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Hypercalcemia

Hypercalcemia is a medical condition characterized by an abnormally high level of calcium in the blood.
It can be caused by a variety of factors, such as primary hyperparathyroidism, malignancy, or certain medications.
Symptons of hypercalcemia may include nausea, vomiting, constipation, abdominal pain, muscle weakness, and confusion.
Proper diagnosis and management of hypercalcemia is crucial to prevent serious complications.
Researchers studying hypercalcemia can utilize the PubCompare.ai platform to optimize their research protocols for reproducibility and accuracy, ensuring their findings are reliable and impactful.

Most cited protocols related to «Hypercalcemia»

The present study was a randomized, double-blind, placebo-controlled, 2X2 factorial trial that examined the benefits and risks of vitamin D3 (cholecalciferol, 2000 IU/day) and marine omega-3 fatty acids (1 g/day) for primary prevention of cancer and cardiovascular disease among 25,871 men aged ≥50 and women aged ≥55. Study protocol has been described elsewhere, 4 (link), 11 (link) and the protocol may be found at NEJM.org. Participants were recruited throughout the U.S., balanced by sex, and with a goal to include at least 5000 African Americans. Eligible participants had no history of cancer (except non-melanoma skin cancer) or cardiovascular disease at study entry, and were required to agree to limit vitamin D from all supplemental sources, including multivitamins, to 800 IU/day; and to complete a three-month placebo run-in phase. Safety exclusions included renal failure or dialysis, cirrhosis, history of hypercalcemia, or other serious conditions that would preclude participation. The recruitment flow diagram appears in Figure 1. Randomization to vitamin D, omega-3 fatty acids, both active agents, or both placebos took place from November 2011 to March 2014 and was computer generated within sex, race, and five-year age groups in blocks of eight. Participants provided written informed consent. Study medication ended as planned on December 31, 2017, yielding a median 5.3-year (range 3.8–6.1 years) intervention period. The trial was approved by the institutional review board of Brigham and Women’s Hospital, Boston, and was monitored by an external Data and Safety Monitoring Board.
Baseline questionnaires collected data on risk factors for cancer, cardiovascular disease, and other conditions, and included a food frequency questionnaire. Participants received follow-up questionnaires at 6 months and 1 year after randomization and annually thereafter to collect information on adherence to randomized treatments, use of nonstudy vitamin D supplements, development of major illnesses, updates on risk factors, and potential side effects of the study agents. Study capsules were mailed with questionnaires to participants.
Baseline blood samples were collected during the run-in from all willing participants, including 16,956 of 25,871 randomized (65.5%). Quest Diagnostics performed serum 25(OH)D assays on all analyzable samples using liquid chromatography-tandem mass spectrometry. Our study participated in the vitamin D standardization program of the Centers for Disease Control and Prevention.12 (link)
Publication 2018
African American Age Groups Biological Assay BLOOD Capsule Cardiovascular Diseases Cholecalciferol Clinical Trials Data Monitoring Committees Diagnosis Dialysis Dietary Supplements Ergocalciferol Ethics Committees, Research Familial Atypical Mole-Malignant Melanoma Syndrome Food Hypercalcemia Kidney Failure Liquid Chromatography Liver Cirrhosis Malignant Neoplasms Marines Omega-3 Fatty Acids Pharmaceutical Preparations Placebos Primary Prevention Safety Serum Tandem Mass Spectrometry Woman
This was a randomized, open-label, phase 3 study of nivolumab compared with everolimus. Stratified randomization (1:1 ratio) with block size of 4 was implemented. Stratification factors were region (US/Canada or Western Europe or rest of world), Memorial Sloan Kettering Cancer Center (MSKCC) prognostic risk group (favorable, intermediate, or poor risk based on the presence of 0, 1 or 2, or 3 prognostic factors, respectively [anemia, hypercalcemia, poor performance status]),18 (link) and number of prior antiangiogenic therapy regimens (one or two) for advanced renal cell carcinoma.
