Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.569
Filtrar
1.
PLoS One ; 14(10): e0223868, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603922

RESUMO

Hypomagnesaemic tetany (HypoMgT) in ruminants is a physiological disorder caused by inadequate intake or impaired absorption of magnesium (Mg) in the gut. If it is not detected and treated in time, HypoMgT can cause the death of the affected animal. A semi-structured questionnaire survey was conducted from July 2016-2017 to assess farmers' awareness of HypoMgT in cattle and sheep in the UK. The questionnaire was distributed to farmers at farm business events and agricultural shows, and through a collaborative group of independent veterinary practices to their clients. Farmers were asked about (i) the incidence of presumed HypoMgT (PHT); (ii) their strategies to treat or prevent HypoMgT; (iii) mineral tests on animals, forage and soil, and (iv) farm enterprise type. A total of 285 responses were received from 82 cattle, 157 mixed cattle and sheep, and 46 sheep farmers, of whom 39% reported HypoMgT in their livestock, affecting 1-30 animals. Treatment and/or prevention against HypoMgT was reported by 96% respondents with PHT and 79% of those without. Mineral tests on animal, forage, and soil was conducted by 24%, 53%, and 66% of the respondents, respectively, regardless of PHT. There was a highly significant association between the use of interventions to tackle HypoMgT and the incidence of PHT (p < 0.01). The top three treatment/prevention strategies used were reported as being free access supplementation (149), in feed supplementation (59) and direct to animal treatments (drenches, boluses and injections) (45) although these did vary by farm type. Although some (9) reported using Mg-lime, no other pasture management interventions were reported (e.g., Mg-fertilisation or sward composition). Generally, the results indicate that UK farmers are aware of the risks of HypoMgT. A more integrated soil-forage-animal assessment may improve the effectiveness of tackling HypoMgT and help highlight the root causes of the problem.


Assuntos
Doenças dos Bovinos/epidemiologia , Fazendeiros/psicologia , Deficiência de Magnésio/veterinária , Doenças dos Ovinos/epidemiologia , Tetania/veterinária , Animais , Bovinos , Doenças dos Bovinos/terapia , Indústria de Laticínios , Fazendas , Conhecimentos, Atitudes e Prática em Saúde , Incidência , Deficiência de Magnésio/complicações , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/terapia , Ovinos , Doenças dos Ovinos/terapia , Inquéritos e Questionários , Tetania/induzido quimicamente , Tetania/epidemiologia , Tetania/terapia , Reino Unido/epidemiologia
2.
J Assoc Physicians India ; 67(8): 79-82, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31562727

RESUMO

Gross electrolytes disturbances including hypokalemia, hypomagnesaemia, and hypocalcaemia have been reported in tuberculosis patients who have been treated with capreomycin.1-3 Capreomycin is recommended in the treatment of M. tuberculosis isolates resistant to kanamycin at baseline in multi drug resistant tuberculosis patients (MDR - TB) and treatment of extensively drug resistant tuberculosis (XDR-TB) under programmatic management of drug resistant tuberculosis (PMDT) in India.4 We report a case of tetany in a extensively drug resistant tuberculosis (XDR-TB) patient treated with capreomycin. She developed hypokalemia after 7 weeks of administration of injection capreomycin intramuscularly daily in dose of 750 mg. Hypokalemia was refractory to intravenous potassium replacement therapy. At 12 weeks during the treatment she developed tetany and hypocalcaemia. Hypomagnesaemia was also associated with hypocalcaemia and hypokalemia. Normal level of serum potassium and calcium were achieved with correction of hypomagnesaemia.


Assuntos
Antibióticos Antituberculose/uso terapêutico , Capreomicina/uso terapêutico , Tuberculose Extensivamente Resistente a Medicamentos , Mycobacterium tuberculosis , Tetania/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos , Antituberculosos , Feminino , Humanos , Índia , Testes de Sensibilidade Microbiana
3.
J Pediatr ; 211: 98-104.e4, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30954245

