Hypomagnesemia

Researchers are conducting a study called Acutelines, a large data and biobank project at the University Medical Center Groningen in the Netherlands. It focuses on patients with a wide range of acute medical conditions who present to the Emergency Department. The goal is to improve how acute diseases are recognized and treated, understand their outcomes, and support personalized medicine by collecting detailed clinical data, imaging, and biomaterials over time. Participants have their medical information, including demographics, health status, medical history, vital signs, diagnostic tests, and treatments, systematically collected. Biomaterials such as blood, urine, feces, and hair are gathered from patients who meet certain severity criteria. Data collection occurs during hospital admission, including continuous monitoring, and continues with follow-ups at 3 months, 1 year, 2 years, and 5 years after the initial emergency visit. Throughout the study, various assessments are performed, such as quality of life, physical functioning, mental health, symptoms, and hospital length of stay. Researchers collect data on mortality and other health outcomes for up to 50 years. The study uses digital tools to automate data capture and integrates information from multiple healthcare sources. Participants will be monitored closely during hospitalization and at scheduled intervals afterward to help improve understanding and treatment of acute diseases.

Researchers are evaluating the effects of four different anesthetic maintenance methods on surgical conditions, blood pressure stability, and brain protection during functional endoscopic sinus surgery (FESS) performed with controlled low blood pressure. The study compares propofol-remifentanil alone, propofol-remifentanil with added ketamine and magnesium, sevoflurane-remifentanil alone, and sevoflurane-remifentanil with added ketamine and magnesium. The main focus is on measuring blood markers of brain injury and assessing the quality of the surgical field and bleeding during surgery. Participants are randomly assigned to one of the four groups receiving general anesthesia with either propofol-remifentanil or sevoflurane-remifentanil, with or without continuous infusions of ketamine and magnesium. The infusions are administered continuously during surgery according to the assigned group. This trial is conducted at a single center and includes a triple-blind design to reduce bias. During the study, participants will have blood samples taken at three key times: before surgery starts, 20 minutes after controlled low blood pressure begins, and at surgery end to measure brain injury markers. Surgeons will rate surgical field visibility and bleeding at the end of surgery. Recovery will be assessed immediately after extubation using standard scores, and postoperative pain will be measured within 24 hours. The total participation involves the surgery and immediate postoperative period, with ongoing monitoring of outcomes related to anesthesia methods and brain protection.

Researchers are conducting a prospective clinical cohort study called TRUST to better understand long-term outcomes and factors that predict recurrence in patients treated for cardiac arrhythmias or those at high risk for arrhythmias. This study focuses on conditions such as atrial fibrillation, ventricular tachycardia, and other serious arrhythmias that contribute significantly to illness and death, especially in aging populations. It aims to collect detailed clinical and procedural information alongside systematic biobanking to enable precise patient characterization. Participants will be enrolled at a single tertiary care center specializing in heart conditions. The study involves collecting routine follow-up data and detailed information about treatments, including medications, devices, and interventions used to manage arrhythmias. Biosamples will be collected for molecular analysis, and digital tools will be used to capture clinical data and monitor heart rhythms over time. During the study, participants will undergo systematic rhythm monitoring with digital devices and regular clinical assessments over a five-year follow-up period. Researchers will evaluate outcomes such as cardiovascular mortality, stroke, heart failure hospitalizations, new arrhythmias, and quality of life. Safety outcomes including complications from rhythm control therapies and overall survival will also be monitored. The study aims for near-complete inclusion of eligible patients treated at the center to gather robust real-world data.

