scholarly journals Evaluation of Diagnostic Workup and Etiology of Hypercalcemia of Malignancy in a Cohort of 167,551 Patients over 20 Years

2021 ◽  
Author(s):  
Michael T Sheehan ◽  
Ya-Huei Li ◽  
Suhail A Doi ◽  
Adedayo A Onitilo
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Medical Records ◽  
Laboratory Data ◽  
Hypercalcemia Of Malignancy ◽  
Patients With Cancer ◽  
Initial Dataset ◽  
Osteolytic Metastases ◽  
The One ◽  
Over Time

Abstract Context Hypercalcemia of malignancy (HCM) has not been studied in a fashion to determine all possible mechanisms of hypercalcemia in any given patient. Objective The two objectives were to assess the completeness of evaluation and to determine the distribution of etiologies of HCM in a contemporary cohort of patients. Methods A retrospective analysis was performed of patients with cancer who developed hypercalcemia over 20 years at a single health system. Laboratory data were electronically captured from medical records to identify cases of parathyroid hormone (PTH)-independent hypercalcemia. The records were then manually reviewed to confirm the diagnosis of HCM, document the extent of evaluation, and determine underlying etiology(ies) of HCM in each patient. Results The initial dataset included 167,551 adult patients with malignancy, of which 11,589 developed hypercalcemia. Of these, only a quarter (25.4%) had assessment of PTH with a third of the latter (30.9%) indicating PTH-independent hypercalcemia. Of those with PTH-independent hypercalcemia, a third (31.6%) had assessment of PTH-related peptide (PTHrP) and/or 1,25-dihydroxy vitamin D (1,25-OH vitamin D) and constituted the one hundred and fifty three cases of HCM examined in this study. Eighty three of these patients had an incomplete evaluation of their HCM. The distribution of etiologies of HCM was therefore determined from the remaining 70 patients who had assessment of all three possible etiologies (PTHrP, 1,25-OH vitamin D and skeletal imaging) and was as follows: PTHrP 27%, osteolytic metastases 50% and 1,25-OH vitamin D 39%, with combinations of etiologies being common (approximately 20%). Conclusion HCM is incompletely evaluated in many patients. The distribution of etiologies of HCM in this report differs significantly from the previous literature warranting further study to determine if its causes have indeed changed over time.

Vitamin D, Parathyroid Hormone, and Acroosteolysis in Systemic Sclerosis

2008 ◽  
Vol 35 (11) ◽  
pp. 2201-2205 ◽  
Author(s):  
YOLANDA BRAUN-MOSCOVICI ◽  
DANIEL E. FURST ◽  
DORON MARKOVITS ◽  
ALEXANDER ROZIN ◽  
PHILIP J. CLEMENTS ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Systemic Sclerosis ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Medical Records ◽  
Disease Duration ◽  
Laboratory Evaluation ◽  
Vitamin D Levels ◽  
Calcium Phosphorus

ObjectiveSclerodactyly with acroosteolysis (AO) and calcinosis are prominent features of systemic sclerosis (SSc), but the pathogenesis of these findings is poorly understood. Vitamin D and parathyroid hormone (PTH) have a crucial role in bone metabolism and resorption and may affect AO and calcinosis. We assessed vitamin D and PTH in patients with SSc.MethodsMedical records of 134 consecutive patients with SSc (American College of Rheumatology criteria) followed at the rheumatology department during the years 2003–2006 were reviewed for clinical assessment, laboratory evaluation [including 25(OH) vitamin D, calcium, phosphorus, alkaline phosphatase, PTH, creatinine, and albumin]; imaging data confirming AO and/or calcinosis. Patients followed routinely at least once a year were included (81 patients). Of these, 60 patients’ medical records were found to have complete, relevant clinical, laboratory, and radiographic imaging.ResultsThirteen patients had diffuse disease and 47 limited disease — 51 women and 9 men, 44 Jews and 16 Arabs; mean age 55 ± 14 years; disease duration 8 ± 6 years. AO with or without calcinosis was observed in 42 patients (70%). Vitamin D deficiency was found in 46% of patients (16 out of 44 Jewish patients, 10 out of 16 Arab patients). PTH was elevated in 21.7% of patients. Significant correlations were observed between acroosteolysis and PTH (p = 0.015), calcinosis (p = 0.009), and disease duration (p = 0.008), and between PTH and vitamin D levels (p = 0.01). All patients had normal serum concentrations of calcium, phosphorus, magnesium, and albumin, and liver and kidney functions.ConclusionIn this group of Mediterranean patients with SSc, the incidence of vitamin D deficiency and secondary hyperparathyroidism was surprisingly high. This finding correlated with the occurrence of AO and calcinosis. Low levels of vitamin D may reflect silent malabsorption and might be a risk factor for secondary hyperparathyroidism and bone resorption. Traditional dress habits and low exposure to sun may contribute to vitamin D deficiency in an Arab population but do not explain all the findings. The pathogenesis of these findings needs to be corroborated in other SSc populations.

