Serum Calcium Research Articles

Depression, Anxiety, and Pain Predict Quality of Life in Patients with Differentiated Thyroid Cancer Postradiotherapy Ablation in Taiwan: A 48-Week Follow-Up Study.

Despite the generally good prognosis of differentiated thyroid cancer (DTC), impairments in health-related quality of life (HRQoL) remain a major concern in these patients. This study examined the patterns and predictors of change in mental and physical HRQoL in DTC survivors following radiotherapy ablation. Two hundred patients with DTC who received radiotherapy ablation in southern Taiwan between 2015 and 2018 were interviewed using the Taiwan version of the 36-item Short-form Health Survey (SF-36), the Taiwanese Depression Questionnaire (TDQ), and the Hamilton Rating Scale for Anxiety (HAM-A) at baseline and after 24 and 48 weeks of treatment. The demographic characteristics, thyroid-related factors, recombinant human thyroid-stimulating hormone (rhTSH), and serum calcium level were also collected. Improvements in both mental and physical HRQoL were noted over the first 24 weeks following radiotherapy ablation. Between 24 and 48 weeks, mental HRQoL was increasing, whereas physical HRQoL decreased. Higher levels of anxiety and pain predicted both poor physical and mental HRQoL. Further, higher levels of depression predicted poor mental HRQoL. Additionally, factors such as low income, rhTSH use, elevated TSH levels, low free T4, and higher physical HRQoL were associated with poorer mental HRQoL during the follow-up period. The early detection and intervention of depression, anxiety, and pain should be the objective for programs aiming to improve HRQoL.

Metabolic Alkalemia in Hypercalciuria Stone Formers: Does It Matter?

Introduction: The literature lacks whether metabolic alkalemia occurs in outpatients with hypercalciuric nephrolithiasis. Thus, we aim to investigate it because these patients are often treated with thiazides to reduce urinary calcium excretion. However, thiazides induce chloride losses due to the inhibition of Na-Cl cotransporter expressed in the renal distal tubule cells. Besides thiazide prescription, many of these patients are also supplemented with potassium citrate, which is an addition of alkali source in their bodies. Methods: We collected clinical, demographic characteristics, and laboratory data from electronic medical charts of outpatients with calcium kidney stones followed in our institution from January 2013 to July 2021. We diagnosed those cases as metabolic alkalemia, in which the venous blood gas tests showed pH ≥7.46 and bicarbonate concentration >26 mEq/L. Then, we applied statistical analysis to compare distinct categories between patients with and without metabolic alkalemia. Results: We diagnosed metabolic alkalemia in 4.3% of hypercalciuric nephrolithiasis outpatients, and we verified that thiazides had been used in all of them except in one case. Furthermore, we observed that the amount of thiazide taken daily was higher in patients with metabolic alkalemia than in those without this imbalance. Additionally, hypokalemia was present in 37% of patients who developed metabolic alkalemia. We also found lower chloride, magnesium and ionic calcium serum concentrations in patients with metabolic alkalemia than in those without an acid-base disequilibrium. Conclusion: Despite the low prevalence of metabolic alkalemia in hypercalciuric kidney stone formers, it is important to monitor these patients due to the high incidence of hypokalemia and the potential presence of other electrolyte disorders.

Osteoporosis and Normocalcemic Primary Hyperparathyroidism (Conservatively or Surgically Managed).

