Mean Ca Research Articles

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Effect of Lower Calcium Dialysate on Laboratory Abnormalities in Chronic Kidney Disease–Associated Mineral and Bone Disorder

Increased vascular calcification, possibly due to the biochemical problem of calcium (Ca) and phosphate excess, has been associated with cardiovascular disease in patients with end stage renal disease. The use of a lower dialysate Ca concentration (<2.50 mEq/L) has been postulated as one of the methods to prevent long-term Ca accumulation. Concern, however, has been raised over the possibility that using a low Ca dialysate may lead to an increase in the intact parathyroid hormone concentration and therefore the need for higher doses of vitamin D analogs. This may thus mitigate the much desired long-term benefits. With an aim to decrease the total Ca load in our patients, the standard dialysate Ca concentration in our outpatient dialysis center was decreased from 2.5 to 2.25 mEq/L in September 2009. We found that the use of a lower Ca dialysate in our maintenance hemodialysis patients led to a significant reduction in the mean serum Ca concentration without a significant increase in serum parathyroid hormone levels or an increase in vitamin D analogs/Ca-based phosphate binder dose requirements. Further prospective studies are needed to assess the impact of this intervention on long-term cardiovascular morbidity and mortality.

Observation and modelling of main-sequence star chromospheres - XIX. FIES and FEROS observations of dM1 stars

We present 187 high-resolution spectra for 62 different M1 dwarfs from observations obtained with the FIbre-fed Echelle Spectrograph (FIES) on the Nordic Optical Telescope (NOT) and from observations with the Fibre-fed Extended Range Echelle Spectrograph (FEROS) from the European Southern Observatory (ESO) data base. We also compiled other measurements available in the literature. We observed two stars, Gl 745A and Gl 745B, with no Ca ii line core emission and Hα line equivalent widths (EWs) of only 0.171 and 0.188 Å, respectively. We also observed another very low activity M1 dwarf, Gl 63, with an Hα line EW of only 0.199 Å. These are the lowest activity M dwarfs ever observed and are of particular interest for the non-local thermodynamic equilibrium radiative transfer modelling of M1 dwarfs. Thanks to the high signal-to-noise ratio of most of our spectra, we were able to measure the Ca ii H&K full width at half-maximum (FWHM) for most of our stars. We find good correlations between the FWHM values and the mean Ca ii line EW for dM1 stars. Then the FWHM seems to saturate for dM1e stars. Our previous models of M1 dwarfs can reproduce the FWHM for dM1e stars and the most active dM1 stars, but fail to reproduce the observations of lower activity M1 dwarfs. We believe this is due to an effect of metallicity. We also investigate the dependence of the Hα line FWHM as a function of its EW. We find that the models globally agree with the observations including subwarfs, but tend to produce too narrow profiles for dM1e stars. We re-investigate the correlation between the Ca ii line mean EW and the absolute magnitude. With our new data that notably include several M1 subdwarfs, we find a slightly different and better correlation with a slope of −0.779 instead of −0.909. We also re-investigate the variations of the Hα line EW as a function of radius and find that the EW increases continuously with increasing radius. This confirms our previous finding that the level of magnetic activity in M1 dwarfs increases with the radius. For the first time, we investigate the Wilson–Bappu correlation for a given spectral type. We find a rather linear correlation for stars of absolute magnitude greater than 9.6, but below this value the FWHM seems to saturate. In fact, we show that these Wilson–Bappu type correlations are activity–FWHM correlations and are due to the diminishing column mass of the transition region with decreasing activity level.