Nivolumab and everolimus were provided by the Sponsor, except in cases when everolimus was procured as a local commercial product in certain countries. Nivolumab was administered at a dose of 3 mg/kg as a 60-minute intravenous infusion every 2 weeks. Everolimus was administered as a daily oral dose of 10 mg. Dose modifications were not permitted for nivolumab but were permitted for everolimus.
This study was approved by the institutional review board/independent ethics committee for each center and conducted in accordance with Good Clinical Practice guidelines defined by the International Conference on Harmonisation. All patients provided written informed consent to participate based on the principles of the Declaration of Helsinki. A data monitoring committee reviewed efficacy and safety during the study.
The authors vouch for the accuracy and completeness of analyses reported and for the fidelity of the study to the protocol. Development of the manuscript first draft was led by the lead author. All authors contributed to drafting the manuscript and provided final approval to submit for publication. Medical writing support, funded by the sponsor, was provided by PPSI. The study protocol is available with the full text of this article at www.nejm.org.
Publication 2015
Anemia Conferences Ethics Committees, Research Everolimus Hypercalcemia Intravenous Infusion Malignant Neoplasms Nivolumab Patients Population at Risk Prognostic Factors Renal Cell Carcinoma Safety Therapeutics Treatment Protocols
Pregnant women with a pre-pregnancy body mass index (BMI) ≥ 29 kg/m2 are eligible for inclusion
[17 (link)]. Where pre-pregnancy weight is not known the most earliest antenatal weight will be used. Further inclusion criteria are: before 19+6days of gestation, singleton pregnancy and aged ≥ 18 years.
Women will be excluded from the study if they: are diagnosed with GDM on oral glucose tolerance testing, before randomization, using IADPSG criteria defined as fasting venous plasma glucose ≥ 5.1 mmol/l and/or 1 hour glucose ≥10 mmol/l and/or 2 hour glucose ≥ 8.5 mmol/l at baseline measurement
[18 (link)]; have pre-existing diabetes; are not able to walk at least 100 meter safely; require complex diets; have chronic medical conditions (e.g. valvular heart disease); have significant psychiatric disease; are unable to speak major language of the country of recruitment fluently or are unable to converse with the lifestyle coach in another language for which translated materials exist. For the vitamin D arm, two additional exclusion criteria apply: have current or past abnormal calcium metabolism, e.g. hypo/hyperparathyroidism, nephrolithiasis, hypercalciuria; have hypercalciuria (>0.6 mmol/mmol creatinine in spot morning urine) or hypercalcaemia (>10.6 mg/dl | 2.65 mmol/l) detected at baseline measurement.
Women who have developed GDM at baseline are informed that they can not participate any further in DALI and are recommended to contact their health care provider regarding their GDM. These women are asked to consent to have the information regarding their pregnancy outcomes collected. As the IADPSG criteria are not used to diagnose GDM at all sites, each site has a protocol on how to link women with appropriate services in their locality.
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Publication 2013
Calcium, Dietary Chronic Condition Creatinine Diagnosis Diet Ergocalciferol Glucose Health Personnel Hypercalcemia Hyperparathyroidism Index, Body Mass Mental Disorders Metabolism Nephrolithiasis Plasma Pregnancy Pregnant Women States, Prediabetic Urine Valve Disease, Heart Veins Woman
In this review we summarize evidence for optimal serum 25(OH)D levels with respect to benefit and risk. The established benefits of higher vitamin D dose and higher achieved serum 25(OH)D levels were reduction in falls and fractures as summarized in two 2009 meta-analyses of double-blind RCTs[1 (link), 2 (link)]. The established risk of higher intakes of vitamin D or higher achieved serum 25(OH)D level that we evaluated in the same RCT's and any available RCTs of vitamin D supplementation and reported 25(OH)D status was hypercalcemia, evaluated as mean serum calcium level. We also examined case reports of hypercalcemia or nephrolithiasis in these trials. Additionally, we review benefits of vitamin D with the strongest evidence today from prospective epidemiological studies that are supported by strong mechanistic evidence, specifically reduction of cardiovascular disease (incident hypertension and cardiovascular mortality) and colo-rectal cancer. Weaker evidence of a beneficial effect of vitamin D exists for other diseases, including multiple sclerosis[9 (link)], tuberculosis[10 ], insulin resistance[11 (link), 12 (link)], other cancers[13 (link)–16 ], osteoarthritis[17 (link), 18 (link)] and prevalent hypertension [19 (link)–21 (link)], but these are not considered here. For the assessment of risk in observational studies, we include data on serum calcium levels with any reported 25(OH)D level from case-reports of vitamin D intoxication.
