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hypocalcemia guidelines

Eyas Alkhalili, Mark D Ehrhart, Houriya Ayoubieh, Mark R Burge
INTRODUCTION: Postoperative hypocalcemia is frequent after total thyroidectomy. The role of preoperative vitamin D levels in the pathogenesis of this condition has not been studied under the most current guidelines for evaluation of the role of vitamin D in calcium homeostasis. We hypothesized that patients with preoperative vitamin D deficiency are more likely to suffer from postoperative hypocalcemia, thereby requiring prolonged hospitalization. METHODS: A retrospective chart review of patients undergoing total thyroidectomy at the University of New Mexico Hospital between 2005 and 2014 was performed...
September 15, 2016: Endocrine Practice
Rahul Vasudev, Vijay Sawhney, Mitu Dogra, Tilak Raj Raina
AIMS: In this study we have evaluated the various adverse reactions related to transfusion occurring in our institution as a pilot institutional effort toward a hemovigilance program. This study will also help in understanding the problems faced by blood banks/Transfusion Medicine departments in implementing an effective hemovigilance program. MATERIALS AND METHODS: All the adverse reactions related to transfusion of whole blood and its components in various clinical specialties were studied for a period of 1 year...
January 2016: Asian Journal of Transfusion Science
Maria Luisa Brandi, John P Bilezikian, Dolores Shoback, Roger Bouillon, Bart L Clarke, Rajesh V Thakker, Aliya A Khan, John T Potts
OBJECTIVE: Hypoparathyroidism is a rare disorder characterized by hypocalcemia and absent or deficient PTH. This report presents a summary of current information about epidemiology, presentation, diagnosis, clinical features, and management and proposes guidelines to help clinicians diagnose, evaluate, and manage this disorder. PARTICIPANTS: Participants in the First International Conference on the Management of Hypoparathyroidism represented a worldwide constituency with acknowledged interest and expertise in key basic, translational, and clinical aspects of hypoparathyroidism...
June 2016: Journal of Clinical Endocrinology and Metabolism
Daejin Kim, Eun-Jung Ko, HyeJeong Cho, Su Hyung Park, Sang Hwan Lee, Nam-Gil Cho, So-Young Lee, Hye Yun Jeong, Dong Ho Yang
Non-traumatic exertional rhabdomyolysis (exRML) occurs in individuals with normal muscles when the energy supplied to the muscle is insufficient. Here, we report 11 cases of spinning-induced rhabdomyolysis and review related literature. Spinning is a kind of indoor bicycle sport. The 11 patients who were diagnosed with exRML and admitted to CHA Bundang Medical Center were female and their ages ranged from 15 to 46 years. Two to three days prior to the presentation, the patients had attended a spinning class for the first time...
December 2015: Electrolyte & Blood Pressure: E & BP
Solenne Pelletier, Hubert Roth, Jean-Louis Bouchet, Tilman B Drueke, Thierry Hannedouche, Guillaume Jean, Gérard London, Denis Fouque
INTRODUCTION: Chronic kidney disease progressively induces a disorder of mineral and bone metabolism (CKD-MBD) which also leads to cardiovascular abnormalities. Previous studies showed that only few hemodialysis patients had serum calcium, phosphate and parathyroid hormone levels within the K/DOQI (Kidney-Disease Outcomes Quality Initiative) targets of 2003. Our aim was to identify the impact of different therapeutic strategies and that of the KDIGO (Kidney-Disease: Improving Global Outcomes) targets of 2009 on the control of CKD-MBD...
June 2016: Néphrologie & Thérapeutique
Ryo Okazaki
Vitamin D insufficiency/deficiency, a medical condition in which vitamin D store is decreased, is the most frequent cause of decreased action of vitamin D. Severer form vitamin D deficiency can cause hypocalcemia and rickets/osteomalacia. Milder form vitamin D insufficiency also harms bone health via secondary hyperparathyroidism, the increase in fracture risk, and poor responses to anti-osteoporotic medications. Diagnosis can only be made by measuring serum 25(OH)D, which is not currently covered by the Japanese health insurance policy...
February 2016: Clinical Calcium
Keiichi Ozono
Vitamin D deficiency causes rickets or osteomalacia, which is associated with hypomineralization of bone and chondrocytes, and/or hypocalcemia. Accumulating evidence indicates increase in frequency of vitamin D deficiency due to insufficient intake of vitamin D and calcium and decrease in sunshine. It is necessary for clinician to diagnose vitamin D deficiency accurately and treat patients with vitamin D deficiency adequately. For the purpose, clinical guideline or expert opinion on vitamin D deficiency has been reported...
February 2016: Clinical Calcium
Min-Jeong Lee, Seirhan Kim, Inwhee Park, Heungsoo Kim, Gyu-Tae Shin
BACKGROUND: Estimated glomerular filtration rate (eGFR) is one of the most important guidelines in deciding the optimal timing of dialysis initiation. In the present study, we calculated the eGFR at the time of hemodialysis (HD) initiation using 5 commonly used equations to relate them with clinical and laboratory characteristics of the patients and to evaluate which of these equations best define the eGFR at HD initiation. METHODS: We retrospectively analyzed 409 end-stage renal disease patients who were newly started on HD treatment in our institution...
December 2015: Kidney Research and Clinical Practice
Luca Revelli, Gianfranco Damiani, Caterina Bianca Neve Aurora Bianchi, Serafino Vanella, Walter Ricciardi, Marco Raffaelli, Celestino Pio Lombardi
BACKGROUND: To evaluate the incidence of postoperative complications, hemostatic effects and safety of Total Thyroidectomy (TT) performed using the Harmonic Scalpel (HS), the Harmonic Focus (HF) or Conventional Hemostasis (CH). METHODS: The meta-analysis was performed according to PRISMA guidelines. A literature search was conducted from 2003 to 2014 and stringent criteria were required for inclusion. Thirteen studies concerning an overall population of 1458 compared HS versus CH, whilst 8 studies with 1667 patients compared HF versus CH...
April 2016: International Journal of Surgery
Kerri L Tang, Kevin M Antshel, Wanda P Fremont, Wendy R Kates
22q11.2 Deletion syndrome (22q11.2DS) is a chromosomal microdeletion that affects approximately 40 to 50 genes and affects various organs and systems throughout the body. Detection is typically achieved by fluorescence in situ hybridization after diagnosis of one of the major features of the deletion or via chromosomal microarray or noninvasive prenatal testing. The physical phenotype can include congenital heart defects, palatal and pharyngeal anomalies, hypocalcemia/hypoparathyroidism, skeletal abnormalities, and cranial/brain anomalies, although prevalence rates of all these features are variable...
October 2015: Journal of Developmental and Behavioral Pediatrics: JDBP
Joe Grainger, Mohammed Ahmed, Rousseau Gama, Leonard Liew, Harit Buch, Ronald J Cullen
Hypocalcemia is a recognized complication following thyroid surgery. Variability in the definition of hypocalcemia and different opinions on its management can lead to unnecessary patient morbidity and longer hospital stays as a result of inappropriate or untimely treatment. Therefore, we developed a management guideline for the recognition and treatment of post-thyroidectomy hypocalcemia, and we conducted a retrospective study to assess its impact on length of stay (LOS). Between April 1, 2007, and March 31, 2009, 29 adults had undergone a total or completion thyroidectomy at our large district general hospital...
July 2015: Ear, Nose, & Throat Journal
Wouter P Kluijfhout, Dirk-Jan van Beek, Annemarie A Verrijn Stuart, Lutske Lodewijk, Gerlof D Valk, David C van der Zee, Menno R Vriens, Inne H M Borel Rinkes
The aim of this study was to investigate whether younger age at surgery is associated with the increased incidence of postoperative complications after prophylactic thyroidectomy in pediatric patients with multiple endocrine neoplasia (MEN) 2. The shift toward earlier thyroidectomy has resulted in significantly less medullary thyroid carcinoma (MTC)-related morbidity and mortality. However, very young pediatric patients might have a higher morbidity rate compared with older patients. Hardly any literature exists on complications in the very young...
July 2015: Medicine (Baltimore)
Thibault Senterre, Ibrahim Abu Zahirah, Catherine Pieltain, Virginie de Halleux, Jacques Rigo
OBJECTIVES: The aim of the present study was to evaluate electrolyte and mineral homeostasis in very-low-birth-weight (VLBW) infants who received high protein and energy intakes with a unique standardized parenteral nutrition solution containing electrolytes and minerals from birth onward. METHODS: Prospective cohort study in 102 infants with birth weight <1250 g. The evolution of plasma biochemical parameters was described during the first 2 weeks of life. RESULTS: During the first 3 days of life, mean parenteral intakes were 51 ± 8 kcal · kg · day with 2...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
Sarah C Oltmann, Tariq M Madkhali, Rebecca S Sippel, Herbert Chen, David F Schneider
BACKGROUND: Patients with end-stage renal disease develop hypocalcemia, resulting in secondary hyperparathyroidism (SHPT). No clear criterions exist to aid in surgical decision making for SHPT. The 2009 Kidney Disease Improving Global Outcomes (KDIGO) guidelines provide target ranges for serum calcium, phosphate, and parathyroid hormone (PTH) levels in patients with end-stage renal disease. Parathyroidectomy can help achieve these targets. The study purpose was to examine how parathyroidectomy for SHPT impacts KDIGO targets during immediate and long-term follow-up and to evaluate KDIGO categorization with receipt of additional surgical intervention...
