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The aim of this study was to explore maternity care providers' knowledge, attitudes, and perceptions about the use of calcium supplements during pregnancy for the prevention of preeclampsia in three hospitals from Metropolitan Buenos Aires, Argentina. We conducted semi-structured interviews and followed a thematic analysis framework. Maternity care providers' knowledge, attitudes, and practices regarding calcium supplementation during pregnancy are linked to barriers to the potential implementation of calcium supplementation. Free provision of calcium supplements by the government, coupled with training that reinforces the scientific evidence supporting their use to prevent preeclampsia, along with documented recommendations from credible sources, would be crucial to ensure that health providers adopt the use of calcium supplements in antenatal care. Future studies should assess pregnant women and policymakers' perceptions about calcium supplementation during pregnancy, as well as local infrastructure to provide access to free-of-charge calcium supplements in antenatal care settings. Economic evaluation with local information could inform policymakers and advocate for the implementation of strategies to reduce preeclampsia.

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BACKGROUND: Obesity is a major health problem worldwide as it can lead to high blood pressure, heart disease, stroke, diabetes, and insulin resistance. The prevalence of overweight and obesity is increasing worldwide across different age groups. There is evidence of an inverse relationship between calcium intake and body weight. The clinical relevance of a small reduction in body weight has been questioned. However, at a population level, a small effect could mitigate the observed global trends. OBJECTIVES: To assess the effects of calcium supplementation on weight loss in individuals living with overweight or obesity. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS (Latin American and Caribbean Health Science Information database), and two clinical trials registries. The date of the last search of all databases (except Embase) was 10 May 2023. No language restrictions were applied. SELECTION CRITERIA: We included randomised controlled trials evaluating the effect of calcium in participants with overweight or obesity of any age or gender. We excluded studies in participants with absorption problems. We included studies of any dose with a minimum duration of two months. We included the following comparisons: calcium supplementation versus placebo, calcium-fortified food or beverage versus placebo, or calcium-fortified food or beverage versus non-calcium-fortified food or beverage. We excluded studies that evaluated the effect of calcium and vitamin D or mixed minerals compared to placebo. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Our primary outcomes were body weight, health-related quality of life, and adverse events. Our secondary outcomes were anthropometric measures other than body weight, all-cause mortality, and morbidity. MAIN RESULTS: We found 18 studies that evaluated the effect of calcium compared to placebo or control, with a total of 1873 randomised participants (950 participants in the calcium supplementation groups and 923 in the control groups). All included studies gave oral calcium supplementation as the intervention. We did not find any studies evaluating calcium-fortified foods. We excluded 38 studies, identified four ongoing studies, and listed one study as 'awaiting classification'. Sixteen studies compared calcium supplementation to placebo; two studies compared different doses of calcium supplementation. Doses ranged from very low (0.162 g of calcium/day) to high (1.5 g of calcium/day). Most studies were performed in the USA and Iran, lasted less than six months, and included only women. Low-certainty evidence suggests that calcium supplementation compared to placebo or control may result in little to no difference in body weight (mean difference (MD) -0.15 kg, 95% confidence interval (CI) -0.55 to 0.24; P = 0.45, I2 = 46%; 17 studies, 1317 participants; low-certainty evidence). We downgraded the certainty of the evidence by two levels for risk of bias and heterogeneity. None of the included studies reported health-related quality of life, all-cause mortality, or morbidity/complications as outcomes. Only five studies assessed or reported adverse events. Low-certainty evidence suggests a low frequency of adverse events, with no clear difference between intervention and control groups. Moderate-certainty evidence shows that calcium supplementation compared to placebo or control probably results in a small reduction in body mass index (BMI) (MD -0.18 kg/m2,95% CI -0.22 to -0.13; P < 0.001, I2 = 0%; 9 studies, 731 participants) and waist circumference (MD -0.51 cm, 95% CI -0.72 to -0.29; P < 0.001, I2 = 0%; 6 studies, 273 participants). Low-certainty evidence suggests that calcium supplementation compared to placebo or control may result in a small reduction in body fat mass (MD -0.34 kg, 95% CI -0.73 to 0.05; P < 0.001, I2 = 97%; 12 studies, 812 participants). AUTHORS' CONCLUSIONS: Calcium supplementation for eight weeks to 24 months may result in little to no difference in body weight in people with overweight or obesity. The current evidence is of low certainty, due to concerns regarding risk of bias and statistical heterogeneity. We found that the degree of heterogeneity might be partly explained by calcium dosage, the presence or absence of a co-intervention, and whether an intention-to-treat analysis was pursued. While our analyses suggest that calcium supplementation may result in a small reduction in BMI, waist circumference, and fat mass, this evidence is of low to moderate certainty. Future studies could investigate the effect of calcium supplementation on lean body mass to explore if there is a change in body composition.

