Hipocalcemia posterior a tiroidectomía total: Análisis de dosis para suplemento rutinario profiláctico / Hypocalcemia after total thyroidectomy: Dose analysis for routine prophylactic supplementation

Introducción. La hipocalcemia es la complicación más frecuente de la tiroidectomía. La profilaxis con calcio/calcitriol es una alternativa costo-efectiva, sencilla y expedita para disminuir esta situación, sin alterar la función paratiroidea residual. Lo que no está claro es si hay superioridad de una dosis frente a otra, por lo que el objetivo de este estudio fue evaluar el comportamiento entre diferentes esquemas de profilaxis para hipocalcemia. Métodos. Estudio de cohorte retrospectivo de adultos operados en un hospital de cuarto nivel, entre febrero de 2017 y diciembre de 2020. Se calculó la tasa de síntomas, la hipocalcemia e hipercalcemia bioquímica en el control postquirúrgico durante las siguientes dos semanas. Se hizo análisis bivariado y multivariado entre dosis de calcio/calcitriol, otros factores asociados y los desenlaces mencionados. Resultados. Se incluyeron 967 pacientes. El 10 % presentaron síntomas. No hubo diferencias significativas en el calcio sérico del control posquirúrgico entre los grupos con distintas dosis de calcio. La dosis de carbonato de calcio >3600 mg/día y el calcio en las primeras 24 horas de cirugía se asociaron a la presencia de síntomas. La dosis de calcitriol <1 mcg/día y el bocio aumentaron el riesgo de hipocalcemia bioquímica, mientras que la dosis de 1,5 mcg/día lo disminuyó. Ninguna variable evaluada se asoció a hipercalcemia bioquímica. Conclusiones. Podemos establecer que dosis altas de carbonato de calcio no se asocian con menos hipocalcemia bioquímica, lo cual está a favor de usar dosis intermedias (3600 mg/día). De forma similar, la dosis de calcitriol de 1,5 mcg/día disminuye el riesgo de este desenlace. La identificación de variables que aumentan o disminuyen el riesgo de hipocalcemia posterior a tiroidectomía, como bocio o el nivel de calcio en las primeras 24 horas para este estudio, pueden determinar ajustes individuales en la dosis rutinaria profiláctica de calcio/calcitriol.

Introduction. Hypocalcemia is the most frequent complication of thyroidectomy. Calcium/calcitriol prophylaxis is a cost-effective, simple and expeditious alternative to reduce this situation, without altering residual parathyroid function. It is not clear whether there is superiority of one dose over another, so the objective of this study was to evaluate the behavior between prophylaxis doses for hypocalcemia. Methods. Retrospective cohort study of adults operated in a fourth level hospital, between February 2017 and December 2020. The rate of symptoms, biochemical hypocalcemia and hypercalcemia was calculated in the post-surgical control during the following two weeks. Bivariate and multivariate analyses were performed between calcium/calcitriol dose, other associated factors, and the mentioned outcomes. Results. Out of the 967 patients included, 10% presented symptoms. There were no significant differences in postoperative control serum calcium between the groups with different doses of calcium. The dose of calcium carbonate > 3600 mg/day and calcium in the first 24 hours of surgery were associated with the presence of symptoms. The dose of calcitriol <1 mcg/day and goiter increased the risk of biochemical hypocalcemia, while the dose of 1.5 mcg / day decreased it. No variable evaluated was associated with biochemical hypercalcemia. Conclusion. We can establish that high doses of calcium are not less associated with biochemical hypocalcemia, which is in favor of intermediate doses (i.e. 3600mg/day). In a similar way, the calcitriol dose of 1.5mcg/day decreases the risk of this outcome. The identification of variables that increase or decrease the risk of this complication (goiter or the 24h serum calcium in this study) can decide settings in the rutinary prophylactic dose of calcium/calcitriol.

Experimental nano calcium aluminate/tri calcium silicate root repair: Synthesis, physical and mechanical properties compared to mineral trioxide aggregate and Biodentine / Reparo radicular experimental de nano aluminato de cálcio/silicato de tri cálcio: Síntese, propriedades físicas e mecânicas em comparação com agregado de trióxido mineral e Biodentine

Objective: Endodontic perforation is a challenging mishap that should be repaired with a biocompatible material, Mineral trioxide aggregate (MTA) and Biodentine are the most commonly used repair materials. However, these materials are expensive, (MTA) has prolonged setting time and difficult manipulation. The purpose of this study is to prepare the experimental nano calcium-aluminate/tri-calcium-silicate (CA/C3S) material and comparing its physical properties with biodentine and MTA, to evaluate the experimental material eligibility to compete the commercial repair materials. And to perform part two (animal study) that will evaluate the cytotoxicity, the biocompatibility and the efficacy of (CA/C3S) in furcal perforation repair compared to diode laser. Material and Methods: A mixture of calcium carbonate and aluminum oxide was used to formulate calcium aluminate phase (CA), tri-calcium-Silicate phase (C3S) was formulated by firing of calcium carbonate and quartz. The produced powders were investigated by X-ray diffraction, then (CA) and (C3S) mixed with water.(CA/ C3S) compared with MTA and biodentine for setting-time, micro-hardness, dimensional-stability and solubility. Results: Mean setting time of (CA/C3S) was (32.70±0.75min) which is significantly higher than MTA and Biodentine. The Mean microhardness of (CA/C3S) was (56.50±7.41VHN) which has no statical difference with MTA and Biodentine. Solubility results showed weight increase for (CA/C3S) as following (6.29±3.05)and loss of weight for MTA and Biodentine. The percentage of change in dimensions for(CA/C3S) increased as following (0.64±0.78) while decreased for MTA and Biodentine. Conclusion: The experimental (CA/C3S) material showed good microhardness, dimensional stability and acceptable setting time that could be improved in further work (AU)