Asymptomatic primary hyperparathyroidism (PHPT) involves 80-90% of the parathyroid tumor-associated cases of PHPT in the modern medical era, while normocalcemic PHPT (NPHPT) has a prevalence of 0.1-11%. We aimed to analyze the bone status and mineral metabolism in NPHPT amid conservative or surgical management. In this narrative review, we searched PubMed (between January 2020 and July 2024) via different keywords. Fourteen studies from the final analysis (388 patients with NPHPT; 1188 with PHPT; and 803 controls) showed that mean serum calcium levels varied between 2.57 and 2.26 mmol/L in NPHPT. Ten studies identified a similar 24 h urinary calcium in NPHPT versus hypercalcemic PHPT (HPHPT). Except for one study, a mandatory vitamin D analysis was performed, but the 25-hydroxyvitamin D cut-offs varied. Osteoporosis (n = 6 studies; N = 172 with NPHPT) was confirmed in 41.7-100% of NPHPT subjects. In surgery candidates, this rate might be overestimated. A DXA analysis was performed in eight studies (235 subjects with NPHPT, and 455 patients with HPHPT); two studies identified a lower BMD in HPHPT < NPHPT, but the results were not homogenous. A single study analyzed the TBS and found similar results in NPHPT. The prevalence of fractures (n = 9) varied between 7.4% and 42.8% in NPHPT. Bone turnover markers (N = 262 patients, n = 8 studies) showed lower bone formation markers in NPHPT versus PHPT (n = 3). Two studies analyzed the BMD and bone turnover markers following parathyroidectomy (161 patients, including 30 patients with NPHPT; mean ages over 60 years). To conclude, given the wide spectrum of complications associated with PHPT, an early diagnosis and proper management is essential. A more extensive screening in patients with osteoporosis and kidney stones might lead to the discovery of NPHPT, a more recently described form of PHPT. While it is still unclear whether NPHPT is an early stage of HPHPT or a separate entity, recent findings show similar osteoporosis and fracture occurrence, and an improvement in bone metabolism, following parathyroidectomy. More extensive prospective studies are crucial to understand the natural course of the disease, to reach a consensus regarding parathyroidectomy indications and surgery candidates' selection, and to ensure proper personalized management for these patients. With the evolving diagnosis methods, PHPT has become a condition with a changing clinical presentation, which now requires modern evaluation and treatment approaches.

The Pathology and Blood Biochemistry of Juvenile Lates calcarifer on Diets Contaminated With Mycotoxins, Histamines and Rancid Fats-A Case Study.

Mycotoxins, originating from contaminated raw materials or suboptimal feed storage, are a growing concern in tropical aquaculture. Common fungi such as Aspergillus spp. and Fusarium spp. produce mycotoxins including aflatoxin, fumonisin, deoxynivalenol and zearalenone. High doses or prolonged exposure (weeks) to low doses of these mycotoxins (< 20 μg/kg) can depress growth, immunity, and cause mortality. This study investigated poor growth and low survival in juvenile Asian seabass, Lates calcarifer fed two different diets (FM40 and ABS3) for 5 weeks. Analysis of these diets revealed high peroxide values, multiple mycotoxins and high histamine levels. Fish fed the FM40 diet, which was contaminated with aflatoxin B1 (13.2 μg/kg), aflatoxin B2 (1.9 μg/kg), deoxynivalenol (29.5 μg/kg), alternariol (2.2 μg/kg), elevated peroxide value (45.91 mEq/kg), and histamine (129.51 mg/kg) developed mild bile duct hyperplasia, depressed total serum proteins (50.40 ± 10.06 g/L), markedly elevated blood potassium (8.2 ± 0.18 mmol/L), and heavy iron deposits in splenic melanomacrophage centres (Perl's stain) indicative of increased haemolysis. The presence of multiple cytotoxic mycotoxins in FM40 diet could explain the increased haemolysis and elevated blood potassium. In contrast, fish fed the ABS3 diet, which had high histamine levels (210.05 mg/kg), exhibited protein-losing nephropathy with multifocal fibrin plugs (Martius scarlet blue stain) indicating acute renal damage, and elevated blood calcium and phosphorus levels. Histamine is metabolised and excreted through the kidneys and known to induce renal arteriolar constriction, disrupt glomerular filtration barrier and increase permeability resulting in protein loss. This study shows that blood biochemistry and histopathology are useful diagnostic tools for assessing the impact of mycotoxins and histamines on fish health.

Serum calcium relative decline as a predictor of post thyroidectomy hypocalcemia.

Serum calcium relative decline as a predictor of post thyroidectomy hypocalcemia.

Serum Lipid Profile and Electrolytes Reference Intervals for Apparently Healthy Children and Adolescents in Addis Ababa, Ethiopia.

