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1.
Arch Osteoporos ; 15(1): 168, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-33083846

RESUMO

BACKGROUND: Calcium is an essential mineral compound and one of the most abundant minerals in the human body. A long-term low calcium intake predisposes the bones to fractures, osteopenia, and osteoporosis. This study was conducted to assess calcium intake and knowledge of calcium-related information among healthcare students in King Saud bin Abdulaziz University for Health Sciences (KSAU-Hs). METHODS: This cross-sectional survey was conducted using a self-administered questionnaire that has been distributed as a soft copy of 289 participants aged 19 years or older and studied at KSAU-Hs. The questionnaire had three sections assessing demographical data, calcium knowledge, and calcium intake. The knowledge outcome variables were good and poor, and participants were categorized as good knowledge if they answer 11 or more of the 18 questions, while the intake outcome variables were sufficient and insufficient intake based on the Recommended Dietary Allowance (RDA) of 1000 mg. RESULTS: Among all variables, 91.7% of the participants were found to be having an insufficient intake, and 74% were classified to be poor knowledge. As for knowledge, the highest score under the "Good" category were females 32.7% compared to males 22.2%, P = 0.05. The average intake of calcium was 497 mg/day. In terms of sufficient calcium intake, males scored 11.9% compared to females who scored 1.9% with a P value of 0.00. CONCLUSION: The results of this study have shown that there are significantly insufficient calcium intake and poor knowledge about calcium among healthcare students. The results indicate the urge to improve calcium intake and calcium knowledge among the healthcare students.


Assuntos
Cálcio/administração & dosagem , Alimentos Fortificados , Estudantes/psicologia , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Minerais , Inquéritos e Questionários , Universidades , Adulto Jovem
2.
J Anim Sci ; 98(8)2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32790838

RESUMO

This experiment compared the performance and physiological responses of the offspring from cows supplemented with Ca salts of soybean oil (CSSO) or prilled saturated fat (CON) during late gestation. Nonlactating, pregnant, multiparous Angus × Hereford cows (n = 104) that conceived during the same fixed-time artificial insemination protocol were assigned to this experiment. Cows were ranked by pregnancy sire (one of two sires), body weight (BW), and body condition score (BCS) on day -15 of the experiment (day 180 of gestation). Cows were then assigned to receive (dry matter basis) 415 g of soybean meal per cow daily in addition to: 1) 195 g/cow daily of CSSO (n = 52) or 2) 170 g/cow daily of CON (n = 52). Cows were maintained in two pastures (26 cows/treatment per pasture) and received daily 12.7 kg/cow (dry matter basis) of grass-alfalfa hay from day -15 to calving. Cows were segregated into 1 of 24 feeding pens three times weekly and received treatments individually from day 0 to calving. Calves were weaned on day 290 of the experiment, preconditioned for 35 d (day 291 to 325), and transferred to a feedyard, where they remained until slaughter (day 514). Cows receiving CSSO and their calves had greater (P < 0.01) plasma concentrations of linoleic acid and total ω-6 PUFA compared with CON after calving. Concentrations of immunoglobulin G in the colostrum and in calf plasma 24 h after birth were greater (P ≤ 0.02) in CSSO vs. CON cattle. Calves from CSSO cows had greater (P ≤ 0.05) expression of adipogenic (adipocyte fatty acid-binding protein and stearoyl-CoA desaturase) and myogenic (myogenic differentiation 1 and myogenin) genes in the longissimus muscle (LM) compared with CON. No treatment differences in birth BW, weaning BW, and final preconditioning BW were noted (P ≥ 0.36). Average daily gain and final BW in the feedyard were greater (P ≤ 0.05) in steers from CSSO cows compared with CON. The incidence of calves diagnosed with BRD that required a second antimicrobial treatment was less (P = 0.03) in calves from CSSO cows, resulting in reduced (P = 0.05) need of treatments to regain health compared with CON. Upon slaughter, LM area was greater (P = 0.03) in calves from CSSO cows compared with CON. Collectively, these results are indicative of programming effects on postnatal offspring growth and health resultant from CSSO supplementation to late-gestating cows. Hence, supplementing CSSO to beef cows during pregnancy might be a feasible alternative to optimize offspring productivity and welfare.


Assuntos
Ração Animal/análise , Cálcio/administração & dosagem , Dieta/veterinária , Óleo de Soja/química , Fenômenos Fisiológicos da Nutrição Animal , Animais , Cálcio/química , Bovinos , Suplementos Nutricionais , Ácidos Graxos , Feminino , Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal
3.
PLoS One ; 15(7): e0235135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628733

