Ratio Of Calcium Research Articles

Normocalcemic hyperparathyroidism after successful parathyroidectomy for single parathyroid adenoma: Prevalence, etiological factors, predictive markers, treatment and evolution

Background and objectivePostparathyroidectomy normocalcemic hyperparathyroidism (PPNCHPPT) is a frequent situation for which we have no information in our country. The objective is to know our prevalence of PPNCHPPT, the associated etiological factors, the predictive markers, the treatment administered and the evolution. Patients and methodRetrospective observational cross-sectional study on 42 patients. Twelve patients with PPNCHPPT and 30 without PPNCHPPT are compared. ResultsHPPTNCPP prevalence: 28.6%. Etiological factors: vitamin D deficiency: 75%; bone remineralization: 16.7%; renal failure: 16.7%; hypercalciruria: 8.3%. No change in the set point of calcium-mediated parathormone (PTH) secretion was observed, but an increase in the preoperative PTH/albumin-corrected calcium (ACC) ratio was observed. Predictive markers: PTH/ACC ratio (AUC 0.947; sensitivity 100%, specificity 78.9%) and PTH (AUC 0.914; sensitivity 100%, specificity 73.7%) one week postparathyroidectomy. Evolution: follow-up 30 ± 16.3 months: 50% normalized PTH and 8.3% had recurrence of hyperparathyroidism. Patients with PPNCHPPT less frequently received preoperative treatment with bisphosphonates and postoperative treatment with calcium salts. ConclusionsThis is the first study in our country that demonstrates a mean prevalence of PPNCHPPT, mainly related to a vitamin D deficiency and a probable resistance to the action of PTH, which can be predicted by the PTH/ACC ratio and PTH a week post-intervention and often evolves normalizing the PTH. We disagree with the etiological effect of hypercalciuria and the change in the PTH/calcemia regulation set point, and we acknowledge the scant treatment administered with calcium salts in the postoperative period.

Hiperparatiroidismo normocalcémico tras paratiroidectomía exitosa por adenoma único paratiroideo: prevalencia, factores etiológicos, marcadores predictivos, tratamiento y evolución

Background and objectivePostparathyroidectomy normocalcemic hyperparathyroidism (PPNCHPPT) is a frequent situation for which we have no information in our country. The objective is to know our prevalence of PPNCHPPT, the associated etiological factors, the predictive markers, the treatment administered and the evolution. Patients and methodRetrospective observational cross-sectional study on 42 patients. Twelve patients with PPNCHPPT and 30 without PPNCHPPT are compared. ResultsHPPTNCPP prevalence: 28.6%. Etiological factors: vitamin D deficiency: 75%; bone remineralization: 16.7%; renal failure: 16.7%; hypercalciruria: 8.3%. No change in the set point of calcium-mediated parathormone (PTH) secretion was observed, but an increase in the preoperative PTH/albumin-corrected calcium (ACC) ratio was observed. Predictive markers: PTH/ACC ratio (AUC 0.947; sensitivity 100%, specificity 78.9%) and PTH (AUC 0.914; sensitivity 100%, specificity 73.7%) one week postparathyroidectomy. Evolution: follow-up 30±16.3 months: 50% normalized PTH and 8.3% had recurrence of hyperparathyroidism. Patients with PPNCHPPT less frequently received preoperative treatment with bisphosphonates and postoperative treatment with calcium salts. ConclusionsThis is the first study in our country that demonstrates a mean prevalence of PPNCHPPT, mainly related to a vitamin D deficiency and a probable resistance to the action of PTH, which can be predicted by the PTH/ACC ratio and PTH a week post-intervention and often evolves normalizing the PTH. We disagree with the etiological effect of hypercalciuria and the change in the PTH/calcemia regulation set point, and we acknowledge the scant treatment administered with calcium salts in the postoperative period.

256 Evaluation Calcium and Phosphorus Ratios in the Presence of Phytase on Performance and Whole-Body Bone Mineralization in Growing Pigs

