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Incidence and risk of hypomagnesemia in advanced cancer patients treated with cetuximab: a meta-analysis

Bibliographic details: Chen P, Wang L, Li H, Liu B, Zou Z.  Incidence and risk of hypomagnesemia in advanced cancer patients treated with cetuximab: a meta-analysis. Oncology Letters 2013; 5(6): 1915-1920 Available from: http://www.spandidos-publications.com/ol/5/6/1915

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Risk of anti-EGFR monoclonal antibody-related hypomagnesemia: systematic review and pooled analysis of randomized studies

INTRODUCTION: The typical class side effect of anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (panitumumab and cetuximab) is a cutaneous maculopapular rash, although hypomagnesemia is also described to be a frequent adverse event. The purpose of our meta-analysis is to evaluate the frequency and the relative risk of hypomagnesemia in patients treated with cetuximab or panitumumab in randomized trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Meta-analysis of incidence and risk of hypomagnesemia with cetuximab for advanced cancer

The review concluded that cetuximab was associated with a significant risk of hypomagnesaemia in cancer patients. The authors' conclusions broadly reflected the evidence presented and appear likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Enabling Medication Management Through Health Information Technology

The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: April 2011
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Magnesium as an adjuvant to postoperative analgesia: a systematic review of randomized trials

BACKGROUND: Randomized trials have reached different conclusions as to whether magnesium is a useful adjuvant to postoperative analgesia.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Meta-analysis: the efficacy and safety of monoclonal antibody targeted to epidermal growth factor receptor in the treatment of patients with metastatic colorectal cancer

This review concluded that monoclonal antibodies targeted to epidermal growth factor receptor could be effective in increasing response rates over chemotherapy or best supportive care, and could be a key therapeutic agent in the treatment of metastatic colorectal cancer despite a moderate increase in the rate of grade 3 or 4 adverse events. This conclusion is probably reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Cetuximab-based therapy versus non-cetuximab therapy for advanced cancer: a meta-analysis of 17 randomized controlled trials

This review concluded that cetuximab improved survival and overall response rate compared with non-cetuximab therapy. The authors acknowledged the differences between subgroups of patients, including a lack of sufficient evidence in pancreatic cancer and limited evidence of benefit in non-small cell lung cancer. Given these caveats and the overall conduct of the review, the authors' conclusions are probably reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Anti-EGFR-targeting agents in recurrent or metastatic head and neck carcinoma: a meta-analysis

The review concluded that monoclonal antibody anti-EGFR therapies (except tyrosine kinase inhibitors) were associated with improvements in overall survival, progression-free survival and overall response rates compared with standard therapies but some side-effects were increased. There were some issues with the review but the authors' conservative conclusions were based on the evidence and seem reasonable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Magnesium for the prevention or treatment of alcohol withdrawal syndrome in adults

Alcohol withdrawal syndrome (AWS) is a set of symptoms experienced when one reduces or stops alcohol consumption after prolonged periods of alcohol intake. Some studies show that AWS coincides with low levels of magnesium in the blood. Since magnesium may play a role in dampening the excitability of the central nervous system, some researchers believe that low levels of magnesium may make the central nervous system 'hyper‐excitable' and may cause AWS symptoms, which include sleeplessness, tremors, anxiety, headache, excessive sweating and reduced appetite. Many AWS treatment protocols therefore recommend magnesium supplementation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Magnesium for acute traumatic brain injury

Traumatic head injury is a leading cause of death and disability in the teenage population, primarily arising from traffic accidents. The estimated annual cost of treating and rehabilitating victims of head injury is approximately US$2Billion in the United States alone. Most of the neurological damage occurs at the time of injury, though the hours or days following the injury account for addition damage. It is believed that excessive calcium entry into the cells is the biggest threat to brain damage, in which the calcium excess ultimately leads to increased free radicals, proteolysis, initiation of apoptosis, and inflammation. As one of the most important ions in the central nervous system, magnesium is important in various physiological effects, such as ischemia, cellular energy metabolism, and protein synthesis. Magnesium is also a potent calcium channel blocker, and helps to control intracellular calcium activity. Magnesium increases cardiac output and cerebral blood flow. Low levels of magnesium can lead to an increase of intracellular calcium levels. Hypomagnesaemia is a risk to head injuries, and this has been associated with poor neurological outcome and increased mortality. Restoring the levels of magnesium may reduce edema, improve neurological and cognitive outcomes, and help with problems associated with ischemia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Continuous infusion of loop diuretics are safer and more effective than intermittent administration for people with congestive heart failure

