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1.
Arch. latinoam. nutr ; 73(1): 1-7, mar. 2023. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1427663

RESUMO

Introducción. El Síndrome Metabólico (SM) comprende un conjunto de factores de riesgo cardiometabólico representado por obesidad central, dislipidemia, hipertensión arterial y glucosa alterada, se ha evidenciado que el consumo adecuado de calcio representa una disminución del riesgo para este síndrome. Objetivo. Analizar la relación entre el consumo de calcio total, de origen animal y vegetal con el SM y sus indicadores. Materiales y métodos. Estudio transversal de eje correlacional, con una muestra de 100 adultos de la región amazónica ecuatoriana, durante el último trimestre del 2020. La ingesta dietética de calcio se determinó mediante un recordatorio de 24 horas y el SM según los criterios de Adult Treatment Panel-IV (ATP-IV). Resultados. La población estuvo conformada por adultos maduros (40 a 60 años) que evidenciaron una ingesta de calcio deficiente (182,50 mg y 228,60 mg en mujeres y hombres respectivamente). Se evidenció, además, una relación directamente proporcional entre la circunferencia abdominal (r=0,391 ­ p=0,000), presión arterial sistólica (r=0,290 ­ p=0,000) y glucosa en ayuno (r=0,326 ­ p=0,000) con la edad. La ingesta de calcio total se relacionó positivamente con los triglicéridos, (r=0,221 ­ p=0,027). Conclusiones. La ingesta dietética de calcio en ambos sexos no alcanza el requerimiento diario y se relaciona positivamente con los triglicéridos(AU)


Introduction. The Metabolic Syndrome (MS) comprises a set of cardiometabolic risk factors represented by central obesity, dyslipidemia, high blood pressure and altered glucose, it has been shown that adequate calcium intake represents a decreased risk for this syndrome. Objective. To analyze the relationship between the consumption of total calcium, animal and vegetable origin, with MS and its indicators. Materials and methods. Cross-sectional study of correlational axis, with a sample of 100 adults from the Ecuadorian Amazon region, during the last quarter of 2020. Dietary calcium intake was determined through a 24-hour recall and the diagnosis of MS according to the Adult Treatment Panel- IV (ATP-IV) criteria. Results. The population consisted of mature adults (40 to 60 years) who showed a deficient calcium intake in both sexes (182.50 mg and 228.60 mg in women and men respectively). There is also evidence of a directly proportional relationship between abdominal circumference (r=0.391 - p=0.000), systolic blood pressure (r=0.290 - p=0.000) and fasting glucose (r=0.326 - p=0.000) with age. Total calcium intake was positively related to triglycerides (r=0.221 ­ p=0.027). Conclusions. Calcium dietary intake in both sexes does not reach the daily requirement and is positively related to triglycerides(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cálcio/administração & dosagem , Fatores de Risco , Síndrome Metabólica/complicações , Diabetes Mellitus , Circunferência Abdominal , Dislipidemias , Hipertensão , Obesidade
2.
Anal Biochem ; 641: 114556, 2022 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-35063435

RESUMO

The purpose of the study was to explore the effect of calcium (Ca) supplementation on liver injury induced by cadmium (Cd) in rats and its potential metabolic mechanisms through metabolomics analysis. Seventy rats were randomly allotted into 7 groups, including a control group, 3 groups with different levels of Cd exposed (1, 5, and 50 mg Cd/kg diet), and 3 corresponding Ca supplement groups (4 g Ca/kg diet) based on the Cd exposed groups. Dietary intake was simulated by giving Cd or Cd+Ca in the diets of rats. After 13-week feeding, serum biochemical parameters and liver histopathology were examined. Then the metabolic analysis of rat liver tissues was performed by ultra-performance liquid chromatography quadrupole-time-flight mass spectrometry (UPLC-Q-TOF-MS). It was demonstrated that Ca supplementation could reverse the abnormal alterations in TG, TC, GSH, MDA induced by Cd exposure, as well as the hepatic pathological changes in rats. Furthermore, the metabolomics analysis of liver samples revealed several distinct regulatory pathways, including energy, amino acid, and lipid metabolic pathways. In conclusion, it showed that Ca supplementation had an ameliorative effect on liver injury induced by Cd exposure in rats, which may be related to the role of Ca in regulating multiple metabolic pathways.


Assuntos
Cálcio/farmacologia , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Metabolômica , Animais , Cádmio/administração & dosagem , Cádmio/efeitos adversos , Cádmio/metabolismo , Cálcio/administração & dosagem , Cálcio/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Suplementos Nutricionais , Feminino , Substâncias Protetoras , Ratos , Ratos Sprague-Dawley
3.
Medicine (Baltimore) ; 101(1): e28538, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35029924

