[Calcium and phosphorus metabolism disorders in Cushing's syndrome and Addison's disease].
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The investigation of a number of 286 patients having disorders of binocular seeing shows a very frequent association of these to spasmophilia, especially for persons of feminine sex during their third or fourth decades of life. The medicamentous treatment of spasmophilia has ameliorated the disturbing binocular seeings, which had appeared again after stopping the treatment for a long time. The authors recommend the cover-test end the examination using Maddox's experiment for tracing rapidly out the binocular seeing disturbings. In order to stimulate the movements of the ocular globe in an reverse sense to the deviation formed by the oculomotor existed lack of poise, it had been used the prescription of classes with prisms assembled conversely to the classic rules, having the indication of wearing them for 3-4 hours a day.
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Keeping rats on a ration with a 1:3 proportion of calcium and phosphorus for 2 weeks results in hyperprosphatemia, hypocalcemia and renal calcinosis with uremia. When putting these animals on a food ration with the calcium and phosphorus ratio of 1:1 the concentration of these elements in the blood quickly returns back to normal, while renal calcinosis continues for the whole period of observation (7 months). The growing animals are more sensitive to a phosphorus excess than are the adult ones. An excessive consumption of phosphorus leads to its increased excretion with the urine with concurrent diminution of the calcium excretion. The blood and urine pH then experiences no change, whereas the ability of the turned inside out segments of the small intestine to absorb calcium as against the concentration gradient (active transport) in vitro not only does not diminish, but initially even goes up. It is suggested that the excess phosphorus content in the food ration tends to directly derange absorption of calcium in the intestines, this resulting in the development of hypocalciemia, hyperparathyroidism and calcinosis of the viscera and tissues.
Brain phosphorus metabolism was measured in 22 patients with depressive disorders. Ten of them had DSM-III-R bipolar disorder, and 12 had major depression. In bipolar patients, phosphomonoester (PME) and intracellular pH were significantly increased in the depressive state than in the euthymic state, while those values in the euthymic state were significantly low as compared to age-matched normal controls. Phosphocreatine (PCr) was significantly decreased in severely depressed patients compared to mild depressives. These findings suggest that high energy phosphate metabolism, intracellular pH and membrane phospholipid metabolism are altered in depressive disorders.
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The authors examined 114 epileptic patients who were taking anticonvulsant drugs from different periods of time. Serum and urinary calcium and phosphorus and serum alkaline phosphatase levels have been studied. Roentgenographic researches have been made in order to asses the bone mineral content. Urinary D-glucaric acid excretion as a quantitative index of hepatic enzyme induction has been determined in some subjects. The results show the presence of minor alterations both in calcium and phosphorus metabolism and in bone structure at a subclinical level. These findings suggest the importance of climatic and nutritional factors in the development of bone alterations pointed out by several authors in epileptic patients on long-term anticonvulsant therapy.
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Hemodialysis induced changes in calcium (Ca) and phosphorous (P) metabolism are studied in a group of ten (10) patients with chronic renal failure. There was a significant rise in total serum calcium (Ca), that was closely related to changes in serum proteins level, and a very significant decrease in serum phosphorous (P). Calcium levels of 7 to 8 mgs/100 cc in the dialyzer fluid were considered ideale.
Studied were mass disease outbreaks on eight farms in calves intensively fed concentrate mixtures that were rich in phosphorus compounds. Clinically, there were selling and deformations of the joints with pains. The tarsal and carpal joints were chiefly involved. Kyphosis of the backbone, spastic paresis of the posterior part of the body as well as tetaniform spasms in the initial stage of the disease were also observed. Morphologically, the diseased animals manifested erosions and thinning of the joint cartilage, tearing of the Achilles tendon, and increased amounts of the joint fluid. The histologic study revealed edema of the cartilage cells, disorders in the structure of the hyalin cartilage, formation of cavities, and broadening of the lumen of the Haversian canals. In most cases the blood serum presented hyperphosphatemia (up to 15.67 mg% inorganic P) and relative or absolute hypocalcemia (up to 4.47 mg% Ca). On the farm both hypocalcemia and hypophosphatemia were observed. Good prophylactic results were obtained through correct Ca:P ratios in the diet that contained calcium additives as well as by the injection of vitamin D solutions, etc. It is believed that these cases should be referred to a distinctive form of rickets of a characteristic clinical course' the inadequate Ca:P ratios in the rations playing the main etiologic role. Subsidiary causes are probably vitamin D deficiency, restricted movement of the animals, and mechanical traumata caused by the animal's own bodyweight.
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