RESUMO

OBJECTIVES: To determine the incidence of potentially life-threatening complications of hypocalcemia in infants and children in Olmsted County, Minnesota; and to determine if vitamin D deficiency contributed to these events and was, at the time of clinical presentation, considered as a possible cause. STUDY DESIGN: In this population-based descriptive study, data were abstracted from the Rochester Epidemiology Project, a medical record linkage system covering 95% of patients in Olmsted County, Minnesota. Participants were children aged 0-5 years who resided in Olmsted County between January 1, 1996 and June 30, 2017, and who received diagnoses of seizures, cardiomyopathy, cardiac arrest, respiratory arrest, laryngospasm, and/or tetany. The incidence of hypocalcemia plus a potentially life-threatening complication was calculated. RESULTS: Among 15 419 patients aged 0-5 years in Olmsted County during the study period, 1305 had eligible complications: 460 had serum calcium checked within 14 days of presentation and 85 had hypocalcemia. Patients were excluded when causes other than hypocalcemia likely triggered the complication, leaving 16 children whose complication was attributed to hypocalcemia. Three of these 16 patients had a serum 25-hydroxyvitamin D measurement and 2 were deficient (≤6 ng/mL [15 nmol/L]). Among children aged 0-5 years, the incidence of hypocalcemia plus a potentially life-threatening complication was 6.1 per 100 000 person-years (95% CI, 3.5-10.0). CONCLUSIONS: Vitamin D deficiency is an underinvestigated cause of complications of hypocalcemia in children. Serum calcium and 25-hydroxyvitamin D should be measured in children with these complications to identify possibly life-threatening vitamin D deficiency.


Assuntos
Hipocalcemia/complicações , Deficiência de Vitamina D/complicações , Cálcio/sangue , Cardiomiopatias/complicações , Cardiomiopatias/epidemiologia , Pré-Escolar , Coleta de Dados , Registros Eletrônicos de Saúde , Feminino , Parada Cardíaca/complicações , Parada Cardíaca/epidemiologia , Humanos , Hipocalcemia/epidemiologia , Incidência , Lactente , Recém-Nascido , Laringismo/complicações , Laringismo/epidemiologia , Masculino , Minnesota , Insuficiência Respiratória/complicações , Insuficiência Respiratória/epidemiologia , Convulsões/complicações , Convulsões/epidemiologia , Tetania/complicações , Tetania/epidemiologia , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia
4.
Rev Fac Cien Med Univ Nac Cordoba ; 76(1): 56-58, 2019 02 27.
Artigo em Espanhol | MEDLINE | ID: mdl-30882343

RESUMO

Introduction: celiac disease is an autoimmune disease with symptoms involving multiple organs. The forms of presentation vary considerably, which makes it difficult to diagnose. The objective is to present an atypical case of celiac disease. Methodology: descriptive, retrospective, cross-sectional study of a case of an adult woman who presented with tetany Results: investigating the case, the diagnosis of tetany was reached secondary to an intestinal malabsorption Conclusion: celiac disease can occur atypically as a tetany


Assuntos
Doença Celíaca/complicações , Tetania/etiologia , Adulto , Doença Celíaca/diagnóstico , Doença Celíaca/patologia , Estudos Transversais , Feminino , Humanos , Mucosa Intestinal/patologia , Intestino Delgado/patologia , Estudos Retrospectivos , Tetania/diagnóstico , Tetania/patologia
5.
Nurs Crit Care ; 24(6): 349-354, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-28677878

RESUMO

Presentations to the emergency department with a diagnosis of hypocalcaemia-induced tetany secondary to total thyroidectomy are rare. A patient presented to the emergency department of a regional Australian hospital with hypocalcaemia-induced tetany. A case study was employed to reflect on the care provided and identify knowledge practice deficits within this unusual patient presentation. Calcium plays a central role within the nervous system and is vital for both cardiac and muscular contraction. The clinical manifestations of electrolyte disturbances such as hypocalcaemia can be life threatening, and therefore, appropriate assessment, monitoring and management are essential to ensure positive patient outcomes. Understanding the importance of calcium imbalance for the emergency and critical care nurse is paramount in preventing complications associated with cardiac conduction and muscle tone, especially the potential for airway compromise. Education is central to this and may include clinical case reviews, the application of pathophysiological presentations of electrolyte imbalance and a review of electrolyte administration guidelines. Understanding the role of calcium within the body will assist emergency and critical care nurses to assess, monitor and intervene appropriately, thereby preventing the life-threatening manifestations of hypocalcaemia.


