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Hypercalcaemia approach

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https://www.readbyqxmd.com/read/27896639/seom-clinical-guideline-for-bone-metastases-from-solid-tumours-2016
#1
C Grávalos, C Rodríguez, A Sabino, M Á Seguí, J A Virizuela, A Carmona, J Cassinello, D Isla, C Jara, M Martín
Bone metastases are common in many advanced solid tumours, being breast, prostate, thyroid, lung, and renal cancer the most prevalent. Bone metastases can produce skeletal-related events (SREs), defined as pathological fracture, spinal cord compression, need of bone irradiation or need of bone surgery, and hypercalcaemia. Patients with bone metastases experience pain, functional impairment and have a negative impact on their quality of life. Several imaging techniques are available for diagnosis of this disease...
December 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27670154/vitamin-d-in-newborns-a-randomised-controlled-trial-comparing-daily-and-single-oral-bolus-vitamin-d-in-infants
#2
Julie Huynh, Thao Lu, Danny Liew, James Cg Doery, Ronald Tudball, Madeleine Jona, Roisin Bhamjee, Christine P Rodda
AIM: There are no published data to demonstrate the efficacy of bolus dose vitamin D in newborn infants. The study sought to evaluate this alternative approach of supplementation. METHODS: This single centre, open randomised controlled trial was conducted from August 2013 to May 2014. It compared the efficacy and safety of daily (400 IU) versus a bolus dose (50 000 IU) of cholecalciferol in newborn infants of vitamin D deficient mothers. The primary outcome measure was the rate of 25 hydroxyvitamin D (25OHD) repletion-defined as 25OHD greater than 50 nmol/L...
September 27, 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27278807/outcome-in-dogs-with-advanced-stage-3b-anal-sac-gland-carcinoma-treated-with-surgery-or-hypofractionated-radiation-therapy
#3
V Meier, G Polton, S Cancedda, M Roos, P Laganga, T Emmerson, C Rohrer Bley
Stage 3b anal sac gland carcinoma (ASGC) can be life-threatening. A surgical approach is not always possible or may be declined. Dogs with stage 3b ASGC treated with surgery or conformal radiation therapy (RT) with 8 × 3.8 Gy (total dose 30.4 Gy, over 2.5 weeks) were retrospectively evaluated. Patient characteristics, median progression-free interval (PFI) and median survival time (MST) were compared. Twenty-eight dogs were included; 15 underwent surgery, 13 underwent RT. At the time of presentation, 21% showed life-threatening obstipation and 25% showed hypercalcaemia...
June 9, 2016: Veterinary and Comparative Oncology
https://www.readbyqxmd.com/read/27143041/hypercalcaemia-in-cats-the-complexities-of-calcium-regulation-and-associated-clinical-challenges
#4
REVIEW
Natalie C Finch
PRACTICAL RELEVANCE: Calcium is essential for many normal physiological processes within the body. Aberrations in calcium homeostasis leading to hypercalcaemia can result in clinical signs such as polyuriav and polydipsia, lethargy and weakness due to depressed excitability of muscle and nervous tissue, and gastrointestinal (GI) signs due to effects on GI smooth muscle. Hypercalcaemia in cats is mostly idiopathic, with chronic kidney disease and neoplasia also being common causes. CLINICAL CHALLENGES: Hypercalcaemia can be a diagnostic challenge and a good understanding of the regulation of calcium homeostasis can aid in interpreting results of diagnostic tests...
May 2016: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/26939669/elevated-pth-with-normal-serum-calcium-level-a-structured-approach
#5
Rachel K Crowley, Neil J Gittoes
Normocalcaemic hyperparathyroidism is a common biochemical finding, usually identified during an assessment of bone or renal health. Hypercalcaemia must be considered by calculation of adjusted calcium, and a careful history taken to assess dietary calcium intake and for the possibility of a malabsorption syndrome. 25-hydroxyvitamin D (25OHD) should be measured and replaced if indicated. The management plan for the patient is influenced by the context in which calcium and PTH were measured. In this brief review we describe the assessment of a patient with normocalcaemic hyperparathyroidism...