Parathyroid hormone-related protein, parathyroid hormone, and vitamin D in hypercalcemia of malignancy

2000 ◽  
Vol 290 (2) ◽  
pp. 189-197 ◽  
Author(s):  
J.L Motellón ◽  
F.Javier Jiménez ◽  
F de Miguel ◽  
M.J Jaras ◽  
A Dı́az ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Related Protein ◽  
Hypercalcemia Of Malignancy ◽  
Parathyroid Hormone Related Protein

scholarly journals Vitamin D Insufficiency Predicts Susceptibility of Parathyroid Hormone Reduction after Total Thyroidectomy in Thyroid Cancer Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yan Zhang ◽  
Weihui Zheng ◽  
Yuanyuan Huang ◽  
Chao Chen
Keyword(s):  
Vitamin D ◽  
Thyroid Cancer ◽  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Independent Predictor ◽  
Laboratory Data ◽  
Vitamin D Insufficiency ◽  
Reduction Ratio ◽  
Postoperative Hypoparathyroidism ◽  
Significant Difference

Objective. Given its role in the regulation of calcium and PTH levels, vitamin D was presumed as a potential predictor of postoperative hypoparathyroidism. However, the reports about their association were controversial. This study aims to reveal the relationship between preoperative vitamin D and postoperative parathyroid hormone (PTH). Methods. A total of 242 papillary thyroid cancer (PTC) patients who underwent total thyroidectomy (TT) during the period from June 2016 to December 2017 at our hospital were enrolled. Patients were divided into two groups, HypoP and Non-HypoP groups, based on postoperative PTH < 15.0 or ≥15.0 pg/mL, and ΔPTH50+ and ΔPTH50− groups, based on postoperative PTH reduction ratio ≥ 50% or <50%. Clinicopathological features and laboratory data were compared between two sets of groups. Results. Preoperative PTH level was lower in the HypoP group than in the Non-HypoP group (42.83 vs. 47.52 pg/mL, p = 0.018 ). No significant difference of vitamin D insufficiency was found between the HypoP and Non-HypoP groups (80.8% vs. 74.1%, p = 0.226 ). The rate of vitamin D insufficiency was higher in the ΔPTH50+ group than in the ΔPTH50− group (82.6% vs. 68.4%, p = 0.010 ). By multivariate logistic regression analysis, vitamin D insufficiency was an independent predictor of postoperative PTH reduction ratio ≥ 50% (OR = 2.2, p = 0.017 ). Conclusion. Vitamin D insufficiency is not associated with postoperative PTH in PTC patients undergoing TT. However, vitamin D insufficiency is an independent predictor of postoperative PTH reduction ratio.

Adaptation of vitamin D metabolism to calcium challenge: is it dependent on parathyroid hormone?

1989 ◽  
Vol 120 (3_Suppl) ◽  
pp. S122-S123
Author(s):  
S. H. SCHARLA ◽  
H. W. MINNE ◽  
U. G. LEMPERT ◽  
C. OSWALD ◽  
H. SCHMIDT-GAYK ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Metabolism

Vitamin D supplementation for 12 months in older people prevents bone loss and suppresses parathyroid hormone levels

2016 ◽  
Author(s):  
Terry J Aspray ◽  
Roger M Francis ◽  
Elaine McColl ◽  
Thomas Chadwick ◽  
Elaine Stamp ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Bone Loss ◽  
Older People ◽  
Vitamin D Supplementation ◽  
Hormone Levels

Correspondances étymologiques, lexicales et sémantiques dans le processus de féminisation de noms de profession, métiers et activités dans les sociétés française et roumaine

2020 ◽  
Vol 65 (4) ◽  
pp. 401-422
Author(s):  
Estelle Variot
Keyword(s):  
The Other ◽  
Roman World ◽  
Other Hand ◽  
The One ◽  
Over Time

"Etymological, Lexical and Semantic Correspondences in the Process of Feminization of Professional Names, Trades and Activities in French and Romanian Societies. The feminization of thought represented by language and of its varieties in the Roman World has allowed to highlight some convergences that come from a common linguistic heritage, often from Greek and Latin and some hesitation about adapting society to its realities. The feminization of some words which comes from an ancient process illustrates on the one hand the potential of the language and on the other hand some constraints sometimes linked to the society itself, which creates transitional periods, between matching grammatical correction and the evolution of linguistic uses over time. The possibilities of lexical enrichment (internal creation or loan) show the means available in French and Romanian and some convergences in the area of derivation, of lexical units and their etymologies. The grammatical perspective and word constructing methods make it possible to give keys for the feminization of names of trades or professions. Likewise, recording entries in the lexicon, their evolution, their assimilation or sometimes their forgetfulness, for the benefit of new constructions highlight the existence of objective and subjective criteria which teach us a lot about society as a whole. Keywords: feminization of professions, internal and external enrichment, suffixal match, use of words, grammar, lexicon, French and Romanian."

Land Warfare

2018 ◽  
Author(s):  
Christopher Tuck
Keyword(s):  
Armed Conflict ◽  
Modern System ◽  
The One ◽  
Over Time

This chapter charts the key developments in European land warfare since 1900. On the one hand, it is possible to identify overarching explanatory ideas, metanarratives, that can be used to identify continuities in development over time across Europe’s armies. These include the concept of ‘modern system’ land warfare and the ‘transformation paradigm’. However, as this chapter also shows, these two points of continuity do not mean either that European armies are homogenous, or that their conceptual assumptions are uncontested. European land warfare remains a heterogeneous phenomenon, shaped by the variety in national contexts and by contending debates on how appropriate Europe’s armies are to the actual challenges of contemporary and future armed conflict.

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