Gabriela Rossi

Serum magnesium and proton-pump inhibitors use: a cross-sectional study

OBJECTIVE The aim of this study was to evaluate the association of serum magnesium levels with proton pump inhibitors (PPIs) use and other factors. METHODS This was a cross-sectional study of 151 patients admitted with acute diseases in the Internal Medicine Division of the Hospital de Clinicas de Porto Alegre, after the exclusion of conditions that are commonly associated with hypomagnesemia: diarrhea; vomiting; chronic alcohol use; severely uncompensated diabetes mellitus; and chronic use of laxatives, diuretics or other drugs causing magnesium deficiency. RESULTS All patients had normal serum magnesium levels. Serum albumin and creatinine levels were positively associated with serum magnesium levels, after adjusting for confounders. There was no difference between mean serum magnesium levels of PPI users and non-users, nor between men and women; there was also no correlation among age, serum phosphorus, and potassium levels with serum magnesium levels. Limitations of this study include the absence of an instrument for measuring adherence to PPI use and the sample size. CONCLUSION The association of PPI use and hypomagnesemia is uncommon. Congenital defects in the metabolism of magnesium may be responsible for hypomagnesemia in some patients using this drug class.

Low-dose albumin in the treatment of spontaneous bacterial peritonitis: should we change the standard treatment?

We read with interest the recent paper published on the management of patients awaiting liver transplant.1 The authors carried out a comprehensive review of liver complications, including spontaneous bacterial peritonitis (SBP). They stated that intravenous albumin (IV-A) at a dose of 1.5 g/kg at diagnosis and 1 g/kg 48 h later has been shown to prevent renal impairment and reduces mortality. We would like to address this point as this benefit has only been demonstrated in one clinical trial in which an arbitrary dose of albumin was used.2 …

Is there yet any place for reagent strips in diagnosing spontaneous bacterial peritonitis in cirrhotic patients? An accuracy and cost-effectiveness study in Brazil

Background:  Diagnosis of spontaneous bacterial peritonitis (SBP) is currently based on ascitic cell counting, but there is a need for a more simple and rapid diagnostic tool. The objectives of this study are to evaluate the accuracy of reagent strips in diagnosing SBP and compare their costs with total and differential cell counts.