Presenting Symptoms of Pancreatic Adenocarcinoma Are Related to Diagnostic Delay and Stage at Diagnosis

Context Pancreatic ductal adenocarcinoma (PDAC), is an aggressive neoplasm, with an high mortality rate linked to its advanced stage in most cases at diagnosis. The advanced stage may depend on the diagnostic delay due to unspecific symptoms. However, only few studies investigated the relation between presenting symptoms, diagnostic delay and stage of disease in PDAC. Objectiv: To assess whether different presenting symptoms result in different diagnostic delay (defined as months from the very first symptom and diagnosis) and stage of disease in PDAC patients. Methods Retrospective analysis of a prospectively collected database including data on demographics, presentation symptoms, diagnostic delay and disease stage at diagnosis in PDAC patients seen at our Unit between 2005-2012. Results Two-hundreds and 27 PDAC patients enrolled (125 males, 55%; mean age at diagnosis 68 years). The most frequent presentation symptoms were jaundice (102 patients, 44%), weight loss (115 patients, 50.6%%) and recent onset (diagnosed in the last 12 months before PDAC diagnosis) diabetes (41 patients, 18%). Patients presenting with or without jaundice did not have a different mean diagnostic delay (3.7 vs . 3.8 months; P=0.9), but patients with jaundice were more frequently resectable at diagnosis than non jaundiced patients (41.2% vs . 25%; P=0.01). Patients with or without recent-onset diabetes did not have a different diagnostic delay (3.9 vs . 3.8 months; P=0.9), without an impact on disease stage at diagnosis. On the other hand, patients who experienced a weight loss greater than 5 kg before diagnosis, not only had a longer diagnostic delay than those without weight loss (5 vs . 2.44 months; P=0.0001), but were also more frequently metastatic at diagnosis (46.1% vs . 33.1%; P=0.05). Patients with weight loss were also more often males (61% vs . 26%; P=0.009) and had higher CA 19-9 than those without (mean 11,369 vs . 2,735; P=0.05), while mean CA 19-9 values, sex distribution, mean age and mean primary tumour size were all not different in subgroups of patients classified according to the presence/absence of other symptoms. Conclusion When analyzing distinct presentation symptoms of PDAC, only weight loss is associated with a longer diagnostic delay, and this results in a more advanced disease stage at diagnosis. The presence of jaundice is not related with the diagnostic delay, but with a more favourable disease stage at diagnosis. Weight loss seems an undervalued alarm symptom associated with aggressive PDAC. Future studies should consider whether these symptoms, or their combination, independently affect the efficacy of treatments and survival.

Evaluation of metal concentrations in mentha herbal teas (Mentha piperita, Mentha pulegium and Mentha species) by inductively coupled plasma spectrometry

Phytopharmaceuticals are gaining popularity worldwide; however, cases of adverse effects and drug interactions have also increased. One reason is in the high metal content both as ingredients but also as contaminants. Metal monitoring in food, like herbal teas, provides basic information on safety aspects in regulatory processes as well as nutritional values. In the present work, Cd, Pb, K, Na, Ca, Mg, Al, B, Ba, Co, Cr, Cu, Fe, Mn, Zn, Li, Ni, and Mo were determined by inductively coupled plasma spectrometry (ICPS) in 36 samples of Mentha sp. Mint tea bags and loose leaves were randomly obtained from supermarkets, traditional markets, herbal stores, and pharmacies in Tenerife (Canary Islands, Spain). Metal contents varied significantly, dependent on the stores the products were purchased in and on tea packaging (loose leaves versus tea bags). Pb analyses revealed levels (0.65±0.71mg/kg) below legal limits. The maximum permissible limit for Cd, 0.3mg/kg, set by the WHO for medicinal plants, was exceeded by 19.44% of the samples (0.22±0.13mg/kg), but all values were below the limit given in the European Pharmacopoeia for this metal (4mg/kg). We observed high Al (151.24±162.73mg/kg) and Li (5.46±3.94mg/kg) levels. B, Ba, Co, Cr, Cu, Fe, Mn, Ni, Zn, and Mo mean levels were 20.51, 14.15, 0.26, 1.65, 10.65, 406.00, 55.05, 1.72, 33.67, and 0.73mg/kg, respectively. Mean Ca, Mg, K, and Na were detected in concentrations of 10.32, 3.83, 7.23 and 1.17g/kg, respectively. In conclusion, metal exposure through herbal mint teas does not seem to be of health concern, as to most of the studied metals, but regulatory limits for Al contents should be imposed.