Objetivo: A perfuração endodôntica é um percalço desafiador que deve ser reparado com um material biocompatível, Agregado de trióxido mineral (MTA) e Biodentina são os materiais de reparo mais comumente usados. No entanto, esses materiais são caros, (MTA) tem tempo de presa prolongado e difícil manipulação. O objetivo deste estudo é preparar o material experimental de nano aluminato de cálcio/silicato tricálcico (CA/C3S) e comparar suas propriedades físicas com biodentina e MTA, para avaliar a elegibilidade do material experimental para competir com os materiais de reparo comerciais. E realizar a segunda parte (estudo animal) que avaliará a citotoxicidade, a biocompatibilidade e a eficácia do (CA/C3S) no reparo de perfuração de furca em comparação ao laser de diodo.Material e Métodos: Uma mistura de carbonato de cálcio e óxido de alumínio foi usada para formular a fase de aluminato de cálcio (CA), a fase tri-cálcio-silicato (C3S) foi formulada por queima de carbonato de cálcio e quartzo. Os pós produzidos foram investigados por difração de raios X, em seguida (CA) e (C3S) misturados com água. (CA/ C3S) comparados com MTA e biodentina para tempo de presa, microdureza, estabilidade dimensional e solubilidade. Resultados: O tempo médio de presa de (CA/C3S) foi (32,70±0,75min) que é significativamente maior que MTA e Biodentine. A microdureza média de (CA/C3S) foi (56,50±7,41VHN) que não tem diferença estática com MTA e Biodentine. Os resultados de solubilidade mostraram aumento de peso para (CA/C3S) conforme a seguir (6,29±3,05) e perda de peso para MTA e Biodentine. A porcentagem de mudança nas dimensões para (CA/C3S) aumentou como segue (0,64±0,78), enquanto diminuiu para MTA e Biodentine. Conclusão: O material experimental (CA/C3S) apresentou boa microdureza, estabilidade dimensional e aceitável tempo de presa, que pode ser melhorado em trabalhos futuros (AU)

Hipoparatiroidismo y calcificaciones cerebrales: reporte de caso / Hypoparathyroidism and brain calcifications: a case report

Introducción. El hipoparatiroidismo es una enfermedad caracterizada por la ausencia o concentraciones inadecuadamente bajas de hormona paratiroidea (PTH), que conduce a hipocalcemia, hiperfosfatemia y excreción fraccional elevada de calcio en la orina. Las calcificaciones del sistema nervioso central son un hallazgo frecuente en estos pacientes. Caso clínico. Mujer de 56 años con antecedente de hipotiroidismo, que ingresó por un cuadro de 6 días de evolución caracterizado por astenia, parestesias periorales y movimientos anormales de manos y pies. Las pruebas de laboratorio demostraron hipocalcemia, hiperfosfatemia y niveles bajos de hormona paratiroidea. Se realizó una tomografía computarizada de cráneo que mostró áreas bilaterales y simétricas de calcificaciones en hemisferios cerebelosos, ganglios basales y corona radiata. No se evidenciaron trastornos en el metabolismo del cobre y hierro. Se estableció el diagnóstico del síndrome de Fahr secundario a hipoparatiroidismo y se inició tratamiento con suplementos de calcio y vitamina D con evolución satisfactoria. Discusión. El síndrome de Fahr es un trastorno neurológico caracterizado por el depósito anormal de calcio en áreas del cerebro que controlan la actividad motora. Se asocia a varias enfermedades, especialmente, hipoparatiroidismo. La suplementación con calcio y vitamina D con el objetivo de normalizar los niveles plasmáticos de estos cationes es el tratamiento convencional. (AU)

Introduction. Hypoparathyroidism is a disease characterized by absence or inappropriately low concentrations of circulating parathyroid hormone, leading to hypocalcaemia, hyperphosphataemia and elevated fractional excretion of calcium in the urine. Central nervous system calcifications are a common finding in these patients. Case report. 56-year-old woman with a history of hypothyroidism who was admitted for a 6-day course of illness characterized by asthenia, perioral paresthesias, and abnormal movements of the hands and feet. Laboratory tests showed hypocalcemia, hyperphosphatemia, and low parathyroid hormone levels. A cranial computed tomography was performed. It showed bilateral and symmetrical areas of calcifications in the cerebellar hemispheres, basal ganglia, and radiata crown. No disorders of copper or iron metabolism were evident. The diagnosis of Fahr syndrome secondary to hypoparathyroidism was established and treatment with calcium and vitamin D supplements was started with satisfactory evolution. Discussion. Fahr's syndrome is a neurological disorder associated with abnormal calcium deposition in areas of the brain that control motor activity. It is associated with various diseases, especially hypoparathyroidism. The conventional treatment is supplementation with calcium and vitamin D, with the aim of normalizing their plasma levels. (AU)

Chemical Recovery of Degraded Soil and Consequence in the Cost of Corn Production

Abstract Improper management degrades the soil, decreases corn productivity and is reflected in the cost of production. The objective of this research was to evaluate the soil recovery in non-conservationist treatments after the change of management and cultivation to the conservation condition direct sowing, and compare these systems to consolidated direct seeding; This evaluation was based on the soil responsiveness to crop production and water erosion control, and based on the financial cost of soil recovery and corn production when soil management was converted from non-conservationist (tillage rotation - RT, minimum tillage - MT, conventional tillage - CT and bare soil - BS) to no-tillage (NT) condition, in a Humic Cambisol. The transition from managements to no-tillage occurred in 2015 year, after 27 years of conducting the preexisting managements. The chemical recovery was carried out with the application of limestone, phosphorus, and potassium. At the end of the research the yield of the corn crop, the cost of recovering the soil fertility and the cost of crop production were evaluated. Previous soil management influenced the cost of soil chemical recovery. The cost of production showed a financial loss for the previous treatments CT and BS, on the average of the three corn crops.

Acidity Control After Surface Application of Micronized Liming Material in a Typic Distrudept Under No-Tillage

Abstract The objected to evaluate the pH and soil base saturation (V) values, during 45 months after, surface application and without incorporation of the liming materials in deeper layers of soil. The experimental design was completely randomized blocks in split-plot with four replications. In the plots were studied the dolomitic limestone (DL) and micronized liming materials (MLM) - granulated micronized calcite (GMC) and dolomite (GMD), and carbonated suspension (CS). In the subplots were studied doses of all the liming materials aiming to increase V to 50, 70 and 90% besides of control treatment. We measured the pH and V values in 0-5, 5-10, 10-20, 20-40 and 40-60 cm soil layers over time (5, 15, 28, 37 and 45 months). The MLM were more efficient to increase and maintain the pH and V, over time, than DL. The doses of MLM aiming V to 50-70% increasing the pH and V of Typic Distrudept. Despite the MLM are more fineness than DL, the effectiveness for soil acidity control in subsoil were inefficient, because theses pH and V increases/maintains occurred just in 0-5 cm layer. However, the MLM present lower gap between the V estimated and obtained, in the 0-5 cm layer, than DL.

