scholarly journals SUN-LB67 Revisit Serum Calcium Correction

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yulong Li ◽  
JunJia Zhu ◽  
Jenny Blau ◽  
William F Simonds
Keyword(s):  
Serum Calcium ◽  
Repeated Measures ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Total Serum ◽  
P Value ◽  
Total Calcium ◽  
Total Serum Calcium ◽  
Parathyroid Disease ◽  
Calcium Status

Abstract Context: The serum calcium level is one of most routinely ordered tests in clinical practice. Many factors can affect calcium level and its interpretation. There are challenges and barriers in applying calcium correction formulas to every-day practice. Objective: Revisit correlation between total and ionized calcium levels, and dependence of serum calcium on albumin, pH and creatinine levels. Methods: This study included 1537 subjects enrolled in a parathyroid disease clinical protocol. We examined calcium and relevant biochemistry tests collected simultaneously and repetitively over consecutive years. Histograms, repeated measures correlation, correlation plots, and liner regression plots were used to analyze and visualize the data. Results: We found that: 1) directly measured total serum calcium and ionized calcium had excellent correlation and dependence with p-value=2.2e-16, repeated measures correlation coefficient (rmcorr)=0.919, and 95% interval (CI) = 0.916 to 0.922; 2) there was a low dependence between total serum calcium and albumin levels (rmcorr=0.454, 95% CI=0.433 to 0.474), a low dependence between ionized calcium and pH levels (rmcorr=-0.309, 95% CI= -0.326 to -0.292), and no dependence between total calcium and creatinine levels (rmcorr=0.026 95% CI=0.012 to 0.040); 3) using the commonly applied correction formulas, to either adjust total calcium based on albumin levels or else adjust ionized calcium based on pH levels, did not improve dependence among them. Conclusions: We therefore suggest using directly measured total serum calcium and/or ionized calcium level to assess clinical calcium status in general patients tested for parathyroid related disorders.

scholarly journals Correlation between QoTc and serum as well as ionised calcium in sick neonates

2020 ◽  
Vol 7 (5) ◽  
pp. 1033
Author(s):  
Yashoda H. T. ◽  
Kavya C. ◽  
Nithya E. ◽  
Laghna Gowda
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Perinatal Asphyxia ◽  
Surrogate Marker ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Calcium ◽  
Serum Total Calcium ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Background: Hypocalcemia is a frequently observed clinical and laboratory abnormality in neonates with risk factors such as prematurity, infant of diabetic mothers and perinatal asphyxia. Hypocalcemia can be asymptomatic or can cause apnoea, seizures, jitteriness, stridor, cardiac abnormalities. Clinically as calcium levels are maintained within narrow ranges. It is therefore imperative to measure and correct any deficit at the earliest. Unfortunately, total serum calcium level correlates poorly with ionized calcium level. Measurement of ionized calcium is both time consuming and expensive and therefore the need for more rapid, inexpensive and non-invasive method for screening at risk-neonates. Serum calcium levels are known to affect the duration of the QoTc interval. Therefore establishing a good correlation between serum/ionized calcium levels and QoTc will validate ECG as a reliable marker of hypocalcemia. Objective was to find correlation between QoTc interval and serum calcium levels in sick neonates.Methods: Total 730 infants were for serum total calcium and ionized calcium levels. Off these 142 infants with hypocalcemia, 29 infants were excluded based on exclusion criteria. The remaining 113 neonates were subjected to three cycles of ECG measurement before correction of calcium and were taken as cases. QoTc intervals were measured and were correlated with corresponding serum total calcium and ionized calcium levels.Results: In this study, a moderate negative or downhill correlation was found between total serum calcium QoT (r = -0.694 and p = <0.001) and QoTc (r = -0.680 and p = <0.001). The ionized calcium levels were found to have strong negative or downhill correlation with QoT (r = -0.837 and p = <0.001), QoTc (r = -0.819 and p = <0.001). All these correlations were found to be statistically significant with p<0.05.Conclusions: QoTc interval can be used as a surrogate marker for blood total or ionized calcium levels.

