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Introduction: Dengue fever, a widespread viral infection, poses a significant global health threat with diverse clinical outcomes. Early identification of severe cases is vital for effective intervention and reducing mortality. This study investigates the potential of serum calcium levels as a biomarker for dengue severity, aiming to enhance clinical management strategies. Method: This cross-sectional study spanning six months investigated serum calcium levels as a biomarker for dengue severity and prognosis. Dengue-positive indoor patients over 18 years were included while those with co-morbidities or endocrine conditions were excluded. Data from Medicine wards/MICU patients were categorised into non-severe and severe dengue groups based on WHO classification. Result: The average Calcium level in non-severe Dengue (n=13), was higher (8.68 ± 0.2) compared to severe dengue (n=60) patients (7.25 ± 0.6). Hypocalcemia correlated with elevated haematocrit levels and reduced platelet counts, suggesting a relationship between calcium status and haematological parameters. Warning signs such as plasma leakage and bleeding were also linked to lower calcium levels (p < 0.05). Deceased patients demonstrated notably lower calcium levels (6.1 ±0.7) compared to survivors (7.57 ±0.7). Conclusion: Serum calcium levels show promise as a valuable biomarker for predicting dengue severity. These findings highlight the importance of further research to validate and implement calcium levels as a predictive tool in dengue fever.

Background. Serum phosphate is a key parameter in the management of chronic kidney disease-mineral and bone disorder (CKD-MBD). The timing of phosphate measurement is not standardized in the current guidelines. Since the optimal range of these biomarkers may vary depending on the duration of the interdialytic interval, in this analysis of the Current management of secondary hyperparathyroidism: a multicentre observational study (COSMOS), we assessed the influence of a 2- (midweek) or 3-day (post-weekend) dialysis interval for blood withdrawal on serum levels of CKD-MBD biomarkers and their association with mortality risk. Methods. The COSMOS cohort (6797 patients, CKD Stage 5D) was divided into two groups depending upon midweek or post-weekend blood collection. Univariate and multivariate Cox's models adjusted hazard ratios (HRs) by demographics and comorbidities, treatments and biochemical parameters from a patient/centre database collected at baseline and every 6 months for 3 years. Results. There were no differences in serum calcium or parathyroid hormone levels between midweek and post-weekend patients. However, in post-weekend patients, the mean serum phosphate levels were higher compared with midweek patients (5.5 ± 1.4 versus 5.2 ± 1.4 mg/dL, P < 0.001). Also, the range of serum phosphate with the lowest mortality risk [HR ≤ 1.1; midweek: 3.5–4.9 mg/dL (95% confidence interval, CI: 2.9–5.2 mg/dL); post-weekend: 3.8–5.7 mg/dL (95% CI: 3.0–6.4 mg/dL)] showed significant differences in the upper limit (P = 0.021). Conclusion. Midweek and post-weekend serum phosphate levels and their target ranges associated with the lowest mortality risk differ. Thus, clinical guidelines should consider the timing of blood withdrawal when recommending optimal target ranges for serum phosphate and therapeutic strategies for phosphate control. [ABSTRACT FROM AUTHOR]

Introduction: The numerous evidence showing spectrum of vitamin D effects on human health resulted in both updates of vitamin D supplementation guidelines for general population and concerns on potential risk of hypercalcaemia. The aim of this study was to analyse trends in serum 25-hydroxyvitamin D concentration (25(OH)D) change over the 30 years of operation of a single pediatric diagnostic unit.Materials and methods: Calcium-phosphate metabolism markers and 25(OH)D concentrations were analyzed in a group that consisted of newborns and infants commissioned for diagnostics due to suspected calcium-phosphate metabolic disturbances (n = 3,163; mean age 8.0 ± 3.0 months).Results: 25(OH)D < 10 ng/ml was noted in 4.5% of patients (n = 163), 10–20 ng/ml in 14.7% (n = 465), 20–30 ng/ml in 23.9% (n = 756) and 30–50 ng/ml in 35.9% (n = 1,136). The mean 25(OH)D concentration in analyzed group was 37.5 ± 24.5 ng/ml. In patients with 25(OH)D concentration < 10 ng/ml a normal calcaemia (2.25–2.65 mmol/l) was noted in 83.4% cases (n = 136). Eighty one patients had 25(OH)D concentrations above 100 ng/ml with co-existing calcaemia in range of 2.6–4.38 mmol/l (mean Ca = 2.69 mmol/l). Hypocalcaemia (Ca < 2.25 mmol/l) was observed in 0.54%, (n = 17). 13.8% patients revealed calcium levels >2.65 mmol/l (n = 435). In general, the mean calcium-phosphate markers values were within the reference range for age. The highest mean 25(OH)D concentration of 51.8 ng/ml ± 38.8 was noted in years 1981–1999 (n = 305). The lowest mean 25(OH)D value was observed in years 2010–2011 (29.0 ng/ml ± 13.6; n = 412). The trend of decreasing 25(OH)D concentration during analyzed time period was significant (r = −0.29, p < 0.0001).Conclusions: Eighty percentage of children aged 0–36 months had 25(OH)D concentration >20 ng/ml, however, during 3 decades a mean 25(OH)D concentrations trended significantly to decrease. A direct relationship between low 25(OH)D concentration and hypocalcaemia was not observed nor between high 25(OH)D concentration and hypercalcemia.

