je me demande si quelqu'un de la liste ne nous a pas dit (et publi�) le magn�sium dans la FA, presse m�dicale. Wachsal ou Haegy ?
>Messsage du 09/01/2002 02:31 >De : <[EMAIL PROTECTED]> >A : <[EMAIL PROTECTED]> >Copie � : >Objet : URG-L: Le magn�sium est efficace pour ralentirune FA > > Je n'ai pas les textes en entier qui sont toutes fois disponibles pour certains >abonn�s du web. Je suis un peu frustr� �galement comme toi par les abstracts, mais >j'ai vu de mes yeux vus (en fait c'�tait pas moi, mais un coll�gue de bonne foi et de >bon foie) un r�animateur ralentir une FA comme qui rigole avec une pichnette de > magn�sium. Alors je m'interroge,;.. et je vous interroge. En tout cas �� me donne >envie d'essayer. > A propos des "test and go", je viens d'en faire un autre (je ne partage pas le point >de vue commun de la liste qui est de se m�fier des tests que moi je qualifie de >judicieux). Un tableau foireux de dyskin�sie pr�coce aux NL avec une r�action superbe >au lepticur (tropat�pine) IM en 20 minutes laquelle m'a ot� tout doute (oui je sais, > c'�tait peut �tre une forme rare de t�tanos... et il faut pas laisser sortir le >malade...). Moi j'aime les test and go. Na > > Axel ELLRODT a *crit : > > > Prouve ? Ce serait sympa que l'on prouve l'efficacit� d'un m�dicament assez anodin. > > > > Pour la premi�re �tude, le r�sum� ne donne pas les m�thodes. C'est une petite >s�rie et je me demande si on peut faire une �tude "d'�quivalence" avec un si petit >effectif, avec une puissance suffisante ? Les auteurs ne disent pas dans le r�sum� la >rapidit� et intensit� du ralzentissement. Et quelle dose comment ? Tu as les d�tails ? > > > > Pour le second, ils disent "cliniquement peu significatif. Donc �a ralenti mais >pas beaucoup. Tu as les d�tails ? > > > > >Messsage du 08/01/2002 14:17 > > >De : <[EMAIL PROTECTED]> > > >A : <[EMAIL PROTECTED]> > > >Copie � : > > >Objet : URG-L: Le magn�sium est efficace pour ralentir une FA > > > > > > Le magn�sium est efficace pour ralentir une FA (par action de frein sur > > > le noeud AV). Ces deux r�f�rences le prouvent. Certains d'entre vous > > > l'utilisent d�j� ? > > > > > > 1: Chiladakis JA, Stathopoulos C, Davlouros P, Manolis AS. Intravenous > > > magnesium sulfate versus diltiazem in paroxysmal atrial fibrillation. > > > Int J Cardiol 2001 Jul;79(2-3):287-91 > > > > > > BACKGROUND: Drugs currently available for the acute treatment of > > > paroxysmal atrial fibrillation have significant limitations. We assessed > > > the safety and effectiveness of intravenous magnesium sulfate versus > > > diltiazem therapy in patients with prolonged episodes of paroxysmal > > > atrial fibrillation. METHODS: In a prospective randomized trial, 46 > > > symptomatic patients presenting with paroxysmal atrial fibrillation were > > > given intravenous magnesium sulfate (n=23) or diltiazem (n=23) therapy. > > > Primary outcome measures were effects on ventricular rate control and > > > proportion of patients restored to sinus rhythm at 6 h after initiation > > > of treatment. RESULTS: There were no differences in baseline > > > characteristics between the two groups. Both forms of treatment were > > > well tolerated, with no adverse clinical events. Both drugs had similar > > > efficacy in reducing the ventricular rate at the first hour of treatment > > > (P<0.05) with a tendency toward a further decrease during infusion times > > > of 2 (P<0.01), 3, 4, 5 and 6 h, respectively (P<0.001). However, at the > > > end of the 6-h treatment period, restoration of sinus rhythm was > > > observed in a significantly higher proportion of patients in the > > > magnesium group compared with the diltiazem group [13 of 23 patients, > > > (57%), versus five of 23 patients, (22%), P=0.03]. CONCLUSIONS: > > > Magnesium sulfate favorably affects rate control and seems to promote > > > the conversion of long lasting episodes of paroxysmal atrial > > > fibrillation to sinus rhythm, representing a safe, reliable and > > > cost-effective alternative treatment strategy to diltiazem. > > > > > > 2: Eur J Emerg Med 2000 Dec;7(4):287-90 Magnesium efficacy in magnesium > > > deficient and nondeficient patients with rapid ventricular response > > > atrial fibrillation. Eray O, Akca S, Pekdemir M, Eray E, Cete Y, Oktay > > > C. > > > We assessed the effect of magnesium sulphate (MgSO4) on lowering the > > > rate in ventricular atrial fibrillation (AF), and evaluated the effect > > > of this therapy in magnesium (Mg) deficient and nondeficient patients. > > > This experimental clinical study was performed on 34 patients with rapid > > > AF (ventricular rate [VR] > 120/minute) presenting to the emergency > > > department of a tertiary care university hospital. Patients with > > > systolic blood pressure < or = 100 mmHg, Hb level < or = 11.8, saO2 of < > > > or = 96%, BUN > or = 40 or creatine > or = 1.8 were excluded (n = 15). > > > Nineteen patients were given an initial 2 g MgSO4 bolus i.v. and a 1 > > > g/hour continuous infusion over 6 hours. To evaluate the presence of Mg > > > deficiency, urine was collected from the onset of treatment and > > > continued for the next 24 hours, and the excretion rate of administered > > > Mg was calculated. Ventricular rates were obtained at baseline, after > > > MgSO4 bolus, and every 15 minutes for the first hour. The decrease in > > > the VR was statistically significant at 15, 30 and 60 minutes after Mg > > > therapy (p = 0.0025, p < 0.001, p > 0.001). There was no difference in > > > the response to Mg therapy between Mg deficient and nondeficient > > > patients at 15, 30 or 60 minutes after therapy (p = 0.41, p = 0.28, p = > > > 0.08). It is concluded that i.v. MgSO4 has a statistically significant > > > but clinically limited effect on VR and this effect did not differ > > > between patients with and without Mg deficiency. > > > > > > > >