Avaliação antimicrobiana de macroestrutura e nanoestruturas de carbonato de cálcio / Antimicrobial evaluation of macrostructures and nanostructures of calcium carbonate

A ocorrência de doenças transmitidas por alimentos se dá principalmente pelas bactérias Salmonella e E.coli. A Salmonella pode causar infecções generalizadas ao entrar na corrente sanguínea por meio das paredes do intestino e a E. coli produz toxinas que podem causar complicações. Uma solução é encontrada no uso da nanotecnologia que desperta o interesse dos cientistas em suas possíveis aplicações inovadoras nas indústrias. Esse trabalho estudou os efeitos antimicrobianos do Carbonato de Cálcio macro e nanoestruturado em E. Coli e Salmonella Typ. Para a nanoestrutura os melhores resultados foram com 1250 e 1875 µg.mL-1 em E. Coli e S. Typ. As concentração de 1000, 1500 e 1875 µg.mL-1 de macro CaCO3 mostraram-se mais eficientes para E. Coli e no caso da S. Typ 1000 e 1500 µg.mL-1. Para validar e tornar aplicável o uso de nano CaCO3 são sugeridos estudos toxicológicos e estudos com diferentes tamanhos do material nanoestruturado.

Hypoparathyroidism: what is the best calcium carbonate supplementation intake form? / Hipoparatireoidismo: qual é a melhor forma de ingestão de suplemento de carbonato de cálcio?

Abstract Introduction: In hypoparathyroidism, calcium supplementation using calcium carbonate is necessary for the hypocalcemia control. The best calcium carbonate intake form is unknown, be it associated with feeding, juice or in fasting. Objective: The objective was to evaluate the calcium, phosphorus and calcium × phosphorus product serum levels of hypoparathyroidism women after total thyroidectomy, following calcium carbonate intake in three different forms. Methods: A crossover study was carried out with patients presenting definitive hypoparathyroidism, assessed in different situations (fasting, with water, orange juice, breakfast with a one-week washout). Through the review of clinical data records of tertiary hospital patients from 1994 to 2010, 12 adult women (18-50 years old) were identified and diagnosed with definitive post-thyroidectomy hypoparathyroidism. The laboratory results of calcium and phosphorus serum levels dosed before and every 30 min were assessed, for 5 h, after calcium carbonate intake (elementary calcium 500 mg). Results: The maximum peak average values for calcium, phosphorus and calcium × phosphorus product were 8.63 mg/dL (water), 8.77 mg/dL (orange juice) and 8.95 mg/dL (breakfast); 4.04 mg/dL (water), 4.03 mg/dL (orange juice) and 4.12 mg/dL (breakfast); 34.3 mg2/dL2 (water), 35.8 mg2/dL2 (orange juice) and 34.5 mg2/dL2 (breakfast), respectively, and the area under the curve 2433 mg/dL min (water), 2577 mg/dL min (orange juice) and 2506 mg/dL min (breakfast), 1203 mg/dL min (water), 1052 mg/dL min (orange juice) and 1128 mg/dL min (breakfast), respectively. There was no significant difference among the three different tests (p > 0.05). Conclusion: The calcium, phosphorus and calcium × phosphorus product serum levels evolved in a similar fashion in the three calcium carbonate intake forms.

Resumo Introdução: No hipoparatireoidismo, a suplementação de cálcio com carbonato de cálcio é necessária para o controle da hipocalcemia. A melhor forma de ingestão de carbonato de cálcio ainda é desconhecida, seja concomitante com alimentação, no suco ou em jejum. Objetivo: Avaliar os níveis séricos de cálcio, fósforo e produto cálcio-fósforo em mulheres pós-tireoidectomia por hipoparatireoidismo, após a ingestão de carbonato de cálcio em três formas diferentes. Método: Foi realizado um estudo cruzado em pacientes com hipoparatireoidismo definitivo, avaliados em diferentes situações (em jejum, com água, suco de laranja, café da manhã, após washout de uma semana). A revisão dos prontuários dos pacientes de um hospital terciário de 1994 a 2010 identificou 12 mulheres adultas (18-50 anos), diagnosticadas com hipoparatireoidismo definitivo pós-tireoidectomia. Os resultados laboratoriais dos níveis séricos de cálcio e fósforo foram mensurados antes e a cada 30 minutos durante 5 horas, após a ingestão de carbonato de cálcio (cálcio elementar 500 mg). Resultados: Os valores de pico máximo médio de cálcio, fósforo e produto cálcio-fósforo foram 8,63 mg/dL (água), 8,77 mg/dL (suco de laranja) e 8,95 mg/dL (café da manhã); 4,04 mg/dL (água), 4,03 mg/dL (suco de laranja) e 4,12 mg/dL (café da manhã); 34,3 mg2/dL2 (água), 35,8 mg2/dL2 (suco de laranja) e 34,5 mg2/dL2 (café da manhã), respectivamente, e a área sob a curva foi 2.433 mg/dL.min. (água), 2.577 mg/dL.min. (suco de laranja) e 2.506 mg/dL.min. (café da manhã), 1.203 mg/dL.min. (água), 1.052 mg/dL.min. (suco de laranja) e 1.128 mg/dL.min. (café da manhã), respectivamente. Não houve diferença significante entre os três diferentes testes (p > 0,05). Conclusão: Os níveis séricos de cálcio, fósforo e produto cálcio-fósforo evoluíram de forma semelhante nas três formas de ingestão de carbonato de cálcio.