RESUMO

BACKGROUND: In patients on hemodialysis (HD), the various chemical elements in the dialysate may influence survival rates. In particular, calcium modifies mineral and bone metabolism and the vascular calcification rate. We studied the influence of the dialysate calcium concentration and the treatments prescribed for mineral bone disease (MBD) on survival. METHODS: All patients in REIN having initiated HD from 2010 to 2013 were classified according to their exposure to the different dialysate calcium concentrations in their dialysis unit. Data on the individual patients' treatments for MBD were extracted from the French national health database. Cox proportional hazard models were used to estimate mortality hazard ratios (HR) associated with time-dependent exposure to dialysate calcium concentrations and MBD therapies, adjusted for comorbidities, laboratory and technical data. RESULTS: Dialysate calcium concentration of 1.5 mmol/L was used by 81% of the dialysis centers in 2010 and in 83% in 2014. Most centers were using several formulas in up to 78% for 3 formulas in 2010 to 86% in 2014. In full adjusted Cox survival analyses, the percentage of calcium >1.5 mmol/L and <1.5 mmol/l by center and the number of formula used per center were not associated with survival. Depending on the daily dose used, the MBD therapies were associated with survival improvement for calcium, native vitamin D, active vitamin D, sevelamer, lanthanum and cinacalcet in the second and third tertiles of dose. CONCLUSION: No influence of the dialysate calcium concentration was evidenced on survival whereas all MBD therapies were associated with a survival improvement depending on the daily dose used.


Assuntos
Osso e Ossos/efeitos dos fármacos , Cálcio/análise , Soluções para Hemodiálise/análise , Sistema de Registros , Diálise Renal , Insuficiência Renal Crônica/terapia , Idoso , Vasos Sanguíneos/efeitos dos fármacos , Vasos Sanguíneos/metabolismo , Vasos Sanguíneos/fisiopatologia , Osso e Ossos/metabolismo , Osso e Ossos/fisiopatologia , Calcinose/epidemiologia , Calcinose/metabolismo , Calcinose/fisiopatologia , Cálcio/administração & dosagem , Cálcio/metabolismo , Cinacalcete/análise , Feminino , França/epidemiologia , Soluções para Hemodiálise/administração & dosagem , Soluções para Hemodiálise/química , Humanos , Lantânio/análise , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/fisiopatologia , Sevelamer/análise , Vitamina D/análise , Vitamina D/metabolismo
4.
J Bone Miner Metab ; 38(6): 848-858, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32671481

RESUMO

INTRODUCTION: In anti-osteoporosis drug trials, vitamin D and calcium (Ca) are common supplements; however, the optimal dose of each is unclear. Using data from the randomized, double-blind, placebo-controlled DIRECT trial, we assessed whether baseline serum 25-hydroxy vitamin D (25[OH]D) level influences the efficacy of denosumab co-administered with vitamin D and Ca. MATERIALS AND METHODS: In this prespecified sub-analysis, subjects with primary osteoporosis who received denosumab or placebo, plus vitamin D (≥ 400 IU/day) and Ca (≥ 600 mg/day), were classified as 25(OH)D deficient (< 20 ng/mL), insufficient (≥ 20 to < 30 ng/mL), and sufficient (≥ 30 ng/mL). Study endpoints included absolute serum 25(OH)D level at baseline, 12 months, and 24 months; change in serum 25(OH)D and bone mineral density (BMD) status from baseline; and incidence of new vertebral fractures at 24 months. RESULTS: In 475 denosumab-treated and 481 placebo-treated subjects, proportions with deficient/insufficient/sufficient 25(OH)D at baseline were 53.1%/37.1%/9.9% and 50.9%/42.0%/7.1%, respectively. Supplementation significantly increased mean serum 25(OH)D levels; at 24 months, mean levels were > 30 ng/mL (sufficient) in both treatment groups. Increase in BMD over time was higher in the denosumab group vs. placebo group in all three vitamin D status groups. At month 24, denosumab-treated subjects with deficient/insufficient baseline 25(OH)D had a significantly lower risk of new vertebral fracture vs. placebo-treated subjects. CONCLUSION: Among DIRECT trial subjects supplemented with ≥ 400 IU/day of vitamin D and ≥ 600 mg/day of Ca, baseline 25(OH)D sufficiency may not influence the efficacy of denosumab in increasing BMD or preventing vertebral fractures.


Assuntos
Cálcio/administração & dosagem , Denosumab/administração & dosagem , Vitamina D/administração & dosagem , Vitamina D/sangue , Idoso , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/farmacologia , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/farmacologia , Cálcio/uso terapêutico , Denosumab/farmacologia , Denosumab/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Masculino , Fraturas da Coluna Vertebral/sangue , Fraturas da Coluna Vertebral/tratamento farmacológico , Fraturas da Coluna Vertebral/fisiopatologia , Resultado do Tratamento , Vitamina D/análogos & derivados , Vitamina D/farmacologia
5.
Ann Agric Environ Med ; 27(2): 219-224, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32588596