Retrospective Analysis of Patient Survival Based on Nutritional Status in a Cohort of Hemodialysis patients From Two Large Centers in a Metropolitan City in a Developing Country

This is a retrospective analysis of 858 patients from 2 medical centers on maintenance hemodialysis from January 1998 - January 2010(Males–599, females 259) (364 diabetics [42.5%]) (Mean Age - 48.5+22.74, >60 - 76.5% and + 0.67 g/dL, mean Hb - 8.56 + 5.75 g/L, Serum calcium (corrected) - 8.6 + 0.9 mg/dL, serum phosphorus - 5.32 + 1.85 mg/dL, mean Ca*Po4 product - 43.27 + 17.62 mg 2 /dL 2 , mean iPTH - 260.3 + 295.3pg/mL, 25-OH D 3 - 23.3 + 20.2 mg/dL. Overall, 191 patients died (22%) with an 86% and 78% patient survival at 1 year and 3 years. Age Hb (g/L) Cor Ca. (mg/dL) Albumin (g/L) Ca*PO4 (mg/dL) 25-OH D 3 (mg/dL) ≥60 9.0±7.9 8.6±0.9 3.5±0.6 42.6±16.7 22.9±18.7 8.4±4.7 8.4±1.1 3.6±0.5 45.3±20 24.5±24.8 p value .550 .2660 .396 .235 .687 There is no statistically significant association between age, albumin levels, vegetarianism with mortality.

Structure and Transformation of Amorphous Calcium Carbonate: A Solid-State 43Ca NMR and Computational Molecular Dynamics Investigation

Amorphous calcium carbonate (ACC) is a metastable precursor to crystalline CaCO3 phases that precipitates by aggregation of ion pairs and prenucleation clusters.(1, 2) We use 43Ca solid-state NMR spectroscopy to probe the local structure and transformation of ACC synthesized from seawater-like solutions with and without Mg2+ and computational molecular dynamics (MD) simulations to provide more detailed molecular-scale understanding of the ACC structure. The 43Ca NMR spectra of ACC collected immediately after synthesis consist of broad, featureless resonances with Gaussian line shapes (FWHH = 27.6 ± 1 ppm) that do not depend on Mg2+ or H2O content. A correlation between 43Ca isotropic chemical shifts and mean Ca–O bond distances for crystalline hydrous and anhydrous calcium carbonate phases indicates indistinguishable maximum mean Ca–O bond lengths of ∼2.45 A for all our samples. This value is near the upper end of the published Ca–O bond distance range for biogenic and synthetic ACCs obtained by Ca-X-ray ...

Evaluation of left ventricular mechanical work and energetics of normal hearts in SERCA2a transgenic rats

Cardiac sarcoplasmic reticulum (SR) Ca(2+)-ATPase (SERCA2a) is responsible for most of the Ca(2+) removal during diastole and a larger Ca(2+) handling energy consumer in excitation-contraction (E-C) coupling. To understand the cardiac performance under long-term SERCA2a overexpression conditions, we established SERCA2a transgenic (TG) Wistar rats to analyze cardiac mechanical work and energetics in normal hearts during pacing at 300 beats/min. SERCA2a protein expression was increased in TGI and TGII rats (F2 and F3 of the same father and different mothers). Mean left ventricular (LV) end-systolic pressure (ESP) and systolic pressure-volume area (PVA; a total mechanical energy per beat) at midrange LV volume (mLVV) were significantly larger in TGI rats and were unchanged in TGII rats, compared to those in non-TG [wildtype (WT)] littermates. Mean myocardial oxygen consumption per minute for E-C coupling was significantly increased, and the mean slope of myocardial oxygen consumption per beat (VO(2))-PVA (systolic PVA) linear relation was smaller, but the overall O(2) cost of LV contractility for Ca(2+) is unchanged in all TG rats. Mean Ca(2+) concentration exerting maximal ESP(mLVV) in TGII rats was significantly higher than that in WT rats. The Ca(2+) overloading protocol did not elicit mitochondrial swelling in TGII rats. Tolerance to higher Ca(2+) concentrations may support the possibility for enhanced SERCA2a activity in TGII rats. In conclusion, long-term SERCA2a overexpression enhanced or maintained LV mechanics, improved contractile efficiency under higher energy expenditure for Ca(2+) handling, and improved Ca(2+) tolerance, but it did not change the overall O(2) cost of LV contractility for Ca(2+) in normal hearts of TG rats.