Introduction: The numerous evidence showing spectrum of vitamin D effects on human health resulted in both updates of vitamin D supplementation guidelines for general population and concerns on potential risk of hypercalcaemia. The aim of this study was to analyse trends in serum 25-hydroxyvitamin D concentration (25(OH)D) change over the 30 years of operation of a single pediatric diagnostic unit. Materials and methods: Calcium-phosphate metabolism markers and 25(OH)D concentrations were analyzed in a group that consisted of newborns and infants commissioned for diagnostics due to suspected calcium-phosphate metabolic disturbances (n = 3,163; mean age 8.0 ± 3.0 months). Results: 25(OH)D < 10 ng/ml was noted in 4.5% of patients (n = 163), 10–20 ng/ml in 14.7% (n = 465), 20–30 ng/ml in 23.9% (n = 756) and 30–50 ng/ml in 35.9% (n = 1,136). The mean 25(OH)D concentration in analyzed group was 37.5 ± 24.5 ng/ml. In patients with 25(OH)D concentration < 10 ng/ml a normal calcaemia (2.25–2.65 mmol/l) was noted in 83.4% cases (n = 136). Eighty one patients had 25(OH)D concentrations above 100 ng/ml with co-existing calcaemia in range of 2.6–4.38 mmol/l (mean Ca = 2.69 mmol/l). Hypocalcaemia (Ca < 2.25 mmol/l) was observed in 0.54%, (n = 17). 13.8% patients revealed calcium levels >2.65 mmol/l (n = 435). In general, the mean calcium-phosphate markers values were within the reference range for age. The highest mean 25(OH)D concentration of 51.8 ng/ml ± 38.8 was noted in years 1981–1999 (n = 305). The lowest mean 25(OH)D value was observed in years 2010–2011 (29.0 ng/ml ± 13.6; n = 412). The trend of decreasing 25(OH)D concentration during analyzed time period was significant (r = −0.29, p < 0.0001). Conclusions: Eighty percentage of children aged 0–36 months had 25(OH)D concentration >20 ng/ml, however, during 3 decades a mean 25(OH)D concentrations trended significantly to decrease. A direct relationship between low 25(OH)D concentration and hypocalcaemia was not observed nor between high 25(OH)D concentration and hypercalcemia. [ABSTRACT FROM AUTHOR]

Abomasal displacement is one of the most important disorders of the digestive tract in high-yield dairy cows. The etiology and pathogenesis of its occurrence has not been fully clarified to this day. The work examines calcaemia and phosphataemia in cows during the antepartal and postpartal periods and their connection with the incidence of abomasal displacement. The experiment covered 30 cows in advanced stages of gravidity. Blood samples were taken two weeks before expected parturition and two weeks after calving. In all blood samples (taken antepartal and postpartal), concentrations of calcium and an organic phosphorus were determined using a commercial test package (Bio-Merieux). Following parturition, left displacement of the abomasums was established in seven (23.33 %) of the 30 cows covered by the experiment (experimental group). The remaining 23 cows in the experiment were clinically healthy, they were placed in a group and represented control animals. The average value of calcaemia for the control group of cows during the antepartal period was 2.72±0.25 mmol/l, and of phosphataemia 2.04±0.25 mmol/l. In the same cows postpartum, average calcaemia values were 2.46±0.22 mmol/l and phosphataemia 1.85±0.29 mmol/l. The average antepartal value for calcaemia in the experimental group of cows was 2.51±0.25 mmol/l, and for phosphataemia 1.73± 0.22 mmol/l. The average values for this group of cows postpartally was 2.13±0.31 mmol/l for calcaemia and 1.43±0.24 mmol/l for phosphataemia. The differences between the concentration values for calcium and phosphorus obtained postpartally between the experimental and control groups were statistically significant. .

