels (r = .267 and .138, respectively). Folate deficiency was more common in the 18- to 30-year-old age group (P = .042) and the patients with BMI>45 kg/m(2) (P = .001). WC had an association with rates of albumin, folate, and corrected calcium deficiencies, as well as hemoglobin, albumin, and globulin, folate, phosphorus, and ferritin levels. CONCLUSION Electrolyte and nutritional deficiencies are common in Chinese bariatric surgery candidates. Routine evaluation of electrolyte and nutritional levels should be carried out in this population.
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Electrolyte disorders assessment in solid tumor patients treated with anti-EGFR monoclonal antibodies: a pooled analysis of 25 randomized clinical trials.
Wang, Q, Qi, Y, Zhang, D, Gong, C, Yao, A, Xiao, Y, Yang, J, Zhou, F, Zhou, Y
Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine. 2015;(5):3471-82
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Abstract
The role of anti-epithelial growth factor receptor monoclonal antibodies (anti-EGFR MoAbs) in treatment-related electrolyte disorders is still controversial. Therefore, we conducted a meta-analysis of published randomized controlled trials (RCTs) to evaluate the incidences and overall risks of all-grade and grade 3/4 electrolyte disorder events. We searched relevant clinical trials from PubMed, EMBASE, and Web of Knowledge databases, meeting proceedings of American Society of Clinical Oncology and the European Society of Medical Oncology, as well as ClinicalTrials.gov. Eligible studies included phases II, III, and IV RCTs. Statistical analysis was performed to calculate the summary incidence, relative risk (RR), and 95 % confidence intervals (CIs) using fixed effects or random effects models based on the heterogeneity of included studies. A total of 16,411 patients from 25 RCTs were included in this meta-analysis. The all-grade incidence of hypomagnesemia related to anti-EGFR MoAbs was 34.0 % (95 % CI 28.0-40.5 %), and that for hypokalemia and hypocalcemia were 14.5 % (95 % CI 8.2-24.4 %) and 16.8 % (95 % CI 14.2-19.7 %), respectively. Compared with chemotherapy alone in colorectal cancer, addition of cetuximab increased the risk of grade 3/4 hypomagnesemia and grade 3/4 hypokalemia with RRs of 7.14 (95 % CI 3.13-16.27, p < 0.001) and 2.19 (95 % CI 1.14-4.23, p = 0.019). Additionally, colorectal cancer patients in panitumumab cases were more vulnerable to grade 3/4 hypomagnesemia and hypokalemia (RR 18.29, 95 % CI 7.29-48.41, p < 0.001, and RR 3.3, 95 % CI 1.32-8.25, p = .011). Treatment with anti-EGFR MoAbs is associated with significantly higher risks of electrolyte disorders such as hypomagnesemia, hypomagnesemia, and hypocalcemia, especially in colorectal cancer. Rigorous monitoring and early treatment of electrolyte disorders are proposed.
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Translating molecular physiology of intestinal transport into pharmacologic treatment of diarrhea: stimulation of Na+ absorption.
Singh, V, Yang, J, Chen, TE, Zachos, NC, Kovbasnjuk, O, Verkman, AS, Donowitz, M
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2014;(1):27-31
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Abstract
Diarrheal diseases remain a leading cause of morbidity and mortality for children in developing countries, while representing an important cause of morbidity worldwide. The World Health Organization recommended that low osmolarity oral rehydration solutions plus zinc save lives in patients with acute diarrhea, but there are no approved, safe drugs that have been shown to be effective against most causes of acute diarrhea. Identification of abnormalities in electrolyte handling by the intestine in diarrhea, including increased intestinal anion secretion and reduced Na(+) absorption, suggest a number of potential drug targets. This is based on the view that successful drug therapy for diarrhea will result from correcting the abnormalities in electrolyte transport that are pathophysiologic for diarrhea. We review the molecular mechanisms of physiologic regulation of intestinal ion transport and changes that occur in diarrhea and the status of drugs being developed to correct the transport abnormalities in Na(+) absorption that occur in diarrhea. Mechanisms of Cl(-) secretion and approaches to anti-Cl(-) secretory therapies of diarrhea are discussed in a companion review.