On-farm evaluation of improved Brachiaria grasses in low rainfall and aluminium toxicity prone areas of Rwanda

The aim of this study was to determine the production of improved Brachiaria grass in comparison with indigenous Brachiaria under low rainfall and aluminium toxicity areas of Rwanda. Three varieties and five hybrids of Brachiaria grass from CIAT and two local grasses (control) were used for on-farm participatory trials without fertilizer application. Twelve farms were selected in each study area and on each farm ten grasses were established in 2 × 3 m plots. Herbage was harvested six times during the year at two monthly intervals. Each cut, dry matter (DM) was measured. The crude protein (CP), calcium (Ca) and phosphorus (P) were also measured once in the wet season and once in the dry season. In the low rainfall area, Brachiaria brizantha cv. Toledo and Brachiaria decumbens (local) had the highest DM yields (5.71 and 5.61 t ha-1 respectively), while DM of the rest of the grasses ranged from 1.2 to 5.13 t ha-1. In the acidic soil area, Brachiaria hybrid Bro2/1485 had higher DM (5.95 t ha-1) than the rest of the grasses (1 to 4.47 t ha-1). The highest quality grass was Brachiaria hybrid Bro2/1485 which obtained a CP value of 12.15% in the low rainfall area, whereas in the acidic soil area hybrid cv. Mulato II obtained the highest CP value of 11.6%. In the low rainfall area the Brachiaria hybrid cv. Mulato obtained a high mean Ca value of 2.15% while in the acidic soil area, cv. Marandu obtained a high Ca value of 2.41% during the wet and dry seasons. The cv. Toledo had high P (0.28%) compared to the other grasses (0.07 to 0.11%) in the low rainfall area. In the acidic soil area, the Brachiaria hybrid Bro2/1485 had high P of 0.53% as compared to other grasses in which P varied between 0.16 and 0.47%. Local control grasses had lower nutrients than the improved Brachiaria grass in the low rainfall and acidic soil area. Although, Brachiaria hybrid cv. Mulato II was not the most productive grass, it was selected by farmers as the preferred cultivar at both sites because of its adaptability to low rainfall and acidic soil stress, and its production of green forage year round without any input of fertilizer. Key words: Dry matter production, forage quality, forage selection.

Influence of Foliar Nitrogen and Magnesium Fertilization on Concentration of Ash Micronutrients in Potato Tubers

Abstract: The paper contains a discussion of the results of an experiment concerning the effect of foliar nitrogen and magnesium fertilization on the concentration of ash macronutrients in edible potato tubers of a medium-early cultivar called Zebra. The trials were based on a three-year, two-factorial field experiment, carried out in 2005–2007 at the Research Station in Tomaszkowo, owned by the University of Warmia and Mazury in Olsztyn. The applied fertilization consisted of 80 kgN, 35 kgP and 100 kgK ha. The first experimental factor comprised foliar nitrogen fertilization in the range of doses (8; 40) kgN ha accompanied by simultaneously diminished doses of soil nitrogen fertilization. The second factor included three series: without magnesium, with magnesium introduced to soil in a rate of 24 kg ha and with magnesium sprayed over potato leaves in a rate of 12 kgMg ha. Tuber samples were analyzed for the concentrations of phosphorus, potassium, magnesium and sodium. The content of these macronutrients tended to decrease under the influence of the increasing nitrogen fertilization, with the exception of phosphorus, whose concentration rose in the series unfertilized with magnesium under the effect of 8 and 16 kgN, and the concentration of sodium, which continued to increase in the Mg fertilized series up to the rate of 24 kg of N applied as a foliar fertilizer. The mean Ca : P = 0.28, Ca : Mg = 0.39 and K : Ca = 11.9 ratios suggest very poor calcium supply of the potato cultivar. In contrast, very broad ratios between K : (Ca + Mg) = 3.32 and K : Mg = 4.60 prove that the concentrations of potassium and magnesium were relatively high. The foliar application of nitrogen, tested in this experiment, had a significant effect on the ratios between ash elements in tubers. It has been demonstrated that as the top-dressing rate of nitrogen increased, the Ca : P and Ca : Mg ratios narrowed while the ratios of K : (Ca + Mg) and K : Ca were broader. The applied fertilization had no effect on the K : Mg ratio.