RESUMO

ABSTRACT: Calcium (Ca) and magnesium (Mg), which play an important role in several cellular processes, is essential for normal development of the skeleton and maintenance of tissue homeostasis. Deficiency of these elements might delay bone fracture recovery or accelerates bone loss. We aimed to examine whether supplementation of trace element (TE) promotes fracture healing in accidentally fracturing adults by involvement of inflammatory mechanism.A short-term follow-up in clinic was performed. Totally, 117 subjects diagnosed with multiple fractures by traffic accidents were recruited in this study. Serum Ca and Mg levels were measured by inductively coupled plasma atomic emission spectrophotometry. Short-term changes such as serum C-reactive protein, interleukin (IL)-1ß, IL-6, and tumor necrosis factor alpha in normal treatment and TE supplement groups were detected by enzyme-linked immunosorbent assay. Student t test and the Spearman correlation were performed to analyze the data.Significantly negative correlations between Ca (r = 0.7032; P < .001) and Mg (r = 0.2719; P < .05) and injury severity score were observed. Serum Ca and Mg were significantly increased at Day 5, 7, and 9 following TE supplements. After treatment, serum C-reactive protein, IL-1ß, IL-6, and tumor necrosis factor alpha were significantly reduced whereas cytokine levels of the TE supplement group were found to be lower than that of the normal treatment group after Day 3.These findings suggest that Ca and Mg levels are associated with the injury severity of multiple fractures, and the supplement could reduce the inflammation, which may be beneficial for the bone recovery and disease process.


Assuntos
Cálcio/sangue , Citocinas/sangue , Fraturas Ósseas , Fraturas Múltiplas , Magnésio/sangue , Acidentes de Trânsito , Adulto , Proteína C-Reativa/análise , Cálcio/administração & dosagem , Feminino , Seguimentos , Humanos , Escala de Gravidade do Ferimento , Interleucina-6/sangue , Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Espectrofotometria Atômica , Fator de Necrose Tumoral alfa/sangue
4.
Am Surg ; 88(3): 519-520, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32988244

RESUMO

Neuroleptic malignant syndrome (NMS) is described in the medical literature but rarely seen among acutely ill trauma patients. A 44-year-old man with burns to the hands and back after a chemical explosion was transported to an outside facility where he received treatment for presumed acute coronary syndrome after developing ventricular tachycardia and elevated serum troponins after the exposure. His cardiac catheterization was unremarkable, but an echocardiogram revealed severe cardiomyopathy, and he was also in multisystem organ failure. He was transferred to our facility after hospital day 2 for treatment of his multisystem organ failure and 2% total body surface area burns. His laboratory results were remarkable for a creatine kinase of >100 000 units/L, and he required 14 g of intravenous calcium. Upon further investigation, the patient reported taking ziprasidone for his bipolar disorder, and he had a core temperature of 103.5 °F on his initial presentation to the outside facility. As he convalesced, the unifying diagnosis was NMS. NMS is a side effect of antipsychotic therapy and is manifested by hyperpyrexia, rigidity, autonomic instability, and altered consciousness. An elevated creatine kinase >100 000 units/L is almost pathognomonic for NMS. Patients can also present with leukocytosis, organ failure, and electrolyte disturbances including hypocalcemia. We hypothesized that dehydration, the warm environmental conditions at our patient's job, and immense stress resulting in a catecholamine surge following his trauma were inciting triggers to this event. This case highlights the importance of considering alternate diagnoses in patients whose clinical presentation does not fit the most "obvious cause."


Assuntos
Antipsicóticos/efeitos adversos , Queimaduras Químicas/complicações , Insuficiência de Múltiplos Órgãos/etiologia , Síndrome Maligna Neuroléptica/complicações , Piperazinas/efeitos adversos , Tiazóis/efeitos adversos , Acidentes de Trabalho , Síndrome Coronariana Aguda/tratamento farmacológico , Adulto , Transtorno Bipolar/tratamento farmacológico , Superfície Corporal , Queimaduras Químicas/sangue , Cálcio/administração & dosagem , Creatina Quinase/sangue , Humanos , Hipocalcemia/etiologia , Hipocalcemia/terapia , Masculino , Síndrome Maligna Neuroléptica/sangue , Síndrome Maligna Neuroléptica/diagnóstico , Taquicardia Ventricular/tratamento farmacológico , Troponina/sangue
5.
Nutr Neurosci ; 25(1): 22-32, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31900080

RESUMO

Objectives: Postpartum depression (PPD) is a major depressive disorder. Vitamin D deficiency may play a role in PPD pathogenesis. This study was designed to determine the effect of vitamin D and calcium supplementation on the severity of symptoms and some related inflammatory biomarkers in women with PPD.Materials and Methods: Eighty-one women with a PPD score >12 participated in this study. A total of 27 patients were randomly assigned into three groups (1:1:1 ratio) to receive either 50,000 IU vitamin D3 fortnightly + 500 mg calcium carbonate daily; or 50,000 IU vitamin D3 fortnightly + placebo of calcium carbonate daily, or placebo of vitamin D3 fortnightly + placebo of calcium carbonate daily (placebo group) for 8 weeks. At the baseline and end of the study, the severity score of PPD, levels of 25-hydroxy vitamin D, calcium, tumor necrosis factor-alpha (TNFα), interleukin 6 (IL6) and estradiol were measured.Results: The PPD score had more reduction in the vitamin D + calcium and vitamin D + calcium placebo groups than that of the placebo group (-1.7 ± 3.44, -4.16 ± 5.90 and 0.25 ± 2.81, respectively; p = 0.008). The effect of vitamin D on the PPD score was larger when vitamin D was given alone than given together with calcium (p = 0.042 and p = 0.004, respectively). No significant differences in estradiol, IL6 and TNFα were observed between the three groups.Discussion: Vitamin D may be effective in improving the clinical symptoms of PPD; however, the mechanism of the effect might not entirely operate through inflammatory and/or hormonal changes.


