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Parathyroidectomy

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https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#1
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28213926/association-of-hypercalcemia-before-treatment-with-hypocalcemia-after-treated-in-dogs-with-primary-hyperparathyroidism
#2
J D Dear, P H Kass, A M Della Maggiore, E C Feldman
BACKGROUND: Development of hypocalcemia after treatment of hyperparathyroidism results in increased costs and risk of poorer outcomes. Previous studies have shown conflicting data about predictors of hypocalcemia after these procedures. HYPOTHESIS/OBJECTIVES: The objective of this study was to investigate whether ionized calcium (iCa) concentrations before treatment are predictive of hypocalcemia or its clinical signs after surgical removal or heat ablation in dogs with primary hyperparathyroidism...
February 18, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28199935/surgical-management-of-a-giant-parathyroid-adenoma-through-minimal-invasive-parathyroidectomy-a-case-report
#3
Georgios Sahsamanis, Konstantinos Gkouzis, Stavros Samaras, Dionysios Pinialidis, Georgios Dimitrakopoulos
INTRODUCTION: Primary hyperparathyroidism is a common endocrine disorder mostly associated to parathyroid adenomas. Although those tend to be small in size, rare cases of giant parathyroid adenomas may be present. CASE PRESENTATION: A 42year old female was admitted in our department due to weakness and vague abdominal pain for the past 8 months. Preoperative laboratory exams indicated primary hyperparathyroidism as a cause to her symptomatology, with elevated values of parathormone and normal values of serum calcium...
January 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28192245/feasibility-and-safety-of-minimally-invasive-radioguided-parathyroidectomy-using-very-low-intraoperative-dose-of-tc-99m-mibi
#4
Mostafa Mehrabibahar, Zohreh Mousavi, Ramin Sadeghi, Parvin Layegh, Masoumeh Nouri, Mehdi Asadi
BACKGROUND: Surgical resection of the abnormal parathyroid glands is the only curative treatment for primary hyperparathyroidism (PHPT). Radioguided parathyroidectomy with technetium-99m (TC-99m) sestamibi has been successfully used in patients with PHPT. This study was designed to evaluate the results of a series of patients with PHPT who underwent minimally invasive radioguided parathyroidectomy (MIRP) using very low dose (1 mCi) of TC-99m sestamibi (MIBI) without application of intraoperative parathyroid hormone (PTH) assay or frozen section analysis...
February 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28170301/influence-of-parathyroidectomy-on-bone-calcium-concentration-evaluation-with-spectral-ct-in-patients-with-secondary-hyperparathyroidism-undergoing-hemodialysis-a-prospective-feasibility-study
#5
Qiang Ma, Zhenghan Yang, Xue Han, Fen Liu, Dechun Su, Haidong Xing
Purpose To use spectral computed tomography (CT) to evaluate the influence of parathyroidectomy (PTX) on calcium concentration in trabecular bone and cortical bone in patients undergoing hemodialysis with secondary hyperparathyroidism. Materials and Methods This study was performed with institutional review board approval. Written consent was obtained from each patient. Thirty-eight men (mean age ± standard deviation, 55.69 years ± 8.05; range, 42-72 years) undergoing maintenance hemodialysis who underwent PTX and 40 patients (mean age, 56...
February 7, 2017: Radiology
https://www.readbyqxmd.com/read/28166819/validation-of-selective-use-of-intraoperative-pth-monitoring-in-parathyroidectomy
#6
Alexandra Thielmann, Paul Kerr
BACKGROUND: The objective of this study was to validate our approach of treating primary hyperparathyroidism using sestamibi scan directed parathyroidectomy, without routine use of intraoperative parathyroid hormone measurements (ioPTH). METHODS: We prospectively established a protocol limiting the use of ioPTH to patients with negative or equivocal sestamibi scans, and those who had risk factors for multi-gland disease. We then performed a retrospective review to determine our disease control rate...
February 6, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28161839/osteoprotegerin-and-uremic-osteoporosis-in-chronic-hemodialysis-patients
#7
Diana Moldovan, Crina Rusu, Alina Potra, Ioan Moldovan, Ioan Mihai Patiu, Mirela Gherman-Caprioara, Ina Maria Kacso
INTRODUCTION: Osteoprotegerin (OPG) is a powerful inhibitor of osteoclast activity, and it plays an important role in bone metabolism. In hemodialysis (HD) patients, the relationship between OPG and bone mineral density (BMD) is important, but remains unclear yet. The study objective was to assess the OPG role related to uremic osteoporosis in HD patients. METHODS: This cross-sectional study has been realized on a cohort of 63 chronic HD patients. INCLUSION CRITERIA: elderly prevalent HD patients with an age over 55 years old...