Assuntos
Cálcio/sangue , Enfermagem de Cuidados Críticos , Complicações Pós-Operatórias , Tetania/diagnóstico , Tireoidectomia , Administração Intravenosa , Austrália , Gluconato de Cálcio/administração & dosagem , Serviço Hospitalar de Emergência , Feminino , Humanos , Pessoa de Meia-Idade
6.
Reumatismo ; 70(4): 251-256, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30570243

RESUMO

This paper is aimed at investigating whether peripheral dysfunction at the neuromuscular level may represent a pain generator in fibromyalgia. We studied the prevalence of spasmophilia (SP), carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE) in a group of 40 subjects suffering from fibromyalgia. Clinical and electrophysiological data were obtained to ascertain whether comorbid conditions were present. For subjective evaluation of symptoms severity, validated questionnaires for CTS and UNE were completed by patients. Twenty subjects were positive for SP (50%); CTS was diagnosed in 12 subjects (30%); no patient suffered from UNE; 6 subjects were affected at the same time by SP and CTS (15%); 14 subjects (35%) were affected by SP alone. The prevalence of CTS and SP was higher in fibromyalgia subjects than in the general population. The scores of the questionnaires related to CTS were significantly higher in fibromyalgia subjects positive for CTS, with respect to the other subjects. In fibromyalgia, CTS and SP may be considered clinical entities in themselves, the importance of which lies in their acting as peripheral pain generators that enhance or initiate central sensitization, thereby contributing to chronic widespread pain. The amplification of pain is indeed a correctable/misguided message that occurs inside the brain of fibromyalgia subjects and identification and local treatment of pain generators would lessen the total pain burden. The magnitude of the overlap in symptoms between fibromyalgia and CTS/SP necessitates careful investigation of these conditions.


Assuntos
Síndrome do Túnel Carpal/complicações , Fibromialgia/complicações , Dor/etiologia , Tetania/complicações , Neuropatias Ulnares/complicações , Síndrome do Túnel Carpal/epidemiologia , Comorbidade , Cotovelo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Neuropatias Ulnares/epidemiologia
7.
BMC Res Notes ; 11(1): 588, 2018 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-30107822

RESUMO

BACKGROUND: Primary hypoparathyroidism is associated with diverse variety of symptomatology of hypocalcemia including seizures and tetany. We report a case of previously undiagnosed asymptomatic primary hypoparathyroidism with extensive basal ganglia calcifications presenting for the first time with hypocalcemic tetany during acute dengue infection. Although hypocalcemia is known to occur in dengue infection symptomatic hypocalcemia is very infrequent. CASE PRESENTATION: A 32 year old male with short stature who has undergone bilateral cataract surgery 2 years ago but who was otherwise healthy, presented with fever and generalized body aches of 3 days duration and carpal spasms/tetany occurring on the third day of the illness. He was diagnosed to have acute dengue fever along with severe hypocalcemia. Subsequent workup confirmed that the patient had primary hypoparathyroidism with extensive basal ganglia and cerebellar calcifications which was previously undiagnosed. His acute illness and hypocalcemia was managed successfully and was commenced on regular calcium supplementations to alleviate the hypocalcemic effects of his chronic illness. CONCLUSION: Clinical features of hypocalcemia may not commonly manifest up to the same degree of severity of hypocalcemia in primary hypoparathyroidism even till late adulthood but potential early clues such as short stature and premature cataract should be actively investigated. Worsening of already existing hypocalcemia during acute dengue fever led to the ultimate diagnosis of primary hypoparathyroidism in this patient which was lifesaving.


Assuntos
Dengue/complicações , Hipoparatireoidismo/complicações , Tetania/complicações , Adulto , Humanos , Hipocalcemia , Masculino , Sri Lanka
8.
Nephron ; 139(4): 359-366, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29791908

RESUMO

Mutations in the KCNA1 gene encoding the voltage-gated potassium (K+) channel Kv1.1 have been linked to rare neurological syndromes, episodic ataxia type 1 (EA1) and myokymia. In 2009, a KCNA1 mutation was identified in a large family with autosomal dominant hypomagnesemia. Despite efforts in establishing a genotype-phenotype correlation for the wide variety of symptoms in EA1, little is known on the serum magnesium (Mg2+) levels in these patients. In the present study, we describe a new de novo KCNA1 mutation in a Polish patient with tetany and hypomagnesemia. Electrophysiological and biochemical analyses were performed to determine the pathogenicity of the mutation. A female patient presented with low serum Mg2+ levels, renal Mg2+ wasting, muscle cramps, and tetanic episodes. Whole exome sequencing identified a p.Leu328Val mutation in KCNA1 encoding the Kv1.1 K+ channel. Electrophysiological examinations demonstrated that the p.Leu328Val mutation caused a dominant-negative loss of function of the encoded Kv1.1 channel. Cell surface biotinylation showed normal plasma membrane expression. Taken together, this is the second report linking KCNA1 with hypomagnesemia, thereby emphasizing the need for further evaluation of the clinical phenotypes observed in patients carrying KCNA1 mutations.