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Abstract: In vivo iontophoretic delivery of salmon calcitonin (SCT) in hairless rats using a self-contained wearable and disposable iontophoretic patch was investigated. Iontophoretic patches with built-in proprietary Zn/AgCl electrodes were used. SCT was formulated in citrate buffer (50mM, pH 4.0) to impart a positive charge for anodal iontophoresis. SCT was delivered intravenously to determine primary pharmacokinetic parameters. Pharmacokinetics of iontophoretic delivery of SCT was compared with subcutaneous route of administration. Blood samples were collected through tail vein and analyzed for serum SCT and calcium levels. Pharmacokinetic parameters were calculated by non-compartmental analysis. An average current of 0.43±0.01mA was maintained during patch application. Iontophoretic patches delivered SCT at an average infusion rate of 177.9±58.7ng/(minkg) and an average steady state concentration of 7.58±1.35ng/ml was achieved. There was no difference between the calcium lowering effect of iontophoretic patch and subcutaneous injection (p >0.05). Clearance and half-life of SCT after IV administration were found to be 16.8±0.9ml/(minkg) and 33.5±3.3min, respectively. The iontophoretic delivery of SCT was well defined by a one-compartment model with zero-order infusion. Iontophoretic patch delivered therapeutically relevant concentrations of SCT in hairless rats and delivery was comparable to conventional routes. [Copyright &y& Elsevier]

Le récepteur aux ions calcium extracellulaires (CaSR) appartient à la famille 3 des récepteurs couplés aux protéines G. Il contrôle la sécrétion de l’hormone parathyroïdienne (PTH) et joue un rôle clef dans la régulation de l’homéostasie calcique. Son activité est modulée par de faibles variations de la concentration des ions calcium (Ca2+) et magnésium (Mg2+) extracellulaires conduisant à la stimulation de la voie des phospholipases C et A2. Le développement récent de molécules de synthèse capables de potentialiser (calcimimétiques) les actions du Ca2+ sur ce récepteur et de réduire la concentration de PTH circulant in vivo, suggère qu’il constitue une nouvelle cible thérapeutique pour le traitement des hyperparathyroïdies primaires et secondaires. Son blocage par un antagoniste (calcilytique) stimule la sécrétion de PTH et pourrait être mis à profit pour le traitement de l’ostéoporose. Ce récepteur est aussi exprimé dans d’autres tissus tels que la thyroïde, les reins, l’os ou encore dans des populations neuronales et gliales, où il participerait aux réponses cellulaires complexes induites par les ions Ca2+ et Mg2+ présents dans les fluides extracellulaires. Mots clés : hormone parathyroïdienne, calcémie, insuffisance rénale chronique, ostéoporose, récepteur ionique Abstract The calcium sensing receptor (CaSR) belongs to family 3 of G-protein coupled receptors. The CaSR, expressed at the surface of the parathyroid cells, controls parathyroid hormone (PTH) secretion and is the main regulator of calcium homeostasis. Its activity is regulated by small changes in the physiological concentrations of calcium and magnesium ions present in the serum and extracellular fluids, leading to the stimulation of the phospholipases C and A2. Molecules that potentiate the effect of extracellular calcium are called calcimimetics. They reduce the PTH level in vivo and have been proposed to be of therapeutic benefit for the treatment of both primary and secondary hyperparathyroidism. The blocking of CaSR by a calcilytic molecule results in the increase in serum PTH and might be of interest in the treatment of osteoporosis. The CaSR is also expressed in the thyroid, kidney, bone and in neuronal and glial cell populations, where it should be involved in the complex responses associated with calcium and magnesium ions present in the extracellular fluids. Keywords: parathyroid hormone, calcaemia, chronic renal insufficiency, osteoporosis, ionic receptor Texte reçu le 11 février 2003 ; accepté le 15 septembre 2003 [ABSTRACT FROM AUTHOR]

This case report presents fluoconazole efficacy to reduce hypercalcaemia and increased urinary calcium excretion in a patient with nephrocalcinosis after a long history of recurrent renal stones caused by a loss-of-function mutation of the CYP24A1 gene. The CYP24A1 gene codes for a key enzyme in the vitamin D endocrine system that protects against vitamin D toxicity by degrading the circulating excess of both 1,25-dihydroxyvitamin D, the hormonal form of vitamin D, and its precursor, 25-hydroxyvitamin D. In order to expedite the identification of this rare disorder and improve therapies to avoid its progression to nephrocalcinosis, this editorial updates the current knowledge on the frequency of CYP24A1-inactivating mutations, the features of their early clinical presentation and progression, and the pathophysiology of vitamin D activation in health and in granulomatous disorders that may help improve current treatment. [ABSTRACT FROM AUTHOR]