Effect of cimetidine on serum carboxyl and aminoterminal fragments of parathyroid hormone in chronic uraemic patients

1984 ◽  
Vol 105 (1) ◽  
pp. 66-71
Author(s):  
P. Dupont ◽  
B. Carlier ◽  
M. Marchetti ◽  
J. Ducobu ◽  
C. Van der Donckt
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Normal Limit ◽  
Elevated Serum ◽  
Serum Levels ◽  
Total Serum ◽  
Mean Values ◽  
Total Serum Calcium ◽  
The Mean ◽  
Pre Treatment

Abstract. The effect of cimetidine on abnormally elevated serum levels of parathyroid hormone was studied in 21 patients with secondary hyperparathyroidism due to chronic renal failure, receiving regular dialysis treatment. The concentrations of carboxyl (-COOH) and aminoterminal (-NH2) fragments of circulating immunoreactive parathyroid hormone (iPTH) were determined before and after 2 months af treatment with cimetidine 400 mg/day. All patients had, on admission, raised levels of either hormonal fragment. The mean pre-treatment value was 17.2 mU/ml for -COOH terminus (upper normal limit 6.5 mU/ml) and 5.7 mU/ml for -NH2 terminus (upper normal limit 1.9 mU/ml). At the end of cimetidine treatment the mean values were 19.9 and 5.7 mU/ml respectively for the two forms of circulating iPTH. No changes in total serum calcium, phosphate or alkaline phosphatase activity were recorded during the study. These results do not indicate any lowering effect of cimetidine on serum iPTH in chronic uraemic patients with secondary hyperparathyroidism.

scholarly journals Role of Cardiac Biomarkers in the Assessment of Acute Cerebrovascular Accident

2021 ◽  
Vol 12 (01) ◽  
pp. 106-111
Author(s):  
Srinivasan Radhakrishnan ◽  
Swathy Moorthy ◽  
Sudish Gadde ◽  
Krishnaswamy Madhavan
Keyword(s):  
Acute Stroke ◽  
Cerebrovascular Accident ◽  
Troponin I ◽  
Serum Levels ◽  
Assay Method ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cardiac Enzymes ◽  
Mean Values ◽  
Creatine Kinase Mb ◽  
The Mean

Abstract Background Stroke (cerebrovascular accident) has for long been a global burden in terms of its morbidity and mortality. Serum levels of cardiac enzymes such as creatine kinase-MB (CK-MB) component, troponin T, and brain natriuretic peptide have been found to be elevated among the patients with stroke and also serve to prognosticate these patients. The serum levels of these enzymes correlate directly to the severity of stroke in these patients. Objective Elevated cardiac enzymes among patients with acute cerebrovascular accidents are not uncommon despite the patients not having any cardiac problems. We aimed to identify the occurrence of elevated cardiac enzymes among patients with acute stroke and their correlation with the severity of stroke. Materials and Methods Our study included 100 patients of acute stroke with no previous history of cardiac ailments. Serum levels of troponin I and CK-MB were analyzed among these patients using enzyme-linked immunosorbent assay method within the first 2 hours of admission. Patients outcome during the hospital stay were analyzed. Stroke severity was assessed using the National Institute of Health Stroke score (NIHS score) and the modified Rankin Score (mRS). The cardiac enzyme levels were correlated with these scores. Results Twenty-eight percent of patients had elevated troponin I, while 72% patients had normal levels with the mean values of 10.36 to 106.54 ng/mL and 0.00 to 0.02 ng/mL, respectively. CK-MB levels were found elevated among 14% patients and normal among 86% patients with mean values of 5.8 to 124.36 and 0.0 to 4.3 ng/mL, respectively. Among the six patients who succumbed to death, three patients had increased troponin I and four had elevated CK-MB. NIHS scores of 21.0357±6.79 and 105.277±5.564 were seen in patients with elevated and normal troponin I, whereas NIHS scores of 20.4285±8.658 and 11.8721±9.273 were seen among patients with increased and normal CK-MB, respectively. The mRS scores were 4.3214±0.367, 2.4305±1.374, 4.2143±1.412, and 2.756±1.749 ng/mL among the patients with elevated and normal troponin I and CK-MB, respectively. Conclusion The mean values of cardiac enzymes troponin I and CK-MB were higher among patients with higher scores of NIHS and mRS. Among them, troponin I was very significant and it may serve as an early biomarker for the severity of stroke and hint on early cardiac evaluation among these patients.

scholarly journals Study of Adverse Effect Profile of Zoledronic Acid Infusion Among Patients with Cancer: A Retrospective Analysis