Abstract The objective of this study was to evaluate the effects of dietary calcium and phosphorus ratios in the presence of super dose phytase on grower pigs growth performance and bone mineral density. In two replicates, a total of 48 mixed sex pigs (26.7 kg BW) were allotted by BW and sex into individual pens across 3 dietary treatments (16 pigs/treatment) for 28 days. All diets contain phytase at 1,500 FTU/kg of complete feed and the three diet treatments were formulated with differing levels of Ca to achieve 0.7, 1.1 and 1.5 total Ca:total P. All diets were formulated to be isocaloric and isonitrogenous and ratios were achieved by vary limestone and sand. Pig BW and feed disappearance were recorded at the start (d 0) and end (d 28) of the study to calculate ADG, ADFI and G:F. On day 28, all pigs were euthanized to determine whole body bone, foot, rib, femur and tibia bone mineral density via dual x-ray absorptiometry. Data were analyzed with pen as the experimental unit, fixed effect of dietary treatment, sex and their interaction, and initial BW block and repartition as random effects. Differences were determined significant at P ≤ 0.05. Pig ADG was increased in the 1.1 verses 0.7 and 1.5 Ca:P diets (1.01, 0.95 and 0.95 kg/d, respectively, P = 0.046). End body weight was not different in the 0.7, 1.12 and 1.5 Ca:P treatments (53.5, 54.8 and 53.1 kg, respectively, P = 0.106). Diet Ca:P ratio did not alter ADFI or G:F. Whole body, tibia and femur bone mineral density was increased by 110% in 1.5 verses 0.7 Ca:P fed pigs, with bone mineral density being intermediated in the 1.1 Ca:P diets. Whole body (0.740, 0.752, 0.797, g/cm2, for 0.7, 1.1 and 1.5 Ca:P respectively, P = 0.033). For 0.7, 1.1 and 1.5 Ca:P femurs, bone mineral density was 0.463, 0.498 and 0.516, respectively, P = 0.034). Dietary treatment did not alter whole foot or 10th rib bone mineral densities (P > 0.05). Sex did not affect pig performance, but gilts had a 9% increase in bone mineral content. In conclusion, formulating dietary Ca:P in the presence of super dosing phytase at 1.1:1 total Ca:P resulted in the best ADG, but a ratio of 1.5:1 had the greatest bone mineral density.

Risk factors and construction of a nomogram model for cirrhotic portal vein thrombosis combined with esophagogastric variceal bleeding

Objective: To investigate the risk factors and construct a nomogram model for predicting the occurrence of cirrhotic portal vein thrombosis in patients combined with esophagogastric variceal bleeding (EVB). Methods: Clinical data on 416 cirrhotic PVT cases was collected from the First Hospital of Lanzhou University between January 2016 and January 2022. A total of 385 cases were included after excluding 31 cases for retrospective analysis. They were divided into an esophagogastric variceal bleeding group and a non-esophagogastric variceal bleeding group based on the clinical diagnosis. The esophagogastric variceal group was then further divided into an EVB group and a non-bleeding group. All patients underwent gastroscopy, serology, and imaging examinations. The risk factors of PVT combined with EVB were identified by univariate analysis using SPSS 26. The prediction model of cirrhotic PVT in patients combined with EVB was constructed by R 4.0.4. The prediction efficiency and clinical benefits of the model were evaluated by the C-index, area under the receiver operating characteristic curve, calibration plots, and decision curve. The measurement data were examined by a t-test or Mann-Whitney U test. The counting data were tested using the χ(2) test or the Fisher exact probability method. Results: There were statistically significant differences in the etiology, Child-Pugh grade,erythrocyte count, hematocrit, globulin, and serum lipids between the esophageal and non-esophageal varices groups (P < 0.05). There were statistically significant differences in etiology, erythrocyte count, hemoglobin, hematocrit, neutrophil percentage, total protein, globulin, albumin/globulin, urea, high-density lipoprotein cholesterol, calcium, and neutrophil lymphocyte ratio (NLR) between the EVB and non-bleeding groups (P < 0.05). Multivariate logistic regression analysis showed that etiology (OR = 3.287, 95% CI: 1.497 ~ 7.214), hematocrit (OR = 0.897, 95% CI: 0.853 ~ 0.943), and high-density lipoprotein cholesterol (OR = 0.229, 95% CI: 0.071 ~ 0.737) were independent risk factors for cirrhotic PVT patients combined with EVB. The constructed normogram model predicted the probability of bleeding in patients. The nomogram model had shown good consistency and differentiation (AUC = 0.820, 95% CI: 0.707 ~ 0.843), as verified by 10-fold cross-validation (C-index = 0.799) and the Hosmer-Lemeshow goodness of fit test (P = 0.915). The calibration plot and the decision curve suggested that the prediction model had good stability and clinical practicability. Conclusion: The risk factors for EVB occurrence include etiology, erythrocyte, hemoglobin, hematocrit, percentage of neutrophils, total protein, globulin, albumin/globulin, urea, high-density lipoprotein cholesterol, calcium, and NLR in patients with cirrhotic liver. The constructed prediction model has good predictive value, and it can provide a reference for medical personnel to screen patients with high bleeding risk for targeted treatment.