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Introducción. El Síndrome Metabólico (SM) comprende un conjunto de factores de riesgo cardiometabólico representado por obesidad central, dislipidemia, hipertensión arterial y glucosa alterada, se ha evidenciado que el consumo adecuado de calcio representa una disminución del riesgo para este síndrome. Objetivo. Analizar la relación entre el consumo de calcio total, de origen animal y vegetal con el SM y sus indicadores. Materiales y métodos. Estudio transversal de eje correlacional, con una muestra de 100 adultos de la región amazónica ecuatoriana, durante el último trimestre del 2020. La ingesta dietética de calcio se determinó mediante un recordatorio de 24 horas y el SM según los criterios de Adult Treatment Panel-IV (ATP-IV). Resultados. La población estuvo conformada por adultos maduros (40 a 60 años) que evidenciaron una ingesta de calcio deficiente (182,50 mg y 228,60 mg en mujeres y hombres respectivamente). Se evidenció, además, una relación directamente proporcional entre la circunferencia abdominal (r=0,391 ­ p=0,000), presión arterial sistólica (r=0,290 ­ p=0,000) y glucosa en ayuno (r=0,326 ­ p=0,000) con la edad. La ingesta de calcio total se relacionó positivamente con los triglicéridos, (r=0,221 ­ p=0,027). Conclusiones. La ingesta dietética de calcio en ambos sexos no alcanza el requerimiento diario y se relaciona positivamente con los triglicéridos(AU)

Introduction. The Metabolic Syndrome (MS) comprises a set of cardiometabolic risk factors represented by central obesity, dyslipidemia, high blood pressure and altered glucose, it has been shown that adequate calcium intake represents a decreased risk for this syndrome. Objective. To analyze the relationship between the consumption of total calcium, animal and vegetable origin, with MS and its indicators. Materials and methods. Cross-sectional study of correlational axis, with a sample of 100 adults from the Ecuadorian Amazon region, during the last quarter of 2020. Dietary calcium intake was determined through a 24-hour recall and the diagnosis of MS according to the Adult Treatment Panel- IV (ATP-IV) criteria. Results. The population consisted of mature adults (40 to 60 years) who showed a deficient calcium intake in both sexes (182.50 mg and 228.60 mg in women and men respectively). There is also evidence of a directly proportional relationship between abdominal circumference (r=0.391 - p=0.000), systolic blood pressure (r=0.290 - p=0.000) and fasting glucose (r=0.326 - p=0.000) with age. Total calcium intake was positively related to triglycerides (r=0.221 ­ p=0.027). Conclusions. Calcium dietary intake in both sexes does not reach the daily requirement and is positively related to triglycerides(AU)

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Calcium Supplementation in Pregnancy Trial This Patient Platform recalls the experience of four pregnant women who were enrolled in a clinical trial in Argentina 35 years ago, as described to narrator and translator, Dr. José M. Belizán. None had enrolled in a clinical trial before, but all four women found it rewarding. The trial examined the role of calcium supplementation in pregnancy in the incidence of hypertensive events in the pregnancy.

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Calcium supplementation and fortification are strategies widely used to prevent adverse outcome in population with low-calcium intake which is highly frequent in low-income settings. We aimed to determine the effectiveness and cost-effectiveness of calcium fortified foods on calcium intake and related health, or economic outcomes. We performed a systematic review and meta-analysis involving participants of any age or gender, drawn from the general population. We searched PubMed, Agricola, EMBASE, CINAHL, Global Health, EconLit, the FAO website and Google until June 2019, without language restrictions. Pair of reviewers independently selected, extracted data and assessed the risk of bias of included studies using Covidence software. Disagreements were resolved by consensus. We performed meta-analyses using RevMan 5.4 and subgroup analyses by study design, age group, and fortification levels. We included 20 studies of which 15 were randomized controlled trials (RCTs), three were non-randomised studies and two were economic evaluations. Most RCTs had high risk of bias on randomization or blinding. Most represented groups were women and children from 1 to 72 months, most common intervention vehicles were milk and bakery products with a fortification levels between 96 and 1200 mg per 100 g of food. Calcium intake increased in the intervention groups between 460 mg (children) and 1200 mg (postmenopausal women). Most marked effects were seen in children. Compared to controls, height increased 0.83 cm (95% CI 0.00; 1.65), plasma parathyroid hormone decreased -1.51 pmol/L, (-2.37; -0.65), urine:calcium creatinine ratio decreased -0.05, (-0.07; -0.03), femoral neck and hip bone mineral density increased 0.02 g/cm2 (0.01; 0.04) and 0.03 g/cm2 (0.00; 0.06), respectively. The largest cost savings (43%) reported from calcium fortification programs came from prevented hip fractures in older women from Germany. Our study highlights that calcium fortification leads to a higher calcium intake, small benefits in children's height and bone health and also important evidence gaps for other outcomes and populations that could be solved with high quality experimental or quasi-experimental studies in relevant groups, especially as some evidence of calcium supplementation show controversial results on the bone health benefit on older adults.

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Functional variants in genes of the renin-angiotensin (RAS) and kallikrein-kinin (KKS) systems have already been implicated in blood pressure (BP) modulation, but few studies have focused on a nutrigenetics approach. Thus, the aim of this study is to verify the effects of the interaction between genetic polymorphisms (rs4340-ACE, rs699-AGT, and rs1799722-BDKRB2) and micronutrient consumption (sodium, potassium, calcium, and magnesium) on BP values of normotensive adult individuals. The study included 335 adults, men and women, 25.5 (6.6) years old. Biochemical, anthropometric, BP measurements, and food intake data were assessed for all participants. Gene-nutrient interaction on BP outcome was tested by multiple linear regression with manual backward stepwise modeling. Our results indicated that individuals with G allele for rs699 polymorphism, in the increase of sodium and magnesium consumption, both in the genotypic model (sodium, p = 0.035; magnesium, p = 0.016) and in the dominant model (sodium, p = 0.009; magnesium, p = 0.006) had higher systolic BP (SBP) levels compared to AA homozygotes (sodium, p = 0.001; magnesium, p < 0.001). Also, individuals with the T allele for the rs1799722 polymorphism, with higher calcium intake, had significantly higher levels of SBP and diastolic BP (DBP) when compared to CC homozygotes (p = 0.037). In conclusion, our findings pointed for significant interactions between genetic polymorphisms (rs699-AGT and rs1799722-BDKRB2) and the consumption of micronutrients (sodium, magnesium, and calcium) on the BP variation. These findings contribute to the understanding of the complex mechanisms involved in BP regulation, which probable include several gene-nutrition interactions.

