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1.
Methodist Debakey Cardiovasc J ; 15(3): 207-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687100

RESUMO

Vitamin D has traditionally been known as the "bone vitamin". However, a large body of observational data has also linked low concentrations of serum 25-hydroxyvitamin D (25[OH]D), the primary storage form of vitamin D, to an increased risk of incident cardiovascular disease (CVD) and mortality, garnering public excitement about the purported nonskeletal benefits of vitamin D. Despite this, more recent meta-analyses and randomized clinical trials have failed to find a beneficial effect of vitamin D supplements on CVD and cancer outcomes. These findings, along with the lack of consensus on optimal serum 25(OH)D concentrations, have dampened some of the initial enthusiasm for vitamin D supplements. Residual confounding or reverse causation may explain some of the discrepancy between the observational and trial results. At this time, vitamin D supplements should not be prescribed for the primary purpose of CVD prevention. Adding to this complexity is the fact that many adults take vitamin D and calcium supplements together for bone health, and there is some concern (albeit inconclusive) related to calcium use and increased CVD risk. In this light, it may be best to achieve the recommended daily allowances of calcium intake through food and reserve calcium supplementation only for those at risk for calcium intake deficiency, with the smallest dosage needed after dietary modifications have been exhausted. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health.


Assuntos
Cálcio/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Animais , Biomarcadores/sangue , Cálcio/efeitos adversos , Cálcio/deficiência , Cálcio na Dieta/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais/efeitos adversos , Humanos , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Vitamina D/efeitos adversos , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia
2.
Bone Joint J ; 101-B(11): 1402-1407, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31674239

RESUMO

AIMS: Bone health assessment and the prescription of medication for secondary fracture prevention have become an integral part of the acute management of patients with hip fracture. However, there is little evidence regarding compliance with prescription guidelines and subsequent adherence to medication in this patient group. PATIENTS AND METHODS: The World Hip Trauma Evaluation (WHiTE) is a multicentre, prospective cohort of hip fracture patients in NHS hospitals in England and Wales. Patients aged 60 years and older who received operative treatment for a hip fracture were eligible for inclusion in WHiTE. The prescription of bone protection medications was recorded from participants' discharge summaries, and participant-reported use of bone protection medications was recorded at 120 days following surgery. RESULTS: Of 5456 recruited patients with baseline data, 2853 patients (52%) were prescribed bone protection medication at discharge, of which oral bisphosphonates were the most common, 4109 patients (75%) were prescribed vitamin D or calcium, and 606 patients (11%) were not prescribed anything. Of those prescribed a bone protection medication, only 932 patients (33%) reported still taking their medication 120 days later. CONCLUSION: These data provide a reference for current prescription and adherence rates. Adherence with oral medication remains poor in patients with hip fracture. Cite this article: Bone Joint J 2019;101-B:1402-1407.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Fraturas do Quadril/cirurgia , Idoso , Cálcio/uso terapêutico , Estudos de Coortes , Denosumab/uso terapêutico , Difosfonatos/uso terapêutico , Humanos , Hidroxicolecalciferóis/uso terapêutico , Adesão à Medicação , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Teriparatida/uso terapêutico , Reino Unido , Vitamina D/uso terapêutico
3.
Bratisl Lek Listy ; 120(10): 789-793, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31663356

RESUMO

AIM: Lipid emulsions are promising with regard to the treatment of toxicity by agents of high lipophilic nature. Our objective is to investigate the efficacy of intralipid 20% and calcium administration at different times when symptoms of cardiac toxicity occur during verapamil infusion. METHOD: 24 adult male Spraque-Dawley rats were randomly divided into 4 different groups, the control group, calcium group, calcium following 20% intralipid group and concomitant 20% intralipid and calcium group. Following monitoring under ketamine anesthesia, all groups were administered 37.5 mg kg-1 h-1 verapamil infusion until a 50% decrease occurred in MAPb. At the end of the infusion, verapamil infusion was decreased down to 15 mg kg-1h-1 and the treatment agents predetermined for the groups were administered concomitantly. RESULTS: There is no statistically significant difference between the administration of 20% intralipid synchronized with calcium or as a pretreatment, but both groups provided a higher survival rate when compared to the other groups. CONCLUSIONS: The administration of calcium alone in verapamil toxicity is not sufficient; when calcium and 20% intralipid are administered together, there is no difference between the administration of lipid and calcium concomitantly and the administration of lipid prior to calcium (Tab. 1, Fig. 2, Ref. 23).