Accurate reference intervals generated from an apparently healthy population and stratified by crucial variables such as age and gender are required to guarantee appropriate interpretation of test results. Since there were no local reference intervals in the study area, the present study aimed to establish reference intervals on serum lipid profiles and electrolytes for children and adolescents in Addis Ababa. This community-based cross-sectional study was conducted from April to October 2019. Laboratory analysis was performed using the automatic biochemical analyzer Cobas 6000 (c501) from Roche. According to Clinical and Laboratory Standards Institute (CLSI) guidelines, reference intervals for lipid profile and electrolyte tests for apparently healthy children and adolescents were established. We used a non-parametric method to calculate the 2.5th and 97.5th percentiles with a 90% confidence interval. In children, the reference intervals for serum potassium, sodium, chloride, calcium, magnesium, and phosphate in mmol/L were 4.37-5.20, 137-145.50, 101.90-107.90, 2.34-2.70, 0.74-0.97, and 1.42-1.85, respectively; and for total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein, the respective values were 100.76-171.70, 44.16-126.36, 60.60-105.60, and 31.60-53.70 in mg/dL, for both genders. For adolescents, the reference intervals were 4.03-5.58, 137-146, 98.90-120.90, 2.39-2.70, 0.73-0.96, and 0.96-1.80 for serum potassium, sodium, chloride, calcium, magnesium, and phosphate in mmol/L, respectively; and 97.20-189.10, 40.50-143.60, 41.70-120.90, and 21.30-57.0 in mg/dL for total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein, respectively, for both genders. The established reference intervals in the current study revealed that both the lower and upper limits contradicted the manufacturer values as well as the available literature. The study also discovered significant gender differences in reference values for TC, TG, LDL-C, potassium, phosphate, and chloride in the adolescent age groups.

Real world feasibility of patient-based real time quality control (PBRTQC) using five analytes in a South African laboratory

BackgroundPatient-based real-time quality control (PBRTQC) identifies possible bias in methods by utilising shifts in trend of statistical measures in laboratory results. In this study we aimed to compare and optimize various PBRTQC procedures for serum alanine aminotransferase, albumin, calcium, ferritin and sodium. MethodsIn a bias simulation study, we added artificial bias to intervals of patient data and then evaluated the efficiency with which various PBRTQC procedures were able to detect this bias. PBRTQC procedures used included block size, moving statistic calculation, control limits as well as truncation limits. The number of patients till error detection, the false alarm rate as well as validation charts were utilised to select the optimal PBRTQC procedure for each analyte. ResultsThe optimal PBRTQC procedures identified for each analyte were: ALT − MA T0 50 MaxMin; Albumin − MA T5 100 Perc; Calcium − MM T5 50 Perc; Ferritin − MA T0 100 MaxMin; and Sodium − MA T5 75 MaxMin. (T, Truncation limits; Control limits- MA, Moving Average, MM, Moving median; Perc, percentile) ConclusionsThe use of large, real patient datasets allows for the reliable determination of laboratory-specific PBRTQC procedures. This study demonstrates that the moving average calculation excels in both normal and transformed analyte distributions. Whilst, the benefits of PBRTQC procedures are proven, the complex and time-consuming optimisation process may be a barrier to the rapid implementation in under-resourced countries.

Seasonal dynamics of indicators of mineral metabolism in horses in the conditions of the Leningrad region