Comparison of efficacy of the phosphate binders nicotinic acid and sevelamer hydrochloride in hemodialysis patients

Hyperphosphatemia is a significant risk factor for the development of ectopic calcification and coronary artery diseases in patients on hemodialysis (HD), and must be controlled with the use of phosphate binders. Studies comparing the effects of sevelamer and nicotinic acid, both similar non-calcium and non-aluminum phosphate binders, are not available. In this study, 40 patients on HD with a serum phosphorus level of more than 6 mg/dL were enrolled. After a two week washout period without phosphate binders, the patients were randomly divided into two equal groups (n = 20) and were started on nicotinic acid or sevelamer for a period of four weeks. The dose of nicotinic acid used was 500 mg and that of sevelamer was 1600 mg daily. Blood samples were drawn for the measurement of the total calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), triglyceride (TG), total cholesterol (Chol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), uric acid and parathyroid hormone (PTH). Patients receiving sevelamer showed a significant reduction in serum P level (2.2 ± 0.69 mg/dL; P <0.0001) in comparison with the nicotinic acid group (1.7 ± 1.06 mg/dL; P = 0.004). Reduction in the Ca-P product was significantly different in the two groups; in the sevelamer group, it was 21 ± 7; (P <0.0001) while in the nicotinic acid group, it was 16 ± 11 (P = 0.007). Also, patients on sevelamer showed greater reduction in the mean TG level (38.9 ± 92 mg/dL; P = 0.005). No significant changes were observed in the mean serum Ca, total Chol, HDL, LDL, ALP and iPTH levels in the two study groups. Our short-term study suggests that although nicotinic acid reduced hyperphosphatemia, sevelamer showed higher efficacy in controlling hyperphosphatemia as well as the Ca-P product.

Red blood transfusion in preterm infants: changes in glucose, electrolytes and acid base balance

Background:Preterm neonates comprise the most heavily transfused group of patients, and about 85% of extremely low birth weight newborns receive a transfusion by the end of their hospital stay. The aim of this study was to assess the possible metabolic effects of RBC transfusion on preterm infants, especially during the first 2 weeks of life, and its relation to blood volume.Materials and Methods:This study was conducted on 40 preterm neonates with gestational age of less than or equal to 34 weeks. They received RBCs transfusion during first 2 weeks of life. Venous blood samples of infants were collected 2 to 4 hours before and 1 hour after the end of transfusion to evaluate hemoglobin (Hb) level, hematocrit, acid-base, electrolytes, and glucose status. Then, infants were classified into two main groups: those who received RBCs volume less than or 20 ml/kg and those who received RBCs volume more than 20 ml/kg.Results:Infants received a mean volume of 20.38 ± 3.2 ml/kg RBCs (range, 10.9 - 26.6 ml/kg) at a median age of 9.8 ± 3.6 days. After transfusion, a significant increase of mean Hb (P<0.001), mean Hct (P<0.001), pH (P<0.001), pO2 (P<0.05), and a significant decrease of the pCO2 (41.46 ± 8.8torr vs 35.4 ± 9.34 torr; P<0.001) were observed. In addition, there was a significant increase of serum K+ (P<0.001), and a significant decrease of Ca+2 (P<0.001). A positive correlation was found between the K+ intake and the changes of kalemia (r = 0.99; P = 0.00). Furthermore, we observed an inverse correlation between the patients’ calcium intake and the changes of calcemia (r = -0.35; P = 0.02). On comparing the changes in clinical and biochemical variables between two groups after transfusion, we observed a significant increase in mean Hb and Hct associated with a significant decrease in mean serum Ca+2 (P<0.001) in the group receiving the larger blood volume.Conclusion:RBC transfusion was effective in improving anemia, oxygenation, increasing pH, and decreasing CO2 and Ca+2. However, from a more clinically relevant point of view, we demonstrated the development of hyperkalemia, especially in infants with a previously borderline hyperkalemia.

