RESUMO
The appearance on the skin of herpes virus lesions, concomitantly with the coronavirus disease 2019 (COVID-19) pandemic, leads us to suspect an underlying infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Diagnostic reverse transcriptase polymerase chain reaction tests and immunoglobulin M (IgM) and IgG seroconversion studies have therefore been carried out. We present three cases of herpes virus infections in immunocompetent patients: one of the infections was herpes simplex 1 in a 40-year-old woman, and the other two were herpes varicella-zoster infections in a 62-year-old man and a 25-year-old woman. The patients were in the care of the southern health district of Seville of the SAS (Andalusian Health Service) during the Spanish state of alarm over the COVID-19 pandemic. The SARS-CoV-2 infection was confirmed in only one of the three cases. In this study, we briefly review the etiopathogenic role of the COVID-19 pandemic situation, whereby immunodeficiencies are generated that favour the appearance of other viral infections, such as herpes virus infections.
Assuntos
COVID-19/complicações , Herpes Simples/etiologia , Herpes Zoster/etiologia , Herpesvirus Humano 3/fisiologia , Simplexvirus/fisiologia , Ativação Viral , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Herpes Simples/diagnóstico , Herpes Simples/virologia , Herpes Zoster/diagnóstico , Herpes Zoster/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha/epidemiologiaRESUMO
BACKGROUND: Paediatric obesity and insulin resistance (IR) are potentially reversible inflammatory conditions. Long chain polyunsaturated fatty acids omega-3 (LCPUFA-ω3) show anti-inflammatory and metabolic properties, but their clinical efficacy is unclear. OBJECTIVE: The objective of this study is to evaluate whether supplementation with LCPUFA-ω3 for 3 months reduces insulin resistance and weight to adolescents with obesity. METHODS: Double-blind trial of 366 adolescents with obesity randomly assigned to 1.2-g LCPUFA-ω3 (DO3) or 1-g sunflower oil (DP) daily for 3 months; both groups received an energy-restricted diet. Children attended monthly for anthropometric, dietary, and clinical measurements. Basal and final blood samples were obtained to measure metabolic markers and erythrocytes fatty acids. Regression models were used for analysis. RESULTS: A total of 119 DO3 and 126 DP children completed follow-up. At baseline, 92% of children presented IR, 66% hypertriglyceridemia, 37% low-grade inflammation, and 32% metabolic syndrome. Despite erythrocytes LCPUFA-ω3 increased more in DO3 (Median differences = 0.984 w/w%; 95 IC = 0.47, 1.53, P < 0.001), body weight, insulin, and HOMA changed similarly in both groups at the end of intervention. Adjusting for basal values, changes in weight, insulin, and HOMA was not related with supplementation. CONCLUSIONS: Supplementation with LCPUFA-ω3 does not affect body weight or insulin in adolescents with obesity.
Assuntos
Peso Corporal/efeitos dos fármacos , Ácidos Graxos Ômega-3/uso terapêutico , Resistência à Insulina/fisiologia , Obesidade Infantil/tratamento farmacológico , Adolescente , Biomarcadores/sangue , Peso Corporal/fisiologia , Criança , Suplementos Nutricionais , Método Duplo-Cego , Ácidos Graxos Ômega-3/sangue , Feminino , Seguimentos , Humanos , Masculino , Obesidade Infantil/fisiopatologia , Resultado do TratamentoRESUMO
Introducción: La seguridad de la hernioplasta ambulatoria en adultos es un procedimiento bien establecido. El objetvo de este estudio es mostrarla factbilidad de la Hernioplasta de la pared abdominal y de la región inguino-femoral en forma ambulatoria bajo anestesia local en pacientes de latercera edad y evaluar la tasa de recidiva a mediano y largo plazo.Pacientes y Método: Presentamos nuestra experiencia sobre 547 Pacientes a quienes se le realizó Hernioplasta de la Pared Abdominal y Región Inguino-femoralen una Unidad Independiente de Cirugía Ambulatoria del Insttuto Guatemalteco de Seguridad Social (IGSS), localizada en el Centro de AtenciónMédica Integral para Pensionados (CAMIP), que atende pacientes jubilados de la tercera edad y de los benefciarios del programa de jubilación.Todos los pacientes fueron atendidos de manera ambulatoria y operados con anestesia local durante el período de mayo de 1994 a Julio del 2002. Latécnica quirúrgica dependió del diagnóstco pre-operatorio y en ningún paciente se utlizó malla. Se hizo seguimiento a inmediato y mediano plazo enlas clínicas de los cirujanos y posteriormente se hace seguimiento a 11 años a través de contacto telefónico.Resultados: La tasa de complicaciones fue del 4.3%, siendo el hematoma de la pared abdominal la principal causa. Nuestra tasa de recidiva a cortoplazo fue de 2.93 % (16/547) y 5.55% (13/234) a largo plazo.Conclusiones: La Hernioplasta ambulatoria de la pared abdominal y de la región inguinal bajo anestesia local en pacientes de la tercera edad es unprocedimiento seguro y puede ser reproducible con mínima morbilidad y nula mortalidad.