The risk assessment method used is a slight modification of the Institute of Medicine's Tolerable Upper Intake Level (UL) method, as applied in a previous risk assessment on vitamin D by some of the current authors[22 (link)]. Our procedure uses the UL protocol exactly, except for a conservative selection of data so that no further correction for uncertainty is required[23 (link)]. Details of the entire literature up to that time were described in the previous risk assessment[22 (link)].
The benefit and risk that occur with increases in 25(OH)D concentration were placed in context with each other graphically using trend plots for each selected endpoint (decreased risk of falls and non-vertebral fractures) at different doses of vitamin D and achieved 25(OH)D levels. Given the limitations of using mean achieved serum calcium levels reported as a risk endpoint in trials of vitamin D supplementation, we also used individual serum calcium values in published case reports of hypercalcemia alleging vitamin D intoxication to compare with the prospective cohort data relating 25(OH)D concentrations to risks of cardiovascular disease and colorectal cancer.
Publication 2009
Calcium Cardiovascular Diseases Cardiovascular System Colorectal Carcinoma Degenerative Arthritides Ergocalciferol Fracture, Bone Health Risk Assessment High Blood Pressures Hypercalcemia Insulin Resistance Malignant Neoplasms Multiple Sclerosis Nephrolithiasis Serum Spinal Fractures Tuberculosis Vitamin A
This study is based on information from healthy volunteers participating in a preventive health program provided by the Pure North S'Energy Foundation (PN), a not-for-profit charitable organization providing free services since October 2007. The program and data collection protocol are described elsewhere [21] (link), [22] (link). In brief, PN offers health promotion counseling with an emphasis on vitamin D supplementation as their volunteers mostly reside in the Canadian province of Alberta which is located between the 49th and 60th parallel north. PN asks participants to complete a lifestyle questionnaire, have their height and weight measured, have a medical history, and have blood drawn for the assessment of serum 25(OH)D. Since January 2009 the medical history recorded the question ‘how much vitamin D supplementation are you using?’ This includes vitamin D from vitamin D supplementation and from multivitamins. Also calcium supplementation was recorded in the medical history. All 22,214 per protocol study visits, that are typically scheduled once a year, prior to June 2013 were included in the present study. All 25(OH)D measurements were assessed with an automated chemiluminescent immunoassay from DiaSorin (LIAISON) which measures the combination of D2 and D3 and which has coefficients of variation ranging from 6.8% to 8.8%.
Various shapes of the relationship between vitamin D intake and 25(OH)D have been proposed [11] (link), [23] (link)–[26] (link). These include linear, polynominal, bi-phasic, exponential and ‘exponential plus linear’ relationships [11] (link), [23] (link)-[26] (link). We therefore sought to identify the regression model that best characterized the relationship by comparing linear, quadratic, cubic, linear-log, exponential and ‘exponential plus linear’ regression models on the basis of the Akaike Information Criteria (AIC) [27] .
We examined the importance of both BMI and absolute body weight for the dose response relationship of oral vitamin D supplementation and serum 25(OH)D while adjusting for the confounding potential of age, sex and season using multivariable regression models. We compared BMI and absolute body weight both as continuous and categorical variables. When categorized, individuals with a BMI of less or equal than 18.5, more than 18.5 and less or equal than 25, more than 25 and less or equal than 30, and more than 30 were considered underweight, normal weight, overweight and obese, respectively [28] . Weight was categorized as less than 60 kg, 60 kg to 80 kg, more than 80 kg and less or equal to 100 kg, and more than 100 kg.
Assessments of height and weight were missing in 3% of the assessments. These records were excluded in analyses with BMI and absolute body weight as continuous covariates, but were included in analyses with BMI and absolute body weight as categorical covariates by considering missing values as a missing category. Differences in the dose response relationship of oral vitamin D supplementation and serum 25(OH)D by BMI were visualized through plots of model estimated 25(OH)D levels for any given supplementation levels.
