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Vitamins
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Administration of vitamin D in excess of daily requirements may cause clinical signs of acute or chronic overdosage (hypervitaminosis D syndrome), most of which are related to elevated calcium levels (Table 22.2)†. Concomitant high intake of calcium and phosphate may cause the development of similar abnormalities. Treatment of accidental overdose requires general supportive measures, whereas treatment of hypervitaminosis D with hypercalcemia consists of prompt withdrawal of vitamin D supplements, a low-calcium diet, laxatives, and attention to serum electrolyte imbalances and cardiac function. Major blood vessels, myocardium, and kidneys are at risk of developing ectopic calcification. Hypercalcemic crisis with dehydration, stupor, and coma requires more immediate attention, such as prompt hydration, diuretics, short-term hemodialysis, corticosteroids, and urine acidification.
Burns
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
By definition, heterotopic ossification (HO) is the formation of lamellar bone in soft tissues where it does not normally form. Myositis ossificans (MO) is HO in muscles and other soft tissues, and strictly it is a misnomer and should be termed fibrodysplasia ossificans progressiva (FOP). It can occur with or without previous injury. FOP is a rare AD disease that begins at age 5 on average. Non-hereditary MO is uncommon in children and occurs from direct muscle trauma with ossification confined to the muscle. Ectopic calcification is mineralisation but histologically is not bone.
Molecular Structure and Functions of Collagen
Published in Marcel E. Nimni, Collagen, 1988
Marcel E. Nimni, Robert D. Harkness
The administration of pharmacological doses of glucocorticoids to neonatal animals suppresses cartilage growth and bone formation, probably by inhibiting DNA synthesis.168 The marked reduction of thymidine incorporation observed in proliferating cartilage cells seems to be associated with a decline in protein and RNA synthesis and a receptor-mediated event. Developing long bones shows an initial retardation or inhibition of calcification, but this is followed by the appearance of more numerous and larger matrix vesicles which, in turn, seem to lead to enhanced calcification.168,169 These events may be relevant to the mode of induction of ectopic calcification processes that can lead to functional and structural abnormalities.
Optimal targets of chronic kidney disease-mineral and bone disorder markers for Chinese patients with maintenance peritoneal dialysis: a single-center retrospective cohort study
Published in Renal Failure, 2022
Xueqing Tang, Hua Zheng, Haiyun Wang, Peng Xia, Ying Wang, Xue Zhao, Zijuan Zhou, Ling Qiu, Xuemei Li, Limeng Chen
In the case of hypocalciumea, several speculations arise to explain its significant association with mortality in our study. Apart from arrhythmia, tumble, and fracture caused by hypocalcemia, patients with low serum calcium level usually had hyperphosphatemia which has been proved to be correlated with increased mortality. Doctors would prescribe more calcium supplements, vitamin D or its analog which in turn results in calcium overloading and leads to ectopic calcification. Therefore, hypocalcemia could also be an important risk factor for increased mortality. However, abnormal serum CorCa had no significant association with mortality in PD patients in Noordij et al. [31] and Stevens et al. [32]’s result. Liu’s study demonstrated serum CorCa level of ≥2.38 mmol/L was associated with increased mortality using the time-averaged value, while the average value of first-year serum CorCa level of 2.38–2.63 mmol/L was associated with increased mortality in Taiwan PD patients [11]. The differences among the optimal ranges of serum CorCa level found in different studies might be explained by different ethnics, regions, sunshine duration, and the heterogeneity of the different cutoff reference values used in each study. In the current literature, almost all studies used CorCa corrected by the serum albumin to predict the mortality instead of total serum Ca thus limited literature was available to compare with our results in total calcium.
Aortic valve stenosis: drivers of disease progression and drug targets for therapeutic opportunities
Published in Expert Opinion on Therapeutic Targets, 2022
Giuseppe Pinto, Gabriele Fragasso
Given the role of calcium deposition in degenerative AS pathogenesis, Fetuin-A, an inhibiting protein of ectopic calcification, has been studied in animal and human models [84,85]. As for other potential markers of AS progression, inconclusive results have arisen. In a retrospective study on 77 patients, lower plasma levels of Fetuin-A have determined a significantly higher increase of aortic valve calcification [86] while, in a prospective cohort of 296 patients from COFRASA – GENERAC study, serum Fetuin-A levels were neither associated with hemodynamic nor with anatomic AS progression [87]. Matrix γ-carboxyglutamate protein (MGP), another inhibitor of vascular calcification, has been evaluated in a sub-analysis of the ASTRONOMER trial with the hypothetical association with AS progression [88]. Increased circulating plasma levels of dephosphorylated MGP were associated to faster worsening of AS in younger patients [88].
Calciphylaxis in patient with peritoneal dialysis: A case report
Published in Cogent Medicine, 2020
Yunlei Deng, Ying Shu, Rong Gong
The treatment of calciphylaxis is comprehensive including wound management, elimination of underlying risk factors and pharmacotherapy. It is important that treatment schema should be in a multidisciplinary manner (Celik et al., 2016; Nigwekar et al., 2018). Under the MDT, we dealt with the wound, and enhanced the management of calcium-phosphorus-iPTH and infection. The combination of MDT and low dose STS was effective to alleviate the ectopic calcification and relief the pain. Here, cinacalcet was effective to shrink the proliferated parathyroid, but it failed to control the level of iPTH. Combined PD and HD has gained popularity in some Asian countries, especially in Japan, where about 20% of all patient received the module (Maruyama & Yokoyama, 2016; Nakai et al., 2014). Compared with PD alone, PD+HD could improve inadequate dialysis and fluid overload, and has the potential effects on improving quality of life and correction of peritoneal deterioration (Maruyama & Yokoyama, 2016). Because the patient refused to treatment with hemodialysis alone, we chose PD+HD for him.