calcium hopantothenate (Hopate / hopantenate calcium)

Sedentary ageing remodels the structure-function relationships that underlie calcium signalling at super-resolution scales in the heart.

Hurley Miriam E ME, Conesa David D, Benson Alan P AP, Colman Michael A MA

Intracellular calcium handling underpins excitation-contraction coupling in the heart, and its dysfunction has been linked to both mechanical and electrical impairments. Age-related remodelling of the structure-function relationships that underpin calcium spark morphology and dynamics may therefore be causatively linked to associated cardiac dysfunction. We aim to uncover age-dependent features of calcium spark morphology and the distribution of type-2 ryanodine receptor (RyR) clusters, responsible for intracellular calcium release. Isolated ventricular cardiomyocytes were obtained from male Wistar rats at 6, 18 and 24 months of age. Subcellular structure was assessed using expansion microscopy to localize RyR, and calcium sparks were recorded in the absence and presence of 1 µM isoprenaline using spinning disk confocal microscopy. Super-resolution imaging revealed that both aged points were associated with a greater degree of cluster fragmentation, sparseness and structural disorder than the 6-month group, leading to an increased prevalence of remodelled phenotype cells in the aged groups. The 18-month group exhibited the most substantial remodelling of many properties, including the prevalence of remodelled cells, indicating either a genuine biphasic progression of remodelling with age or the divergence of structurally healthy and structurally remodelled groups with age. Moreover, ageing enhanced the impact of β-adrenergic stimulation on calcium spark morphology, increasing spark amplitude, full-width half maximum and spark mass. Our study reveals that RyR cluster properties are non-linearly remodelled with age, with RyR phosphorylation leading to remodelling of calcium spark morphology with age, which may contribute to reduced contractile performance and increased arrhythmia incidence. KEY POINTS: Calcium spark morphology and ryanodine receptor cluster properties were assessed in a rat model of sedentary ageing at three age points. Calcium spark morphology was much more strongly influenced by β-adrenergic stimulation in the aged cohorts compared to the young group, corresponding to an increase in the spatial extent and overall spark mass and indicating an increased responsiveness to sympathetic regulation in ageing. Ageing was associated with a non-linear remodelling of the ryanodine receptor cluster pattern. At the submicron scale ageing led to an increase in fragmented-like clusters; at the broader scale ageing led to an increase in axial spacing and sparseness, as well as a reduction in the regularity of cluster distribution. Across all metrics the younger of the two aged groups exhibited the most substantial and highest probability of remodelling, indicating a potential biphasic progression of structure-function relationships with age, corresponding to remodelling and partial recovery.

Interappointment pain reduction with three intracanal medicaments: A randomized clinical trial.

Maloo Labdhi L, Nair Rashmi R, Bichpuriya Anjali A, Dorlikar Vaishnavi V et al.

The aim of this study was to evaluate and compare the efficacy of calcium hydroxide, modified triple antibiotic paste (mTAP), and ferumoxytol as intracanal medicaments in reducing interappointment pain during endodontic treatment. A randomized in vivo study was conducted on patients undergoing root canal therapy. Following chemo-mechanical preparation, teeth were assigned to three groups: calcium hydroxide, mTAP, and ferumoxytol. Pain intensity was assessed using the Visual Analog Scale at defined intervals posttreatment. Data were conducted using one-way analysis of variance, followed by Tukey's post hoc test to assess intergroup differences. All three medicaments reduced interappointment pain but with varying degrees of effectiveness. Ferumoxytol demonstrated the most consistent reduction in pain scores, followed by mTAP, while calcium hydroxide showed comparatively higher residual pain levels. Statistical analysis revealed significant differences among the groups (P < 0.05), confirming the superior performance of Ferumoxytol and mTAP over calcium hydroxide. Ferumoxytol emerges as a promising intracanal medicament with targeted biofilm disruption and reduced drawbacks compared to conventional agents. Its clinical potential in minimizing interappointment pain highlights its relevance as an alternative to calcium hydroxide and mTAP.

Eldecalcitol in older adults with kidney vulnerability: a narrative review of risk-based use, dose adjustment, and monitoring.

Furuto Yoshitaka Y, Yoshino Daiki D, Namikawa Akio A, Sato Dai D et al.

Eldecalcitol is an active vitamin D analogue used for osteoporosis in Japan. Its usual dose is 0.75 μg/day, but calcium-related adverse effects can become clinically important when reduced kidney reserve, frailty, low body weight, poor intake, dehydration risk, interacting medicines, or unreliable follow-up coexist. This narrative review synthesizes trial, post-marketing, pharmacovigilance, and real-world monitoring evidence to define a practical safety framework. Eldecalcitol reduces vertebral fractures compared with alfacalcidol, whereas hip-fracture protection has not been established; therefore, its role should be determined by the patient's fracture pattern, treatment objective, kidney function, and availability of alternatives with established hip-fracture efficacy. Before treatment, clinicians should confirm osteoporosis, measure total serum calcium with albumin (and use albumin-adjusted calcium where appropriate), and assess serum creatinine with reported eGFR. Primary hyperparathyroidism and other metabolic bone disorders should be considered when baseline findings are atypical. Creatinine-based eGFR is the pragmatic minimum standard; cystatin C is most useful when low muscle mass or discordance makes kidney reserve uncertain. A lower dose of 0.5 μg/day is a dose-adjustment or re-challenge option after calcium normalization; it does not remove the need for calcium surveillance and clinical reassessment, and long-term fracture-prevention efficacy at that dose is not established. Eldecalcitol should be withheld during poor intake, dehydration, or acute illness and reconsidered when calcium rises or kidney function deteriorates. Safe use therefore requires risk-based selection rather than passive routine-dose prescribing, planned biochemical follow-up, and explicit treatment reassessment.

Iatrogenic calcinosis cutis from calcium gluconate extravasation.

Vlahos Fotios F, Giannakikou Iosifina I