scholarly journals Association of dietary calcium intake, total and ionized serum calcium levels with preeclampsia in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel D. Gebreyohannes ◽  
Ahmed Abdella ◽  
Wondimu Ayele ◽  
Ahizechukwu C. Eke
Keyword(s):  
Serum Calcium ◽  
Calcium Intake ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Dietary Calcium ◽  
Ionized Calcium ◽  
Dietary Calcium Intake ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Abstract Background Preeclampsia is a well-known cause of maternal mortality and morbidity in Ethiopia. The exact pathophysiology has not been fully understood. Calcium and magnesium deficiencies have been given emphasis to play roles in the pathophysiology. Although evidence is abundant, they are equivocal. The study aimed to see the association of dietary calcium intake, serum total calcium level and ionized calcium level with preeclampsia. It also evaluated the association between dietary calcium intake and serum calcium levels. Materials and methods An unmatched case–control study was conducted in Gandhi Memorial, Tikur Anbessa, and Zewditu Memorial Hospitals, all in Addis Ababa, between October to December, 2019. Cases were 42 women with preeclampsia and controls were 42 normotensive women. The medical and obstetric history was gathered using a structured questionnaire and the dietary calcium intake information using a 24-h dietary recall. The serum levels of total serum calcium and ionized (free) calcium were measured using an inductively coupled mass spectrophotometer. Bivariate and multivariate logistic regression and Pearson correlation test were utilized during data analysis. Results In comparison with controls, women with preeclampsia had lower mean (± 1SD) levels of ionized calcium level (1.1 mmol/l ± 0.11), total serum calcium level (1.99 mmol/l ± 0.35) and lower median (IQR) dietary calcium intake (704 mg/24 h,458–1183). The odds of having preeclampsia was almost eight times greater in those participants with low serum ionized calcium level (OR 7.5, 95% CI 2.388–23.608) and three times higher in those with low total serum calcium level (OR 3.0, 95% CI 1.024–9.370). Low dietary calcium intake also showed statistically significant association with preeclampsia (OR 3.4, 95% CI 1.092 -10.723). Serum ionized calcium level and total serum calcium level showed positive correlation of moderate strength (p = 0.004, r = 0.307), but no correlation was found between dietary calcium intake with both forms of serum calcium levels. Conclusion This study showed significant association between low dietary calcium intake and low serum calcium levels with preeclampsia, hence this can be used as a supportive local evidence for the current context-specific recommendation of calcium supplementation in societies with low-dietary calcium consumption in an attempt to prevent preeclampsia, therefore implementation study should be considered in Ethiopia to look for the feasibility of routine supplementation.

scholarly journals To Study the Association of Total Serum Calcium Level in Assessing the Severity of Pancreatitis

2021 ◽  
pp. 781-785
Author(s):  
V. Lingesh Kumar ◽  
Saravanan Sundaram
Keyword(s):  
Acute Pancreatitis ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Tertiary Care ◽  
Total Serum ◽  
Total Calcium ◽  
Blood Calcium ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Background: Pancreatitis is an inflammatory condition that affects the pancreas and may also affect other tissues or distant organ. In this study our aim is to see if blood calcium level can be used as a prognostic marker in determining the severity of acute pancreatitis because hypocalcaemia is linked to higher mortality and hospitalization. Method: A retrospective study was conducted in the medical records department of a tertiary care health facility. A total of 75 participants were included in the research. .demographic details of all patients were collected .Patients above 18 years who presented with of epigastric pain, pre-Diagnosed gallstones, alcoholism were included int this study. The lowest total calcium levels were collected in order to examine total calcium as a predictive factor for severity. All of these information were collected and analyzed to get the appropriate findings. Results: A total of 75 patients were included in the research. The age of patients in each severity grade did not differ significantly (p value>0.05). The gender distribution of the two groups did not differ. (P >0.05). For mild and severe acute pancreatitis, mean total calcium levels were 7.98 and 6.67, respectively, which was statistically significant (p< 0.05). Conclusion: The total serum calcium level is a useful indicator for assessing  pancreatitis.

Ionized Calcium, Cardiac Function, and Electrocardiogram in Preterm Neonates

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 541-542
Author(s):  
JENS MÖLLER ◽  
F. K. TEGTMEYER
Keyword(s):  
Cardiac Function ◽  
Causal Relationship ◽  
Serum Calcium ◽  
Cardiac Failure ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Preterm Neonates ◽  
Total Serum ◽  
Total Serum Calcium

To the Editor.— We would like to add some comments on the article by Venkataraman et al.1 In one respect it might be quite dangerous not to measure the ionized calcium in preterm neonates. If you find prolongation of QTc or QoTc intervals in the ECG during cardiac failure in these infants and find subnormal total serum calcium levels, you might make a wrong conclusion on causal relationship. Until now, we have seen five preterm neonates with OTc/QoTc prolongation and profound low total serum calcium levels, whereas the measured ionized calcium level was normal.