As the available data included repeated observations for a subset of 3416 (19.4%) subjects, we included a random intercept in all the exponential regression models. The effects of vitamin D supplementation on calcium levels and probability of hypercalcemia were analyzed using linear regression and logistic regression, respectively.
All analyses were conducted using SAS 9.4 (SAS Institute, Cary NC) and the dose response curves were fitted using PROC NLMIXED, a SAS procedure for fitting nonlinear mixed effect models. Statistical significance was defined as p-values less than 0.05.
PN anonymized their data prior to forwarding it to the University of Alberta for analyses. The Human Research Ethics Board of the University of Alberta had approved access to and analysis of the PN data for the purpose of the present analyses.
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Publication 2014
BLOOD Body Weight Calcium, Dietary Cuboid Bone Ergocalciferol Health Promotion Healthy Volunteers Homo sapiens Hypercalcemia Immunoassay Obesity Preventive Health Programs Serum Voluntary Workers

Most recents protocols related to «Hypercalcemia»

After the randomization procedure, patients were allocated to either the study or control group. Both groups were required to take blood samples of 25-OH-vitamin D and calcium, and they followed through with the standard treatment procedure. The standard treatment procedure was based on fracture complexity but included casting, closed reduction, and open reduction. X-ray and clinical follow-ups were done after 1 day, 3 weeks, 5 weeks, 2 months, 6 months, and 1 year.
Patients in the study group were asked to perform the following blood tests: 25-OH-vitamin D and total calcium. They repeated them after 6 months of supplementation.
For vitamin D, the values for 25-OH-vitamin D were classified with standard laboratory values as follows: toxic value: over 100 ng/mL, normal value: between 30 ng/mL and 100 ng/mL, poor value: between 20 ng/mL and 29 ng/mL, and insufficient value: less than 20 ng/mL. For calcium, the values of total calcium were considered as follows: hypercalcemia: over 10.6 mg/dL; normal value: between 8.80 mg/dL and 10.6 mg/dL.
The following therapeutic interventions were applied to the study group for the following 6 months if vitamin D was less than 30 ng/mL: oral treatment: patients would receive vitamin D [2000 I.U./day] and calcium [600 mg/day] in the first part of the day.
The control group performed blood tests at the beginning of the study and was monitored clinically and radiologically for fracture healing and functional outcomes.
The study duration was at least one year for each patient included.
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Publication 2023
Administration, Oral BLOOD Calcium, Dietary Ergocalciferol Fracture, Bone Hematologic Tests Hypercalcemia Open Fracture Reductions Patients Radiography Therapeutics
Anonymised data were obtained from the VITdAL-ICU trial population (NCT01130181). Between May 2010 and September 2012, 475 patients were recruited from five intensive care units (ICUs) in a single large tertiary centre in Austria, as part of a randomised, double-blind, placebo-controlled trial investigating the effect of vitamin D replacement in vitamin D-deficient, critically ill patients [5 (link)]. Both medical and surgical patients were recruited. Ethics approval was granted by the Medical University of Graz, Austria (reference number 21–214 ex 09/10, EudraCT-Nr.: 2010-018798-39). Patients were randomly assigned to either a placebo or a vitamin D3 group (which received a high-loading-dose regimen of a single dose of 540,000 IU vitamin D3, followed by once-monthly 90,000 IU doses for 5 months). The database was obtained from the original investigators. FGF23 levels were analysed from blood samples collected on day 0 and day 7, which were thawed from −80 °C and analysed by ELISA. Recruitment to the translational arm was optional, so the number of patients with FGF23 measured was limited. Post critical care discharge, patient samples were not collected, leading to the loss of some day-7 (timepoint 2) FGF23 measurements. Mortality data were recorded at 180 days from recruitment.
