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C A Mautalen

Publications and source records attributed to C A Mautalen.

At least 19 recordsLinked to original sources
PubMed1998

Hyperthyroidism influences ultrasound bone measurement on the Os calcis.

The objective of our study was to compare bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters in women with hyperthyroidism and controls. In this cross-sectional study, QUS parameters and BMD values observed in untreated hyperthyroid patients were compared with data obtained from age-matched controls. Twenty-four women with Graves' disease were studied. Eight patients were postmenopausal. All patients had evidence of thyrotoxicosis as indicated by a raised total serum thyroxine and a suppressed serum thyroid stimulating hormone. BMD of the hip, lumbar spine and whole body, and body composition, were measured by DXA. Ultrasound evaluation on the os calcis was performed with an Achilles device. All measurements were performed before antithyroid therapy. The QUS parameters of BUA, SOS and Stiffness were significantly lower in hyperthyroid patients than in controls. Similar results were observed for the BMD of lumbar spine, femoral neck and total skeleton. Lean tissue and fat mass were also significantly decreased in hyperthyroid patients. In conclusion, these findings suggest that hyperthyroidism affects cortical and trabecular bone equally, as well as bone quality. QUS measurements may be helpful for assessing, using a simple and non-irradiating method, the bone effects of thyrotoxicosis.

Absorptiometry, Photon↗
PubMed1998

Professional football (soccer) players have a markedly greater skeletal mineral content, density and size than age- and BMI-matched controls.

The total skeletal bone mineral content (BMC), bone mineral density (BMD), bone size, and body composition were measured by dual-energy x-ray absorptiometry (DXA) in all professional male football players of a 1st division team (n = 24) and age- and BMI-matched (n = 22) controls (less than 3 hours of recreational sport activities per week). Average (+/- 1 SD) age of the athletes was 22.6 +/- 2.5 years. Intensive training is conducted during 48 weeks a year for 20-22 hours/week. The length of the registered playing career before the study was 8.2 +/- 2.7 years. Total skeleton BMC was 18.0% (P < 0.001) greater in the football players. The difference resulted from the sum of 5.2% (P < 0.02) increment of bone size and 12.3% (P < 0.001) increment of BMD. The analysis of skeletal subareas revealed that the difference of the BMC and BMD was greater at the level of the pelvis and legs compared with the arms or trunk. The BMC and BMD of the head was equal for both groups. Also, the bone size of the legs and pelvis was significantly greater for the players compared with controls; there was no difference at the level of the arms or head. Within the group of football players the increment of total skeleton BMD was similar in the young players, with less than 7 years of practice (age 20.6 +/- 0.9 years) compared with relative older players (age 24.6 +/- 1.9) with more than 7 years of practice. Lean body mass was significantly greater in the players (63.3 +/- 4.0 kg) compared with the controls (56.7 +/- 3.6, P < 0.001) whereas fat mass was markedly lower (9.4 +/- 2.9 kg versus 14.9 +/- 6.3 kg), P < 0.002). The BMD of the controls was significantly correlated to total weight, height, and lean mass whereas the BMD of the players was only correlated to muscle mass. The calcium intake from dairy products was similar in both groups. The range of calcium intake was wide among the players (184-2519 mg/day) but it was not significantly correlated to BMD (r = 0.03). In conclusion, male professional football players develop a significant increment of BMC as a result of increased bone size and density. This is already present at the end of the second decade and maintained at least to the end of the third decade in active players. As in other high impact loading sports, the effect on area is specific involving mainly the pelvis and legs. The increment was totally unrelated to the calcium intake from dairy products. The fate of the increased BMC after intensive training is discontinued should be assessed. However, if the findings of the present cross-sectional study are supported by detailed longitudinal investigations, the presently reported observations might be important for the prevention of future osteoporotic fractures.

Absorptiometry, Photon↗
PubMed1996

Are the etiologies of cervical and trochanteric hip fractures different?