Muscle strength training is better than the use of growth hormone (GH) in bone health of Wistar rats / Entrenamiento de la fuerza muscular es mejor que el uso de la hormona del crecimiento (GH) en salud ósea del ratas Wistar

SUMMARY: The objective of this study was to evaluate the effects of growth hormone (GH) and muscle strength training (ST) on the composition of bone tissue of Wistar rats through Raman spectroscopy. In total, 40 male rats were randomly distributed into four groups: (N = 10) control (C), control with the application of GH (GHC), strength training (T), and strength training with the application of GH (GHT). The training consisted of four series of 10 water jumps, performed three times a week, with an overload corresponding to 50 % of body weight and duration of four weeks. GH was applied at a dose of 0.2 IU / kg in each animal three times a week and every other day. After four weeks, the animals were euthanized and the right femurs collected for analysis of the bone structure. Raman spectroscopy (ER) was used to observe the following compounds from their respective bands: Calcium Carbonate-Triglycerides (fatty acids) 1073 cm-1, Collagen type I 509 cm-1, Bone-DNA Phosphate (Protein) 589 cm-1, Phosphate Phospholipids 1078 cm-1. For the statistical analysis, the Shapiro-Wilk and ANOVA One-Way variance analysis normality tests were performed, followed by the Tukey post-test. The results showed an increase in the concentrations of calcium carbonate-triglycerides (fatty acids), type I collagen, bone phosphate-DNA (protein), and phosphate phospholipids in all experimental groups, with or without ST and/or GH , But only the isolated training group differed significantly from the control group (P <0.05). It was concluded that all treatments could promote bone tissue gain, however, only the T group demonstrated a significant difference in the mineral compounds analyzed.

RESUMEN: El objetivo del estudio fue avaluar el efecto de la aplicación de la hormona del crecimiento (GH) y entrenamiento de la fuerza muscular (EF) en la composición del tejido óseo de ratas Wistar a partir de la espectroscopía Raman. Fueron utilizadas 40 ratas machos distribuidas de forma aleatoria en cuatro grupos (n=10): control (C), control y aplicación de GH (GHC), entrenamiento de la fuerza muscular (EF) y entrenamiento de la fuerza muscular y aplicación del GH (GHE). El entrenamiento fue consistió en cuatro series de 10 saltos acuáticos, realizados tres veces en la semana, con sobrecarga correspondiente a 50 % de la masa corporal y durante cuatro semanas. El GH fue aplicado en la dosificación de 0,2 UI/kg en cada animal, tres veces en la semana y en días alternados. Después de cuatro semanas, los animales fueran eutanasiados y retirados los fémures derechos para un análisis de la estructura ósea. La espectroscopía Raman fue utilizada para observar los siguientes compuestos a partir de las respectivas bandas: Carbonato de Calcio-Triglicéridos (ácidos grasos) 1073 cm-1, Colágeno Tipo I 509 cm-1, Fosfato Óseo-DNA (Proteína) 589 cm1, Fosfato Fosfolípidos 1078 cm-1. Para el análisis estadístico, fueron realizadas las pruebas Shapiro-Wilk y el análisis de variancia ANOVA One-Way, seguida de test post hoc de Tukey. Los resultados revelaran aumento de la concentración de Carbonato de Calcio-Triglicéridos (ácidos grasos), Colágeno Tipo I, Fosfato Óseo- DNA (Proteína), Fosfato Fosfolípidos en todos los grupos experimentales, asociados o no a la realización del EF y/o aplicación del GH. Además, solamente el grupo EF mostró diferencia significativa del grupo C (p<0,05). Es posible concluir que todos los tratamientos mostraran aumentos en el tejido óseo, sin embargo, solamente el grupo T demostró una diferencia significativa en los compuestos minerales analizados.

Effect of calcium sources in the diets of adult cats on urinary parameters and acid-base balance / Efeitos das fontes de cálcio na dieta de gatos adultos sobre parâmetros urinários e equilíbrio ácido-básico

Calcium is a macroelement that is part of the mineral composition of the diet of companion animals, and is considered a cation of strong alkalizing power, increasing urinary pH. Calcium salts have different solubilities and depending on the anion to which calcium is associated with, it can be more or less absorbed, modifying the pH of the urine. The aim of this study was to evaluate the efficiency of calcium sources on alkalinization of urinary pH, as well as excretion of urinary electrolytes and acid-base balance of adult cats. An extruded diet for cats was selected, and had 160mEq/kg of calcium from the sources of either calcium carbonate (CaCO3) or calcium gluconate (C12H22CaO14) added. In the control treatment there was no addition of calcium sources, resulting in three treatments. Nine adult cats were used, mixed breed, in two experimental periods, with six replicates per treatment. Animal average age was 4±1.3 years old and average weight was 3.96±0.71kg. The cats remained in metabolic cages for an adaptation period of seven days, followed by six days of urine total collection, with volume, density, pH and calcium concentration (g/d) measurements. The acid-base balance was studied by blood gas analysis of venous blood. The two sources of calcium alkalinized the urine (P<0.001). However, calcium gluconate had less alkalinization power compared to the calcium carbonate (P<0.05). Urinary calcium was not affected by treatments, and represented less than 0.5% of calcium intake. The experiment showed that calcium, although an alkaline cation and considered strong influencer of the EB of the diet, cannot be evaluated individually, because depending on its associated anion it may have greater or lesser influence on cats urine pH.(AU)

O cálcio (Ca) é um macroelemento que faz parte da composição mineral da dieta de animais de companhia. Este macroelemento é considerado um cátion de forte capacidade alcalinizante e, de acordo com a fonte e quantidade inclusa, pode aumentar o pH urinário. Os sais de cálcio têm diferentes solubilidades e dependendo do ânion ao qual o cálcio está associado, pode ser mais ou menos absorvido e assim, alterar o pH da urina. O objetivo deste estudo foi avaliar os efeitos de duas fontes de cálcio na alcalinização do pH urinário, bem como a excreção de eletrólitos urinários e o equilíbrio ácido-básico de felinos. Foi selecionada uma dieta extrusada para gatos e adicionados 160mEq/kg de cálcio das fontes carbonato de cálcio (CaCO3) ou gluconato de cálcio (C12H22CaO14). No tratamento controle, não houve adição de fontes de cálcio. Foram utilizados nove gatos adultos, de raças mistas, em dois períodos experimentais, com seis repetições por tratamento. Os animais apresentavam idade média de 4,0±1,3 anos e peso corporal médio de 3,96±0,71kg. Estes permaneceram em gaiolas metabólicas em período de adaptação durante sete dias, seguido de coleta total de urina durante seis dias. Nestas amostras foram aferidos o volume, densidade, pH e concentração de cálcio (g/d). O equilíbrio ácido-básico foi avaliado por hemogasometria em amostras de sangue venoso. As duas fontes de cálcio alcalinizaram a urina (P<0,001). No entanto, o gluconato de cálcio apresentou menor potencial de alcalinização em comparação ao carbonato de cálcio (P<0,05). O cálcio urinário não foi afetado pelos tratamentos e representou menos de 0,5% da ingestão de Ca. O experimento demonstrou que o cálcio, apesar de ser um cátion alcalinizante e influenciador do EB da dieta, não pode ser avaliado individualmente, porque dependendo do ânion associado, pode apresentar maior ou menor influência no pH da urina de gatos.(AU)