This clinical trial is focused on critically ill patients who are at risk for refeeding syndrome (RS) and are receiving supportive nutrition in an ICU setting. Researchers aim to find the best protein administration method to improve nutritional and clinical outcomes, reduce complications, and lower mortality. The study tests the hypothesis that a higher protein intake may decrease the occurrence of refeeding syndrome and improve overall patient outcomes, including shorter ICU and hospital stays. Participants are randomly assigned to either a high-protein group or a standard-protein group. Both groups receive nutritional support starting with low calorie intake that gradually increases. The high-protein group targets 2 grams of protein per kilogram of body weight per day, while the standard-protein group targets 1.3 grams per kilogram per day. Protein is gradually introduced, with whey protein powder added if needed, and the intervention lasts for 14 days with a minimum of 5 days. All patients receive daily thiamine and multivitamin-mineral supplements during the study. During the trial, patients are closely monitored with daily laboratory tests for key blood levels and organ function using scoring systems like SOFA. Researchers track the number of patients who develop refeeding syndrome within the first week, as well as secondary outcomes like infections, organ failure, length of ICU and hospital stays, and mortality up to 45 days after admission. The study involves regular assessments and careful monitoring to understand the effects of protein intake on these critically ill patients.

This research aims to compare the effects of adding dexamethasone or magnesium sulfate to bupivacaine during bilateral erector spinae plane blocks for controlling pain after cesarean section under spinal anesthesia. The study focuses on women undergoing elective cesarean delivery and explores ways to improve postoperative pain management, which is important to support recovery and reduce complications like chronic pain and stress. Participants will be divided into three groups: one receiving 20 ml of 0.25% isobaric bupivacaine alone, another receiving 20 ml of the same bupivacaine plus 4 mg dexamethasone, and the third receiving 20 ml of bupivacaine with 200 mg magnesium sulfate. These treatments are delivered using ultrasound-guided erector spinae plane blocks during surgery. During the study, participants will be monitored for pain control, time to first need for additional pain relief, total morphine consumption, ability to move independently, and any complications within 24 hours after surgery. Researchers will assess pain levels, quality of recovery, and safety outcomes to evaluate the effects of the added medications. The study period includes immediate postoperative assessments and follow-up within the first day after cesarean delivery.

This research aims to understand whether medications known to prolong the QT interval (QTPmeds) actually increase the risk of major adverse cardiac events (MACE) in hospitalized adult patients. These medications are widely flagged in healthcare settings due to potential serious heart risks, but the evidence linking them to real harms is limited. The study uses a large database of nearly one million adult hospital patients from Ontario to explore this important patient safety issue. Researchers will also apply machine learning to identify which patient or treatment factors best predict these risks. The study compares patients exposed to known QT-prolonging drugs during hospitalization with those who were not exposed. Data from the Ontario GEMINI network and Epic-Dovetale electronic medical records (EMRs) will be analyzed, focusing on events such as death, cardiac arrest, ventricular arrhythmias, and syncope occurring up to about four weeks after first drug exposure. The study will examine time periods when patients were exposed or not exposed to these medications during the same hospital stay to better estimate risk. Participants will be adult patients admitted to participating hospitals between December 2017 and March 2025. Researchers will review anonymized hospital EMR data, including medication exposures and outcomes. They will measure the occurrence of major cardiac events and use advanced data methods to predict risk factors. The study seeks to improve the accuracy of medication alerts, enhance patient safety, and reduce unnecessary healthcare disruptions related to these drug warnings.

Researchers are evaluating the use of effervescent calcium magnesium citrate (EffCaMgCit) to prevent complications associated with long-term use of proton pump inhibitors (PPIs). PPIs are commonly used to treat gastric ulcers, gastroesophageal reflux disease, peptic ulcers, and heartburn, but their use has been linked to risks such as osteoporosis, magnesium deficiency, and chronic kidney disease (CKD). This trial aims to determine whether EffCaMgCit can reduce these complications in adults taking chronic PPI therapy. The trial is a randomized, quadruple-blind study comparing EffCaMgCit to a placebo. Participants will receive either EffCaMgCit, containing calcium, magnesium, and citrate, or a placebo sachet dissolved in water daily for one year. The study will test if EffCaMgCit stabilizes bone mineral density, improves magnesium levels, and protects kidney function during PPI use. The placebo contains no active mineral components and is taken similarly. Participants will be monitored over one year with assessments at the start and end of the study. Evaluations include bone mineral density scans, measurements of magnesium levels in blood, urine, and muscle, kidney function tests, and hormone levels related to bone health. Researchers will track changes in these measures to assess the impact of EffCaMgCit. Safety and adherence will be observed throughout, with the study concluding after one year of treatment.

