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Biomedical subjects

R Whang

Publications and source records attributed to R Whang.

At least 19 recordsLinked to original sources
PubMed1992

Refractory potassium repletion. A consequence of magnesium deficiency.

Experimental and clinical observations support the view that uncorrected magnesium (Mg) deficiency impairs repletion of cellular potassium (K). This is consistent with the observed close association between K and Mg depletion. Concomitant Mg deficiency in K-depleted patients ranges from 38% to 42%. Refractory K repletion due to unrecognized concurrent Mg deficiency can be clinically perplexing. Refractory K repletion as a consequence of Mg deficiency may be operative in patients with congestive failure, digitalis toxicity, cisplatin therapy, and in patients receiving potent loop diuretics. Therefore, we recommend that: (1) serum Mg be routinely assessed in any patients in whom serum electrolytes are necessary for clinical management and (2) until serum Mg is routinely performed consideration should be given to treating hypokalemic patients with both Mg as well as K to avoid the problem of refractory K repletion due to coexisting Mg deficiency.

Electrolytes↗
PubMed1991

Carbohydrate-electrolyte solutions during field training: an overview.

The rationale and methods of evaluating two carbohydrate-electrolyte solutions at a field training exercise in hot weather are presented in this overview. The carbohydrate-electrolyte solutions were formulated to produce a multipurpose replacement beverage which could satisfy diverse requirements of troops working in hot climates. Several uses of these beverages include replacement of electrolytes and fluid while in Mission Oriented Protective Posture IV, fluid replacement for mild heat casualties, and oral rehydration therapy for treatment of diarrheal losses.

Adult↗
PubMed1991

Health screening in elderly Oklahomans.

A total of 550 males and 457 females in their 60s and 70s were screened for height and weight, blood pressure, glucose, cholesterol, and hemoglobin. Statistical analysis was performed using SAS software. Male values were abnormal for all screening parameters except for cholesterol. Statistically significant lower hemoglobin in males suggests that blood loss may be a problem, and in males increases in body weight and glucose may herald a higher frequency of cardiovascular disease. Control of blood pressure, weight reduction, decreased consumption of fat and salt, and regular exercise may be the health imperatives in this group of elderly Oklahomans.

Aged↗
PubMed1991

Incidence of hypohydration when consuming carbohydrate-electrolyte solutions during field training.

Carbohydrate-electrolyte solutions (CE1, CE2) were evaluated for their ability to reduce the incidence of hypohydration during field training in hot weather (max Tamb = 88 degrees-100 degrees F). Hydration status was monitored twice daily in Army reservists who consumed ad libitum CE1, or CE2, or water, or a flavored water placebo. The water group had the highest percentage incidence of urine specific gravity greater than or equal to 1.030 (22%), whereas CE2 and flavored water placebo groups had the lowest (6% and 8%, respectively). Average total fluid intake was greatest in CE2 and lowest in CE1. CE2 and flavored water placebo were more effective than CE1 and water in reducing the overall incidence of hypohydration during this field exercise.

Adult↗
PubMed1991

Acceptability and effect of carbohydrate-electrolyte solutions on electrolyte homeostasis during field training.

Two lemon-lime flavored 2.5% carbohydrate-electrolyte solutions (CE1 supplemented with Na+, K+, and Mg+; and CE2 supplemented with NA+) were compared to plain water (water) and lemon-lime flavored water placebo (placebo) to evaluate their acceptability and consumption during 8 days of field training in hot weather. Acceptability ratings and consumption of CE2 and the flavored water placebo were similar and greater, respectively, than those for CE1. Average Na+ and K+ intakes, and serum electrolytes levels, were not affected during the 8-day trial. If food intake is adequate, consumption of carbohydrate-electrolyte solutions is apparently unnecessary to maintain electrolyte homeostasis.

Carbohydrates↗
PubMed1990

Frequency of hypomagnesemia and hypermagnesemia. Requested vs routine.

This study was designed to assess the effectiveness of identifying serum magnesium abnormalities by comparing physician-initiated requests for this analyte with routine magnesium determinations. Because magnesium abnormalities frequently accompany other electrolyte abnormalities, we measured magnesium in 1033 serum specimens submitted for electrolyte analyses. Physician-initiated requests for magnesium measurements were received for 81 (7.4%) of these specimens. Serum magnesium abnormalities were identified in 546 of the 1033 specimens (hypomagnesemia [less than 0.74 mmol/L], 487; hypermagnesemia [greater than 0.99 mmol/L], 59). Only 10% of the hypomagnesemic patients (48/487) and 13% of the hypermagnesemic patients (7/59) were identified by physician-initiated requests for this analyte. Fifty-three patients were both hypomagnesemic/hypokalemic and 30 patients were both hypomagnesemic/hyponatremic, but only 8 (15%) and 3 (10%), respectively, had physician-initiated requests for magnesium. Because magnesium abnormalities in significant numbers of patients are not being detected, we recommend routine measurement of this analyte when analyses of electrolytes are required for the care of patients.