Predictors of malignancy in pancreatic head mass: a prospective study

The objective of the study was to identify the predictive factors for malignancy in pancreatic head mass as a primary outcome and assess the value of CA 19-9 as a diagnostic tool for malignancy as a secondary outcome. A prospective study of patients presented with pancreatic head mass was conducted in a tertiary care referral hospital, Manipal, India from May 2006 to November 2008. The study population was divided into malignant and benign groups based on the final histopathology report. A univariate and multivariate analysis of potential predictive factors for malignancy were conducted. A total of 102 patients with pancreatic head mass were included in the study after fulfilling the inclusion/exclusion criteria. 78 were malignant and 24 were benign. There was significant weight loss (p<0.001) and high mean bilirubin levels (p=0.002) in the malignant group. Mean CA 19-9 was significantly higher in the malignant group (290.7 vs. 30.3 U/ml; p<0.001). Sensitivity and specificity of CA 19-9 for detecting malignancy in pancreatic head mass at a cut off of 35 U/ml was 86% and 79% respectively. CA 19-9 positivity rate was higher with increasing cut off values of 100, 200 and 300 U/ml but such high levels occurred in fewer patients. All the non-jaundiced patients (100%) with raised CA 19-9 levels were found to be malignant compared to 86% malignancy in jaundiced patients. In multivariate analysis, a combination of weight loss>10% of body weight and bilirubin>3 mg/dl and CA 19-9>35 U/ml had specificity and positive predictive value of 100% for predicting malignancy in pancreatic head mass. The presence of weight loss and jaundice and raised CA 19-9 levels together in a patient with pancreatic head mass can be predictive of malignancy. A very high CA 19-9 level can be an indicator of malignancy in a pancreatic head mass. A raised CA 19-9 level may be more predictive of malignancy in non-jaundiced patients than in jaundiced patients.

Variation of heavy metal and micro and macro element concentrations of bread and durum wheats and their relationship in grain of Turkish wheat cultivars

The 64 varieties displayed a large variation for all mineral elements, investigated Fe, Mn and Zn, ranging from 24.2 to 43.1 mg/kg, 27.6 to 64.8 mg/kg and 10.4 to 38.2 mg/kg, respectively. The mean Ca, K, Mg, Na, P and S concentrations in wheat rain varieties amounted to 378, 4,266, 1,183, 317, 3,513 and 1,542 mg/kg, respectively. Ca, K, Mg, Na, P and S contents of wheat varieties changed at the levels between 266 and 531 mg/kg, 3,029 and 5,566 mg/kg, 972 and 1,525 mg/kg, 277 and 368 mg/kg, 2,422 and 4,610 mg/kg and 1,241 to 2,052 mg/kg, respectively. The concentrations of Al, Cu, Fe, Mn and Zn of durum wheat samples were found at high levels. The mean Al, Cr, Mo, Ni, Cu, Fe, Mn and Zn concentrations in durum wheat varieties amounted to 10.93, 0.47, 0.72, 0.72, 5.37, 34.9, 37.28 and 20.88 mg/kg, respectively.