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Lina Elsalem ◽  
Haneen A. Basheer ◽  
Ayat Alshoh ◽  
Abdullah Abu-Aqoulah ◽  
Hussein Alsa'di ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Adverse Effects ◽  
Biochemical Parameters ◽  
Symptomatic Treatment ◽  
Serum Levels ◽  
Mean Values ◽  
Protein Levels ◽  
Patients With Cancer ◽  
Significant Difference ◽  
Pre Treatment

Background: Zoledronic acid (ZA) is widely used in the management of cancer-related bone events. It, however, might be associated with serious adverse effects. Objectives: To evaluate ZA adverse effects and changes in biochemical parameters related to ZA toxicities among patients with cancer. Methods: Ninety-eight oncology patients, who were prescribed ZA intravenous (IV) infusion, were interviewed to assess whether they experienced ZA related symptoms, including acute events and serious adverse effects. ZA’s effects on the serum levels of different biochemical parameters were retrospectively assessed by checking patients’ electronic medical records. Results: The most commonly reported adverse effects were: myalgia (48%), bone pain (36.7%), influenza-like symptoms (34.7%), headache (31.6%), and pyrexia (22.45%) with decreasing frequency of such adverse effects upon repeated infusions. Serious side effects including jaw osteonecrosis, cardiac, and renal problems were not reported. A small, but statistically significant reduction in serum calcium, creatinine, and total protein levels was observed upon comparing levels before and after the first IV infusion of ZA (P ≤ 0.031). No significant change was recorded with other serum electrolytes including phosphorus, sodium, potassium, and magnesium as well as urea levels (P ≥ 0.271). No significant difference was determined in terms of final serum levels of all parameters in comparison to pre-treatment (P ≥ 0.059), except for potassium, where a significant reduction was observed (P = 0.003). Notably, the mean values of all parameters were within the normal range. Conclusions: ZA acute events resolved with symptomatic treatment and reduced with repeated IV infusions. ZA appears as a safe treatment modality for skeletal-related events among patients with cancer and the reported adverse effects should not affect patients’ compliance.

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.

Optimal Discrimination of Mild Hyperparathyroidism with Total Serum Calcium, Ionized Calcium and Parathyroid Hormone Measurements

1987 ◽  
Vol 92 (2) ◽  
pp. 147-176 ◽  
Author(s):  
Lars Benson ◽  
Sverker Ljunghall ◽  
Torgny Groth ◽  
Hans Falk ◽  
Andreas Hvarfner ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Serum Calcium ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Serum Calcium

Urinary Steroids in Depressive Illness

1971 ◽  
Vol 16 (4) ◽  
pp. 224-227 ◽  
Author(s):  
A. Balfour Sclare ◽  
J. K. Grant
Keyword(s):  
Depressive Illness ◽  
Post Treatment ◽  
Normal Range ◽  
Mean Values ◽  
Female Patients ◽  
Significant Difference ◽  
The Mean ◽  
Pre Treatment ◽  
Depressive Patients ◽  
Source Of Information

A longitudinal study of urinary 17-OHCS in 16 depressive patients showed mean values within the accepted normal range. There were no significant differences between pre-treatment and post-treatment values; only the female patients showed a tendency to have somewhat lower post-treatment levels. 17-KS output was measured in 18 depressive patients. The mean values were within the normal range. There was no significant difference between pre-treatment and post-treatment values although the female patients displayed a tendency towards somewhat lower levels following treatment. DHA and EA excretion were measured in 9 depressive patients. There was a very wide variance in the findings. There was no significant difference between pre-treatment and post-treatment levels. The significance of the above findings is discussed. It is considered that measurements of urinary excretion of corticosteroids in affective disorders constitute a limited source of information.

P1425EFFICACY AND SAFETY OF INTRAVENOUS PARICALCITOL TREATMENT IN CHINESE HEMODIALYSIS PATIENTS WITH SECONDARY HYPERPARATHYROIDISM: A REAL-WORLD DATABASE ANALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Niansong Wang ◽  
Gengru Jiang
Keyword(s):  
Parathyroid Hormone ◽  
Observational Study ◽  
Secondary Hyperparathyroidism ◽  
Median Time ◽  
Real World ◽  
Hemodialysis Patients ◽  
Target Range ◽  
Total Serum ◽  
Weekly Dose