Background: Safety of ambulatory hernioplasty in adults is a well-established procedure. The aim of this study was to show the feasibility of ambulatoryabdominal wall and inguino-femoral region hernioplasty, under local anesthesia in elderly patents, and assess medium and long term recurrences.Patents and Methods: A total of 547 senior patents from May 1994 to July 2002 underwent ambulatory hernioplasty of the abdominal wall and inguino-femoralregion at the Center for Integral Health Care for Pensioners (CAMIP). All ambulatory surgeries were performed under local anesthesia withan open surgical technique. Mesh was not used in any patent. Immediate, medium-term and long term follow-up was performed to assess long-termrecurrence rate 11 years afer the procedure.Results: Complicaton rate was 4.3%, abdominal wall hematoma was the leading cause of morbidity. Short term recurrence rate was 2.93% (16/547)and long term 5.55% (13/234).Conclusions: Ambulatory hernia repair of abdominal wall and groin region under local anesthesia of senior patents is a safe procedure.
Assuntos
Humanos , Idoso , Anestesia Local , Herniorrafia , Pacientes AmbulatoriaisRESUMO
Lemon growing areas in the north of Argentina have industries that produce concentrated juice, peel and essential oil and generate a significant amount of liquid and solid waste as lemon pulp. In Argentina, despite the potential applications that the pulp has as animal feed and human and industrial raw material, only 10% is used for these purposes and the rest is discarded into the environment causing many ecological and economic problems. There is little information in the literature on biotechnologies for the treatment of this industrial waste. This paper shows that lemon pulp is a suitable substrate to be treated by anaerobic digestion. We obtained 86 and 92% reduction of chemical oxygen demand in a digester with a semi-continuous feed and retention time of 10 and 20 days respectively and a productivity of 0.406 g CH(4)/g VS h. Comparative tests showed that pre-digesting the pulp improved the process of digestion and increased biogas generation by 20%.
Assuntos
Biocombustíveis , Reatores Biológicos , Citrus/metabolismo , Metano/metabolismo , Anaerobiose , Poluição Ambiental/prevenção & controle , Frutas/metabolismoRESUMO
Acute sport exercise leads to a strong stimulation of muscle tissue and a change in the organism energy demands. This study was designed to investigate the effect of oral melatonin supplementation on human physiological functions associated with acute exercise. Immune, endocrine and metabolic parameters were measured in 16 young male football players, who were divided into two groups, an experimental group (supplementation with 6 mg of melatonin administered 30 min prior to exercise) and a control group (placebo without melatonin). They performed a continuous exercise of high intensity (135 beats/min). Samples were collected 30 min before the exercise and 3, 15 and 60 min during the exercise. The results indicated that the acute sport training presented: a) increased lipid peroxidation products (MDA) in both groups, control and experimental, with levels significantly decreased in the group treated with melatonin after 15 and 60 min of high-intensity exercise, b) the total antioxidant activity (TAS) was lower in the control group than in the experimental, the latter showing significant differences at 60 min of high-intensity exercise c) the lipid profile of subjects in the experimental group showed lower triglyceride levels than the control group after 15 and 60 min of high-intensity exercise, d) immunological studies only showed, in the experimental group, an increase in IgA levels at 60 min after the exercise, and finally there were no significant differences between the groups for any of the other variables. In conclusion these results indicated that treatment with melatonin in acute sports exercise reversed oxidative stress, improved defenses and lipid metabolism, which would result in an improvement in fitness.