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Calcium (Ca) is often supplied to crop species to prevent the occurrence of Carelated disorders. Mechanisms of Ca absorption and transport are not fully understood and the effectiveness of root and/or foliar Ca fertilization may be variable. To characterize the rate of Ca absorption and transport, trials were developed with chili pepper and sweet cherry plants, using 45CaCl2 as a tracer. The Ca treatments supplied were: (1) No 45Ca (control); (2) 45Ca soil application; (3) 45Ca supply to basal leaves, and (4) 45Ca application to apical leaves. After two months, plants were harvested for biomass and Ca content determination. The recovery of 45Ca in different plant parts was measured with a liquid scintillation counter and leaf traits were observed by scanning electronic microscopy. In general, the highest 45Ca concentrations were recovered in treated organs, while root applications led to highest 45Ca translocation rates, which varied between chili pepper and cherry plants. For chili pepper, 45Ca applied to the soil was detected mainly in roots (44 %) followed by leaves (36.6 %) stems (17.4 %) and fruits (2 %). In sweet cherry trees, soilapplied 45Ca was principally recovered in roots (45.3 %), shoots (28.5 %), leaves (14.3 %) and trunks (11.9 %). The results provide evidence of increased absorption of rootapplied Ca, as well as different degrees of Ca mobility between species. Foliar application led to major Ca increases in treated leaves, with Ca transported to other plant organs after apical leaf Ca supply chiefly in cherry trees.

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Calcium (Ca) is often supplied to crop species to prevent the occurrence of Carelated disorders. Mechanisms of Ca absorption and transport are not fully understood and the effectiveness of root and/or foliar Ca fertilization may be variable. To characterize the rate of Ca absorption and transport, trials were developed with chili pepper and sweet cherry plants, using 45CaCl2 as a tracer. The Ca treatments supplied were: (1) No 45Ca (control); (2) 45Ca soil application; (3) 45Ca supply to basal leaves, and (4) 45Ca application to apical leaves. After two months, plants were harvested for biomass and Ca content determination. The recovery of 45Ca in different plant parts was measured with a liquid scintillation counter and leaf traits were observed by scanning electronic microscopy. In general, the highest 45Ca concentrations were recovered in treated organs, while root applications led to highest 45Ca translocation rates, which varied between chili pepper and cherry plants. For chili pepper, 45Ca applied to the soil was detected mainly in roots (44 %) followed by leaves (36.6 %) stems (17.4 %) and fruits (2 %). In sweet cherry trees, soilapplied 45Ca was principally recovered in roots (45.3 %), shoots (28.5 %), leaves (14.3 %) and trunks (11.9 %). The results provide evidence of increased absorption of rootapplied Ca, as well as different degrees of Ca mobility between species. Foliar application led to major Ca increases in treated leaves, with Ca transported to other plant organs after apical leaf Ca supply chiefly in cherry trees.(AU)

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El carcinoma paratiroideo (CP) es una neoplasia maligna con una incidencia de 0,015 cada 100.000 habitantes por año. Representa el 1% de los diagnósticos de hiperparatiroidismo primario y se manifiesta entre la 4.a y 5.a década de la vida, con una incidencia similar entre hombres y mujeres. La etiología del CP es incierta, ha sido asociada a formas esporádicas o familiares. Está caracterizado por altos niveles séricos de calcio y PTH y el desafío clínico-quirúrgico es el diagnóstico diferencial con otras entidades benignas como el adenoma o la hiperplasia de paratiroides. Aunque el diagnóstico de certeza es anatomopatológico, la sospecha clínica y el uso de métodos de baja complejidad (ecografía) con operadores avezados permite una correcta localización y abordaje pertinente del paciente para dirigir el tratamiento quirúrgico adecuado (resección en bloque) evitando persistencias y recurrencias de enfermedad. Se presenta el caso clínico de un paciente masculino que ingresa por síndrome de impregnación asociado a hipercalcemia, su abordaje diagnóstico, tratamiento y manejo interdisciplinario con discusión y revisión bibliográfica. (AU)

Parathyroid carcinoma (CP) is a malignant disease with an incidence of 0.015 per 100,000 inhabitants per year. It accounts for 1% of primary hyperparathyroidism diagnoses and occurs between the 4th and 5th decade of life, with a similar incidence between men and women. The etiology of CP is uncertain and has been associated with sporadic or family forms. CP is characterized by high serum calcium and PTH levels and the clinical-surgical challenge is the differential diagnosis with other benign entities such as parathyroid adenoma or hyperplasia. Although the diagnosis of certainty is achieved by pathological anatomy examination, the clinical suspicion and the use of low complexity methods (ultrasound) by experienced operators allows a correct localization and a patient-specific approach to direct the appropriate surgical treatment (block resection), avoiding persistence and recurrences of disease. The clinical case of a male patient admitted for severe hypercalcemia with multiple organ disfunction, the diagnostic approaches, treatment, and interdisciplinary management, together with review and discussion of the current literature are presented. (AU)

