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hypercalcemia treatment

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https://www.readbyqxmd.com/read/29020855/retrospective-chart-evaluation-of-hypercalcemia-management-in-oncology-patients-at-the-university-of-chicago-medical-center
#1
Kelly Plach, Randall W Knoebel, Rita Nanda, Katherine Shea
Introduction Due to the lack of formal guideline recommendations, available primary literature was used to develop a proposed protocol for management of hypercalcemia of malignancy at the University of Chicago Medical Center. Methods A retrospective, single center, observational study was performed including adult patients hospitalized with a diagnosis of hypercalcemia and active malignancy. Patients were retrospectively identified as treated in a manner aligned with the proposed protocol ("per protocol") or not treated according to the proposed protocol ("off protocol"), and the outcomes were compared...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29020057/high-dose-teriparatide-rpth1-34-therapy-increases-callus-volume-and-enhances-radiographic-healing-at-8-weeks-in-a-massive-canine-femoral-allograft-model
#2
Kohei Nishitani, Zachary Mietus, Christopher A Beck, Hiromu Ito, Shuichi Matsuda, Hani A Awad, Nicole Ehrhart, Edward M Schwarz
Small animal studies have demonstrated significant high-dose recombinant parathyroid hormone1-34 (rPTH1-34) effects on intercalary allograft healing. Towards a human adjuvant therapy to decrease non-unions, we evaluated rPTH1-34 safety and efficacy in a clinically relevant canine femoral allograft model. Adult female mongrel hounds (n = 20) received a 5cm mid-diaphyseal osteotomy reconstructed with a plated allograft, and were randomized to: 1) Placebo (n = 5; daily saline), 2) Continuous rPTH1-34 (n = 7; 5 μg/kg/day s...
2017: PloS One
https://www.readbyqxmd.com/read/28992983/primary-hyperparathyroidism
#3
REVIEW
Manuel Muñoz-Torres, Antonia García-Martín
Primary hyperparathyroidism (PHPT) is a common endocrinological process, characterized by chronic elevation of serum concentrations of calcium and parathyroid hormone (PTH). Many years ago, the most frequent forms of clinical presentation were symptomatic renal or skeletal disease with moderate or severe hypercalcemia; however, currently, most patients have few symptoms and mild hypercalcemia. A new form of presentation called normocalcemic PHPT has also been described but clinical consequences are not well established...
October 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28977163/use-of-cinacalcet-and-sunitinib-to-treat-hypercalcaemia-due-to-a-pancreatic-neuroendocrine-tumor
#4
Hernan Valdes-Socin, Matilde Rubio Almanza, Mariana Tomé Fernández-Ladreda, Daniel Van Daele, Marc Polus, Marcela Chavez, Albert Beckers
Neuroendocrine tumors (NETs) can secrete hormones, including ectopic secretions, but they have been rarely associated with malignant hypercalcemia. A 52-year-old man with a history of diabetes mellitus was diagnosed with a pancreatic tumor. A pancreatic biopsy confirmed a well-differentiated pancreatic NET (pNET). The patient subsequently developed liver metastasis and hypercalcemia with high 1,25 OH vitamin D and suppressed parathyroid hormone (PTH) levels. Hypercalcemia was refractory to chemotherapy, intravenous saline fluids, diuretics, calcitonin and zoledronate...
September 18, 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28945857/calcimimetic-use-in-familial-hypocalciuric-hypercalcemia-a-perspective-in-endocrinology
#5
Stephen J Marx
Introduction: Familial hypocalciuric hypercalcemia (FHH) causes lifelong hypercalcemia that even persists after subtotal parathyroidectomy. Symptoms are usually mild. Past recommendations have often been for monitoring and against surgical or pharmacologic treatments. Methods: Review of publications about FHH, calcium sensing receptors (CaSR)s, and calcimimetics. Results: FHH reflects hetrerozygous germline mutation of CASR, GNA11, or AP2S1...
September 18, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28941764/kdoqi-us-commentary-on-the-2017-kdigo-clinical-practice-guideline-update-for-the-diagnosis-evaluation-prevention-and%C3%A2-treatment-of-chronic-kidney-disease-mineral-and-bone%C3%A2-disorder-ckd-mbd
#6
Tamara Isakova, Thomas L Nickolas, Michelle Denburg, Sri Yarlagadda, Daniel E Weiner, Orlando M Gutiérrez, Vinod Bansal, Sylvia E Rosas, Sagar Nigwekar, Jerry Yee, Holly Kramer
Chronic kidney disease-mineral and bone disorder (CKD-MBD) encompasses laboratory and bone abnormalities and vascular calcification and has deleterious effects on clinical outcomes. KDOQI (Kidney Disease Outcomes Quality Initiative), an initiative of the National Kidney Foundation, addressed this issue with the publication of a clinical practice guideline for bone metabolism and disease in CKD in 2003, and 2 years later, a new definition and classification scheme for CKD-MBD was developed following a KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference...