Inclusion criteria: patients 18 years of age or older, expected to stay in the ICU >48 h, with a plasma 25-hydroxyvitamin D level of 20 ng/mL. Exclusion criteria: patients with severely impaired gastrointestinal function; participants of other trials; pregnant or lactating women; patients with hypercalcaemia (total calcium > 10.6 mg/dL or ionised calcium > 5.4 mg/dL), tuberculosis, sarcoidosis, or nephrolithiasis; or patients deemed unsuitable for study participation (e.g., those with psychiatric disease, those living remote from the clinic, or prisoners).
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Publication 2023
BLOOD Calcifediol Calcium Cholecalciferol Critical Care Critical Illness Enzyme-Linked Immunosorbent Assay Ergocalciferol FGF23 protein, human Hypercalcemia Mental Disorders Nephrolithiasis Operative Surgical Procedures Patient Discharge Patients Placebos Plasma Prisoners Protein Biosynthesis Sarcoidosis Treatment Protocols Tuberculosis Vitamin D Deficiency Woman
The study drug was TZP. All other drugs were used as comparators for signal detection of TZP-related EDs. The 10 most important and popular EDs were selected to assess TZP-associated EDs: hypokalemia, hyperkalemia, hyponatremia, hypernatremia, hypocalcemia, hypercalcemia, hypomagnesemia, hypermagnesemia, hypophosphatemia, and hyperphosphatemia. The MedDRA preferred terms used for the extraction of EDs were as follows: “hypokalaemia”, “blood potassium decreased”, “hyperkalaemia”, “blood potassium increased”, “hyponatraemia”, “blood sodium decreased”, “hypernatraemia”, “blood sodium increased”, “hypocalcaemia”, “blood calcium decreased”, “hypercalcaemia”, “blood calcium increased”, “hypomagnesaemia”, “blood magnesium decreased”, “hypermagnesaemia”, “blood magnesium increased”, “hypophosphataemia”, “blood phosphorus decreased”, “hyperphosphataemia”, and “blood phosphorus increased”.
The PCNs used as comparators are listed in Table 6. We selected PCNs that had been used in the United States during the study period and flucloxacillin, which was not available in the US but is commonly used in European Union countries.
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Publication 2023
BLOOD Calcium, Dietary Floxacillin Hypercalcemia Hypernatremia Hyperphosphatemia Hypocalcemia Hyponatremia Hypophosphatemia Magnesium Pharmaceutical Preparations Phosphorus Potassium Signal Detection (Psychology) Sodium
Prior to the initiation of the study, the Carilion Health System (located in Southwest Virginia) institutional review board (IRB) approval was obtained. Once approved (IRB approval number #IRB-21-1463) a query of the electronic medical record (EMR) EpicTM (Epic Systems, Verona, USA), as well as augmentation with TrinetX (TrinetX, Cambridge, USA), was performed with a goal of finding outpatients with at least one elevated serum calcium (serum calcium ≥ 11.0 mg/dL) and no parathyroid hormone (PTH) value found. Other parameters on the population included age greater than 18 and the years when examined between 2021 and 2022. Although multiple options exist and vary regarding what normal, elevated, and low PTH levels are, in this study the decision was made to choose a PTH of 65 pg/mL as the cut-off point for elevation and 21 pg/mL as the cut-off point for depression - both based on previous studies and on local institutional cut-offs [6 (link)].
In total, a group of 546 patients were found that had elevated serum calcium and no PTH based on a computerized query. Charts were then manually reviewed by members of the research team to confirm query findings, and patients were excluded based on the lack of hypercalcemia (serum calcium ≥ 11.0 mg/dL) as well as previous testing of parathyroid hormone (PTH) levels. A total of 150 patients were excluded and 396 were included in this study.
Letters were sent to the 396 patients advising the patients to discuss whether PTH testing would be indicated with their primary care provider (PCP). A repeat query was run following the letters, six months later, and a total of 20 patients were found to have new reported PTH levels tested in the time period following the letters. These patients’ charts were re-examined manually and PTH values were verified. Additionally, any referrals over the same time frame (explicitly for hypercalcemia or PHPT) were also recorded.
