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Magnesium is an important cation present in more than 300 enzymes in the body. This review evaluates the information on magnesium and pregnancy. In normal pregnancies Mg responsive genes are upregulated, suggesting Mg deficiency. Blood pressure increase is related to the urinary excretion of Mg. In pregnancies complicated by preeclampsia the Mg homeostasis is different from normal pregnancies. Supplementation with Mg has shown beneficial effects on high blood pressure and infant conditions in some studies. Although several studies show important relationships between Mg homeostasis and pregnancy, particularly those with pre-eclampsia, further studies are needed to assess the relationship and formulate requirements for intervention programmes., (Copyright © 2014 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Objectives: High blood pressure during the last part of pregnancy is a risk indicator of pre-eclampsia and eclampsia which augment infant and maternal morbidity and mortality. Magnesium deficiency has been related to the risk of hypertension. A study was performed to assess the relation between pregnancy induced hypertension, excretion of urinary magnesium and expression of magnesium sensitive genes (MgSG)., Methods: A cohort of healthy, nulliparous women with singleton pregnancies was recruited. Blood pressure was recorded throughout pregnancy. Urinary magnesium excretion and expression of MgSGs in leukocytes were determined., Results: The expression of the gene TRPM6 was higher among pregnant women compared to non-pregnant controls at week 12. All other genes had lower expressions in pregnant women. At week 37 the expressions of all genes were lower than at week 12. The expressions of SLC41A1, SLC41A3, and TRPM7 were related to the systolic and diastolic blood pressures. Furthermore, the expression of TRPM6 was related to the urinary excretion of magnesium and the change in diastolic blood pressure weeks 12-37 was inversely related to the change in magnesium excretion., Conclusions: Systolic and diastolic blood pressure and the excretion of magnesium during pregnancy were related to the expression of different MgSGs. The results suggest that magnesium is involved in the regulation of blood pressure during pregnancy., (Copyright © 2013 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Several epidemiological investigations over the last 50 y have demonstrated a relation between risk for cardiovascular disease and drinking water hardness or its content of magnesium and calcium. An additional parameter, first suggested in a study from Japan 50 y ago, is the acidity of the water. It is known that acid load influences the reabsorption of calcium and magnesium in the renal tubuli. Intervention studies have shown that acid-base conditions influence the homeostasis of minerals. Data from intervention studies using magnesium, calcium, and hydrogen carbonate are reviewed. It is suggested that the health effects related to drinking water found in some studies may be caused by an increased urinary excretion of minerals induced by acid conditions in the body and that drinking water should contain sufficient amounts of hydrogen carbonate to prevent this effect.

Background: Sarcoidosis is generally treated with corticosteroids that are not always an effective therapy., Objectives: To assess if treatment with antifungal drugs would improve the clinical status of patients with sarcoidosis., Methods: Patients (n=18) with sarcoidosis grades II and III according to established criteria and without clinical and immunological signs of fungal infection, were treated with antifungal medication together with corticosteroids for 3-6 months. Pulmonary X-ray infiltration, lung function, and severity of symptoms were registered before and after the treatment and at follow up 9-58 months later., Results: The treatment resulted in statistically significant decreases in the degree of pulmonary infiltration with an average decrease in the group from 2.0 to 1.0. There were also significant increases in diffusion capacity and decreases in the severity of symptoms., Conclusion: It is suggested that treatment with antifungal drugs may be useful, at least in certain cases of sarcoidosis.

Magnesium and calcium deficiency in humans is related to a number of pathological phenomena such as arrhythmia, osteoporosis, migraine, and fatal myocardial infarction. Clinically established metabolic acidosis induces renal losses of calcium. In normal subjects, even moderate increases in net endogenous acid production (NEAP) impair renal calcium reabsorption but no information is available whether this also influences renal magnesium handling. The aim of the study was to examine the relation between NEAP and renal magnesium excretion in healthy, free-living, elderly subjects. The subjects (age 64 +/- 4.7 y, n = 85) were randomly selected from the population register in Gothenburg (Sweden). Magnesium, calcium, and potassium were measured in 24-h urine samples and NEAP was quantified as renal net acid excretion (NAE). NAE was positively correlated with excretions of magnesium (R(2) = 0.27, P < 0.0001) and calcium (R(2) = 0.30, P < 0.0001) but not potassium. When 24-h urinary magnesium excretion was adjusted for 24-h urinary potassium excretion, a biomarker for dietary potassium intake, the association between magnesium excretion and NAE remained significant (R(2) = 0.21, P < 0.0001). The significant association between potassium-adjusted magnesiuria and NAE suggests that the acid-base status affects renal magnesium losses, irrespectively of magnesium intake. Magnesium deficiency could thus, apart from an insufficient intake, partly be caused by the acid load in the body.

