{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:20:56Z","timestamp":1760984456831,"version":"build-2065373602"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,7,24]],"date-time":"2012-07-24T00:00:00Z","timestamp":1343088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2012,7,24]],"date-time":"2012-07-24T00:00:00Z","timestamp":1343088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:p><jats:italic>Background:<\/jats:italic> Long\u2010term parenteral nutrition (PN) can be associated with micronutrient deficiency or toxicity depending on supplementation. Recently, hypermanganesemia and potential neurological toxicity were reported. The aim of this study was to assess the effect of manganese supplementation in a sample of patients on long\u2010term PN receiving manganese (Mn) as part of a multi\u2013trace element (TE) supplement. <jats:italic>Methods:<\/jats:italic> A convenience sample of 16 patients underwent clinical and blood biochemical measurements as well as magnetic resonance imaging (MRI) of the brain. Descriptive statistics were performed. <jats:italic>Results:<\/jats:italic> The mean daily Mn supplementation was 7.28 \u00b1 0.97 \u00b5mol\/d (400 \u00b1 53 \u00b5g\/d), which was within the American Medical Association Nutrition Advisory Group guidelines of 2.73\u201314.56 \u03bcmol\/d (150\u2013800 \u00b5g\/d) but exceeded the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) 2002 recommendations of 1.09\u20131.82 \u00b5mol\/d (60\u2013100 \u00b5g\/d). The mean whole blood Mn level was 1.38 \u00b1 0.29 times the upper limit of normal (ULN), and 8 of 14 patients with blood measurements had Mn levels above ULN. On MRI, 81% of patients had high signals on T1\u2010weighted images assumed to be Mn deposits in their basal ganglia. Two patients with positive MRI (15%) had a clinical diagnosis of Parkinson disease. Multiple neuropsychiatric complaints were reported, including depression (66%), lack of concentration (42%), memory disturbances (17%), and gait instability (8%). <jats:italic>Conclusion:<\/jats:italic> These results suggest that Mn status is elevated in these patients. Manganese supplementation should be used with caution in patients receiving long\u2010term PN, and attention should be paid to the Mn content of multi\u2010TE supplements.<\/jats:p>","DOI":"10.1177\/0148607112454543","type":"journal-article","created":{"date-parts":[[2012,7,24]],"date-time":"2012-07-24T23:42:13Z","timestamp":1343173333000},"page":"538-543","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Effects of Manganese From a Commercial Multi\u2013Trace Element Supplement in a Population Sample of Canadian Patients on Long\u2010Term Parenteral Nutrition"],"prefix":"10.1002","volume":"37","author":[{"given":"R.","family":"Abdalian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Saqui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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