Review of results published in the past few years indicates that there are several differences between women sustaining trochanteric fractures of cervical hip fractures. In most series women with trochanteric fractures are older, shorter, and lighter than those with cervical fractures. The bone mineral density was found to be lower in trochanteric fractures, but although in the majority of the studies the diminution was statistically significant at the level of the trochanter and spine--with predominant trabecular bone--the decrease was not uniformly significant at the level of the femoral neck or total skeleton. Previous vertebral fractures were twice as common in patients with trochanteric fractures. Ultrasound exploration of the calcaneus disclosed that the values were significantly lower in women with trochanteric fractures and this finding was independent of the diminution of the bone mineral density. On the other hand, fall biomechanics have not been found to be different in the two types of hip fractures. In summary, women with trochanteric fractures have a more severe and generalized bone loss, especially of the trabecular component. Cervical fractures seem to be more related to pelvic structure-failure of the outer diameter of the femoral neck to expand with age and increased acetabular bone width-added to a focal bone loss. The two main types of fractures should be treated separately in epidemiological or clinical studies to increase the knowledge and the possibilities of preventing hip fractures.

Absorptiometry, Photon↗
PubMed1996

Clinical utility of bone mass measurements in adults: consensus of an international panel. The Society for Clinical Densitometry.

Low bone mass predicts future fracture risk as well as high cholesterol or high blood pressure can predict the risk of heart disease or stroke. Prevention of the first fracture should be a clinical goal. In patients without fractures, osteopenia and osteoporosis can be diagnosed based on the extent of reduction in bone mass below mean peak bone mass of young healthy individuals. As bone mass decreases, fracture risk increases exponentially. Clinical situations in which an assessment of bone mass and fracture risk affects therapeutic decisions include estrogen deficiency, vertebral abnormalities, radiographic osteopenia, asymptomatic primary hyperparathyroidism, and long-term corticosteroid therapy. Serial measurements can also be used to monitor the effects of osteoporosis treatments. The appropriate technique and skeletal site for bone mass measurements should be chosen based on the patient's circumstances and the precision of measurement. A clinical interpretation can enhance the value of computer-generated bone mass measurement reports and improve decision making.

Absorptiometry, Photon↗
PubMed1996

[Proximal femoral fractures: risk factors, bone mineral density, body composition and biochemical changes in and age-matched patients and controls].

During one year (6/93-5/94) we performed a prospective study in patients with hip fracture, treated at the Hospital de Clínicas. A total of 102 women 52 to 94 years of age (Mean +/- 1SD: 79.5 +/- 9.1 years) and 17 men 61 to 98 years of age (79.7 +/- 9.9 years) who had sustained a hip fracture due to mild or moderate trauma were included. The ratio women: men was 6:1. We also studied 55 age-matched control women without diseases that could affect the skeleton or previous hip fracture (77.1 +/- 5.8 years of age). We did not study a control group in men. Women with hip fractures had lower weight (p < 0.01), lower age of onset of the menopause (p < 0.01) and a tendency to have with a greater frequency a mother with hip fracture (p < 0.08) compared with age-matched controls. When vertebral fractures were excluded, 44% of the hip fracture women had sustained previous skeletal fractures, while only 16% of the age-matched controls had suffered previous skeletal fractures (p < 0.001) (Table 2). The most frequent previous skeletal fractures were wrist and humerus. Forty eight percent of hip fracture women had had at least one vertebral fracture. About 17% of the hip fractured men had sustained previous skeletal fractures, while 5/12 men had suffered at least one vertebral fracture. Hip fractured women and men sustained greater history of diseases which provoke postural instability (Table 3). Biochemical determinations showed significantly diminished levels of serum albumin (p < 0.001) and calcium (p < 0.01), and increased serum PTH (p < 0.05) compared to age-matched controls (Table 4). Bone mineral density (determined by dual energy X-ray absorptiometry) was significantly diminished over proximal femur, total skeleton, legs and pelvis (p < 0.001), head and spine (p < 0.05) (Table 5). Body composition measurements showed that hip fracture women had a significantly lower lean mass compared with controls (p < 0.05). Fat mass also was lower in fracture patients compared with controls, but the difference was not statistically significant (Table 5). We conclude that hip fracture in our population is related to several previous factors: earlier onset of menopause, lower nutrition and body weight, previous diseases that increase the likelihood of falling, increased levels of PTH and reduced bone mass. Prevention of hip fractures should take into account all these factors, specially those that could be modified.

Aged↗
PubMed1994

Influence of the menopausal age on the severity of osteoporosis in women with vertebral fractures.