The aim of immediate breast reconstruction is to improve well-being and quality of life for women undergoing mastectomy for breast cancer. This prospective study used the SF-36 Health Survey questionnaire to assess quality of life before and 12 months after mastectomy and immediate breast reconstruction together with patients' expectations of and satisfaction with the immediate breast reconstruction with implant. Scores for 76 participants were compared with those in 920 age-matched women from the general population. Preoperative scores for emotional well-being and physical role functioning were lower than in the reference population, while after 12 months the scores in all domains had improved and were comparable with those in the reference population. The most common reason for immediate reconstruction was the desire to avoid an external prosthesis. Most women were satisfied with immediate reconstruction, and the major determinant of aesthetic satisfaction was completion of the procedure. Although many factors may influence quality of life, 1 year after breast cancer surgery with immediate reconstruction scores are equivalent to those of the normal population.

The effects of night-time exposure to traffic noise (TN) or low frequency noise (LFN) on the cortisol awakening response and subjective sleep quality were determined. Twelve male subjects slept for five consecutive nights in a noise-sleep laboratory. After one night of acclimatisation and one reference night, subjects were exposed to either TN (35dB L(Aeq), 50dB L(Amax)) or LFN (40dB L(Aeq)) on alternating nights (with an additional reference night in between). Salivary free cortisol concentration was determined in saliva samples taken immediately at awakening and at three 15-minute intervals after awakening. The subjects completed questionnaires on mood and sleep quality. The awakening cortisol response on the reference nights showed a normal cortisol pattern. A significant interaction between night time exposure and time was found for the cortisol response upon awakening. The awakening cortisol response following exposure to LFN was attenuated at 30 minutes after awakening. Subjects took longer to fall asleep during exposure to LFN. Exposure to TN induced greater irritation. Cortisol levels at 30 minutes after awakening were related to "activity" and "pleasantness" in the morning after exposure to LFN. Cortisol levels 30 minutes after awakening were related to sleep quality after exposure to TN. This study thus showed that night time exposure to LFN may affect the cortisol response upon wake up and that lower cortisol levels after awakening were associated with subjective reports of lower sleep quality and mood.

Salivary free cortisol concentration, rated stress and annoyance were determined in 32 subjects before, during and after carrying out a battery of performance tasks for 2 hours during exposure to ventilation noise, with dominant low frequencies (low frequency noise) or a flat frequency spectrum (reference noise). Both noises had a level of 40 dBA. All subjects were studied on two occasions and were exposed to both noises in strict rotation. Subjects were categorised as high- or low-sensitive to noise in general and low frequency noise in particular on the basis of questionnaires. Cortisol concentrations during the task were not significantly modulated by the noises or related to noise sensitivity alone. The normal circadian decline in cortisol concentration was however significantly attenuated in subjects high-sensitive to noise in general, when they were exposed to the low frequency noise. This noise was rated as more annoying and more disruptive to working capacity than the reference noise. The study showed physiological evidence of increased stress related to noise sensitivity and noise exposure during work. This is the first study to demonstrate an effect of moderate levels of noise on neuroendocrine activity. The impact of long-term exposure to moderate noise levels, and particularly low frequency noise, in the workplace deserves further investigation.

(1-->3)-beta-D-glucan is a polyglucose structure in the cell wall of moulds, some bacteria and plants. Due to its unique (1-->3)-beta linkage it binds to specific receptors on phagocytosing cells and induces changes in their metabolism. Under realistic environmental concentrations, available data suggest that these changes express themselves as alterations of the defense mechanisms to other agents. Inhalation of (1-->3)-beta-D-glucan in humans causes symptoms from the upper respiratory tract and induction of cytokines in blood monocytes. (1-->3)-beta-D-glucan can be used as a marker of mould biomass in field studies. Relationships between the amount of (1-->3)-beta-D-glucan and the extent of symptoms as well as lung function changes and inflammatory markers have been described. In view of the mechanisms involved in the normal development of the immune system, children seem to be a particular group at risk due to (1-->3)-beta-D-glucan exposure.

Normal subjects were exposed to an aerosol of Escherichia coli endotoxin. Carbon monoxide diffusion (Dco), spirometry, blood neutrophils, white blood cells, and platelets were determined at various times thereafter. A significant decrease in Dco and an increase in blood neutrophils was found, with a maximum effect 4 to 8 h after exposure. Exposure to distilled water caused a tendency for Dco to decrease and a significant increase in blood neutrophils. No effect on spirometry or body temperature was detected. It is suggested that the changes observed represent an inflammation at the alveolar level that appears at dose levels of endotoxin below those which cause bronchoconstriction and fever.

To study the possible association between drinking tea and lung cancer, epidemiological and experimental materials were collected from the Chinese population in Hong Kong. In a retrospective study of 200 female lung cancer patients and 200 matched controls, all subjects were interviewed concerning their eating habits, smoking histories, and lifetime exposures to environmental pollutants. Analysis of the data demonstrated an adjusted and statistically significant increased lung cancer risk of 2.7 among those who drank green tea. Several brands of tea commonly drank in Hong Kong were assayed for mutagenicity using Ames' assay. Significantly elevated levels of mutagenic activity were found to be present after metabolic activation using cell-free extracts of cecal bacteria from rats. These data suggest that further research is needed to understand the possible consequences to human health of ingestants taken at low doses but long duration over the normal lifespan, and the possible interactive effect between mutagens in tea and other ingestants and inhalants in human cancer etiology.