Abstract Background and Aims The aim of this retrospective, real-world data based observational study was to evaluate the efficacy, safety profile of paricalcitol in Chinese hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT) under routine clinical practice. Method From the Zemplar Engagement Program (ZEP) database, a total of 668 Chinese hemodialysis patients from 104 dialysis centers between January 2015 and May 2019 were included in the analysis set. Intact parathyroid hormone (iPTH), total serum calcium (Ca), phosphate (P), dosage of intravenous (IV) paricalcitol (Zemplar®) were analyzed and discussed via retrospective analysis of the database during the treatment. The comparison between baseline and end of treatment was made to reveal the fluctuation trend of each biomarker and reflected us with clues of IV paricalcitol’s algorithm in real-world practice. Results Patients were divided into five groups according to the duration of follow-up, which includes Month 0.5-3 (Day 14–90), Month 3-6 (Day 91–180), Month 6-12 (Day 181–360), Month 12-24 (Day 361–720) and Month 24-48 (Day 721–1440). Median iPTH levels decreased from 1183.05 pg/ml at baseline to 676.03 pg/ml at last visit by 30.88% (p < 0.0001). 56.14% of patients had a ≥30% decrease and 29.34% of patients had a ≥50% decrease in iPTH. The proportion of patients achieving the Chinese CKD-MBD Guideline target range (<600 pg/ml) increased from 9.88% at treatment initiation to 40.12% at last observation. Serum Ca levels remained within the normal range throughout the study with only a slight but statistically significant increase in the group of Month 12-24 (P=0.0479). Serum phosphate remained stable in all follow-up groups (P>0.05). Subgroup analyses of 221 patients with hyperphosphatemia at baseline >1.78 mmol/l showed a rapid phosphate reduction from 2.00±0.20 mmol/l to 1.76±0.34mmol/l by 11.64% (P< 0.0001), within the first few weeks, along with the reduction of iPTH. Of all patients, 62.72% experienced a 30% decrease in iPTH within a median time of 16.86 weeks (95% CI, 15.57-17.86), 38.17% experienced a 50% decrease in iPTH within a median time of 21.29 weeks (95% CI, 19.86-23.14). The average weekly dose of paricalcitol was 19.69±8.99ug/week. Total dose of paricalcitol used and baseline iPTH were negatively correlated with the decrease in iPTH. Conclusion This is the first national retrospective real-world observational study since IV paricalcitol is available in China since 2014. It proves that up to 20ug weekly IV paricalcitol treatment is safe and effective in China HD patients with higher iPTH level. Physicians and patients could expect significantly iPTH decrease within 16-21 weeks when IV paricalcitol is initiated. This study also encores the pre-published results of paricalcitol trials and high-quality cohorts, from the real-world perspective. In summary, IV paricalcitol is well tolerated and serves as an effective approach to treat SHPT in Chinese HD patients. Figure.1 Mean iPTH values from baseline to last measurement (pg/ml) Figure.2 iPTH changes compared with baseline stratified by baseline iPTH values (%) Figure.3 Proportion of patients with a >=30% or 50% decrease in parathyroid hormone (%) Figure.4 Changes of iPTH and P from baseline to last measurement in the subgroup of hyperphosphatemia (Mean ± SD); (Hyperphosphatemia, defined as P>1.78 mmol/l)

A Membrane Ultrafiltration Procedure for Determining Diffusible Calcium in Serum

1970 ◽  
Vol 16 (3) ◽  
pp. 226-228 ◽  
Author(s):  
Genevieve Farese ◽  
Milton Mager ◽  
William F Blatt
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Simple Procedure ◽  
Total Serum ◽  
High Flux ◽  
Ultrafiltration Membranes ◽  
Serum Calcium Concentration ◽  
Normal Value ◽  
Total Serum Calcium ◽  
The Mean

Abstract A rapid, simple procedure is described for separating diffusible from proteinbound serum calcium by centrifugation through high-flux ultrafiltration membranes. The mean normal value for ultrafilterable calcium was 57.1% (range 52 to 61%) of the total serum calcium concentration.

Secretion of calcium by rat submandibular gland

1959 ◽  
Vol 196 (3) ◽  
pp. 645-648 ◽  
Author(s):  
Robert H. Dreisbach
Keyword(s):  
Submandibular Gland ◽  
Calcium Concentration ◽  
Total Serum ◽  
Transient Phase ◽  
Secretory Rate ◽  
Total Serum Calcium ◽  
The Mean ◽  
Rat Submandibular Gland ◽  
Calcium Loss ◽  
Mean Concentration

The mean concentration of calcium in rat submandibular gland saliva after maximal pilocarpine stimulation was initially 3.2 µEq/gm and gradually fell during the 1st hour to 0.93 µEq/gm. The final concentration was approximately 30% of the concentration of calcium in the serum ultrafiltrate whether the total serum calcium was normal or elevated threefold by the infusion of calcium chloride. At the end of the transient phase, the gland calcium concentration was from 28 to 57% less than the initial gland concentration depending upon the type of anesthesia used. The calcium loss from the gland correlated well with the excess calcium secreted in the saliva during the transient phase. After the initial transient phase was ended, the saliva calcium concentration bore an inverse relationship to the secretory rate and was directly proportional to the serum ultrafiltrate calcium concentration.

