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1.
Pol Merkur Lekarski ; 47(280): 128-133, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31760394

RESUMO

As a long-term multisystem disorder, chronic heart failure (CHF) can gravely affect on bone metabolism, prompting a severe bone loss and increasing predisposition to fractures and the development of osteoporosis. AIM: The aim of the study was to investigate whether in patients with CHF a therapy combining calcium and vitamin D3 supplement (Calcemin Advance) and calcitonin (Miacalcic) can help to prevent and treat osteopenia and osteoporosis. MATERIALS AND METHODS: Using dual-energy X-ray absorptiometry, we measured bone mineral density (BMD) in 59 patients with coronary heart disease (CHD) complicated with chronic heart failure. RESULTS: Our results suggest that following the standard treatment protocol of CHD complicated with CHF resulted in significant BMD loss in the lumbar vertebrae, approaching the level of osteopenia. After taking a calcium and vitamin D3 supplement, patients with this heart disorder had significant increase of BMD in the lumbar vertebrae and in the femoral bone. Patients with CHD complicated with CHF and diagnosed osteoporosis taking Calcemin Advance did not experience osteoprotection outcome, rather their BMD continued to decrease. However, combined therapy with Miacalcic and Calcemin Advance was effective in significantly increasing L1, L2 - L4 BMD in these patients. CONCLUSIONS: We demonstrated effectiveness of using a calcium and vitamin D3 supplement, for patients with CHD complicated with CHF and diagnosed osteopenia. Patients with CHD complicated by CHF and diagnosed osteoporosis did not experience osteoprotective action when using Calcemin Advance. However, in these patients L1 lumbar vertebra BMD significantly increased after the combined therapy.


Assuntos
Densidade Óssea , Colecalciferol , Doença das Coronárias , Insuficiência Cardíaca , Calcitonina , Cálcio/administração & dosagem , Colecalciferol/administração & dosagem , Humanos , Vértebras Lombares
2.
Am Surg ; 85(10): 1171-1174, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657318

RESUMO

Avoiding excess fluid administration is necessary when managing critically ill surgical patients. The aim of this study was to delineate the current practices of IV electrolyte (IVE) replacement in a surgical ICU and quantify their contribution to the fluid balance (FB) status. Patients admitted to the surgical ICU over a six-month period were reviewed. Patients undergoing dialysis and those with ICU stay <72 hours were excluded. A total of 248 patients were included. The median age was 60 years, and 57 per cent were male. Overall, 1131 patient ICU days were analyzed. The median daily FB was 672 mL. IVEs were administered in 62 per cent of ICU days. In days that IVEs were used, negative FB was significantly less likely to be achieved (62% vs 69%, P = 0.02). The most commonly administered IVE was calcium (32% of ICU days); however, the largest volume of IVE was administered in the form of phosphorus (median 225 mL). Diuretics were administered in 17 per cent of ICU days. Patients who received diuretics were significantly more likely to receive IVE (70% vs 61%, P = 0.02). Administration of IVE may contribute to the daily positive FB of surgical ICU patients. Implementation of practices that can ameliorate this effect is encouraged.


Assuntos
Estado Terminal , Eletrólitos/administração & dosagem , Infusões Intravenosas/métodos , Procedimentos Cirúrgicos Operatórios , Equilíbrio Hidroeletrolítico , Cálcio/administração & dosagem , Diuréticos/administração & dosagem , Feminino , Hidratação/efeitos adversos , Hidratação/métodos , Humanos , Infusões Intravenosas/estatística & dados numéricos , Unidades de Terapia Intensiva , Sulfato de Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Fósforo/administração & dosagem , Potássio/administração & dosagem , Estudos Retrospectivos
3.
Medicine (Baltimore) ; 98(40): e17421, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577757

RESUMO

Regional citrate anticoagulation (RCA) was recommended as the first treatment option for adults by the Kidney Disease Improving Global Outcomes Kidney Foundation in 2012, for the characteristic of sufficient anticoagulation in vitro, but almost no anticoagulation in vivo. Traditionally, the substitute for RCA is calcium-free. This study investigated a simplified protocol of RCA for continuous hemofiltration (CHF) in children using a commercially available substitute containing calcium.An analytical, observational, retrospective study assessed 59 pediatric patients with 106 sessions and 3580 hours of CHF. Values before and after treatment were compared, including Na, ionic calcium (iCa) and HCO3 concentrations, pH, and the ratio of total calcium to iCa (T/iCa). In addition, in vivo and in vitro iCa, treatment time, sessions with continuous transmembrane pressure >200 mm Hg, and sessions with clotting and bleeding were recorded.The average treatment time was 33.8 ±â€Š10.1 hours. In vitro, 88.5% of iCa achieved the target (0.25-0.35 mmol/L), and in vivo, 95.4% of iCa achieved the target (1.0-1.35 mmol/L). There were 8 sessions with a transmembrane pressure >200 mm Hg and 3 sessions with filters clotted. After treatment, there were 2, 1, and 2 sessions with T/iCa > 2.5 (implying citrate accumulation), iCa < 0.9 mmol/L, and iCa > 1.35 mmol/L. No sodium disorders were recorded. There were fewer cases of acidemia and more cases of alkalemia after treatment compared to before.RCA-CHF with a substitute containing calcium and close monitoring could be a safe and effective treatment for children. In addition, the calcium test site in vitro and the adjustment of citrate should be given strict attention.