Diabetes, especially type 2 diabetes (T2DM) with insulin resistance, is linked to an increased risk of sudden cardiac death. This risk is partly related to changes in the heart's electrical activity, measured by QTc interval prolongation on ECGs. Researchers are studying how the antibiotic moxifloxacin might worsen QTc prolongation in people with T2DM, particularly when blood sugar levels are high or insulin is deficient. The study also aims to explore differences between males and females and analyze blood markers to understand the molecular reasons behind these effects. Participants in this study will receive controlled doses of glucose and moxifloxacin or placebos in a randomized, single-blind setting. On Day 1, participants get glucose with a placebo for moxifloxacin, while on Day 3 they receive intravenous glucose combined with moxifloxacin infused over 45 minutes. Blood glucose levels will be carefully raised and maintained at high levels for a set time, monitored continuously with glucose sensors and blood samples. The study includes both inpatient stays for treatment and outpatient follow-up visits. During the study, participants will undergo regular ECGs to measure heart electrical activity, blood tests to track glucose and moxifloxacin levels, and monitoring for any side effects. Outcomes measured include changes in ECG intervals and heart rhythms, pharmacokinetic profiles of glucose and moxifloxacin, and differences between sexes. The trial lasts several days with follow-up visits up to about 75 days after initial treatment to ensure participant safety and collect final data.

Researchers are evaluating the effect of magnesium sulfate on intraoperative neuromonitoring (IONM) during complex spine and cranial surgeries. This study aims to understand how magnesium sulfate influences the amplitude and latency of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs). Magnesium sulfate is used in multimodal pain management during surgery, but its impact on IONM, which helps monitor neural pathways in real-time to prevent injury, has not been studied before. The study is a double-blind, randomized, placebo-controlled trial comparing a magnesium sulfate bolus and infusion to a saline placebo. Participants undergoing surgery with planned IONM will receive a 40 mg/kg magnesium sulfate bolus over 10 minutes followed by a continuous infusion, or a saline bolus over 10 minutes. Anesthesia will be maintained with propofol and remifentanil. Baseline and repeated measurements of SSEPs and MEPs will be recorded before and after drug administration at specific time points up to 30 minutes. Participants will be monitored continuously during surgery with standard anesthesia and brain function monitors. Hemodynamic data will be collected every five minutes up to 30 minutes after drug administration. Researchers will compare changes in the amplitude and latency of SSEPs and MEPs to assess magnesium sulfate's effects on IONM. The trial lasts through the surgery and immediate monitoring period. Safety and neurological function will be closely observed throughout.

This research aims to evaluate how well a combination of ketamine and magnesium sulfate infusions during surgery controls pain after open rhinoplasty. The study focuses on managing postoperative pain, which is important for patient comfort and satisfaction. Both ketamine and magnesium sulfate target NMDA receptors but act differently, so their combined use may better control pain and reduce the need for opioid painkillers. Participants in the study will receive either a combination of ketamine and magnesium sulfate or a saline placebo during their rhinoplasty surgery. The ketamine dose includes a bolus followed by a constant infusion, while magnesium sulfate is given as a bolus and then a continuous infusion. The control group receives saline infusions. This comparison aims to assess the pain relief effects of the combined drugs during and after surgery. During the study, researchers will monitor total morphine use within 24 hours after surgery, time until first rescue pain medication, pain levels, heart rate, blood pressure, patient satisfaction, and any side effects. Monitoring occurs up to 24 hours postoperatively with heart rate and blood pressure tracked during surgery. The trial will help understand how this drug combination affects pain control and opioid use after rhinoplasty.