RESUMO

INTRODUCTION: Osteoporosis, the "quiet epidemic", is one of the most serious threats to public health. It is known that estrogen plays a significant role in the regulation of bone turnover, and its loss at menopause causes osteoporosis. Added to this, insufficient calcium intake accelerates bone mass loss, increasing the risk of fractures. OBJECTIVE: The study aimed to answer the question whether a fructan-enriched diet could be helpful in preventing from disturbances in bone turnover caused by calcium restriction combined with ovariectomy-induced estrogen deficiency. The differences related to the kind of fructan and 'matrix effect' of fructan action (form of addition) were also evaluated. MATERIAL AND METHODS: The study was conducted using sham-operated (control groups) or ovariectomized (OVX) rats fed a calcium restricted diet. The treatment diets contained one of three fructan sources - Jerusalem artichoke, yacon and Beneo Orafti Synergy1 - added alone or as an ingredient of strawberry sorbet, all in the amount providing 8% fructans. Analyses of biological material included: serum Ca, Mg and P concentrations, alkaline phosphatase activity (ALP), osteocalcin (OC) and C-telopeptide degradation products from type I collagen (CTX). Densitometric parameters of femora were also assayed. RESULTS: Among markers of bone turnover, the ALP activity depended both on the kind of fructan and the form of addition. The highest value was shown in the OVX group fed a low-calcium diet, whereas administration of diet enriched with Jerusalem artichoke led to an almost 50% decrease in the value of this parameter. Dietary fructans also lowered the OC level. Feeding rats with diet containing sorbet enriched in yacon or Jerusalem artichoke resulted in a decrease of CTX, compared to the diet containing yacon alone or fructan formulation in both forms No significant differences were observed in densitometric parameters between treatment groups. CONCLUSIONS: The obtained findings suggest that fructan administration with a calcium-restricted diet might exert a positive effect on bone turnover parameters. Regarding the form of their addition, it is possible that other constituents of sorbets contributed to the fructan action. It remains open whether this impact would be significant over a longer period of time.


Assuntos
Remodelação Óssea/efeitos dos fármacos , Cálcio/deficiência , Fêmur/efeitos dos fármacos , Frutanos/metabolismo , Osteoporose/prevenção & controle , Ovariectomia , Ração Animal/análise , Animais , Cálcio/administração & dosagem , Cálcio na Dieta/administração & dosagem , Dieta , Suplementos Nutricionais/análise , Feminino , Frutanos/administração & dosagem , Ratos , Ratos Wistar
6.
Eur J Endocrinol ; 183(2): 149-159, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32580147

RESUMO

Objective: Hypoparathyroidism is a common complication after thyroidectomy. It is not yet possible to predict in which patients hypoparathyroidism will persist. We aim to determine whether a decrease in PTH levels, measured at the first postoperative day, can identify patients with a high risk for persistent hypoparathyroidism one year after thyroidectomy. Design: Prospective multi-center cohort study. Methods: Patients undergoing total or completion thyroidectomy were included. We measured PTH levels preoperatively and on the first postoperative day. Primary outcome is the proportion of patients with persistent hypoparathyroidism, defined as the need for calcium supplementation one year after surgery. Results: We included 110 patients of which 81 were used for analysis of the primary outcome. At discharge 72.8% of patients were treated with calcium supplementation. Persistent hypoparathyroidism was present in 14 patients (17.3%) at one-year follow-up, all of them had a decrease in PTH >70% at the first postoperative day. These 14 were 43.8% of the 32 patients who had such a decrease. In the group of 49 patients (59.8%) without a PTH >70% decrease, none had persistent hypoparathyroidism one year after surgery (P-value <0.001). A decrease of >70% in PTH levels had a sensitivity of 100.0% (95% CI: 85.8-100.0%), a specificity of 73.1% (95% CI: 62.5-83.7%) and an area under the curve of 0.87 (95% CI: 0.79-0.94) to predict the risk for persistent hypoparathyroidism. Conclusion: In our study a decrease in PTH levels of >70% after total or completion thyroidectomy is a reliable predictor for persistent hypoparathyroidism, and this should be confirmed in larger cohorts.


Assuntos
Hipoparatireoidismo/diagnóstico , Hipoparatireoidismo/etiologia , Hormônio Paratireóideo/sangue , Tireoidectomia/efeitos adversos , Adulto , Idoso , Cálcio/administração & dosagem , Cálcio/sangue , Estudos de Coortes , Suplementos Nutricionais , Feminino , Seguimentos , Humanos , Hipoparatireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Valores de Referência , Fatores de Risco , Doenças da Glândula Tireoide/cirurgia
7.
PLoS One ; 15(6): e0235285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32598402

RESUMO

Spindly leg syndrome (SLS) is a relatively common musculoskeletal abnormality associated with captive-rearing of amphibians with aquatic larvae. We conducted an experiment to investigate the role of environmental calcium and phosphate in causing SLS in tadpoles. Our 600-tadpole experiment used a fully-factorial design, rearing Atelopus varius tadpoles in water with either high (80mg/l CaCO3), medium (50mg/l CaCO3), or low calcium hardness (20mg/l CaCO3), each was combined with high (1.74 mg/l PO4) or low (0.36 mg/l PO4) phosphate levels. We found that calcium supplementation significantly improved tadpole survival from 19% to 49% and that low calcium treatments had 60% SLS that was reduced to about 15% at the medium and high calcium treatments. Phosphate supplementation significantly reduced SLS prevalence in low calcium treatments. This experimental research clearly links SLS to the calcium: phosphate homeostatic system, but we were unable to completely eliminate the issue, suggesting an interactive role of other unidentified factors.