To study the long-term effect of inhaled asbestos, guinea-pigs were exposed to airborne amosite at a concentration of 49 mg/m3, 2 h/day for 3 or 6 weeks and examined up to 2 years after exposure. Macrophages in lung lavage fluid (LLF) were increased at 16, 24 and 93 weeks and lymphocytes at 24 weeks. Examination of lung wall cells (LWC) 2 years after exposure compared to cells obtained by LLF showed higher proportions of LWC lymphocytes and neutrophils. Percoll gradient centrifugation of these cells showed a higher proportion of high density macrophages in LLF from the amosite-exposed animal and an increased number of low density lymphocytes in the LW. Cathepsin D was increased in LLF at 8 and 24 weeks and in alveolar macrophages 24 weeks and 2 years after exposure. Fibroblast cultures exposed to LLF did not show any statistical significant changes in their collagen synthesis. Histology 93 weeks after exposure showed macrophage and mediastinal lymph node accumulation of asbestos, as well as collagen in alveolar walls. Granulomas were found in the vicinity of blood vessels and in connection with the bronchioles. The data suggest that amosite at low doses ultimately causes fibrosis with a reaction pattern different from that seen in silicosis. The inflammation and fibrosis seems to develop only within the interstitium.

Lung function and blood neutrophils were measured in 13 cotton mill workers on different days of the work week. Antigen was prepared from cotton dust and a radioallergosorbent (RAST) test made on serum and plasma. The exposure was determined as airborne dust and bacterial endotoxin using vertical elutriators and personal samplers. Reductions in FEV1 and increased blood neutrophils were found on Monday at an exposure level of 0.32 to 0.48 mg respirable dust/m3 and 0.19 to 0.28 micrograms endotoxin/m3. The changes in blood neutrophils correlated with endotoxin levels. The FEV1 decreases were present on Monday but not on Wednesday and Friday. The RAST ratios were low and not correlated with FEV1. No systematic changes in RAST ratios were present over the Monday shift. The results suggest that the importance of immunologic reactions other than type 1 should be investigated.

Lactate dehydrogenase (LDH) and lysosomal enzyme activity were measured in lung lavage fluid of guinea pigs exposed for 3 weeks to different concentrations of silica dust. Eight weeks and later after cessation of exposure, the amounts of N-acetyl-beta-D-glucosaminidase, cathepsin D, acid phosphatase, and LDH were increased. It is suggested that this increase indicates cell damage to alveolar macrophages, and that the enzyme changes are of relevance to determine the risk for pulmonary fibrosis caused by airborne substances.

In order to investigate the possibility of the synergistic effects of tobacco smoke and/or silica dust (SiO2) or bacterial endotoxins (LPS), guinea pigs were exposed to combinations of these agents. A 15-day exposure to SiO2 alone caused a decrease in intracellular lysosomal enzymes of alveolar macrophages (AM) and an increase of lysosomal enzymes detected in lung lavage fluid which was present 16 weeks after exposure. The effect was the same in animals which received SiO2 in combination with tobacco smoke. Exposure to LPS caused an increase in the number of neutrophils recovered in lavage fluid. The increase in neutrophils was less in animals previously exposed to tobacco smoke alone or in combination with LPS. Acute exposure to LPS also caused an increase in lactate dehydrogenase, N-acetyl-beta-D-glucosaminidase and acid phosphatase activity detectable in lung lavage fluid. The increase was less pronounced in animals previously exposed to smoke. Cathepsin D was increased in AM after tobacco smoke exposure alone and was decreased to below control values of the animals which received an acute LPS exposure.

Guinea pigs were acutely exposed to different airborne dusts and freshly generated cigarette smoke. The effect was evaluated by counting the number of free lung cells using a lavage method. An exposure to MnO2 and smoke on the same day caused an increase in the number of leukocytes 24 h thereafter. By increasing the time interval between the MnO2 and smoke exposure, the effect gradually disappeared. Al2O2 or SiO2 also caused an increase in the number of leukocytes, whereas TiO2 had no effect. The pathogenesis behind the reaction and the epidemiological implications are discussed.

The kinetics of endotoxin in the airway and the blood was studied after an inhalation exposure using guinea pigs. The amounts of endotoxin in the pulmonary lavage fluid, and in arterial and venous blood were determined. Forty minutes after the start of exposure to 400 micrograms/m3 of Escherichia coli 026:B6-LPS, 7.7 +/- 2.9 ng/ml of lipopolysaccharide (LPS) could be demonstrated in the pulmonary lavage fluid, and 60 minutes afterwards, the amount was 4.9 +/- 1.4 ng/ml. In the arterial blood, the amounts at 10 and 40 minutes of exposure, and 60 minutes afterwards were 21.2 +/- 23.8 pg/ml, 29.2 +/- 31.8 pg/ml, and 1.1 +/- 1.0 pg/ml, respectively. There was no significant difference of LPS content in the arterial and venous blood. The results demonstrate that the lung is a potent barrier for penetration of endotoxins into the body. The experimental model enables studies of how other exposures such as mineral dusts, tobacco smoke, or viral or bacterial infections might affect this defense.