Assuntos
Lesão Renal Aguda/metabolismo , Lesão Renal Aguda/terapia , Anticoagulantes/farmacocinética , Cálcio/farmacocinética , Ácido Cítrico/farmacocinética , Hemofiltração , Lesão Renal Aguda/etiologia , Anticoagulantes/administração & dosagem , Cálcio/administração & dosagem , Criança , Pré-Escolar , Ácido Cítrico/administração & dosagem , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
4.
Best Pract Res Clin Rheumatol ; 33(2): 290-300, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31547984

RESUMO

In view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements. Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teriparatide should be considered. Adequate calcium and vitamin D are needed in all patients, together with appropriate nutrition, including adequate protein intake.


Assuntos
Acidentes por Quedas/prevenção & controle , Fraturas Ósseas/prevenção & controle , Necessidades Nutricionais , Prevenção Secundária/métodos , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Masculino , Vitamina D/administração & dosagem
5.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 459-463, ago.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182865

RESUMO

El hipoparatiroidismo es la complicación más frecuente tras la tiroidectomía total. Se define por la presencia de hipocalcemia con unos niveles de hormona paratiroidea (PTH) bajos o inadecuadamente normales. La hipocalcemia aguda es una complicación potencialmente grave. Su tratamiento se basa, según la gravedad del cuadro, en la administración de calcio por vía oral o intravenosa, pudiendo requerir asimismo calcitriol oral. El riesgo de hipocalcemia sintomática tras una tiroidectomía es muy bajo si la PTH postoperatoria desciende menos del 80% respecto de la preoperatoria. Estos pacientes podrían ser dados de alta sin tratamiento, aunque los umbrales son variables entre laboratorios y recomendamos extremar la vigilancia en los casos de riesgo aumentado (enfermedad de Graves, grandes bocios, reintervenciones o constancia de la extirpación de alguna paratiroides). El tratamiento a largo plazo busca controlar los síntomas manteniendo la calcemia en el límite bajo de la normalidad, vigilando el producto calcio-fósforo y la aparición de hipercalciuria


Hypoparathyroidism is the most common complication after total or completion thyroidectomy. It is defined as the presence of hypocalcemia accompanied by low or inappropriately normal parathyroid hormone (PTH) levels. Acute hypocalcemia is a potential lethal complication. Hypocalcemia treatment is based on endovenous or oral calcium supplements as well as oral calcitriol, depending on the severity of the symptoms. The risk of clinical hypocalcemia after bilateral thyroidectomy is considered very low if postoperative intact PTH decrease less than 80% with respect to preoperative levels. These patients could be discharged home without treatment, although this threshold may vary between institutions, and we recommend close surveillance in cases with increased risk (Graves disease, large goiters, reinterventions or evidence of parathyroid gland removal). Long-term treatment objectives are to control the symptoms and to keep serum calcium levels at the lower limit of the normal range, while preserving the calcium phosphate product and avoiding hypercalciuria


Assuntos
Humanos , Consenso , Hipoparatireoidismo/complicações , Hipoparatireoidismo/epidemiologia , Tireoidectomia/métodos , Tireoidectomia/efeitos adversos , Cálcio/administração & dosagem , Cuidados Pré-Operatórios/métodos , Liberação de Cirurgia/normas
6.
Lupus ; 28(10): 1224-1232, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31409184

