Incidence of hypercalcemia, hypercalciuria and related factors in patients treated with recombinant human parathyroid hormone (1-84).

AIM: The aim of this paper was to determine the incidence of hypercalcemia and hypercalciuria (and related factors) in 22 postmenopausal women with osteoporosis treated with PTH (1-84) in daily practice. METHODS: Osteoporosis was defined as history of osteoporotic fracture or a T score less than -3 SD on bone densitometry. Patients were treated with PTH (1-84), 100 mcg/daily, for 12 months. Clinical and laboratory data at baseline and after 6 months of treatment were assessed. RESULTS: The mean age was 71.9 years. The incidence of hypercalcemia and the hypercalciuria were 6 events. Increase in serum calcium levels showed a statistically significant correlation with 24-hour urinary calcium (rho [ρ]=0.83, P<0.001), serum alkaline phosphatase (ρ=0.76, P=0.001), total proteins (ρ=0.77, P=0.005), and ß-CTx (ρ=0.82, P=0.002). On the other hand, 24-hour urinary calcium excretion correlated significantly with ß-CTx (ρ=0.83, P=0.002), alkaline phosphatase (ρ=0.73, P=0.005), total proteins (ρ=0.73, P=0.02), and serum phosphate (ρ=0.58, P=0.04). When the group of patients with and without hypercalcemia were compared, there were statistically significant differences in increases of ß-CTx and baseline ß-CTx values, whereas the group of patients with and without hypercalciuria showed significant differences in serum calcium increases and baseline values of T score at the femoral neck. CONCLUSION: The incidence of hypercalcemia and hypercalciuria after treatment with PTH (1-84) is similar to that expected according to the product's technical specifications. There was a significant correlation between increases of serum calcium, urinary calcium excretion, serum alkaline phosphatase, and ß-CTx after treatment with PTH (1-84). Baseline ß-CTx values were significantly lower in patients who developed hypercalcemia than in those with normal serum calcium levels.

Valoración de la exactitud de la infiltración de toxina botulínica a ciegas en niños y adolescentes con parálisis cerebral / Blinded evaluation of the accuracy of botulinum toxin in children and adolescents with cerebral palsy

Objetivos. Evaluar la exactitud de la infiltración manual frente a la guiada con electroestimulación de los músculos distales o profundos de las extremidades. Material y método. Estudio prospectivo en el que se infiltran 289 músculos en 29 pacientes afectos de parálisis cerebral con edades comprendidas entre 1 y 19 años, comparándose la exactitud de la infiltración guiada por referencias anatómicas asociada a la reproducción del movimiento muscular frente a aquella realizada mediante guía con electroestimulación. Resultados. Se muestran los distintos patrones de espasticidad tratados y los porcentajes de aciertos obtenidos en cada músculo al realizar infiltración guiada mediante referencias anatómicas. Existe un porcentaje de aciertos inferior al 50% en 10 de los 16 músculos infiltrados. Conclusiones. La infiltración de los músculos pequeños, profundos y distales precisa de una guía instrumentada, de las cuales la electroestimulación es asequible y certera(AU)

Objective. To evaluate the accuracy of manual infilitration versus electrostimulation-guided of the distal or deep muscles of the limbs. Material and method. A prospective study was carried out in which 289 muscles were injected in 29 patients who had cerebral palsy (aged 1 to 19years). The accuracy of manual puncturing following anatomical references associated to the reproduction of muscle movement was compared to that guided by electrostimulation. Results. The spasticity patterns treated as well as the percentages of successful injections guided for anatomical reference for each muscle are shown. The percentage of successful injections was <50% in 10 out of the 16 muscles injected. Conclusions. To inject small, deep and distal muscles, an instrumental guide such as electrostimulation, which is both easily available and accurate, is required(AU)