Treatment of Medically Refractory Hypercalcemic Crisis
Bibliographic record
Abstract
INTRODUCTION: A 58-year-old patient was admitted to the intensive care unit for severe hypercalcemia (total Ca 5.30 mmol/L) complicated with status epilepticus, hypertensive crisis and acute renal failure. Renal replacement therapy was explored as a method for treating medically refractory hypercalcemia. METHODS: Because of hemodynamic instability during intermittent hemodialysis (IHD), continuous venovenous hemofiltration (CVVH) with high rates of calcium-free replacement fluids was instituted. Epoprostenol rather than citrate was used as anticoagulation to ensure adequate extracorporeal anticoagulation. RESULTS: CVVH was continued for 40 hours total during which ionized calcium decreased from 2.19 to 1.07 mmol/L. The etiology of the hypercalcemia was from autoinfarction of a parathyroid adenoma. CONCLUSIONS: This is the first case of hypercalcemia treated with CVVH with epoprostenol anticoagulation. This method avoids some of the pitfalls of using intermittent hemodialysis. It is also a rare example of hypercalcemia induced posterior reversible encephalopathy syndrome (PRES).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".