Estudio comparativo de la absorción neta de calcio de dos formulaciones distintas de carbonato de calcio en mujeres posmenopáusicas / Comparative study of net calcium absorption of two different pharma¬ceutical formulations of calcium carbonate in posmenopausal women

La suplementación con calcio reduciría, sola o asociada a otra medicación para osteoporosis, la pérdida de masa ósea y el riesgo de fracturas. Sin embargo, su tasa de adherencia es baja debido a la poca tolerancia. Objetivo: comparar la tasa de absorción neta de calcio entre dos formulaciones distintas de carbonato de calcio (500 mg): comprimidos vs. mousse. Material y métodos: 11 pruebas fueron realizadas en mujeres posmenopáusicas de 58,9±3 años. El diseño fue exploratorio abierto, aleatorizado, prospectivo cruzado de fase 4. Intervención: las participantes fueron aleatorizadas en dos grupos para recibir las dos formulaciones previa suplementación con vitamina D3. La tasa de absorción neta de calcio fue estudiada por la prueba de inhibición de hormona paratiroidea (PTH). Se obtuvieron muestras de sangre: basal y en la 1a, 2a y 3a hora posadministración del calcio asignado, y de orina de 2 horas basal y al final de la prueba. Determinaciones bioquímicas: calcio, fósforo, albúmina, 25-hidroxivitamina D y hormona paratiroidea intacta y calciuria. Análisis estadístico: método de los trapecios para calcular el área bajo la curva (AUC) de la concentración de calcio en el tiempo (R Development Core Team (2008). http://www.Rp-project.org) y Anova con dos términos de error para evaluar el efecto secuencia, período y formulación. Resultados: la mayor inhibición de PTH se observó a dos horas de la toma de ambas formulaciones (comprimidos -39,2% vs. mousse -38,0%; p=ns), con similar AUC0-3 h (comprimidos 3,35; IC 95%: 3,32; 3,37 vs. mousse 3,36; IC 95%: 3,33; 3,38). Cuando analizamos tolerancia y preferencias no se observaron diferencias estadísticamente significativas entre ambas formulaciones. Conclusión: el carbonato de calcio en mousse mostró similar tasa de absorción intestinal, preferencia y tolerancia gastrointestinal que en comprimido. (AU)

Calcium supplementation, administered alone or in combination with a specific medication for osteoporosis, would reduce bone mass loss and fracture risk in postmenopausal women. However, the adherence rate to calcium supplements is low, mainly due to low tolerance. Objective: comparisson of net calcium absorption rate between two different pharmaceutical formulations of calcium carbonate (PFCa) in postmenopausal women. Materials and Methods: 11 tests were performed in postmenopausal women aged 58.9±3 yrs. Design: Comparative, randomized, prospective, open-label exploratory crossover study of calcium mousse versus calcium pills. Intervention: Participants were randomized in 2 groups to receive the 2 different PFCa (500mg): pills vs. mousse, with previous vitamin D3 supplementation. The parathyroid hormone (PTH) inhibition test and the area-under-thecurve (AUC) of calcium were analyzed. Blood samples were taken at baseline and 1, 2 and 3 hrs after intake of the assigned PFCa. Urine samples (2hs) were obtained at -baseline, after 2hs of PFCa intake and at the end of the test. Biochemical Determinations: Serum: calcium, phosphorus, albumin, 25-hydroxyvitamin D, and intact PTH. In urine: calcium. Statistical Analysis: The trapezoid rule was applied to assess AUC in time (R Development Core Team (2008). http://www.Rp-project.org). An ANOVA model with 2 error terms was used to assess the effect of sequence, period, and formulation. Results: The highest inhibition PTH rates were observed after 2 hrs of PFCa (pills -39.2% vs. mousse -38.0%; p=ns). The AUC0-3hrs for both PFCa was similar (pills 3.35; 95%CI: 3.32; 3.37 vs. mousse 3.36; 95%CI: 3.33; 3.38). No statistically significant differences were observed when we analyze tolerance and predilection. Conclusion: The calcium carbonate in mousse showed an adequate rate of intestinal absorption, similarly predilection and gastrointestinal tolerance than the pill presentation. (AU)

Factores asociados a la toma de suplementos de calcio en gestantes en la ciudad de Huancayo, 2018 / Factors associated with taking calcium supplements in pregnant women in Huancayo city, 2018

RESUMEN Introducción: La suplementación durante la gestación es recomendada en países en vías de desarrollo y con un alto índice de mortalidad materna, por ende, se puede medir su adherencia por el grado de comportamiento de una persona. Objetivo: Determinar los factores asociados a la adherencia en la toma de suplemento de calcio en gestantes de la ciudad de Huancayo. Material y Método: Se realizó un estudio transversal analítico, que se basó en la aplicación de una encuesta a las gestantes a partir de los 18 años hasta los 45 años, que radiquen en la provincia de Huancayo, que tengan hasta 20 semanas de embarazo y que acudan por lo menos a un control prenatal. Resultados: El 78,9% (135) tomaba suplementos de calcio. En el análisis multivariado, hubo una mayor frecuencia de toma de calcio a mayor edad gestacional (p=0,001), entre las que percibían que tomarlo trae beneficios (p=0,018) y en las que percibían que consumirlas tenía un alto costo (p<0,001), por el contrario, tomaron menos calcio las que tenían estudios técnicos (p=0,027), las que trabajaban (p=0,002) y las que tenían alguna discapacidad (p<0,001); ajustado por el que les hayan explicado los beneficios de tomarlas. Discusión: La gran mayoría de las encuestadas refirieron consumir calcio, así mismo, hubo muchos factores que influían de forma positiva y negativa para su mayor consumo; por lo que deberían emplearse técnicas para fomentar su ingesta en las gestantes, que consistan en explicar los beneficios de este suplemento.