The article analyzes the seasonal dynamics of mineral metabolism indicators in adult horses kept in private stables in the Leningrad region. As a result of the research, knowledge of the concentration and dependence of indicators on the seasonality of the year was obtained. It is important to remember that macro- and microelements are not synthesized in the body, they come from food, water, and air. The degree of their assimilation depends on the state of the respiratory and digestive organs. The most difficult period for animals is winter, when there is a decrease in the resistance of the body as a whole due to poor climatic conditions and minimizing physical activity in the fresh air. All these are predisposing factors for the imbalance of indicators at the level of the whole organism.It is established that in the autumn-winter period there is a decrease in indicators relative to the average annual digital values. Thus, there is a linear relationship between the concentration of calcium and phosphorus in blood serum – the minimum values are observed in winter and are 2.53±0.27 mmol/l and 1.76± 0.11 mmol/l, respectively. And the maximum values are typical for the autumn period and are 3.63±0.29 mmol/l for calcium and 2.33±0.12 mmol/l for phosphorus. Similar dynamics is observed in other indicators of the body's mineral metabolism. Thus, for trace elements such as copper, iron, protein-bound iodine, the minimum values were noted in the spring period. This can be explained by a decrease in the mineral components of the feed itself, as a result of long-term storage, resulting in changes in the chemical composition of vegetable feed with fat oxidation. Microelementoses and osteodystrophic processes are observed in animals. The autumn period is characterized by the highest concentrations of minerals in the blood serum of horses, on average by 8-12% compared with the average annual figures, This is explained by the fact that it was in the summer period that the greatest benefit was obtained from juicy plant substances of feed and proper exercise.This knowledge is necessary to understand the processes occurring in the body of horses at different times of the year and the possibility of correcting mineral supplements based on the data obtained

Variation in blood glucose, cholesterol, urea and calcium levels according to the physiological stage in Ouled-Djellal ewes in Algerian arid zone. Technical note

Sheep farming in arid and semi-arid regions of Algeria is confronted with large fluctuations in the availability of fodder, which is all the more restrictive for pregnant ewes whose needs are at a maximum and constitute a major obstacle to the development of this sector. This study aims to evaluate the influence of the physiological stage on the energy, nitrogen and mineral status of Ouled-Djellal ewes living in arid zones (Biskra), by determining the plasma levels of glucose, cholesterol, urea and calcium. Blood samples were taken from 40 ewes divided into two groups according to their physiological stage (pregnant and empty). The obtained results showed that the physiological stage had a significant influence only on blood glucose, being higher in empty sheep than in pregnant sheep (P&lt;0.05), whereas for the other blood parameters: cholesterol, urea, and the plasma concentrations of calcium do not seem to be influenced by the physiological stage.

The polar vessel sign: insights from CT imaging analysis in Asian Indian primary hyperparathyroidism.

Data on the polar vessel sign (enlarged feeding vessel terminating in parathyroid lesions) on four-dimensional computed tomography (4D-CT) is limited. We performed a retrospective analysis to determine the prevalence, predictors, and adjunctive utility of polar vessel sign in pre-operative 4D-CT of patients with primary hyperparathyroidism (PHPT). One radiologist blinded to the patients' details reported the 4D-CT of eighty-four operated patients with histopathology-proven single-gland PHPT. Two protocols were used to obtain arterial-phase images: timed via bolus tracking (n = 41) or fixed at 20 s after contrast injection (n = 43). Seventy-one patients were symptomatic for PHPT, with median serum calcium 12.1 mg/dL. On the arterial phase of 4D-CT, 88.1% of lesions had the polar vessel sign, including 7/9 asymptomatic patients, 6/6 parathyroid carcinomas, and 3/4 ectopic(1:mediastinum, 2:thyro-thymic ligament). Predictors of polar vessel sign were maximum lesion dimension (2.2 vs. 1.4 cm; P = 0.03), solid-cystic CT morphology (47.3% vs. none; P = 0.004), and bolus tracking-timed arterial phase (55.4% vs. none; P = 0.001). Of these, bolus tracking improved the polar vessel's visualization (100% vs. 76.7%; P = 0.001) independent of lesion dimension and solid-cystic morphology. The latter two predicted polar vessel sign in images obtained at a fixed interval (20 s). A significantly lower proportion of bolus tracking-timed scans had lesion percentage arterial enhancement (PAE) < 128.9% (2/41 vs. 9/43; P = 0.04). Even with suboptimal PAE, the polar vessel helped identify 9/11 lesions. The polar vessel sign demonstrated an additive role to PAE during CT reporting. Bolus tracking is valuable in optimizing vessel and tumor arterial enhancement and is easily incorporated into parathyroid 4D-CT protocol.

Association between serum calcium and in-hospital mortality in intensive care unit patients with cerebral infarction: a cohort study.