Assuntos
Cálcio/uso terapêutico , Fosfolipídeos/administração & dosagem , Óleo de Soja/administração & dosagem , Verapamil/toxicidade , Animais , Emulsões/administração & dosagem , Emulsões Gordurosas Intravenosas , Masculino , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
4.
J Altern Complement Med ; 25(10): 1044-1053, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31460771

RESUMO

Objectives: To assess the change in the bone mineral density (BMD) score, bone-specific biomarkers (serum vitamin D3, tartrate-resistant acid phosphatase 5b [TRAP-5b], and osteocalcin), quality of life, Ayurvedic symptoms (Asthikshaya Lakshanas), and fracture risk assessment tool (FRAX) scores following treatment with Panchatikta Ghrita (PG), a classical herbal formulation as add-on therapy to calcium and vitamin D3 supplements. Study design: Randomized, open-labeled, comparative, controlled clinical study. Location: TN Medical College and BYL Nair Hospital, Mumbai, India. Study participants: Eighty adult patients, aged between 40 and 75 years, diagnosed to have osteopenia (BMD T-score between -1 and -2.5 in at least two of the three joints tested-lumbar spine L1-L4, left femur-neck, left forearm-radius total). Study intervention: Treatment group received two tablespoons of PG (10 mL in lukewarm milk) along with calcium and vitamin D3 supplements twice a day, whereas control group received only calcium and vitamin D3 supplements twice a day for a period of 12 months. Outcome measures: BMD, bone-specific biomarkers (vitamin D3, TRAP-5b, and osteocalcin), quality of life, Ayurvedic symptoms, and FRAX scores were evaluated before and at 6 and 12 months. Results: Eighty patients were enrolled; of which, 65 patients completed the study while 15 patients dropped out. Improvement in the BMD scores was observed at 6 and 12 months with the maximum benefit in the lumbar spine region. Significant improvement in the bone-specific biomarkers, namely serum vitamin D3 (p < 0.001), osteocalcin (p < 0.001), and TRAP-5b (p < 0.05), was observed in the PG-treated group compared with the standard treatment group. Improvement in the quality of life, Ayurvedic symptoms scores, and risk reduction in FRAX scores of major osteoporotic fracture risk and hip fracture risk was greater with PG, although not statistically significant. Conclusions: The study findings demonstrate that PG slows down the bone degeneration processes by its stabilizing effect on the bone-specific biomarkers, indicating its potential usefulness as preventive therapy in osteopenia. The positive improvement noted in this study needs to be confirmed in studies with a larger sample size and longer duration.


Assuntos
Doenças Ósseas Metabólicas/tratamento farmacológico , Cálcio/uso terapêutico , Colecalciferol/uso terapêutico , Medicina Ayurvédica , Preparações de Plantas/uso terapêutico , Adulto , Idoso , Densidade Óssea/fisiologia , Cálcio/sangue , Colecalciferol/sangue , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteocalcina/sangue , Fraturas por Osteoporose/epidemiologia , Qualidade de Vida
5.
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
7.
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
8.
Br J Surg ; 106(9): 1126-1137, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31236917

