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Sustainable healthy diets are promoted, and consequently vegetarian diets are currently increasing. However, scientific information on their effects on bone health is scarce. A cross-sectional study was performed in adults (66% women) classified into three groups: omnivores (n = 93), lacto-ovo vegetarians (n = 96), and vegans (n = 112). Nutrient intake, body composition, physical activity, vitamin D status (25-hydroxycholecalciferol, 25-OHD), parathormone (PTH), and bone formation (bone alkaline phosphatase, BAP) and resorption (N-telopeptides of type I collagen, NTx) markers were determined. Lacto-ovo vegetarians and especially vegans showed lower protein, fat, calcium, phosphorous, vitamin D, retinol, iodine, and zinc intakes, and higher carbohydrate, fibre, carotenes, magnesium, and vitamin K intakes compared to omnivores. Body composition was similar in the three groups that performed vigorous physical activity regularly. Body bone mass and muscle mass were positively correlated with BAP, and time performing physical activity with 25-OHD. The prevalence of vitamin D deficiency or insufficiency (25-OHD < 75 nmol/L) was 93.7% in the studied population, and vitamin D deficiency (25-OHD < 25 nmol/L) was significantly higher in vegans. Vegetarians of both groups had increased PTH and NTx with vegans showing significantly higher PTH and NTx than omnivores. Conclusion: Adult vegetarians, especially vegans, should reduce the risk of bone loss by appropriate diet planning and vitamin D supplementation.

Background: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. Methods: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function – handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity – short physical performance battery (SPPB); and Participation – participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. Results: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS ( R2 = 0.558); HAP and PTH were associated with 5-STS ( R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS ( R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB ( R2 = 0.689). Finally, only HAP was associated with the participation scale ( R2 = 0.067). Conclusion: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Background: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. Methods: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function – handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity – short physical performance battery (SPPB); and Participation – participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. Results: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS ( R2 = 0.558); HAP and PTH were associated with 5-STS ( R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS ( R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB ( R2 = 0.689). Finally, only HAP was associated with the participation scale ( R2 = 0.067). Conclusion: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Background: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. Methods: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function – handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity – short physical performance battery (SPPB); and Participation – participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. Results: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS ( R2 = 0.558); HAP and PTH were associated with 5-STS ( R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS ( R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB ( R2 = 0.689). Finally, only HAP was associated with the participation scale ( R2 = 0.067). Conclusion: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Background: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. Methods: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function – handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity – short physical performance battery (SPPB); and Participation – participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. Results: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS ( R2 = 0.558); HAP and PTH were associated with 5-STS ( R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS ( R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB ( R2 = 0.689). Finally, only HAP was associated with the participation scale ( R2 = 0.067). Conclusion: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Amaç: Çalışmamızın amacı meme kanseri ile ilişkili lenfödem (MKİL) ve sağlıklı popülasyondaki hastalarda plazma D vitamini düzeylerini karşılaştırmak ayrıca sosyo-demografik ve klinik faktörlerin ve lenfödem şiddetinin D vitamini düzeylerine etkilerini tespit etmekti. Gereç ve Yöntem: MKİL’li 80 hasta [yaş ortalaması 55,5±8,9 (36-81)] ve kalsiyum ya da Vitamin D tedavisi altında olmayan 80 yaş ve cinsiyet uyumlu sağlıklı kontrol [yaş ortalaması 53,7±7,4 (32-70)] çalışmaya alındı. Olguların sosyo-demografik ve klinik özellikleri sorgulandı. Plazma 25-Hydroxyvitamin D3, kalsiyum, fosfor, alkalen fosfataz (ALP), parathormon (PTH) düzeyleri değerlendirildi. Lenfödem evre 0, I, II veya III olarak sınıflandırıldı. Bulgular: Ortalama lenfödem süresi 23,5±13,8 aydı. MKİL’li hastalarda sağlıklı kontrollere oranla daha düşük D vitamini düzeyleri ve daha yüksek PTH ve ALP düzeyleri saptandı. Çok değişkenli regresyon analizi sonucunda, MKİL hastalarında D vitamini düzeyleri ile yaş, meme kanseri evresi ve hastalık süresi arasında anlamlı bir ilişki olduğu ortaya çıkarıldı. Evre 3 lenfödem hastalarında, evre 1’e kıyasla D vitamini düzeyi daha düşük ve PTH düzeyi anlamlı olarak daha yüksekti. Sonuç: D vitamini düzeyleri lenfödemli hastalarda sağlıklı kontrollere oranla daha düşük saptanmıştır. Şiddetli lenfödemi olan hastalarda D vitamini düzeylerinin daha düşük saptanmasına rağmen, çok değişkenli regresyon analizi lenfödem şiddetinin D vitamini düzeyleri üzerinde anlamlı bir etkisi olmadığını ortaya koymuştur., Objective: The aim of our study was to compare plasma vitamin D levels between patients with breast cancer-related lymphedema (BCRL) and healthy population, and also to investigate the effects of socio-demographic and clinical factors and lymphedema severity on vitamin D levels. Materials and Methods: Eighty patients with BCRL [mean age 55.5±8.9 (36-81)] and age- and sex-matched 80 healthy controls [mean age 53.7±7.4 (32-70)] who were not on calcium or vitamin D supplementation were included in the study. Socio-demographic and clinical characteristics of the subjects were questioned. Plasma 25-Hydroxyvitamin D3, calcium, phosphorus, alkaline phosphatase (ALP), and parathormone (PTH) levels were evaluated. Lymphedema was classified as stage 0, I, II, or III. Results: The mean duration of lymphedema was 23.5±13.8 months. Comparisons revealed lower vitamin D levels and higher PTH and ALP levels in patients with BCRL than healthy controls. As a result of multivariate regression analysis, a significant relationship was revealed between vitamin D levels and age, breast cancer stage, and disease duration in patients with BCRL. Vitamin D levels were significantly lower and PTH levels were significantly higher in stage 3 lymphedema patients compared to stage 1. Conclusion: Vitamin D levels were detected lower in patients with lymphedema than healthy controls. Although vitamin D levels were found to be lower in patients with severe lymphedema, the multivariate regression analysis revealed that the severity of lymphedema does not have a significant effect on vitamin D levels.

