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Parathyroid carcinoma and hungry bone syndrome
In this study, HBS was observed in both patients, who presented severe bone disease prior to surgery. HBS would be expected post-operatively in successful parathyroid carcinoma removal.O presente artigo descreve o relato de dois pacientes com carcinoma de paratiroide que apresentavam valores intensamente elevados de cálcio sérico e de PTH, associado a doença óssea e presença de nódulo cervical palpável ao diagnóstico. Ambos foram submetidos à paratiroidectomia, sendo que um evoluiu com metástases pulmonares. Hipocalcemia importante foi observada após a paratiroidectomia em um paciente e somente após remoção c...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - February 26, 2013 Category: Endocrinology Source Type: research
Bilateral pneumothoraces in a patient undergoing minimally invasive parathyroidectomyduring monitored anesthesia care
We describe a case of MIP during monitored anesthesia care, which was complicated by bilateral pneumothoraces and pneumomediastinum. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - February 1, 2013 Category: Anesthesiology Authors: Jeff C. Kwok, Vijaykumar C. Tarnal, Satya K. Ramachandran, Paul G. Gauger Tags: Correspondence Source Type: research
Clinicopathological Analysis of Persistent Hypercalcemia and Hyperparathyroidism After Kidney Transplantation in Long‐Term Dialysis Patients
This study on consecutive deceased donor kidney transplantation performed from 2002 to 2010 measured biochemical parameters related to bone and mineral disorders and examined parathyroid tissues in parathyroidectomy cases. Thirty‐four subjects (22 males; mean age, 53.8 ± 7.9 years; mean dialysis period, 14.4 ± 4.3 years) were enrolled. Multivariate analysis of potential predictors for the hypercalcemia group at 12 months after transplantation showed that pre‐transplantation and early post‐transplantation calcium and parathyroid hormone levels were significant determinants. Pathological examination showed th...
Source: Therapeutic Apheresis and Dialysis - February 1, 2013 Category: Hematology Authors: Michio Nakamura, Kiho Tanaka, Yuhji Marui, Shinji Tomikawa Tags: Original Article Source Type: research
Early-phase technetium-99m sestamibi scintigraphy can improve preoperative localization in primary hyperparathyroidism
Conclusions: A review of early scans in patients with negative imaging increases accurate adenoma localization and allows for minimally invasive operations in more patients. (Source: American Journal of Surgery)
Source: American Journal of Surgery - January 24, 2013 Category: Surgery Authors: Jocelyn F. Burke, Kalpana Naraharisetty, David F. Schneider, Rebecca S. Sippel, Herbert Chen Tags: Presidential Address Source Type: research
Parathyroid Localization and Implications for Clinical Management.
Conclusions:Parathyroid localization is indicated in surgical candidates. Crucial considerations when selecting an imaging study include availability, cost, radiation exposure, local expertise, and accuracy. Additional factors include the patient's anticipated pathology and whether it is de novo or refractory disease. An approach to imaging for patients with primary hyperparathyroidism is presented. PMID: 23345096 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - January 23, 2013 Category: Endocrinology Authors: Kunstman JW, Kirsch JD, Mahajan A, Udelsman R Tags: J Clin Endocrinol Metab Source Type: research
Radioguided Parathyroidectomy Effective in Pediatric Patients
(Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: J.F. Burke, K. Jacobson, A. Gosain, R.S. Sippel, H. Chen Tags: Quickshot Session: Thursday 2/7 3:30 PM to 5:30 PM Source Type: research
Significance of Rebounding Parathyroid Hormone Levels During Parathyroidectomy
(Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: D.F. Schneider, K.A. Ojomo, H. Mazeh, S.C. Oltmann, R.S. Sippel, H. Chen Tags: Quickshot Session: Thursday 2/7 3:30 PM to 5:30 PM Source Type: research
Analysis of 405 Parathyroid Glands Resected During Radioguided Parathyroidectomy for Tertiary Hyperparathyroidism
(Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: Y.R. Somnay, R. Sippel, H. Chen Tags: Quickshot Session: Thursday 2/7 3:30 PM to 5:30 PM Source Type: research
Negative Imaging is Not a Contraindication to Surgical Parathyroidectomy
(Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: H. Wachtel, M.C. Wismer, E.K. Bartlett, P.K. Shah, K.K. Shah, R.R. Kelz, G.C. Karakousis, D.L. Fraker Tags: Quickshot Session: Thursday 2/7 3:30 PM to 5:30 PM Source Type: research
A United States Population Based Outcomes Study involving 23,992 Symptomatic and Asymptomatic Patients Undergoing Parathyroidectomy: Can we Predict Endocrine Related Complications and Mortality?
