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Jesse P Goff, Nicholas J Koszewski
Most studies demonstrating that diets with low dietary cation-anion difference (DCAD) reduce hypocalcemia in cows add enough anions to the diet to reduce urine pH below 7.0. One objective of these experiments was to determine whether there is any benefit to periparturient plasma Ca concentration if diet anion addition results in a lesser degree of acidification of the cow and urine pH does not go below 7.0. Another method for reducing hypocalcemia involves feeding a prepartal diet that is Ca deficient. This places the cow in negative Ca balance before calving, stimulating parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D secretion before calving and thus promoting Ca homeostasis at calving...
March 14, 2018: Journal of Dairy Science
Mirza Sultan Ahmad, Danial Ahmad, Naila Medhat, Syed Aizaz Hussain Zaidi, Hadia Farooq, Sair Ahmad Tabraiz
OBJECTIVE: To ascertain the frequency of electrolyte abnormalities in patients of probable and culture-proven sepsis on admission and assess any association of electrolyte disorders with mortality. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: NICU, Fazle-Omar Hospital, Rabwah, from October 2015 to September 2016. METHODOLOGY: All neonates with the diagnosis of probable and culture-proven sepsis during the study period admitted in NICU, Fazle-Omar Hospital, were included in the study...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Asmaa Y Elsary, Alkassem A Elgameel, Wael S Mohammed, Osman M Zaki, Shaimaa A Taha
To assess the prevalence of hypocalcemia in outpatient clinic neonates and its relation to vitamin D and calcium supplementation.  Methods: This cross-sectional analytical study was conducted at the University Teaching Hospital from May to October 2016. Data were collected from 100 neonates by interviewing mothers using a structured questionnaire; which included socio-demographic information, maternal and neonatal history; in addition to investigations of serum calcium total and ionized and serum vitamin D level...
March 2018: Saudi Medical Journal
Venkatesh Ravi, Fady Iskander, Abhimanyu Saini, Carolyn Brecklin, Rami Doukky
BACKGROUND: Pericardial effusion is common in hospitalized patients with chronic kidney disease (CKD). We sought to identify predictors of pericardial effusion in CKD patients and to evaluate the impact of pericardial effusion on their mortality and morbidity. METHODS: In a retrospective nested case control study design, we analyzed hospitalized adult patients with CKD stage 4, 5, and end-stage renal disease (ESRD) diagnosed with pericardial effusion. Randomly selected patients with CKD stage 4, 5, and ESRD without pericardial effusion were used as controls...
March 13, 2018: Clinical Cardiology
M Rroji, G Spasovski
Secondary hyperparathyroidism (SHPT) is common among patients with end-stage renal disease (ESRD). SHPT is associated with high-turnover bone disease, interstitial and vascular calcifications, cardiovascular morbidity and mortality. The pharmacological management of SHPT has progressed in recent years. The introduction of targeted therapies, such as selective vitamin D receptors activators and calcium-sensing receptor modulators, offers an increased opportunity to adequately control elevated parathyroid hormone (PTH), especially in patients with chronic kidney disease under dialysis treatment...
March 12, 2018: International Urology and Nephrology
Harry H Ching, Jacob B Kahane, Megan J Foggia, Annabel E Barber, Robert C Wang
BACKGROUND: Resection of massive goiters with suprahyoid, retropharyngeal, and substernal extension may not be amenable to standard approaches. This study evaluates a surgical approach allowing resection of massive goiters with minimal substernal and deep neck dissection. METHODS: Cases of thyroidectomy for goiters with substernal, retropharyngeal, or suprahyoid extension at a single institution from 2006 to 2017 were reviewed. The technique involves initial complete division of the medial thyroid tracheal attachments after identification of the RLN medial-inferiorly or superiorly...
March 12, 2018: World Journal of Surgery
Takuo Kubota, Hirofumi Nakayama, Taichi Kitaoka, Yosikazu Nakamura, Seiji Fukumoto, Ikuma Fujiwara, Yukihiro Hasegawa, Kenji Ihara, Sachiko Kitanaka, Satomi Koyama, Satoshi Kusuda, Haruo Mizuno, Keisuke Nagasaki, Koji Oba, Yuko Sakamoto, Noriyuki Takubo, Toshiaki Shimizu, Yusuke Tanahashi, Kosei Hasegawa, Hirokazu Tsukahara, Tohru Yorifuji, Toshimi Michigami, Keiichi Ozono
There is concern that vitamin D deficiency is prevalent among children in Japan as well as worldwide. We conducted a nationwide epidemiologic survey of symptomatic vitamin D deficiency to observe its incidence rate among Japanese children. A questionnaire inquiring the number of new patients with vitamin D deficiency rickets and/or hypocalcemia for 3 years was sent to 855 randomly selected hospitals with a pediatrics department in Japan. In this survey, we found that 250 children were diagnosed with symptomatic vitamin D deficiency...
March 10, 2018: Endocrine Journal
Jürgen Floege, Kate Tsirtsonis, Jan Iles, Tilman B Drueke, Glenn M Chertow, Patrick Parfrey
The calcimimetic cinacalcet is used to treat secondary hyperparathyroidism in patients receiving dialysis, and asymptomatic hypocalcemia is often observed following its initiation. Here we investigated the incidence, predictors and therapeutic consequences of hypocalcemia by a post hoc analysis of the randomized, double-blind, placebo-controlled EValuation Of Cinacalcet Hydrochloride Therapy to Lower CardioVascular Events (EVOLVE) trial. Hypocalcemia was classified as mild (total serum calcium 8.0-8.39 mg/dL), moderate (7...
March 7, 2018: Kidney International
Wei Ling Lau, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Secondary hyperparathyroidism develops in CKD due to a combination of vitamin D deficiency, hypocalcemia, and hyperphosphatemia, and it exists in nearly all patients at the time of dialysis initiation. There is insufficient data on whether to prefer vitamin D analogs compared with calcimimetics, but the available evidence suggests advantages with combination therapy. Calcium derangements, patient adherence, side effects, and cost limit the use of these agents. When parathyroid hormone level persists >800 pg/ml for >6 months, despite exhaustive medical interventions, monoclonal proliferation with nodular hyperplasia is likely present along with decreased expression of vitamin D and calcium-sensing receptors...
March 9, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Katsuhiko Nakatsukasa, Hiroshi Koyama, Yoshimi Ouchi, Kouichi Sakaguchi, Yoshifumi Fujita, Takayuki Matsuda, Makoto Kato, Eiichi Konishi, Tetsuya Taguchi
Adjuvant aromatase inhibitor (AI) therapy, for hormone receptor-positive breast cancer, in postmenopausal women is associated with bone loss, leading to an increased risk of fractures. Denosumab, an antibody raised against the receptor activator of nuclear factor-κB ligand, has been proven to protect against AI-induced bone loss. Hence, we aimed to determine whether denosumab is effective in postmenopausal Japanese women with osteoporosis, treated with AI. We prospectively evaluated the bone mineral density (BMD) in the lumbar spine and the bilateral femoral neck in 102 postmenopausal women with clinical hormone receptor-positive breast cancer, stages I-IIIA, during a postoperative period of 12 months...
March 8, 2018: Journal of Bone and Mineral Metabolism
Guido Kranenburg, Pim A de Jong, Jonas W Bartstra, Suzanne J Lagerweij, Marnix G Lam, Jeannette Ossewaarde-van Norel, Sara Risseeuw, Redmer van Leeuwen, Saskia M Imhof, Harald J Verhaar, Job J de Vries, Riemer H J A Slart, Gert Luurtsema, Annemarie M den Harder, Frank L J Visseren, Willem P Mali, Wilko Spiering
BACKGROUND: In pseudoxanthoma elasticum (PXE), low pyrophosphate levels may cause ectopic mineralization, leading to skin changes, visual impairment, and peripheral arterial disease. OBJECTIVES: The authors hypothesized that etidronate, a pyrophosphate analog, might reduce ectopic mineralization in PXE. METHODS: In the Treatment of Ectopic Mineralization in Pseudoxanthoma Elasticum trial, adults with PXE and leg arterial calcifications (n = 74) were randomly assigned to etidronate or placebo (cyclical 20 mg/kg for 2 weeks every 12 weeks)...
March 13, 2018: Journal of the American College of Cardiology
Gretel Ruprechter, Maria de Lourdes Adrien, Alejandro Larriestra, Otavio Meotti, Chester Batista, Ana Meikle, Mirela Noro
The predictive values of plasma non-esterified fatty acid (NEFA), beta-hydroxybutyrate (BHB), cholesterol, albumin and calcium to predict risk of peripartum diseases in primiparous (PP) and multiparous (MP) Holstein cows was investigated. Besides it was assessed if the health status interacted with parity on body condition score and metabolic profiles during the transition period. Dairy cows (126 PP and 182 MP) from a commercial dairy free stall herd (loose-housing system) were weekly body condition scored and tail bled for metabolites determination from -3 to +4 weeks relative to calving...
February 19, 2018: Research in Veterinary Science
Primploy Greeviroj, Thidarat Kitrungphaiboon, Pisut Katavetin, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Bertrand L Jaber, Paweena Susantitaphong
BACKGROUND: Cinacalcet could decrease serum calcium, phosphate, and parathyroid hormone (PTH) in previous meta-analyses. However, the effect of cinacalcet on the new biomarkers such as fibroblast growth factor-23 (FGF-23), bone markers, and vascular calcification are still unestablished. We conducted a meta-analysis to examine the effects of cinacalcet on all laboratory and clinical spectrums of chronic kidney disease-mineral bone disorders (CKD-MBD). METHODS: A systematic literature search was conducted in MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and Clinical Trials...