Amaç: Çalışmamızın amacı meme kanseri ile ilişkili lenfödem (MKİL) ve sağlıklı popülasyondaki hastalarda plazma D vitamini düzeylerini karşılaştırmak ayrıca sosyo-demografik ve klinik faktörlerin ve lenfödem şiddetinin D vitamini düzeylerine etkilerini tespit etmekti. Gereç ve Yöntem: MKİL’li 80 hasta [yaş ortalaması 55,5±8,9 (36-81)] ve kalsiyum ya da Vitamin D tedavisi altında olmayan 80 yaş ve cinsiyet uyumlu sağlıklı kontrol [yaş ortalaması 53,7±7,4 (32-70)] çalışmaya alındı. Olguların sosyo-demografik ve klinik özellikleri sorgulandı. Plazma 25-Hydroxyvitamin D3, kalsiyum, fosfor, alkalen fosfataz (ALP), parathormon (PTH) düzeyleri değerlendirildi. Lenfödem evre 0, I, II veya III olarak sınıflandırıldı. Bulgular: Ortalama lenfödem süresi 23,5±13,8 aydı. MKİL’li hastalarda sağlıklı kontrollere oranla daha düşük D vitamini düzeyleri ve daha yüksek PTH ve ALP düzeyleri saptandı. Çok değişkenli regresyon analizi sonucunda, MKİL hastalarında D vitamini düzeyleri ile yaş, meme kanseri evresi ve hastalık süresi arasında anlamlı bir ilişki olduğu ortaya çıkarıldı. Evre 3 lenfödem hastalarında, evre 1’e kıyasla D vitamini düzeyi daha düşük ve PTH düzeyi anlamlı olarak daha yüksekti. Sonuç: D vitamini düzeyleri lenfödemli hastalarda sağlıklı kontrollere oranla daha düşük saptanmıştır. Şiddetli lenfödemi olan hastalarda D vitamini düzeylerinin daha düşük saptanmasına rağmen, çok değişkenli regresyon analizi lenfödem şiddetinin D vitamini düzeyleri üzerinde anlamlı bir etkisi olmadığını ortaya koymuştur., Objective: The aim of our study was to compare plasma vitamin D levels between patients with breast cancer-related lymphedema (BCRL) and healthy population, and also to investigate the effects of socio-demographic and clinical factors and lymphedema severity on vitamin D levels. Materials and Methods: Eighty patients with BCRL [mean age 55.5±8.9 (36-81)] and age- and sex-matched 80 healthy controls [mean age 53.7±7.4 (32-70)] who were not on calcium or vitamin D supplementation were included in the study. Socio-demographic and clinical characteristics of the subjects were questioned. Plasma 25-Hydroxyvitamin D3, calcium, phosphorus, alkaline phosphatase (ALP), and parathormone (PTH) levels were evaluated. Lymphedema was classified as stage 0, I, II, or III. Results: The mean duration of lymphedema was 23.5±13.8 months. Comparisons revealed lower vitamin D levels and higher PTH and ALP levels in patients with BCRL than healthy controls. As a result of multivariate regression analysis, a significant relationship was revealed between vitamin D levels and age, breast cancer stage, and disease duration in patients with BCRL. Vitamin D levels were significantly lower and PTH levels were significantly higher in stage 3 lymphedema patients compared to stage 1. Conclusion: Vitamin D levels were detected lower in patients with lymphedema than healthy controls. Although vitamin D levels were found to be lower in patients with severe lymphedema, the multivariate regression analysis revealed that the severity of lymphedema does not have a significant effect on vitamin D levels.