June 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/26791116/genital-vasculitis-secondary-to-all-trans-retinoic-acid
#6
Uday Yanamandra, Alka Khadwal, Uma Nahar Saikia, Pankaj Malhotra
Acute promyelocytic leukaemia is among the most curable haematological malignancies after the introduction of differentiating agents (arsenic trioxide (ATO) and all-trans-retinoic-acid (ATRA)). Despite excellent cure rates, approaching 85-95% in various series, APL is associated with significant early mortality and morbidity. ATRA-related side effects partly contribute to this morbidity, which commonly presents as differentiation syndrome, pseudo tumour cerebri, dermatitis, gastrointestinal disorders, liver dysfunction (raised transaminases) and dryness of skin/eyes...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26646659/retrospective-evaluation-of-the-pre-and-postoperative-factors-influencing-the-sensitivity-of-localization-studies-in-primary-hyperparathyroidism
#7
Fabio Medas, Enrico Erdas, Alessandro Longheu, Luca Gordini, Giuseppe Pisano, Angelo Nicolosi, Pietro Giorgio Calò
INTRODUCTION: Over the last decades, mini-invasive surgery has become increasingly common for treatment of primary hyperparathyroidism; such approach requires preoperative localization of a suspected parathyroid adenoma. Neck ultrasound (US) and technetium-99 m sestamibi (MIBI) scan are the main imaging studies used for this purpose. The aim of the present study is to evaluate what pre- and post-operative factors may alter the reliability of localization studies. METHODS: A retrospective analysis on 212 patients with preoperative diagnosis of primary hyperparathyroidism was conducted...
January 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/26450137/hereditary-hyperparathyroidism-a-consensus-report-of-the-european-society-of-endocrine-surgeons-eses
#8
Maurizio Iacobone, Bruno Carnaille, F Fausto Palazzo, Menno Vriens
BACKGROUND: Hereditary hyperparathyroidism has been reported to occur in 5-10 % of cases of primary hyperparathyroidism in the context of multiple endocrine neoplasia (MEN) types 1, 2A and 4; hyperparathyroidism-jaw tumour (HPT-JT); familial isolated hyperparathyroidism (FIHPT); familial hypocalciuric hypercalcaemia (FHH); neonatal severe hyperparathyroidism (NSHPT) and autosomal dominant moderate hyperparathyroidism (ADMH). This paper aims to review the controversies in the main genetic, clinical and pathological features and surgical management of hereditary hyperparathyroidism...
December 2015: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/26290127/calciphylaxis-with-evidence-of-hypercoagulability-successfully-treated-with-unfractionated-heparin-a-multidisciplinary-approach
#9
A Carter, A G Ortega-Loayza, J Barrett, J Nunley
Calciphylaxis is characterized by abnormal calcification of vessels and skin; however, its aetiology and pathogenesis remain unclear. Entities frequently associated with calciphylaxis are end-stage renal disease, diabetes mellitus, hypercalcaemia, hyperphosphataemia, elevated calcium-phosphate product, hyperparathyroidism and possible hypercoagulable states. Skin lesions may remain quiescent or may develop suddenly and progress rapidly. They are more common on the legs. Treatment of calciphylaxis is very challenging and requires interdisciplinary management...
April 2016: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/26263956/radiological-considerations-and-surgical-planning-in-the-treatment-of-giant-parathyroid-adenomas
#10
G Garas, M Poulasouchidou, A Dimoulas, P Hytiroglou, M Kita, E Zacharakis
Giant parathyroid adenomas constitute a rare clinical entity, particularly in the developed world. We report the case of a 53-year-old woman where the initial ultrasonography significantly underestimated the size of the lesion. The subsequent size and weight of the adenoma (7 cm diameter, 27 g) combined with the severity of the hypercalcaemia raised the suspicion for the presence of a parathyroid carcinoma. This was later disproven by the surgical and histological findings. Giant parathyroid adenomas are encountered infrequently among patients with primary hyperparathyroidism, and appear to have distinct clinical and biochemical features related to specific genomic alterations...