Assuntos
Bufonidae/anormalidades , Cálcio/efeitos adversos , Anormalidades Musculoesqueléticas/patologia , Fosfatos/efeitos adversos , Animais , Bufonidae/crescimento & desenvolvimento , Cálcio/administração & dosagem , Meio Ambiente , Anormalidades Musculoesqueléticas/etiologia , Fosfatos/administração & dosagem , Síndrome
8.
J Nutr ; 150(8): 2112-2119, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32588047

RESUMO

BACKGROUND: Hong Kong faces several public health problems including malnutrition and osteoporosis. Considering the typical Chinese diet and overall low physical activity levels of Chinese adults, timely interventions to improve nutritional status and bone health are needed. OBJECTIVES: We examined the effects of a nutrition plus exercise intervention on serum vitamin B-12 and 25-hydroxyvitamin D [25(OH)D], bone turnover markers, and parathyroid hormone (PTH) concentrations in apparently healthy Chinese middle-aged and older adults. METHODS: In this 24-wk randomized controlled trial, 180 Chinese adults (85 women, mean ± SD age: 61 ± 6 y) were randomly assigned to receive a fortified milk supplement (2 × 30 g/d) and an exercise program (2 × 1 h/wk including resistance, balance, and aerobic training) or no intervention. The primary outcome was physical performance. In this article we analyzed the secondary outcomes serum vitamin B-12 and 25(OH)D concentrations, assessed at baseline, 12 wk, and 24 wk. Also, bone turnover markers and PTH concentrations were studied. Linear mixed models evaluated group differences over time. RESULTS: A significant time × group interaction (P < 0.001) was found for serum vitamin B-12 and 25(OH)D concentrations and the bone turnover markers, but not for serum PTH concentrations (P = 0.09). The intervention increased mean ± SD vitamin B-12 concentrations from baseline (345 ± 119 pmol/L) to 24 wk (484 ± 136 pmol/L), whereas concentrations remained stable within the control. For 25(OH)D concentrations, the intervention group had a greater increase from baseline (54.7 ± 14.2 nmol/L) to 24 wk (80.1 ± 19.2 nmol/L) than the control (60.6 ± 15.2 compared with 65.6 ± 14.6 nmol/L). The ratio of the net effect of bone formation and resorption was greater in the intervention group, suggesting less bone remodeling, irrespective of sex. CONCLUSIONS: A fortified milk supplement and exercise intervention successfully improved vitamin B-12 and 25(OH)D concentrations as well as the balance of bone turnover markers of Chinese middle-aged and older adults.This trial was registered at trialregister.nl as NTR6214.


Assuntos
Osso e Ossos/metabolismo , Exercício Físico , Vitamina B 12/sangue , Vitamina D/análogos & derivados , Idoso , Grupo com Ancestrais do Continente Asiático , Biomarcadores , Cálcio/administração & dosagem , Proteínas na Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vitamina B 12/administração & dosagem , Vitamina D/administração & dosagem , Vitamina D/sangue
9.
Eur Rev Med Pharmacol Sci ; 24(10): 5778-5782, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32495915

RESUMO

Since the end of 2019, China and other regions around the world have been facing a pandemic of novel coronavirus pneumonia (COVID-19). The virus is highly transmissible, and the human population is generally susceptible. Most patients with osteoporosis are postmenopausal women or elderly people with hypoimmunity, so the osteoporosis clinic has become a new hotspot for corona virus infection. During the COVID-19 pandemic, it is necessary to establish standardized out-patient protocols to provide safe and effective treatment for osteoporosis patients and medical staff. In an osteoporosis clinic, we advocate the following suggestions to prevent and control osteoporosis during the pandemic period: (1) specialized diagnosis and treatment techniques for osteoporosis patients in the outpatient care, including enhancing the prevention for outpatient medical staff, strengthening awareness of COVID-19 prevention, strictly screening outpatients with COVID-19 infection, and insistent administration of anti-osteoporosis drugs during outbreaks; (2) home prevention for osteoporosis patients including keeping windows open, exposing them to sunlight, supplementing them with enough protein, exercising regularly, and administrating calcium supplements; and (3) simplifying the follow-up and evaluation of osteoporosis using online platforms.


