What Causes Hypercalcemia?
Discussion Calcium homeostasis is regulated by mechanisms involving the absorption from the gastrointestinal tract, bone deposition and resorption, and renal excretion. To review Vitamin D homeostasis click here. Serum calcium is found in three forms: free (47%), protein bound (43%) and diffusable calcium complexes (10%). The protein binding proteins are albumin (80%) and globulin (20%). The free calcium is the most important biologically. Acidosis also increases free calcium and alkalosis decreases free calcium. Problems associated with hypercalcemia include nausea, emesis, abdominal pain, constipation, polyuria, dehydration, mental status changes and coma. Learning Point The differential diagnosis of hypercalcemia includes: Hyperparathyroidism Primary Familial isolated Familial hypercalciuria hypercalcemia MEN I and II Vitamin D excess Chronic granulomatous disorders Drugs Catecholamines Lithium Teriparatide Theophylline Thiazides Vitamin A excess Malignancies Ectopic PTH-producing tumors Pheochromocytoma Other Acromegaly Aluminum excess Adrenal insufficiency Hypophosphatemia Hyperthyroidism Immobilization Idiopathic infantile hypercalcemia Milk alkali syndrome Parenteral nutrition Renal failure Williams syndrome Questions for Further Discussion 1. What are treatments for hypercalcemia? 2. What is included in the differential diagnosis of hypocalcemia? Related Cases Disease: Calcium | Fluid and Electrolyte Balance Symptom/Presentation: Abnormal Laboratory Test S...
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In one night, the Savage family lost two sons to opioid overdoses. Now they are working to prevent other families from experiencing the same pain.
Plunge into water at near-freezing temperatures, and your body goes into extreme distress. Your skin screams signals of pain. You can't breathe, because your chest is cramping up. Talking is nearly impossible. Your heart is pounding. Fear mounts -- as it should. Without any protection, you may lose consciousness in under 15 minutes. You'll be dead within an hour.
Conclusion: Our case report underlines the importance of active endoscopic surveillance of the remaining colon and rectum in patients with diverting stomas and inflammatory bowel disease in order to detect stenosis. If endoscopic control is not possible due to obliteration, surgical therapy must be discussed due to the risk of developing cancer.Case Rep Gastroenterol 2018;12:143 –146
CONCLUSIONS: Elevation of TNFα level might be a predictor of OA progression after hip arthroscopy. PMID: 29665766 [PubMed - in process]
CONCLUSION: Our results show unsatisfactory improvement in patients with irreparable RCT treated with the sub-acromial balloon spacer. Careful patient selection with attention to preoperative ROM should be considered. LEVEL OF EVIDENCE: Therapeutic level IV. PMID: 29665765 [PubMed - in process]
Conclusions: This study is the first nationwide study presenting an increase in incidence of EP-NEC patients from 196 to 260 cases annually in the Netherlands. We found the best 5 year relative survival to be for EP-NEC patients with local disease located in the bladder, where the worst 5 year relative survival was found in the oesophagus.
DEMENTIA can be a stressful and costly process for all those involved, so it is important to know what type of dementia is affecting the person with the condition. Dementia with Lewy Bodies is one of them.
Karine A. Al Feghali, Rami A. Ballout, Assem M. Khamis, Elie A. Akl, Fady B. Geara
Mayra A. Carrillo, Anjie Zhen, Scott G. Kitchen
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