Assuntos
Biomarcadores/sangue , Cálcio/administração & dosagem , Depressão Pós-Parto/tratamento farmacológico , Estradiol/sangue , Inflamação/sangue , Vitamina D/administração & dosagem , Cálcio/sangue , Depressão Pós-Parto/sangue , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Interleucina-6/sangue , Fator de Necrose Tumoral alfa/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue
6.
Horm Metab Res ; 53(12): 779-786, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34687025

RESUMO

Since medullary thyroid carcinoma is an aggressive cancer, it is important to have an early detection based on stimulated calcitonin (CT), especially when basal-CT is slightly elevated. The objective of this work was to set specific thresholds for basal-CT- and calcium-stimulated calcitonin for prediction of thyroid malignancy in female population. The study included 2 groups: group A-women with elevated basal-CT (>9.82 pg/ml) and group B-women with normal basal-CT (control group). After calcium stimulation test precise protocol, histopathological reports of those that required surgery were correlated with both basal and stimulated calcitonin. The best basal and stimulated calcitonin cut-offs for distinguishing female patients with medullary thyroid carcinoma or C-Cell-hyperplasia from other pathologies or normal cases were: 12.9 pg/ml, respectively 285.25 pg/ml. For basal-CT above 30 pg/ml, malignancy was diagnosed in 9/9 patients (100%): 9 MTC. For stimulated calcitonin above 300 pg/ml, malignancy was diagnosed in 17/21 patients (80.95%): 12 MTC and 5 papillary thyroid carcinomas. The smallest nodule that proved to be medullary thyroid carcinoma had only 0.56/0.34/0.44 cm on ultrasound, with no other sonographic suspicious criteria. In conclusion, we have identified in Romanian female population basal and stimulated calcitonin thresholds to discriminate medullary thyroid carcinoma or C-Cell-hyperplasia from other cases. We recommend thyroid surgery in all women with stimulated calcitonin above 285 pg/ml. Further studies on larger groups are necessary to establish and confirm male and female cut-offs for early diagnosis of medullary thyroid carcinoma, and interestingly, maybe for macro-papillary thyroid carcinomas alike. The calcium administration has minimum side-effects, but continuous cardiac monitoring is required.


Assuntos
Biomarcadores Tumorais/sangue , Calcitonina/sangue , Cálcio/administração & dosagem , Carcinoma Neuroendócrino/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Idoso , Cálcio/sangue , Carcinoma Neuroendócrino/sangue , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias da Glândula Tireoide/sangue , Adulto Jovem
7.
Carbohydr Polym ; 270: 118382, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34364624

RESUMO

The treatment of osteochondral (OC) defects remains challenging because of the lack of economical and feasible therapeutic strategies for OC repair and reconstruction. In this study, we report an integrated bilayer hydrogel with robust interface binding force (40 kPa) by facilitating the diffusion of calcium ions to the secondary crosslink of the bilayer hydrogel, in which gellan gum and sodium alginate acted as the chondral layer, gellan gum and hydroxyapatite acted as subchondral layer. This integrated construct has high cytocompatibility, and can seed with mesenchymal stem cells (MSCs) related to different functional protein expression for cartilage and bone formation, respectively. Furthermore, in the rabbit critical-sized osteochondral defect model (4.0 mm in diameter and 8.0 mm in depth), the calcium enriched hydrogel act as a calcium reservoir, promote neovascularization at week 4, and repair the critical defect at week 8, demonstrating the feasible preparation of an acellular hydrogel for OC repair.


Assuntos
Alginatos/administração & dosagem , Cálcio/administração & dosagem , Doenças das Cartilagens/terapia , Hidrogéis/administração & dosagem , Polissacarídeos Bacterianos/administração & dosagem , Alginatos/química , Animais , Regeneração Óssea/efeitos dos fármacos , Cálcio/química , Doenças das Cartilagens/metabolismo , Cartilagem Articular/efeitos dos fármacos , Condrócitos/efeitos dos fármacos , Condrogênese/efeitos dos fármacos , Durapatita/administração & dosagem , Durapatita/química , Hidrogéis/química , Osteogênese/efeitos dos fármacos , Polissacarídeos Bacterianos/química , Coelhos , Engenharia Tecidual/métodos , Alicerces Teciduais/química
8.
Isr Med Assoc J ; 23(8): 490-493, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34392623