RESUMO

OBJECTIVE: Juvenile-onset systemic lupus erythematosus (JoSLE) is associated with low bone mass for age and fractures; nevertheless, risk factors for bone impairment are poorly understood. The aim of this study was to evaluate risk factors for bone mass loss in JoSLE patients. METHODS: Forty-nine female JoSLE patients were evaluated at baseline and after a 3.5-year follow-up regarding clinical, laboratory (including bone turnover markers), areal bone mineral density (aBMD) and bone microarchitecture parameters using high-resolution peripheral quantitative computed tomography (HR-pQCT). Based on the difference between final and baseline aBMD value, the patients were divided into three groups: aBMD gain (BG), aBMD loss (BL) and aBMD no change (NC). RESULTS: The mean patient age was 18.7 ± 3.3 years. Sixty-one percent of patients presented with aBMD gain, 18.4% aBMD loss, and 20.4% remained stable during this follow-up period. Comparing the BL with the BG group, there was a higher frequency of alcohol consumption (p = 0.009), a higher frequency of inadequate calcium intake (p = 0.047) and lower levels of baseline procollagen type 1 amino-terminal propeptide (P1NP) (p = 0.036) in the BL group. Moreover, worsening of HR-pQCT parameters trabecular volumetric density (p = 0.003) and cortical thickness (p = 0.009) was observed in the BL group. In addition, a higher frequency of renal activity was observed comparing the BL + NC with the BG group (p = 0.036). CONCLUSIONS: This is the first longitudinal study that has analyzed the risk factors of bone loss in JoSLE patients. The authors emphasize the importance of evaluating lifestyle habits and renal disease activity in these young women. Furthermore, this study suggests that trabecular and cortical compartments deteriorated, and low levels of P1NP may be a predictor of bone impairment in JoSLE.


Assuntos
Densidade Óssea/fisiologia , Osso e Ossos/patologia , Lúpus Eritematoso Sistêmico/complicações , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Osso e Ossos/metabolismo , Cálcio/administração & dosagem , Feminino , Seguimentos , Humanos , Nefropatias/etiologia , Nefropatias/fisiopatologia , Estilo de Vida , Estudos Longitudinais , Lúpus Eritematoso Sistêmico/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X , Adulto Jovem
7.
Transplant Proc ; 51(9): 3186-3188, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31371218

RESUMO

INTRODUCTION: Parathyroid allotransplantation is one of the methods used in the treatment of permanent hypoparathyroidism. We present a patient who underwent continuous intravenous (IV) calcium replacement therapy because of permanent hypoparathyroidism after total thyroidectomy. CASE PRESENTATION: A 47-year-old woman who underwent a total thyroidectomy with a multinodular goiter developed hypoparathyroidism and hypocalcemia 1 week after discharge. The patient was started on daily oral calcitriol, magnesium effervescent, vitamin D, and IV calcium gluconate and was unable to be discharged because the IV calcium could not be stopped. After 3.5 years, 50×106 parathyroid cells were transplanted by injecting the cells into the left deltoid muscle of the patient. The immunosuppression of the patient, who used 20-mg methylprednisolone for the first month, was completely discontinued. RESULTS: No complications were observed in the patient after transplantation. The parenteral calcium replacement of the patient was progressively interrupted after transplantation. The patient's serum calcium level was 7.8 mg/dL and the PTH level was 6.9 pg/mL without IV calcium replacement at 12 weeks after transplantation, and the patient was discharged using oral ionized calcium. In the 10-week follow-up after discharge, the need for IV calcium was not observed in the patient. CONCLUSION: Parathyroid allotransplantation is a simple, fast, and cost-effective method that should be tried in patients with persistent hypoparathyroidism, especially those who have to take IV calcium replacement, because its cost is much cheaper than standard medical care, its morbidity is much more limited, and it increases the patient's quality of life.


Assuntos
Hipoparatireoidismo/cirurgia , Glândulas Paratireoides/transplante , Tireoidectomia/efeitos adversos , Administração Intravenosa , Cálcio/administração & dosagem , Feminino , Humanos , Hipocalcemia/etiologia , Hipoparatireoidismo/etiologia , Pessoa de Meia-Idade , Alta do Paciente , Transplante Homólogo/métodos
8.
J Anim Sci ; 97(10): 4182-4192, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31425585