Assuntos
Canal de Potássio Kv1.1/genética , Deficiência de Magnésio/genética , Tetania/genética , Biotinilação , Pré-Escolar , DNA/genética , Fenômenos Eletrofisiológicos/genética , Exoma , Feminino , Células HEK293 , Humanos , Magnésio/sangue , Deficiência de Magnésio/sangue , Cãibra Muscular/genética , Mutação/genética , Técnicas de Patch-Clamp , Linhagem , Análise de Sequência de DNA
10.
Paediatr Int Child Health ; 38(4): 281-284, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-28648114

RESUMO

Pseudohypoparathyroidism (PHP) is a rare group of disorders characterised by end-organ resistance to the parathyroid hormone (PTH). A 16-year-old boy presented with a 2-year history of involuntary dystonic movements involving mainly the left hand, initially after writing and later during physical exercise. Serum calcium was 1.37 mmol/L (2.20-2.69), phosphate 2.1 mmol/L (0.8-1.45) and PTH 302 ng/L (12-88). CT scan of the head demonstrated multiple subcortical and diffuse basal ganglia calcifications. Genetic analysis confirmed a methylation defect in the GNAS cluster on chromosome 20q13.32 which established the diagnosis. Treatment with calcitriol and calcium carbonate led to complete remission of symptoms. Causes of hypocalcaemia should be considered in evaluating patients with movement disorders. The diagnosis of PHP-1B is challenging but the overall prognosis is excellent.


Assuntos
Pseudo-Hipoparatireoidismo/diagnóstico , Pseudo-Hipoparatireoidismo/patologia , Tetania/etiologia , Tetania/patologia , Adolescente , Análise Química do Sangue , Encéfalo/diagnóstico por imagem , Cromossomos Humanos Par 20 , Deleção de Genes , Humanos , Masculino , Pseudo-Hipoparatireoidismo/genética , Tomografia Computadorizada por Raios X
14.
Internist (Berl) ; 58(10): 1029-1036, 2017 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-28835974

RESUMO

A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. The analysis of serum levels for calcium, phosphorous, intact parathyroid hormone, electrophoresis and renal function parameters indicate which further radiological, scintigraphic or serum diagnostic steps are adequate to identify the cause of the patient's acute situation (i. e. most frequently 1HPT or malignant disease with bone involvement, e. g. myeloma) and thus to initiate the required surgical or oncological intervention. However, the primary goals in the treatment of HC include correcting dehydration and improving kidney function, lowering calcium levels and decreasing osteoclastic bone resorption. The goals are accomplished by volume repletion, forced diuresis, antiresorptive agents and hemodialysis on an intensive care unit. Hypocalcemic tetany (HT) is the consequence of severely lowered calcium levels (<2.0 mmol/l), usually in patients with chronic hypocalcemia. The causal disease for hypocalcemic tetany is frequently a lack of parathyroid hormone (PTH), (e. g. as a complication of thyroid surgery) or, rarely, resistance to PTH. HT due to severe and painful clinical symptoms requires rapid i. v. calcium replacement by central venous catheter on an intensive care unit. For the treatment of chronic hypocalcemia oral calcium and 25OH-vitamin D or even 1,25(OH)2-vitamin D3 and magnesium supplements may be necessary to achieve the desired low normal calcium levels. Thiazides are useful to reduce renal calcium loss and to stabilize the calcium levels. Some patients continue to exhibit clinical symptoms despite adequate calcium levels; in these cases s. c. parathyroid hormone 1-84 should be considered to stabilize calcium levels and to lower the dosage of calcium and vitamin D supplements.