15,000 parathyroidectomies/year are performed yearly in the USA. Parathyroidectomy results from specific institutions are well documented but little is known about National outcomes. (Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: C. Quinn, S. Patil, R.S. Chamberlain Tags: Oral Session: Wednesday 2/6 7:30 AM to 9:30 AM Source Type: research
Should the Criteria for Parathyroidectomy in Women of Childbearing Age be More Liberal? A 35-year Experience With Primary Hyperparathyroidism During Pregnancy
(Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: R.H. Grogan, I. Mamhoud, P. Angelos, E.L. Kaplan Tags: Quickshot Session: Tuesday 2/5 7:30 AM to 9:30 AM Source Type: research
Safety of Outpatient Thyroidectomy and Parathyroidectomy in the United States: An Analysis of 55,887 Patients
(Source: Journal of Surgical Research)
Source: Journal of Surgical Research - January 10, 2013 Category: Surgery Authors: Z.G. Schwam, S.A. Roman, J.A. Sosa Tags: Quickshot Session: Tuesday 2/5 7:30 AM to 9:30 AM Source Type: research
Peak Incidence of Pheochromocytoma and Primary Hyperparathyroidism in Multiple Endocrine Neoplasia 2: Need for Age-Adjusted Biochemical Screening.
Conclusions:These data, revealing phases of greater amidst phases of lower penetrance, support adjustment of biochemical screening to carrier age and ATA class. PMID: 23284010 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - January 2, 2013 Category: Endocrinology Authors: Machens A, Lorenz K, Dralle H Tags: J Clin Endocrinol Metab Source Type: research
Surgery in Primary Hyperparathyroidism: Extensive Personal Experience
This article reviews our approach reflecting advances in preoperative localization, anesthetic techniques, and intraoperative management of patients undergoing parathyroidectomy for the treatment of PHPT. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - January 1, 2013 Category: Radiology Authors: Brooks Van Udelsman, Robert Udelsman Tags: Original Articles Source Type: research
Impact of post‐kidney transplant parathyroidectomy on allograft function
ConclusionParathyroidectomy may lead to transient kidney allograft dysfunction with eventual recovery of graft function by 12 months post‐parathyroidectomy. Higher level of serum PTH pre‐parathyoidectomy is associated with a more profound decrease in eGFR post‐parathyroidectomy. (Source: Clinical Transplantation)
Source: Clinical Transplantation - January 1, 2013 Category: Transplant Surgery Authors: Samir Parikh, Haikady Nagaraja, Anil Agarwal, Srinivas Samavedi, Jon Visger, Uday Nori, Kenneth Andreoni, Todd Pesavento, Neeraj Singh Tags: Original Article Source Type: research
Surgical Management of Primary Hyperparathyroidism
This article provides an overview of the contemporary surgical management of PHPT. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - January 1, 2013 Category: Radiology Authors: Samuel A. Dowthwaite, J. Edward Young, Jesse D. Pasternak, John Yoo Tags: Original Articles Source Type: research
Nontraditional Manifestations of Primary Hyperparathyroidism
Abstract: Classical primary hyperparathyroidism (PHPT) was previously a multisystemic symptomatic disorder not only with overt skeletal and renal complications but also with neuropsychological, cardiovascular, gastrointestinal, and rheumatic effects. The presentation of PHPT has evolved, and today most patients are asymptomatic. Osteitis fibrosa cystica is rarely seen today, and nephrolithiasis is less common. Gastrointestinal and rheumatic symptoms are not part of the clinical spectrum of modern PHPT. It remains unclear whether neuropsychological symptoms and cardiovascular disease, neither of which are currently indicati...