Mineral bioavailability in grains of Pakistani bread wheat declines from old to current cultivars

Estimating variation in grain mineral concentration and bioavailability in relation to grain yield and the year of cultivar release is important for breeding wheat with increased content of bioavailable minerals. The grain yield and yield components, grain phytate concentration, and concentration and bioavailability of minerals (zinc Zn, iron Fe and calcium Ca) in wheat grains were estimated in 40 wheat cultivars released in Punjab (Pakistan) during the last five decades. Mean grain Zn and Ca concentrations in current-cultivars were significantly lower (≥14%) than in obsolete cultivars released during the Green Revolution (1965–1976). Much of this variation was related to increased grain weight in current-cultivars. There was a positive correlation among minerals (r = 0.39 or higher, n = 40) and minerals with phytate in wheat grains (r = 0.38 or higher, n = 40). The tested cultivars varied widely in grain yield and grain phytate-to-mineral molar ratios (phytate:mineral). Compared to obsolete cultivars, the current-cultivars had a higher phytate:mineral ratio in grains, indicating poor bioavailability of minerals to humans. The study revealed a non-significant relationship between grain yield and phytate:mineral ratios in grains. Therefore, breeding for lower phytate:mineral ratios in wheat grains can ensure increased mineral bioavailability without significant reduction in the yield potential. Future breeding should be focused on developing new genotypes suitable for mineral biofortification and with increased mineral bioavailability in grains.

Preoperative Serum CA 125 Level as a Predictor for Metastasis and Survival in Endometrioid Endometrial Cancer

ObjectiveWe wished to determine the relationship between preoperative serum CA 125 levels and the risk of metastatic disease, recurrent disease, and death in women with endometrial cancer. MethodsWe reviewed the records of women with endometrial adenocarcinoma of all stages who underwent primary surgery. We abstracted multiple data variables, including demographic characteristics, serum CA 125 levels, postoperative histopathology results, progression-free survival, and overall survival rates. ResultsThe records of 97 women with endometrial carcinoma were analyzed. With a serum CA 125 cut-off level of 35 kU/L, the likelihood of disease-related death could be predicted with 70% sensitivity and 83% specificity; disease progression could be predicted with 60% sensitivity and 84% specificity; and lymph node metastasis could be predicted with 75% sensitivity and 84% specificity. There was a significant relationship between a serum CA 125 level ≥ 35 kU/L and depth of myometrial invasion, cervical stromal invasion, stage, frequency of recurrence, and disease-related death. Having deep myometrial invasion, cervical stromal involvement, positive peritoneal cytology, lymph node metastasis, disease recurrence, and disease-related death were each associated with significantly higher mean CA 125 levels. In women with serum CA 125 levels < 35 kU/L, fiveyear progression-free survival rates (88%) and overall survival rates (92%) were significantly better than in women with levels ≥ 35 kU/L (57% and 70%, respectively; P = 0.001 for both). ConclusionSerum CA 125 levels and extension of disease are highly correlated in women with endometrioid endometrial cancer, and elevated CA 125 levels predict a higher risk of disease recurrence and death.

Influence of diet and rennet on the composition of goats' milk and cheese.

Dry matter, protein, fat, pH, mineral (Na, K, Ca and Mg) and trace elements (Fe, Cu, Zn and Se) concentrations were determined in samples of goats' milk and in fresh, semi-hard and hard cheeses to study the effect of the goats' diet and the type of rennet used for the cheese processing of the Palmero Protected Designation of Origin cheeses. Two groups of 20 Palmero goats were fed 2 different diets: a Palmero diet (PD supplied by native forages adapted to subhumid areas, which had a high ratio of long fibre to concentrates (65:35), and an actual diet (AD), the most commonly used by goat farmers, with a low ratio of long fibre to concentrates (35:65). In general, the cheese samples from goats fed with PD had higher mean Ca, Zn, Cu and Se concentrations than the samples obtained from AD fed goats. The diet exhibited a greater influence on the chemical composition of the cheeses than the rennet used in their production. Applying a stepwise linear discriminant analysis a complete percentage of correct classifications of the three types of cheeses according to the diet of the goats was observed.