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This study was performed to evaluate the effects of supplementation of lactating Nelore cows with calcium salts of long-chain fatty acids (Ca-LCFA) of soybean oil on in vitro oocytes competency, cleavage rate, embryo production rate, pregnancy rate, and sex ratio of transferred embryos. Fifteen multiparous Nelore cows grazed on a Tifton 85 pasture were allotted to two treatments: (1) supplement without fat inclusion (CONT, n = 6) and (2) supplement containing 47.2 g Ca-LCFA /kg (to provide an intake of 0.2 kg Ca-LCFA/day) based on dry matter (n = 9). Animals were subjected to 2.53 ± 1.35 rounds of consecutive ovum pick up at intervals of 27.65 ± 21.72 days. Oocytes were morphologically evaluated, selected, maturated, fertilized, and cultivated for embryo production in vitro and then transferred into recipients who had previously undergone an embryo transfer protocol at a fixed time. The number of aspirated oocytes, the proportion of viable oocytes, cleavage rate, embryo percentage, pregnancy rate, and sex ratio were not affected when Nelore cows were supplemented with Ca-LCFA of soybean oil compared with non-supplemented Nelore cows. In conclusion, our results suggest that feeding a supplement containing 47.2 g Ca-LCFA/kg (to provide an intake of 0.2 kg Ca-LCFA/day) to Nelore cows does not affect in vitro embryo production in lactating Nelore cows. However, further studies...(AU)

Este estudo foi realizado para avaliar os efeitos da suplementação de vacas Nelores em lactação com sais de cálcio de ácidos graxos de cadeia longa (Ca-SCACL) feitos com óleo de soja sobre a competência in vitro de oócitos, taxa de clivagem, taxa de produção de embriões, taxa de prenhez e proporção de sexo de embriões transferidos. Foram utilizadas 15 vacas Nelore (lactantes, multíparas e mantidas em pastagem de Tifton 85) distribuídas em dois tratamentos: (1) suplemento sem inclusão de lipídios (CONT, n = 6) e (2) suplemento contendo 47,2 g Ca-SCACL/kg (para proporcionar uma ingestão de 0,2 kg Ca-SCACL/ dia) com base na matéria seca (n = 9). Os animais foram submetidos a 2,53 ± 1,35 rodadas consecutivas de aspiração folicular a intervalos de 27,65 ± 21,72 dias. Os oócitos foram avaliados morfologicamente, selecionados, maturados, fertilizados e cultivados para produção de embriões in vitro. Em seguida, os embriões foram transferidos para receptoras previamente submetidas a um protocolo de transferência de embriões em tempo fixo. O número de oócitos aspirados, a proporção de oócitos viáveis, a taxa de clivagem, a porcentagem de embriões, a taxa de prenhez e a proporção de sexo de embriões não foram afetados quando as vacas Nelore foram suplementadas com Ca-SCACL de óleo de soja em comparação com as vacas Nelore não suplementadas. Em conclusão, nossos resultados sugerem que suplemento contendo 47,2 g de Ca-SCACL/kg (para fornecer uma ingestão de 0,2 kg de Ca-SCACL) não afeta a produção in vitro de embriões de vacas Nelore em lactação. No entanto, novos estudos utilizando doses mais altas de gordura na dieta poderiam ser úteis para determinar o seu potencial sobre produção embrionária in vitro.(AU)

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This study aimed to evaluate the effects of oral administration of calcium (Ca) formate in the postpartum of high-producing dairy cows on calcemia, on other blood biochemical markers, and on the occurrence of diseases at the beginning of lactation. One hundred and twenty healthy Holstein cows, distributed according to the lactation order (first, second, third and fourth to sixth), were treated or not with oral Ca formate (two doses: one after calving and one 24 h later; equivalent to 50 g of Ca per dose), comprising 8 groups (n = 15). The following variables were measured in the blood serum of samples collected after calving (0 h) and after 24, 48, 72, and 96 h: total Ca, phosphate (P), magnesium (Mg), non-esterified fatty acids (NEFA), beta-hydroxybutyrate (BHB), glucose, total protein (TP), albumin (Alb), urea nitrogen (BUN), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT). Blood BHB was also measured at 7, 14, and 21 DIM. For the assessment of disease occurrence, cows were distributed in treated (n = 60) and untreated (n = 60) groups and in hypocalcemic (n = 71) and normocalcemic (n = 49) groups. Two-way repeated measures ANOVA and a chi-square test were used for comparisons. The lactation order did not influence the studied blood constituents, except for primiparous cows which had the highest calcemia. Serum Ca was lower up to 24 h and increased after 48 h and subclinical hypocalcemia (SCH) ([Ca] < 2.125 mmol/L) was more frequent in cows with a higher number of lactations. Treatment with Ca formate had no effect on the variation of serum Ca and the other studied variables in the first days of lactation. Treated and untreated cows did not differ in terms of milk yield at 21 DIM, the presentation of diseases at the beginning of lactation, the rate of discard or death up to 60 DIM and the frequency of SCH (60 % and 58 %, respectively). Hypocalcemic cows became more ill (64.8 % vs. 42.9 %; P = 0.028) and had a higher frequency of retained placenta (43 % vs. 20.7 %; P < 0.001). Oral administration of Ca formate after calving and 24 h later is not justified as a preventive measure to be adopted indiscriminately in dairy herds. Studies involving larger number of animals may clarify whether the selective treatment of cows with a higher risk of hypocalcemia is advantageous.

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The aim of this study was to evaluate the influence of the chelating mineral on propionic acid, calcium or sodium on the composition, dynamics and richness of the intestinal microbiota of a native silver catfish Rhamdia quelen through high-throughput sequencing (HTS). A total of 225 fish (8.43 ± 0.18 g) were distributed in tanks, 15 fish per tank in five groups with three replicates each: Control, Ca-propionate 0.25% (Ca0.25%) Ca-propionate 1% (Ca1%), Na-propionate 0.25% (Na0.25%) and Na-propionate 1% (Na1%). The feed was provided four times a day for 60 days. After experimental period, the fish were fasted for 24 h and the intestine was aseptically collected, pooled by treatment, and fixed in pure absolute ethanol for subsequent DNA extraction and HTS. The HTS showed that the supplementation of the propionic acid chelated to the mineral calcium or sodium in the different concentrations increased the operational taxonomic units and richness in comparison to control group. The main phyla found were Fusobacteria, Firmicutes, Proteobacteria and Bacteroides. Both the fusobacteria and the genus Cetobacterium, especially C. somerae, were positively modulated with Ca0.25% and Na1% supplementation. It can be emphasized that supplementation with calcium or sodium propionate at different concentrations changed the natural microbiota of R. quelen.

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Introducción. El hipoparatiroidismo es una enfermedad caracterizada por la ausencia o concentraciones inadecuadamente bajas de hormona paratiroidea (PTH), que conduce a hipocalcemia, hiperfosfatemia y excreción fraccional elevada de calcio en la orina. Las calcificaciones del sistema nervioso central son un hallazgo frecuente en estos pacientes. Caso clínico. Mujer de 56 años con antecedente de hipotiroidismo, que ingresó por un cuadro de 6 días de evolución caracterizado por astenia, parestesias periorales y movimientos anormales de manos y pies. Las pruebas de laboratorio demostraron hipocalcemia, hiperfosfatemia y niveles bajos de hormona paratiroidea. Se realizó una tomografía computarizada de cráneo que mostró áreas bilaterales y simétricas de calcificaciones en hemisferios cerebelosos, ganglios basales y corona radiata. No se evidenciaron trastornos en el metabolismo del cobre y hierro. Se estableció el diagnóstico del síndrome de Fahr secundario a hipoparatiroidismo y se inició tratamiento con suplementos de calcio y vitamina D con evolución satisfactoria. Discusión. El síndrome de Fahr es un trastorno neurológico caracterizado por el depósito anormal de calcio en áreas del cerebro que controlan la actividad motora. Se asocia a varias enfermedades, especialmente, hipoparatiroidismo. La suplementación con calcio y vitamina D con el objetivo de normalizar los niveles plasmáticos de estos cationes es el tratamiento convencional. (AU)

Introduction. Hypoparathyroidism is a disease characterized by absence or inappropriately low concentrations of circulating parathyroid hormone, leading to hypocalcaemia, hyperphosphataemia and elevated fractional excretion of calcium in the urine. Central nervous system calcifications are a common finding in these patients. Case report. 56-year-old woman with a history of hypothyroidism who was admitted for a 6-day course of illness characterized by asthenia, perioral paresthesias, and abnormal movements of the hands and feet. Laboratory tests showed hypocalcemia, hyperphosphatemia, and low parathyroid hormone levels. A cranial computed tomography was performed. It showed bilateral and symmetrical areas of calcifications in the cerebellar hemispheres, basal ganglia, and radiata crown. No disorders of copper or iron metabolism were evident. The diagnosis of Fahr syndrome secondary to hypoparathyroidism was established and treatment with calcium and vitamin D supplements was started with satisfactory evolution. Discussion. Fahr's syndrome is a neurological disorder associated with abnormal calcium deposition in areas of the brain that control motor activity. It is associated with various diseases, especially hypoparathyroidism. The conventional treatment is supplementation with calcium and vitamin D, with the aim of normalizing their plasma levels. (AU)

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O objetivo do estudo foi avaliar a disponibilidade de cálcio (Ca2+) a partir de duas formas farmacêuticas (oral e intravaginal) e o seu efeito sobre o metabolismo de ruminantes. O estudo foi realizado na fazenda experimental da Universidade Federal de Pelotas, foram estudadas 24 ovelhas lactantes, divididas de forma randomizada em 4 grupos: dispositivo tratamento (DT); dispositivo controle (DC); oral tratamento (OT); e oral controle (OC). Os animais tratados receberam formiato de cálcio e cloreto de magnésio, as avaliações foram realizadas após a administração dos tratamentos. Foi feita avaliação de cálcio total (CaT), magnésio (Mg), proteínas plasmáticas totais (PPT), aspartato aminotransferase (AST), gama glutamil transpeptidase (GGT), ureia, albumina e pH urinário, e realizado exame clínico em todos os animais. As concentrações séricas de CaT, CaI e Mg diferiram entre os grupos (P≤ 0,05), os animais dos grupos DT e DC, diferiram nas três avaliações, o grupo DT apresentou as maiores médias, sendo significativamente igual ao grupo OT. Não houve diferença nas concentrações séricas de PPT, AST, GGT, Albumina, Ureia e pH urinário. Conclui-se que a disponibilidade sanguínea de CaT, CaI e Mg é igual quando a administração de formiato de cálcio e magnésio é por via intravaginal ou por via oral, sem alterar outros parâmetros metabólicos avaliados.(AU)