Source: Journal of Clinical Densitometry - January 1, 2013 Category: Radiology Authors: Marcella Donovan Walker, Mishaela Rubin, Shonni J. Silverberg Tags: Original Articles Source Type: research
Adhesive strip wound closure after thyroidectomy/parathyroidectomy: A prospective, randomized controlled trial
Conclusion: Adhesive strips offer a safe and effective alternative approach to epidermal closure of surgical wounds in the neck. In addition, adhesive strips provide an equivalent if not better cosmetic benefit compared to traditional methods of epidermal closure. (Source: Surgery)
Source: Surgery - December 26, 2012 Category: Surgery Authors: D. Peter O'Leary, A.James Clover, John G. Galbraith, Muhammad Mushtaq, Azher Shafiq, H.Paul Redmond Tags: Original Communications Source Type: research
Functioning glucagonoma associated with primary hyperparathyroidism: multiple endocrine neoplasia type 1 or incidental association?
Conclusions: Despite well-defined diagnostic criteria and guidelines, diagnosis of MEN1 can still be challenging. When diagnosis is doubtful, appropriate management may be difficult to establish. (Source: BMC Cancer)
Source: BMC Cancer - December 22, 2012 Category: Cancer & Oncology Authors: Enrico ErdasNicola AsteLuca PilloniAngelo NicolosiSergio LicheriAntonello CappaiMarco MastinuFilomena CetaniElena PardiStefano MariottiMariano Pomata Source Type: research
Cinacalcet in the management of primary hyperparathyroidism: post marketing experience of an Italian multicentre group
ConclusionsThere is a wide heterogeneity in the prescription of cinacalcet in PHPT patients in Italy and the EMA labelling is not always followed, particularly in fPHPT patients. Cinacalcet effectively reduces serum calcium in patients with either sPHPT or fPHPT.© 2012 Blackwell Publishing Ltd (Source: Clinical Endocrinology)
Source: Clinical Endocrinology - December 10, 2012 Category: Endocrinology Authors: Federica Saponaro, Antongiulio Faggiano, Franco Grimaldi, Giorgio Borretta, Maria Luisa Brandi, Salvatore Minisola, Andrea Frasoldati, Enrico Papini, Alfredo Scillitani, Chiara Banti, Michela Del Prete, Fabio Vescini, Laura Gianotti, Loredana Cavalli, Eli Tags: Original Article Source Type: research
Adenomas of cervical maldescended parathyroid glands: pearls and pitfalls
ConclusionsDespite their rare occurrence, incompletely or abnormally descended PTAs can be encountered by any surgeon who performs parathyroidectomies. It is important to develop a strategy to systematically locate these glands. High cure rates can still be achieved with minimally invasive parathyroidectomy if confident preoperative localization is available. A sound knowledge of embryology and a thorough exploration also facilitate an overall high success rate with open exploration. (Source: ANZ Journal of Surgery)
Source: ANZ Journal of Surgery - December 10, 2012 Category: Surgery Authors: James C. Lee, Haggi Mazeh, Jonathan Serpell, Leigh W. Delbridge, Herbert Chen, Stanley Sidhu Tags: Original Article Source Type: research
Occurrence of new bone-like tissue formation in uremic tumoral calcinosis
Abstract: A 55-year-old woman who had been on hemodialysis for 5years was admitted for evaluation of a hard mass in the right hip region. Her serum calcium (Ca)–phosphate (P) product was elevated. Radiographs showed periarticular calcified masses in the soft tissues around both hips and shoulders, which were characteristic of uremic tumoral calcinosis (UTC). Biopsy specimens were obtained from both right hip mass and the right iliac crest. Histological examination of hip mass revealed bone-like tissue with marrow, as well as calcified material. The bone-like tissue was categorized as heterotopic ossification (HO), becaus...