Assuntos
Exercício Físico/fisiologia , Melatonina/fisiologia , Estresse Oxidativo/fisiologia , Esforço Físico/fisiologia , Administração Oral , Antioxidantes/administração & dosagem , Atletas , Humanos , Imunoglobulina A/sangue , Metabolismo dos Lipídeos/efeitos dos fármacos , Metabolismo dos Lipídeos/fisiologia , Lipídeos/sangue , Masculino , Melatonina/administração & dosagem , Estresse Oxidativo/efeitos dos fármacos , Esforço Físico/efeitos dos fármacos , Futebol/fisiologiaAssuntos
Analgésicos/uso terapêutico , Anestesia Local/métodos , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/cirurgia , Implante de Prótese Vascular/métodos , Hipnóticos e Sedativos/uso terapêutico , Acetaminofen/uso terapêutico , Anestesia Geral/efeitos adversos , Transfusão de Eritrócitos , Fentanila/uso terapêutico , Humanos , Masculino , Midazolam/uso terapêutico , Pessoa de Meia-Idade , Morfina/uso terapêutico , Piperidinas/uso terapêutico , Plasma , Doença Pulmonar Obstrutiva Crônica/complicações , Radiografia Intervencionista , Remifentanil , StentsRESUMO
In vitro evaluation of leishmanicidal activity of aqueous and ethanolic extracts of Maytenus illicifolia against three species of Leishmania. The root extracts showed differential activity against parasites, whereas the aerial part of the extracts was inactive.
Assuntos
Antiprotozoários/farmacologia , Leishmania/efeitos dos fármacos , Maytenus/química , Extratos Vegetais/farmacologia , Raízes de Plantas/química , Animais , Antiprotozoários/química , Componentes Aéreos da Planta/química , Extratos Vegetais/químicaRESUMO
Pacific oysters (Crassostrea gigas) collected on the coast of British Columbia, Canada have occasionally shown cadmium (Cd) concentrations at or above 2 microg g(-1) (wet weight), which has resulted in the loss of some international markets. This study investigated the source and transfer of Cd to oysters by focusing on the role of dissolved and particulate Cd in seawater. Parameters monitored for 1 year at two oyster farm sites on Vancouver Island included: oyster tissue mass and shell length, Cd in oysters, dissolved Cd, particulate Cd, temperature and salinity. Results show that dissolved Cd was the main source of Cd to the oysters and that Cd was mainly concentrated in the gut tissues. A seasonal trend was observed in Cd in oysters, in which levels were lowest during periods of higher temperatures. Results also indicate that the local oceanographic inputs and sediment diagenesis directly affect dissolved Cd and thereby influence the Cd levels in oysters. Particulate matter was not found to be a source of Cd in oysters, and was actually negatively correlated. This was likely due to the uptake of dissolved Cd by phytoplankton and the effect of phytoplankton on oyster tissue mass.
Assuntos
Cádmio/metabolismo , Crassostrea/metabolismo , Poluentes Químicos da Água/metabolismo , Animais , Colúmbia Britânica , Cádmio/análise , Crassostrea/crescimento & desenvolvimento , Monitoramento Ambiental , Sedimentos Geológicos/análise , Fósforo/análise , Salinidade , Estações do Ano , Temperatura , Titânio/análise , Poluentes Químicos da Água/análiseRESUMO
AIM: To derive predictors of good glycaemic control in patients presenting with diabetic ketoacidosis (DKA) followed prospectively in a specialized clinic. METHODS: One hundred and sixty-one adult patients were admitted during a 31-month period and followed for at least 12 months. After 1 year, the patients were classified into three groups: good control (GC) (HbA1c < or = 7%), intermediate control (IC) (HbA1c 7-9%) and poor control (PC) (HbA1c > 9%). Characteristics of patients in the three groups were compared both at baseline and during follow-up. RESULTS: At 12 months, 36% of the patients were classified as GC, 27% as IC and 37% as PC. GC patients had higher fasting serum C-peptide levels 0.7 +/- 0.54 compared to 0.38 +/- 0.29 and 0.16 +/- 0.21 nmol/l, respectively, for the IC and PC patients (p < 0.0001). A higher proportion GC patient had a C-peptide level greater than 0.33 nmol/l than that for IC and PC patients (86, 61 and 19%, respectively; p < 0.0001). Exogenous insulin was safely discontinued in 50, 30 and 3% of patients, respectively, in the GC, IC and PC groups (p < 0.0001). Compliance with life-style interventions was higher in the GC than that in IC and PC patients (87, 41 and 5%, respectively; p < 0.0001). In the logistic regression analysis, predictors of good glycaemic control were having baseline fasting serum C-peptide value > or =0.33 mmol/l, OR: 3.01 (95% CI 1.07-8.55, p = 0.03) and compliance with life-style interventions OR 12.66 (95% CI 3.73-51.57, p = 0.0001). CONCLUSION: Among adult patients with DKA, significant predictors of good glycaemic control are preserved beta-cell function and compliance with life-style modifications.
Assuntos
Peptídeo C/análise , Cetoacidose Diabética/prevenção & controle , Hemoglobinas Glicadas/análise , Cooperação do Paciente , Adulto , Biomarcadores/sangue , Cetoacidose Diabética/sangue , Cetoacidose Diabética/tratamento farmacológico , Feminino , Seguimentos , Humanos , Hipoglicemiantes/uso terapêutico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Valor Preditivo dos Testes , Estudos Prospectivos , Resultado do TratamentoRESUMO
The authors retrospectively analyzed the long-term outcome of 67 patients over 1 year of age at diagnosis with high-risk neuroblastoma (stage 4 or stage 3 with N-myc amplification) who were treated with megatherapy and stem cell rescue from 1984 to 1998. Median age at transplant was 4 years (range 1.6-15 years). The source of cells was peripheral stem cells in 29 and bone marrow in 38 patients. In 12 patients, an in vitro purging of bone marrow harvest was performed. Most patients were conditioned with melphalan, BCNU, and VM-26. After transplant 19 patients received complementary treatment with IL-2 (16) or 13-cis-retinoic acid (3). Six patients (8%) died from transplant-related toxicity and 39 from disease progression. Three patients were alive with active disease at the time of analysis. Nineteen patients are alive and disease-free at a median follow-up of 104 months. Five-year event-free survival is 0.30. Survival of patients who received a purged graft was not significantly better than the rest. Post-transplant complementary treatment significantly improved overall and event-free survival (p = .01 and p = .04, respectively).
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Neuroblastoma/terapia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Neuroblastoma/mortalidade , Estudos Retrospectivos , Transplante AutólogoRESUMO
AIM: To describe two cases of diabetic ketoacidosis in newly diagnosed type 1- and type-2-diabetic individuals associated with Metabolife-356. METHODS: We report the acute hospitalizations and clinical courses of two individuals with diabetic ketoacidosis taking Metabolife-356. RESULTS: Both patients presented without a previous diagnosis of diabetes mellitus. One patient clinically has type 1 diabetes (positive islet cell antibodies and subnormal pancreatic beta cell function to glucagon stimulation) and is treated with insulin. The second patient, after 5 days of treatment with intravenous insulin of up to 25 units per hour, is now treated with oral medications. Several possible mechanisms may exist, including the increases in catecholamines and in blood glucose after ingestion of the ingredients of these supplements. Recent clinical trial data shows an increase in blood glucose (in non-diabetics) with these supplements despite significant weight loss at 8 weeks, although no association with diabetes mellitus has been shown in these closely monitored studies. CONCLUSIONS: Although no precipitating factor of diabetic ketoacidosis was found in these individuals, the dietary supplement Metabolife cannot be established as a precipitant. However, patients with diabetes should take this supplement only after consultation with their health care provider, as stated on the product label. Most individuals using this supplement meet the current criteria for screening to detect undiagnosed diabetes mellitus and should consider these tests.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Cetoacidose Diabética/etiologia , Suplementos Nutricionais/efeitos adversos , Doença Aguda , Adolescente , Adulto , Cetoacidose Diabética/tratamento farmacológico , Hospitalização , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , MasculinoRESUMO
We have evaluated the efficacy of administering recombinant human erythropoietin (rh-Epo) to 11 healthy bone marrow donors weighing less than 30 kg. Three weeks before harvesting, the donors received 100 units/kg/day rh-Epo subcutaneously and oral iron supplementation (2.5 mg/kg twice daily). Six children with hematocrit values below the normal ranges for their ages after bone marrow harvesting received 150 units/kg rh-Epo three times a week for 2 weeks and oral iron supplementation at the same dose. No rh-Epo side-effects were observed. Hematocrit values before harvesting increased to between 5.7 and 18.5 (mean 10.6 +/- 1.2) above the baseline values (P = 0.0001). Hematocrit after harvesting decreased to between 4 and 19.5% (mean, 11.1) below the day 0 pre-harvest values. On day + 15 all but one patient had a hematocrit value > or = baseline value. No patient required transfusion during or after bone marrow harvest. Our results show that rh-Epo administration can avoid transfusion and has no side-effects in low weight child bone marrow donors.
