Severe Hypocalcemia After the Administration of Zoledronic Acid for Osteoporotic Fracture
Bibliographic record
Abstract
Zoledronic acid is a potent intravenous bisphosphonate used in the treatment of osteoporosis and malignancy-induced hypercalcemia or bone metastasis. Although zoledronic acid generally seems to be safe and well-tolerated, rare but life-threatening nephrotoxicity or hypocalcemia may occur. The majority of cases of hypocalcemia with zoledronic acid have been seen in patients with underlying malignancy and are asymptomatic or mild. Vitamin D deficiency, renal failure, hypoparathyroidism, and hypomagnesemia have been reported as risk factors for hypocalcemia. Here, the author reports a case of severe symptomatic hypocalcemia following the administration of zoledronic acid for the treatment of osteoporotic fracture. This patient also had underlying but unrecognized vitamin D deficiency and chronic kidney disease. Following the administration of calcium and vitamin D, her symptoms improved and calcium levels returned to normal within several days. To avoid serious hypocalcemia with zoledronic acid, calcium and vitamin D status and renal function should be assessed and corrected if appropriate. J Med Cases. 2016;7(10):441-444 doi: http://dx.doi.org/10.14740/jmc2646w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".