Comparative Analysis of Whole Blood Ionised Calcium, Lactate and Chloride Concentrations by Gem Premier 3000 and Edan I15 Vet and the Effect of Parity and Postpartum Blood Collection Time on Blood Calcium Status in Holstein With and Without Subclinical Hypocalcemia - Part 1

Lactating Holstein (n=125) were enrolled randomly for the coccygeal whole blood analysis by blood gas devices GEM Premier 3000 (GEM) and Edan i15 Vet (EDAN) between calving to postpartum day 3 (G1) and postpartum day 4 to 27 (G2). Blood pH, ionised calcium (ICA7.4) and lactate analysis were significantly correlated between GEM and EDAN (r=0.86, 0.94, 0.87 respectively). The bias for ICA7.4, lactate and pH analysis was -0.054, -0.344 mmol/L and +0.009 respectively. ICA7.4 was correlated negatively with parity and chloride, but positively with lactate. The averages of ICA7.4 and serum total calcium (TC) was significantly lower in G1 than G2. Chloride and lactate were significantly higher in G1 than G2. Subclinical hypocalcemia prevalence (SCH) (serum TC<2.15 mmol/L, as reference) was 52.9% in G1 and 21.1% in G2. Cows with SCH had frequently over 50% ICA7.4/TC ratio. Sensitivity analysis provided a sensitivity of 57.4% for ICA7.4 cut-points of 1.02 (GEM) and 1.05 (EDAN) mmol/L to detect SCH based on reference serum TC. Primiparous (PRP) with and without SCH in G1 had significantly higher ICA7.4 than multiparous (MUL). Cows with SCH had significantly higher chloride in G1 than G2. MUL had significantly higher lactate and chloride in G1 than G2. Conclusively, ICA7.4 and pH analysis between GEM and EDAN were correlated well with acceptable biases, but high differences occurred in lactate analysis. MUL was at risk in G1 due to lower ICA7.4 and TC over PRP. Higher ICA7.4 of PRP can reduce the risk and frequency of clinical hypocalcemia. SCH correlated negatively with Cl concentration in G1, but not lactate.

The atmosphere of WASP-76b seen with CARMENES: looking for CaII IRT and HeI

&lt;p&gt;Currently, one of the most used techniques to study the atmosphere of the exoplanets is transmission spectroscopy by means of high-resolution facilities (R &gt; 10&lt;sup&gt;5&lt;/sup&gt;). This methodology has led to the detection of several species in the atmosphere of exoplanets, showing that ultra-hot Jupiters (T&lt;sub&gt;eq&lt;/sub&gt; &gt; 2000 K) are one of the most intriguing exoplanets, possessing the richest atmospheres measured to date. Here, using two transit observations with the high-resolution spectrograph CARMENES, we study the atmosphere of one of the most famous ultra-hot Jupiters: WASP-76b. We take advantage of the redder wavelength coverage of CARMENES, in comparison with the facilities used in previous studies of this same planet, and focus our analysis on the CaII IRT triplet at 850nm and the metastable HeI triplet at 1083nm. In line with recent studies, we detect ionised calcium in the atmosphere of WASP-76b and, additionally, find possible evidence of HeI. We contextualise our findings with previous atmospheric studies of other ultra-hot Jupiters and, in particular, with those showing the presence of CaII and HeI absorption in their transmission spectrum. We show that this planet is a potential candidate for further follow up studies of the HeI lines using high-resolution spectrographs located at larger telescopes, such as CRIRES+.&lt;/p&gt;

Bone Sclerostin and Dickkopf-related protein-1 are positively correlated with bone mineral density, bone microarchitecture, and bone strength in postmenopausal osteoporosis