Assuntos
Transplante de Medula Óssea , Medula Óssea/efeitos dos fármacos , Eritropoetina/administração & dosagem , Doadores de Tecidos , Administração Cutânea , Peso Corporal , Medula Óssea/patologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Proteínas RecombinantesRESUMO
Production of pectinesterase and polygalacturonase by Aspergillus niger was studied in submerged and solid-state fermentation systems. With pectin as a sole carbon source, pectinesterase and polygalacturonase production were four and six times higher respectively in a solid state system than in a submerged fermentation system and required a shorter time for enzyme production. The addition of glucose increased pectinesterase and polygalacturonase production in the solid state system but in submerged fermentation the production was markedly inhibited. A comparison of enzyme productivities showed that those determined for pectinesterase and polygalacturonase with pectin as a carbon source were three and five times higher by using the solid state rather than the submerged fermentation system. The productivities of the two enzymes were affected by glucose in both fermentation systems. The membranes of cells from the solid state fermentation showed increased levels of C18:1, C16:0 and C18:0 fatty acids. Differences in the regulation of enzyme synthesis by Aspergillus niger depended on the fermentation system, favoring the solid state over the submerged fermentation for pectinase production.
Assuntos
Aspergillus niger/enzimologia , Hidrolases de Éster Carboxílico/biossíntese , Pectinas/metabolismo , Poligalacturonase/biossíntese , Biomassa , Membrana Celular , Centrifugação , Cromatografia Líquida de Alta Pressão , Ácidos Graxos/biossíntese , Fermentação , Glucose/farmacocinética , Ácidos Hexurônicos/metabolismo , Pectinas/farmacocinéticaAssuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Fluoruracila/uso terapêutico , Pterígio/tratamento farmacológico , Antimetabólitos Antineoplásicos/administração & dosagem , Quimioterapia Adjuvante , Método Duplo-Cego , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pterígio/etiologia , Pterígio/cirurgia , RecidivaRESUMO
We report a simple method using copy RNA (cRNA) internal standards for quantitative Northern hybridization. This was accomplished by synthesis of a full-length or "half"-length cRNA and mixing these RNA internal standards with samples to be tested for the abundance of a given mRNA. Both full-length and truncated cRNAs are detected in Northern analysis by the nucleic acid detection probe (which can be labeled with 32P or biotin), and the known amount of the truncated cRNA is compared to the homologous mRNA present in the specimen being examined. We demonstrate the usefulness of this method by measuring the expression of renin in rat kidney with ureteral obstruction and angiotensin II receptor (AT1-R) mRNA in kidneys from spontaneously hypertensive rats. It was found that this method of preparing cRNA internal standards successfully controlled for variables (such as differences in loading, transfer and hybridization efficiency) that often frustrate efforts to use Northern analysis as a quantitative tool and enabled direct estimation of absolute mRNA amount present in samples. This technique may have wide applicability and permit a more quantitative use of Northern analysis.
Assuntos
Northern Blotting/métodos , RNA Mensageiro/análise , RNA/análise , Animais , RNA Complementar , Ratos , Receptores de Angiotensina/genética , Padrões de Referência , Renina/genéticaRESUMO
The purpose of the present study was to determine whether the administration of a biosynthetic human growth hormone was capable of enhancing the efficacy of total parenteral nutrition. Patients (n = 38) who had undergone major gastrointestinal surgery were randomly divided into two groups. Group I (n = 20) treated only with PN, and Group II (n = 18) treated as in Group I plus human growth hormone (4 IU daily). Our study shows that the administration of human growth hormone produces a statistically significant increase in serum levels of growth hormone, somatomedin-C, transferrin, albumin and total proteins. It also causes a positive nitrogen balance from the first 24 hours onward. These findings suggest that the administration of human growth hormone produces an increase in protein synthesis, perhaps through somatomedin-C as mediator.