RESUMO

BACKGROUND: The aim was to assess the effectiveness of routine administration of calcium +/- vitamin D3 compared with a serum calcium level-based strategy to prevent symptomatic hypocalcaemia after thyroidectomy. METHODS: RCTs comparing routine supplementation of calcium +/- vitamin D3 with treatment based on serum calcium levels measured after total thyroidectomy, published between 1980 and 2017, were identified in MEDLINE, Embase, LILACS and Google Scholar databases. Risk of bias was evaluated using the Cochrane Collaboration tool. Risk differences were calculated by random-effects meta-analysis. Meta-regression and cumulative meta-analysis were used to explore the best therapeutic approach. RESULTS: Fifteen studies with 3037 patients were included, and seven treatment comparisons were made. Routine supplementation with calcium + vitamin D3 offered a lower risk of symptomatic (risk difference (RD) -0·25, 95 per cent c.i. -0·32 to -0·18) and biochemical (RD -0·24, -0·31 to -0·17) hypocalcaemia than treatment based on measurement of calcium levels. The number needed to treat was 4 (95 per cent c.i. 3 to 6) for symptomatic hypocalcaemia. No publication bias was found; although heterogeneity was high for some comparisons, sensitivity analysis did not change the main results. CONCLUSION: Routine postoperative administration of calcium + vitamin D3 is effective in decreasing the rate of symptomatic and biochemical hypocalcaemia.


Assuntos
Cálcio/uso terapêutico , Colecalciferol/uso terapêutico , Suplementos Nutricionais , Hipocalcemia/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Tireoidectomia/efeitos adversos , Cálcio/sangue , Colecalciferol/sangue , Humanos , Hipocalcemia/sangue , Hipocalcemia/etiologia
9.
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
10.
J Med Case Rep ; 13(1): 115, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31039808

RESUMO

BACKGROUND: Hypertension is common in pregnant women presenting with aortic coarctation or Takayasu's arteritis. Uncontrolled hypertension leads to increased adverse maternal and neonatal events. CASE PRESENTATION: A 36-year-old gravida 2, para 1 Caucasian woman presented at 9 weeks of gestation with headaches but normal blood pressure. She had a past medical history of an in vitro fertilization pregnancy complicated by preeclampsia at 27 weeks of gestation (birth weight 1900 g) and infrarenal aortic stenosis. In the current pregnancy, she received aspirin and calcium as preeclampsia prophylaxis, remained normotensive throughout pregnancy, and was delivered by elective cesarean section at 37 weeks without complications. CONCLUSIONS: This case demonstrates a significant chronic aortopathy in pregnancy with normal fetal growth and uterine blood flow through collateral supply from the internal mammary and epigastric arteries.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Aspirina/uso terapêutico , Hormônios e Agentes Reguladores de Cálcio/uso terapêutico , Cálcio/uso terapêutico , Inibidores da Agregação de Plaquetas/uso terapêutico , Pré-Eclâmpsia/prevenção & controle , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Adulto , Estenose da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/prevenção & controle , Cesárea , Angiografia por Tomografia Computadorizada , Feminino , Cefaleia , Humanos , Pré-Eclâmpsia/tratamento farmacológico , Gravidez , Complicações Cardiovasculares na Gravidez/fisiopatologia , Complicações Cardiovasculares na Gravidez/prevenção & controle , Resultado da Gravidez , Proteinúria
11.
Reprod Health ; 16(1): 46, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046778

RESUMO

BACKGROUND: Calcium and low-dose aspirin are two potential approaches for primary prevention of hypertensive disorders of pregnancy (HDP). This study aimed to explore the acceptability, views and preferences of pregnant women and primary healthcare providers for a fixed-dose combined preparation of aspirin and calcium (a polypill) as primary prevention of HDP in an unselected pregnant population. METHODS: In this qualitative study eight in-depth semi-structured interviews were conducted with Dutch primary care midwives and general practitioners. Seven focus group discussions were organised with women with low-risk pregnancies. Topics discussed were: perceptions of preeclampsia; information provision about preeclampsia and a polypill; views on the polypill concept; preferences and needs regarding implementation of a polypill. Thematic analysis of the data transcripts was carried out to identify emerging themes. RESULTS: Two major themes shaped medical professionals' and women's views on the polypill concept: 'Informed Choice' and 'Medicalisation'. Both could be divided into subthemes related to information provision, personal choice and discussions with regard to the balance between 'unnecessary medicalisation' and 'scientific progress'. CONCLUSIONS: In general, women and healthcare practitioners expressed a positive attitude towards a polypill intervention as primary prevention strategy with aspirin and calcium, providing some conditions are met. The most important conditions for implementation of such a strategy were safety, effectiveness and the possibility to make a well-informed autonomous decision.