Assuntos
Infecções por Coronavirus/diagnóstico , Osteoporose/patologia , Pneumonia Viral/diagnóstico , Betacoronavirus , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/administração & dosagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Suplementos Nutricionais , Humanos , Estilo de Vida , Corpo Clínico/psicologia , Medicina Tradicional Chinesa , Osteoporose/complicações , Osteoporose/tratamento farmacológico , Pacientes Ambulatoriais , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Vitamina D/administração & dosagem
10.
Am J Clin Nutr ; 112(1): 48-56, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32401318

RESUMO

BACKGROUND: Clinical trials evaluating the effect of calcium supplementation on bone loss in lactating women have been small, with inconsistent results. OBJECTIVES: We aimed to determine the effect of calcium supplementation on bone mineral density (BMD) in lactating women. METHODS: An electronic search of databases was conducted from inception to January 2020. Two authors screened studies, extracted data, and assessed the risk of bias of eligible studies. Percentage change in BMD was pooled using random-effects models and reported as weighted mean differences (WMDs) with 95% CIs. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS: Five randomized controlled trials including 567 lactating women were included. All had a high risk of bias. Mean baseline calcium intake ranged from 562 to 1333 mg/d. Compared with control groups (placebo/no intervention), calcium supplementation (600/1000 mg/d) had no significant effect on BMD at the lumbar spine (WMD: 0.74%; 95% CI: -0.10%, 1.59%; I2 = 47%; 95% CI: 0%, 81%; n = 527 from 5 trials) or the forearm (WMD: 0.53%; 95% CI: -0.35%, 1.42%; I2 = 55%; 95% CI: 0%, 85%; n = 415 from 4 trials). BMD at other sites was assessed in single trials: calcium supplementation had a small to moderate effect on total-hip BMD (WMD: 3.3%; 95% CI: 1.5%, 5.1%) but no effect on total body or femoral neck BMD. CONCLUSIONS: Overall, the meta-analysis indicates that calcium supplementation does not provide clinically important benefits for BMD in lactating women. However, there was adequate dietary intake before supplementation in some studies, and others did not measure baseline calcium intake. Advising lactating women to meet the current recommended calcium intakes (with supplementation if dietary intake is low) is warranted unless new high-certainty evidence to the contrary from robust clinical trials becomes available. More research needs to be done in larger samples of women from diverse ethnic and racial groups.This systematic review was registered at www.crd.york.ac.uk/prospero as CRD42015022092.


Assuntos
Densidade Óssea/efeitos dos fármacos , Cálcio na Dieta/administração & dosagem , Cálcio/administração & dosagem , Adulto , Suplementos Nutricionais/análise , Feminino , Humanos , Lactação/efeitos dos fármacos , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
11.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(5): 310-316, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191306

RESUMO

INTRODUCCIÓN: El síndrome del hueso hambriento (SHH) es una complicación tras la cirugía paratiroidea que puede causar una hipocalcemia grave y prolongada. El objetivo fue conocer los factores de riesgo de SHH después de la cirugía por hiperparatiroidismo primario y su relación con los niveles de calcio sérico y de hormona paratiroidea (PTH). MATERIALES Y MÉTODOS: Se realizó un estudio analítico observacional de casos y controles en pacientes operados por hiperparatiroidismo primario en los últimos 10 años (2008-2017). Se estudió la evolución analítica del calcio, la PTH y las características generales de los pacientes. RESULTADOS: La incidencia de SHH en nuestra serie fue del 12,2%. Se encontró una asociación significativa de SHH con la cirugía tiroidea en el mismo acto quirúrgico (odds ratio ajustada [ORa] = 17,241), con la edad mayor de 68 años (Ora = 6,666) y con el tamaño de la lesión mayor a 1,7cm (Ora = 7.165). Observamos una relación estadísticamente significativa entre presentar SHH con un valor mayor a la media de calcio sérico corregido el día después de la cirugía, a la semana y a los 3 meses, así como con un valor mayor de la media de PTH preoperatoria, en la cirugía y un día después de la cirugía. CONCLUSIÓN: Los factores de riesgo independientes para el desarrollo de SHH en nuestra serie fueron la edad del paciente, el tamaño de la lesión y si la intervención se acompaña de cirugía tiroidea, lo que obliga a una monitorización más estrecha del metabolismo mineral durante el perioperatorio


INTRODUCTION: Hungry bone syndrome (HBS) is a complication occurring after parathyroid surgery that can cause severe and prolonged hypocalcemia. The study objective was to know the risk factors for HBS after surgery for primary hyperparathyroidism and its relationship with serum calcium and parathyroid hormone levels. MATERIAL AND METHODS: A case-control, observational, analytical study was conducted in patients who had undergone surgery for primary hyperparathyroidism in the past 10 years (2007-2016). Changes over time in serum calcium and PTH levels and the general characteristics of patients were analyzed. RESULTS: The incidence rate of HBS in our series was 12.2%. HBS was found to be significantly associated to thyroid surgery during the surgical procedure itself (adjusted odds ratio [aOR] = 17.241), to age older than 68 years (aOR = 6.666), and to lesions greater than 1.7cm (aOR = 7.165). A statistically significant relationship was seen between presence of HBS and corrected serum calcium levels higher than the mean the day after surgery and one week and 3 months later, and also with PTH levels higher than the mean before, during, and one day after surgery. CONCLUSIÓN: In our series, independent risk factors for development of HBS included patient age, lesion size, and whether or not the procedure was accompanied by thyroid surgery, which requires closer monitoring of mineral metabolism during the perioperative period