The aim of the study wasto assessthe outcomes of surgical treatment for secondary and tertiary hyperparathyroidism in patients with chronic renal failure who were on dialysis in Vinnytsia region. Materials and methods. From 2012 to 2017 on the base of the Vinnytsia Regional Clinical Highly Specialized Endocrinology Center 36 patients on peritoneal dialysis and hemodialysis were treated surgically. Duration of substitution dialysis therapy ranged from 1.7 to 18 years. In 12 patients, subtotal parathyroidectomy was performed and 24 underwent total para­thyroi­dectomy with autotransplantation of the parathyroid gland to shoulder muscles. Results and discussions. The indications for the surgical treatment was a significant increase in pa­­rathormone (PTH) levels, increased pruritus, increased joint pain, significant muscle weakness and progressing hypercalcemia. Contraindications to the surgical inter­vention were cardiovascular insufficiency and uncor­rected arterial hypertension. Patients with severe anemia needed preoperative preparation with an average duration of 3 to 4 weeks; in all cases, iron supplements and eryt­hropoietin were used. Three patients were treated twice; indication for re-surgery was the inc­rease of PTH. The average period before re-surgery was from 8 months to 4 years. One patient was treated during the pre-dialysis period. Four patients underwent surgery on the parathyroid gland, 2 of which had thyroidectomy and for the other 2 he­­mithyroidecto­­my were performed. Two patients were histologically diagnosed with highly differentiated thyroid cancer. The reason for re-surgery was the primary subtotal parathyroidectomy with the preservation of 1/3 or 1/4 of the gland in a typical place. In one case, the reason for recurrence occurred due to an unidentifi­ed single parathyroid gland, which was located behind the sternum. During the preparati­­on for primary surgery in this case a routine MIBI scan with technetium was not used. In all relapse surge

Introduction. Primary hyperparathyroidism is an endocrine disorder, which ranks third in prevalence after diabetes mellitus and diseases of the thyroid gland. Abnormal laboratory results lead to in-depth study of anamnesis and clinical appearance and providing diagnostic procedures for locating the pa­­rathyroid gland with altered functional activity. At the first stage of instrumental diagnosis, ultrasound and scintigraphy with 99mTc-MIBI (in many cases, a combination of them) are used. In the case of positive laboratory tests, false-negative scintigraphy results, orquestionable ultrasound data (presence of multiple nodes),computer tomographyis used as a second stage of instrumental diagnosis. Surgical intervention to eliminate hormonally active parathyroid gland is a gold standard for the treatment of patients with this pat­hology. Aim. The aim of our publication is to explore the relationship between the size of hormonally active lesions of the parathyroid glands and the preoperative serum level of parathormone, calcium, phosphorus, and vitamin D using examples from the clinical practice of the USPCES, TEO and T for the period from January 1, 2017 until December 25, 2018. Materials and methods. The study included cases of single parathyroid adenoma. The observation group consisted of 188 patients — 13 men (6.1 %) and 175 women (93.9 %) aged from 17 to 82 years old; the average age was 55.5 ± 1.0 years. Patient information was obtained from the medical records and included: date of surgery, gender, age, preoperative level of total (normal range 2,20—2,55 mmol/l) and ionized calcium (normal range 1,16—1,32 mmol/l), phosphorus (normal range 0.81—1.45 mmol/l), vitamin D (normal range 30—50 ng/ml) in serum, preoperative PTH level (normal range 11—55 pg/ml), and the largest measurement of the modified PTA in centimeters according to the histopathological report. Results and discussion. We found a statistically significant correlation between the size of the adenoma and