September 20, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28919050/disease-and-treatment-factors-associated-with-lower-quality-of-life-scores-in-adults-with-multiple-endocrine-neoplasia-type-i
#7
Sneha Goswami, Benjamin J Peipert, Irene Helenowski, Susan E Yount, Cord Sturgeon
BACKGROUND: Physical and psychosocial morbidity of multiple endocrine neoplasia type-1 is ill-defined. How disease and treatment-related factors relate to patient-reported outcomes including health-related quality of life is unknown. We hypothesized that disease and treatment burden negatively impacts health-related quality of life in adults with multiple endocrine neoplasia type-1. METHODS: Adults (≥18 years) with multiple endocrine neoplasia type-1 completed an online survey of demographics, disease features, treatments, and Patient-Reported Outcomes Measurement Information System 29-item profile measure, and scores were compared with normative US data...
September 14, 2017: Surgery
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#8
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than 2 standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
September 15, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28913556/high-dose-vitamin-d3-supplementation-decreases-the-number-of-colonic-cd103-dendritic-cells-in-healthy-subjects
#9
Nina Friis Bak, M Bendix, S Hald, L Reinert, M K Magnusson, J Agnholt
PURPOSE: Vitamin D may induce tolerance in the intestinal immune system and has been shown to regulate the phenotype of tolerogenic intestinal dendritic cells (DCs) in vitro. It is unknown whether vitamin D supplementation affects human intestinal DCs in vivo, and we aimed to investigate the tolerability and effect on intestinal CD103(+)DCs of high-dose vitamin D3 treatment in healthy subjects. METHODS: Ten healthy subjects received a total of 480,000 IU oral vitamin D3 over 15 days and colonic biopsies were obtained before and after intervention by endoscopy...
September 14, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28894614/pancreatic-adenocarcinoma-producing-parathyroid-hormone-related-protein
#10
Reiko Yamada, Kyosuke Tanaka, Hiroyuki Inoue, Takashi Sakuno, Tetsuro Harada, Naohiko Yoshizawa, Hiroshi Miura, Toshihumi Takeuchi, Misaki Nakamura, Masaki Katsurahara, Yasuhiko Hamada, Noriyuki Horiki, Yoshiyuki Takei
A 48-year-old woman presented to our hospital with a 1-year history of a continuous high fever. She was diagnosed with metastatic pancreatic adenocarcinoma accompanied by leukocytosis without infection. Her serum concentration of granulocyte colony-stimulating factor was highly elevated. Forty-five days after initiating chemotherapy, she was readmitted because of a neuropsychiatric disturbance and hypercalcemia. Her serum concentration of parathyroid hormone-related protein (PTH-rP) was elevated. A pretreatment biopsy specimen showed strong cytoplasmic immunoreactivity to anti-PTH-rP antibody, suggesting that overproduction of PTH-rP accounted for the hypercalcemia...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28879535/hypercalcemia-a-consultant-s-approach
#11
Ari Auron, Uri S Alon
Due to their daily involvement in mineral metabolism, nephrologists are often asked to consult on children with hypercalcemia. This might become even more pertinent when the hypercalcemia is associated with acute kidney injury and/or hypercalciuria and renal calcifications. The best way to assess the severity of hypercalcemia is by measurement of plasma ionized calcium, and if not available by adjusting serum total calcium to albumin concentration. The differential diagnosis of the possible etiologies of the disturbance in the mineral homeostasis starts with the assessment of serum parathyroid hormone concentration, followed by that of vitamin D metabolites in search of both genetic and acquired etiologies...
September 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28861842/myeloma-and-bone-disease
#12
REVIEW
Cristina Panaroni, Andrew J Yee, Noopur S Raje
PURPOSE OF REVIEW: Bone disease is a defining characteristic of multiple myeloma (MM) and the major cause of morbidity. It manifests as lytic lesions or osteopenia and is often associated with severe pain, pathological fracture, spinal cord compression, vertebral collapse, and hypercalcemia. Here, we have reviewed recent data on understanding its biology and treatment. RECENT FINDINGS: The imbalance between bone regeneration and bone resorption underlies the pathogenesis of osteolytic bone disease...
August 31, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28841848/comparative-efficacy-and-safety-of-paricalcitol-versus-vitamin-d-receptor-activators-for-dialysis-patients-with-secondary-hyperparathyroidism-a-meta-analysis-of-randomized-controlled-trials
#13
Yifeng Xie, Peiling Su, Yifan Sun, Hongsheng Zhang, Rong Zhao, Liang Li, Lanfen Meng
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a severe complication for dialysis patients. Vitamin D receptor activators (VDRAs) are used to treat SHPT, but the comparative efficacy and safety between paricalcitol and other vitamin D receptor activators for management of SHPT in dialysis patients has been unproven. METHODS: We searched PubMed, Embase, and the Cochrane Library for the time period through June 2017 to identify randomized controlled trials that evaluated paricalcitol compared with other VDRAs for treatment of SHPT...
August 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28835974/-hypercalcemic-crisis-and-hypocalcemic-tetany
#14
REVIEW
C Kasperk
A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. The analysis of serum levels for calcium, phosphorous, intact parathyroid hormone, electrophoresis and renal function parameters indicate which further radiological, scintigraphic or serum diagnostic steps are adequate to identify the cause of the patient's acute situation (i...