Assuntos
Atitude do Pessoal de Saúde , Hipertensão Induzida pela Gravidez/prevenção & controle , Hipertensão/prevenção & controle , Gestantes/psicologia , Adulto , Aspirina/uso terapêutico , Cálcio/uso terapêutico , Tomada de Decisões , Feminino , Clínicos Gerais/psicologia , Humanos , Gravidez , Pesquisa Qualitativa
12.
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
13.
Osteoporos Int ; 30(8): 1693-1698, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31069439

RESUMO

Interventions that alter PTH levels in an animal model of chronic kidney disease have effects on the perfusion of bone and bone marrow. INTRODUCTION: Patients with chronic kidney disease (CKD) have accelerated bone loss, vascular calcification, and abnormal biochemistries, together contributing to an increased risk of cardiovascular disease and fracture-associated mortality. Despite evidence of vascular pathologies and dysfunction in CKD, our group has shown that cortical bone tissue perfusion is higher in a rat model of high-turnover CKD. The goal of the present study was to test the hypothesis that parathyroid hormone (PTH) suppressive interventions would normalize cortical bone vascular perfusion in the setting of CKD. METHODS: In two separate experiments, 35-week-old CKD animals and their normal littermates underwent intra-cardiac fluorescent microsphere injection to assess the effect of 10 weeks of PTH suppression (Experiment 1: calcium supplementation, Experiment 2: calcimimetic treatment) on alterations in bone tissue perfusion. RESULTS: In Experiment 1, CKD animals had serum blood urea nitrogen (BUN) and PTH levels significantly higher than NL (+ 182% and + 958%; p < 0.05). CKD+Ca animals had BUN levels that were similar to CKD, while PTH levels were significantly lower and comparable to NL. Both femoral cortex (+ 220%, p = 0.003) and tibial cortex (+ 336, p = 0.005) tissue perfusion were significantly higher in CKD animals when compared to NL; perfusion was normalized to those of NL in CKD+Ca animals. MicroCT analysis of the proximal tibia cortical porosity showed a trend toward higher values in CKD (+ 401%; p = 0.017) but not CKD+Ca (+ 111%; p = 0.38) compared to NL. Experiment 2, using an alternative method of PTH suppression, showed similar results as those of Experiment 1. CONCLUSIONS: These data demonstrate that PTH suppression-based interventions normalize cortical bone perfusion in the setting of CKD.


Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/fisiopatologia , Osso Cortical/irrigação sanguínea , Hormônio Paratireóideo/antagonistas & inibidores , Insuficiência Renal Crônica/fisiopatologia , Animais , Nitrogênio da Ureia Sanguínea , Cálcio/farmacologia , Cálcio/uso terapêutico , Distúrbio Mineral e Ósseo na Doença Renal Crônica/sangue , Distúrbio Mineral e Ósseo na Doença Renal Crônica/tratamento farmacológico , Suplementos Nutricionais , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos/métodos , Masculino , Hormônio Paratireóideo/sangue , Peptídeos/farmacologia , Peptídeos/uso terapêutico , Projetos Piloto , Porosidade , Ratos , Fluxo Sanguíneo Regional/efeitos dos fármacos , Fluxo Sanguíneo Regional/fisiologia , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/tratamento farmacológico , Microtomografia por Raio-X
14.
Horm Metab Res ; 51(5): 288-295, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31071733