ABSTRACT Introduction: Supplementation during pregnancy is recommended in developing countries that have a high maternal mortality rate, therefore the adherence can be measured by the behavior of a person Objective: The aim was to determine the factors associated with the adherence of calcium supplements intake in pregnant women from the city of Huancayo. Material and Method: A cross-sectional study was carried out based on the application of a survey to pregnant women from 18 to 45 years old, that live in the province of Huancayo, who also have up to 20 weeks of pregnancy and attended at least one prenatal checkup Results: 78.9% (135) took calcium supplements. In the multivariate analysis, there was a higher frequency of calcium intake at a higher gestational age (p=0.001), among those who perceived that taking it brings benefits (p=0.018) and in those who perceived that consuming it had a high cost (p<0.001), on the contrary, those who had technical education (p=0.027), those who worked (p=0.002) and those who had some disability (p<0.001) took less calcium; adjusted for receiving an explanation of the benefits of taking this supplement Discussion: The vast majority of the respondents reported consuming calcium. Likewise, there were many factors that influenced positively and negatively for its greater consumption; therefore techniques should be used to encourage its use in pregnant women, which consist in explaining the benefits of this supplement.

Changes in energetic metabolism of Biomphalaria glabrata (Mollusca, Planorbidae) in response to exogenous calcium / Alterações no metabolismo energético de Biomphalaria glabrata em resposta ao cálcio exógeno

Abstract Calcium is considered an essential element for the metabolism of aquatic snail Biomphalaria glabrata (Say, 1818), intermediate host of Schistosoma mansoni Sambon, 1907 in Brazil, and represents a limiting factor to its distribution and adaptation to the environment. This study investigated the effect of different concentrations of exogenous CaCO3 on the energetic metabolism of B. glabrata for better understanding the physiological interference of chemical elements dissolved in the environment with the physiology of this species. Sixty-day-old snails were distributed into six groups, five exposed to different concentrations of CaCO3 (20, 40, 60, 80 and 100 mg/L) and a control group. The exposure to CaCO3 was assessed over time, with analysis of 15 snails of each group in the following intervals: 1, 14, 21 or 30 days for hemolymph extraction. Concentrations of calcium and glucose in the hemolymph were determined by commercial kits, and organic acids were extracted using an ion exchange column and analyzed by high-performance liquid chromatography. Concentration of calcium in the hemolymph showed no significant difference (p>0.05) from the control group and between the concentrations tested. Concentration of glucose decreased (p<0.05) in the treatments of exposure to 20 and 40 mg/L and increased when exposed to 80 and 100 mg/L CaCO3 compared to control and to other concentrations tested over 30 days. The organic acids pyruvate, oxaloacetate, citrate, succinate, fumarate, beta-hydroxybutyrate and lactate presented increased concentrations, while propionate and acetoacetate, decreased concentrations, when exposed to CaCO3 compared to control. Considering the influence of different periods of exposure to CaCO3, on the 14th day, there were stronger alterations in the metabolism of B. glabrata. In conclusion, exposure to CaCO3 reduced the concentration of glucose, which is metabolized into pyruvate, the final product of glycolysis, and also influenced the energetic metabolism pathways, indicating an aerobic or partially anaerobic functioning.

Resumo O cálcio é considerado um elemento essencial no metabolismo do molusco aquático Biomphalaria glabrata (Say, 1818), principal hospedeiro intermediário de Schistosoma mansoni Sambon, 1907 no Brasil e, tem sido descrito como um fator limitante na distribuição e adaptação desse molusco no ambiente. O presente trabalho avaliou o efeito de diferentes concentrações de carbonato de cálcio (CaCO3) exógeno ao metabolismo energético de B. glabrata, a fim de subsidiar uma melhor compreensão da interferência de elementos químicos dissolvidos no meio aquático na fisiologia destes moluscos. Foram utilizados moluscos com sessenta dias de vida, distribuídos em seis grupos, cinco expostos a diferentes concentrações de CaCO3 (20, 40, 60, 80 e 100mg/L) e um controle. A exposição ao CaCO3 foi avaliada em função do tempo, sendo retirados 15 moluscos de cada grupo nos seguintes intervalos: 1, 14, 21 ou 30 dias para extração da hemolinfa. As concentrações de cálcio e glicose na hemolinfa foram determinadas usando-se kits comercial e os ácidos orgânicos foram extraídos por meio da coluna de troca iônica e analisados através cromatografia líquida de alta eficiência. Os resultados demonstraram que a concentração de cálcio na hemolinfa não apresentou diferença significativa (p>0,05) em relação ao controle e nas concentrações testadas. A concentração de glicose diminuiu (p<0,05) nas exposições a 20 mg e 40 mg/L e aumentou nas exposições a 80 mg e 100 mg/L de CaCO3 em relação ao controle e demais concentrações testadas ao longo de 30 dias. Os ácidos orgânicos piruvato, oxaloaceato, citrato, succinato, fumarato, β-hidroxibutirato e lactato tiveram suas concentrações aumentadas, enqunato, propionato e acetoacetato tiveram suas concentrações diminuídas na exposição ao CaCO3 comparada ao controle. Quanto a influência dos diferentes períodos de exposição ao CaCO3, aos 14 dias, as alterações no metabolismo de B. glabrata foram mais expressivas. Conclui-se que as exposições ao CaCO3 influenciaram na redução de glicose, sendo esta metabolizada a piruvato, produto final da glicólise e alteraram as vias de metabolismo energético, indicando um funcionamento aeróbio ou parcialmente anaeróbio.

Biomineralization of a calcifying ureolytic bacterium Microbacterium sp. GM-1

Background: Biomineralization is a significant process performed by living organisms in which minerals are produced through the hardening of biological tissues. Herein, we focus on calcium carbonate precipitation, as part of biomineralization, to be used in applications for environmental protection, material technology, and other fields. A strain GM-1, Microbacterium sp. GM-1, isolated from active sludge, was investigated for its ability to produce urease and induce calcium carbonate precipitation in a metabolic process. Results: It was discovered that Microbacterium sp. GM-1 resisted high concentrations of urea up to 60 g/L. In order to optimize the calcification process of Microbacterium sp. GM-1, the concentrations of Ni2+ and urea, pH value, and culture time were analyzed through orthogonal tests. The favored calcite precipitation culture conditions were as follows: the concentration of Ni2+ and urea were 50 µM and 60 g/L, respectively, pH of 10, and culture time of 96 h. Using X-ray diffraction analysis, the calcium carbonate polymorphs produced by Microbacterium sp. GM-1 were proven to be mainly calcite. Conclusions: The results of this research provide evidence that Microbacterium sp. GM-1 can biologically induce calcification and suggest that strain GM-1 may play a potential role in the synthesis of new biominerals and in bioremediation or biorecovery.