To assess the effect of age at the onset of menopause over the skeleton we have determined the age and cause of menopause and bone mineral density (BMD), by dual and single photon absorptiometry of the lumbar spine, the proximal femur and the radius shaft on 1050 osteoporotic women (suffering with at least one atraumatic vertebral fracture). The mean +/- 1 S.D. menopausal age was 47.1 +/- 7.6 years. The onset of menopause occurred prior to age 45 in 22% (premature), after age 52 in 9% (late), and between 45 and 52 years of age in 69% (normal menopausal age). When the osteoporotic women were categorized into three groups according to the age of menopause, those osteoporotic with premature menopause had a significantly greater frequency of hip fractures, a significantly lower age, weight and BMD over the spine, proximal femur and radius shaft compared with those of normal menopausal age. In turn, patients with late menopause had a significantly increased weight and BMD over the spine. These findings indicate that among patients with vertebral osteoporosis those women with premature menopause had a more severe bone loss and a significantly greater frequency of hip fractures.

Age Factors↗
PubMed1994

Calcium metabolism and its regulating hormones in patients with leprosy.

Calcium metabolism was studied in 47 patients with borderline or lepromatous leprosy. Total and ionized calcium, phosphorus, creatinine, total alkaline phosphatase, parathyroid hormone (PTH), 25-hydroxy vitamin D [25(OH)D], and 1,25-dihydroxy vitamin D [1,25(OH)2D] were measured in serum; calcium and total hydroxyproline were determined in urine. Total subperiosteal diameter and medullar cavity diameter were measured on an X-ray of the hand of all patients. Average values were within normal ranges for all of the biochemical determinations. Total serum calcium was moderately below the normal range in eight patients but ionized calcium levels were within the normal ranges in all of the patients. Four patients, all of them with lepromatous leprosy, had levels of 1,25(OH)2D higher than normal but none of them was hypercalcemic and PTH levels were within normal range. Although all values were within the normal ranges, lepromatous leprosy patients had lower total calcium, higher alkaline phosphatase, and higher urinary hydroxyproline than borderline leprosy patients (9.1 +/- 0.4 vs 9.4 +/- 0.3 mg%, p < 0.001; 10.3 +/- 2.9 vs 7.4 +/- 2.3 King-Armstrong units, p < 0.02 and 27.2 +/- 12 vs 19.4 +/- 5.6 mg/24 hr, p < 0.02, respectively). No differences were found between patients and controls in the average micrometric measurements of the second metacarpal bone but significant osteopenia was found in 19% of the patients. The main finding of the present study in a representative sample of leprosy patients is that the average total serum calcium was in the lowest limit of the normal range, but the ionized serum calcium was in the middle of the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Seasonal variations of 25 hydroxyvitamin D and parathyroid hormone in Ushuaia (Argentina), the southernmost city of the world.

Serum levels of calcium, phosphorus, alkaline phosphatase, 250HD, 1.25(OH)2D and PTH were studied in a group of 42 children aged 8.5 +/- 1.8 years (X +/- SD) from the city of Ushuaia (latitude 55 degrees S), at both the end of the winter and the end of summer. Calcium, phosphorus, alkaline phosphatase and 1.25(OH)2D serum levels were not different in summer and winter. The levels of serum 25OHD were significantly higher in summer (18.4 +/- 7.3 ng/ml) than in winter (9.8 +/- 3.8 ng/ml P < 0.001). The levels of 25OHD in children with fair or dark skin were similar in winter but were significantly higher in children with fair skin in summer (20.0 +/- 7.2 ng/l vs 15.3 +/- 5.1 ng/ml (P < 0.05). Serum levels of PTH were higher in winter (58.2 +/- 30.5 pg/ml) than in summer (47.9 +/- 28.3 pg/ml) (P < 0.03). The results demonstrate the existence of a population with low serum levels of 25OHD in winter. The higher levels of PTH in winter when serum 25OHD levels are lower could be the cause of the lack of seasonal variation in serum calcium and 1.25(OH)2D levels. Further studies are needed to establish whether these changes besides increasing the incidence of rickets, could also affect the mineral density of the skeleton in the population of this vitamin-D-deficient area.

Alkaline Phosphatase↗
PubMed1993

[Bone mineral density in osteoporotic and normal women of Buenos Aires].

The bone mineral density (BMD) of the lumbar spine and proximal femur was determined in 406 osteoporotic females with vertebral fractures and 50 osteoporotic females with hip fractures from 48 to 86 years of age. These results were compared with those obtained in a group of 120 control women from 20 to 80 years of age. In the controls we measured also the BMD of the vertebral bodies in lateral position, total skeleton and total body calcium to obtain the normal references values. The BMD was determined by dual-energy X-ray absorptiometry with a Lunar DPX-L equipment. The percentage fall of the BMD in the normal population between the 3rd and 8th decades of age was greater on spine in lateral (-36%) than in antero-posterior position (-22%) and femoral neck (-22%), while the lesser diminution occurred in the total skeleton (-13%) and total body calcium (-16%) (Figure 1). The results obtained were similar to the values observed in studies performed in United States and Europe (Table 1). The mean BMD of the spine (L2-L4) in osteoporotic women with vertebral fractures was 0.78 +/- 0.09 g/cm2. The BMD of the femoral neck in patients with hip fractures was 0.61 +/- 0.07 g/cm2 (Table 2). The osteoporotic patients had significantly lower BMDs in spine and femur (p < 0.001) compared to age-matched controls. These differences were -21% for L2-L4 and -25% for femoral BMD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Nutritional status of vitamin D in mothers and neonates of Ushuaia and Buenos Aires].

Serum levels of calcium, phosphorus, total alkaline phosphatase (AP) and 25 hydroxyvitamin D (250HD) were measured at the end of the winter in Group 1 (Ushuaia, latitude 55 degrees S): 16 women (24-48 hs postpartum serum blood) and 20 neonates (cord blood) and in Group 2 (Buenos Aires, latitude 34 degrees S) 21 women (24-48 hs postpartum serum blood) and their 21 neonates (cord blood). The neonatal serum calcium and phosphorus were higher and the neonatal serum AP and 250HD level were lower than maternal levels in both groups (Table 1 and 2). Serum levels of 250HD were diminished (< 8 ng/ml) in 62% of the mothers and 81% of the neonates of Ushuaia and in 24% of the mothers and 16% of the neonates of Buenos Aires (figure 1). Neonatal serum 250HD levels correlate with maternal serum 250HD levels in the paired group of Buenos Aires (r = 0.65, p < 0.003) (Figure 2). In Ushuaia the serum 250HD levels (X +/- SD) in neonates (3.9 +/- 2.7 ng/ml) and in mothers (6.3 +/- 4.8 ng/ml) were lower than in Buenos Aires (neonates: 11.3 +/- 6.0 ng/ml and mothers: 14.4 +/- 8.4 ng/ml, p < 0.001). Maternal serum calcium levels were lower in Ushuaia (8.7 +/- 0.8 mg/dl) than in Buenos Aires (9.2 +/- 0.4 mg/dl) (p < 0.05). In conclusion, 1) In Ushuaia pregnant women and their neonates had a deficient nutritional state of vitamin D. Preventive administration of vitamin D would probably be beneficial.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Risk for developing osteoporosis in untreated premature menopause.

The bone mineral density (BMD) of the lumbar spine and proximal femur was determined by dual photon absorptiometry in 32 women with untreated premature menopause (cessation of menses before 45 years of age). The BMD of the spine and proximal femur in four obese patients was not different from the BMD of the age-matched controls. On the contrary, the BMD of the nonobese females with premature menopause was significantly lower with respect to the average values found in healthy young women, in age-matched and menopause-matched controls. The BMD deficit was greater over the lumbar spine than in the proximal femur. Forty three percent of nonobese patients were already under the vertebral fracture threshold and 25% of nonobese patients were below the hip fracture threshold. The BMD deficit in the lumbar spine was correlated to the loss observed in the femoral neck (r = 0.59, P less than 0.001), in the trochanter (r = 0.65, P less than 0.001) and in the Ward's triangle (r = 0.73, P less than 0.001). A negative correlation was observed between years of menopause and the BMD of the lumbar spine (r = -0.39, P less than 0.05). The results indicate the high individual risk for osteoporotic fractures in nonobese females with untreated premature menopause. The BMD loss was greater over the skeletal areas that are predominantly composed of trabecular bone compared with cortical bone.

Absorptiometry, Photon↗
PubMed1992

Familial idiopathic hyperphosphatasia (FIH): response to long-term treatment with pamidronate (APD).