The aim of the study was to evaluate the availability of calcium (Ca2+) from two pharmaceutical forms (oral and intravaginal) and its effect on the metabolism of ruminants. The study was carried out at the experimental farm of the Federal University of Pelotas. Twenty-four lactating ewes were randomly divided into 4 groups: treatment device (TD); control device (DC); oral treatment (OT); and oral control (OC). Treated animals received calcium formate and magnesium chloride, evaluations were performed after administration of the treatments. Total calcium (CaT), magnesium (Mg), total plasma proteins (PPT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), urea, albumin and urinary pH, and clinical examination were performed on all animals. Serum CaT, CaI and Mg levels differed between the groups (P≤ 0.05), the animals in the DT and DC groups differed in the three evaluations, the DT group had the highest mean values, being significantly equal to the OT group. There was no difference in the serum concentrations of PPT, AST, GGT, Albumin, Urea and urinary pH. In conclusion, the blood availability of CaT, CaI and Mg is the same when administration of calcium and magnesium formate is intravaginal or orally, without altering other metabolic parameters evaluated.(AU)

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O objetivo do estudo foi avaliar a disponibilidade de cálcio (Ca2+) a partir de duas formas farmacêuticas (oral e intravaginal) e o seu efeito sobre o metabolismo de ruminantes. O estudo foi realizado na fazenda experimental da Universidade Federal de Pelotas, foram estudadas 24 ovelhas lactantes, divididas de forma randomizada em 4 grupos: dispositivo tratamento (DT); dispositivo controle (DC); oral tratamento (OT); e oral controle (OC). Os animais tratados receberam formiato de cálcio e cloreto de magnésio, as avaliações foram realizadas após a administração dos tratamentos. Foi feita avaliação de cálcio total (CaT), magnésio (Mg), proteínas plasmáticas totais (PPT), aspartato aminotransferase (AST), gama glutamil transpeptidase (GGT), ureia, albumina e pH urinário, e realizado exame clínico em todos os animais. As concentrações séricas de CaT, CaI e Mg diferiram entre os grupos (P≤ 0,05), os animais dos grupos DT e DC, diferiram nas três avaliações, o grupo DT apresentou as maiores médias, sendo significativamente igual ao grupo OT. Não houve diferença nas concentrações séricas de PPT, AST, GGT, Albumina, Ureia e pH urinário. Conclui-se que a disponibilidade sanguínea de CaT, CaI e Mg é igual quando a administração de formiato de cálcio e magnésio é por via intravaginal ou por via oral, sem alterar outros parâmetros metabólicos avaliados.(AU)

The aim of the study was to evaluate the availability of calcium (Ca2+) from two pharmaceutical forms (oral and intravaginal) and its effect on the metabolism of ruminants. The study was carried out at the experimental farm of the Federal University of Pelotas. Twenty-four lactating ewes were randomly divided into 4 groups: treatment device (TD); control device (DC); oral treatment (OT); and oral control (OC). Treated animals received calcium formate and magnesium chloride, evaluations were performed after administration of the treatments. Total calcium (CaT), magnesium (Mg), total plasma proteins (PPT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), urea, albumin and urinary pH, and clinical examination were performed on all animals. Serum CaT, CaI and Mg levels differed between the groups (P≤ 0.05), the animals in the DT and DC groups differed in the three evaluations, the DT group had the highest mean values, being significantly equal to the OT group. There was no difference in the serum concentrations of PPT, AST, GGT, Albumin, Urea and urinary pH. In conclusion, the blood availability of CaT, CaI and Mg is the same when administration of calcium and magnesium formate is intravaginal or orally, without altering other metabolic parameters evaluated.(AU)

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BACKGROUND: Symptomatic hypocalcemia is a common complication of total thyroidectomy. Management strategies include responsive treatment initiation for symptoms or prevention by routine or parathyroid hormone-directed calcium supplementation. The comparative cost-effectiveness of even the most often utilized strategies is unclear. METHODS: A Markov cohort model was created to compare routine supplementation with calcium alone (RS), postoperative parathyroid hormone-based selective supplementation with calcium and calcitriol (SS), and no supplementation (NS) in asymptomatic patients. Patients could remain asymptomatic or develop symptomatic hypocalcemia, managed with outpatient oral supplementation or intravenous calcium infusion and administered either inpatient or outpatient. Effectiveness was measured in quality-adjusted life years. Sensitivity analyses were performed to test model parameter assumptions. RESULTS: RS was the preferred strategy, costing $329/patient and resulting in 0.497 quality-adjusted life years, which was only marginally better compared to SS ($373 for 0.495 quality-adjusted life years). NS was most costly at $4,955 for 0.491 quality-adjusted life years. Preference for RS over SS was sensitive to the probability of developing symptoms and the probability of symptom treatment with intravenous supplementation. On probabilistic sensitivity analysis, RS was preferred in 75.4% of scenarios. CONCLUSION: After total thyroidectomy, a preventative calcium supplementation strategy should be strongly considered. In this data-driven theoretical model, RS was the least costly option and resulted in an incremental gain in quality-adjusted life years.