Costo efectividad del suplemento de calcio para reducir la mortalidad materna asociada a preeclampsia en Colombia / Cost effectiveness of calcium supplement in reducing preeclampsia-related maternal mortality in Colombia

Objetivo Estimar el costo-efectividad de la administración de calcio (1 200 mg diarios) a partir de la semana 14 de gestación a todas las gestantes, comparada con no administrarlo, para reducir la incidencia de preeclampsia. Métodos Se construyó un árbol de decisión en TreeAge® con desenlace en años de vida ganados (AVG). Los costos se incluyeron desde la perspectiva del sistema de salud colombiano, en pesos (COP) de 2014. La tasa de descuento fue de 0%. Se realizaron análisis de sensibilidad univariados y probabilísticos para costos y efectividad. Resultados El suplemento de calcio es una alternativa dominante frente a la no intervención. Si la incidencia de preeclampsia es menor a 51,7 por 1 000 gestantes o el costo por tableta de calcio de 600 mg es mayor a COP$ 507,85, el suplemento de calcio deja de ser una alternativa costo-efectiva en Colombia para un umbral de 3 veces el PIB per cápita de 2013 (COP$ 45 026 379) por AVG. Conclusiones La administración de calcio a todas las gestantes a partir de la semana 14 de gestación es una alternativa dominante frente a la no intervención, que permite ganar 200 años de vida, al tiempo que disminuye costos del orden de COP$ 5 933 millones por 100 000 gestantes.(AU)

Objectives To estimate the cost-effectiveness of administering calcium (1200 mg per day) starting in week 14 of pregnancy to all pregnant women compared to not supplying it to reduce the incidence of preeclampsia. Methods A decision tree was built in TreeAge® with outcome measured in life years gained (LYG) associated with the reduction in maternal deaths. Costs were included from the perspective of the health system in Colombia and expressed in Colombian pesos in 2014 (COP). The discount rate was 0 %. We performed sensitivity univariate and probabilistic analyses for costs and effectiveness. Results Compared to no intervention, calcium supplement is a dominant alternative. If the incidence of preeclampsia is lower than 51.7 per 1 000 pregnant women or the cost per tablet of calcium of 600 mg is greater than COP $507.85, calcium supplement is no longer a cost-effective alternative in Colombia for a threshold of COP $ 45 026 379 (3 times the Colombian per capita GDP of 2013 per LYG). Conclusions Supplying calcium to all pregnant women from week 14 of gestation is a dominant alternative compared to no intervention, which saves 200 LYG, while it decreases costs to the order of COP$5 933 million per 100.000 pregnant women.(AU)

Preeclampsia prevention: a case-control study nested in a cohort / La prevención de la preeclampsia: un estudio de casos y controles anidado en una cohorte

Introduction: Preeclampsia is the main complication of pregnancy in developing countries. Calcium starting at 14 weeks of pregnancy is indicated to prevent the disease. Recent advances in prevention of preeclampsia endorse the addition of conjugated linoleic acid. Objective: To estimate the protective effect from calcium alone, compared to calcium plus conjugated linoleic acid in nulliparous women at risk of preeclampsia. Methods: A case-control design nested in the cohort of nulliparous women attending antenatal care from 2010 to 2014. The clinical histories of 387 cases of preeclampsia were compared with 1,054 normotensive controls. The exposure was prescriptions for calcium alone, the first period, or calcium plus conjugated linoleic acid, the second period, from 12 to 16 weeks of gestational age to labor. Confounding variables were controlled, allowing only nulliparous women into the study and stratifying by age, education and ethnic group. Results: The average age was 26.4 yrs old (range= 13-45), 85% from mixed ethnic backgrounds and with high school education. There were no differences between women who received calcium carbonate and those who did not (OR= 0.96; 95% CI= 0.73-1.27). The group of adolescents (13 to 18 yrs old) in the calcium plus conjugated linoleic acid was protected for preeclampsia (OR= 0.00; 95% CI= 0.00-0.44) independent of the confounder variables. Conclusions: 1. Calcium supplementation during pregnancy did not have preventive effects on preeclampsia. 2. Calcium plus Conjugated Linoleic acid provided to adolescents was observed to have preventive effect on Preeclampsia.

Introducción: La preeclampsia es la principal causa de mortalidad materna y bajo peso al nacer en países en vías de desarrollo. Empezar la suplementación de calcio en la semana 14 de gestación es indicada para prevenir la enfermedad. Recientes avances en prevención de preeclampsia han sugerido la suplementación de calcio y la combinación de calcio con ácido linoleico conjugado. Objetivo: Estimar el efecto protector de la suplementación de calcio (CC), comparado con la suplementación de calcio más ácido linoleico conjugado (CC+ALC) en mujeres embarazadas primigravidas con relación al desarrollo de preeclampsia. Métodos: Se realizó un estudio de casos y controles anidado en una cohorte retrospectiva de mujeres embarazadas primigravidas que asistieron al programa de control prenatal entre el año 2010 hasta el años 2014. La historia clínica de 387 casos de preeclampsia fueron comparadas con 1,054 controles en pacientes embarazadas primigestantes, normotensas. Las gestantes expuestas fueron consideradas como aquellas gestantes que recibieron solo calcio, en el primer periodo de evaluación, o calcio más ácido linoleico conjugado, segundo periodo de evaluación, desde las semanas 12 a la 16 del embarazo. Los posibles factores de confusión se controlaron admitiendo solo las primigestantes y estratificando, por edad, educación y grupo étnico de la paciente. Resultados: La edad promedio de las pacientes fue de 26.4 años (rango= 13-45), 85% con etnia mestiza y educación secundaria completa. La exposición a CC+ALC tuvo un efecto protector en las adolescentes (13 a 18 años) (OR= 0.00, IC 95%= 0.00-0.44; p= 0.005), mientras que la exposición a CC no modificó la incidencia de preeclampsia (OR= 0.96, IC 95%= 0.73-1.27; p= 0.82). Conclusiones: 1. La suplementación de solo calcio durante el embarazo no tuvo efecto preventivo para la preeclampsia, 2. La suplementación con calcio y ácido linoleico conjugado previno la aparición de preeclampsia en adolescentes.

