Practice patterns for chronic hypoparathyroidism: data from patients and physicians in France

Context. Recent guidelines have provided recommendations for the care of patients with chronic hypoparathyroidism. Very little is known about actual physicians’ practices or their adherence to such guidelines. Objective. To describe the practice patterns and their compliance with international guidelines. Design. Cohort studies: Épi-Hypo (118 Physicians and 107 patients, from 09/2016 to 12/2019) and ePatients (110 patients, November 2019). Methods. Internet-based cohorts involving all settings at a nationwide level (France). Participants were i) physicians treating patients with chronic hypoparathyroidism and patients with chronic hypoparathyroidism either participating in the ii) Épi-Hypo study (Épi-Hypo 2019 patients) or iii) Hypoparathyroidism France, the national representative association (ePatients). Results. The physicians’ specialties were mainly endocrinology (61%), nephrology (28%), family medicine (2.5%), pediatrics (2.5%), rheumatology (2%) or miscellaneous (4%). Forty-five percent were practicing in public universities. The median number of pharmaceutical drug classes prescribed was 3 per patient. The combination of active vitamin D and calcium salt was given to 59% and 58% of ePatients and Épi-Hypo 2019 patients, respectively. Eighty-five percent of ePatients and 87% of physicians reported monitoring plasma calcium concentrations at a steady state at least twice a year. In 32% and 26% of cases, respectively, ePatients and physicians reported being fully in accordance with international guidelines that recommend targeting symptoms, plasma calcium and phosphate values, and urine calcium excretion. Conclusions. The care of patients with chronic hypoparathyroidism involves physicians with very different practices, so guidelines should include and target not only endocrinologists. Full adherence to the guidelines is low in France.

Effects of Calcium Salts on the Physicochemical Quality of Cured Beef Sausages during Manufacturing and Storage: A Potential Calcium Application for Sausages with Alginate Casings

The impacts of adding calcium chloride (CaCl2) and calcium lactate (CaLac) with different concentrations (0%, 0.2%, 0.4%, and 0.7%) on the physicochemical properties of cured beef sausages were investigated in this study. Meat color, pH, lipid oxidation, and cooking loss were measured at respective manufacturing stages (ground beef, raw chopped batter, and after cooking). Additionally, meat color, pH, lipid oxidation, nitrosylhemochrome, residual nitrite, and texture profiles of vacuum-packaged sausages were evaluated during seven days of storage. Compared with the control (no Ca added), both calcium salts resulted in deteriorative color and texture properties, and promoted pH decline, cooking loss, and lipid oxidation of sausages during manufacturing and storage. However, increased calcium salt addition led to the reduction of residual nitrite over time. Compared to CaCl2 addition, 0.2–0.4% CaLac resulted in greater redness and oxidative stability and softer texture. These results may be useful when considering calcium salt additions in sausages, for the purpose of co-extruded sausages coated with alginate where Ca salts are used to form the casing during the co-extrusion of the sausages.

Improved Stability of a Stable Crystal Form C of 6S-5-Methyltetrahydrofolate Calcium Salt, Method Development and Validation of an LC–MS/MS Method for Rat Pharmacokinetic Comparison

Folate is a vitamin beneficial for humans that plays an important role in metabolism, but it cannot be well supplemented by food; it is necessary to supplement it in other ways. Based on this consideration, a novel crystal form C of 6S-5-methyltetrahydrofolate calcium salt (MTHF CAC) was obtained. To explore the difference between MTHF CAC and the crystal form Ⅰ of 6S-5-methyltetrahydrofolate calcium salt (MTHF CA) as well as an amorphous product of 6S-5-methyltetrahydrofolate glucosamine salt (MTHF GA), their stability and pharmacokinetic behaviours were compared. The results of high-performance liquid chromatography coupled with ultraviolet detection analysis indicated that MTHF CAC showed a better stability than MTHF CA and MTHF GA. After oral administration of MTHF CAC, MTHF CA, and MTHF GA to male rats, the MTHF concentrations were analysed using a validated liquid chromatography–tandem mass spectrometry, and the pharmacokinetic parameters were compared. The mean residence times (0–t) of MTHF CAC, MTHF CA, and MTHF GA were 3.7 ± 1.9 h, 1.0 ± 0.2 h (p < 0.01), and 1.5 ± 0.3 h (p < 0.05), respectively. The relative bioavailability of MTHF CAC was calculated to be 351% and 218% compared with MTHF CA and MTHF GA, respectively, which suggests that MTHF CAC can be better absorbed and utilized for a longer period of time.

A Rare Case of Calcinosis Cutis: Easily Mistaken as a Foreign Body

Calcinosis cutis is a very rare disease characterized by insoluble calcium salt deposits in the skin. There are five types of calcinosis, dystrophic type being the most common among them. Dystrophic calcinosis is generally caused by local tissue damage. We present the dystrophic calcinosis cutis case of a patient with no underlying diseases but a burn injury which occurred 10 years ago. She visited the hospital for an ulcerative wound on the same area. She also had sustained a dog bite injury on the same site 9 months ago, which was treated at an oriental clinic with no improvement. Physical examination by palpation revealed a hard mass under the skin. As the mass was of a large size, the possibility of a foreign body was considered. Surgical resection and biopsy of the mass diagnosed it as dystrophic calcinosis cutis. Although clinical features of this case were unlike previous calcinosis cutis cases, performing a biopsy proved helpful towards its diagnosis.

Rhinolitiasis about 16 Cases and Review of the Literature

Rhino lithiasis is defined as a solid concretion secondary to the gradual deposition of calcium salt around an exogenous or endogenous central formation in the nasal cavity it is a relatively common condition in developing countries. We report a retrospective study spread over period of 9 years, from January 2012 to December 2020, relating to 16 cases of rhino lithiasis treated in our department. The protocol Included for each patient: an anamnesis, an ENT examination meticulous and systematic scam. Patients consulted for purulent and fetid rhinorrhea associated with nasal obstruction rhino lithiasis affected as many adults as children, the formal sex was affected in 68% of cases un favorable socioeconomic conditions were noted, in 75% of cases diagnostic times ranged from six months to ten years, the examination she the rhinolith as a grayish, hard concretion, unilateral in 15 cases ( 5 cases on the right an on the left ) and bilateral in one case in 2 cases, a foreign body was visualized on endonasal examination, the treatment consisted of an instrumental extraction by natural means (100% of cases) under general Anas the sea in 75% of cases the size of the rhinoliths varied between 5 to 30 mm in diameter. An underlying foreign body was found intraoperatively in 6 cases. Complication was rare (epistaxis: 3 cases), No recurrence was detected. It is always necessary to evoke a rhinolithiasis in front of a chronic unilateral fetid rhinnorhea with or without nasal obstruction on the same side. The nasosinus scanner confirms the diagnosis and helps to prepare the therapeutic strategy alongside the endonasal endocopic examination with the rigid optic which remains a means used both in diagnosis and in therapy.

STUDY OF THE PROCESS OF PYROLYSIS OF CALCIUM ADIPATE AT DIFFERENT TEMPERATURES

This article discusses a method for producing cyclopentanone and cyclopentene on the basis of wateracid effluents from caprolactam production during pyrolysis of the calcium salt of adipic acid at different temperatures. The compound of the obtained liquid product has proved by the method of chromatographic analysis and the dependence of the yields of cyclopentanone on the process temperature has investigated. A qualitative analysis of calcium adipate by X-ray fluorescence spectrometry has carried out, and the possibility of using zinc salts as process catalysts has studied.