March 7, 2018: Nephron
Mitchell S Cappell, Ahmed Edhi, Mitual Amin
RATIONALE: Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation...
January 2018: Medicine (Baltimore)
E N Gonc, A Ozon, G Buyukyilmaz, A Alikasifoglu, O P Simsek, N Kandemir
Juvenile Paget's disease (JPD) is a rare autosomal recessive osteopathy. There is still a question about the most effective treatment modality in long-term prognosis. A 9-month-old boy who suffered from bone pain and deformities with a very high alkaline phosphatase level was diagnosed as JPD by radiographic findings. Genetic analysis showed a homozygous large deletion in TNFRSF11B gene encoding osteoprotegerin. Clinical improvement was observed with intravenous pamidronate therapy. However, the effect of drug reduced in time so the annual dose per kilogram body weight was increased after 2 years...
March 3, 2018: Osteoporosis International
A Valldecabres, J A A Pires, N Silva-Del-Río
The effects of prophylactic oral Ca supplementation on blood mineral status and markers of energy balance were evaluated on 205 multiparous Jersey cows at a commercial dairy. Postpartum, cows were systematically assigned to control (n = 105) or oral Ca supplementation (CaOS; 50 to 60 g of Ca as boluses; n = 100) at 0 and 1 d in milk (DIM). Blood samples for analysis of serum minerals (Ca, P, Mg, K, Na, Fe, Zn, and Cu) were collected before and 1 h after treatment at 0 and 1 DIM, and at 2 DIM. Urine pH was measured immediately before and 1 h after treatment administration (n = 96)...
February 28, 2018: Journal of Dairy Science
Salma A Ajarmeh, Eyad M Al Tamimi
Backgorund: Sanjad-Sakati syndrome (SSS) is a rare autosomal recessive disease caused by a deletion mutation (155-166del) in exon 3 of the TBCE gene on chromosome 1q42-43. The syndrome is characterized by primary hypoparathyroidism, typical dysmorphic features and severe growth retardation. CASE PRESENTATION: We encountered a 2-year-old boy with hypocalcemia, failure to thrive and macrocytic anemia. The patient had the characteristic features of SSS and genetic testing confirmed that he was homozygous for the TBCE mutation...
March 1, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Ling Li, Haisong Yang, Jian Li, Yunli Yu, Fan Wang, Xianghui Zhu, Guicheng Liu
RATIONALE: Idiopathic hypoparathyroidism (IHP) is a rare endocrine condition, which is frequently represented by neuropsychiatric disorders. Hence, the misdiagnosis rate of the disease is rather high, especially for neurologists. PATIENT CONCERNS: We reported a case of misdiagnosed, atypical IHP. In addition, the literature on IHP and the misdiagnosis published in China in the past 2 decades has been reviewed and summarized. DIAGNOSES: Blood testing confirmed that parathyroid hormone (PTH) = 0 pg/mL and the final diagnosis was IHP...
March 2018: Medicine (Baltimore)
Lawrence Chen, Yi-Hsiu Wu, Chia-Hwa Lee, Hsin-An Chen, El-Wui Loh, Ka-Wai Tam
BACKGROUND: Central neck dissection and total thyroidectomy are standard treatments for patients with papillary thyroid carcinoma (PTC) with clinically involved central nodes. However, prophylactic central neck dissection (pCND) in patients with clinically uninvolved cN0 has been beneficial in some studies but ineffective in others. We conducted a meta-analysis to evaluate the efficacy and safety of pCND in patients with central neck lymph nodes cN0 PTC. METHODS: The PubMed, EMBASE, Cochrane Library, and Scopus databases and the ClinicalTrials...
February 27, 2018: World Journal of Surgery
Benedicte De Muynck, Mathias Leys, Joke Cuypers, Dirk Vanderschueren, Marion Delcroix, Catharina Belge
We report the case of a 50-year-old woman with anorexigen-induced pulmonary arterial hypertension treated with epoprostenol, who presented with Trousseau's sign, leading to the diagnosis of severe hypocalcemia for which substitution was started (initially orally, followed by intravenous substitution). After further analysis, we assume that epoprostenol-induced diarrhea caused malabsorption (as other reasons were excluded), leading to nutritional osteomalacia with secondary hyperparathyroidism. We discovered that even more severe hypocalcemia was induced by the treatment with the anti-osteoporotic drug denosumab, which was started after the diagnosis of osteoporosis on bone densitometry...
2018: Respiration; International Review of Thoracic Diseases
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