Source: Bone - December 3, 2012 Category: Orthopaedics Authors: Rikako Hiramatsu, Yoshifumi Ubara, Noriko Hayami, Masayuki Yamanouchi, Eiko Hasegawa, Keiichi Sumida, Tatsuya Suwabe, Junichi Hoshino, Naoki Sawa, Norio Amizuka, Kenmei Takaichi Tags: Case Reports Source Type: research
Primary hyperparathyroidism in adolescents: the same but different
Conclusion Adolescents with primary hyperparathyroidism typically have more severe disease than adults. Contrary to popular belief, most adolescents have single gland disease and not hyperplasia associated with a genetic disorder. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00383-012-3222-3Authors Itai Pashtan, Endocrine Surgery Research Program, Department of Surgery, University of Chicago Pritzker School of Medicine, 5841 S. Maryland Ave MC 4052, Chicago, IL 60637, USARaymon H. Grogan, Endocrine Surgery Research Program, Department of Surgery, University of Chicago Pr...
Source: Pediatric Surgery International - November 27, 2012 Category: Surgery Tags: Pediatric Surgery International Source Type: research
Feasibility of video-assisted bilateral neck exploration for patients with primary hyperparathyroidism and failed or discordant localization studies
Conclusion In experienced hands, video-assisted BNE for pHPT is feasible and safe and provides results equivalent to the conventional open technique. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00423-012-1033-6Authors Pier Francesco Alesina, Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Henricistrasse 92, 45136 Essen, GermanyJakob Hinrichs, Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Akademisches Lehrkrankenhaus der Univer...
Source: Langenbeck's Archives of Surgery - November 25, 2012 Category: Surgery Tags: Langenbeck's Archives of Surgery Source Type: research
Symptoms of gastroesophageal reflux disease improve after parathyroidectomy
Conclusion: All symptoms of GERD improved after parathyroidectomy for hyperparathyroidism. Despite the decrease in symptoms, there was not a change in the number of patients who remained on anti-reflux therapy. For patients with symptoms of GERD, a trial off antireflux medications after parathyroidectomy should be considered. (Source: Surgery)
Source: Surgery - November 19, 2012 Category: Surgery Authors: Alexandra E. Reiher, Haggi Mazeh, Sarah Schaefer, Jon Gould, Herbert Chen, Rebecca S. Sippel Tags: American Association of Endocrine Surgeons Source Type: research
Calcium Reabsorption in the Distal Tubule: Regulation by Sodium, pH, and Flow.
Abstract We developed a mathematical model of Ca(2+) transport along the late distal convoluted tubule (DCT2) and the connecting tubule (CNT) to investigate the mechanisms that regulate Ca(2+) reabsorption in the DCT2-CNT. The model accounts for apical Ca(2+) influx across transient receptor potential vanilloid 5 (TRPV5) channels, and basolateral Ca(2+) efflux via plasma membrane Ca(2+)-ATPase pumps and type 1 Na(+)/ Ca(2+) exchangers (NCX1). Model simulations reproduce experimentally observed variations in Ca(2+) uptake as a function of extracellular pH, Na(+), and Mg2+ concentration. Our results indicate that ami...
Source: American Journal of Physiology. Renal Physiology - November 14, 2012 Category: Physiology Authors: Bonny O, Edwards A Tags: Am J Physiol Renal Physiol Source Type: research
Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism.A systemic review of the literature.
Abstract Hungry bone syndrome refers to the rapid, profound and prolonged hypocalcaemia associated with hypophosphataemia and hypomagnesaemia and exacerbated by suppressed parathyroid hormone levels, which follows parathyroidectomy in patients with severe primary hyperparathyroidism and preoperative high bone turnover. It is a relatively uncommon, but serious adverse effect of parathyroidectomy. We conducted a literature search of all available studies reporting a "hungry bone syndrome" in patients who had a parathyroidectomy for primary hyperparathyroidism, to identify patients at risk and address the pitfalls in ...
Source: European Journal of Endocrinology - November 14, 2012 Category: Endocrinology Authors: Witteveen J, van Thiel S, Romijn JA, Hamdy N Tags: Eur J Endocrinol Source Type: research
Further Insights into the Pathogenesis of Primary Hyperparathyroidism: A Nested Case-Control Study.