The relationship between serum calcium levels and the prognosis of cerebral infarction remains controversial. This study aims to investigate the correlation between serum calcium levels and in-hospital mortality in critically ill patients with ischemic stroke admitted to the intensive care unit (ICU). A retrospective cohort study was conducted using data from the MIMIC-IV database. Demographic and clinical data of all participants were collected including gender, age, hypertension, diabetes, myocardial infarction, heart failure, chronic obstructive pulmonary disease, hemoglobin, potassium, sodium, anion gap, platelets, white blood cells, glucose, creatinine, Glasgow coma score (GCS), IV-tPA administration (rt-PA), and mechanical thrombectomy (MT). The outcome measure was in-hospital death. Multivariable-adjusted logistic regression analysis, curve fitting, interaction analysis, and threshold effect analysis were employed to evaluate the relationship between serum calcium levels and in-hospital mortality among ICU patients with cerebral infarction. A total of 2,680 critically ill patients with cerebral infarction were enrolled, with a mean serum calcium level of 8.6 ± 0.8 mg/dL. The overall in-hospital mortality rate was 19.5%, where Group 1 (serum calcium < 8.0 mg/dL) had a mortality rate of 27.7%, Group 2 (serum calcium 8-9 mg/dL) had a rate of 19.8%, and Group 3 (serum calcium ≥ 9 mg/dL) had a rate of 13.9%. There was a non-linear, S-shaped relationship between serum calcium levels and in-hospital mortality. Serum calcium levels within the range of 7.70-9.50 mg/dL were found to be independently associated with increased in-hospital mortality in ICU patients with cerebral infarction. No significant interactions were detected in subgroup analyses, and the results of sensitivity analyses remained stable. Serum calcium levels are independently associated with in-hospital mortality in critically ill patients with cerebral infarction in the ICU setting. Within the range of 7.70-9.50 mg/dL, lower serum calcium levels increase the risk of in-hospital death among these patients, emphasizing the importance of close monitoring by ICU physicians.

Incidental Parathyroidectomy After Thyroid Surgery: A Single-Center Study.

Hypoparathyroidism with hypocalcemia is the most frequent complication after thyroid surgery. Many risk factors have been involved in the development of this complication, with conflicting results. Incidental parathyroidectomy (IP) may be a frequent cause of postoperative hypocalcemia. In this study, we have evaluated the risk factors associated with the IP in a single-center cohort of patients undergoing thyroid surgery. The incidence and the risk factors for IP were evaluated in 799 patients scheduled for surgical treatment for thyroid disease between January 2018 and December 2023. Parathyroid hormone levels and serum calcium levels, together with the histological specimens, were evaluated in all patients. Post-operative temporary hypocalcemia was present in 239 (29.9%) patients. A total of 144 patients (21.9%) had an incidental parathyroidectomy. Younger patients (<40 years) had the highest risk of having an incidental parathyroidectomy (RR 1.53 (95% CI 1.084-2.161), OR 1.72 (95% CI 1.091-2.710), p = 0.014). Moreover, thyroid cancer (RR 1.4 (95 CI 1.114-1.882) OR 1.68 (95% CI 1.145-2.484), p < 0.05) and the neck dissection (RR 1.75 (95% CI 1.409-2.198) OR 2.38 (95% CI 1.644-3.460), p < 0.001) were strongly associated with the risk of incidental parathyroidectomy. Younger female patients with thyroid cancer and neck dissection were at the highest risk of incidental parathyroidectomy. A meticulous surgical dissection, together with imaging methods for the detection of the parathyroid glands, may reduce the incidence of this complication.

Serum biochemical evaluation of healing of critical-sized long bone defects in rats treated with biphasic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) bioceramic scaffolds