scholarly journals Total Serum Level of Calcium and Ion Calcium is Lower in Hypotonic Uterine Inertia

2016 ◽  
pp. 145-148
Author(s):  
Josef Wattimury ◽  
Wiryawan Permadi ◽  
Edwin Armawan
Keyword(s):  
Serum Level ◽  
Correlation Coefficient ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Total Serum ◽  
Total Calcium ◽  
Uterine Contractility ◽  
Total Serum Calcium ◽  
Uterine Inertia

Objectives: To know the correlation between total and ion serum calcium level with the uterine contractility of laboring patient. Methods: This is a cross-sectional analytic correlative study measuring the strength of correlation of total and ion calcium serum level between groups with hypotonic uterine inertia - and normal labor. Each group consists of 20 subjects who met inclusion criteria and presented to Dr. Hasan Sadikin Hospital in August - September 2012. Statistical analysis was performed by using Eta (η) coefficient. Results: Mean total calcium serum level on hypotonic uterine inertia is 6.66 mg/dl, while mean of total calcium serum level on normal labor is 8.56 mg/dl, with Eta (η) correlation coefficient 0.721. Mean ion calcium serum level on hypotonic uterine inertia is 4.14 mg/dl, while mean of total calcium serum level on normal labor is 4.92 mg/dl, with Eta (η) correlation coefficient 0.802. Conclusion: Total serum level of calcium and ion calcium in hypotonic uterine inertia is lower than the level of which in normal labor. There is a strong correlation between total and ion serum calcium level with uterine contractility, the Eta (η) correlation coefficient are 0.721 and 0.802 respectively. [Indones J Obstet Gynecol 2013; 1-3: 145-8] Keywords: hypotonic uterine inertia, ion serum calcium level, normal labor, total serum calcium level

scholarly journals Non-corrected total serum calcium sufficiently reflects ionized calcium level.

2002 ◽  
Vol 35 (12) ◽  
pp. 1523-1525
Author(s):  
Naganori Sato ◽  
Yoshitaka Maeda ◽  
Tatsuo Shiigai
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Serum Calcium

scholarly journals Duration and dose of antiepileptic drugs and serum calcium levels in children

2017 ◽  
Vol 57 (2) ◽  
pp. 104
Author(s):  
Arinta Atmasari ◽  
Masayu Rita Dewi ◽  
Aditiawati Aditiawati ◽  
Masagus Irsan Saleh
Keyword(s):  
Valproic Acid ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Total Serum ◽  
Total Calcium ◽  
Total Serum Calcium ◽  
Carbamazepine Therapy ◽  
Epileptic Children ◽  
Total Serum Calcium Level

Background Antiepileptic drugs (AEDs) may affect calcium metabolism through several mechanisms. Much evidence has confirmed that carbamazepine and valproic acid, as the most widely used AEDs in epileptic children, leads to decreased serum calcium levels. This effect was suggested to be time and dose dependent. However, correlations between AEDs and calcium levels in Indonesian epileptic children have not been well studied.Objective To investigate possible correlations between total calcium levels and durations of therapy as well as doses of carbamazepine and valproic acid.Methods This analytical, cross-sectional study was performed from March to May 2015 in the Neuropediatric Outpatient Ward of Mohammad Hoesin Hospital, Palembang, South Sumatera. A total of 60 epileptic children taking carbamazepine and or valproic acid monotherapy were included and grouped accordingly. A single blood test was done for every participant to measure total serum calcium level. Correlation between daily dose or duration of AED with calcium level was assess using the Spearman-rho test.Results The mean total serum calcium levels in the carbamazepine and valproic acid groups were 9.48 (SD 0.83) mg/dL and 9.58 (SD 0.63) mg/dL, respectively. There was a statistically significant moderate correlation between the duration of carbamazepine therapy and total calcium level (r = 0.36; P=0.001). The cut-off point for duration of therapy was 23 months. There were no significant correlations between total calcium level and mean daily carbamazepine dose, nor between total calcium level and duration and dose of valproic acid therapy.Conclusion Longer duration of carbamazepine therapy is associated with low total serum calcium level, but carbamazepine dose is not. In addition, duration and dose of valproic acid are not associated with low total serum calcium level.