Conclusion:Years prior to a clinical diagnosis of PHPT, calcium homeostasis shows signs of perturbations. Latent PHPT may be characterized by either normocalcemic hyperparathyroidism or normoparathyroid hypercalcemia. Such patients should be offered long-term follow-up to ascertain whether their biochemical profile represents an early state of PHPT. PMID: 23150677 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - November 12, 2012 Category: Endocrinology Authors: Rejnmark L, Amstrup AK, Mollerup CL, Heickendorff L, Mosekilde L Tags: J Clin Endocrinol Metab Source Type: research
Current trends in surgery for renal hyperparathyroidism (RHPT)—an international survey
Conclusions The survey reflects the divergent strategies applied for AT, cryopreservation, and PTH monitoring in RHPT. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00423-012-1025-6Authors Philipp Riss, Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaReza Asari, Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaChristian Scheuba, Section of Endocrine Surgery, ...
Source: Langenbeck's Archives of Surgery - November 11, 2012 Category: Surgery Tags: Langenbeck's Archives of Surgery Source Type: research
Prolonged hypophosphatemia following parathyroidectomy in chronic hemodialysis patients.
Conclusion: In patients on maintenance dialysis, persistent hypoparathyroidism post-parathyroidectomy may lead to chronic hypophosphatemia, in contrast to the hyperphosphatemia usually associated with hypoparathyroidism. Proposed mechanisms for this paradoxical phenomenon include ongoing phosphorus deposition into bone (Hungry Bone Syndrome), phosphorus deposition into soft tissue and/or diminished intestinal phosphorus absorption or increased intestinal phosphorus loss. PMID: 23084333 [PubMed - in process] (Source: Clinical Nephrology)
Source: Clinical Nephrology - November 1, 2012 Category: Urology & Nephrology Authors: Shavit L, Lifschitz M, Slotki I Tags: Clin Nephrol Source Type: research
Impact of mineral and bone disorder on healthcare resource use and associated costs in the European Fresenius medical care dialysis population: a retrospective cohort study
Conclusions: These data suggest that elevated SHPT parameters increase the economic burden of CKD in Europe. (Source: BMC Nephrology)
Source: BMC Nephrology - October 29, 2012 Category: Urology & Nephrology Authors: Silvia ChiroliCaroline MattinVasily BelozeroffLouise PerraultDominic MitchellIoanna Gioni Source Type: research
Parathyroid-gland ultrasonography in clinical and therapeutic evaluation of renal secondary hyperparathyroidism
Conclusions US parameters of PTGs are correlated to the degree of SHPT and type of hyperplasia and predict responsiveness to medical therapy. Content Type Journal ArticleCategory Head and Neck Radiology / Radiologia del Capo e del ColloPages 1-16DOI 10.1007/s11547-012-0882-xAuthors C. Vulpio, Istituto Clinica Chirurgica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, ItalyM. Bossola, Istituto Clinica Chirurgica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, ItalyS. C. Magalini, Istituto Clinica Chirurgica, Università Cattolica del Sacro Cuore, Largo A. G...
Source: La Radiologia Medica - October 22, 2012 Category: Radiology Tags: La Radiologia Medica Source Type: research
Primary hyperparathyroidism in a patient with familial hypocalciuric hypercalcaemia due to a novel mutation in the calcium-sensing receptor gene
We describe the clinical and genetic findings in pedigree with a novel mutation in the calcium sensing receptor (CaSR) gene and the unusual coexistence of primary hyperparathyroidism (HPT) and familial hypocalciuric hypercalcaemia (FHH) and its clinical management. The occurrence of both FHH and primary HPT in the same patient has been described rarely. Our pedigree has a novel mutation in the CaSR gene. Parathyroidectomy led to a reduction, but not normalization of the calcium levels in the patient identified as having HPT. The coexistence of HPT and FHH was considered in this patient as her calcium and PTH levels wer...
Source: Journal of Bone and Mineral Metabolism - October 19, 2012 Category: Orthopaedics Tags: Journal of Bone and Mineral Metabolism Source Type: research
Cervical tumoral calcinosis with secondary hyperparathyroidism in a chronic hemodialysis patient
We report here a case of a patient on maintenance hemodialysis who presented with progressively increasing, solitary, tumor‐like swelling over the nape of the neck. A 50‐year‐old female on thrice weekly maintenance hemodialysis for the last 3 years presented with a small swelling over the nape of the neck that had been progressively increasing over the last 1 year to cricket ball size. The patient was investigated and diagnosed as having tumoral calcinosis. The metastatic calcification occurring in the patient was most likely related to high calcium × phosphate product with coexistent secondary hyperparathyroidi...
Source: Hemodialysis International - October 16, 2012 Category: Hematology Authors: Sham Sunder, Himanshu Verma, Krishnamoorthy Venkataramanan Tags: Case Report Source Type: research
Intrathyroidal parathyroid glands: Small, but mighty (a Napoleon phenomenon)
Conclusion: Single intrathyroidal parathyroid adenomas are smaller than nonintrathyroidal parathyroid adenomas, but patients with intrathyroidal parathyroid adenomas present with similar laboratory values and symptoms. Recognition of this rare entity can lead to a successful surgical outcome. (Source: Surgery)
Source: Surgery - October 15, 2012 Category: Surgery Authors: Haggi Mazeh, Guennadi Kouniavsky, David F. Schneider, Konstantinos I. Makris, Rebecca S. Sippel, Alan P.B. Dackiw, Herbert Chen, Martha A. Zeiger Tags: American Association of Endocrine Surgeons Source Type: research
Is minimally invasive parathyroidectomy associated with greater recurrence compared to bilateral exploration? Analysis of more than 1,000 cases
Conclusion: MIP appears equivalent to OP in single-gland disease. Although patients undergoing OP experienced more transient hypocalcemia, patients undergoing MIP appear to have a greater long-term recurrence rate. Therefore, proper patient selection and counseling of these risks is necessary for either approach. (Source: Surgery)
Source: Surgery - October 15, 2012 Category: Surgery Authors: David F. Schneider, Haggi Mazeh, Rebecca S. Sippel, Herbert Chen Tags: American Association of Endocrine Surgeons Source Type: research
Submaximal suppression of parathyroid hormone ameliorates calcitriol-induced aortic calcification and remodeling and myocardial fibrosis in uremic rats
Conclusion: Submaximal suppression of PTH by either CINA or PTX reduced vascular calcifications, arterial remodeling and myocardial fibrosis to a similar degree and independent of the serum calcium and phosphorus levels. These data do not indicate vasculotropic effects of calcimimetics independent of PTH suppression. (Source: Journal of Hypertension)
Source: Journal of Hypertension - October 11, 2012 Category: Cardiology Tags: ORIGINAL PAPERS: Kidney Source Type: research
Intraoperative Parathyroid Hormone Kinetics and Influencing Factors with High Baseline PTH: A Prospective Study
ConclusionIOPTH monitoring is reliable even in patients with extremely high baseline IOPTH value, with a greater percentage drop at 5 and 10 minutes postexcision. In patients with high baseline IOPTH, a 50% decay in PTH value at 5 minutes may be indicative of cure, obviating the need for 10 and 15 minute samples. IOPTH kinetics are altered by adenoma weight but not affected by vitamin D status or baseline IOPTH levels.© 2012 Blackwell Publishing Ltd (Source: Clinical Endocrinology)
Source: Clinical Endocrinology - October 9, 2012 Category: Endocrinology Authors: Dependra Narayan Singh, Sushil Kumar Gupta, Gyan Chand, Anjali Mishra, Gaurav Agarwal, A.K. Verma, S.K. Mishra, Manoj Shukla, Amit Agarwal Tags: Original Article Source Type: research
An analysis of genotype–phenotype correlations and survival outcomes in patients with primary hyperparathyroidism caused by multiple endocrine neoplasia type 1: the experience at a single institution
Conclusions Premature deaths related to MEN1 are due to the development of malignant PNET, pituitary crisis or thymic tumors associated with mutations in exons 2, 3 and a large deletion. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00595-012-0354-yAuthors Kiyomi Horiuchi, Department of Endocrine Surgery, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 JapanTakahiro Okamoto, Department of Endocrine Surgery, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 JapanMasatoshi Iihara, Department of Endocrine Surger...