Critical-sized long bone defects are those that would not heal spontaneously despite surgical stabilisation. The use of bioceramic scaffold has shown promising results in the repair of bone defects. The present study was undertaken to evaluate the serum biochemical parameters of Wistar rats treated for critical-sized segmental bone loss using biphasic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) bioceramic scaffolds. The study was conducted in eighty male Wistar rats aged between 8-12 weeks, weighing 200-250 g body weight with critical-sized segmental defects in the femur. A 6 mm segmental mid-diaphyseal femoral defect was created under general anaesthesia. The bone defect was bridged with bioceramic scaffolds and retained in position with microplate and screws. Serum biochemical parameters serum calcium, phosphorous, acid phosphatase and alkaline phosphatase were evaluated four weeks before surgery, immediately after surgery and 4th, 8th, 12th, and 16th week after surgery. The evaluation of both serum calcium and phosphorous were found to be reliable indicators of new bone formation and mineralisation, whereas the evaluation of both serum acid phosphatase and alkaline phosphatase were found to be reliable indicators of bone healing during the treatment of critical-sized long bone defects in rats using biphasic hydroxyapatite and β-tricalcium phosphate bioceramic scaffolds Keywords: Beta-tricalcium phosphate, bioceramic scaffold, hydroxyapatite, serum acid phosphatase, serum alkaline phosphatase, serum calcium, serum phosphorous

Delving into diversity: Exploring different risk factors of premature greying of hair.

Dear Madam, Hair is said to grey prematurely when a minimum of five grey hairs occur before the age of 20 in Caucasians, 25 in Asians and 30 in Africans1. Some authors propose using 25 years as a cut-off for people in the South Asian subcontinent. Also, there's no universal grading system for premature greying of hair (PGH). This letter addresses the various evolving risk factors for PGH in young adults worldwide. PGH may be familial or genetically influenced, traveling in an Autosomal Dominant pattern. A positive family history, in particular the paternal history is the most powerful risk factor2. PGH is also linked to nutritional deficiencies including vitamins (especially B12) and minerals. For example in one study, significantly lower levels of serum calcium, ferritin, vitamin B12, and high HDL were observed in patients3. T3 and T4 act on hair follicles to cause melanogenesis and their deficiency is therefore associated with PGH, alopecia, and changes in hair morphology. Another study found notably reduced levels of copper in cases (PGH) as compared to the control group. This study, however, did not observe lower levels of zinc or iron among the affected population. A separate case-control study concerning the association of epidemiological and biochemical factors with PGH reported that a significantly higher percentage of individuals with premature greying had atopic diathesis, led sedentary lifestyles, had family histories of the condition, smoked, and had reported higher levels of perceived stress compared to controls. Though, interestingly enough, regular application of hair oil seemed to confer a safeguarding effect against premature greying. Upon further review of the literature, it became apparent that both BMI and exposure to sunlight emerged as substantial predictors of PGH. Despite the prescription of various vitamins and minerals like biotin, calcium pantothenate, zinc, copper, and selenium (all of which have been recognized as risk factors), the outcomes have been disappointing. Calcium pantothenate is frequently recommended for premature greying of hair (PGH)4. This highlights an existing knowledge gap concerning the precise causative risk factors, necessitating further investigation for a comprehensive understanding and improved management of individuals experiencing premature greying of hair.

Study of Association of PPH due to Uterine Atonicity and Serum Calcium levels

Background: Uterine atonicity stands out as a primary and leading factor contributing to maternal morbidity and mortality. Postpartum hemorrhage (PPH) resulting from uterine atony poses a life-threatening risk. Oxytocic drugs, by elevating intracellular calcium, enhance uterine tonicity, with optimal calcium levels playing a crucial role in facilitating effective uterine contractions. The study aimed to explore the relationship between the concentration of calcium in the bloodstream and the occurrence of PPH associated with inadequate uterine contractions admitted during the 1st and 2nd stages of labour at a tertiary care facility such as the Combined Military Hospital in Dhaka. The study likely involved analyzing data to identify any patterns or connections between serum calcium levels and the incidence of uterine atony-related PPH. Methods: The study follows a randomizing controlled trial (RCT) design within the Department of Obstetrics and Gynecology at Combined Military Hospital, Dhaka. The study duration spans from January 2016 to January 2019, involving a total of 306 subjects. Group A includes those with serum calcium levels between 8-10.4 mg/dl without uterine atonicity, while Group B comprises individuals with serum calcium levels below 8 mg/dl experiencing uterine atonicity, either post cesarean or vaginal delivery. Atonicity features include a soft, distended uterus with a lack of muscle tone. Results: A total of 306 patients were included in the study, with 153 having serum calcium levels exceeding 8 mg/dl and another 153 having levels below 8 mg/dl. Among women with serum calcium levels below 8 mg/dl, 37 patients experienced uterine atonicity. In contrast, it was observed that among women with serum calcium levels exceeding 8 mg/dl, only one patient experienced uterine atonicity. This highlights a potential association between higher serum calcium levels and a reduced likelihood of developing uterine atony in the studied population. Conclusions: The study findings indicate a strong association between low calcium levels and reduced uterine tonicity, establishing low calcium as a significant risk factor for uterine atony. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 28-34