Clinical application of regional citrate anticoagulation for membrane-based therapeutic plasma exchange in children with liver failure.

Regional citrate anticoagulation (RCA) is being used more commonly in children for continuous renal replacement therapy. Few reports describe the application of membrane-based therapeutic plasma exchange (mTPE) with RCA in children with liver failure (LF). To explore the application of RCA-mTPE in children with LF. We retrospectively analyzed data from children with LF who underwent RCA-mTPE in the Children's Hospital of Chongqing Medical University's pediatric intensive care unit. We used the total to ionized calcium ratio (T/iCa) > 2.5 as the diagnostic criteria for citrate accumulation (CA). The patients were divided into two groups according to the occureence of CA at the end of RCA-mTPE (CA group: T/iCa > 2.5; NCA group: T/iCa ≤ 2.5). To evaluate the clinical safety and efficacy of RCA-mTPE, the following data from medical records were assessed and compared between groups: clinical characteristics, reasons for LF, RCA-mTPE parameters and duration, laboratory findings, and complications. In total, 92 RCA-mTPE treatments were administered to 21 children with LF over 3.8 ± 0.9 h. The following mean values were determined: blood flow rate (QB) = 2.8 ml/kg/min, 4% sodium citrate dose/blood flow rate ratio (QCi/QB) = 1.1(QCi,ml/kg/h); plasma dose/body weight ratio(QP/BW) = 18.5 (QP, ml/kg/h); 10% calcium gluconate dose/blood flow rate ratio (QCa/QB) = 0.2(QCa, ml/kg/h). The mean concentration of iCa in vitro was 0.38 ± 0.07 mmol/L. Citrate accumulation was recorded after 34 (37%) treatments. Hypocalcemia occurred in 11 (12%) and 7 (7.6%) treatments, during and after mTPE, respectively. Three hypotensive and one convulsive events, related to hypocalcemia, and two clotting events occurred during RCA-mTPE. After RCA-mTPE, the patients' pH, HCO3- and Na+ levels, and T/iCa were significantly increased and the total bilirubin (TB), conjugated bilirubin (DB), prothrombin time (PT), activated partial thromboplastin time (APTT), alanine aminotransferase (ALT), aspartate aminotransferase (AST),and ammonia levels were significantly decreased. The TB, DB, and lactic acid levels, before RCA-mTPE, were significantly higher in the CA group than in the NCA group, but there were no significance between the two groups in QB/BW, QCi/QB, and QP/BW, mTPE duration, and estimated amount of citrate metabolized. Children with LF undergoing RCA-mTPE are at risk of hypocalcemia. With proper protocol adjustment, however, RCA-mTPE can be used safely and effectively in these patients.

VOLUNTARY INTAKE OF CAPTIVE PSITTACINES FED MIXED DIETS OF SEEDS AND EXTRUDED FEED

Psittacines are popular pet birds throughout the world. In the wild these birds consume a varied diet composed of seeds, nuts, flowers and invertebrates, according to seasonal availability. It is rare for captive birds to have a similar lifestyle and such a diverse diet. In captivity, mixed feeds (seeds and extruded feed) are available on the petfood market. However, these mixed diets allow birds to actively eat seeds resulting in non-balanced diets. The aim of this study was to determine selective voluntary intake of different diets based on different types of seeds and extruded feed in three different small/medium psittacine species commonly maintained as pets. Rose-ringed parakeets (P. krameri) preferentially consumed sunflower seeds, while lovebirds (Agapornis spp.), in the absence of sunflower seed, selected smaller seeds (canary grass and millet seeds). Cockatiels (N. hollandicus) consumed balanced amounts of seed and extruded feed. When sunflower seed was not provided, all three species selected canary grass and millet seeds over extruded feed. Extruded feed was only consistently consumed when offered as the only food source. This selective feeding resulted in excess intake of fat, protein and gross energy and generally a low calcium and imbalanced calcium and phosphorus ratio in diets in which extruded feed was not consistently consumed. Finally, metabolizable energy intake was above the recommended maintenance energy requirement when experimental diets containing sunflower seeds and exclusively extruded feed were offered. Voluntary intake of mixed diets can predispose captive psittacines to nutrient deficiencies, specially especially in the long term.

PROSPECTIVE EXAMINATION OF THE K/ICA RATIO AS A PREDICTOR FOR MORTALITY IN SEVERE HEMORRHAGE.

