Successful treatment of tumor lysis syndrome associated with hepatic artery infusion chemotherapy in a patient with hepatocellular carcinoma: a case report.

Background: Tumor lysis syndrome is a life-threatening complication in the treatment of cancer. However, it rarely occurs in solid tumors, especially in hepatocellular carcinoma.

Case Presentation: We present a 52-year-old male Asian patient with advanced hepatocellular carcinoma treated with hepatic artery infusion chemotherapy that resulted in tumor lysis syndrome.

Plasmapheresis for extracorporeal membrane oxygenation (ECMO)-induced hemolysis in infants.

Background: Intravascular hemolysis is a known complication of extracorporeal membrane oxygenation (ECMO). Characterized by elevated plasma-free hemoglobin (PFH), intravascular hemolysis is associated with cytotoxic effects leading to renal replacement therapy (RRT), longer ECMO runs, and mortality. Therapeutic plasma exchange (TPE) in tandem with ECMO was described as a therapy for various pathologic conditions, but there are no Extracorporeal Life Support Organization (ELSO) guidelines for the treatment of ECMO-induced hemolysis.

Potential determinants and predictors of hypoparathyroidism after total thyroidectomy in pediatric patients.

Objective: Few studies have reported risk factors for post-thyroidectomy hypoparathyroidism (HPT) in children. We aimed to identify predicting factors for transient and permanent HPT after total thyroidectomy in pediatric patients.

Study Design: Retrospective review of medical charts.

Effectivity and safety profile of tenapanor, a sodium-hydrogen exchanger isoform 3 inhibitor, as an innovative treatment for hyperphosphatemia in chronic kidney disease: A systematic review of clinical studies.

Background: Chronic kidney disease (CKD) is a major global health problem. Hyperphosphatemia is frequent in CKD and a reason for increased morbidity and mortality as it generates hyperparathyroidism, high fibroblast growth factor 23 (FGF23), and hypocalcemia. Available hyperphosphatemia therapies still have limitations, including risk of metal overload, cardiovascular calcification, and systemic adverse effects (AEs).

An electrolyte disturbance masquerading as a panic attack.

Because proton pump inhibitors (PPIs) are so commonly used, their safety and potential adverse reactions often are not considered. This article describes a patient whose paresthesias and severe muscle cramps were attributed to panic attacks but actually were caused by hypocalcemia secondary to PPI-induced hypomagnesemia. This case serves as a reminder that PPIs should be used cautiously and appropriately with consideration for regular monitoring of electrolytes and vitamin B12.

Outcomes of Total Thyroidectomy in Large Goiters With Retrosternal Extension and Tracheal Compression: A Multivariate Analysis.

Introduction: Large retrosternal goiters often cause tracheal compression and deviation, leading to respiratory symptoms and complicating surgical treatment. Total thyroidectomy is the treatment of choice though it carries a risk of complications due to the altered anatomy and its proximity to vital structures. This study examines the outcomes of total thyroidectomy in patients with retrosternal goiters and assesses the impact of tracheal compression on clinical results.

Severe hypophosphataemia and hypocalcaemia following intravenous ferric derisomaltose and denosumab administration.

Serum calcium and phosphorus levels are tightly regulated by the calciotropic hormone parathyroid hormone, fibroblast growth factor 23 and 1,25(OH) vitamin D. Commonly prescribed therapies for iron-deficiency anaemia (IDA) such as ferric carboxymaltose and ferric derisomaltose (FDM) have been shown to disrupt phosphorus homeostasis, resulting in hypophosphataemia. Similarly, denosumab use can result in hypocalcaemia due to the inhibition of osteoclastic maturation, activity and survival.

Idiopathic hypoparathyroidism presenting as fatigue.

Fatigue is a common symptom encountered in clinical practice, often posing a diagnostic challenge due to its myriad underlying causes. A comprehensive clinical history can serve as a valuable guide in such diagnostic dilemmas. A man in his 30s presented with a history of intermittent fatigue.

Outcome Analysis of Parathyroid Gland Auto-transplantation in Pediatric Patients: A Retrospective Review.

Parathyroid gland (PG) auto-transplantation is performed to preserve the function of de-vascularized or unintentionally removed PGs, however, little has been published about the technique and outcomes in children. In our study, we aimed to present the results of PG auto-transplantation in children undergoing thyroidectomy or parathyroidectomy at a tertiary single institution. A retrospective review identified 14 patients (<18 years of age) who underwent PG auto-transplantation from January 2000 to December 2022.

ST-Segment Elevation: Hypocalcemia or Takotsubo Syndrome? A Diagnostic Dilemma.

A wide range of etiologies, both ischemic and nonischemic, can produce an electrocardiographic pattern of ST-segment elevation (STE), including Takotsubo syndrome (TTS) and electrolyte imbalances. Instances of hypocalcemia-induced TTS and STE are exceedingly rare in medical literature. This paper presents the case of a 75-year-old woman with advanced ovarian cancer and no prior heart issues, who exhibited diffuse STE on electrocardiogram, resembling acute coronary syndrome.

Comparative effectiveness totally endoscopic thyroidectomy via completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.

Objective: This study aims to evaluate the therapeutic effectiveness of totally endoscopic thyroidectomy via the completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.

Methods: A total of 60 patients with thyroid tumors who were admitted to Panyu College Affiliated Hospital from August 2022 to August 2023 were collected in this study. The patients were divided into two groups, the transoral endoscopic thyroidectomy group (20 cases) and the totally endoscopic thyroidectomy via the completely submental tri-hole approach group (40 cases).