May 2015: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/26230154/small-cell-carcinoma-of-the-ovary-hypercalcemic-type-report-of-a-bilateral-case-in-a-teenager-associated-with-smarca4-germline-mutation
#11
Pierre-Marie Lavrut, François Le Loarer, Charline Normand, Céline Grosos, Rémi Dubois, Annie Buenerd, Cécile Conter, Frédérique Dijoud, Jean-Yves Blay, Sophie Collardeau-Frachon
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a highly aggressive neoplasm that typically occurs in young females. Paraneoplastic hypercalcemia is associated in two thirds of the cases. Recent studies demonstrated that this rare tumor harbors the same molecular features of malignant rhabdoid tumor secondary to SMARCA4/BRG1 mutations. We illustrate herein a typical bilateral case of SCCOHT with comprehensive molecular characterization in a 14-year-old girl. We also discuss the value of SMARCA4 immunostaining in the diagnostic approach of undifferentiated ovarian and pelvic malignancies...
January 2016: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/26138838/approach-to-the-child-with-hypercalcaemia
#12
REVIEW
Justin H Davies
Hypercalcaemia is rare in children. In adulthood, the causes are most frequently malignancy and primary hyperparathyroidism. In children, however, the aetiologies are diverse and age specific, and many have an underlying genetic basis. Hypercalcaemia is a serious condition that frequently leads to end-organ damage. In order to provide the most appropriate treatment, a key part of the management pathway is to establish the correct diagnosis promptly. When considering a practical approach to hypercalcaemia in children, it is helpful to consider the causes of hypercalcaemia according to the accompanying levels of parathyroid hormone (PTH), indicating whether the causes are PTH dependent or PTH independent...
2015: Endocrine Development
https://www.readbyqxmd.com/read/25949433/hyperparathyroidism-with-hypercalcaemia-in-chronic-kidney-disease-primary-or-tertiary
#13
Mitchell R Lunn, Jair Muñoz Mendoza, Lezlee J Pasche, Jeffrey A Norton, Alexander L Ayco, Glenn M Chertow
Objective . This study aims to highlight the challenges in the diagnosis of hyperparathyroidism (HPT) in patients with advanced chronic kidney disease (CKD). Methods . In this report, we describe a middle-aged Filipino gentleman with underlying CKD who presented with intractable nausea, vomiting, severe and medically refractory hypercalcaemia and parathyroid hormone (PTH) concentrations in excess of 2400 pg/mL. The underlying pathophysiology as well as the aetiologies and current relevant literature are discussed...
August 2010: NDT Plus
https://www.readbyqxmd.com/read/25931046/-primary-hyperparathyroidism-due-to-parathyroid-cancer-a-diagnostic-and-management-challenge
#14
Anna Dąbrowska, Jerzy Tarach, Agnieszka Zwolak
Parathyroid carcinoma (PC) is a rare endocrine malignancy and the cause of primary hyperparathyroidism. It is usually associated with a high rate of local and distant recurrence. Laboratory findings and clinical symptoms may be similar to those in parathyroid adenoma. The histological features of PC may also be non-specific and the affected gland is often indistinguishable from a benign lesion. The proper diagnosis is commonly made months to years later when the disease recurs or metastases are present. Therefore, parathyroid carcinoma still remains a diagnostic and management challenge for many physicians...
2015: Endokrynologia Polska
https://www.readbyqxmd.com/read/25882891/asymptomatic-and-mild-primary-hyperparathyroidism
#15
REVIEW
David P Macfarlane, Ning Yu, Graham P Leese
Primary hyperparathyroidism is common, with epidemiological studies suggesting it may effect up to 1% of the population, and up to 3% of post-menopausal females. Many cases are diagnosed incidentally on routine blood sampling, with the majority of patients being seemingly asymptomatic at diagnosis, and often having mild hypercalcaemia of <2.85mmol/L. Individuals with this so-called mild or asymptomatic primary hyperparathyroidism may however have undiagnosed complications, along with subtle neuropsychological symptoms, and possibly increased cardiovascular risk...