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OBJECTIVES: To investigate the effect of oral vitamin D-calcium supplementation on serum intact parathyroid hormone (PTH), calcium, phosphorous, and alkaline phosphatase (ALK-P) concentrations in children with habitually low calcium intakes. STUDY DESIGN: In this follow-up study to a randomized controlled trial that aimed to assess the effect of vitamin D-calcium supplementation on immunity, data related to dietary intake, anthropometry, and biochemistry [serum 25(OH)D and bone profile] were collected from 178 children-79 in the vitamin D group and 99 in the non-vitamin D group. RESULTS: Dietary calcium to phosphorus intake ratio was 0.4:1. Baseline serum 25(OH)D concentration was 58.2 ± 10.9 nmol/L; 66% children were vitamin D sufficient and none deficient. After supplementation, vitamin D group, compared with the non-vitamin D group, had significantly (P < .05) greater 25(OH)D (83.9 ± 30.1 nmol/L vs 58.3 ± 15.7 nmol/L), significantly greater PTH (6.7 ± 3.6 pmol/L vs 5.5 ± 3.2 pmol/L), and positive correlation (rs = 0.24) between serum 25(OH)D and PTH (vs negative correlation [rs = -0.1] in non-vitamin D group). Mean concentrations of serum bone measures in the vitamin D group were calcium (2.2 ± 0.1 mmol/L), phosphorus (1.7 ± 0.2 mmol/L), and ALK-P (178.7 ± 40.7 IU/L). At follow-up, 1-year post-supplementation, in the vitamin D group, PTH concentrations continued to remain high (but not significantly different from levels at 6 months), with low normal serum calcium, high normal phosphate, and ALK-P in reference range. CONCLUSIONS: In children who are vitamin D sufficient but with habitually low dietary calcium intake, vitamin D-calcium supplementation paradoxically and significantly increased serum PTH concentrations with no apparent effect on other bone biochemistry. Chronic low dietary calcium to phosphorus ratio is likely to have caused this paradoxical response.

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The objective of this study was to determine the apparent and true digestibility coefficients and relative bioavailability of charru mussel, maçunim (Anomalocardia brasiliana) and oyster shells as organic calcium sources for meat quail. In the digestibility trial, 240 quail were distributed in a completely randomized experimental design with five diets (calcitic limestone, calcium carbonate and three marine calcium sources), five replicates and eight quails per experimental unit. The relative bioavailability of calcium was determined by the standard-curve and slope ratio methods in a growth trial in which 288 European quail were distributed in completely randomized experimental design. Treatments consisted of basal diet with a low calcium concentration (0.166%) that was supplemented with two levels of calcium (0.342% and 0.684%) derived from different calcium sources. The apparent and true digestibility coefficients of calcium from charru mussel-, maçunim- and oyster-shell meals for meat quail were 91.85 and 92.04%; 91.71 and 91.90%; and 89.39 and 89.63%, respectively. The relative bioavailability of calcium from charru mussel-, maçunim- and oyster-shell meals obtained using standard-curve and slope ratio methods were 133.22 and 119.18%; 140.05 and 113.69%; and 141.73 and 106.22%, respectively, allowing the use of these organic calcium sources in diet formulations for meat quail.

O objetivo deste estudo foi determinar os coeficientes de digestibilidade aparente e verdadeiro e a biodisponibilidade relativa de conchas de sururu, maçunim (Anomalocardia brasiliana) e ostra como fontes orgânicas de cálcio para codornas de corte. No ensaio de digestibilidade, 240 codornas foram distribuídas em um delineamento inteiramente casualizado constituído de cinco dietas (calcário calcítico, carbonato de cálcio e três fontes marinhas de cálcio), cinco repetições e oito aves por unidade experimental. A biodisponibilidade relativa do cálcio foi determinada pelo método da curva padrão e Slope Ratio em um ensaio de crescimento no qual 288 codornas Europeias foram distribuídas em um delineamento inteiramente casualizado. Os tratamentos consistiram em uma dieta basal, com baixa concentração de cálcio (0,166%) a qual foi suplementada com dois níveis de cálcio (0,342% e 0,684%)proveniente das diferentes fontes de cálcio. Os coeficientes de digestibilidade aparente e verdadeiro das farinhas de conchas de sururu, maçunim e ostra, para codornas de corte foram 91,85 e 92,04%; 91,71 e 91,90%; e 89,39 e 89,63%, respectivamente. A biodisponibilidade do cálcio das farinhas de conchas de sururu, de maçunim e de ostra obtidas utilizando-se os métodos da curva padrão e Slope Ratio foram133,22 e 119,18%; 140,05 e 113,69%; e 141,73 e 106,22%, respectivamente, permitindo o uso destas fontes orgânicas de cálcio na formulação de ração para codornas de corte.

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This study was performed to evaluate the effects of supplementation of lactating Nelore cows with calcium salts of long-chain fatty acids (Ca-LCFA) of soybean oil on in vitro oocytes competency, cleavage rate, embryo production rate, pregnancy rate, and sex ratio of transferred embryos. Fifteen multiparous Nelore cows grazed on a Tifton 85 pasture were allotted to two treatments: (1) supplement without fat inclusion (CONT, n = 6) and (2) supplement containing 47.2 g Ca-LCFA /kg (to provide an intake of 0.2 kg Ca-LCFA/day) based on dry matter (n = 9). Animals were subjected to 2.53 ± 1.35 rounds of consecutive ovum pick up at intervals of 27.65 ± 21.72 days. Oocytes were morphologically evaluated, selected, maturated, fertilized, and cultivated for embryo production in vitro and then transferred into recipients who had previously undergone an embryo transfer protocol at a fixed time. The number of aspirated oocytes, the proportion of viable oocytes, cleavage rate, embryo percentage, pregnancy rate, and sex ratio were not affected when Nelore cows were supplemented with Ca-LCFA of soybean oil compared with non-supplemented Nelore cows. In conclusion, our results suggest that feeding a supplement containing 47.2 g Ca-LCFA/kg (to provide an intake of 0.2 kg Ca-LCFA/day) to Nelore cows does not affect in vitro embryo production in lactating Nelore cows. However, further studies...