RESUMO

BACKGROUND: Osteoporosis is a common medical condition in older ages. A devastating result of osteoporosis may be a hip fracture with up to 30% mortality rate in one year. The compliance rate of osteoporotic medication following a hip fracture is 20% in the western world. OBJECTIVES: To evaluate the impact of the fracture liaison service (FLS) model in the orthopedic department on patient compliance following hip fracture. METHODS: We performed a retrospective review of all patients with hip fracture who were involved with FLS. We collected data regarding kidney function, calcium levels, parathyroid hormone levels, and vitamin D levels at admission. We educated the patient and family, started vitamin D and calcium supplementation and recommended osteoporotic medical treatment. We phoned the patient 6-12 weeks following the fracture to ensure treatment initiation. RESULTS: From June 2018 to June 2019 we identified 166 patients with hip fracture who completed at least one year of follow-up. Over 75% of the patients had low vitamin D levels and 22% had low calcium levels at admission. Nine patients (5%) died at median of 109 days. Following our intervention, 161 patients (96%) were discharged with a specific osteoporotic treatment recommendation; 121 (73%) received medication for osteoporosis on average of < 3 months after surgery. We recommended on injectable medications; however, 51 (42%) were treated with oral biphsophonate. CONCLUSIONS: FLS improved the compliance rate of osteoporotic medical treatment and should be a clinical routine in every medical center.


Assuntos
Cálcio/administração & dosagem , Fraturas do Quadril , Osteoporose , Fraturas por Osteoporose , Período Pós-Operatório , Prevenção Secundária , Vitamina D/administração & dosagem , Idoso , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/classificação , Suplementos Nutricionais , Quimioterapia Combinada , Feminino , Fraturas do Quadril/mortalidade , Fraturas do Quadril/prevenção & controle , Fraturas do Quadril/cirurgia , Humanos , Israel/epidemiologia , Masculino , Mortalidade , Procedimentos Ortopédicos/estatística & dados numéricos , Osteoporose/sangue , Osteoporose/complicações , Osteoporose/tratamento farmacológico , Osteoporose/epidemiologia , Fraturas por Osteoporose/mortalidade , Fraturas por Osteoporose/prevenção & controle , Fraturas por Osteoporose/cirurgia , Estudos Retrospectivos , Prevenção Secundária/métodos , Prevenção Secundária/organização & administração , Vitamina D/sangue
9.
Am J Otolaryngol ; 42(6): 103115, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34214713

RESUMO

BACKGROUND: The transient acute hypocalcemia (HypoCa) is the most prevalent complication after total thyroidectomy, detected primarily by subnormal intact parathyroid hormone (iPTH) and calcium levels. However, the need for calcium supplementation is ambiguous in patients who exhibit low iPTH with normal calcium levels. The aim of this study was to evaluate complementary predictors of HypoCa in this scenario. METHODS: A retrospective cohort study with of 1597 consecutive patients undergoing total thyroidectomy, with or without neck dissection, from January 2014 to December 2018 at a single institution. Patients with an iPTH <12 pg/mL and a total calcium level ≥8 mg/dL in the first 8 h after surgery were included. RESULTS: 1597 patients identified with low postoperative iPTH without overt calcium deficiency was diagnosed. The transient HypoCa in that specific subgroup was 509 (31.9%). Multivariate analysis indicated that HYPOCA was associated with bilateral level VI neck dissection and pre- to postoperative calcium reduction >38 pg/mL. To better illustrate the model, we plotted a nomogram with the variables selected for the final model. CONCLUSION: Total thyroidectomy patients who exhibit low postoperative iPTH levels without overt calcium deficiency should be considered for calcium replacement therapy when they a marked drop in iPTH postoperatively and underwent bilateral level VI neck dissection.


Assuntos
Hipocalcemia/etiologia , Hipoparatireoidismo/etiologia , Complicações Pós-Operatórias/etiologia , Tireoidectomia/efeitos adversos , Doença Aguda , Adulto , Biomarcadores/sangue , Cálcio/administração & dosagem , Cálcio/sangue , Cálcio/deficiência , Feminino , Humanos , Hipocalcemia/diagnóstico , Hipocalcemia/tratamento farmacológico , Hipoparatireoidismo/diagnóstico , Hipoparatireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/tratamento farmacológico , Estudos Retrospectivos
10.
Surg Oncol ; 38: 101634, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34303953

RESUMO

In this study, irreversible electroporation (IRE), electrochemotherapy (ECT), and calcium electroporation (CaEP) techniques were investigated as new strategies for human pancreatic cancer. Qualification of the patients, best "therapeutic moment" for each patient, safety, and complications after procedures were examined. In this pilot study were included 13 patients in this study, which were operated on in different pancreatic cancer stages. Patients underwent IRE or ECT with intravenous admission of cisplatin or electroporation with calcium intratumoral administration. The IRE procedure was safe for the patients. Medium overall survival for IRE, IRE + CTH, and IRE + CaCl2 was respectively: 16, 29.5, and 19 months comparing to 10 months in control chemotherapy (CTH) group. Thus, IRE, ECT, and CaEP can be effective strategies for pancreatic cancer treatment.


