Browsing by Author "Laranjinha, I"
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- Hypomagnesemia: a Potential Underlooked Cause of Persistent Vitamin D Deficiency in Chronic Kidney DiseasePublication . Matias, P; Ávila, G; Ferreira, AC; Laranjinha, I; Ferreira, AMagnesium and vitamin D play important roles in most cells of the body. These nutrients act in a coordinated fashion to maintain physiologic functions of various organs, and their abnormal balance could adversely affect these functions. Therefore, deficient states of both nutrients may lead to several chronic medical conditions and increased cardiovascular and all-cause mortality. Chronic kidney disease (CKD) patients have altered metabolism of both magnesium and vitamin D. Some studies indicate that magnesium could have a role in the synthesis and metabolism of vitamin D, and that magnesium supplementation substantially reversed the resistance to vitamin D treatment in some clinical situations. Recent observational studies also found that magnesium intake significantly interacted with vitamin D status and, particularly with the risk of cardiovascular mortality. It is therefore essential to ensure adequate levels of magnesium to obtain the optimal benefits of vitamin D supplementation in CKD patients. In this review, we discuss magnesium physiology, magnesium and vitamin D metabolism in CKD, potential metabolic interactions between magnesium and vitamin D and its clinical relevance, as well as the possible role of magnesium supplementation to assure adequate vitamin D levels.
- Nocturnal Blood Pressure Dipping in Acute Ischemic StrokePublication . Sargento-Freitas, J; Laranjinha, I; Galego, O; Rebelo-Ferreira, A; Moura, B; Correia, M; Silva, F; Machado, C; Cordeiro, G; Cunha, LOBJECTIVES: We aim to assess the impact of early nocturnal blood pressure (BP) variation in the functional outcome of patients after an acute ischemic stroke. MATERIALS AND METHODS: We included consecutive stroke patients treated with intravenous thrombolysis (IVrtPA) in a tertiary stroke center. BP measurements were performed at regular intervals throughout day and night during the first 48 h after stroke onset, and subjects were divided into four dipping categories (extreme dippers, dippers, non-dippers, and reverse dippers). Recanalization was assessed by transcranial color-coded Doppler and/or angiographic CT. Hemorrhagic transformation was evaluated at 24 h follow-up CT scan. Functional outcome was evaluated at 3 months after stroke using the modified Rankin Scale. RESULTS: A total of 304 patients were included, mean age 72.80 ± 11.10 years. After 24 h of systolic BP monitoring, 30.59% were classified as reverse dippers, 39.14% as non-dippers, 19.10% as dippers, and 11.18% as extreme dippers. Multivariate analysis did not show an independent association of any dipping class with 3-month functional outcome. Hemorrhagic transformation was not uniform between dipping classes: 25.81% for reverse dippers, 14.29% for non-dippers, 15.52% for dippers, and 5.88% for extreme dippers, P = 0.033. CONCLUSIONS: Nocturnal BP dipping pattern is not associated with functional outcome at 3 months in acute stroke patients treated with IVrtPA. Hemorrhagic transformation was more frequent in reverse dippers.