Postoperative hypoparathyroidism is one of frequent specific complications after thyroid surgery that occupies the special place, having regard to severity of manifestation and complicated prevention. A research aim is to assess frequency of hypocalcemia after thyroidectomy concerning different thyroid pathology. Materials and methods. 50 patients with a multinodular goiter (MNG), 50 patients with diffuse toxic goiter (DTG) and 50 patients with thyroid cancer (TC) were under observation. All patients underwent thyroidectomy with the further assessment of thyroid hormones. Results. Thyroidectomy in patients with TC and DTG is accompanied by more expressed transitory hypoparathyroidism as compared to an analogical operation in patients with MNG. A postoperative hypoparathyroidism more often develops after thyroidectomy in patients with TC and DTG as compared to the patients with MNG. Conclusions. The risk of development of hypoparathyroidism after thyroidectomy is highest in patients with TC, less pronounced – in patients with DTG and MNG.

BACKGROUND: Predictors of hypovitaminosis D were extensively studied in the adult population, leading to an approximately complete understanding of them, while there is a lack of studies in the pediatric population, especially in migrant and internationally adopted children. In this retrospective study, we tried to identify the major laboratory predictors of hypovitaminosis D in a cohort of internationally adopted children. METHODS: Data were extracted from the database of the "Ethnopediatrics Outpatient Clinic" of the "A. Gemelli" Foundation University Hospital in Rome, Italy. Our study included 873 children evaluated from March 2007 to May 2016. Analysis of variance, chi square test, t test and multivariate logistic regression were performed, a "p" value < 0.05 was considered significant, with a confidence interval of 95%. RESULTS: We did not find any significant correlation between Vitamin D and Calcium, Phosphates or Magnesium levels within the population we examined. Moreover, parathyroid hormone is not a good predictor of Vitamin D Status. CONCLUSIONS: Considering the strong influence Vitamin D status has not only on bone health, but also on general well-being, it is due to perform a vitamin D assessment as soon as possible, especially in internationally adopted children.

De nombreux cas de tumeurs de Krukenberg ont été décrits dans la littérature, et plusieurs revues ont été publiées sur ce sujet durant ces trois dernières décennies. L'origine précise de ces tumeurs métastastiques n'est cependant pas toujours élucidée, malgré les marqueurs biologiques et immunohistochimiques dont nous disposons à l'heure actuelle. L'objectif de cet article est de présenter les difficultés diagnostiques et thérapeutiques posées par les tumeurs de Krukenberg dans un contexte d'adénocarcinome peu différencié de présentation atypique, ainsi que d'effectuer une revue de la littérature à ce sujet. Nous décrivons le cas d'une patiente de 29 ans référée au service d'endocrinologie pour un remodelage osseux accru et une élévation du taux de parathormone dans un contexte de lombalgies chroniques. Les examens complémentaires ont mis en évidence des tumeurs de Krukenberg bilatérales, des métastases osseuses multifocales ostéoblastiques et une probable dissémination péritonéale. L'origine de ces métastases reste indéterminée mais est probablement digestive haute, après avoir exclu soigneusement un cancer mammaire. Bien qu'il n'existe pas de ligne de conduite bien établie pour la prise en charge des tumeurs de Krukenberg, le traitement actuel consiste en une bi- ou tri-chimiothérapie concomitante à une annexectomie bilatérale, prolongeant ainsi la survie de quelques mois à quelques années. Le pronostic vital, quant à lui, reste sombre avec une médiane de survie à 16 mois, sauf si la tumeur primitive est connue et réséquée avec les métastases, ce qui peut allonger la survie de manière considérable. Que retenir de ce cas clinique ? Les tumeurs de Krukenberg sont des lésions ovariennes stromales d'origine métastatique et secondaires à des adénocarcinomes à cellules en bague à chaton dont les origines les plus fréquentes sont le tube digestif, le sein et les voies bilio-pancréatiques. Bien souvent décelées à un stade avancé de la maladie, le pronostic de survie est s, [Krukenberg tumors, osteoblastic metastases, and elevated parathormone levels : clinical case report and literature review] Numerous cases of Krukenberg tumors have been described in the literature, with several reviews on this topic published over these last three decades. The precise origin of these metastatic tumors is often unknown, in spite of the availability of biological and immunohistochemical markers. This case-report sought to present the diagnostic and therapeutic challenges raised by Krukenberg tumours in the course of a poorly-differentiated adenocarcinoma of atypical presentation, along with a review of the literature on this topic. We report the case of a 29-year-old patient referred to the endocrinology department for increased bone turnover and elevated parathormone levels, in the context of chronic lower back pain. Further examinations revealed bilateral Krukenberg tumors, multifocal osteoblastic bone metastases, as well as probable peritoneal dissemination. While the primary origin of the metastases is still unknown, they are likely of gastrointestinal origin, following careful exclusion of breast carcinoma. Whereas there are no guidelines on the management of Krukenberg tumors, actual therapy primarily consists of bi- or tri-chemotherapy with bilateral adnexectomy, leading to extended survival from a few months to several years. Yet prognosis remains poor with a median survival time of only 16 months, unless both primary tumor and metastases can be fully resected, with then considerably extended survival.