Este estudo foi realizado para avaliar os efeitos da suplementação de vacas Nelores em lactação com sais de cálcio de ácidos graxos de cadeia longa (Ca-SCACL) feitos com óleo de soja sobre a competência in vitro de oócitos, taxa de clivagem, taxa de produção de embriões, taxa de prenhez e proporção de sexo de embriões transferidos. Foram utilizadas 15 vacas Nelore (lactantes, multíparas e mantidas em pastagem de Tifton 85) distribuídas em dois tratamentos: (1) suplemento sem inclusão de lipídios (CONT, n = 6) e (2) suplemento contendo 47,2 g Ca-SCACL/kg (para proporcionar uma ingestão de 0,2 kg Ca-SCACL/ dia) com base na matéria seca (n = 9). Os animais foram submetidos a 2,53 ± 1,35 rodadas consecutivas de aspiração folicular a intervalos de 27,65 ± 21,72 dias. Os oócitos foram avaliados morfologicamente, selecionados, maturados, fertilizados e cultivados para produção de embriões in vitro. Em seguida, os embriões foram transferidos para receptoras previamente submetidas a um protocolo de transferência de embriões em tempo fixo. O número de oócitos aspirados, a proporção de oócitos viáveis, a taxa de clivagem, a porcentagem de embriões, a taxa de prenhez e a proporção de sexo de embriões não foram afetados quando as vacas Nelore foram suplementadas com Ca-SCACL de óleo de soja em comparação com as vacas Nelore não suplementadas. Em conclusão, nossos resultados sugerem que suplemento contendo 47,2 g de Ca-SCACL/kg (para fornecer uma ingestão de 0,2 kg de Ca-SCACL) não afeta a produção in vitro de embriões de vacas Nelore em lactação. No entanto, novos estudos utilizando doses mais altas de gordura na dieta poderiam ser úteis para determinar o seu potencial sobre produção embrionária in vitro.

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The objective of this study was to determine the apparent and true digestibility coefficients and relative bioavailability of charru mussel, maçunim (Anomalocardia brasiliana) and oyster shells as organic calcium sources for meat quail. In the digestibility trial, 240 quail were distributed in a completely randomized experimental design with five diets (calcitic limestone, calcium carbonate and three marine calcium sources), five replicates and eight quails per experimental unit. The relative bioavailability of calcium was determined by the standard-curve and slope ratio methods in a growth trial in which 288 European quail were distributed in completely randomized experimental design. Treatments consisted of basal diet with a low calcium concentration (0.166%) that was supplemented with two levels of calcium (0.342% and 0.684%) derived from different calcium sources. The apparent and true digestibility coefficients of calcium from charru mussel-, maçunim- and oyster-shell meals for meat quail were 91.85 and 92.04%; 91.71 and 91.90%; and 89.39 and 89.63%, respectively. The relative bioavailability of calcium from charru mussel-, maçunim- and oyster-shell meals obtained using standard-curve and slope ratio methods were 133.22 and 119.18%; 140.05 and 113.69%; and 141.73 and 106.22%, respectively, allowing the use of these organic calcium sources in diet formulations for meat quail.(AU)

O objetivo deste estudo foi determinar os coeficientes de digestibilidade aparente e verdadeiro e a biodisponibilidade relativa de conchas de sururu, maçunim (Anomalocardia brasiliana) e ostra como fontes orgânicas de cálcio para codornas de corte. No ensaio de digestibilidade, 240 codornas foram distribuídas em um delineamento inteiramente casualizado constituído de cinco dietas (calcário calcítico, carbonato de cálcio e três fontes marinhas de cálcio), cinco repetições e oito aves por unidade experimental. A biodisponibilidade relativa do cálcio foi determinada pelo método da curva padrão e Slope Ratio em um ensaio de crescimento no qual 288 codornas Europeias foram distribuídas em um delineamento inteiramente casualizado. Os tratamentos consistiram em uma dieta basal, com baixa concentração de cálcio (0,166%) a qual foi suplementada com dois níveis de cálcio (0,342% e 0,684%)proveniente das diferentes fontes de cálcio. Os coeficientes de digestibilidade aparente e verdadeiro das farinhas de conchas de sururu, maçunim e ostra, para codornas de corte foram 91,85 e 92,04%; 91,71 e 91,90%; e 89,39 e 89,63%, respectivamente. A biodisponibilidade do cálcio das farinhas de conchas de sururu, de maçunim e de ostra obtidas utilizando-se os métodos da curva padrão e Slope Ratio foram133,22 e 119,18%; 140,05 e 113,69%; e 141,73 e 106,22%, respectivamente, permitindo o uso destas fontes orgânicas de cálcio na formulação de ração para codornas de corte.(AU)

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