Association of regular plasmapheresis donation with serum protein and electrolyte levels: a multicentre cross-sectional study in China

BackgroundChina’s plasmapheresis donation policy differs from that of Western countries. The association between regular plasmapheresis donation and donor health in China is still unknown.ObjectivesTo investigate the association of regular plasmapheresis...

Parathyroid carcinoma: molecular pathology and correlation with clinicopathologic features, a single center experience

Abstract Introduction/Objective Parathyroid Carcinomas are rare malignant neoplasms, accounting for less than 1% of primary hyperparathyroidism cases. Parathyroid carcinomas are characterized by markedly elevated levels of PTH, severe hypercalcemia and established target organ damage. The authors report the experience of a single center regarding the clinic-pathologic and genetic analysis of parathyroid carcinoma cases. Methods/Case Report The study is a retrospective review of all patients with parathyroid carcinoma that were evaluated at a tertiary oncologic center from 2001 until 2023. Results (if a Case Study enter NA) A total of nine cases (6 male and 3 female) were identified, with a mean age at diagnosis of 52 ± 16 years and a median follow-up of 16.5 years. Most patients presented with hypercalcemia (n = 7), with a mean serum calcium concentration of 13.5 mg/dl (9.6-16.5) and a mean PTH of 1123 pg/ml (&amp;lt;a href=“tel:276- 2500”&amp;gt;276-2500&amp;lt;/a&amp;gt;). En bloc surgical resection was performed in 6 patients and 3 patients underwent adjuvant radiotherapy. Recurrence was observed in 4 cases (44.4%) after a median of 24 months following surgery. Negative immunohistochemical staining of parafibromin was noted in 3/4 cases of recurrence. Parathyroid carcinoma was diagnosed on the basis of finding lesions with vascular or perineural invasion, capsular penetration, and/or documented metastases. Immunohistochemical staining for parafibromin, Ki-67, and E-cadherin was performed on formalin-fixed, paraffin-embedded tissue samples. Next generation sequencing (NGS) was performed in 6/9 cases and CDC73 mutations were present in 38.5% of analyzed patients. Loss of TP53 and RB1 alleles and CCND1 amplification were other reported genetic alterations in the study cohort. Conclusion Parathyroid carcinoma is associated with a significant rate of recurrence and limited effective treatment beyond initial complete surgical resection. Inactivating CDC73 alterations which include truncating or frameshift mutations, as well as missense mutations lead to the loss of parafibromin immunoreactivity. Other molecular alterations like PTEN and PIK3CA mutations may represent potential targets for molecular therapy. An IHC panel of parafibromin, Ki-67 and E-cadherin may help to distinguish parathyroid carcinoma from other parathyroid neoplasms.

Effect of Combination of Alcoholic Extract of Zingiber Officinale (AEZO) and Hydroalcoholic Extract of Brassica Oleracea (HAEBO) on Papain Induced Osteoarthritis in Wistar Rats

Background: The “degenerative joint disease” i.e. Osteoarthritis (OA) is very common nowadays, which affects generally the knee joints. Osteoarthritis occurs in all the synovial joints of the hand, spine, wrist, hip, knee, and ankles. While we are focusing on the current Indian scenario, it was found that the prevalence rate of osteoarthritis ranges from 22-39 percent. Overall, it often affects both males and females after the age of 45. It affects more than 500 million people globally. Age, weight, gender, joint damage, and heredity were additional risk factors for OA. Osteoarthritis causes pain, functional limitation, and deterioration. Herbal remedies can be used to treat such diseases. Methods: The alcoholic extract of Zingiber officinale (AEZO) and the hydroalcoholic extract of Brassica oleracea (HAEBO) in 1:1 proportion were evaluated against papain-induced OA. Evaluation: The paw volume, blood and liver parameters, serum calcium level, histopathology, and radiology were performed once after the treatment of 28 days with the combination. Result: The results of the combination of AEZO and HAEBO-treated groups show that paw volume was reduced but the percentage of paw edema is enhanced. The histological and radiological results also indicated that a mixture of AEZO and HAEBO in 1:1 proportion has anti-osteoarthritic activity in papain-induced osteoarthritis.