Aims : LV hypertrophy (LVH) is frequent after aortic valve replacement (AVR) and is often associated with comorbidities, including hypertension, obesity, renal failure and prosthesis-patient mismatch (PPM). However, whether other biological mechanism(s) may participate to LVH after AVR is still unknown. Parathyroid hormone (PTH) may play a role in LVH. However, it is presently unknown whether PTH is associated with LVH in patients that have undergone an AVR. Methods : In this cross-sectional study, 195 patients have been investigated at a mean of 8±3.5 years following AVR. LV function and mass were evaluated by Doppler echocardiography. The plasma levels of PTH, 25-hydroxyvitamin D (25-OHD), calcium and phosphate were measured. Results : There were 102 (52%) patients with LVH after AVR. In univariate analyses, PTH blood level was associated with LV mass (LVMi) and LVH. After adjustment for other risk factors, elevated PTH remained associated with LVMi (p=0.003) and LVH (p=0.02). In turn, the blood levels of 25-OHD and the renal function (GFR) were independently and inversely related to the blood level of PTH. Conclusions : After AVR, the level of PTH is independently associated with LVH. In turn, the level of PTH is related with the renal function and the level of 25-OHD.

Background: Primary hyperparathyroidism is often diagnosed by high calcium levels in blood. It is well known that calcium levels are dependent on vitamin D and Parathyroid hormone (PTH). Since vitamin D has a seasonal variation the calcium levels might also be influenced by seasonal variation. If a seasonal variation in calcium levels exists, this must be considered in the investigation of suspected hyperparathyroidism. The aim of the present study was to investigate the possible influence and magnitude of the seasonal variation of vitamin D and PTH on calcium levels. Method: In the present study the individual seasonal variation of 25-hydroxyvitamin D [25(OH) D], PTH and calcium in 69 healthy volunteers living at latitudes with extremely variable seasonal exposure to sunlight have been investigated. Results: As expected the 25(OH) D levels were significantly higher (42%) in summer compared to winter. PTH levels were significantly lower (7%) in summer than in winter. The mean serum concentration of calcium was 1% higher in August than in February, however not statistically significant. A good agreement between summer and winter calcium values was confirmed by Bland-Altman analysis. Conclusion: This study did not show any clinically important influence of seasonal variation of 25(OH) D and PTH on calcium that may influence a clinician's decision to investigate suspected hyperparathyroidism.