RESUMO

This study evaluated the effects of supplementing Ca salts of soybean oil (CSSO) to beef steers at 2 mo of age via creep-feeding, and/or during a 40-d preconditioning period on performance and carcass development responses. A total of 64 steers were enrolled in this study over 2 yr (32 steers per year), with 4 periods each year: creep-feeding (CF; day 0 to 60), preweaning (day 61 to weaning on day 124 and 127 of year 1 and 2, respectively), preconditioning (PC; day 132 to 172 in year 1 and day 135 to 175 of year 2), and feedlot (feedlot arrival to slaughter, day 173 to 378 in year 1 and day 176 to 385 in year 2). On day 0 steers were ranked by body weight (BW) and age (114 ± 4 kg of BW; 66.1 ± 0.9 d of age) and allocated to 1 of 16 pens. Pens were randomly assigned to receive CSSO during CF (80 g/d per steer) and/or PC (150 g/d per steer) in a 2 × 2 factorial arrangement of treatments. During CF and PC, nonsupplemented steers (CON) were provided an isolipidic prilled saturated fat supplement. Steer BW was recorded on day 0, 60, at weaning, and prior to feedlot shipping. Carcass traits were recorded upon slaughter. On day 0, 60, at weaning, prior to feedlot shipping, and during the feedlot period, blood samples were collected and longissimus muscle (LM) biopsies were collected. On day 60, steers that received CSSO during CF had greater (P < 0.01) plasma concentrations of linoleic and ω-6 compared with CON (CF treatment × day; P ≤ 0.05). Steers that received CSSO during PC had greater (P < 0.01) plasma concentrations of linoleic, ω-6, and total fatty acids compared with CON at feedlot shipping (PC treatment × day; P ≤ 0.05). A PC treatment × day interaction was also detected (P = 0.04) for mRNA expression of peroxisome proliferator-activated receptor gamma (PPAR-γ), which was greater (P = 0.04) at feedlot shipping for steers receiving CSSO during PC. Interactions between CF treatment × day were detected (P ≤ 0.01) for mRNA expression of adipocyte fatty acid-binding protein, fatty acid synthase, PPAR-γ, and stearoyl-CoA desaturase, which were greater (P ≤ 0.02) in the feedlot in steers receiving CSSO during CF. No treatment differences were detected for (P ≥ 0.18) performance or carcass traits, including marbling and backfat thickness. Results from this study suggest that supplementing CSSO to suckled beef steers via creep-feeding upregulated mRNA expression of the adipogenic genes investigated herein later in life. These outcomes, however, were not translated into improved carcass quality.


Assuntos
Cálcio/administração & dosagem , Bovinos/fisiologia , Suplementos Nutricionais/análise , Ácidos Graxos/metabolismo , Óleo de Soja/administração & dosagem , Ração Animal/análise , Animais , Peso Corporal , Bovinos/crescimento & desenvolvimento , Dieta/veterinária , Masculino , Sais , Desmame
9.
Dtsch Med Wochenschr ; 144(16): 1120-1124, 2019 08.
Artigo em Alemão | MEDLINE | ID: mdl-31416103

RESUMO

Adequate intake of vitamin D and calcium are fundamental for the treatment of osteoporosis. A normal vitamin D status is required for optimal intestinal calcium absorption. However, general calcium and vitamin D supplementation is not sufficient for prevention of osteoporotic fractures in persons older than 50 years. Nevertheless, vitamin D deficiency should be avoided and corrected. In particular, parts of the population with increased risk for vitamin D deficiency (immobilized or older individuals, swarthy, migrants) should be tested. Secondary causes of vitamin D deficiency should be identified and treated.


Assuntos
Conservadores da Densidade Óssea , Osteoporose , Vitamina D , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/administração & dosagem , Cálcio/uso terapêutico , Suplementos Nutricionais , Humanos , Osteoporose/tratamento farmacológico , Osteoporose/fisiopatologia , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico , Deficiência de Vitamina D
10.
Adv Exp Med Biol ; 1155: 349-358, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31468413

RESUMO

Taurine is a ß-amino acid found most broadly distributed in human body, abundant in animal foods, and has an antioxidative function. Current nutritional intake and dietary habits of children in elementary schools show low level of the intake of vegetable foods and high level of the intake of processed foods and fast foods; this necessitates the emphasis of the intake of antioxidative nutrients for children. On account of the less consumption of vegetable foods as a main source of antioxidative nutrients for elementary school children, animal foods containing abundant amount of taurine can be preferably taken as an alternative foods therefor. Many previous studies have reported the protein intake of the children in elementary schools so far. However, the studies, reported the intake of taurine of elementary school children, are few. Thus, this study analyzed taurine and nutrients intake for children in Daegu, Korea. The average daily energy intake of the children was 153 ± 155 mg/day. The mean taurine intake values are followed; 27.6 ± 11.6 mg/day in the Q1 group, 61.2 ± 10.0 mg/day in the Q2 group, 137.7 ± 51.1 mg/day in the Q3 group, and 385.9 ± 123.6 mg/day in the Q4 group (p < .001). Q3 and Q4 groups showed significantly higher level of the intake of vitamin D, vitamin B12, Calcium, and folate than those of Q1 and Q2 groups. In the study, foods that affected the intake of taurine were as followed; fish and shellfish (79%), meat (14%), seaweed (5%), and other food products (2%).As a consequence, Taurine intake appears to be affected by seafood intake, and if seafood is consumed primarily, the amount of energy intake would be appropriate and will contribute to the increase of intakes of taurine, calcium and vitamin D.