Diagnostic Tests, Routine↗
PubMed1990

Routine serum magnesium determination: a contemporary clinical imperative.

Identification of hypomagnesaemia or hypermagnesaemia is presently the most expeditious method of clinically identifying perturbations in Mg metabolism. Clinicians may overlook as much as 90% of clinical hypomagnesaemia and hypermagnesaemia when serum Mg is determined on order versus on a routine basis. Routine serum Mg determination will facilitate management of digitalis toxicity in patients who are not currently identified as being hypomagnesaemic as well as preventing the occurrence of refractory K repletion. In our opinion routine serum Mg determination represents a clinical need which has not been addressed to date.

Animals↗
PubMed1989

Refractory potassium repletion due to cisplatin-induced magnesium depletion.

Cisplatin is a common cause of hypomagnesemia and hypokalemia due to renal magnesium (Mg) and potassium (K) losses. Magnesium plays an important role in the maintenance of intracellular K. An unrecognized and untreated Mg depletion can lead to a refractory K repletion. We describe two patients with hypomagnesemia-associated refractory hypokalemia following cisplatin following cisplatin therapy. Potassium supplementation failed to replace the K deficit. Profound hypokalemia persisted until hypomagnesemia was recognized and corrected. In neither patient was the concurrent hypomagnesemia recognized until the 11th and 9th hospital days. These two cases demonstrated the association of a refractory K repletion and an Mg deficiency. Thus, both serum K ion and Mg levels should routinely be assessed in patients who require cisplatin therapy.

Adult↗
PubMed1988

Arginine-induced hypermagnesemia and hyperkalemia in nephrectomized rats.

This study examined the effect of arginine monohydrochloride infusion on serum Mg and K in nephrectomized rats. Hyperkalemia exceeded the hypermagnesemia both of which occurred in response to arginine infusion and/or metabolic acidosis. This observation is consonant with our earlier reports which demonstrated that the activity of K exceeded that of Mg in shifts between the intracellular and extracellular compartments under a variety of experimental conditions.

Acidosis↗
PubMed1987

Magnesium deficiency: pathogenesis, prevalence, and clinical implications.

Hypomagnesemia is probably the most underdiagnosed electrolyte deficiency in current medical practice. Patients with cardiovascular disease who are at greatest risk for the development of magnesium deficiency are those treated with diuretics or digitalis. Both potassium and magnesium deficiencies are associated with increased ventricular ectopy and may increase the risk of sudden unexpected death. Refractory potassium repletion can be caused by concomitant magnesium depletion, and can be corrected with magnesium supplementation. Routine serum magnesium determination is recommended whenever the testing of electrolyte levels is required, especially in patients taking diuretic drugs or digitalis. Because hypomagnesemia is not necessarily present in a magnesium-deficient state, it is recommended that both potassium and magnesium be repleted in patients with hypokalemia. Potassium-/magnesium-sparing diuretics may be helpful in the prevention of these electrolyte deficiencies.

Animals↗
PubMed1987

Hypomagnesemia.

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Humans↗
PubMed1987

Routine serum magnesium determination--a continuing unrecognized need.

Abnormalities of serum Mg may be the most underdiagnosed serum electrolyte abnormality in clinical practice today. The incidence appears to range from 12.5 to 20% on routine determination. Hypomagnesemia is found in 6.9-11% of hospitalized patients on routine determination of serum Mg. A high frequency of hypomagnesemia occurs with other common electrolyte abnormalities: hypokalemia (38-42%), hypophosphatemia (29%), hyponatremia (23%), and hypocalcemia (22%). Routine serum Mg determination would facilitate identification of hypomagnesemia which may be a more frequent contributor to digitalis toxicity than hypokalemia. Identification and treatment of patients at risk for refractory K repletion would be facilitated by routine serum Mg determination. As in our 1976 report to the 2nd International Symposium on Mg Deficiency, it is again our opinion as in 1985 that routine clinical determination of serum Mg represents a continuing unrecognized need. In our opinion routine determination of serum Mg will materially enhance the care of the patient.

Humans↗