Assuntos
Eletroquimioterapia , Eletroporação/métodos , Neoplasias Pancreáticas/terapia , Antineoplásicos/administração & dosagem , Cálcio/administração & dosagem , Cisplatino/administração & dosagem , Feminino , Humanos , Íons/administração & dosagem , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/mortalidade , Projetos Piloto
11.
Transfus Apher Sci ; 60(4): 103147, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33931360

RESUMO

Peripheral blood progenitor cells (PBPCs) are a predominant graft source in allogeneic hematopoietic cell transplantation. Citrate-induced hypocalcemia remains the most frequent side effect of PBPC apheresis. Although the method for preventing severe adverse events is established, more efficient prophylaxis is required so that volunteer donors can donate PBPCs without pain and anxiety. We studied 80 healthy donors who underwent PBPC harvest between February 2014 and June 2020. Of these, 23 donors who underwent apheresis between February 2014 and December 2015 received only the standard prophylaxis of intravenous calcium gluconate. Oral calcium drinks were provided to 57 donors who underwent apheresis from January 2016 to June 2020 to supplement intravenous calcium gluconate prophylaxis. The ionized calcium (ICa) levels at multiple time intervals and the hypocalcemic symptoms were evaluated. Oral supplementation with a calcium drink maintained significantly higher ICa levels. Analysis using the inverse probability weighted regression adjustment method suggested that calcium drinks reduced the frequency of citrate-related reactions by 39.2 %. Administering a prophylactic oral calcium drink before apheresis with intravenous administration of calcium gluconate is promising to further reduce citrate-induced hypocalcemia in volunteer donors.


Assuntos
Gluconato de Cálcio/administração & dosagem , Ácido Cítrico , Suplementos Nutricionais , Mobilização de Células-Tronco Hematopoéticas , Células-Tronco de Sangue Periférico/metabolismo , Doadores de Tecidos , Administração Oral , Adulto , Remoção de Componentes Sanguíneos , Cálcio/administração & dosagem , Ácido Cítrico/efeitos adversos , Ácido Cítrico/farmacologia , Feminino , Transplante de Células-Tronco Hematopoéticas , Humanos , Masculino , Pessoa de Meia-Idade
12.
Am J Clin Nutr ; 114(2): 450-461, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-33964859

RESUMO

BACKGROUND: Epidemiologic studies examining the relations between dairy product and calcium intakes and breast cancer have been inconclusive, especially for tumor subtypes. OBJECTIVE: To evaluate the associations between intakes of specific dairy products and calcium and risk of breast cancer overall and for subtypes defined by estrogen receptor (ER) status. METHOD: We pooled the individual-level data of over 1 million women who were followed for a maximum of 8-20 years across studies. Associations were evaluated for dairy product and calcium intakes and risk of incident invasive breast cancer overall (n = 37,861 cases) and by subtypes defined by ER status. Study-specific multivariable hazard ratios (HRs) were estimated and then combined using random-effects models. RESULTS: Overall, no clear association was observed between the consumption of specific dairy foods, dietary (from foods only) calcium, and total (from foods and supplements) calcium, and risk of overall breast cancer. Although each dairy product showed a null or very weak inverse association with risk of overall breast cancer (P, test for trend >0.05 for all), differences by ER status were suggested for yogurt and cottage/ricotta cheese with associations observed for ER-negative tumors only (pooled HR = 0.90, 95% CI: 0.83, 0.98 comparing ≥60 g/d with <1 g/d of yogurt and 0.85, 95% CI: 0.76, 0.95 comparing ≥25 g/d with <1 g/d of cottage/ricotta cheese). Dietary calcium intake was only weakly associated with breast cancer risk (pooled HR = 0.98, 95% CI: 0.97, 0.99 per 350 mg/d). CONCLUSION: Our study shows that adult dairy or calcium consumption is unlikely to associate with a higher risk of breast cancer and that higher yogurt and cottage/ricotta cheese intakes were inversely associated with the risk of ER-negative breast cancer, a less hormonally dependent subtype with poor prognosis. Future studies on fermented dairy products, earlier life exposures, ER-negative breast cancer, and different racial/ethnic populations may further elucidate the relation.


Assuntos
Neoplasias da Mama/prevenção & controle , Cálcio/administração & dosagem , Laticínios , Receptores de Estrogênio/metabolismo , Estudos de Coortes , Feminino , Humanos , Análise Multivariada , Receptores de Estrogênio/genética , Fatores de Risco
13.
Orthop Surg ; 13(4): 1262-1268, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33951328