Assuntos
Dieta , Ingestão de Energia , Taurina/administração & dosagem , Cálcio/administração & dosagem , Criança , Humanos , Nutrientes/administração & dosagem , República da Coreia , Alimentos Marinhos , Vitamina D/administração & dosagem
11.
Actual. osteol ; 15(2): 94-102, mayo - ago. 2019. tab.
Artigo em Espanhol | LILACS | ID: biblio-1048478

RESUMO

El propósito de la terapia en el desorden del metabolismo óseo mineral asociado a la enfermedad renal crónica (IRC) consiste en restaurar el balance mineral, y, en la osteoporosis, mantener o aumentar la masa ósea. Ambas terapias tratan de evitar la fractura ósea. La mayoría de los osteoactivos están contraindicados en la insuficiencia renal crónica avanzada (estadios 4 y 5), y las terapias son empíricas. Algunos autores opinan que sin anomalías bioquímicas del desorden del metabolismo óseo mineral asociado a la enfermedad renal crónica avanzada se podría intentar el tratamiento estándar para la osteoporosis. Antes de intentar la terapia osteoactiva se debe corregir el desorden mineral óseo que pudiera presentarse asociado a la IRC, y en la indicación del tipo de osteoactivo se sugiere seleccionar al paciente según su estado óseo. Se aconseja que la administración de los antirresortivos se realice a dosis menores con respecto a los que tienen mejor función renal junto con aportes adecuados de calcio y vitamina D, antes y durante el tratamiento para prevenir el riesgo de severas hipocalcemias y un efecto óseo excesivo. Se presenta el caso clínico de una mujer de 65 años, con diagnóstico de osteoporosis de etiología multifactorial, fractura de pelvis, múltiples fracturas vertebrales e insuficiencia renal crónica avanzada, entre otras comorbilidades, y probable enfermedad ósea adinámica. Recibió inicialmente terapia con teriparatide y luego con denosumab, complicándose con hipocalcemia asintomática. (AU)


The purpose of therapy for the bone mineral metabolism disorder associated with chronic kidney disease is to restore the mineral balance; and to maintain or increase bone mass in osteoporosis. The goal of both types of therapy is to avoid bone fractures. Most antiosteoporotic drugs are contraindicated in advanced chronic renal failure (CRF) stages 4 and 5, and the therapies are empirical. Some authors believe that without biochemical abnormalities of the mineral bone metabolism disorder associated with advanced chronic kidney disease, standard treatment for osteoporosis could be attempted. Before attempting antiosteoporotic therapy, the bone mineral disorder that may be associated with CRF must be corrected, and in the indication of the type drug it is suggested that the patient be selected according to their bone status. It is advised that the administration of anti-resorptives be performed at lower doses in individuals with poor renal function compared to those with better renal function together with adequate calcium and vitamin D, before and during treatment to prevent the risk of severe hypocalcemia, and an excessive bone effect. We present the clinical case of a 65-year-old woman with a diagnosis of osteoporosis of multifactorial etiology, pelvic fracture, multiple vertebral fractures and advanced chronic renal failure, among other comorbidities and probable adynamic bone disease. The patient received initial therapy with teriparatide and followed by denosumab administration and exhibited asymptomatic hypocalcemia. (AU)


Assuntos
Humanos , Feminino , Idoso , Distúrbio Mineral e Ósseo na Doença Renal Crônica/tratamento farmacológico , Fraturas Ósseas/prevenção & controle , Osteoporose/terapia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/complicações , Distúrbio Mineral e Ósseo na Doença Renal Crônica/metabolismo , Distúrbio Mineral e Ósseo na Doença Renal Crônica/terapia , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico , Cálcio/administração & dosagem , Cálcio/uso terapêutico , Alendronato/uso terapêutico , Teriparatida/administração & dosagem , Teriparatida/efeitos adversos , Teriparatida/uso terapêutico , Difosfonatos/administração & dosagem , Difosfonatos/efeitos adversos , Difosfonatos/uso terapêutico , Cinacalcete/uso terapêutico , Ácido Risedrônico/uso terapêutico , Denosumab/administração & dosagem , Denosumab/efeitos adversos , Denosumab/uso terapêutico , Hipocalcemia/prevenção & controle
12.
Expert Opin Drug Saf ; 18(8): 679-689, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31159612

RESUMO

INTRODUCTION: Antiepileptic drugs (AEDs) have been associated with a negative impact on bone health. Comorbid disorders in patients with epilepsy may require drugs exerting a pro-osteoporotic effect, so a possibility of untoward interactions with AEDs is probable. AREAS COVERED: This review discusses evidence related to the deteriorating influence of AEDs on bone, demonstrating generally stronger negative effects of conventional AEDs. Lamotrigine seems to be a safer AED in this regard. Further, literature data indicate that generally AEDs can lower the serum concentration of vitamin D. Importantly, pediatric patients are of greater risk of bone problems during therapy with AEDs, which is probably due to their effects on bone-forming processes. EXPERT OPINION: Supplementation with vitamin D and calcium is frequently recommended in patients taking AEDs chronically. Whether to add a bisphosphonate remains an open question due to the limited data on this issue. A possibility of negative interactions exists between AEDs and other pro-osteoporotic drugs: glucocorticoids, proton pump inhibitors and aromatase inhibitors. Depression is a frequent comorbidity in patients with epilepsy. Clinical data indicate that antidepressant drugs may also increase the risk of fractures. Again, patients with epilepsy and depression may be exposed to a greater risk of osteoporosis.


