Tamoxifen induced hypercalcaemia: a case report

The present case demonstrates the important of close observation of patients with cancer metastatic to bone, newly started on endocrine therapy. Nonspecific symptoms should alert the physician to the possibility of hypercalcaemia. The serum calcium is better monitored regularly during the first 2 weeks of tamoxifen therapy, especially in patients with renal impairment. Volume repletion with normal saline is the most important initial treatment for hypercalcaemia. Patients with serum calcium levels above 3.25 m mol/1 [13 mg/dl] required additional intravenous bisphosphonate treatment. Oral bisphosphonate given for two weeks may prevent possible recurrence of hyperercalcaemia when tamoxifen therapy is reinstitkuted

Response of overweight and non-overweight hypertensives to hydrochlorothiazide

Overweight subjects with essential hypertension have characteristic features. Forty-four overweight and 36 non-overweight hypertensive Egyptian patients were treated with hydrochlorothiazide 50 mg orally once daily, for six months. The blood pressure response was excellent and statistically significant in the overweight group. 38 overweight patients [86.4%] had their blood pressures normalized [140/90 mmHg. or less]. Only 4 out of 36 non-overweight hypertensives [11%], had their blood pressures normalized. 80% of overweight subjects required 6-8 weeks to show maximal blood pressure reduction whereas 80% of the non-overweight group responded maximally in 2-4 weeks. The difference in response of the two groups to hydrochlorothiazide may be explained by the different hemodynamic pattern of hypertension in the overweight and non-overweight subjects. Therefore, hydrochlorothiazide is recommended for the initial treatment of overweight subjects with essential hypertension. After adequate control of their blood pressures, a physical exercise program to help reducing weight, can be safely started