RESUMO

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of calcium-vitamin D co­supplementation on insulin, insulin sensitivity, and glycemia. A systematic search was carried out in Web of Science, PubMed, EMBASE, Scopus, and Cochrane library without any language and time restriction up to 12 August 2018, to retrieve the RCTs, which examined the effect of calcium and vitamin D co-supplementation on fasting blood glucose (FBG), insulin, HOMA-B, HOMA-IR, and QUICKI. Meta-analyses were carried out using a random effects model, and I2 indexes were used to evaluate the heterogeneity. Search yielded 2225 publications. Twelve RCTs with 4395 patients were eligible. Results demonstrated that calcium and vitamin D co­supplementation had significantly reducing effects on FBG, HOMA-IR and circulating levels of insulin. As the subgroup analysis demonstrated, short-term (≤12 weeks) calcium and vitamin D co­supplementation had a significant reducing effect on FBG. However, beneficial effects of calcium and vitamin D co­supplementation on circulating level of insulin and HOMA-IR were seen in both short-term and long-term (>12 weeks) supplementations. Furthermore, we found that high doses of vitamin D and calcium co-supplementation (vitamin D≥2000 mg/day and calcium≥1000 mg/day) had significantly reducing effects on FBG, HOMA-IR and insulin. Present meta-analysis indicated the beneficial effects of high-dose and short-term combined vitamin D and calcium supplementation on insulin, insulin resistance and glycemia; however, further large-scale RCTs with adequate and multiple dosing schedules are needed.


Assuntos
Cálcio/uso terapêutico , Suplementos Nutricionais , Hiperglicemia/tratamento farmacológico , Resistência à Insulina , Insulina/metabolismo , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina D/uso terapêutico , Glicemia/metabolismo , Jejum/sangue , Humanos , Viés de Publicação
15.
Nutrients ; 11(5)2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31075833

RESUMO

Dairy food consumption is known to be inversely associated with periodontal disease. However, there are conflicting results depending on the type of dairy foods. The aim of this study was to determine the relationship between individual dairy food consumption and periodontal disease. A total of 9798 Korean adults, aged ≥30 years, who participated in the fifth and sixth Korea National Health and Nutrition Examination Survey were included in this study's analysis. Dairy food consumption was measured by the semi-quantitative food frequency questionnaire. Periodontal disease was defined as Community Periodontal Index score ≥3 in more than one of six sextants. Frequent intake of dairy foods (≥7 servings/week) was associated with a 24% lower prevalence of periodontal disease compared with never consumers after adjustment for age, gender, income, education, smoking, alcohol consumption, body mass index, diabetes mellitus status, calcium intake, tooth brushing frequency, and use of dental floss (Odds ratio (OR)= 0.76, 95% CI = 0.63-0.91, p for trend = 0.052). Also, frequent intake of milk (≥7 servings/week) was associated with a 26% lower prevalence of periodontal disease after adjustment for potential confounders (OR = 0.74, 95% CI = 0.61-0.89, p for trend = 0.022). Frequent consumption of dairy food including milk may have a beneficial effect on periodontal disease in the Korean adult population.


Assuntos
Dieta , Comportamento Alimentar , Leite/química , Nutrientes/uso terapêutico , Doenças Periodontais/prevenção & controle , Iogurte , Adulto , Animais , Cálcio/uso terapêutico , Caseínas , Laticínios , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , Probióticos/uso terapêutico , República da Coreia , Soro do Leite
16.
Nutrients ; 11(4)2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30991710

RESUMO

Estimation of the skeleton-protective effects of Ca in Cd-induced bone damage is helpful in the assessment of Cd health risk. The aim of this study was to identify whether Ca supplementation during exposure to different population-relevant doses of Cd can prevent Cd-induced bone damage under the tolerable upper intake level of Ca supplementation. Young female Sprague-Dawley rats were given different population-relevant doses of Cd (1, 5, and 50 mg Cd/kg diet) and Ca supplementation (0.4% Ca supplementation) intervention. Ca supplementation significantly decreased Cd-induced bone microstructure damage, increased bone biomechanics (p < 0.05), serum bone formation marker level (p < 0.05) and expression of osteogenic gene markers exposure to the 5 and 50 mg Cd/kg diets. However, it had no impact on these indicators under the 1 mg Cd/kg diets, with the exception of expression of osteogenic marker genes. Ca supplementation significantly decreased serum Klotho level (p < 0.05), and fibroblast growth factor 23/Klotho-associated gene expression in the kidney and bone showed significant changes. In conclusion, Ca supplementation has a positive effect on bone formation and bone quality against the damaging impact of Cd, especially with exposure to the 5 mg and 50 mg Cd/kg diet, which may be related to its impact on the fibroblast growth factor 23/Klotho axis.