Assuntos
Anticonvulsivantes/efeitos adversos , Epilepsia/tratamento farmacológico , Osteoporose/induzido quimicamente , Adulto , Animais , Anticonvulsivantes/administração & dosagem , Antidepressivos/administração & dosagem , Antidepressivos/efeitos adversos , Cálcio/administração & dosagem , Criança , Depressão/tratamento farmacológico , Difosfonatos/administração & dosagem , Interações de Medicamentos , Humanos , Osteoporose/tratamento farmacológico , Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controle , Fatores de Risco , Vitamina D/administração & dosagem
13.
Bioelectrochemistry ; 129: 251-258, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31229863

RESUMO

Electrochemotherapy (ECT) is an anticancer bioelectrochemical therapy where electrical field pulses (electropermeabilization) increase intracellular concentration of antitumor drugs. The procedure is very effective against skin tumors. The restrictive regulations concerning anticancer drugs in veterinary medicine limit use of ECT. Electroporation with calcium (Electroporation Calcium Therapy)(ECaT) was proved to be effective in vivo on induced tumors in laboratory animals. This study evaluated the effects of ECaT in equine sarcoids (spontaneous skin tumors) on an animal cohort. Pulse parameters for ECaT were choosen for using skin contact electrodes. ECaT was applied under general anesthesia. The tumors were removed at different days after the treatment and analyzed by histology. The study assessed the volume fraction of necrosis that was >50% for 9 of 13 sarcoids. Sixteen sarcoids in 10 horses were treated with ECaT. Macroscopic changes (a crust) were observed in 14/16 tumors. The main microscopic changes were necrosis, ulceration,hemorrhages, calcifications and thrombosis. The adverse effect was an inflammatory local reaction. Surrounding tissues were not affected. This targeted effect can be explained by its control by the field distribution in the tissue and on the interstitial diffusion of the injected Ca2+.


Assuntos
Cálcio/uso terapêutico , Eletroquimioterapia/métodos , Doenças dos Cavalos/terapia , Cavalos , Neoplasias Cutâneas/veterinária , Animais , Cálcio/administração & dosagem , Doenças dos Cavalos/patologia , Cavalos/fisiologia , Masculino , Pele/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia
14.
J Agric Food Chem ; 67(25): 7073-7081, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31240927

RESUMO

Obesity has been demonstrated as a disruptor of female fertility. Our previous study showed the antiobesity effects of calcium on HFD-fed male mice. However, the role of calcium in alleviating reproductive dysfunction of HFD-fed female mice remains unclear. Here, we found that HFD led to estrus cycle irregularity (longer cycle duration and shorter estrus period) and subfertility (longer conception time, lower fertility index, and less implantations) in mice. However, the HFD-induced reproductive abnormality was alleviated by calcium supplementation. Additionally, calcium supplementation enhanced activation/thermogenesis of BAT and browning of WAT in HFD-fed mice. Consequently, the abnormality of energy metabolism and glucose homeostasis induced by HFD were improved by calcium supplementation, with elevated metabolic rates and core temperature. In conclusion, these data showed that calcium supplementation alleviated HFD-induced estrous cycle irregularity and subfertility associated with concomitantly enhanced BAT thermogenesis and WAT browning, suggesting the potential application of calcium in improving obesity-related reproductive disorders.


Assuntos
Tecido Adiposo Marrom/fisiopatologia , Tecido Adiposo Branco/fisiopatologia , Cálcio/administração & dosagem , Ciclo Estral/efeitos dos fármacos , Doenças dos Genitais Femininos/tratamento farmacológico , Infertilidade/tratamento farmacológico , Obesidade/complicações , Termogênese/efeitos dos fármacos , Tecido Adiposo Marrom/efeitos dos fármacos , Tecido Adiposo Branco/efeitos dos fármacos , Animais , Dieta Hiperlipídica/efeitos adversos , Suplementos Nutricionais/análise , Metabolismo Energético/efeitos dos fármacos , Feminino , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/metabolismo , Doenças dos Genitais Femininos/fisiopatologia , Humanos , Infertilidade/etiologia , Infertilidade/metabolismo , Infertilidade/fisiopatologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL
15.
An Acad Bras Cienc ; 91(2): e20180589, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31241701