February 4, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28160140/optimizing-outpatient-pain-management-after-thyroid-and-parathyroid-surgery-a-two-institution-experience
#8
Irene Lou, Todd B Chennell, Sarah C Schaefer, Herbert Chen, Rebecca S Sippel, Courtney Balentine, David F Schneider, Jacob Moalem
BACKGROUND: Thyroidectomy and parathyroidectomy are the most commonly performed endocrine operations, and are increasingly being completed on a same-day basis; however, few data exist regarding the outpatient postoperative pain requirement of these patients. We aimed to describe the outpatient narcotic medication needs for patients undergoing thyroid and parathyroid surgery, and to identify predictors of higher requirement. METHOD: We examined patients undergoing thyroid and parathyroid surgery at two large academic institutions from 1 January-30 May 2014...
February 3, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28155099/inadvertent-parathyroidectomy-during-thyroid-surgery
#9
D M McGoldrick, M Majeed, A A Achakzai, H P Redmond
INTRODUCTION: Inadvertent parathyroidectomy is a recognised complication of thyroid surgery. We aimed to investigate the incidence of and risk factors for inadvertent parathyroidectomy during thyroid surgery, in our patient cohort. METHODS: A retrospective review of the records of all patients undergoing thyroid surgery in our institution between January 2012 and December 2014 was performed. Medical records, laboratory investigations and histopathology reports were evaluated...
February 2, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28145779/scan-directed-mini-incision-focused-parathyroidectomy-how-accurate-is-accurate-enough
#10
I M Shapey, S Jabbar, Z Khan, J E Nicholson, R J Watson
INTRODUCTION Mini-incision focused parathyroidectomy (MI-FP) is advocated as an alternative to bilateral neck exploration (BNE), owing to its reduced morbidity. The site and side of the affected gland is identified preoperatively using a combination of ultrasound and sestamibi scans. However, the acceptable degree of inter-scan concordance required to prompt MI-FP without compromising accuracy is undetermined. METHODS Accuracy of preoperative imaging was determined both individually and in combination for all parathyroidectomies (2007-2014)...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28138716/-accidental-esophageal-resection-in-subtotal-parathyroidectomy
#11
H Dralle, K Kols, C Dotzenrath, W T Knoefel
No abstract text is available yet for this article.
February 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28133267/-multiple-endocrine-neoplasia-type-1-men1-presenting-with-hypoglycemic-attacks-a-case-report
#12
Yusuke Okubo, Takeshi Tono, Maki Fukamizu, Yasuhito Kawasaki, Koji Shinozaki, Takaaki Ishii, Tomohiro Katayama, Yumiko Yamauchi, Hideaki Fukamizu, Takashi Tominaga, Shuho Senba, Seiji Yasuda, Minoru Otsuru
A woman in her 60s visited our hospital because of frequent hypoglycemia and episodes of unconsciousness over the last 6 years. A 4 cm tumor was detected on the pancreatic tail using abdominal computed tomography and ultrasonography. An insulinoma was strongly suspected from the results of the fasting test and glucagon load test, and a distal pancreatectomy with splenectomy was performed. Pathological examination indicated an insulinoma and neuroendocrine tumor(NET)G2 based on the WHO 2010 classification. The patient's blood sugar and insulin levels returned to normal, and hypoglycemic attacks disappeared postoperatively...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131138/primary-hyperparathyroidism-effects-on-bone-health
#13
REVIEW
Kyle A Zanocco, Michael W Yeh
Primary hyperparathyroidism (PHPT) is the most common cause of chronic hypercalcemia. With the advent of routine calcium screening, the classic presentation of renal and osseous symptoms has been largely replaced with mild, asymptomatic disease. In hypercalcemia caused by PHPT, serum parathyroid hormone levels are either high, or inappropriately normal. A single-gland adenoma is responsible for 80% of PHPT cases. Less frequent causes include 4-gland hyperplasia and parathyroid carcinoma. Diminished bone mineral density and nephrolithiasis are the major current clinical sequelae...
March 2017: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/28121013/incidental-parathyroidectomy-during-thyroidectomy-increases-the-risk-of-postoperative-hypocalcemia
#14
Yann-Sheng Lin, Chuen Hsueh, Hsin-Yi Wu, Ming-Chin Yu, Tzu-Chieh Chao
OBJECTIVES/HYPOTHESIS: The correlation between incidental parathyroidectomy (IP) during thyroidectomy and postoperative hypocalcemia remains controversial. Our aim was to investigate the incidence of IP, risk factors, and impact on patient outcomes. STUDY DESIGN: Retrospective cohort study. METHODS: This was a retrospective observational study including 3,186 consecutive patients who underwent thyroidectomy between January 2007 and December 2014...
January 25, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28116482/is-unilateral-neck-surgery-feasible-in-patients-with-sporadic-primary-hyperparathyroidism-and-double-negative-localisation
#15
D M Scott-Coombes, J Rees, G Jones, M J Stechman
INTRODUCTION: Ultrasound and Tc99mMIBI scans are used to localise parathyroid tumours in sporadic primary hyperparathyroidism (pHPT). Intra-operative PTH (ioPTH) assay facilitates unilateral neck exploration (UNE). When both ultrasound and MIBI are negative, it is our policy to explore the left side of the neck and only proceed to bilateral neck exploration (BNE) when either a tumour is not found or when ioPTH does not fall to >50% of the highest pre-excision value. The aim of this study was to investigate the outcome of our approach to 'double negative' patients...
January 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28108069/predictors-of-operative-failure-in-parathyroidectomy-for-primary-hyperparathyroidism
#16
David C Cron, Steven R Kapeles, Elizabeth A Andraska, Sebastian T Kwon, Peter S Kirk, Brendan L McNeish, Christopher S Lee, David T Hughes
INTRODUCTION: Many adjuncts guide surgical decision making in parathyroidectomy, yet their independent associations with outcome are poorly characterized. We examined a broad range of perioperative factors and used multivariate techniques to identify independent predictors of operative failure (persistent disease) after parathyroidectomy. METHODS: This was a retrospective review of 2239 patients with primary hyperparathyroidism who underwent parathyroidectomy at a single-center from 1999 to 2014...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28104158/incidence-and-risk-factors-of-persistent-hyperparathyroidism-after-kidney-transplantation
#17
K Nakai, H Fujii, T Ishimura, M Fujisawa, S Nishi
Persistent hyperparathyroidism after kidney transplantation is related to graft function, but pre-transplantation risk factors of persistent hyperparathyroidism have not been evaluated in detail. We enrolled 86 patients who had undergone kidney transplantation between 2008 and 2014. Nine patients showed persistent hyperparathyroidism characterized by the following: 1) serum parathyroid hormone levels >65 pg/mL and serum calcium levels >10.5 mg/dL at 1 year after kidney transplantation; 2) parathyroidectomy after kidney transplantation; and 3) reintroduction of cinacalcet after kidney transplantation...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104108/persisting-hypocalcemia-after-surgical-parathyroidectomy-the-differential-effectiveness-of-calcium-citrate-versus-calcium-carbonate-with-acid-suppression
#18
Sabahat Afshan, Abdeen R Farah Musa, Vonda Echols, Anna A Lerant, Tibor Fülöp
The effectiveness of oral calcium (Ca) may be contingent on a patient׳s factors beyond compliance, such as proton-pump inhibitor use and the choice of calcium supplements. A 32-year-old Hispanic male with end-stage renal disease on peritoneal dialysis underwent successful surgical parathyroidectomy (intact parathyroid hormone level: 2,328pg/mL; postsurgical: 287-69pg/mL [normal: 8.5-72.5]). His postoperative course was complicated by severe and recurrent hypocalcemia as outpatient and he needed repeated admissions for intravenous Ca gluconate...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28103657/-a-case-of-primary-hyperparathyroidism-complicated-with-hypercalcemic-crisis-during-treatment-with-cinacalcet-and-improved-by-active-treatment
#19
Tomoki Takeda, Atsushi Okada, Rei Unno, Yukihiro Umemoto, Keiichi Tozawa, Takahiro Yasui
A 77-year-old man was referred to our department for surgical treatment of a right ureteral stone identified on computed tomography (CT) during intensive examination for spondylolisthesis of L4-L5. At the initial visit, performance status was 4, and renal dysfunction was identified (Cr 1.3 mg/dl). Corrected calcium level was 11.8 mg/dl, and intact parathyroid hormone level was 555 pg/ml. A CT scan showed a well-defined mass measuring 22×16×20 mm on the right side of the esophagus, along with 99mTc-MIBI uptake in the lesion...
December 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28091771/localization-of-parathyroid-adenomas-using-11-c-methionine-pet-after-prior-inconclusive-imaging
#20
Milou E Noltes, Annemieke M Coester, Anouk N A van der Horst-Schrivers, Bart Dorgelo, Liesbeth Jansen, Walter Noordzij, Clara Lemstra, Adrienne H Brouwers, Schelto Kruijff
PURPOSE: Minimally invasive parathyroidectomy (MIP) is the recommended treatment in primary hyperparathyroidism (pHPT) for which accurate preoperative localization is essential. The current imaging standard consists of cervical ultrasonography (cUS) and MIBI-SPECT/CT. (11)C-MET PET/CT has a higher resolution than MIBI-SPECT/CT. The aim of this study was to determine the diagnostic performance of (11)C-MET PET/CT after initial inconclusive or negative localization. METHODS: We performed a retrospective single center cohort study of patients with pHPT undergoing parathyroid surgery after prior negative imaging and later localization by means of (11)C-MET PET/CT between 2006 and 2014...
January 14, 2017: Langenbeck's Archives of Surgery
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