Assuntos
Densidade Óssea/efeitos dos fármacos , Doenças Ósseas/prevenção & controle , Osso e Ossos/efeitos dos fármacos , Cádmio/efeitos adversos , Cálcio/uso terapêutico , Suplementos Nutricionais , Osteogênese/efeitos dos fármacos , Animais , Biomarcadores/sangue , Doenças Ósseas/metabolismo , Cálcio/administração & dosagem , Cálcio/farmacologia , Dieta , Exposição Ambiental/efeitos adversos , Feminino , Fatores de Crescimento de Fibroblastos/metabolismo , Glucuronidase/metabolismo , Rim/efeitos dos fármacos , Rim/metabolismo , Ratos Sprague-Dawley
17.
Hypertens Pregnancy ; 38(2): 129-139, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30935246

RESUMO

OBJECTIVES: The purpose of this study is to investigate whether calcium supplement with or without other drugs could reduce the risk of preeclampsia and gestational hypertension based on existed evidence, and to clarify whether there is discrepant effect among different population and using different dose. METHODS: PubMed, Cochrane library, and EMBASE database were searched. Two authors independently screened all records and extracted data. The meta-analysis was performed to calculate risk ratios and 95% CIs using random-effects models. RESULTS: 27 studies, with 28 492 pregnant women were included. The results showed calcium supplement was associated with lower incidence of preeclampsia (RR 0.51, 95% CI: 0.40 to 0.64) and gestational hypertension (RR 0.70, 95% CI: 0.60 to 0.82). Sub-analyses revealed high-dose (1.2-2 g/day), moderate-dose (0.6-1.2 g/day), and low-dose (<0.6 g/day) of calcium supplement could reduce the risk of preeclampsia. For gestational hypertension, only high dose and moderate dose groups were associated with reducing the risk of gestational hypertension. However, we could draw a conclusion which does group was the most protective, as we were unable to directly compare the effects of different doses. CONCLUSIONS: This study indicated calcium supplementation might decrease the risk of preeclampsia and gestational hypertension. And results of subgroups analyses enhanced our confidence to the protective effect of calcium supplementation. However, further studies with direct comparison of different dose of calcium supplementation are needed to explore the ideal dose of calcium supplementation to prevent preeclampsia and gestational hypertension.


Assuntos
Cálcio/uso terapêutico , Pré-Eclâmpsia/prevenção & controle , Suplementos Nutricionais , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Dalton Trans ; 48(17): 5735-5740, 2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-30972392

RESUMO

At present, though calcium (Ca) reagents with high calcium contents are widely synthesized, their wide application is limited due to their low absorption rates and poor bioavailability. Here we use a carboxymethyl cellulose (CMC) derivative with high water solubility and biocompatibility as a ligand to bind Ca2+. The resulting CaCMC complex exhibits remarkable solubility and absorbability under both basic and acidic conditions as well as in stomach mimicking and the gastrointestinal tract. Importantly, this Ca reagent shows high in vivo calcium bioavailability. Data from osteoporosis mouse models show that the CaCMC complex is superior to calcium carbonate in the treatment of osteoporosis. Therefore, the resulting CaCMC complex is used as a new, highly effective and desirable Ca supplement for daily life and clinical applications.