Background: Patients receiving massive transfusion protocol (MTP) are at risk for posttransfusion hypocalcemia and hyperkalemia. Previous retrospective analysis has suggested the potassium/ionized calcium (K/iCa) ratio as a prognostic indicator of mortality. This prospective study sought to validate the value of the K/iCa ratio as a predictor for mortality in patients receiving MTP. Methods: This was a prospective analysis of adult trauma patients who underwent MTP activation from May 2019 to March 2021 at an urban level 1 trauma center. Serum potassium and iCa levels within 0 to 1 h of MTP initiation were used to obtain K/iCa. Receiver operator characteristic curve analysis assessed predictive capacity of K/iCa on mortality. Kaplan-Meier survival analysis and Cox regression examined the effect of K/iCa ratio on survival. Results: A total of 110 of 300 MTP activation patients met inclusion criteria. Overall mortality rate was 31.8%. No significant differences between the elevated K/iCa and lower K/iCa groups were found for prehospital or emergency department initial vitals, shock index, or injury severity. However, nonsurvivors had a significantly higher median K/iCa ratio compared with those who survived ( P < 0.01). Multivariable logistic regression revealed the total number of blood products to be significantly associated with elevated K/iCa (odds ratio, 1.02; 95% CI, 1.01-1.04; P = 0.01). The Kaplan Meier survival curve demonstrated a significantly increased rate of survival for those with an elevated K/iCa ratio ( P < 0.01). Multivariable Cox regression adjusted for confounders showed a significant association between K/iCa and mortality (Hazard Ratio, 4.12; 95% CI, 1.89-8.96; P < 0.001). Conclusion: This evidence further highlights the importance of the K/iCa ratio in predicting mortality among trauma patients receiving MTP. Furthermore, it demonstrates that posttransfusion K levels along with iCa levels should be carefully monitored in the MTP setting. Level of Evidence: Level II. Study Type: Prognostic/epidemiological.

Relative Availability of Nitrogen and Calcium Regulates the Growth of Poplar Seedlings Due to Transcriptome Changes

The concentrations of exogenous nitrogen and calcium can significantly regulate plant growth and photosynthesis and mutually affect their absorption and utilization. However, whether there is an optimal nitrogen–calcium ratio (N:Ca ratio) in poplar seedling growth and physiological adaptation and what the mechanism of changes in the transcriptome is remain unclear. In this study, three different N:Ca ratios were used to grow poplar seedlings, and physiological and transcriptomic methods were used to study the molecular mechanisms of poplar growth under nitrogen–calcium synergy and to determine the optimal N:Ca ratio for poplar seedling growth. The results of this study showed that maximum poplar seedling growth occurred in the treatment with an N:Ca ratio of 2, which resulted in significantly greater induction of growth than the two other treatments (p &lt; 0.05). Under the lowest N:Ca ratio, poplar seedlings can ensure normal development by regulating photosynthesis, while under the highest N:Ca ratio, regulating nitrogen metabolism can achieve the same result. These results contribute to a better understanding of the molecular mechanisms by which poplar seedlings respond to different ratios of N:Ca. This study provides a valuable basis for exploring the synergistic effects of nitrogen and calcium on the growth of poplar shelterbelts.

Calcium-Citrate Anticoagulation during Continuous Renal Replacement Therapy in Patients with Metformin Intoxication: A Case Series, Mathematical Estimation of Citrate Accumulation, and Literature Review

Plain Language SummaryMetformin intoxication is a potentially life-threatening condition characterized by severe metabolic acidosis that could require intensive care unit admission and renal replacement therapy (RRT) for metformin removal. According to current guidelines, a citrate solution is commonly administered to generate regional anticoagulation in RRT due to its effect on chelating ionized calcium, an essential element of the coagulation pathway. Citrate metabolism can be impaired during metformin intoxication, and its administration could lead to accumulation worsening the metabolic acidosis. Citrate is not routinely measured, and its accumulation is clinically diagnosed by the ratio between total and ionized plasma calcium concentration (T/I calcium ratio) >2.5 or estimating the presence of unmeasured anions (UA), calculating the strong ion gap (SIG), i.e., the difference between the strong anions and cation, and the concentration of bicarbonate, dissociated albumin, and phosphates. We compared our results obtained from a case series of three patients with a theoretical model of citrate accumulation. Finally, we reviewed the literature to unveil clinical practice in this scenario. Our results support that diluted citrate can be safely used for RRT in patients with metformin toxicity, and the SIG is a valuable tool to estimate the presence of UA and can be used to detect and monitor citrate accumulation in this context.