Cultivation of marine shrimp in biofloc technology (BFT) system under different water alkalinities / Cultivo de camarões marinhos em sistema de bioflocos (BFT) sob diferentes alcalinidades da água

AbstractThe aim of this study was to evaluate the influence of different levels of alkalinity for the superintensive cultivation of marine shrimp Litopenaeus vannamei in biofloc system. A total of 12 experimental circular units of 1000L were used supplied with 850L water from a nursery, populated at a density of 165 shrimps.m–3 and average weight of 5.6 g. The treatments, in triplicate, consisted in four levels of alkalinity in the water: 40, 80, 120 and 160 mg.L–1 of calcium carbonate. To correct the alkalinity was used calcium hydroxide (CaOH). It was observed a decrease in pH of the water in the treatments with lower alkalinity (p<0.05). The total suspended settleable solids were also lower in the treatment of low alkalinity. No significant difference was observed in other physico-chemical and biological parameters in the water quality assessed, as well as the zootechnical parameters of cultivation between treatments (p≥0.05). The results of survival and growth rate of shrimps were considered suitable for the cultivation system used in the different treatments. The cultivation of marine shrimp Litopenaeus vannamei in biofloc at density of 165 shrimps.m–3 can be performed in waters with alkalinity between 40 and 160 mg.L–1 of CaCO3, without compromising the zootechnical indexes of cultivation.

ResumoO objetivo deste trabalho foi avaliar a influência de diferentes níveis de alcalinidade para o cultivo do camarão marinho Litopenaeus vannamei em sistema superintensivo em bioflocos. Foram utilizadas 12 unidades experimentais circulares de 1000L abastecido com 850L de água provenientes de um berçário intensivo, povoadas a uma densidade de 165 camarões.m-3 e peso médio 5,6g. Os tratamentos em triplicata consistiram de quatro níveis de alcalinidade na água: 40, 80, 120 e 160 mg.L–1 de carbonato de cálcio. Para correção da alcalinidade, foi utilizado cal hidratada (CaOH). Foi observado um decréscimo no pH da água nos tratamentos de menor alcalinidade (p<0,05). Os sólidos suspensos sedimentáveis totais também foram menores nos tratamentos de menor alcalinidade. Não foi observada diferença significativa nos demais parâmetros físico-químicos e biológicos de qualidade de água avaliados, assim como nos parâmetros zootécnicos do cultivo entre os tratamentos (p≥0,05). Os resultados de sobrevivência e taxa de crescimento dos camarões foram considerados adequados para o sistema de cultivo utilizado nos distintos tratamentos. O cultivo do camarão marinho Litopenaeus vannamei em bioflocos na densidade de 165 camarões.m–3 pode ser realizado em águas com alcalinidade entre 40 a 160 mg.L–1 de CaCO3, sem comprometer os índices zootécnicos do cultivo.

Biomineralization processes of calcite induced by bacteria isolated from marine sediments

Biomineralization is a known natural phenomenon associated with a wide range of bacterial species. Bacterial-induced calcium carbonate precipitation by marine isolates was investigated in this study. Three genera of ureolytic bacteria, Sporosarcina sp., Bacillus sp. and Brevundimonas sp. were observed to precipitate calcium carbonate minerals. Of these species, Sporosarcina sp. dominated the cultured isolates. B. lentus CP28 generated higher urease activity and facilitated more efficient precipitation of calcium carbonate at 3.24 ± 0.25 × 10−4 mg/cell. X-ray diffraction indicated that the dominant calcium carbonate phase was calcite. Scanning electron microscopy showed that morphologies of the minerals were dominated by cubic, rhombic and polygonal plate-like crystals. The dynamic process of microbial calcium carbonate precipitation revealed that B. lentus CP28 precipitated calcite crystals through the enzymatic hydrolysis of urea, and that when ammonium ion concentrations reached 746 mM and the pH reached 9.6, that favored calcite precipitation at a higher level of 96 mg/L. The results of this research provide evidence that a variety of marine bacteria can induce calcium carbonate precipitation, and may influence the marine carbonate cycle in natural environments.

O trabalho no cárcere: reflexões acerca da saúde do agente penitenciário / El trabajo en la prisión: reflexiones sobre la salud del guardia penitenciário / The work in prison: reflections on the health of prison officers

RESUMO Objetivo: conhecer as condições de trabalho de agentes penitenciários e os reflexos do exercício da atividade laboral em sua saúde. Método: pesquisa descritiva, qualitativa. Os dados foram coletados por meio de entrevista aberta com agentes de um presídio regional e submetidos a análise de conteúdo na modalidade temática. Resultados: os resultados revelaram condições de trabalho insatisfatórias por deficiência de recursos materiais e descaso do poder público com as questões inerentes à ressocialização do apenado, resultando em exposição aos riscos psicossociais, insatisfação e desgaste emocional dos trabalhadores. Conclusão: investimentos na segurança dos trabalhadores podem contribuir para a promoção de sua saúde. .

RESUMEN Objetivo: conocer las condiciones laborales de guardias de prisión y las consecuencias del ejercicio de la actividad laboral en su salud. Método: investigación cualitativa y descriptiva. Los datos fueron recolectados a través de entrevistas abiertas con agentes de una cárcel regional y se sometieron a análisis de contenido en la modalidad temática. Resultados: los resultados mostraron condiciones insatisfactorias por la falta de recursos materiales y el abandono por parte del gobierno en los asuntos relacionados con la rehabilitación del condenado, lo que resulta en la exposición a riesgos psicosociales, la insatisfacción y el agotamiento emocional de los trabajadores. Conclusión: las inversiones en la seguridad de los trabajadores pueden contribuir a la promoción de su salud. .

ABSTRACT Objective: to understand the working conditions of prison offi cers and the repercutions of labor activity on their health. Method: qualitative and descriptive research. Data were collected through open interviews with the prison offi cers of a regional prision and the speeches were submitted to content analysis. Results: the results showed unsatisfactory working conditions due to poor material resources and neglect of governmental regarding rehabilitation of convicts, resulting in workers’ exposure to psychosocial risks, dissatisfaction, and emotional distress. Conclusion: investments on the security of workers may contribute to their health promotion. .