May 2015: Annales D'endocrinologie
https://www.readbyqxmd.com/read/25296608/case-report-of-multimodality-treatment-for-metastatic-parathyroid-hormone-related-peptide-secreting-pancreatic-neuroendocrine-tumour
#16
Roberta Elisa Rossi, Keval Naik, Shaunak Navalkissoor, Charles Imber, James O'Beirne, Christos Toumpanakis, Martyn Evan Caplin
AIMS AND BACKGROUND: Hypercalcaemia due to metastatic parathyroid hormone-related peptide-secreting pancreatic neuroendocrine tumour is challenging to manage and requires a multimodality approach. METHODS: We present a case of a woman undergoing liver transplantation for metastatic parathyroid hormone-related peptide-secreting pancreatic neuroendocrine tumour. RESULTS: A young woman with a history of parathyroid hormone-related peptide-secreting pancreatic neuroendocrine tumour (Ki-67 5%) removed in 1998 developed bilobar liver metastases in 2004 and underwent repeated transarterial embolisations of liver tumour and therapy with somatostatin analogue...
July 2014: Tumori
https://www.readbyqxmd.com/read/25207208/-parathyroidectomy-in-pregnancy-a-single-centre-experience-with-review-of-evidence-and-proposal-for-treatment-algorithim
#17
Abigail Walker, Jaime Jimeno Fraile, Johnathan G Hubbard
BACKGROUND: As many as 25% of women with primary hyperparathyroidism (PHPT) present during their child bearing years. However there is a paucity of data about management of PHPT in pregnancy, despite its association with severe complications including foetal loss. A recent review called for early surgical intervention to optimise maternal and foetal outcomes. We present our experience of parathyroidectomy in five pregnant patients, representing the largest series reported to date, alongside a review of literature to formulate a best evidence approach to management...
August 2014: Gland Surgery
https://www.readbyqxmd.com/read/25165186/genetics-of-calcium-homeostasis-in-humans-continuum-between-monogenic-diseases-and-continuous-phenotypes
#18
Olivier Bonny, Murielle Bochud
Extracellular calcium participates in several key physiological functions, such as control of blood coagulation, bone calcification or muscle contraction. Calcium homeostasis in humans is regulated in part by genetic factors, as illustrated by rare monogenic diseases characterized by hypo or hypercalcaemia. Both serum calcium and urinary calcium excretion are heritable continuous traits in humans. Serum calcium levels are tightly regulated by two main hormonal systems, i.e. parathyroid hormone and vitamin D, which are themselves also influenced by genetic factors...
September 2014: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/25097236/bones-stones-moans-and-groans-hypercalcaemia-revisited
#19
Ben C Reynolds, Tim D Cheetham
Disorders of calcium homeostasis are uncommon but important because of the broad spectrum of potential underlying causes that lie on a spectrum from the benign to the life-threatening. Paediatricians may find them challenging because they do not arise often enough for the investigative approach to be second nature. We report a 4-year-old with acute onset profound hypercalcaemia. We focus on an approach to the clinical problem that is based on the potential organ systems affected, namely the gut, bone and kidney...
February 2015: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/24992407/day-case-minimally-invasive-excision-of-a-giant-mediastinal-parathyroid-adenoma
#20
A Haldar, A Thapar, S Khan, S Jenkins
Inferior parathyroid adenomas in the mediastinum can be a troublesome cause for hypercalcaemia, requiring a full collar incision or, occasionally, a sternotomy. We report a case of a giant parathyroid adenoma in a 61-year-old woman on warfarin, which we excised via a minimally invasive transcervical approach after radiological localisation. The procedure was performed as a day case and, at six weeks, the patient had recovered fully with biochemical resolution of hypercalcaemia. This case demonstrates that focused transcervical excision of giant parathyroid adenomas is a viable option and should be considered prior to neck exploration or sternotomy...
July 2014: Annals of the Royal College of Surgeons of England
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