Decoupling of nutrient stoichiometry in Suaeda glauca (Bunge) senesced leaves under salt treatment.

The stoichiometry of senesced leaves is pivotal in nutrient cycling and can be significantly influenced by soil salinization, a rising global issue threatening the functionality of ecosystems. However, the impacts of soil salinization on senesced leaf stoichiometry are not fully understood. In this study, we conducted a pot experiment with varying soil salt concentrations to examine their influence on the concentrations and stoichiometric ratios of nitrogen (N), phosphorus (P), sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), and zinc (Zn) in the senesced leaves of Suaeda glauca (Bunge). Compared to the control group, salt treatments significantly enhanced Na concentration while diminishing the concentrations of K, Ca, Mg, Zn, N, and P. Interestingly, as salinity levels escalated, N concentration maintained stability, whereas P concentration exhibited an increasing trend. Moreover, K, Ca, and Mg significantly declined as salt levels rose. Salt treatments brought about significant changes in stoichiometric ratios, with the N:P, K:Na, N:Na, N:Mg, and Ca : Mg ratios dropping and the N:Ca and N:K ratios rising, illustrating the varying nutrient coupling cycles under different salt conditions. These findings shed light on the plasticity of stoichiometric traits in S. glauca senesced leaves in response to soil salinization shifts, which could potentially offer insights into nutrient cycling reactions to soil salinization.

Prolonged deep-ocean carbonate chemistry recovery after the Paleocene-Eocene Thermal Maximum

The Paleocene-Eocene Thermal Maximum (PETM) is a hyperthermal event at ∼56 Ma ago, caused by rapid and massive carbon releases into the ocean-atmosphere system. Currently, the PETM ocean acidification is mainly quantified in the surface ocean. By contrast, PETM carbonate chemistry changes of the deep ocean, a larger carbon reservoir, are largely qualitatively constrained by sedimentary calcium carbonate contents (%CaCO3). Here, we revisit a previously proposed method for quantifying Early Cenozoic deep-water carbonate chemistry, using boron to calcium ratios (B/Ca) in extinct benthic foraminifera Nuttallides truempyi (Brown et al., 2011). We show that calibrating core-top B/Ca in the extant relative of N. truempyi against deep-water calcite saturation degree (Ω, Ω = [CO32−] /[CO32−]saturated), rather than calcite saturation state (Δ[CO32−], Δ[CO32−] = [CO32−] - [CO32−]saturated) as originally proposed better reflects Early Cenozoic carbonate chemistry changes. Furthermore, we provide multiple deep-water Ω reconstructions paired with benthic foraminiferal carbon isotopes during the PETM. At two sites, deep-water Ω recovered synchronously with carbon isotopes but lagged the sedimentary %CaCO3 rebound, indicating a slower post-PETM deep-water Ω recovery than previously thought. This may imply that during the PETM recovery phase, carbon could have been injected into the ocean-atmosphere system, despite net carbon loss, over a prolonged period after the initial release. If so, during this period, carbon removal from the ocean via calcite burial on the seafloor in response to enhanced silicate weathering may be weakened, suggesting that more carbon was sequestered via other processes such as those related to organic carbon burial.

Understanding amphidromy in Hawai'i: 'O'opu nākea (Awaous stamineus).

Hawai'i is home to 'o'opu nākea (Awaous stamineus), a culturally significant, endemic, goby that exhibits an amphidromous life cycle characterized by a marine larval stage followed by post-larval recruitment to streams, where they live to become reproductive adults. However, it was recently suggested that their migration to the ocean might not be obligatory, as originally thought. Despite their importance in Hawaiian traditions and the ecology of Hawaiian freshwater ecosystems, we still lack a full understanding of their migratory patterns and life history due to the difficulties in determining the environmental migratory cues that set the timing and location of their migratory paths. This study examined environmental factors, such as mean annual rainfall, streamflow, and water chemistry, to determine if they play a role in whether A. stamineus spend their larval period in the ocean or their entire life cycle in freshwater streams. We sampled A. stamineus (n = 90) from three streams (Kahana, Kahalu'u, and Waimānalo) on the island of O'ahu, Hawai'i that represented the range of hydroclimatic gradient in wet-habitat conditions on the windward side of the island and characterized their migratory pattern using elemental analysis of sagittae, the largest pair of otoliths (calcareous ear structures). Based on otolith strontium:calcium and barium:calcium ratios, we determined if individuals spent their larval period in the ocean or the stream. We found that 100% of individuals displayed clear evidence of marine residence during their larval phase, regardless of the environmental factors the fish experienced. This study highlights the necessity of stream-ocean connectivity for the survival of A. stamineus and emphasizes the importance of stream-mouth conservation and management as it is a critical transition zone in stream-ocean-stream migratory pathways.