Introduction: There are few data concerning variation over time of mineral and bone me-abolism disorder (MBD) in prevalent chronic dialysis patients (CD) in Argentina. materials and methods: 3-years-period time 2011-2013 data from Argentine Registry of Chronic Dialy-sis was used. Demography, Chronic Renal failure etiology (CRF) and MBD biochemical varia-bles in CD prevalent patients, were analyzed. Results: Prevalent population grew from 26572 to 27966 patients between 2011 and 2013, basi-cally as a consequence of incidents growth. Age increased from 57.2 (± 17.0) to 57.5 (±16.9). In both sexs ≥65 years old rate increased, more in men. Diabetic Nephropathy is the first etiology (27.2%). Between 2011 and 2013 there is a sig-nificant decrease of PTHi (p=0.001) average va-lues. In 2013, 25.5% showed between 150 to 300 pg/ml values, 22.9% < 150, el 27,8 % between 300 and 600, and 23.8% showed >600 pg/ml values. The lowest PTHi values can be observed in elderly, males, diabetic pattiens and in the first years under CD treatment. conclusions: average PTHi, as well as patients with over 600 pg/ml percentage decreased, but the adequate range patients percentage (150-300) remained unchanged. Average PTHi decrease is due to the progressive increase of sub-populations less likely to develop hyperparathyroidism: elderly people, males, diabetics and new patients, Antecedentes: Existen pocos datos acerca de la variación en el tiempo de los trastornos del metabolismo mineral y óseo (TMO) relacionado a la IRC en los pacientes prevalentes en diálisis crónica en Argentina. materiales y métodos: Tomamos los datos del trienio 2011-2013 del Registro Argentino de Diálisis Crónica SAN-INCUCAI. Se analizaron la demografía, etiología de la IRC y las variables bioquímicas del metabolismo mineral y óseo de los pacientes prevalentes en Diálisis Crónica (DC), así como su tratamiento. Resulta-dos: La población prevalente creció desde 26572 pacientes en el año 2011 hasta 27966 pacientes en el año 2013. Este aumento de la población prevalente fue debida, fundamentalmente, al crecimiento de los incidentes en DC. La edad pro-medio de esta población aumentó de 57,2 (±17,0) a 57,5 (±16,9) años entre 2011 y 2013. Aumentó la tasa de prevalentes de 65 o más años de ambos sexos entre 2011 y 2013, pero más en hombres. La Nefropatía Diabética se constituyó en la primera etiología con el 27,2%. En 2013, se logran valores adecuados de Calcemia en el 54,5%, de Fosfatemia en el 55% de los pacientes prevalentes en DC. En el año 2013 el 25,5 % tuvo valores de iPTH entre 150 a 300 pg/ml, el 22,9 % < 150, el 27,8 % entre 300 y 600, y un 23,8 % presentó valores de iPTH > 600 pg/ml. Los valores más bajos de iPTH se obsevan a mayor edad, en varones, en pacientes diabéticos y en los primeros años de DC (nuevos pacientes). conclusiones: En el trienio 2011-2013 hubo mejoría en el control de calcio y fósforo. Si bien la iPTH promedio decreció y hubo una disminución del porcentaje de pacientes con iPTH por encima de 600m pg/ml, el porcentaje de pacientes en rango adecuado (150-300) permaneció sin cambios. La disminución de la iPTH promedio se debe a un aumento progresivo de subpoblaciones con menor probabilidad de desarrollar hiperparatiroidismo: viejos, varones, diabéticos y pacientes nuevos que ingresan a diálisis crónica

Based on the known fact that the parathyroid hormone (PTH) might be extended at its C-terminus with biotechnological protein cargoes, a vector directing the secretion of PTH1–84 C-terminally fused with the antigenic epitope myc (PTH-myc) was exploited. The functional properties and potential of this analog for imaging PTH1R-expressing cells were examined. The PTH-myc construct was recombinantly produced as a conditioned medium (CM) of transfected HEK 293a cells (typical concentrations of 187 nM estimated with ELISAs for PTH). PTH-myc CM induced cyclic AMP formations (10 min), with a minor loss of potency relative to authentic PTH1–84, and c-Fos expression (1–3 h). Treatment of recipient HEK 293a cells transiently expressing PTH1R with PTH-myc CM (supplemented with a fluorescent monoclonal anti-myc tag antibody, either 4A6 or 9E10) allowed the labeling of endosomal structures positive for Rab5 and/or for β-arrestin1 (microscopy, cytofluorometry). Authentic PTH was inactive in this respect, ruling out a non-specific form of endocytosis like pinocytosis. Using a horseradish peroxidase-conjugated secondary antibody, the endocytosis of the PTH-myc-based antibody complex by endogenous PTH1R was evidenced in MG-63 osteoblastoid cells. The secreted construct PTH-myc represents a bona fide agonist that supports the feasibility of transporting cargoes of considerable molecular weight inside cells using arrestin and Rab5-mediated PTH1R endocytosis. PTH-myc is also transported into cells that express PTH1R at a physiological level. Such tagged peptide hormones may be part of a cancer chemotherapy scheme exploiting a modular cytotoxic secondary antibody and the receptor repertoire expressed in a given tumor.