RESUMO

The aim of this study was to evaluate the effects of subcutaneous calcium administration in post-partum dairy cows with respect to carbohydrate, protein and lipids metabolism, as well as its effects on milk composition. Twenty post-partum dairy cows were randomly divided into two groups (n=10): a control and a treated group with a single dose (150 mL) of calcium. Blood collection was performed on post-partum days 1, 2, 3, 7 and 10. In addition, we measured serum levels of total calcium, total proteins, albumin, globulins, glucose, cholesterol, triglycerides, as well as creatine kinase (CK) activity. We determined milk composition on post-partum days 5, 10 and 20. Serum total calcium levels was higher on post-partum days 3 and 7 in the treated group. Serum urea (day 3) and triglycerides (days 7 and 10) levels were higher in the treated group, as were CK activity levels at post-partum days 2 and 3. Serum glucose and cholesterol levels were lower on post-partum day 2 in treated animals. Fat (day 20) and lactose (day 10) content in milk samples were higher than in the treated animals. We concluded that treatment with calcium in cows during the post-partum period changes biochemical variables related to metabolism.


Assuntos
Cálcio/farmacologia , Metabolismo dos Carboidratos/efeitos dos fármacos , Bovinos/sangue , Metabolismo dos Lipídeos/efeitos dos fármacos , Leite/química , Proteínas/efeitos dos fármacos , Animais , Cálcio/administração & dosagem , Feminino , Período Pós-Parto , Proteínas/metabolismo
17.
Indian Pediatr ; 56(4): 307-310, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31064900

RESUMO

OBJECTIVE: To evaluate the effect of vitamin D and calcium supplementation for osteoprotection in thalassemia. METHODS: 29 children (age 2-12 y) were supplemented with oral vitamin D (1000 IU/d) and calcium (500 mg/d) for 1 year. The dual energy X-ray absorptiometry (DXA) was done to assess bone mineral content at baseline and 12 months. Serum 25-hydroxy vitamin D, intact parathyroid hormone, osteocalcin, calcium, phosphate, alkaline phosphatase, and spot urine deoxypyridinoline (DPD)/creatinine were done at baseline, 6 months and 12 months. RESULTS: The mean (SD) bone mineral content increased from baseline value of 8.4 (2.8) g to 10.8 (3.5) g (P<0.001). The mean (SD) vitamin D level increased from baseline value of 16.0 (5.8) ng/mL to 23.4 (6.6) ng/mL (P<0.001). The change in serum osteocalcin and spot urine DPD/creatinine ratio were not significant (P=0.062). CONCLUSION: Oral vitamin D and calcium supplementation increases bone mineral content in children with thalassemia.


Assuntos
Densidade Óssea/efeitos dos fármacos , Cálcio , Talassemia , Vitamina D , Cálcio/administração & dosagem , Cálcio/farmacologia , Cálcio/uso terapêutico , Criança , Pré-Escolar , Suplementos Nutricionais , Feminino , Humanos , Masculino , Vitamina D/administração & dosagem , Vitamina D/sangue , Vitamina D/farmacologia , Vitamina D/uso terapêutico , Deficiência de Vitamina D
18.
J Dairy Sci ; 102(7): 6056-6064, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31079910

RESUMO

Hypocalcemia is a common postpartum condition in dairy cows, which negatively affects health and production. Intravenous Ca infusions are commonly included in calving protocols to prevent or mitigate the effect of hypocalcemia in multiparous cows. Thus, we sought to contrast the effect of intravenous Ca infusion against voluntary oral Ca intake on Ca metabolism. Serum total Ca (tCa) and whole-blood ionized Ca (iCa) were monitored in 24 multiparous Holstein cows after parturition. Precalving diets were formulated with a positive dietary cation-anion difference of 172 mEq/kg of DM and contained 4.1 g of Ca/kg of DM. At parturition, cows were blocked by calving sequence and calcemic status as either normocalcemic (cutoff threshold of iCa ≥1.10 mmol/L) or hypocalcemic (cutoff threshold of iCa <1.10 mmol/L). Cows in each block were randomly assigned to 1 of 2 treatments: either an oral source of Ca (Ca-Oral; n = 12) or an intravenous source of Ca (Ca-IV; n = 12). Cows in the Ca-Oral group were offered a 20-L commercial Ca suspension (48 g of Ca) for voluntary consumption. The supplement contained Ca carbonate, Ca formate, Ca propionate, and other minerals and vitamins (Farm-O-San Reviva, Trouw Nutrition, Amersfoort, the Netherlands). Cows in the Ca-IV group received a 450-mL intravenous Ca solution (13 g of Ca) that contained 298 mg/mL of Ca gluconate, 33 mg/mL of magnesium chloride, and 82 mg/mL of boric acid (AmosCAL, Kommer-Biopharm BV, Heiloo, the Netherlands). Both treatments were initiated within 25 ± 10 min after calving. The oral Ca suspension was offered to cows in a 25-L bucket and was available for 10 min. All cows in the Ca-Oral group voluntarily consumed the entire 20 L of the Ca suspension within 5 min. Blood samples for Ca analyses were collected at 0 (before treatment initiation), 1, 3, 10, and 18 h relative to treatment, and at 0700 and 1900 h for the next 2 consecutive days, to represent the 24-, 36-, 48-, and 60-h sampling time points. In Ca-IV cows, both iCa and tCa concentrations peaked at 1 h (1.54 mmol/L for iCa and 2.85 mmol/L for tCa) and declined to a nadir at 24 h following treatment initiation (0.94 mmol/L for iCa and 1.74 mmol/L for tCa). Although whole-blood iCa and serum tCa were higher at 1 and 3 h in Ca-IV cows, concentrations of iCa were greater for Ca-Oral cows at 18, 24, and 36 h and for tCa at 24 and 36 h. Our data indicate that intravenous Ca infusion immediately induced a state of hypercalcemia followed by lower whole-blood iCa and serum tCa concentrations 24 h later compared with oral Ca.