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Publication 2023
Calcium Ethics Committees, Research Hypercalcemia Hypoparathyroidism Outpatients Parathyroid Hormone Patients Primary Health Care Reading Frames Serum
A total of 272 PHPT patients admitted to the endocrine ward in Peking Union Medical College Hospital (PUMCH) between January 2015 and December 2021 were enrolled in the study. PHPT was diagnosed by hypercalcemia combined with increased or inappropriately normal intact PTH level. Asymptomatic PHPT was defined as PHPT lacking apparent signs or symptoms of hypercalcemia or high levels of parathyroid hormone (18 (link)), such as gastrointestinal disorders, osteoporosis, fragility fractures, nephrolithiasis and nephrocalcinosis. Inclusion criteria were as follows: patients aged 18 and over; patients having received preoperative cardiac ultrasound examination; patients with complete clinical data. Familial or syndromic hyperparathyroidism, such as multiple endocrine neoplasia, familial hypocalciuric hypercalcemia and hyperparathyroidism-jaw tumor syndrome, were excluded based on medical history in combination with laboratory and imaging examination. Patients with coronary artery disease, cardiomyopathy and chronic systemic diseases, such as severe hepatorenal disease, were also excluded. Finally, 153 PHPT patients were included in this investigation, whereas 51 age- and sex-matched healthy subjects with echocardiograms were recruited from the PUMCH health examination center as the control group. All the healthy controls had no history of systemic diseases, including metabolic bone diseases. Serum biochemical indicators such as liver and kidney function, glucose, calcium, and PTH levels were all within normal ranges. This study was approved by the Ethics Committee of PUMCH and conducted in accordance with the principles in the Declaration of Helsinki.
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Publication 2023
A-272 Calcium Cardiomyopathies Coronary Artery Disease Disease, Chronic Echocardiography Ethics Committees, Clinical Fracture, Bone Gastrointestinal Diseases Glucose Healthy Volunteers Heart Hypercalcemia Hyperparathyroidism Hyperparathyroidism-Jaw Tumor Syndrome Hypocalciuric hypercalcemia, familial, type 1 Kidney Liver Metabolic Bone Disease Multiple Endocrine Neoplasia Nephrocalcinosis Nephrolithiasis Osteoporosis Parathyroid Hormone Patients Serum Syndrome System, Endocrine Ultrasonics

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More about "Hypercalcemia"

Hypercalcemia is a medical condition characterized by an abnormally elevated level of calcium in the blood.
This condition can be caused by a variety of factors, such as primary hyperparathyroidism, malignancies, or certain medications.
Symptoms of hypercalcemia may include nausea, vomiting, constipation, abdominal pain, muscle weakness, and confusion.
Proper diagnosis and management of hypercalcemia is crucial to prevent serious complications.
Researchers studying hypercalcemia can utilize the PubCompare.ai platform to optimize their research protocols for reproducibility and accuracy, ensuring their findings are reliable and impactful.
Hypercalcemia is often associated with other medical conditions, such as parathyroid disorders, vitamin D intoxication, and certain cancers.
The condition can be evaluated through blood tests, including the measurement of serum calcium, parathyroid hormone, and other related biomarkers.
In some cases, imaging studies or additional tests may be required to identify the underlying cause.
Treatment for hypercalcemia typically involves addressing the underlying condition, such as treating the associated malignancy or adjusting medication regimens.
In severe cases, intravenous fluids, diuretics, or bisphosphonate medications may be necessary to lower the calcium levels and manage the symptoms.
Researchers studying hypercalcemia can utilize SAS version 9.4, SPSS Statistics version 21, and other statistical software to analyze data and develop predictive models.
The H1299 cell line, a non-small cell lung cancer cell line, has been used in hypercalcemia research to investigate the cellular mechanisms involved.
Additionally, the use of Paricalcitol, a vitamin D analog, and the FuGENE protocol for transfection, as well as the DNeasy Blood & Tissue Kit for DNA extraction, may be relevant to hypercalcemia research.
The SPSS version and SAS statistical software can be used to perform advanced statistical analyses, while Rompun, a sedative and analgesic, and the Cobas e411 analyzer may be utilized in pre-clinical or clinical studies.
By understanding the various aspects of hypercalcemia, researchers can develop more effective and reproducible research protocols, leveraging the capabilities of PubCompare.ai to ensure the reliability and impact of their findings.