Congestive heart failure (CHF) is reduced ability of the heart to pump blood around the body. The body tries to compensate by retaining water to increase blood volume, but this further weakens the heart. Diuretic drugs reduce water in the body. Loop diuretics work on the deep part of the small kidney tubes. They are commonly used in repeated doses intravenously for CHF, but this can cause rapid fluid shifts and adverse effects. The review of trials found that continuous infusion of loop diuretics for people with CHF is more effective and has fewer adverse effects than intermittent doses.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Cetuximab: a new treatment for advanced non‐small cell lung cancer

Lung cancer is the most common cancer in the world. Advanced non‐small cell lung cancer (NSCLC) accounts for about 60% of all lung cancer cases. Since the effectiveness of current standard treatment for advanced NSCLC (i.e. chemotherapy) has reached a ceiling, there is a continuous need for new, more effective treatments to further improve the outcome of patients with the disease. This review of 2018 patients, from four trials, found that adding cetuximab (a newly developed agent) to standard treatment, prolonged the survival time of advanced NSCLC patients by about 1.5 months, and deferred the progression of cancer by about 0.5 month. One year after the treatment, 45% of the patients receiving standard treatment plus cetuximab, and 40% of the patients receiving standard treatment alone were still alive. However, the effects of cetuximab on quality of life of patients were uncertain. Seven types of adverse events, mainly involving skin and blood, occurred much more in the patients receiving cetuximab, while other adverse events seemed to occur equally in both groups. The adverse events were reported as generally manageable. No deaths related to cetuximab were reported. In summary, high quality evidence shows that the use of cetuximab combined with standard treatment leads to better survival than standard treatment alone, in improving survival of patients with advanced NSCLC.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Tacrolimus for treatment of active treatment resistant ulcerative colitis

One study that tested the effectiveness of tacrolimus as therapy for treatment resistant ulcerative colitis was reviewed. Ulcerative colitis is a relapsing inflammatory disease restricted to the colon. Symptoms include bloody diarrhea, passage of pus and/or mucus and abdominal cramping during bowel movements. Tacrolimus is an immunosuppressant that may inhibit transcription of the interleukin 2 gene required for T cell activation thereby suppressing the inflammation associated with ulcerative colitis. The study compared two dosing regimens of tacrolimus (high serum concentration and low serum concentration) with placebo (inactive pill) and found that tacrolimus was effective for improving the symptoms of ulcerative colitis at two weeks. No benefit for induction of remission was noted. Patients in the high serum concentration group were significantly more likely than placebo patients to experience side effects related to treatment. Most of the side effects that occurred during the study were mild and included finger tremor, sleepiness, hot flush, headache, queasiness, stomach discomfort, hypomagnesemia and kidney problems. Two patients developed serious side effects during the study. One patient in the high serum concentration group developed serious viral gastroenteritis. A patient in the low serum concentration group developed Acinetobacter sepsis. Tacrolimus treatment was withdrawn in these patients and both patients recovered after medical therapy. Other side effects that have been associated with tacrolimus in other studies included liver problems, seizures, hypertension, diabetes mellitus, hyperkalemia, itching, insomnia, confusion, loss of appetite, hyperglycemia, weakness, depression, cramps, neuropathy, and infections. Tacrolimus may be effective for short‐term improvement in symptoms in patients with treatment resistant colitis. There are no data from controlled trials to allow conclusions with regard to long term safety and effectiveness. The use of tacrolimus needs to be weighed against the potential risk of serious side effects. More data from well designed and controlled studies are needed to determine the long‐term safety and effectiveness of tacrolimus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Diabetes in Pregnancy: Management of Diabetes and Its Complications from Preconception to the Postnatal Period