November 2015: Journal of Surgical Research
Antoine Kimmoun, Emmanuel Novy, Thomas Auchet, Nicolas Ducrocq, Bruno Levy
Lactic acidosis is a very common biological issue for shock patients. Experimental data clearly demonstrate that metabolic acidosis, including lactic acidosis, participates in the reduction of cardiac contractility and in the vascular hyporesponsiveness to vasopressors through various mechanisms. However, the contributions of each mechanism responsible for these deleterious effects have not been fully determined and their respective consequences on organ failure are still poorly defined, particularly in humans...
April 9, 2015: Critical Care: the Official Journal of the Critical Care Forum
Marjolein Bonthuis, Marco Busutti, Karlijn J van Stralen, Kitty J Jager, Sergey Baiko, Sevcan Bakkaloğlu, Nina Battelino, Maria Gaydarova, Bruno Gianoglio, Paloma Parvex, Clara Gomes, James G Heaf, Ludmila Podracka, Dafina Kuzmanovska, Maria S Molchanova, Tatiana E Pankratenko, Fotios Papachristou, György Reusz, Maria José Sanahuja, Rukshana Shroff, Jaap W Groothoff, Franz Schaefer, Enrico Verrina
BACKGROUND AND OBJECTIVES: Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry to study the prevalence and potential determinants of mineral abnormalities, as well as the predictive value of a disturbed mineral level on graft survival in a large cohort of European pediatric renal transplant recipients...
May 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Nollaig O Donohoe, R Kintu-Luwaga, Jarleth Bolger, Jane Odubu Fualal
BACKGROUND: This study aimed to document thyroidectomy outcomes in the surgical endocrine unit, Mulago Hospital, Kampala, Uganda. The burden of global surgical disease is currently receiving much attention, especially in countries experiencing epidemiological transition. There is a paucity of publications on surgical outcomes from Sub-Saharan Africa. International thyroid guidelines from high-income countries do not factor in the logistical challenges or the advanced pathology faced by the surgeon in resource-limited settings...
July 2015: World Journal of Surgery
Abdulla A Alharthi, Naglaa M Kamal, Mohamed W Abukhatwah, Laila M Sherief
Cinacalcet, a calcimimetic drug, has been shown to be efficacious in adult chronic kidney disease (CKD) patients; however, it was not fully studied in pediatric CKD patients. We aimed at assessing the effect of cinacalcet on intact parathyroid hormone (iPTH) secretion in children with CKD-4/5 with iPTH consistently ≥ 300 pg/mL refractory to conventional treatment. This is a prospective cohort analysis of 28 children with uncontrolled hyper-parathyroidism secondary to stage 4 and 5 CKD admitted to a tertiary center during the period from April 2012 to April 2014...
January 2015: Medicine (Baltimore)
K Yamanouchi, S Minami, S Kuba, C Sakimura, N Hayashida, F Kawakami, T Kuroki, S Eguchi
AIM: In Japan, surgery for Graves' disease (GD), which is considered to be a radical therapy, has been restricted by various guidelines. Nevertheless, some patients benefit from surgery. We sought to identify a reasonable operative method for GD by comparing the efficacy and safety among patients undergoing different extents of thyroidectomy. METHODS: A total of 162 patients underwent thyroidectomy for GD between 2003 and 2012 in our department. We compared the clinical factors among those who underwent subtotal thyroidectomy (ST), near-total thyroidectomy (NTT), and total thyroidectomy (TT)...
April 2015: Minerva Chirurgica
Alexandre O F da Silva, Cláudia B R Martinez
Cadmium (Cd) is a trace element that is very toxic to fish. It is commonly found in surface waters contaminated with industrial effluents. When dissolved in water, Cd can rapidly cause physiological changes in the gills and kidneys of freshwater fish. The objective of this study was to evaluate the acute effects of Cd on the osmoregulation of the Neotropical fish Prochilodus lineatus. Juvenile fish were exposed to Cd at two concentrations [1 (Cd1) and 10 (Cd10) μgL(-1)] for 24 and 96h. The effects of Cd were evaluated through the analysis of ions (Na(+), K(+), Ca(2+), and Cl(-)) and plasma osmolality, and by measuring the activities of enzymes involved in osmoregulation obtained from the gills and kidney...
November 2014: Aquatic Toxicology
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