RESUMO

OBJECTIVE: To evaluate the effects of different intervention measures to prevent falls in elderly osteoporotic patients. METHODS: A randomized controlled trial was conducted in our outpatient ward from August 2014 to September 2015. A total of 420 patients over 60 years of age were assigned to four groups. NA VitD group took 800 mg calcium and 800 IU non-active vitamin D. P-NA VitD group took 800 mg calcium, 800 IU non-active vitamin D, and received physical exercise. A VitD group took 800 mg calcium and 0.5 µg active vitamin D. P-A VitD took 800 mg calcium, 0.5 µg active vitamin D, and received physical exercise. Physical exercise includes guidance in improving muscle strength and balance ability. Short physical performance battery (SPPB), grip strength, modified falls efficacy scale (MFES), blood calcium, and 25-hydroxyl vitamin D were measured before interventions and at 3, 6, and 12 months after interventions. Bone mineral density (BMD) was detected before interventions and at 12 months after interventions. The incidence of falls and fractures, adverse events, and drug reactions were recorded for 12 months. RESULTS: A total of 420 patients were allocated in the four groups: 98 cases into the NA VitD group (11 males, 87 females), 97 cases into the P-NA VitD group (13 males, 84 females), 99 cases in the A VitD group (15 males, 84 females), and 98 cases into the P-A VitD group (11 males, 87 females). At 6 months after interventions, the SPPB of A VitD group significantly increased from 6.9 ± 1.9 to 8.0 ± 2.4 (P < 0.05), and the SPPB of A VitD group significantly increased from 7.2 ± 2.1 to 8.6 ± 1.7 (P < 0.05). At 6 months after interventions, MFES of P-NA VitD group 7.0 ± 1.6 to 7.6 ± 1.6 (P < 0.05), and MFES of P-A VitD group significantly increased from 6.7 ± 1.6 to 7.5 ± 1.6 (P < 0.05). At 12 months after interventions, SPPB of all groups, grip strength, and MFES of P-NA VitD group, A VitD group, P-A VitD group were significantly improved (P < 0.05). The BMD of lumbar vertebrae of A VitD group significantly increased from 0.742 ± 0.042 to 0.776 ± 0.039, and P-A VitD group significantly increased from 0.743 ± 0.048 to 0.783 ± 0.042 (P < 0.05). No serious adverse events occurred during the 12 months of follow-up. CONCLUSION: Active vitamin D is better than non-active vitamin D to improve physical ability and the BMD of lumbar vertebrae and reduce the risk of falls.


Assuntos
Acidentes por Quedas/prevenção & controle , Cálcio/administração & dosagem , Terapia por Exercício/métodos , Osteoporose/prevenção & controle , Vitamina D/administração & dosagem , Idoso , Densidade Óssea/fisiologia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Osteoporose/fisiopatologia , Equilíbrio Postural/fisiologia
14.
J Nutr Biochem ; 94: 108645, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33838230

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is a chronic disease affecting the health of many people worldwide. Previous studies have shown that dietary calcium supplementation may alleviate NAFLD, but the underlying mechanism is not clear. In this study investigating the effect of calcium on hepatic lipid metabolism, 8-week-old male C57BL/6J mice were divided into four groups (n = 6): (1) mice given a normal chow containing 0.5% calcium (CN0.5), (2) mice given a normal chow containing 1.2% calcium (CN1.2), (3) mice given a high-fat diet (HFD) containing 0.5% calcium (HFD0.5), and (4) mice fed a HFD containing 1.2% calcium (HFD1.2). To understand the underlying mechanism, cells were treated with oleic acid and palmitic acid to mimic the HFD conditions in vitro. The results showed that calcium alleviated the increase in triglyceride accumulation induced by oleic acid and/or palmitic acid in HepG2, AML12, and primary hepatocyte cells. Our data demonstrated that calcium supplementation alleviated HFD-induced hepatic steatosis through increased liver lipase activity, proving calcium is involved in the regulation of hepatic lipid metabolism. Moreover, calcium also increased the level of glycogen in the liver, and at the same time had the effect of reducing glycolysis and promoting glucose absorption. Calcium addition increased calcium levels in the mitochondria and cytoplasm. Taken together, we concluded that calcium supplementation could relieve HFD-induced hepatic steatosis by changing energy metabolism and lipase activity.


Assuntos
Cálcio/administração & dosagem , Dieta Hiperlipídica/efeitos adversos , Suplementos Nutricionais , Fígado Gorduroso/induzido quimicamente , Fígado Gorduroso/tratamento farmacológico , Lipólise , Animais , Cálcio/metabolismo , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitoxantrona/farmacologia , Compostos de Rutênio/farmacologia
15.
J Nutr ; 151(5): 1084-1101, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33758936

RESUMO

BACKGROUND: The interaction between dietary (and supplementary) divalent ions has been a long-standing issue in human nutrition research. Developing an optimal calcium and iron supplementation recommendation requires detailed knowledge of the potential trade-offs between: 1) the clinical effects of concurrent intake on iron absorption and hematological indices; and 2) the potentially negative effects of separated ingestion on adherence to iron and/or calcium supplements. Human clinical studies have examined the effects of calcium intake on iron status, but there are no meta-analyses or recent reviews summarizing the findings. OBJECTIVES: To synthesize peer-reviewed, human, randomized, and cross-over studies on effects of calcium consumption on iron indices without age, gender, or any other restrictions. METHODS: Weighted mean differences for total, heme, and nonheme iron absorption (%) and serum ferritin (µg/L) were obtained from pooled analysis of the highest daily calcium intake compared to the lowest daily calcium intake. RESULTS: The negative effect of calcium intake was statistically significant in short-term iron absorption studies, but the effect magnitude was low [weighted mean difference (WMD) = -5.57%; 95% CI: -7.09 to -4.04]. The effect of calcium on the iron status was mixed. The inverse dose-response association of calcium intake with the serum ferritin concentration was significant (P value = 0.0004). There was, however, no reduction in the hemoglobin concentration (WMD = 1.22g/L;  95% CI:  0.37-2.07). CONCLUSIONS: The existing body of studies is insufficient to make recommendations with high confidence due to heterogeneity in designs, limitations of ferritin as an iron biomarker, and a lack of intake studies in pregnant women. Prescribing separation of prenatal calcium and iron supplements in free-living individuals is unlikely to affect the anemia burden. There is a need for effectiveness trials comparing the effects of prescribing separated intake to concurrent intake, with functional endpoints as primary outcomes and adherence to each supplement as intermediate outcomes.