This clinical guideline contains recommendations for the management of diabetes and its complications in women who wish to conceive and those who are already pregnant. The guideline builds on existing clinical guidelines for routine care during the antenatal, intrapartum and postnatal periods. It focuses on areas where additional or different care should be offered to women with diabetes and their newborn babies.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: March 2008
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Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies [Internet]

To determine the efficacy and harms of diet and pharmacological interventions for preventing recurrent kidney stones, and whether stone composition and pre- and post-treatment biochemistries predict treatment efficacy.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: July 2012
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Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition

These guidelines cover most aspects of nutrition support in adult patients (>18 years) who are either malnourished or are at ‘risk’ of malnutrition. In some cases specific guidance related to patients in specific care settings or with specific diseases has been provided but in general the guidance is applicable to patients whatever their setting (hospital or community) or disease. The guideline therefore includes: information on the prevalence of malnutrition and the benefits of good nutrition; guidance on the appropriate forums for the organisation of nutrition support in all settings; guidance on who should be screened for malnutrition and when, along with the criteria for consideration when assessing patients’ nutritional status; the general indications for nutrition support together with ethical and legal considerations that may arise; guidance on the process and special considerations required to prescribe nutrition support and details information on the important parameters to monitor for patients receiving nutrition support; detailed guidance on the administration of oral, enteral and parenteral nutrition including; the appropriate types of access for enteral and parenteral nutrition and the optimum mode of delivering these; specific guidance on the management of providing nutrition support to patients with dysphagia; issues to consider for patients receiving enteral and parenteral nutrition support in the community; issues arising for patients and their carers.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

Version: February 2006
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Treatment‐related early and late side effects on the kidney in survivors of childhood cancer

Over the past few decades, great improvements in diagnostics and treatment have resulted in a major increase in survival rates of childhood cancer. However, childhood cancer survivors (CCS) are at great risk of developing adverse effects as a result of their cancer treatment. One of the potential adverse effects of childhood cancer treatment is kidney damage. Renal adverse effects are common during and just after treatment, but very little evidence is available on the frequency of renal function impairment in long‐term CCS and on what the risk factors are. Survivors with impaired renal function due to childhood cancer treatment are usually symptom free. The kidneys are remarkably well able to compensate for problems in their functioning. However, when renal late adverse events become symptomatic, survivors can experience a range of symptoms, depending on the kidney functions that are damaged. This systematic review aimed to assess the magnitude of asymptomatic and symptomatic early and late renal adverse events in long‐term CCS and to identify which risk factors contribute to impaired renal function.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Intravenous magnesium sulphate and sotalol for prevention of atrial fibrillation after coronary artery bypass surgery: a systematic review and economic evaluation

Atrial fibrillation (AF) is a supraventricular arrhythmia characterised by abnormal heart rhythm, with symptoms such as palpitations and nausea. It is one of the most common complications after coronary artery bypass graft (CABG) and 20–40% of patients experience AF following cardiac or thoracic surgery. AF increases the risk of mortality and morbidity from stroke, heart failure, myocardial infarction and thromboembolism. This can result in prolonged hospitalisation, hospital readmission, excess utilisation of hospital resources and increased health service costs. Risk factors include advanced age (particularly over the age of 50), previous history of AF, male gender, hypertension, diabetes, smoking, myocardial infarction and valvular heart disease.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Evaluation, Trials and Studies Coordinating Centre (UK).

Version: 2008

Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 27, 2014

Bacterial Meningitis and Meningococcal Septicaemia: Management of Bacterial Meningitis and Meningococcal Septicaemia in Children and Young People Younger than 16 Years in Primary and Secondary Care

This guideline covers bacterial meningitis and meningococcal septicaemia, focusing on management of these conditions in children and young people aged younger than 16 years in primary and secondary care, and using evidence of direct relevance to these age groups where available.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010
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Medical Encyclopedia

  • Hypomagnesemia
    Hypomagnesemia is a condition in which the amount of magnesium in the blood is lower than normal.
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Systematic Reviews in PubMed

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