Assuntos
Materiais Biocompatíveis/farmacocinética , Cálcio/metabolismo , Cálcio/uso terapêutico , Carboximetilcelulose Sódica/química , Carboximetilcelulose Sódica/farmacocinética , Osteoporose/tratamento farmacológico , Osteoporose/metabolismo , Animais , Materiais Biocompatíveis/química , Materiais Biocompatíveis/metabolismo , Disponibilidade Biológica , Cálcio/administração & dosagem , Cálcio/farmacocinética , Carboximetilcelulose Sódica/metabolismo , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Tamanho da Partícula , Solubilidade , Propriedades de Superfície
19.
Gulf J Oncolog ; 1(29): 60-65, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30956196

RESUMO

INTRODUCTION: Thyroidectomy for thyroid cancers and central neck dissection are considered as independent predictors of postoperative hypocalcemia. Post-surgical hypocalcemia is the most common and often the most difficult long-term consequence of thyroid surgeries. Management of hypocalcemia is done with calcium supplementation, but there is no consensus on the timing and the amount of calcium supplementation. MATERIALS AND METHODS: A retrospective study of all thyroid cancer patients who underwent total thyroidectomy at our Centre, from August 2009 to August 2017 was done to evaluate the prevalence of symptomatic hypocalcemia. The patients were grouped into two based on the early and late supplementation of calcium in the form of intravenous calcium gluconate and oral calcium with calcitriol. RESULTS: There were 133 patients of which 109 had papillary carcinoma, 11 had follicular, 3 had hurthle cell and 10 had medullary carcinoma. Of these, 49.6% underwent total thyroidectomy alone and the rest with neck dissection. 38 patients (28.6%) had a unilateral neck dissection and 16 patients (12%) had a bilateral neck dissection. 14 out of the 67 patients (20.9%) who underwent neck dissection developed symptomatic hypocalcaemia, in contrast to only 2 patients out of the 66 (3%) without neck dissection. 31.7% of lateral neck dissection and 7.7% of central compartment dissection had symptomatic hypocalcaemia (p value = 0.0053). 22.5% of patients whose parathyroid were not identified had more symptomatic hypocalcaemia than in whom at least one parathyroid gland was seen (p value=0.0004). Eleven out of 73 patients (15.1%) who were treated late with calcium and calcitriol, and one out of 60 (1.7%) who had early calcium supplementation developed symptoms (p value=0.0073). CONCLUSION: Central compartment and lateral neck dissection were significantly associated with higher incidence of symptomatic hypocalcemia. Early intervention with calcium supplementation reduced the symptoms of hypocalcemia. Identification and preservation of parathyroid glands significantly reduces the hypocalcemia.


Assuntos
Cálcio/uso terapêutico , Hipocalcemia/etiologia , Tireoidectomia/efeitos adversos , Feminino , Humanos , Hipocalcemia/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Tireoidectomia/métodos
20.
South Med J ; 112(4): 228-233, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30943542

RESUMO

Hyperkalemia is a common problem in both inpatients and outpatients. Many disease states (eg, chronic kidney disease) and medications may precipitate hyperkalemia. There are several drugs now available to treat hyperkalemia. Many of these drugs are relatively new. This review provides information regarding drug-induced causes of hyperkalemia and provides detailed information on the medications used to treat this problem.


Assuntos
Hiperpotassemia/induzido quimicamente , Hiperpotassemia/tratamento farmacológico , Potássio/metabolismo , Doença Aguda , Administração Intravenosa , Agonistas Adrenérgicos beta/uso terapêutico , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Cálcio/uso terapêutico , Resinas de Troca de Cátion/uso terapêutico , Doença Crônica , Eletrocardiografia , Glucose/uso terapêutico , Humanos , Hiperpotassemia/complicações , Hiperpotassemia/fisiopatologia , Hipoglicemia/prevenção & controle , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Polímeros/uso terapêutico , Poliestirenos/uso terapêutico , Silicatos/uso terapêutico , Bicarbonato de Sódio/uso terapêutico , Inibidores de Simportadores de Cloreto de Sódio e Potássio/uso terapêutico
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