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Contingency Tables
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
A study was conducted to evaluate the relative efficacy of supplementation with calcium versus calcitriol in the treatment of postmenopausal osteoporosis [259]. Calcitriol is an agent that has the ability to increase gastrointestinal absorption of calcium. A number of patients withdrew from this study prematurely due to the adverse effects of treatment which include thirst, skin problems, and neurologic symptoms. The relevant data appear below.
Endocrine diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Emergent therapy of symptomatic hypocalcemia (seizures or carpopedal or laryngospasm) should be treated with intravenous infusion of 10% calcium gluconate, 20mL intravenously over 10minutes, followed by continuous intravenous drip infusion of calcium 0.5 to 2mg/kg/hr, adjusted to keep the plasma calcium level at 8 to 9mg/dL (97). Oral maintenance therapy of chronic hypocalcemic disorders is usually accomplished with synthetic calcitriol (Rocaltrol), 0.25 to 0.5mg orally daily to three times daily, and calcium carbonate 1 to 2g orally three times a day with meals. The dose of calcitriol is titrated as needed at 2- to 4-week intervals to maintain plasma serum calcium of 8 to 9mg/dL. As noted, pregnancy may either decrease or increase the nongravid maintenance dose, and frequent (every 2–4weeks) measurement of serum calcium throughout the gestational period is recommended.
Hyperparathyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Kimberly Ramonell, Erin Partington Buczek
Secondary HPT is a state of elevated PTH in the setting of low to normal serum calcium levels. Secondary HPT commonly occurs in patients with chronic renal failure but may also occur in those with hypocalcemia secondary to inadequate calcium or vitamin D intake or altered enteral malabsorption (Table 14.1). Vitamin D is essential to normal calcium homeostasis. Calcitriol is the activated form of vitamin D and increases intestinal calcium absorption. In vitamin D deficiency, there is inadequate substrate available for calcitriol production leading to reduced circulating calcitriol levels and insufficient intestinal calcium absorption, hypocalcemia, and resultant increased PTH production and bone resorption via osteoclast activation as a means to increase serum calcium levels (9).
Optimal vitamin D level ameliorates neurological outcome and quality of life after traumatic brain injury: a clinical perspective
Published in International Journal of Neuroscience, 2023
Ajay Choudhary, Ashok Kumar, Rajesh Sharma, Lipika Khurana, Smita Jain, Shallu Sharma, Deepak Kumar, Swapnil Sharma
Vitamin D is an important micronutrient required for the growth of body skeleton and the regulation of calcium homeostasis. It is a secosteroid, primarily synthesized in the skin in the presence of sunlight and plays a dual role in skeletal escalation and neurodevelopment [18]. Vitamin D acts as a key biomarker in predicting the recovery outcome in TBI individuals. Clinical subjects with TBI have shown progressive vitamin D paucity and impaired neurocognitive functioning during the indoor stay which could be due to lack of sunlight exposure [4]. Calcitriol, the active form of vitamin D regulates the level of calcium and phosphate in the body [19]. Vitamin D, its metabolites, and other neurosteroids bind to vitamin D receptors located in different regions of the brain namely the hippocampus thalamus, hypothalamus, cerebellum, basal ganglia [19, 20]. Thus, vitamin D has been considered as a vital marker for predicting the extent of neurophysiology and cognitive dysfunction outcomes. It is noteworthy that its paucity negatively affects the recovery and quality of life in TBI individuals [21, 22] (Table 1).
Cholecalciferol complexation with hydroxypropyl-β-cyclodextrin (HPBCD) and its molecular dynamics simulation
Published in Pharmaceutical Development and Technology, 2022
Fang Wang, Wenbo Yu, Carmen Popescu, Ahmed Ashour Ibrahim, Dongyue Yu, Ryan Pearson, Alexander D. MacKerell, Stephen W. Hoag
Cholecalciferol (vitamin D3) is an essential vitamins, and plays important roles in maintaining human health; for example, it is one of the primary biological regulators of calcium homeostasis (Norman 2008). Cholecalciferol is inactive in our body. It is converted to its active form 25-hydroxycholecalciferol (calcifediol, 25-OH vitamin D3) in the liver, then converted to 1,25-dihydroxycholecalciferol (calcitriol, 1,25-(OH)2vitamin D3) in the kidney. Calcitriol is a steroid hormone and functions by interacting with its cognate vitamin D receptor (VDR) (Feldman et al. 2004; Norman 2008). We know that calcitriol and VDR significantly contribute to good bone health (Vitamin D Fact Sheet for Health Professionals 2021). Thus, vitamin D3 is widely used in the prevention and treatment of diseases such as rickets (Stuart et al. 2009; Joint Formulary Committee 2015), osteomalacia, osteoporosis and hypoparathyroidism (HSDB: Cholecalciferol 2022), and Fanconi syndrome (Stuart et al. 2009; Hamilton 2015). In addition to metabolic disorders, recent evidence suggests that vitamin D3 may have a role in colon cancer, prostate cancer, and breast cancer prevention (HSDB: Cholecalciferol 2022). Vitamin D3 is a fat-soluble vitamin which is practically insoluble in water (1.3 × 10−5 mg/L, 25 °C) (Estimation Program Interface (EPI) Suite 2004), and orally delivered. There is no intramuscular (IM) or intravenous (IV) injection available (Stuart et al. 2009).
Inflammasomes in placental explants of women with preeclampsia cultured with monosodium urate may be modulated by vitamin D
Published in Hypertension in Pregnancy, 2022
Priscila Rezeck Nunes, Mariana Romao-Veiga, Vanessa Rocha Ribeiro, Larissa Ragozo Cardoso de Oliveira, Igor de Carvalho Depra, Leandro Gustavo de Oliveira, Jose Carlos Peracoli, Maria Terezinha Serrao Peracoli
In this study, placental explants cultured with MSU showed higher gene expression of NLRP1, NLRP3, and HMGB1 as well as inflammatory cytokines in NT pregnant women, whereas VD and concomitant treatment with MSU+VD decreased significantly these effects. These results confirm that MSU may act as an NLRP3-inflammasome inducer, while VD plays a modulatory role by decreasing the intense inflammatory process in the placenta. Although the results of NLRP1 and NLRP3 inflammasomes activation after MSU stimulation did not reach statistical significance in placental explants from EOPE and LOPE pregnant women, the treatment with VD and MSU+VD led to a decrease in mRNA and protein expression of these inflammasomes, HMGB1, IL-1β, and IL-18 in these preeclamptic groups. These data confirm the inhibitory effect of VD on NLRP1 and NLRP3 inflammasome activation, as well as reducing gene and protein expression of inflammatory cytokines by monocytes from preeclamptic women and THP-1 cells stimulated with hyaluronan, an agonist of NLRP3 activation (43). Another study demonstrated that VD inhibits the ROS-NLRP3-IL-1β signaling axis in human corneal epithelial cells, cultured in an inflammatory environment (44). The regulatory effect of VD on inflammatory cytokines expression and secretion by placental trophoblastic cells from preeclamptic women, cultured with different concentrations of this hormone, was described by Noyola-Martínez et al. (45). The authors emphasized the role of calcitriol in controlling the immune response at the maternal–fetal interface, particularly in pathologies of pregnancy, such as PE.