Methylene Blue Spray as a Tool for Safe Thyroidectomy.

Background The complex surgical anatomy and intricate structural arrangement of the thyroid region pose significant challenges for surgeons in identifying the parathyroids and recurrent laryngeal nerve (RLN) during thyroid surgeries. Therefore, it is crucial to develop techniques that enhance the identification of these structures and reduce complications during thyroidectomies. Objective This study intends to assess the efficacy and diagnostic value of Methylene Blue dye and its usefulness in identifying, conserving and minimizing injury to parathyroid glands and recurrent laryngeal nerve during thyroidectomies.

Inferior-to-Superior Dissection for Recurrent Laryngeal Nerve Identification in Redo Thyroid Surgery: Enhanced Safety and Reduced Injuries.

Hoarseness due to recurrent laryngeal nerve (RLN) injury is the most feared complication of thyroid surgery. Scars and anatomical changes caused by previous surgeries make finding the RLN during redo thyroid surgeries difficult. We aimed to analyze the results of the inferior-to-superior dissection technique that we applied to find the RLN in redo surgeries.

Serum electrolytes in children with heart failure on diuretic therapy at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania: a cross-sectional study.

Introduction: diuretic therapy is among the cornerstones of the management of heart failure in children with acquired or congenital heart diseases (CHD). Electrolyte derangements have been reported by various studies to be among the most common side effects following diuretic therapy. Despite that, there is limited documentation on the magnitude of this problem in our setting.

The different serum albumin assays influence calcium status in haemodialysis patients: a comparative study against free calcium as a reference method.

Objectives: Accurate assessment of calcium levels is crucial for optimal management of regular Haemodialysis (HD) patients. Different calcium adjustment equations and albumin methods; including bromocresol purple (BCP) and bromocresol green (BCG) assays are employed by laboratories, which cause considerable discrepancies between reported results. The aim of this study is to assess the influence of albumin assays on calcium status in stable haemodialysis patients against free calcium (fCa) as a gold standard test.

Paediatric trauma and hypocalcaemia: a systematic review.

Background: Trauma is a leading cause of mortality and morbidity in children worldwide. While adult studies have demonstrated hypocalcaemia's association with adverse outcomes, its impact on paediatric trauma patients remains understudied. This systematic review aims to investigate current evidence into the prevalence, clinical implications and associations of hypocalcaemia in paediatric trauma.

Neurodevelopment of Critical ILL Neonates at the Age of 12 Months.

Critically ill neonates who survive are often left with dire consequences. Cerebral palsy, other neurological and motor deficiencies, intellectual disability, and various degrees of cognitive and behavioral deficiencies all result from neonatal critical diseases. We investigated psychomotor development in 20 children with hypoxic-ischemic encephalopathy (HIE), and as newborns often have multiple comorbidities, the following as well: HIE with respiratory distress syndrome (RDS), infections, hypo and hyperglycemia and hypocalcemia.

The Application of Regional Citrate Anticoagulation in Protein A Immunoadsorption: A Single-Center Retrospective Cohort Study.

Introduction: Protein A immunoadsorption (IA) is proving to be an effective treatment method for autoimmune diseases and other disorders. Regional citrate anticoagulation (RCA) prevents clotting in extracorporeal circuits without increasing hemorrhage risk in high bleeding risk patients, but there are no specific guidelines for its application in IA. We aimed to evaluate the safety and adverse effects of RCA used in IA therapy.

Denosumab-Induced Recurrent Severe Hypocalcaemia in a Patient With Chronic Kidney Disease: A Case Report.

Denosumab is a human monoclonal immunoglobulin G2 (IgG2) antibody that is used in the management of osteoporosis and various bone-related disorders to help strengthen bones and prevent fractures. Declining renal function and the drug denosumab are both associated with an increased risk of hypocalcaemia. The combination of both factors in a patient, along with the long half-life of the drug, can cause further exacerbation of this risk.

An activating CaSR variant with biased signaling reveals a critical residue for Gα11 coupling.

Autosomal dominant hypocalcemia (ADH) is due to enhanced calcium-dependent signaling caused by heterozygous gain-of-function (GOF) variants in the CASR gene (ADH1) or in the GNA11 gene, encoding Gα11 (ADH2). Both ADH1 and ADH2 are associated with hypocalcemia and normal or inappropriately low levels of circulating PTH. ADH1 patients typically manifest hypercalciuria, while ADH2 is associated with short stature in approximately 42% of cases.

Post-thyroidectomy hypoparathyroidism: A clinical surgical dilemma.

Thyroid dysfunction directly affects human health and overall well-being; various approaches are available for the treatment of thyroid diseases, including conservative measures and surgical interventions. Despite advancements in conservative treatment, surgery remains the preferred option. Hypoparathyroidism is the primary cause of hospitalization after thyroidectomy, leading to cost-related concerns and a detrimental impact on patients' overall quality of life.

In-hospital new-onset seizures in patients admitted to the medical intensive care unit: An observational study and algorithmic approach.

Background: Seizures are one of the most common neurological complications encountered in the intensive care unit (ICU). They can occur in the background of exacerbation of a known neurological disease or secondary to non-neurological conditions such as sepsis and metabolic disturbances. However, there is a paucity of literature on the incidence and pattern of new-onset seizures in ICUs.