Assuntos
Cálcio/administração & dosagem , Cálcio/metabolismo , Ferro/administração & dosagem , Ferro/metabolismo , Estudos Cross-Over , Dieta , Ferritinas/sangue , Humanos
16.
J Orthop Surg Res ; 16(1): 195, 2021 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-33731168

RESUMO

BACKGROUND: Osteoporosis (OP) and osteoarthritis (OA) commonly coexist in postmenopausal females. The decrease in bone density and increase in bone resorption in postmenopausal females with OP may consequently affect the surgical outcome of total knee arthroplasty (TKA). However, clinicians often ignore monitoring the treatment of OP in the perioperative management of TKA. Bone turnover marker (BTM) can timely and accurately reflect bone metabolism to monitor the treatment of OP. The purpose of this study was to investigate the effect of BTM monitoring to guide the treatment of OP in postmenopausal females undergoing TKA. METHODS: Postmenopausal females with OP who underwent primary unilateral TKA were randomly divided into two groups (monitoring group and control group), given oral medication (alendronate, calcitriol, and calcium), and followed for 1 year. In the monitoring group, serum BTMs (C-telopeptide of type I collagen (CTX-I), N-terminal propeptide of type I procollagen (PINP), and 25(OH)D) were assessed preoperatively and repeated postoperatively; alendronate was withdrawn when CTX-I and PINP reached the reference interval; and calcitriol and calcium were withdrawn when 25(OH)D reached the reference interval. In the control group, oral medication was implemented for a uniform duration of 3 months. During the 1-year follow-up, the mean maximum total point motion (MTPM) of the tibial component, bone mineral density (BMD), visual analog scale (VAS) score, range of motion, and Oxford Knee Score (OKS) score were obtained. RESULTS: In the monitoring group, BTM monitoring prolonged the medication duration, but did not cause more adverse reactions than in the control group. The mean MTPM values at 6 m and 12 m in the monitoring group were lower than those in the control group, and the BMD at 12 m in the monitoring group was significantly higher than that in the control group. Patients in the monitoring group had lower VAS scores at 6 m and higher OKS scores at 6 m and 12 m than those in the control group. CONCLUSION: In postmenopausal females with osteoporosis undergoing primary TKA, the application of BTM monitoring to guide the treatment of osteoporosis can enhance bone density, maintain prosthesis stability, and improve surgical outcome. TRIAL REGISTRATION: ChiCTR ChiCTR-INR-17010495 . Registered on 22 January 2017.


Assuntos
Alendronato/administração & dosagem , Artroplastia do Joelho , Conservadores da Densidade Óssea/administração & dosagem , Densidade Óssea , Remodelação Óssea , Calcitriol/administração & dosagem , Cálcio/administração & dosagem , Monitorização Fisiológica , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/tratamento farmacológico , Administração Oral , Idoso , Biomarcadores/sangue , Colágeno Tipo I/sangue , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/metabolismo , Fragmentos de Peptídeos/sangue , Peptídeos/sangue , Pró-Colágeno/sangue , Estudos Prospectivos , Vitamina D/análogos & derivados , Vitamina D/sangue
17.
Bioelectrochemistry ; 140: 107769, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33631416

RESUMO

Biomass of Lactobacillus rhamnosus B 442 was subjected to the continuous electroporation using an electroporator with a flow chamber (length of 10 cm, distance between electrodes 0.25 cm, stream width 0.25 cm, flow speed 10 mL/min) to improve accumulation of calcium, magnesium and zinc in the cells. For all tested ions, the following parameters were applied: voltage of 250 V (E = 1 kV/cm), 570 V (E = 2.28 kV/cm), 950 V (E = 3.8 kV/cm), and 1400 V (E = 5.6 kV/cm, the positive control), a frequency of 10 Hz, a pulse width of 100 µs and 30 electrical pulses. The use of PEF increased the accumulation of magnesium, zinc and calcium by 39, 73 and 162%, respectively, compared to the control. Positive correlation was found between ion accumulation and membrane permeability for zinc and magnesium. For calcium, the initial increase in permeability resulted in higher ion accumulation, but with a further increase of this parameter at 3.8 kV/cm, its decrease was observed caused by a drop in cell viability. Total number of bacteria ranged from 1.67 × 108 (for the cultures supplemented with calcium) to 1.34 × 1012 cfu/mL (for the cultures supplemented with magnesium).


