Magnesium is the fourth most common mineral in the human body and the second richest intracellular cation. This element is necessary for many physiological reactions, especially in the cardiovascular and respiratory systems. COVID-19 is an infectious disease caused by SARS-CoV-2. The majority of people who become ill as a result of COVID-19 have mild-to-moderate symptoms and recover without specific treatment. Moreover, there are people who develop severe forms of COVID-19, which require highly specialized medical assistance. Magnesium deficiency may play a role in the pathophysiology of infection with SARS-CoV-2. The primary manifestation of COVID-19 remains respiratory, but the virus can spread to other organs and tissues, complicating the clinical picture and culminating in multiorgan failure. The key mechanisms involved in the disease include direct viral cytotoxicity, endothelial dysfunction, and exaggerated release of inflammatory cytokines. The aim of this review was to summarize the available data regarding the role of magnesium in COVID-19 patients and its particularities in different clinical settings.
Ketoconazole (KZ) is a broad-spectrum drug used to treat fungal infections. Local use of ketoconazole has been associated with some side effects in healthy adults, especially local reactions, such as stinging, severe irritation, and itching. Moreover, the bioavailability of KZ after oral administration is low in tablets due to its low water solubility. In addition, oral administration of ketoconazole produces systemic exposure, associated with significant side effects, such as cholestatic and hepatocellular lesions. In an attempt to reduce hepatotoxicity, ketoconazole may be administered at the primary site of infection with cutaneous candidiasis, specifically on the skin tissue. However, the use of ketoconazole in topical dosage forms is limited by its high lipophilicity and extremely poor aqueous solubility (1 ng/mL), thus leading to the rare availability of topical dosage forms on the market. Therefore, a new approach to the effective delivery of ketoconazole to the site of infection is targeted, including obtaining new derivatives (keeping the imidazolic nucleus), with a similar spectrum of action, and finally, their inclusion in betacyclodextrin complexes in order to optimize bioavailability and physico-chemical stability.
The diagnosis of infective endocarditis (IE) during pregnancy is accompanied by a poor prognosis for both mother and fetus in the absence of prompt management by multidisciplinary teams. We searched the electronic databases of PubMed, MEDLINE and EMBASE for clinical studies addressing the management of infective endocarditis during pregnancy, with the aim of realizing a literature review ranging from risk factors to diagnostic investigations to optimal therapeutic management for mother and fetus alike. The presence of previous cardiovascular pathologies such as rheumatic heart disease, congenital heart disease, prosthetic valves, hemodialysis, intravenous catheters or immunosuppression are the main risk factors predisposing patients to IE during pregnancy. The identification of modern risk factors such as intracardiac devices and intravenous drug administration as well as genetic diagnostic methods such as cell-free deoxyribonucleic acid (DNA) next-generation sequencing require that these cases be addressed in multidisciplinary teams. Guiding treatment to eradicate infection and protect the fetus simultaneously creates challenges for cardiologists and gynecologists alike.
Postpartum depression (PPD) is a major health problem, and in recent years its prevalence has been increasing. The physiological changes and mood disorders associated with pregnancy and the postnatal period are mainly due to a hormonal imbalance. Destabilizing the mother's hypothalamic pituitary adrenal (HPA) axis increases the susceptibility to depression, probably by significantly increasing plasma cortisol. Stress and inflammation play a key role in postpartum. Also, lactogenic hormones have antidepressant and anxiolytic effects, the low concentration of oxytocin in the perinatal period being a triggering factor of PPD. Natural nutrition, ideal for every newborn and infant, positively influences the mother's mental health and may reduce the risk of developing PPD, possibly by attenuating cortisol response to stress. The link between breastfeeding and PPD has not been thoroughly approached. PPD is associated with early termination of breastfeeding, while long-term breastfeeding reduced the risk of PPD. The mother's willingness to breastfeed, her confidence in the ability to breastfeed, her mental health during pregnancy, her family's support, and trained medical staff are some of the mediators that can contribute to the maintenance of natural nutrition in PPD.
Teenager girls represent a particular risk group for unwanted pregnancy and abortion with important consequences on their health, school and professional education and social life. In order to avoid this problem appropriate counseling during contraceptive process is of paramount importance. Apart confi dentiality the contraceptive counselor must also demonstrate other important qualities like expertise, trustworthiness and availability. In hormonal contraception adolescents may be particularly bothered by side eff ects and it is important that they are counseled about these side eff ects prior to method initiation. Combined hormonal contraceptive methods with estrogens and progesterone are commonly used among adolescents, but the failure rate is higher compared to adult women, a possible
The aim of this paper is to describe the temporal progression and clinical picture of a 2-year-old child with infantile Refsum disease, as well as the diagnostic procedures performed; this case presented multiple hematologic, metabolic, and developmental complications and progressive disabilities. Genetic testing revealed a mutation of the PEX6 (Peroxisomal Biogenesis Factor 6) gene, and the metabolic profile was consistent with the diagnosis. Particularly, the child also presented altered coagulation factors and developed a spontaneous brain hemorrhage. The clinical picture includes several neurological, ophthalmological, digestive, cutaneous, and endocrine disorders as a result of the very long chain fatty acid accumulation as well as secondary oxidative anomalies. The study of metabolic disorders occurring because of genetic mutations is a subject of core importance in the pathology of children today. The PEX mutations, difficult to identify antepartum, are linked to an array of cell anomalies with severe consequences on the patient’s status, afflicting multiple organs and systems. This is the reason for which our case history may be relevant, including a vast number of symptoms, as well as modified biological parameters.
One of the essential roles of vitamin D is to maintain a good state of health, its actions being extremely complex. In the past years, the role and involvement of vitamin D have been intensively discussed in a variety of physiological or pathological conditions. To be effective, vitamin D requires binding to specific nuclear receptors (VDRs) that are found in multiple tissues. Therefore, there is a great interest in studies focused on vitamin D in order to evaluate the potential functions and relations with gestational diabetes mellitus (GDM). This disease is defined by glucose intolerance with onset or first recognition during pregnancy. It presents an increased risk of later progression to type 2 diabetes. Now, gestational diabetes represents a global public health problem due to its increasing incidence and possible severe complications of pregnancy. This article centralizes recent studies focused on a possible link between vitamin D deficiency and gestational diabetes, knowing that in pregnant women the insufficiency or deficiency of that vitamin is a common thing.
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