RESUMO
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.
Assuntos
Calcitriol/administração & dosagem , Carbonato de Cálcio/administração & dosagem , Hipocalcemia/tratamento farmacológico , Hipoparatireoidismo/tratamento farmacológico , Tireoidectomia/efeitos adversos , Administração Intravenosa , Administração Oral , Adulto , Citrato de Cálcio/administração & dosagem , Gluconato de Cálcio/administração & dosagem , Substituição de Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Hidroxicolecalciferóis/administração & dosagem , Hipocalcemia/sangue , Hipocalcemia/diagnóstico , Hipocalcemia/etiologia , Hipoparatireoidismo/sangue , Hipoparatireoidismo/diagnóstico , Hipoparatireoidismo/etiologia , Fatores de Risco , Fatores de Tempo , Falha de TratamentoRESUMO
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.
Assuntos
Enedi-Inos/química , Compostos de Epóxi/síntese química , Dessecação , Compostos de Epóxi/química , Ésteres/síntese química , Cetonas/química , Modelos Químicos , Estereoisomerismo , Zinostatina/análogos & derivados , Zinostatina/químicaRESUMO
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.