Self-Adaptive Electrochemistry of Phosphate Cathodes toward Improved Calcium Storage.

Polyanion phosphates exhibit great potential as calcium-ion battery (CIB) cathodes, boasting high working voltage and rapid ion diffusion. Nevertheless, they frequently suffer from capacity decay with irreversible phase transitions; the underlying mechanisms remain elusive. Herein, we report an adaptively layerized structure evolution from discrete NaV2O2(PO4)2F nanoparticles (NPs) to interconnected VOPO4 nanosheets (NSs), triggered by electrochemical (de)calcification, leading to an improvement in Ca2+ storage performance. This electrochemistry-driven self-adapted layerization occurs over approximately 200 cycles, during which NPs undergo a "deform/merge-layerization" process, transitioning from a three-dimensional to a two-dimensional atomic structure, with a distinct 0.68 nm lattice spacing. The transition mechanism is demonstrated to be linked to the gradual separation of structural Na+ and F-. The resultant VOPO4 NSs exhibit exceptional Ca2+ diffusion kinetics (3.19 × 10-9 cm2 s-1, currently the optimal value among inorganic cathode materials for CIBs), enhanced capacity (∼100 mA h g-1), longevity (over 1000 cycles at 50 mA g-1), and high rate (84% retention rates when increasing current density from 50 to 200 mA g-1). Employing advanced electron microscopy, this study reveals an electrochemical activation-induced structure evolution at the atomic level, providing valuable insights into the design of high-performance CIB cathodes.

Clinical Features and Risk Factors for Outcome in Hemodialysis Patients with COVID-19 after Complete Liberalization of Epidemic Control in China

Introduction: Patients undergoing hemodialysis (HD) are highly vulnerable during the COVID-19 pandemic. We aimed to investigate the risk factors associated with the severity of COVID-19 and death after the complete liberalization of epidemic control in China. Methods: We followed the outcomes of the HD patients of Central Hospital of Dalian University of Technology, from December 6, 2022, to January 8, 2023. The non-contrast-enhanced chest computed tomography (CT) was performed on all COVID-19-infected hospitalized patients. We recorded the patient’s clinical characteristics, demographic features, vaccination history, treatments, and lung lesions. Odds ratios and 95% confidence intervals were calculated using logistic regression models to identify independent risk factors for COVID-19-related severity and mortality. Results: This study included a total of 858 HD patients, of which 660 were infected with COVID-19. The mean age was (55.61 ± 14.61) years, with a median (interquartile range) dialysis duration of 44.5 (69.5) months. Over half (60%) of the study participants were male, and the majority had hypertension as a comorbidity. Multivariable analysis revealed that age, pre-dialysis diastolic pressure, fever, white blood cell (WBC) count, potassium, β2-microglobulin level, and calcium were independent risk factors for disease severity, while platelets, urea nitrogen, serum chlorine and creatinine were identified as independent protective factors. Furthermore, total iron-binding capacity and vaccination were found to be independent protective factors against mortality, and WBC count was an independent risk factor for in-hospital mortality (p < 0.05). The most frequent CT finding among hospitalized patients with chest symptoms was patchy shadow or pleural effusion, observed in 64.8% of cases. More than half of the patients exhibited bilateral lung lesions, and over 60% involved two or more lobes. Conclusion: The majority of HD patients are susceptible to COVID-19. Demographic, clinical features, and laboratory indicators can be used to predict the severity and mortality associated with COVID-19. Our findings will assist clinicians in identifying markers for the early detection of high mortality risk in HD patients with COVID-19.