Assuntos
Cálcio/administração & dosagem , Doenças dos Bovinos/prevenção & controle , Homeostase/efeitos dos fármacos , Hipocalcemia/veterinária , Administração Intravenosa/veterinária , Animais , Cálcio/sangue , Cálcio na Dieta/administração & dosagem , Bovinos , Doenças dos Bovinos/sangue , Dieta/veterinária , Feminino , Hipocalcemia/prevenção & controle , Lactação , Países Baixos , Parto , Gravidez , Distribuição Aleatória
19.
J Pediatr Endocrinol Metab ; 32(6): 647-651, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31141481

RESUMO

Background Vitamin D resistant rickets (HVDRR), is a rare autosomal recessive disorder caused by vitamin D receptor (VDR) gene mutations. There is no standard treatment in HVDRR. Case report The patient was a 3-year-old girl presenting with short stature, genu varum deformity, waddling gait and alopecia. She had hypocalcemia, hypophosphatemia, hyperparathyroidism and normal 1.25-(OH)2D levels. The patient was initially treated with calcitriol and high-dose oral calcium (Ca) for 22 months. The patient was treated with continuous high dose intravenous (i.v.) Ca therapy for 4 months, following initial lack of response to oral Ca and calsitriol. At the end of the 4 months, rickets was dramatically improved and did not recur for 3 years after i.v. Ca therapy. DNA sequence analyses of the VDR gene showed a homozygous novel mutation. Conclusions We identified a novel VDR gene mutation, and we concluded that i.v. Ca therapy from the central catheter is a safe treatment in HVDRR.


Assuntos
Hormônios e Agentes Reguladores de Cálcio/administração & dosagem , Cálcio/administração & dosagem , Raquitismo Hipofosfatêmico Familiar/tratamento farmacológico , Mutação , Receptores de Calcitriol/genética , Administração Intravenosa , Pré-Escolar , Raquitismo Hipofosfatêmico Familiar/genética , Raquitismo Hipofosfatêmico Familiar/patologia , Feminino , Humanos , Prognóstico
20.
Nutrients ; 11(5)2019 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-31109099

RESUMO

There is increasing epidemiologic and animal evidence that a low calcium diet increases blood pressure. The aim of this review is to compile the information on the link between low calcium intake and blood pressure. Calcium intake may regulate blood pressure by modifying intracellular calcium in vascular smooth muscle cells and by varying vascular volume through the renin-angiotensin-aldosterone system. Low calcium intake produces a rise of parathyroid gland activity. The parathyroid hormone increases intracellular calcium in vascular smooth muscles resulting in vasoconstriction. Parathyroidectomized animals did not show an increase in blood pressure when fed a low calcium diet as did sham-operated animals. Low calcium intake also increases the synthesis of calcitriol in a direct manner or mediated by parathyroid hormone (PTH). Calcitriol increases intracellular calcium in vascular smooth muscle cells. Both low calcium intake and PTH may stimulate renin release and consequently angiotensin II and aldosterone synthesis. We are willing with this review to promote discussions and contributions to achieve a better understanding of these mechanisms, and if required, the design of future studies.


Assuntos
Cálcio/administração & dosagem , Cálcio/farmacologia , Hipertensão/etiologia , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Humanos , Glândulas Paratireoides/efeitos dos fármacos , Glândulas Paratireoides/fisiologia , Hormônio Paratireóideo/metabolismo
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