EFFECT OF ANTITHYROID TREATMENT ON CALCIUM-PHOSPHORUS METABOLISM IN HYPERTHYROIDISM I: CHEMICAL QUANTITIES IN SERUM AND URINE

1978 ◽  
Vol 87 (4) ◽  
pp. 743-750 ◽  
Author(s):  
Leif Mosekilde ◽  
Merete Sanvig Christensen ◽  
Flemming Melsen ◽  
Niels Schwartz Sørensen
Keyword(s):  
Medical Treatment ◽  
Serum Calcium ◽  
Serum Alkaline Phosphatase ◽  
Elevated Serum ◽  
Total Serum ◽  
Albumin Concentration ◽  
Phosphorus Metabolism ◽  
Total Serum Calcium ◽  
Antithyroid Treatment ◽  
Calcium Phosphorus

ABSTRACT The effect of antithyroid treatment on the disturbed calcium-phosphorus metabolism in hyperthyroidism was studied in 16 patients. Elevated serum concentrations and urinary excretions of calcium and phosphorus were almost normalized 4 weeks after the start of medical treatment. Serum immunoreactive parathyroid hormone was decreased in the hyperthyroid state and became normal after medical treatment. Serum alkaline phosphatase levels were elevated throughout the study with an increase to a maximum peak after 8 weeks of antithyroid treatment. Urinary hydroxyproline excretion was initially markedly increased and fell rapidly during therapy. The observed changes suggest decreased bone resorption and increased bone formation with deposition of bone mineral after antithyroid treatment. Alterations in the serum albumin concentration during the investigation period influenced the total serum calcium concentration. Using albumin adjusted serum calcium values no hypocalcaemia was found during medical treatment or after a subsequent subtotal thyroidectomy.

Use of Erythropoietin (EPO) in Children with Malignancies.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5533-5533
Author(s):  
Gabor T. Kovacs ◽  
Judit Muller ◽  
Monika Csoka ◽  
Eszter Vonnak ◽  
Hajna Erlaky ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Lymphoblastic Leukemia ◽  
Elevated Serum ◽  
Serum Levels ◽  
Control Group ◽  
Recombinant Erythropoietin ◽  
Malignant Diseases ◽  
Human Erythropoietin ◽  
Unsuccessful Treatment ◽  
The Mean

Abstract Recombinant erythropoietin is widely used for the treatment of anemia in malignant diseases in adults. There are only limited data of its use in pediatric population. In this study we analysed the effectiveness and tolerability of recombinant human erythropoietin (NeoRecormon) in children with malignant diseases. 80 children with malignant diseases were analysed. 40 patients (15 girls, 25 boys) received EPO in a mean dosage of 144.5±14.1 IU/kg three times a week. The mean age of the EPO-treated patients was 8.8 (2.5–16) years. 26 children had acute lymphoblastic leukemia and 14 patients had solid tumor. Match-paired, retrospective control patients (n=40) with similar diagnosis were used for the data analysis as control group (C). The mean duration of EPO treatment was 5.8 months (3–8 mo). In 6 patients the therapy was ceased due to elevated serum hemoglobin (Hb) (>130 g/L), in 6 patients the dose was increased up to 200 IU/kg three times a week, and 5 patients discontinued the therapy (2 died, 3 unsuccessful treatment). The mean amount of erythrocyte transfusion in the first 3 months of chemotherapy (CT) was 4.1±3.1 U/patient in the EPO group, and 8.0±4.2 in C, and during 6 months of CT 4.5±3.4 with EPO, and 11.6±7.1 in C (p<0.05). Soluble transferrine receptor (STFR) levels in serum increased in the EPO group after 2 weeks of therapy from 3.2±2.0 up to 4.8±2.9 (p<0.05). In general in 26/40 patients a significant elevation of the Hb levels and decrease of the need of erythrocyte transfusions could be detected. In 22 patients the STFR levels increased more than 50 % after 2 weeks of therapy. In this subgroup 18/22 children responded to EPO therapy. All patients tolerated the therapy well, no severe side effects were detected. In summary, EPO treatment is effective in about 2/3 of pediatric oncology patients. The therapy is well-tolerated. Increase in the STFR serum levels might be a useful marker for the effectiveness of EPO in children.

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