Assuntos
Humanos , Masculino , Feminino , Idoso , Hormônio Paratireóideo/metabolismo , Paratireoidectomia , Hiperparatireoidismo/cirurgia , Hiperparatireoidismo Primário , Doenças Ósseas Metabólicas/diagnóstico , Complicações Pós-Operatórias/terapia , Cálcio/sangue , Fatores de Risco , Hiperparatireoidismo Primário/etiologia , Complicações Pós-Operatórias/diagnóstico , Estudos de Casos e Controles , Cálcio/administração & dosagem , Cálcio/metabolismo , Modelos Logísticos
12.
J Trauma Acute Care Surg ; 88(5): 588-596, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32317575

RESUMO

BACKGROUND: Randomized clinical trials (RCTs) support the use of prehospital plasma in traumatic hemorrhagic shock, especially in long transports. The citrate added to plasma binds with calcium, yet most prehospital trauma protocols have no guidelines for calcium replacement. We reviewed the experience of two recent prehospital plasma RCTs regarding admission ionized-calcium (i-Ca) blood levels and its impact on survival. We hypothesized that prehospital plasma is associated with hypocalcemia, which in turn is associated with lower survival. METHODS: We studied patients enrolled in two institutions participating in prehospital plasma RCTs (control, standard of care; experimental, plasma), with i-Ca collected before calcium supplementation. Adults with traumatic hemorrhagic shock (systolic blood pressure ≤70 mm Hg or 71-90 mm Hg + heart rate ≥108 bpm) were eligible. We use generalized linear mixed models with random intercepts and Cox proportional hazards models with robust standard errors to account for clustered data by institution. Hypocalcemia was defined as i-Ca of 1.0 mmol/L or less. RESULTS: Of 160 subjects (76% men), 48% received prehospital plasma (median age, 40 years [interquartile range, 28-53 years]) and 71% suffered blunt trauma (median Injury Severity Score [ISS], 22 [interquartile range, 17-34]). Prehospital plasma and control patients were similar regarding age, sex, ISS, blunt mechanism, and brain injury. Prehospital plasma recipients had significantly higher rates of hypocalcemia compared with controls (53% vs. 36%; adjusted relative risk, 1.48; 95% confidence interval [CI], 1.03-2.12; p = 0.03). Severe hypocalcemia was significantly associated with decreased survival (adjusted hazard ratio, 1.07; 95% CI, 1.02-1.13; p = 0.01) and massive transfusion (adjusted relative risk, 2.70; 95% CI, 1.13-6.46; p = 0.03), after adjustment for confounders (randomization group, age, ISS, and shock index). CONCLUSION: Prehospital plasma in civilian trauma is associated with hypocalcemia, which in turn predicts lower survival and massive transfusion. These data underscore the need for explicit calcium supplementation guidelines in prehospital hemotherapy. LEVEL OF EVIDENCE: Therapeutic, level II.


Assuntos
Transfusão de Componentes Sanguíneos/efeitos adversos , Cálcio/administração & dosagem , Serviços Médicos de Emergência/normas , Hipocalcemia/prevenção & controle , Ressuscitação/efeitos adversos , Choque Hemorrágico/terapia , Choque Traumático/terapia , Adulto , Transfusão de Componentes Sanguíneos/normas , Cálcio/sangue , Soluções Cristaloides/administração & dosagem , Serviços Médicos de Emergência/métodos , Feminino , Humanos , Hipocalcemia/sangue , Hipocalcemia/epidemiologia , Hipocalcemia/etiologia , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Plasma , Guias de Prática Clínica como Assunto , Ressuscitação/métodos , Ressuscitação/normas , Choque Hemorrágico/sangue , Choque Hemorrágico/mortalidade , Choque Traumático/sangue , Choque Traumático/mortalidade , Resultado do Tratamento
13.
Am J Otolaryngol ; 41(4): 102477, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32307191

RESUMO

Postoperative hypocalcemia is a well-described outcome following thyroid and parathyroid surgery with symptoms ranging from clinically insignificant laboratory findings to tetany and seizures. The aims of this study were 1. To identify the characteristics and management patterns of postoperative hypocalcemia in head and neck endocrine surgery patients and 2. To compare outcomes between patients treated with empiric calcium and patients treated using a biochemically driven calcium replacement algorithm. Clinical electronic medical record (EMR) data was collected from patients who had undergone total thyroidectomy, completion thyroidectomy, and/or parathyroidectomy at Wake Forest Baptist Medical Center (WFBMC), a tertiary referral and academic institution. Between July 1, 2016, and June 30, 2017, 298 adult patients underwent surgery by a WFBMC Head & Neck (H&N) endocrine surgeon. Objective calcium and parathyroid hormone levels, postoperative supplementation with calcium and Vitamin D, 30-day physician access line (PAL) phone call utilization, emergency department (ED) encounters, and readmission rates were queried. The overall rate of hypocalcemia was 17.4%. No statistically significant difference in PAL utilization, ED visits, or readmissions was found between the empiric supplementation group and those whose supplementation was biochemically directed (PAL 5.0% vs. 5.0% [p = 0.983], ED visit 3.3% vs. 2.5% [p = 0.744], Readmission 1.7% vs. 0% [p = 0.276]). The overall postoperative rates of hypocalcemia and hypoparathyroidism following H&N endocrine surgery were consistent with the reported literature. Neither method of calcium supplementation was superior in reducing PAL utilization, ED encounters, or readmission.