Assuntos
Coma/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Hipercalcemia/diagnóstico , Hipocalcemia/diagnóstico , Debilidade Muscular/diagnóstico , Tetania/diagnóstico , Cálcio/sangue , Coma/sangue , Coma/terapia , Diagnóstico Diferencial , Distúrbios do Sono por Sonolência Excessiva/sangue , Distúrbios do Sono por Sonolência Excessiva/terapia , Humanos , Hipercalcemia/sangue , Hipercalcemia/etiologia , Hipercalcemia/terapia , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/diagnóstico , Hipocalcemia/sangue , Hipocalcemia/etiologia , Hipocalcemia/terapia , Debilidade Muscular/sangue , Debilidade Muscular/terapia , Neoplasias/sangue , Neoplasias/complicações , Neoplasias/terapia , Tetania/sangue , Tetania/terapia
15.
Rev Chil Pediatr ; 88(3): 383-387, 2017 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-28737198

RESUMO

Phosphate enemas are frequently used in the treatment of constipation. Errors in dosage and administration can lead to severe complications. OBJECTIVE: To report a case of severe toxicity of phosphate enemas in a child with no risk factors. CASE: 2 years old female, with functional constipation, was brought to emergency department because abdominal pain. She was diagnosed with fecal impaction and received half a bottle of Fleet Adult® (Laboratorio Synthon, Chile) two times, with no clinical resolution, deciding to start proctoclisis in pediatric ward. Soon after admission, she presented painful tetany, but alert and oriented. Patient was transferred to PICU where severe hyperphosphatemia and secondary hypocalcemia were confirmed. Her treatment included electrolyte correction; removal of residual phosphate enema and hyperhydration. Tetany resolved over 2 hours after admission and no other complications. Proctoclisis was performed and patient was discharged three days after admission with pharmacological management of constipation. CONCLUSION: Phosphate enemas may cause serious complications in children with no risk factors. Errors in dosage, administration and removal of the enema are causes of toxicity in this group. Pediatricians and health personnel must be aware of risks and signs of toxicity of phosphate enema.


Assuntos
Constipação Intestinal/terapia , Enema/efeitos adversos , Hiperfosfatemia/induzido quimicamente , Fosfatos/efeitos adversos , Tetania/induzido quimicamente , Pré-Escolar , Feminino , Humanos , Hiperfosfatemia/diagnóstico , Fosfatos/uso terapêutico , Tetania/diagnóstico
16.
Medicine (Baltimore) ; 96(27): e7141, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28682867

RESUMO

RATIONALE: Camurati-Engelmann disease (i.e., progressive diaphyseal dysplasia) is an extremely rare autosomal dominant bone disorder. The most common clinical manifestations were chronic skeletal pain, waddling gait, muscular weakness. PATIENT CONCERNS: We described that a 27-year-old male with a 1-year history of intermittent tetany was referred for bone scintigraphy. The whole body bone scan images showed abnormal increased uptake of the tracer in the long bones of the upper and lower extremities as well as in the skull. DIAGNOSES: Combined the family history, the findings of the images and the genetic study, the diagnosis of Camurati-Engelmann disease was confirmed. INTERVENTIONS AND OUTCOMES: The patient responded well to the treatment of calcium gluconate. LESSONS: Bone scintigraphy would be helpful in the diagnosis and assessing the severity of Camurati-Engelmann disease.


Assuntos
Osso e Ossos/diagnóstico por imagem , Síndrome de Camurati-Engelmann/complicações , Síndrome de Camurati-Engelmann/diagnóstico por imagem , Tetania/diagnóstico por imagem , Tetania/etiologia , Adulto , Gluconato de Cálcio/uso terapêutico , Síndrome de Camurati-Engelmann/tratamento farmacológico , Humanos , Masculino , Cintilografia , Índice de Gravidade de Doença , Tetania/tratamento farmacológico
17.
Presse Med ; 46(9): 838-844, 2017 Sep.
Artigo em Francês | MEDLINE | ID: mdl-28483283

RESUMO

Chronic calcipenia related to hypo- and pseudohypoparathyroidism favors trophic complications, especially expressed on the buccal cavity. Correlated with early onset of the disease and imperfect correction of the metabolic disorders, retardation to appearance and implantation of teeth are observed. The buccal signs often are the most immediately visible expression of the disease. They are painful and disabling. Other acute expressions reflect the neuromuscular hyperexcitability related to tetany. Finally, some etiologies determine specific damage, as in Di George's, HDR syndromes or in Albright's osteodystrophia.


Assuntos
Hipoparatireoidismo/diagnóstico , Doenças da Boca/diagnóstico , Pseudo-Hipoparatireoidismo/diagnóstico , Doenças Dentárias/diagnóstico , Diagnóstico Diferencial , Humanos , Hipocalcemia/complicações , Hipocalcemia/diagnóstico , Hipoparatireoidismo/complicações , Pseudo-Hipoparatireoidismo/complicações , Estatística como Assunto , Tetania/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA