The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia [Editorial]
Patrone, Lorenzo; Pasqui, Edoardo; Conte, Michael S; Farber, Alik; Ferraresi, Roberto; Menard, Matthew; Mills, Joseph L; Rundback, John; Schneider, Peter; Ysa, August; Abhishek, Kumar; Adams, George L; Ahmad, Naseer; Ahmed, Irfan; Alexandrescu, Vlad A; Amor, Max; Alper, David; Andrassy, Martin; Attinger, Christopher; Baadh, Andy; Barakat, Hashem; Biasi, Lukla; Bisdas, Theodosios; Bhatti, Zagum; Blessing, Erwin; Bonaca, Marc P; Bonvini, Stefano; Bosiers, Michel; Bradbury, Andrew W; Beasley, Robert; Behrendt, Christian-Alexander; Brodmann, Marianne; Cabral, Gonzalo; Cancellieri, Roberto; Casini, Andrea; Chandra, Venita; Chisci, Emiliano; Chohan, Omar; Choke, Edward T C; Chong, Patrick F S; Clerici, Giacomo; Coscas, Raphael; Costantino, Mary; Dalla Paola, Luca; Dand, Sabeen; Davies, Robert S M; D'Oria, Mario; Diamantopoulos, Athanasios; Debus, Sebastian; Deloose, Koen; Del Giudice, Costantino; Donato, Gianmarco de; Rubertis, Brian De; Paul De Vries, Jean; Dias, Nuno V; Diaz-Sandoval, Larry; Dick, Florian; Donas, Konstantinos; Dua, Anahita; Fanelli, Fabrizio; Fazzini, Stefano; Foteh, Mazin; Gandini, Roberto; Gargiulo, Mauro; Garriboli, Luca; Genovese, Elizabeth A; Gifford, Edward; Goueffic, Yann; Goverde, Peter; Chand Gupta, Prem; Hinchliffe, Robert; Holden, Andrew; Houlind, Kim C; Howard, Dominic Pj; Huasen, Bella; Isernia, Giacomo; Katsanos, Konstantinos; Katzen, Barry; Kolh, Philippe; Koncar, Igor; Korosoglou, Grigorios; Krishnan, Prakash; Kroencke, Thomas; Krokidis, Miltiadis; Kumarasamy, Arun; Hayes, Paul; Iida, Osamu; Alejandre Lafont, Enrique; Langhoff, Ralf; Lecis, Alexandre; Lessne, Mark; Lichaa, Hady; Lichtenberg, Michael; Lobato, Marta; Lopes, Alice; Loreni, Giorgio; Lucatelli, Pierleone; Madassery, Sreekumar; Maene, Lieven; Manzi, Marco; Maresch, Martin; Santhosh Mathews, Jay; McCaslin, James; Micari, Antonio; Michelagnoli, Stefano; Migliara, Bruno; Morgan, Robert; Morelli, Luis; Morosetti, Daniele; Mouawad, Nicolas; Moxey, Paul; Müller-Hülsbeck, Stefan; Mustapha, Jihad; Nakama, Tatsuya; Nasr, Bahaa; N'dandu, Zola; Neville, Richard; Noory, Elias; Nordanstig, Joakim; Noronen, Katariina; Mariano Palena, Luis; Parlani, Gianbattista; Patel, Ashish S; Patel, Parag; Patel, Rafiuddin; Patel, Sanjay; Pena, Costantino; Perkov, Drazen; Portou, Mark; Pratesi, Giovanni; Rammos, Christos; Reekers, Jim; Riambau, Vicente; Roy, Trisha; Rosenfield, Kenneth; Antonella Ruffino, Maria; Saab, Fadi; Saratzis, Athanasios; Sbarzaglia, Paolo; Schmidt, Andrej; Secemsky, Eric; Siah, Michael; Sillesen, Henrik; Simonte, Gioele; Sirvent, Marc; Sommerset, Jill; Steiner, Sabine; Sakr, Ahmed; Scheinert, Dierk; Shishebor, Mehdi; Spiliopoulos, Stavros; Spinelli, Alessio; Stravoulakis, Konstantinos; Taneva, Gergana; Teso, Desarom; Tessarek, Joerg; Theivacumar, Selva; Thomas, Anish; Thomas, Shannon; Thulasidasan, Narayan; Torsello, Giovanni; Tripathi, Ramesh; Troisi, Nicola; Tummala, Srini; Tummala, Venkat; Twine, Christopher; Uberoi, Raman; Ucci, Alessandro; Valenti, Domenico; van den Berg, Jos; van den Heuvel, Daniel; Van Herzeele, Isabelle; Varcoe, Ramon; Vega de Ceniga, Melina; Veith, Frank J; Venermo, Maarit; Vijaynagar, Badri; Virdee, Sanjiv; Von Stempel, Conrad; Voûte, Michiel T; Khee Yeung, Kak; Zeller, Thomas; Zayed, Hany; Montero Baker, Miguel
PMID: 38523459
ISSN: 1545-1550
CID: 5645462
Vitamin D intoxication in a toddler due to a dispensing error of an imported vitamin D supplement [Meeting Abstract]
Rusyn, L; Patel, P R; David, R; Kohn, B; Brar, P C
Introduction: Vitamin D intoxication is a rare cause of hypercalcemia. There is a recent increase in reports of pediatric cases of hypercalcemia, secondary to vitamin D intoxication. This trend is attributable to the growing popularity of vitamin D supplements, especially as Vitamin D is being marketed as a "panacea" for a number of medical problems.Immigrant families often travel to their countries of origin, where vitamin supplements are available in formulations different from the US. Parents may not report using supplements to their child's pediatrician, as these supplements are perceived "safe" with no dangerous side effects.Case Presentation: A three year old toddler presented to the emergency room with emesis, polyuria, and lethargy. On inquiry, the family reported use of a multivitamin gel (made in Ecuador) dispensed at 1 tsp bid. Per the manufacturer's label, 5 grams (aD;one teaspoon) contains 0.096 mg (aD;100 IU) of cholecalciferol. A standard conversion of 1mug of cholecalciferol equals 40 IU1, secondary to conversion error this patient received 7,680 IU per day and 108,000 IU total vitamin D3 over 14 days, which is toxic. "Teaspoon" dosage inaccuracies and potentially excessive administration by caretakers compounded vitamin D toxicity.Initial lab values revealed Ca 16 mg/dl, iPTH 2.25 pg/mL (15-65), 25 OH vit D3: >512ng/mL(30-100), and UCa/UCreatinine 1.14mg/mg(<0.2). Hydration, lasix, calcitonin (6 days), and prednisolone (7 days) were used to manage the hypercalcemia. After 15 days of treatment, the 25 OH vitamin D3 was 324 ng/ml and the calcium decreased to 11.2 mg/dL. Conclusion s: In our case, dispensing and labeling errors led the parents to administer high doses of vitamin D to their toddler, leading to hypercalcemia. This highlights several issues regarding vitamin supplement usage.First, physicians should be aware of the dosage conversion of vitamin D in terms of IU, mg and mcg to calculate if the prescribed dose is appropriate for their patients. In addition, as there are no established manufacturing standards for certain vitamin supplement formulations-such as gels-caution should be exercised as more reports are emerging of toxic ingestion from overzealous supplementation. Verification of supplement source and composition is essential. Lastly, educating parents about the safe use of vitamin D supplements-emphasizing the need to report imported supplements to the patient's pediatrician-is important to avoiding erroneous toxic ingestion
EMBASE:70833827
ISSN: 0163-769x
CID: 175829