Assuntos
Cálcio/administração & dosagem , Hipocalcemia/tratamento farmacológico , Paratireoidectomia , Complicações Pós-Operatórias/tratamento farmacológico , Tireoidectomia , Adulto , Idoso , Feminino , Humanos , Hipocalcemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Estudos Retrospectivos , Vitamina D/administração & dosagem
14.
Georgian Med News ; (299): 43-47, 2020 Feb.
Artigo em Russo | MEDLINE | ID: mdl-32242843

RESUMO

The purpose of this review is the study of literature for the current data on the metabolism of vitamin D and its role in development of bone tissue in children. The role of the main marker enabling assessing 25(OH)D concentration in the body the reference values has been analyzed. Summarizing the literature data, we may say that vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a mayor impact on health of infants, children and adolescents.


Assuntos
Osso e Ossos/efeitos dos fármacos , Cálcio/administração & dosagem , Osteomalacia , Raquitismo , Deficiência de Vitamina D/complicações , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Adolescente , Criança , Humanos , Lactente , Osteomalacia/diagnóstico , Osteomalacia/tratamento farmacológico , Osteomalacia/etiologia , Raquitismo/diagnóstico , Raquitismo/tratamento farmacológico , Raquitismo/etiologia , Resultado do Tratamento , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/prevenção & controle , Vitaminas/administração & dosagem , Vitaminas/sangue
15.
Trop Doct ; 50(3): 242-243, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32237955

RESUMO

A four-year-old girl presented with accidental ingestion of 200 tablets of Calcarea phosphorica. Although she was asymptomatic, she was found to have marked hypocalcaemia with a prolonged QTc interval on electrocardiogram. She was successfully treated with intravenous calcium, followed by oral maintenance.


Assuntos
Fosfatos de Cálcio/envenenamento , Hipocalcemia/induzido quimicamente , Cálcio/administração & dosagem , Pré-Escolar , Eletrocardiografia , Feminino , Humanos , Hipocalcemia/tratamento farmacológico , Hipocalcemia/fisiopatologia , Síndrome do QT Longo/induzido quimicamente , Síndrome do QT Longo/tratamento farmacológico , Síndrome do QT Longo/fisiopatologia , Resultado do Tratamento
16.
Actual. osteol ; 16(1): 77-82, Ene - abr. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1140152

RESUMO

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


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


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Calcinose/diagnóstico por imagem , Hipoparatireoidismo/diagnóstico , Doenças do Sistema Nervoso/diagnóstico por imagem , Hormônio Paratireóideo/sangue , Calcinose/complicações , Calcinose/tratamento farmacológico , Calcitriol/administração & dosagem , Carbonato de Cálcio/administração & dosagem , Gluconato de Cálcio/administração & dosagem , Cálcio/administração & dosagem , Hiperfosfatemia/sangue , Hipocalcemia/sangue , Hipoparatireoidismo/etiologia , Hipoparatireoidismo/tratamento farmacológico , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/tratamento farmacológico
17.
J Int Soc Sports Nutr ; 17(1): 16, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164702

RESUMO

BACKGROUND: The leucine metabolite ß-hydroxy-ß-methylbutyrate (HMB) is widely used as an ergogenic supplement to increase resistance-training induced gains in fat free mass (FFM) and strength in healthy adults. Recent studies have questioned the effectiveness of HMB, particularly when a high protein diet is habitually consumed. To investigate the additive resistance-training induced effects of HMB and protein in untrained individuals, we conducted a randomized double-blind, placebo-controlled study that compared the effects of combined protein and HMB supplementation to protein supplementation alone on FFM and muscle strength after 12-week resistance training. METHODS: Sixteen healthy men (22 ± 2 yrs) performed a periodized resistance-training program for twelve weeks (four sessions per week). The program comprised two mesocycles, characterized by a linear periodization and non-linear periodization, respectively, and separated by a 1-week tapering period. All participants received 60 g of whey protein on training days and 30 g of whey protein (WP) on non-training days. Participants were randomly assigned to additionally receive 3 g of calcium HMB (WP + HMB) or a placebo (WP + PLA). Body composition and physical fitness were tested before and after the 12-week training program. Whole-body and arm and leg fat free mass (FFM) were assessed by bioimpedance spectroscopy; upper arm and leg fat free cross sectional areas were also quantified using magnetic resonance imaging (MRI); upper and lower body strength were measured by One-repetition maximum (1-RM) bench press and leg press. RESULTS: Whole-body and segmental FFM increased in both groups (P <  0.001). However, gains in leg FFM were higher in WP + HMB vs. WP + PLA (arm FFM: + 6.1% vs. + 9.2%, P = 0.2; leg FFM: + 14.2% vs. + 7.0%, P <  0.01). No change in fat mass was observed (P = 0.59). 1-RM increased in both groups (P <  0.001). CONCLUSIONS: Combined protein and HMB supplementation resulted in segmental, but not whole-body increases in FFM compared to protein supplementation alone. These findings could explain some of the controversial effects of HMB reported in previous studies and have practical implications for maximizing training-induced gains in FFM and clinical conditions associated with skeletal muscle deconditioning such as aging, sedentary lifestyles, bed rest and spaceflight.