Assuntos
Cálcio/metabolismo , Eletroporação/métodos , Lacticaseibacillus rhamnosus/metabolismo , Magnésio/metabolismo , Zinco/metabolismo , Bioacumulação , Cálcio/administração & dosagem , Magnésio/administração & dosagem , Permeabilidade , Zinco/administração & dosagem
18.
Sci Rep ; 11(1): 235, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33420290

RESUMO

The selective arterial calcium injection (SACI) test is useful for patients with functional pancreatic neuroendocrine tumors (F-PNETs). This study evaluated which patients with F-PNETs would benefit from the SACI test. We retrospectively analyzed the preoperative findings of patients on computed tomography (CT), magnetic resonance imaging (MRI), CT angiography (CTA), and the SACI test. Fourteen patients who underwent pancreatectomy between January 1997 and September 2016 for F-PNETs were evaluated. We classified these patients into groups A, B, and C; group A, one tumor detected by either CT or MRI; group B, multiple tumors detected; and group C, the tumor location was accordant on CT, MRI, and CTA, but the SACI test revealed another tumor. In group A, the tumor was also detected by CTA and the SACI test was positive on calcium injection. In group B, the focus tumor among the multiple tumors was detected by the SACI test. In group C, another tumor was identified by the SACI test, whose location was different from that detected using CT and MRI. The SACI test is more useful for multiple F-PNETs on CT or MRI. If CT or MRI detects a single tumor, the SACI test or CTA may be unnecessary.


Assuntos
Artérias , Cálcio/administração & dosagem , Tumores Neuroendócrinos/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/cirurgia , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
19.
Anaesthesia ; 76(5): 655-664, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33399225

RESUMO

Malignant hyperthermia is defined in the International Classification of Diseases as a progressive life-threatening hyperthermic reaction occurring during general anaesthesia. Malignant hyperthermia has an underlying genetic basis, and genetically susceptible individuals are at risk of developing malignant hyperthermia if they are exposed to any of the potent inhalational anaesthetics or suxamethonium. It can also be described as a malignant hypermetabolic syndrome. There are no specific clinical features of malignant hyperthermia and the condition may prove fatal unless it is recognised in its early stages and treatment is promptly and aggressively implemented. The Association of Anaesthetists has previously produced crisis management guidelines intended to be displayed in all anaesthetic rooms as an aide memoire should a malignant hyperthermia reaction occur. The last iteration was produced in 2011 and since then there have been some developments requiring an update. In these guidelines we will provide background information that has been used in updating the crisis management recommendations but will also provide more detailed guidance on the clinical diagnosis of malignant hyperthermia. The scope of these guidelines is extended to include practical guidance for anaesthetists dealing with a case of suspected malignant hyperthermia once the acute reaction has been reversed. This includes information on care and monitoring during and after the event; appropriate equipment and resuscitative measures within the operating theatre and ICU; the importance of communication and teamwork; guidance on counselling of the patient and their family; and how to make a referral of the patient for confirmation of the diagnosis. We also review which patients presenting for surgery may be at increased risk of developing malignant hyperthermia under anaesthesia and what precautions should be taken during the peri-operative management of the patients.


Assuntos
Dantroleno/uso terapêutico , Hipertermia Maligna/tratamento farmacológico , Relaxantes Musculares Centrais/uso terapêutico , Acidose/tratamento farmacológico , Acidose/etiologia , Temperatura Corporal , Cálcio/administração & dosagem , Dióxido de Carbono/análise , Síndromes Compartimentais/tratamento farmacológico , Síndromes Compartimentais/etiologia , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/terapia , Frequência Cardíaca , Humanos , Hiperpotassemia/tratamento farmacológico , Hiperpotassemia/etiologia , Hipertermia Maligna/complicações , Hipertermia Maligna/diagnóstico , Mioglobinúria/tratamento farmacológico , Mioglobinúria/etiologia , Ventilação Pulmonar , Fatores de Risco , Bicarbonato de Sódio/administração & dosagem
20.
J Oncol Pharm Pract ; 27(5): 1287-1290, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33081580

RESUMO

INTRODUCTION: Denosumab is a human monoclonal antibody antiresorptive agent used for the treatment of bone metastasis in different cancer types, including breast cancer. Hypocalcemia is a known adverse effect of denosumab, and early supplementation plays an important role in the prevention and management of hypocalcemia. CASE REPORT: A 63-year-old female with stage IV estrogen receptor-positive breast cancer with diffuse bone metastasis experienced severe, prolonged hypocalcemia following a single dose of denosumab. The patient also had several risk factors for denosumab-associated hypocalcemia. Despite not receiving additional doses of denosumab, the patient required multiple hospitalizations and outpatient infusions of calcium to resolve her symptomatic hypocalcemia.Management and outcome: Severe hypocalcemia associated with denosumab can be prevented or mitigated by recognizing the risk factors for hypocalcemia and supplementing with vitamin D/calcium. Proposed risk factors include poor renal function, hypoparathyroidism, insufficient calcium intake, and diffuse metastatic bone disease. Studies suggest that early supplementation before starting denosumab can lower this risk. DISCUSSION: Several cases of severe hypocalcemia associated with denosumab have been reported. However, to the authors' knowledge, this is the first report that highlights the importance of early vitamin D/calcium supplementations for a patient with diffuse metastatic bone disease with pre-existing low levels of calcium.


Assuntos
Conservadores da Densidade Óssea/efeitos adversos , Denosumab/efeitos adversos , Hipocalcemia/induzido quimicamente , Neoplasias Ósseas/tratamento farmacológico , Neoplasias da Mama/tratamento farmacológico , Cálcio/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Vitamina D/uso terapêutico
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