Assuntos
Hormônio do Crescimento/uso terapêutico , Nutrição Parenteral Total , Cuidados Pós-Operatórios/métodos , Adulto , Idoso , Proteínas Sanguíneas/efeitos dos fármacos , Terapia Combinada , Gastroenteropatias/cirurgia , Hormônio do Crescimento/sangue , Humanos , Pessoa de Meia-Idade , Proteínas Recombinantes/uso terapêuticoAssuntos
Osso e Ossos/metabolismo , Cálcio/urina , Proteínas Alimentares/administração & dosagem , Hormônio Paratireóideo/metabolismo , Vitamina D/metabolismo , Animais , Peso Corporal , Osso e Ossos/ultraestrutura , Cálcio/metabolismo , Rim/metabolismo , Masculino , Microscopia Eletrônica de Varredura , Fósforo/urina , Ratos , Ratos Endogâmicos WF , Ureia/urinaRESUMO
The handling of an acute oral calcium load in 22 men with recurrent calcium stone disease was studied before and after diuretic therapy. As a group, the patients had marginal hypercalciuria (150 mg calcium per gram of creatinine in a 24-hr urine collection). Metolazone, a diuretic with an action in the cortical thick ascending limb of Henle's loop, was given in oral daily doses of 5.0 mg for periods of 9 to 34 mo. An oral calcium load induced a rapid rise in urine calcium exeretion, which was blunted markedly by metolazone. Further analysis of the subjects revealed that one group (11 subjects) had higher baseline 24-hr calcium excretion levels and higher parathyroid hormone (PTH) than the others. The effect of metolazone in reducing the calciuric response was significant only in this group. Thus, while long-term treatment with metolazone inhibited the rise in urinary calcium excretion elicited by an oral calcium load, the effect was significant only in patients who had high baseline urinary calcium and PTH values. The reduction in calcium excretion in response to an acute calcium challenge may explain in part the beneficial effects of cortical diluting segment diuretics in recurrent stone formers.
Assuntos
Cálcio/urina , Diuréticos/uso terapêutico , Metolazona/uso terapêutico , Cálculos Urinários/tratamento farmacológico , Creatinina/urina , Humanos , Masculino , Hormônio Paratireóideo/sangue , Fósforo/sangue , RecidivaRESUMO
The role of parathyroid hormone (PTH) and of Ca(++) in the regulation of bicarbonate absorption (RHCO(3)) and its response to extracellular volume expansion (VE) was studied in HCO(3) (-)-loaded dogs.VE lowered RHCO(3) in both intact (from 24.8 to 22.0 mmol/liter GFR, P < 0.01) and thyroparathyroid-ectomized (TPTX) (from 24.5 to 18.0 mmol/liter GFR, P < 0.001) dogs; glomerular filtration rate (GFR) and filtered HCO(3) (-) did not change. Both groups showed a significant increase in the fractional excretion of sodium (C(Na) x 100/GFR), calcium (C(Ca) x 100/GFR), and chloride (C(Cl) x 100/GFR) and a decrease in phosphorus reabsorption. Fractional clearance of phosphate (C(P) x 100/GFR) rose in both groups but did not achieve significance. Infusion of purified parathyroid extract (PTE) decreased RHCO(3) in intact dogs (from 24.6 to 22.5 mmol/liter GFR, P < 0.025) and in TPTX dogs (from 26.9 to 22.6 mmol/liter GFR, P < 0.05). No change was noted in GFR, renal blood flow (RBF), filtered HCO(3) (-), or fractional excretion of sodium, calcium, or chloride in either group. There was a significant increase in fractional phosphorus clearance and a decrease in phosphorus reabsorption in each group. Infusion of Ca(++) raised ultrafilterable Ca(++) from 5.7 to 7.9 mg/100 ml in intact and from 4.9 to 7.2 mg/100 ml in TPTX dogs; RHCO(3) increased in intact (from 22.9 to 26.9 mmol/liter GFR, P < 0.025) and in TPTX dogs (from 26.6 to 28.6 mmol/liter GFR, P < 0.05). The GFR, RBF, and the fractional excretion of sodium, chloride, and calcium did not change in either group. The reabsorbed phosphate increased in both groups, and fractional phosphorus clearance fell in the intact group but did not change significantly in the TPTX group. Superimposition of PTE on hypercalcemia in TPTX dogs resulted in a decrease in RHCO(3) (from 27.3 to 23.9 mmol/liter GFR, P < 0.001), which was accompanied by an increase in the fractional excretion of phosphate and a decrease in the reabsorbed phosphate. In this group of TPTX dogs hypercalcemia caused a drop in RBF from 135.6 to 105.8 ml/min with no change in GFR. The RBF returned to control value with PTE infusion. IT IS CONCLUDED THAT: (a) the lowering of RHCO(3) by VE is not dependent solely on stimulation of PTH by the lowered Ca(++), (b) PTE acts directly on the renal tubules to lower RHCO(3), (c) Ca(++) enhances RHCO(3) and this effect is exerted in the absence of PTH and calcitonin, (d) neither the effects of Ca(++) nor of PTH appear to be mediated by altered hemodynamics, although this cannot be excluded in Ca(++)-infused TPTX dogs, (e) Ca(++) enhanced phosphate reabsorption in the absence of PTH; this may be a specific effect of hypercalcemia on phosphate reabsorption or the nonspecific consequence of the rise in serum phosphorus.