ABSTRACT
Hypocalcaemia due to hypoparathyroidism following thyroidectomy is a relatively common occurrence. Standard treatment is with oral calcium and vitamin D replacement therapy; lack of response to oral therapy is rare. Herein we describe a case of hypoparathyroidism following thyroidectomy unresponsive to oral therapy in a patient with a complex medical history. We consider the potential causes in the context of calcium metabolism including: poor adherence, hungry bone syndrome, malabsorption, vitamin D resistance, bisphosphonate use and functional hypoparathyroidism secondary to magnesium deficiency. Malabsorption due to intestinal hurry was likely to be a contributory factor in this case and very large doses of oral therapy were required to avoid symptomatic hypocalcaemia.
Subject(s)
Calcitriol/administration & dosage , Calcium Carbonate/administration & dosage , Hypocalcemia/drug therapy , Hypoparathyroidism/drug therapy , Thyroidectomy/adverse effects , Administration, Intravenous , Administration, Oral , Adult , Calcium Citrate/administration & dosage , Calcium Gluconate/administration & dosage , Drug Substitution , Drug Therapy, Combination , Female , Humans , Hydroxycholecalciferols/administration & dosage , Hypocalcemia/blood , Hypocalcemia/diagnosis , Hypocalcemia/etiology , Hypoparathyroidism/blood , Hypoparathyroidism/diagnosis , Hypoparathyroidism/etiology , Risk Factors , Time Factors , Treatment FailureABSTRACT
We present herein our recent efforts towards the synthesis of epoxydiynes which represent an unusual structural feature of the neocarzinostatin chromophore. A number of different routes to these epoxydiynes have been explored with varying success. Ultimately a concise and convergent approach was developed, which involved the addition of an allenyl zinc bromide to propargylic ketones/aldehydes followed by epoxide formation. This new protocol enabled us to synthesise a fully elaborated epoxydiyne which will find application for our studies towards the total synthesis of the NCS chromophore.
Subject(s)
Enediynes/chemistry , Epoxy Compounds/chemical synthesis , Desiccation , Epoxy Compounds/chemistry , Esters/chemical synthesis , Ketones/chemistry , Models, Chemical , Stereoisomerism , Zinostatin/analogs & derivatives , Zinostatin/chemistryABSTRACT
Microwave enhanced diversity-oriented synthesis (MEDOS) using palladium catalysed protocols is introduced as a powerful new strategy for the synthesis of systematically modified small molecules and is highlighted by application to functionalised flavones.