Background Wnt-catenin signaling antagonists sclerostin and dickkopf-related protein-1 (Dkk-1) inhibit bone formation and are involved in the pathogenesis of postmenopausal osteoporosis (PO). However, the association between sclerostin and Dkk-1 and bone mineral density (BMD) in women with PO remains unclear. Objective This study aimed to determine the association between sclerostin and Dkk-1 and BMD, bone microarchitecture, and bone strength in PO. Methods Trabecular bone specimens were obtained from the femoral heads of 76 Chinese women with PO who underwent hip arthroplasty for femoral neck fractures. Micro-computed tomography (Micro-CT) was used to assess the BMD and bone microarchitecture of the trabecular bone. Subsequently, a mechanical test was performed. Finally, sclerostin and Dkk-1 in the bone were measured by enzyme-linked immunosorbent (Elisa) assay. Serum ionized serum ionised calcium, propeptide of type 1 collagen, C-terminal β-telopeptide of type-1 collagen, sclerostin, and Dkk-1 were also detected. Results Bone sclerostin was positively correlated with serum ionised calcium, serum sclerostin, BMD, bone volume/tissue volume (BV/TV), trabecular number (Tb.N), maximum compressive force, and yield strength (r = 0.32, 0.906, 0.355, 0.401, 0.329, 0.355, and 0.293, respectively, P < 0.05) and negatively correlated with age and trabecular separation (Tb.Sp) (r = − 0.755 and − 0.503, respectively, P < 0.05). Bone Dkk-1 was positively correlated with serum ionised calcium, serum Dkk-1, BMD, BV/TV, trabecular thickness, Tb.N, maximum compressive force, yield strength, and Young’s modulus (r = 0.38, 0.809, 0.293, 0.293, 0.228, 0.318, 0.352, 0.315, and 0.266, respectively, P < 0.05) and negatively correlated with age and Tb.Sp (r = − 0.56 and − 0.38, respectively, P < 0.05). Serum levels of sclerostin and Dkk-1 reflected the levels of sclerostin and Dkk-1 in the bone. Conclusion Bone sclerostin and Dkk-1 were positively correlated with BMD in women with PO, and higher levels of bone sclerostin and Dkk-1 might predict better BMD, bone microarchitecture, and bone strength. The potential molecular mechanisms still require further study.

MO189OUTCOMES OF AN ACCELERATED CITRATE ANTIGOAGULATED MEMBRANE SEPARATION PLASMA EXCHANGE ALGORITHM

Background and Aims Plasma exchange is a standard therapy for some anti glomerular basement membrane disease and some types of renal transplant rejection. As with other extracorporeal therapies, anticoagulation is usually required. This study assessed the safety, efficacy and Calcium flux of an accelerated algorithm for regional citrate anticoagulation in membrane-based plasma exchange. Method This was an observational study in patients receiving citrate anticoagulated, membrane-based, plasma exchange at the Canberra Hospital between July 2017 and May 2020. Data was collected prospectively using an electronic medical record and compared to data from our previously published algorithm which had used a slower blood pump speed. Results There were 134 plasma exchange sessions performed during the observational period. Circuit clotting occurred in 4 sessions and 1 session was affected by symptomatic hypocalcaemia. A systemic ionised calcium &lt;0.96 mmol/L was seen in 19.4% of sessions, which was a similar frequency to that seen in our previous algorithm. A systemic ionised Ca &lt;0.81 mmol/L occurred in 4 sessions (all asymptomatic). This hypocalcaemia occurred towards the end of the sessions, after switching from albumin to fresh frozen plasma replacement fluid. Median treatment time was 135 minutes, compared to 219 minutes in our previously published algorithm. Mean net Ca gain/session was 7.7 ± 2.3 mmol. Conclusion An accelerated algorithm for regional citrate anticoagulation achieves substantial time savings while maintaining efficacy and safety. The 4 episodes of systemic ionised calcium &lt;0.81 mmol/L may have been due to recirculation of infused citrate but, probably more likely, are due to the additional citrate load imposed by use of fresh frozen plasma in these sessions. Future algorithms need to better account for the citrate load present in fresh frozen plasma.

Analysis of the extracorporeal anticoagulation effect of modified citrate infusion during continuous haemodialysis in critically ill patients

This study aimed to analyse the anticoagulation effect of different local infusion methods for citrate continuous haemodialysis in critically ill patients in order to identify a safe and effective citrate infusion method. Critically ill patients admitted to our hospital from April 2019 to December 2019 who underwent continuous renal replacement therapy (CRRT) using citrate for anticoagulation were divided into the conventional citrate infusion before the filter (conventional group) and citrate infusion group according to the different local citrate infusion methods (modified group). A total of 30 treatment sessions were performed for each group. the modified group patients were found to have longer mean treatment times(67.67 ± 18.69 vs 52.11 ± 24.26,p = 0.007), lower transmembrane pressures at the disconnection time from dialysis circuit(147.77 ± 66.85 vs 200.63 ± 118.66,p = 0.038), fewer citrate bag replacements(1.43 ± 0.50 vs 10.60 ± 3.19,p < 0.001), and steady ionised calcium at the venous end compared to the conventional group patients with statistically significant differences(0.35 ± 0.06 vs 0.40 ± 0.05,p = 0.006). The total calcium level was significantly higher in the conventional group patients than those of the other(2.29 ± 0.23 vs 2.19 ± 0.14,p = 0.038). Incidences of citrate accumulation and tubing coagulation were also marginally lower in the modified group. We infer that the modified local citrate infusion method can prolong the treatment time, reduce the nursing workload and the occurrence of citrate accumulation, resulting in safe and effective clinical outcome.

Correlation between Arterial and Venous Blood Electrolytes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Cross-sectional Study

Introduction: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is a common health problem coupled with huge mortality and morbidity across the world. Acute exacerbation in COPD patients leads to electrolyte disturbances. Routinely, electrolytes are measured from venous blood. Electrolytes can also be measured from whole blood by blood gas analyser along with blood gases measurement. Aim: To study the correlation between venous and arterial blood electrolytes in AECOPD patients. Materials and Methods: The cross-sectional study was conducted at Clinical Biochemistry Laboratory, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India, from December 2013 to May 2014. Arterial and venous blood were taken at same time from 150 patients of AECOPD and analysed for electrolytes (sodium, potassium and ionised calcium) in arterial blood gas analyser. Correlation of arterial and venous blood electrolyte levels was done by Pearson’s correlation. Results: This study comprised 109 (72.67%) male and 41 (27.33%) female AECOPD patients. Mean age of subjects was 59.01±11.42 years. Mean level of arterial sodium was 143.1±8.81 mmol/L and venous sodium was 144.8±8.47 mmol/L (p-value=0.0973). Mean level of arterial potassium was 3.53±0.73 mmol/L and venous potassium was 3.19±0.56 mmol/L (p-value <0.0001). Mean level of arterial ionised calcium was 0.83±0.13 mmol/L and venous ionised calcium was 0.76±0.17 mmol/L (p-value <0.0001). Correlation coefficient values for sodium, potassium and ionised calcium were 0.878, 0.762 and 0.537, respectively. Conclusion: Arterial sodium and potassium can be used as a substitute of venous sodium and potassium in management of AECOPD patients, while arterial ionised calcium should not be used in place of venous ionised calcium in management of such patients.

The relationship between serum 25-hydroxyvitamin D and parathyroid hormone concentration in assessing vitamin D deficiency in pet rabbits

Background Vitamin D deficiency and related metabolic bone diseases in pet rabbits have been intermittently debated. In human research, the parathyroid hormone concentration in relation to the 25-hydroxyvitamin D concentration is used to determine vitamin D deficiency. Thus, this study aimed to identify the breakpoint in the 25-hydroxyvitamin D concentration indicating a significant change in the parathyroid hormone concentration in 139 pet rabbits. An enzyme immunoassay kit was used for 25-hydroxyvitamin D analysis and the intact parathyroid hormone (PTH 1–84) immunoradiometric assay kit for parathyroid hormone analysis. The mid-tibial cortical bone density was measured using peripheral quantitative computed tomography. A segmented linear regression analysis was performed, with the 25-hydroxyvitamin D concentration as the independent variable, and parathyroid hormone, ionised calcium, total calcium, inorganic phosphorus concentrations and the mid-tibial cortical density as the dependent variables. Results The breakpoint for the parathyroid hormone concentration occurred at a 25(OH)D concentration of 17 ng/mL, whereas the cortical bone density breakpoint occurred at a 25-hydroxyvitamin D concentration of 19 ng/mL. No breakpoints were found for ionised calcium, total calcium or phosphorus. Conclusions These results suggest that a serum 25-hydroxyvitamin D concentration of 17 ng/mL serves as the threshold for vitamin D deficiency in rabbits. Nearly one-third of the rabbits had a serum 25-hydroxyvitamin D concentration below this threshold. Concerns persist regarding the high prevalence of vitamin D deficiency in pet rabbits and the possible health consequences caused by a chronic vitamin D deficiency, including the risk for metabolic bone diseases.