Evaluation of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and other hematologic parameters in canine acute pancreatitis.

To determine if RBC distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and other hematological parameters are associated with increased odds of in-hospital mortality, increased length of hospitalization (LOH), or disease severity as measured by the Canine Acute Pancreatitis Severity (CAPS) score in dogs with acute pancreatitis (AP). Retrospective, multicenter study from January 2016 to August 2020. Four private emergency and specialty referral centers. On initial case search, 118 client-owned dogs were identified with a clinical diagnosis of AP. Out of these cases, 114 dogs met inclusion criteria, defined as sudden onset of ≥2 compatible clinic signs (lethargy, anorexia, vomiting, or abdominal pain), a specific canine pancreatic lipase concentration >400μg/L, hospital admission, as well as CBC and serum biochemistry run within 48hours of initial hospitalization. Disease severity was calculated and measured using the CAPS score, in addition to LOH and in-hospital mortality. None. Clinical endpoints were in-hospital mortality, LOH, and disease severity, as evaluated by the CAPS score. Overall in-hospital mortality was 36.8%. NLR was significantly associated with survival, with a higher percentage being associated with an increased likelihood of nonsurvival (odds ratio: 1.1, 95% confidence interval: 1.0-1.2; P=0.006, adjusted P=0.04). Increased NLR was found to be significantly associated with a longer LOH based on the unadjusted P-value (P=0.02) but was not statistically significant based on a P-value adjusted for multiple comparisons (P=0.12). No significant associations were noted when RDW, platelet-to-lymphocyte ratio, WBC count, mean platelet volume, RDW-to-platelet ratio, or RDW-to-total serum calcium ratio was evaluated against outcome measures. This study retrospectively evaluated the prognostic utility of several readily available hematological parameters in dogs hospitalized for AP. Dogs with an increased NLR may have a higher risk of in-hospital mortality and increased LOH, although future prospective studies are necessary to confirm these findings.

Using otolith microchemistry to determine natal origin of Black Sea Bass off the coast of Maine

AbstractObjectiveA recent expansion of the northern stock of Black Sea Bass Centropristis striata into the northern Gulf of Maine raises questions about this species’ movement and population dynamics in this region. Determining the origin of these fish is essential, as dramatic changes in migration patterns or current population boundaries could have profound effects on stock assessment estimates and subsequent management regulations.MethodsIn this study, we measured otolith core concentrations of stable isotopes (δ18O, δ13C) and trace element:calcium ratios (Mg:Ca, Mn:Ca, Cu:Ca, Zn:Ca, Ba:Ca, Sr:Ca) to assess the natal origin of Black Sea Bass that were caught off the coast of Maine. Spawning condition adults from southern New England (SNE) and the mid‐Atlantic Bight (MAB) were used to characterize the chemical fingerprint of these known spawning regions.ResultUnique chemical fingerprints were identified for fish from SNE and the MAB, with high reclassification success using random forest analysis (16% error rate). The classification of Black Sea Bass of unknown origin that were caught in Maine waters indicated that 85% of the samples matched to SNE and 13% to the MAB, whereas one sample remained unclassified.ConclusionResults from this study support the current management population separation of the northern stock of Black Sea Bass between SNE and the MAB and lends additional information to the understanding of this species’ movement into the northern Gulf of Maine. As fish stocks around the world continue to shift into new regions due to climate change, knowledge of their natal origin will be critical to long‐term sustainable management of this species.

Effects of magnesium reduction in artificial low-salinity water on the growth of Pacific white shrimp Litopenaeus vannamei in a biofloc system