Assuntos
Cálcio/administração & dosagem , Músculo Esquelético/fisiologia , Substâncias para Melhoria do Desempenho/administração & dosagem , Treinamento de Resistência , Valeratos/administração & dosagem , Proteínas do Soro do Leite/administração & dosagem , Composição Corporal , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Masculino , Coxa da Perna/fisiologia , Adulto Jovem
18.
Orthopade ; 49(4): 363-376, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32193562

RESUMO

Osteoporosis is a very common disease all over the world, in which a reduction in bone density can lead to an increased risk of fractures and a diminished physical height. Osteoporosis is also associated with acute and chronic pain, which especially occurs in the back and can significantly reduce the quality of life. To provide sufficient care for affected patients, it is essential to know the particularities of pain management in osteoporosis, such as pharmacological and nonpharmacological treatment options. This article gives a comprehensive review of pain management in osteoporosis and also explains the underlying pathomechanisms, risk factors, and diagnostic procedures.


Assuntos
Conservadores da Densidade Óssea , Fraturas Ósseas , Osteoporose/terapia , Manejo da Dor , Dor nas Costas/tratamento farmacológico , Densidade Óssea , Cálcio/administração & dosagem , Terapia de Reposição de Estrogênios , Terapia por Exercício , Fraturas Ósseas/prevenção & controle , Humanos , Osteoporose/diagnóstico , Osteoporose/psicologia , Qualidade de Vida , Vitamina D/administração & dosagem
19.
J Anim Sci ; 98(3)2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32150262

RESUMO

The objective of this experiment was to test the hypothesis that the concentration of Ca in diets fed to late gestating sows affects the apparent total tract digestibility (ATTD) and retention of Ca and P, serum concentrations of Ca and P, hormones, and blood biomarkers for bone formation and resorption. Thirty-six sows (average parity = 2.8) were housed in metabolism crates from day 91 to day 104 of gestation and fed 1 of 4 experimental diets containing 25, 50, 75, or 100% of the requirement for Ca. All diets met the requirement for P. The initial 5 d of each period were the adaptation period, which was followed by 4 d of quantitative collection of feces and urine. At the end of the collection period, a blood sample was collected from all sows. Results indicated that feed intake, weights of dried fecal and urine samples, and the ATTD of DM were not affected by dietary Ca, but ATTD of Ca increased (quadratic, P < 0.05) as Ca in diets increased. Urine Ca output was not affected by dietary Ca, but Ca retention increased (quadratic, P < 0.05) as Ca intake increased. Fecal P output increased (linear, P < 0.001) as dietary Ca increased, which resulted in a linear decrease (P < 0.001) in the ATTD of P. Urine P output also decreased (linear, P < 0.001) as dietary Ca increased, but P retention increased (linear, P < 0.05). Regressing the apparent total tract digestible Ca against dietary Ca intake resulted in a regression line with a slope of 0.33, indicating that true total tract digestibility of Ca in calcium carbonate was 33%. Serum concentrations of Ca and P and estrogen, calcitonin, and parathyroid hormone were not affected by dietary Ca. Serum concentration of carboxyterminal cross-linked telopeptide of type I collagen (CTX-I) decreased (linear, P < 0.05) as dietary Ca increased, which is a result of reduced bone resorption as dietary Ca increased. Serum bone-specific alkaline phosphatase tended to decrease (linear, P < 0.10) as Ca in diets increased, but the concentration of osteocalcin (OC) in serum was not affected by dietary Ca. The ratio between OC and CTX-I tended to increase (P < 0.10) as dietary Ca increased, which indicated that there was more bone formation than resorption in sows as dietary Ca increased. In conclusion, P digestibility in late gestating sows decreased, but retention of P increased, as dietary Ca increased from inadequate to adequate levels and blood biomarkers for bone resorption changed as Ca and P retention increased.


Assuntos
Ração Animal/análise , Cálcio na Dieta/administração & dosagem , Cálcio/administração & dosagem , Dieta/veterinária , Fósforo na Dieta/metabolismo , Suínos/fisiologia , Animais , Biomarcadores/metabolismo , Reabsorção Óssea , Cálcio/metabolismo , Cálcio na Dieta/metabolismo , Digestão , Fezes , Feminino , Trato Gastrointestinal/metabolismo , Minerais/metabolismo , Fósforo/metabolismo , Fósforo na Dieta/administração & dosagem , Gravidez
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