A 5-year-old child suffering from familial idiopathic hyperphosphatasia (FIH) was treated by: (1) intravenous infusion of pamidronate (APD) (3 h) (0.75 mg/kg/day) for 5 days; and (2) oral administration of APD (8 mg/kg/day) for 1 year, in association with calcium (1 g/day) as calcium gluconate. A decrease of both serum calcium and phosphate, and a slight PTH increase were observed immediately after the IV treatment; serum alkaline phosphatase did not change, but a marked and rapid decline in the hydroxyprolinuria was observed: basal 659 +/- 207 during IV treatment 169 +/- 59 (mean +/- SD mg/24 h, P < 0.005). At the end of one year of oral APD treatment clinical and radiological findings showed a remarkable improvement. Serum calcium, phosphate and PTH returned to the initial values. Plasma alkaline phosphatase levels showed a 70% decrease: basal 1370 IU/l, 1 year 410 IU/l whereas the hydroxyprolinuria values were similar to those determined at the end of the intravenous treatment (212 +/- 13 mg/24 h), but still significantly lower than the basal levels (P < 0.01). No side-effects were observed. APD appears to be a promising treatment for patients with FIH.

Administration, Oral↗
PubMed1991

Differential action of pamidronate on trabecular and cortical bone in women with involutional osteoporosis.

Since osteoporotic fractures are mainly related to the diminution of the bone mineral density (BMD), the effect of pamidronate (3-amino-1-hydroxy-propylidene) 1,1-bisphosphonate on the BMD of the spine, proximal femur and radius shaft was evaluated in an initial cohort of 35 postmenopausal women with at least one vertebral fracture due to involutional osteoporosis. Pamidronate was given continuously during 18 months in a daily oral dose of 4.8 to 6.0 mg/kg supplemented with calcium (1 g/day). BMD--measured by dual photon absorptiometry--increased after one year 5.3 +/- 1.0% (P less than 0.001) in lumbar spine and 5.3 +/- 1.5% (P less than 0.001) over trochanter. However no significant changes were observed in the BMD of the femoral neck, Ward's triangle or in the cortical bone of the radius shaft measured by single photon absorptiometry. Pamidronate also decreased significantly urinary hydroxyproline-creatinine excretion after 6 months and thereafter maintained a plateau. After 18 months of treatment the diminution was 42.6 +/- 4.9% (P less than 0.001). The differing effects of pamidronate on the BMD of lumbar spine and proximal femur might be ascribed to dissimilarities between the proportions of trabecular and cortical bone in these. These results suggest that pamidronate may be prescribed to prevent fractures in cases of involutional osteoporosis with a significant decrease of BMD in lumbar spine and/or trochanter.

Aged↗
PubMed1991

Compensatory parathyroid hypertrophy after hemiparathyroidectomy in rats feeding a low calcium diet.

The functional and anatomic compensatory response of the parathyroid gland was examined in hemiparathyroidectomized (HPTx) rats whose parathyroid hormone (PTH) secretion was stimulated by a low calcium diet. These responses were compared with those observed in the thyroid gland of hemithyroidectomized (HTx) rats. Rats kept on a low calcium diet for 10 days were subjected to HPTx, HTx, or sham operations. Throughout the experiment (up to 28 days after surgery), serum calcium levels of HPTx rats were lower than the basal, with delta values (mg/dl, mean +/- SEM) of -0.66 +/- 0.17 and -0.84 +/- 0.17, (P less than 0.05) 3 and 28 days after surgery, respectively. Serum PTH decreased significantly from 7 to 21 days after HPTx, reaching normality at day 28 after surgery. In HTx rats, serum thyroxine (T4) levels diminished significantly 7 days after surgery, and attained normality thereafter. The mitotic index (number of metaphases/1,000 cells) in parathyroid glands of colchicine-treated HPTx rats increased significantly in comparison to sham-operated controls, when examined 2 or 40 days after surgery. The mitotic index of thyroid follicular cells was significantly higher than that of their respective controls, 2 but not 40 days after HTx. These results indicate that after HPTx, a delayed compensatory response is found when the animals are kept under a low calcium diet. Parathyroid response is both delayed and of a minor degree compared to that found in the thyroid gland after HTx.