Intensive shrimp production in salinized waters proposes to supply fresh seafood away from the coast. However, the high prices of specific salts, such as magnesium chloride, excessively increase costs, impairing financial returns. A 77-day study was conducted to evaluate the effects of reductions in magnesium [Mg2+] concentrations and magnesium: calcium ratio (Mg2+: Ca2+) of artificial seawater at salinity 5 g L−1 on the zootechnical performance of shrimp in the nursery and grow-out phases in a biofloc system. The experiment was composed of five treatments and three repetitions each, with the Mg2+: Ca2+ ratios of 3:1, 2:1, 1:1, 0.5:1, and 0.1:1. Both phases were carried out in 40 L tanks. In the nursery, post-larvae (0.017 ± 0.001 g) were stocked at a density of 1500 m−3 and reared for six weeks until they reached approximately 1.2 g. Grow-out was carried out at a density of 500 m−3 for five weeks. Water quality parameters, major ion composition, and zootechnical performance were evaluated during the experiment. The evolution of the concentrations of total ammoniacal nitrogen, nitrite‑nitrogen, and nitrate‑nitrogen in the 0.1:1 treatment showed different behaviors compared to the other treatments throughout the experimental period. At the end of the nursery and grow-out phases, Mg2+ concentrations in the 0.1:1 treatment were 26.6 ± 2.1 mg L−1 and 7.1 ± 1.0 mg L−1, respectively. In the nursery, final weight, food conversion ratio (FCR), and yield were affected in the 0.5:1 and 0.1:1 treatments compared to the control. In grow-out, FCR, yield, and survival were affected at the 0.1:1 ratio. In addition to low [Mg2+], high nitrite and nitrate concentrations were responsible for the low growth and survival at the 0.1:1 ratio. The study showed that it is possible to reduce [Mg2+] and the Mg2+: Ca2+ to approximately 30 mg L−1 and 1:1, respectively, in a biofloc system without affecting shrimp performance.

Spatial and intra-host distribution of myxozoan parasite Tetracapsuloides bryosalmonae among Baltic sea trout (Salmo trutta).

Proliferative kidney disease caused by the myxozoan parasite Tetracapsuloides bryosalmonae has been actively studied in juvenile salmonids for decades. However, very little is known about parasite prevalence and its geographical and intra-host distribution at older life stages. We screened T. bryosalmonae among adult sea trout (Salmo trutta) (n = 295) collected along the Estonian Baltic Sea coastline together with juvenile trout from 33 coastal rivers (n = 1752) to assess spatial infection patterns of the adult and juvenile fish. The parasite was detected among 38.6% of adult sea trout with the prevalence increasing from west to east, and south to north, along the coastline. A similar pattern was observed in juvenile trout. Infected sea trout were also older than uninfected fish and the parasite was detected in sea trout up to the age of 6 years. Analysis of intra-host distribution of the parasite and strontium to calcium ratios from the otoliths revealed that (re)infection through freshwater migration may occur among adult sea trout. The results of this study indicate that T. bryosalmonae can persist in a brackish water environment for several years and that returning sea trout spawners most likely contribute to the parasite life cycle by transmitting infective spores.

Elemental Concentrations in the Shells of the Mussel Perna perna: Discrimination of Origin.

The potential use of elemental concentrations and element:calcium (Ca) ratios as indicators of provenance for bivalve mollusks on the Brazilian coast is evaluated herein for the first time. The approach was applied to shells of the mussel Perna perna (target of extractive fisheries) from geographically close areas but under distinct environmental and anthropogenic influences. Both concentrations of the elements normalized by Ca and the total concentrations can be applied to discriminate the mussels' origin. However, the canonical approach using the total concentrations indicated variations regarding the discriminatory power, and the concentrations of the elements normalized by Ca were more robust in differentiating the provenance of the shells. The origin of mussels was better discriminated by six elementary ratios: Al:Ca, Fe:Ca, K:Ca, Mg:Ca, Mn:Ca and Na:Ca. Thus, monitoring studies aiming to discriminate the origin of P. perna individuals along their distribution based on these elementary ratios of the shell are recommended.

Novel blood product transfusion regimen to prevent clotting and citrate accumulation during continuous renal replacement therapy with regional citrate anticoagulation in children.