scholarly journals Occurrence of Hypocalcaemia in Admitted Neonates in NICU

2021 ◽  
Vol 20 (2) ◽  
pp. 156-161
Author(s):  
Nisha jyoti Shrestha ◽  
Moon Thapa ◽  
Kalpana Upadhaya Subedi ◽  
Subhana Thapa Karki ◽  
Saroja Adhikari ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Late Onset ◽  
Heart Diseases ◽  
Statistical Significance ◽  
Hypovitaminosis D ◽  
Total Serum ◽  
P Value ◽  
Female Ratio ◽  
Total Serum Calcium

Introduction: Hypocalcaemia is common metabolic manifestation in neonates and associated with both maternal and foetal conditions. Hypocalcaemia is labeled if term neonate’s total serum calcium is < 8 mg/dl and preterm has < 7 mg/dl. Association of neonatal and maternal hypovitaminosis D is very common. .  Methods: One year retrospective study was conducted in a tertiary level private children hospital of Kathmandu, Nepal from 2018 June to 2019 July. Total 299 cases were selected and serum calcium were sent and analysed for its association with illness, associated maternal hypovitaminosis D and other relevant maternal tests. Result: Among 686 NICU cases, calcium level was sent for 299 cases. Among these, 254 were term and 45 were preterm babies and male to female ratio was 4:1. Mean calcium in term babies were 8.6 mg/dl and in preterm it was 8.1 mg/dl. Hypocalcaemia was found in 19% of cases with mean calcium level was 7.1 ± 0.84 mg/dl and severe hypocalcaemia accounted for 12%. There was no significant presence of hypocalcaemia in relation to gestation of newborn (p value 0.798). We found higher incidence of late onset hypocalcemia than early onset hypocalcemia but was not of statistical significance (p value 0.771). Associated disease were perinatal asphyxia, congenital heart diseases and prematurity. Among 27 late onset hypocalcaemia, 22% had hypovitaminosis D both in neonates and mother. Conclusions: Neonatal hypocalcaemia is a common condition associated with sick newborns. In late hypocalcaemia both newborn and mother should be screened for associated lab tests like vitamin D, magnesium, PTH as there may be association between the two.

scholarly journals HYPOCALCEMIA AFTER PARATHYROIDECTOMY

2020 ◽  
Vol 23 (2) ◽  
pp. 75-79
Author(s):  
L. P. Kotelnikova ◽  
G. Yu. Mokina ◽  
N. G. Polyakova
Keyword(s):  
Parathyroid Hormone ◽  
Calcium Level ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Total Serum ◽  
Primary Group ◽  
Total Calcium ◽  
Baseline Serum ◽  
Median Baseline ◽  
Total Serum Calcium

The aim of the study was to estimate the frequency and timing of hypocalcemia after surgical treatment for primary, secondary and tertiary hyperparathyroidism. Materials and methods. 21 patients were operated for hyperparathyroidism, 15 - for primary (group 1), 6 - for secondary and tertiary (group 2). In I group the median baseline level of total serum calcium was 3.06 mmol/l, phosphorus0.9 mmol/l, and parathyroid hormone360 pmol/l. In II group all patients were on program dialysis for end-stage chronic kidney failure for at least five years. The median baseline serum total calcium level was 2.29 mmol/l, phosphorus2.64 mmol/l, and parathyroid hormone-1822 pmol/l. Results. A day after removal of the parathyroid adenoma (1 group) the level of calcium and phosphorus was normalized, the content of parathyroid hormone (median 21.4 pmol/l) significantly decreased. In one case (6.7%) on the fifth day there were clinical signs of hypocalcemia and the level of calcium decreased to 1.86 mmol/l. All patients of the second group underwent subtotal parathyroidectomy. After a day the level of parathyroid hormone significantly decreased (median227 pmol/l). The phosphorus content has returned to normal. The calcium level in all cases exceeded 2 mmol/l. On day 4-5 the total calcium content decreased and ranged from 1.14 mmol/l to 2.04 mmol/l. Four patients (66,7%) showed clinical signs of hypocalcemia. It was found that the development of hypocalcemia has a positive correlation of average value with the level of parathyroid hormone, phosphorus and negative with the content of calcium before surgery. Conclusion. The decrease in the level of total calcium with the development of clinical symptoms occurs on 4-5 days after surgery for primary hyperparathyroidism in 6.7% and for secondary or tertiary - in 66.7%. Risk factors for hypocalcemia are the baseline low level of calcium and high of parathyroid hormone, phosphorus.

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