Source: Surgery Today - October 8, 2012 Category: Surgery Tags: Surgery Today Source Type: research
Clinical evaluation of a novel stop mutation in the extracellular domain of the calcium-sensing receptor
Abstract: Loss-of-function CaR mutations cause elevated parathyroid hormone (PTH) secretion and hypercalcaemia. Though fully ablatable in transgenic mice, normally only point mutations occur in human CaR. However, here we report a case of neonatal severe hyperparathyroidism (NSHPT) in which the truncated CaR lacks any transmembrane domain (CaR-R392X), in effect a full “CaR-knockout”. The infant (daughter of distant cousins) presented with very high serum calcium (5.5mM) and PTH concentrations (650–950pM [12–81]) together with raised alkaline phosphatase activity and skeletal demineralisation. Sequencing of the infa...
Source: Bone - October 8, 2012 Category: Orthopaedics Authors: D.T. Ward, M.Z. Mughal, M. Ranieri, M.M. Dvorak, G. Valenti, D. Riccardi Tags: Poster Presentations Source Type: research
Clinical consequences of CASR mutation in the first few years of life
Abstract: Neonatal severe hyperparathyroidism (NSHPT) is the common phenotype arising from homo- or heteroallelic homozygosity for inactivating mutations of the CASR gene. Early total parathyroidectomy, introduced forty years ago, remains the treatment of choice, but medical options to control hypercalcemia and stabilize the patient prior to surgery have improved in the interim. Although heterozygous inactivating mutations are most often associated with an asymptomatic picture (familial hypocalciuric hypercalcemia or FHH), there are notable exceptions. By itself, a dominant-negative mutation can give rise to frank hyperpar...
Source: Bone - October 8, 2012 Category: Orthopaedics Authors: D.E.C. Cole, G.N. Hendy Tags: Oral Presentations Source Type: research
Changes in bone mineral density after surgical intervention for primary hyperparathyroidism
Conclusion: Bone mineral density improves in up to 75% of patients after curative parathyroidectomy for primary hyperparathyroidism. The hip and lumbar spine responded similarly. Younger patients and those with severe primary hyperparathyroidism may derive the most skeletal benefits from parathyroidectomy, but the uniform positive response supports parathyroidectomy in patients with osteoporosis and possibly osteopenia. (Source: Surgery)
Source: Surgery - October 5, 2012 Category: Surgery Authors: Benzon M. Dy, Clive S. Grant, Robert A. Wermers, Ann E. Kearns, Marianne Huebner, William S. Harmsen, Geoffrey B. Thompson, David R. Farley, Melanie L. Richards Tags: American Association of Endocrine Surgeons Source Type: research
Ultrasound in clinical setting of secondary hyperparathyroidism.
Abstract Secondary hyperparathyroidism (sHPT) is one of the most common and serious complications of chronic kidney disease (CKD) and maintenance hemodialysis (MHD). In sHPT, the biology of parathyroid cells changes significantly toward diffuse and nodular hyperplasia. Diagnosis and treatment of sHPT are based on intact parathyroid hormone (i-PTH) serum levels and on the parameters of mineral metabolism. The morphological diagnosis of sHPT relies on 2 complementary imaging techniques: high-resolution ultrasonography with color Doppler imaging (US/CD) and 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy. The main...
Source: Journal of Nephrology - October 5, 2012 Category: Urology & Nephrology Authors: Meola M, Petrucci I, Cupisti A Tags: J Nephrol Source Type: research
Persistent elevation in serum parathyroid hormone levels in normocalcemic patients after parathyroidectomy: Does it matter?