Introduce a novel protocol to prevent clotting and citrate accumulation (CA) from blood product transfusion (BPT) during continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in children. We prospectively compared fresh frozen plasma (FFP) and platelet transfusions between the two BPT protocols, direct transfusion protocol (DTP) and partial replacement of citrate transfusion protocol (PRCTP), in terms of the risks of clotting, citric accumulation (CA), and hypocalcemia. For DTP, blood products were directly transfused without any adjustment to the original RCA-CRRT regimen. For PRCTP, the blood products were infused into the CRRT circulation near the sodium citrate infusion point, and the dosage of 4% sodium citrate was reduced depending on the dosage of sodium citrate in the blood products. Basic information and clinical data were recorded for all children. Heart rate, blood pressure, ionized calcium (iCa) and various pressure parameters were recorded before, during and after BPT, as well as coagulation indicators, electrolytes, and blood cell counts before and after BPT. Twenty-six children received 44 PRCTPs and 15 children received 20 DTPs. The two groups had similar in vitro ionized calcium (iCa) concentrations (PRCTP: 0.33 ± 0.06 mmol/L, DTP: 0.31 ± 0.04 mmol/L), total filter lifespan (PRCTP: 49.33 ± 18.58, DTP: 50.65 ± 13.57 h), and filter lifespan after BPT (PRCTP: 25.31 ± 13.87, DTP: 23.39 ± 11.34 h). There was no visible filter clotting during BPT in any of the two groups. The two groups had no significant differences in arterial pressure, venous pressure, and transmembrane pressure before, during, or after BPT. Neither treatment led to significant decreases in WBC, RBC, or hemoglobin. The platelet transfusion group and the FFP group each had no significant decrease in platelets, and no significant increases in PT, APTT, and D-dimer. The most clinically significant changes were in the DTP group, in which the ratio of total calcium to ionized calcium (T/iCa) increased from 2.06 ± 0.19 to 2.52 ± 0.35, the percentage of patients with T/iCa above 2.5 increased from 5.0% to 45%, and the level of in vivo iCa increased from 1.02 ± 0.11 to 1.06 ± 0.09 mmol/L (all p < 0.05). Changes in these three indicators were not significant in the PRCTP group. Neither protocol was associated with filter clotting during RCA-CRRT. However, PRCTP was superior to DTP because it did not increase the risk of CA and hypocalcemia.

#4178 HYPERCHLOREMIC METABOLIC ACIDOSIS AFTER PLASMAPHERESIS IN A PATIENT WITH RENAL TRANSPLANT REJECTION: A CASE REPORT

Abstract Background and Aims Plasmapheresis is an effective therapeutic intervention for several renal disorders, including renal transplant rejection. However, repeated plasmapheresis can cause various side effects and complications. Method We present a 61-year-old male with a medical history of type 2 diabetes, hypertension, successfully treated multiple myeloma and a post-mortem kidney transplantation 7 months ago. The patient was hospitalized because of rapid deterioration of his renal function (eGFR CKD-EPI 15 ml/min/1.73m2). Renal biopsy of the transplanted kidney confirmed the diagnosis of antibody-mediated transplant rejection. Treatment with methylprednisolone, plasmapheresis with a 40 g/L albumin solution as a replacement fluid and intravenous immunoglobulins was initiated. After 4 plasmapheresis treatments, the patient developed gastrointestinal complaints and muscle weakness. Despite the patient's use of 3 grams of oral sodium bicarbonate supplements a day, laboratory tests revealed a hyperchloremic metabolic acidosis: bicarbonate 11.7 mmol/L, chloride 111 mmol/L, sodium 138 mmol/L. Metabolic acidosis due to citrate accumulation was ruled out with a normal total-to-ionized calcium ratio. After treatment with intravenous bicarbonate supplementation, the symptoms disappeared. Analysis of the albumin plasmapheresis solution showed a chloride concentration of 132 mmol/L. Results This is the first case that describes metabolic acidosis after albumin plasmapheresis in a patient with impaired renal function. The observed hyperchloremic metabolic acidosis is most likely the result of the administration of large volumes (3.5 litres per session) of a 4% albumin solution with high chloride concentrations. We hypothesize that patients with renal impairment are more prone to develop metabolic acidosis after plasmapheresis with albumin-saline replacement fluids due to their reduced renal capacity to excrete excess acid and chloride. Conclusion Special attention should be paid to the acid-base balance during plasmapheresis in patients with impaired renal function. Future research should investigate the incidence of hyperchloremic metabolic acidosis during albumin plasmapheresis in different eGFR categories.

Evaluation of chemical composition of cribra orbitalia from post-medieval children graves (Olomouc, Czech Republic)

Abstract During an archaeological rescue excavation in center of city Olomouc (Moravia region, Czech Republic) several graves were found. Those graves were a part of a defunct cemetery situated in the area surrounding a church of St. Peter and Paul. The research was focused on analysis of 13 children’s skull samples affected by a chronical pathology known as “cribra orbitalia” (CO). X-ray fluorescence spectrometry (XRF) and inductively coupled plasma-mass spectrometry (ICP-MS) were used to examine differences in the samples with respect to an individual’s age, degree of porosity (representing the progress of CO) and other observed pathologies. Both techniques proved that the ratio of calcium to iron gradually increases with the age of the child without regard to the degree of CO damage. Moreover, the ICP-MS data were evaluated using principal component analysis, which pointed out that the highest contents of Pb were found in samples from individuals suffering from rickets. The preliminary results reveal that more research on this pathology should be performed – not only for post-medieval individuals but also in prehistorical ones.