August 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28833550/cinacalcet-rectifies-hypercalcemia-in-a-patient-with-familial-hypocalciuric-hypercalcemia-type-2-fhh2-caused-by-a-germline-loss-of-function-g%C3%AE-11-mutation
#15
Caroline M Gorvin, Fadil M Hannan, Treena Cranston, Helena Valta, Outi Makitie, Camilla Schalin-Jantti, Rajesh V Thakker
G-protein subunit α-11 (Gα11 ) couples the calcium-sensing receptor (CaSR) to phospholipase C (PLC)-mediated intracellular calcium (Ca(2+)i ) and mitogen-activated protein kinase (MAPK) signaling, which in the parathyroid glands and kidneys regulates parathyroid hormone release and urinary calcium excretion, respectively. Heterozygous germline loss-of-function Gα11 mutations cause familial hypocalciuric hypercalcemia type 2 (FHH2), for which effective therapies are currently not available. Here, we report a novel heterozygous Gα11 germline mutation, Phe220Ser, which was associated with hypercalcemia in a family with FHH2...
August 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28829925/aya-myeloma-real-world-single-center-experience-over-last-5-years
#16
Uday Yanamandra, Neha Saini, Pooja Chauhan, Tanya Sharma, Alka Khadwal, Gaurav Prakash, Neelam Varma, Deepesh Lad, Subhash Varma, Pankaj Malhotra
INTRODUCTION: Multiple myeloma (MM) is considered as a disease of the old with the reported median age of 60-70 years. The disease occurred a decade earlier in the Indian subcontinent. The literature on MM in adolescents and young adult (AYA) is limited. We studied the disease characteristics and outcomes of the AYA-MM in the real-world setting. PATIENTS AND METHODS: It is a retrospective single-center study conducted at a tertiary care center from North India. Records of all consecutive patients with AYA-MM (15-39 years of age) who were managed from January 1, 2010, to December 30, 2015, were reviewed...
August 22, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28808512/a-case-of-hypercalcemia-with-double-pathology
#17
Ahmed Abdalla, Ghassan Bachuwa, Samer Al Hadidi
Hypercalcemia has many causes including primary hyperparathyroidism, malignancy, and other rare etiologies. In most of the cases, hypercalcemia is secondary to one etiology. In this case, we are reporting hypercalcemia with two causes. The initial workup showed primary hyperparathyroidism due to parathyroid adenoma. But because all features were not fully explained by primary hyperparathyroidism, further work-up revealed multiple myeloma. This case represents coexistence of two different diseases, which was rarely reported in the literature previously...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28792693/serum-hepcidin-levels-in-multiple-myeloma
#18
Manolov Victor, Hadjiev Evgeniy, Tzvetkova Gergana, Petrova Julia, Vasilev Vasil, Marinov Borislav, Bogov Ivo, Gramatikova Zlatina, Tzatchev Kamen
BACKGROUND: Multiple myeloma (MM) is a malignant disease with a 10% frequency among all haematology neoplasms. It is characterized by clone proliferation of plasmatic cells in bone marrow, monoclonal gammopathy, and anemia, hypercalcemia, and kidney failure and bone lesions. IL-6 is an inflammatory cytokine, potential growth factor for myeloma cells, as elevated serum levels are connected with poor disease prognosis. IL-6 modulates many gene transcriptions, encoding synthesis of acute phase proteins, including C-reactive protein (CRP) and hepcidin...
July 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28768698/the-future-advances-in-therapeutic-approach-and-management-strategies-for-men1
#19
Rachel S van Leeuwaarde, Joanne M de Laat, Carolina R C Pieterman, Koen M A Dreijerink, Menno Vriens, Gerlof D Valk
Multiple endocrine neoplasia type 1 is a rare autosomal inherited disorder associated with a high risk for patients to simultaneously develop tumours of the parathyroid glands, duodeno-pancreatic neuroendocrine tumors and tumors of the anterior pituitary gland. Early identification of MEN1 in patients enables presymptomatic screening of manifestations which makes timely interventions possible with the intention to prevent morbidity and mortality. Causes of death nowadays have shifted towards local or metastatic progression of malignant neuro endocrine tumors...
August 2, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28748897/milk-alkali-syndrome-induced-by-h1n1-influenza-vaccine
#20
Abdullah K Al-Hwiesh, Ibrahiem Saeed Abdul-Rahman, Nadia Al-Oudah, Sana Al-Solami, Fahd A Al-Muhanna
Milk-Alkali syndrome (MAS) consists of a triad of hypercalcemia, metabolic alkalosis, and acute renal failure. We hereby report a 75-year-old Indian gentleman who presented to our emergency department with a history of generalized weakness and easy fatigability. Investigations were consistent with MAS secondary to calcium carbonate and calcitriol treatment to prevent osteoporosis, aggravated by H1N1 influenza vaccine. The patient was treated with hemodialysis and zoledronate. To our knowledge, this is the first reported case of such association in the literature...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
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