First principles molecular dynamics simulations of diopside (CaMgSi 2O 6) liquid to high pressure

We use first principles molecular dynamics simulations based on density functional theory in the local density approximation to investigate CaMgSi 2O 6 liquid over the entire mantle pressure regime. We find that the liquid structure becomes much more densely packed with increasing pressure, with the mean Si–O coordination number increasing nearly linearly with volume from fourfold near ambient pressure to sixfold at the base of the mantle. Fivefold Si–O coordination environments are most abundant at intermediate compression. The properties of Mg and Si coordination environments are nearly identical to those in MgSiO 3 liquid, whereas Ca is more highly coordinated with larger mean Ca–O bond length as compared with Mg. The density increases smoothly with increasing pressure over the entire range studied. The Grüneisen parameter increases by a factor of three on twofold compression. The density contrast between diopside composition liquid and the isochemical crystalline assemblage is less than 2% at the core mantle boundary, less than that in the case of MgSiO 3. Thermodynamic properties are described in terms of a liquid-state fundamental thermodynamic relation.

Fragility Fractures in Men with Idiopathic Osteoporosis Are Associated with Undermineralization of the Bone Matrix without Evidence of Increased Bone Turnover

The pathogenesis of primary osteoporosis in younger individuals is still elusive. An important determinant of the biomechanical competence of bone is its material quality. In this retrospective study we evaluated bone material quality based on quantitative backscattered electron imaging to assess bone mineralization density distribution (BMDD) in bone biopsies of 25 male patients (aged 18-61 years) who sustained fragility fractures but were otherwise healthy. BMDD of cancellous bone was compared with previously established adult reference data. Complementary information was obtained by bone histomorphometry. The histomorphometric results showed a paucity of osteoblasts and osteoclasts on the bone surface in the majority of patients. BMDD revealed a significant shift to lower mineralization densities for cancellous bone values: CaMean (weighted mean Ca content, -5.9%), CaPeak (mode of the BMDD, -5.6%), and CaHigh (portion of fully mineralized bone, -76.8%) were decreased compared to normative reference; CaWidth (heterogeneity in mineralization, +18.5%) and CaLow (portion of low mineralized bone, +68.8; all P < 0.001) were significantly increased. The shift toward lower mineral content in the bone matrix in combination with reduced indices of bone formation and bone resorption suggests an inherent mineralization defect leading to undermineralized bone matrix, which might contribute to the susceptibility to fragility fractures of the patients. The alteration in bone material might be related to osteoblastic dysfunction and seems fundamentally different from that in high bone turnover osteoporosis with a negative bone balance.

Rising Ca:Mg intake ratio from food in USA Adults: a concern?

USDA food surveys from 1977 through 2007-8 show a rising food Ca:Mg ratio for all USA adult age-gender groups. Food Ca:Mg intake ratios rose from 2.3-2.9 in 1977 to 2.9-3.5 in 2007-8. The % rise in mean Mg intakes compared closely with % rise in mean energy intakes while % rise in mean Ca intakes were substantially higher in all groups, suggesting the rising Ca:Mg comes from higher Ca intakes via food selections, rising food Ca contents or both. Original intake data from these surveys need to be accessed to calculate each individual's Ca:Mg for statistical assessment of this ratio rise. Ca:Mg rose from largely below 3.0 in 1994-5 to generally above or approaching 3.0 after 2000, coinciding with a sharp 2% rise in type 2 diabetes incidence and prevalence in the USA population and a 1994-2005 rise in colorectal cancer incidence among young white, non-Hispanic adult men and women in the USA. The intracellular Ca activation response to low Mg is discussed as a possible mechanism linking metabolic and inflammatory syndromes with low dietary Mg and rising dietary Ca:Mg ratio. Adequacy of both Ca and Mg as well as the Ca:Mg ratio are important in assessing study outcomes. Health consequences should be considered for the USA's 64-67% adults not meeting their Mg requirement from foods, many also consuming below their Ca requirements, and their increasing Ca:Mg ratio from foods.