Aims : LV hypertrophy (LVH) is frequent after aortic valve replacement (AVR) and is often associated with comorbidities, including hypertension, obesity, renal failure and prosthesis-patient mismatch (PPM). However, whether other biological mechanism(s) may participate to LVH after AVR is still unknown. Parathyroid hormone (PTH) may play a role in LVH. However, it is presently unknown whether PTH is associated with LVH in patients that have undergone an AVR. Methods : In this cross-sectional study, 195 patients have been investigated at a mean of 8±3.5 years following AVR. LV function and mass were evaluated by Doppler echocardiography. The plasma levels of PTH, 25-hydroxyvitamin D (25-OHD), calcium and phosphate were measured. Results : There were 102 (52%) patients with LVH after AVR. In univariate analyses, PTH blood level was associated with LV mass (LVMi) and LVH. After adjustment for other risk factors, elevated PTH remained associated with LVMi (p=0.003) and LVH (p=0.02). In turn, the blood levels of 25-OHD and the renal function (GFR) were independently and inversely related to the blood level of PTH. Conclusions : After AVR, the level of PTH is independently associated with LVH. In turn, the level of PTH is related with the renal function and the level of 25-OHD.

The content of parathormone in blood plasma of 604 persons with previously identified elevated general calcium level in blood has been studied. The amount of appeals from females has three times exceeded the males’ ones. All the results have been divided into six groups according to the age of people under study: the first group (from 1 month to 14 years old), the second group (15-29 years old), the third group (30-44 years old), the fourth group (45-59 years old), the fifth group (60-74 years old), and the sixth group (75-90 years old). 105 cases of hyperparathyroidism which make up 17.38% have been registered. The division according to the gender character has pointed out the females’ dominance – 10.92%. The significant increase of hyperthyroidism in age aspect has been marked; in persons of the third-fifth groups hyperthyroidism has been indicated in every fifth person under study, and in the sixth group – in every fourth person under study. The highest percent of persons with low indexes of parathormone has been detected in the first age group. In morphological studying of parathyroid glands the gradual decrease of the principal parathyrocytes’ amount along with the enlargement of their nuclei’ diameter with simultaneous insignificant increase of the nucleic acid content in women of older age groups.

Xenotransplant of the microencapsulated human parathyroid adenoma tissue preserves the high viability and the ability to secrete parathormone, and have marked positive effect on the levels of total and free calcium in rat recipient blood with experimental hypoparathyroidism, which suggests good prospects of using this tissue in the presence of compensated hypofunctional state of parathyroid system in clinical practice.

L’hyperparathyroidie primaire (HPP) est une affection fréquente, aujourd’hui découverte fortuitement dans plus de 50% des cas à l’occasion de la mise au point d’une hypercalcémie biologique. Le diagnostic de cette affection se base sur la mise en évidence concomitante d’une calcémie élevée, d’un taux de parathormone (PTH) élevé (80% des cas) ou normal (20% des cas), et d’une calciurie supérieure à 150 mg/24 heures. Ses principales complications restent osseuses (ostéopénie, ostéoporose fracturaire) et rénales (lithiase, néphrocalcinose), mais plusieurs études récentes ont bien mis en évidence que l’hyperparathyroidie primaire, même dite «asymptomatique», est responsable de divers symptômes altérant la qualité de vie du patient (fatigue, douleurs osseuses, constipation, troubles de la mémoire et de la concentration,…) et partiellement réversibles après correction chirurgicale. De plus, l’HPP s’accompagne fréquemment de calcifications cardiaques et vasculaires et confère de ce fait un risque de mortalité accru. La présence de ces diverses complications et l’amélioration des techniques chirurgicales incitent aujourd’hui à proposer la parathyroïdectomie à la majorité des patients porteurs de l’affection. Les examens préopératoires de localisation (principalement la scintigraphie de soustraction au MIBI-Tc99m combiné à l’iode123 et l’échographie) permettent de repérer la (les) parathyroïde(s) pathologique(s) dans 80 à 85% des cas. Lorsque ces examens sont concordants, une approche chirurgicale mini-invasive, vidéo-assistée ou focale, doit être envisagée. Combinée à la réalisation de dosages intraopératoires de PTH, la chirurgie parathyroïdienne moderne permet la guérison de l’HPP dans plus de 90% des cas avec une morbidité et une mortalité minim