4.3 days

MEDICAL: Inborn Errors of Metabolism

Phosphorus is a major anion in the intracellular fluid that is measured in the serum; normal serum phosphorus levels range between 1.7 and 2.6 mEq/L (2.5 and 4.5 mg/dL). In children, the serum phosphorus level is higher, at 4.0 to 7.0 mg/dL. Hypophosphatemia occurs when the serum phosphorus levels fall below 1.7 mEq/L (2.5 mg/dL). Patients with moderate hypophosphatemia (1.0 to 2.5 mg/dL) are usually asymptomatic and require no treatment except to manage the underlying cause; patients with severe hypophosphatemia (<1 mg/dL) need more aggressive treatment to prevent complications. The possible complications of hypophosphatemia are grave and include dysrhythmias, heart failure, shock, destruction of striated muscles, seizures, and coma. Hypophos-phatemia occurs in approximately 1% to 5% of all hospitalized patients, 30% of patients admitted to critical care units, and 40% to 80% of patients with alcohol dependence, diabetic ketoacidosis, sepsis, or septic shock. Severe hypophosphatemia is rare and occurs in less than 1% of all hospitalized patients.

Approximately 85% of body phosphorus is in bone, and most of the remainder is intracel-lular. Only 1% is in the extracellular fluid. Phosphorus serves many functions in the body, such as maintenance of the normal nerve and muscle activity; formation and strength of bones and teeth; maintenance of cell membrane structure and function; metabolism of carbohydrates, proteins, and fats; maintenance of oxygen delivery to the tissue; maintenance of acid-base balance; and activation of the B complex vitamins. Phosphorus is excreted by the kidneys (90%) and gastrointestinal (GI) tract (10%). Regulation of phosphorus is controlled by parathyroid hormone (PTH). PTH stimulates a vitamin D derivative (calcitriol) to increase phosphorus absorption by the GI tract. PTH acts on the renal tubules to increase phosphate excretion.

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

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