Conclusion: Patients with elevated PTH levels after curative PTX do not have greater rates of recurrence than patients with normal PTH levels. The greater PTH levels and lesser vitamin D levels support postoperative vitamin D supplementation in these patients. (Source: Surgery)
Source: Surgery - October 1, 2012 Category: Surgery Authors: Carrie B. Carsello, Tina W.F. Yen, Tracy S. Wang Tags: Central Surgical Association Source Type: research
Surgeon beware: Many patients referred for parathyroidectomy are misdiagnosed with primary hyperparathyroidism
Conclusion: Considerable confusion exists regarding the differentiation of primary and secondary HPT. Surgeons should be cautioned that patients who are referred for parathyroidectomy, even those with complete laboratory and radiographic evaluations, might not have pHPT at all. (Source: Surgery)
Source: Surgery - October 1, 2012 Category: Surgery Authors: James C. Iannuzzi, Daniel X. Choi, Rachel L. Farkas, Daniel T. Ruan, James L. Peacock, Jacob Moalem Tags: Central Surgical Association Source Type: research
Impact of parathyroidectomy on allograft outcomes in kidney transplantation
Summary We performed retrospective, multi‐center study of the impacts of parathyroidectomy (PTX) after or before kidney transplantation on allograft outcomes. A total of 63 patients who underwent PTX after kidney transplantation were identified. Deterioration in eGFR by more than 25% at 1 month after PTX occurred in 20% of the patients. The baseline eGFR was significantly lower in impairment group than nonimpairment group [adjusted odds ratio (OR) 0.87, 95% confidence interval (CI) 0.77–0.99, P = 0.033]. Low iPTH concentration after PTX was also a significant risk factor for the renal impairment (OR 0.96, CI 0.94...
Source: Transplant International - September 30, 2012 Category: Transplant Surgery Authors: Hee Jung Jeon, Yoon Jung Kim, Hyuk Yong Kwon, Tai Yeon Koo, Seon Ha Baek, Hyo‐Jin Kim, Woo Seong Huh, Kyu Ha Huh, Myoung Soo Kim, Yu Seun Kim, Su‐Kil Park, Curie Ahn, Jaeseok Yang Tags: ORIGINAL ARTICLE Source Type: research
Primary hyperparathyroidism and urolithiasis: Our early experience
Background: Hyperparathyriodism is associated with an increase risk of developing renal calculi. The aim of this study was to quantify the incidence of renal calculi in patients undergoing parathyroidectomy. (Source: International Journal of Surgery)
Source: International Journal of Surgery - September 28, 2012 Category: Surgery Authors: Jun-Hong Lim, Kattedath Madhavan Tags: Abstracts from the Assocation of Surgeons in Training Conference Source Type: research
Parathyroidecomy in a district general hospital: outcomes and evolution in the era of minimally invasive surgery
Aim: To determine the outcomes of bilateral neck exploration(BNE) and uptake as well as outcomes of minimally invasive parathyroidectomy(MIP) for primary hyperparathyroidism in a district general hospital(DGH). (Source: International Journal of Surgery)
Source: International Journal of Surgery - September 28, 2012 Category: Surgery Authors: Sharath Paravastu, David Chadwick Tags: Abstracts from the Assocation of Surgeons in Training Conference Source Type: research
Minimally invasive parathyroidectomy for primary hyperthyroidism guided by intra-operative parathyroid hormone monitoring
In this study, we explored the success rate of our technique. (Source: International Journal of Surgery)
Source: International Journal of Surgery - September 28, 2012 Category: Surgery Authors: Alison Lyon, O.O. Komolafe, Christopher Wilson Tags: Abstracts from the Assocation of Surgeons in Training Conference Source Type: research
Is pre-operative 99M-TC SESTAMIBI scanning preferable to no pre-operative scanning in patients with primary hyperparathyroidism?
Aim: Parathyroidectomy is key in the management of hyperparathyroidism, yet the methods used to preoperatively localize parathyroid pathology are controversial. 99m-Tc sestamibi scanning is the most commonly used method, however, some argue that surgical experience is sufficient. The aim of this study is to establish whether pre-operative 99M-Tc sestamibi scanning is preferable to surgical experience alone in the identification of pathology in patients with primary hyperparathyroidism. (Source: International Journal of Surgery)
Source: International Journal of Surgery - September 28, 2012 Category: Surgery Authors: Chevonne Brady, David Smith Tags: Abstracts from the Assocation of Surgeons in Training Conference Source Type: research