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The aim of this study was to evaluate the effects of a combined low-dose therapy of calcitriol and calcium carbonate on bone metabolism in the early phases of chronic renal failure. A 30-month study involving 17 patients with ECRF was made: 6 months of observation were followed by 24 months of therapy (calcitriol 0.25 μg/day plus calcium carbonate 1 g/day). The most important results were that renal function was stable throughout the study and there was an increase in calcaemia and a decrease in plasma alkaline phosphatase, plasma osteocalcin, plasma PTH and urinary hydroxyproline. We observed a progressive slowing of the rate of loss of appendicular bone density as well as a decrease of osteoblastic and osteoclastic activity and an improvement of bone mineralization. In conclusion, low doses of calcitriol plus calcium carbonate seem to improve the biochemical and bone derangements in early renal failure. [ABSTRACT FROM PUBLISHER]

Background: Premature birth is a growing and serious public health problem affecting more than one of every ten infants worldwide. Bronchopulmonary dysplasia (BPD) is the most common neonatal morbidity associated with prematurity and infants with BPD suffer from increased incidence of respiratory infections, asthma, other forms of chronic lung illness, and death (Day and Ryan, Pediatr Res 81: 210-213, 2017; Isayama et la., JAMA Pediatr 171:271-279, 2017). BPD is now understood as a longitudinal disease process influenced by the intrauterine environment during gestation and modulated by gene-environment interactions throughout the neonatal and early childhood periods. Despite of this concept, there remains a paucity of multidisciplinary team-based approaches dedicated to the comprehensive study of this complex disease., Methods: The Discovery BPD (D-BPD) Program involves a cohort of infants < 1,250 g at birth prospectively followed until 6 years of age. The program integrates analysis of detailed clinical data by machine learning, genetic susceptibility and molecular translation studies., Discussion: The current gap in understanding BPD as a complex multi-trait spectrum of different disease endotypes will be addressed by a bedside-to-bench and bench-to-bedside approach in the D-BPD program. The D-BPD will provide enhanced understanding of mechanisms, evolution and consequences of lung diseases in preterm infants. The D-BPD program represents a unique opportunity to combine the expertise of biologists, neonatologists, pulmonologists, geneticists and biostatisticians to examine the disease process from multiple perspectives with a singular goal of improving outcomes of premature infants., Trial Registration: Does not apply for this study.

The results of a study of caries in a 3 year old cohort of children performed by the CLACyD (Spanish abbreviation by initials for Nutrition, Growth and Development Program of Córdoba) are analysed. The prevalence of caries was 19.7% for boys and 16.1% for girls. Dmf-t and dmf-s values were 0.55-0.75% for girls and 0.73-1.22% for boys. The most affected element was the first mandibular molar (16.30% of the population). Extracted and filled elements accounted for 1.8 and 5.9% of the dmf-t index. According to the Caries Analysis System, a higher prevalence of the PF (pits and fissures) pattern and the AM (anterior maxillary bone) pattern was observed as compared to the PP (proximal posterior) and BL (buccolingual) patterns. The percentage distribution of BL lesions over all the patterns exhibited statistically significant (p = 0.05) differences between girls and boys. The PF and PP patterns were more severe in boys (p = 0.0006 and p = 0.002 respectively). Based on the present data we conclude that this population exhibits marked prevalence which can rapidly increase and pose a threat to temporary and mixed dentitions. We herein recommend preventive measures of widespread use (regarding toothbrushing, and eating habits with particular reference to carbohydrate consumption) and preventive-therapeutic treatments for diseased patients (topical applications of fluoride, sealing agents and active treatment of caries).

The present work describes and analyzes the results of a randomized clinical trial on adolescents (age 18.2 +/- 0.6) carried out in order to evaluate the effects of a twice daily mouthrinse application containing xylitol, sorbitol, sacarine, ciclamate, aspartame, chlorhexidine, hexetidine or NaF for 14 days on amylase, peroxidase, thiocyanate, hypothiocyanite, secretory IgA and total proteins in whole saliva. No significative changes were observed in health and bucodental parameters nor in flow salivary rate, protein, secretory Ig A, or thiocyanate levels as a consequence of the mouthrinses application. On the other hand, NaF treatment (0.02%, 0.05% or 0.1%) did cause an increase in salivary peroxidase and hypothiocyanite, being the former increase higher than the second one. Peroxidase increase was proportional to the mouthrinse dose (r = 0.78; p < 0.01), but not to the hypothiocyanite increase (r = 0.407; p = 0.12). Since the adolescents' health condition was the adequate, it is suggested that the peroxidase increase was due to a higher enzyme synthesis and/or secretion by the parotid and/or submaxillar glands. It is concluded that the increases in salivary peroxidase and hypothiocyanite caused by the NaF treatment favour the host, as they potentiate one of the mechanisms that modulate dental plaque composition, preventing in such a way the colonization by cariogenic pathogens.

Intravenous calcitriol is known to directly suppress PTH secretion and release. We evaluated the effect of four months of treatment with low-dose intravenous calcitriol on PTH levels in 83 hemodialysis patients. The criteria for including patients in the study were a serum PTH levels at least four times the normal limit, a serum total calcium less than 10 mg/dl and good control of the serum phosphorus level. All patients underwent standard bicarbonate or acetate dialysis; dialysate calcium level was maintained at the usual 3.5 mEq/liter concentration. Initial calcitriol dose was 0.87 +/- 0.02 (SEM) micrograms (0.015 micrograms/kg body wt) thrice weekly at the end of dialysis, and it was reduced in case of hypercalcemia or elevated calcium-phosphate product. Seven out of 83 patients dropped out during treatment. Among the 76 patients who completed the study, 58 (76%) showed a highly significant decrease of intact PTH levels (average reduction 48%) and of alkaline phosphatase levels after four months of therapy. Total serum calcium increased slightly but significantly in the responder group but remained unchanged in the non-responders. No significant changes in ionized calcium levels could be detected, even in responders. Treatment was well tolerated by patients, but 60% of them had transient episodes of hyperphosphatemia. Mean serum phosphate was 4.95 mg/dl at the beginning of the study. It increased significantly after four months of treatment in patients who showed a decrease of PTH levels, although it remained within acceptable limits, below 5.5 mg/dl. Twenty-eight of 76 patients (37%) reduced the dose of calcitriol because their calcium-phosphate products exceeded 60.(ABSTRACT TRUNCATED AT 250 WORDS)