Adaptation, Physiological↗
PubMed1991

Bone mineral density of the spine and radius shaft in children with X-linked hypophosphatemic rickets (XLH).

X-linked hypophosphatemic rickets (XLH) is characterized by inadequate skeletal mineralization. The bone mineral density (BMD) of the radius shaft and the lumbar spine was determined in 13 children with XLH. Ten patients were on treatment, whereas three patients had discontinued treatment 20-32 months prior to this study. Two of them had radiological evidence of rickets. The radius shaft BMD was significantly diminished: Z score was -1.33 +/- 0.89 (P less than 0.001), while the BMD of lumbar spine was significantly augmented (Z score +1.95 +/- 1.17, P less than 0.001). A positive correlation was found between the Z scores for the BMD of the radius shaft and spine. The two patients with overt rickets had lower radius shaft BMD values and a lesser increment of BMD of the spine. The BMD deficit of cortical bone may be related to the lack of efficacy of the treatment and/or to an intrinsic defect of the bone on this disease. On the other hand, the augmented BMD of the lumbar spine might reflect the overabundance of partially mineralized osteoid. The determination of the BMD of the radius shaft by SPA was a sensitive method for detecting abnormalities of the bone mass in XLH patients under treatment without radiological signs of rickets.

Absorptiometry, Photon↗
PubMed1991

Bone mass in totally thyroidectomized patients. Role of calcitonin deficiency and exogenous thyroid treatment.

Calcitonin has an uncertain role in the preservation of bone mass. Since surgical thyroidectomy abolishes the calcitonin secretion in response to calcium, the bone mineral density at the radius shaft and lumbar spine was measured in 60 patients (5 men, 16 premenopausal, 34 postmenopausal euparathyroid and 5 postmenopausal hypoparathyroid women) who had undergone near total thyroidectomy for thyroid cancer 8.4 +/- 0.7 years before the study. All patients were maintained on suppressive doses of thyroid hormones. Bone mineral density values of the radius shaft (expressed as Z-score) of 34 postmenopausal euparathyroid women was significantly below the normal average (mean +/- SEM = -0.59 +/- 0.2; p = 0.01). Bone mineral density of the lumbar spine was also below the normal average although the difference only approached statistical significance (-0.36 +/- 0.2; 0.05 less than p less than 0.1). The bone mineral density of neither the radius nor the spine differed from normal levels in the premenopausal women and the postmenopausal hypoparathyroid women. Unexpectedly, the bone mineral density of the spine was significantly increased in the 5 thyroidectomized men. The results indicate that thyroidectomized women have a diminished bone mass after the menopause only if parathyroid function is normal. Since the patients were receiving thyroid hormone at suppressive doses, the present study is not able to separate the relative contributions of calcitonin deficit and exogenous thyroid on bone mass loss.

Adult↗
PubMed1991

Intravenous pamidronic acid in hypercalcemia due to parathyroid carcinoma.

Three patients aged between 31 and 59 were treated with pamidronic acid (APD) due to severe hypercalcemia caused by parathyroid carcinoma. APD was given in 250 cm3 intravenous saline over a 2 h period in a dose of 0.45 to 0.50 mg/kg per day. Two patients received 6 and the other 9 infusions. Mean serum calcium diminished from 15.7 +/- 1.3 mg/dl to 11.7 +/- 0.6 mg/dl (p less than 0.05). Mean serum ionized calcium decreased from 8.1 mg/dl to 5.5 mg/dl, urinary calcium excretion from 478 mg/24 h to 229 mg/24 h and hydroxyproline from 204 mg/24 h to 117 mg/24 h. Serum calcium returned to pretreatment levels after 5 and 15 days post intravenous APD in two patients. In the third patient treated with 900 mg/day of oral APD, after the intravenous therapy the relapse occurred during the fourth month. The three patients received a second course of intravenous (iv) APD. The effect upon serum calcium (14.6 +/- 1.1 mg/dl to 11.8 +/- 0.6 mg/dl, p less than 0.05) was similar to the one obtained with the first course. Intravenous APD administration appears to be an effective and safe treatment of the severe hypercalcemia due to parathyroid carcinoma. To sustain levels of serum calcium attained in patients with non resectable tumors, a suitable program of iv APD pulses should be established.

Adult↗