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Parathyroidectomy

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https://www.readbyqxmd.com/read/28634171/preoperative-functional-status-is-associated-with-unplanned-intubations-following-thyroidectomies
#1
Rodney A Gabriel, Brittany N Burton, Albert P Nguyen, Ulrich H Schmidt
BACKGROUND: Unplanned postoperative intubation is an important event that may influence the outcome of thyroid- and parathyroidectomies. We performed a focused study on the association of preoperative functional status with unplanned intubation outcomes in these relatively common surgeries. METHODS: Utilizing data from the National Surgical Quality Improvement Program database from 2007 to 2013, a propensity score-matched retrospective cohort study was performed assessing this outcome in the functionally independent versus dependent groups...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28634117/to-assess-the-effects-of-parathyroidectomy-tptx-versus-tptx-at-for-secondary-hyperparathyroidism-in-chronic-renal-failure-a-meta-analysis
#2
REVIEW
Nian-Cun Qiu, Si-Luo Zha, Miao-E Liu, Zhi-Peng Du, Yi-Fan Wang, Qiang Wang, Qi Chen, Ying Jiang, Cheng-Xiang Shan, Ming Qiu
BACKGROUND: Secondary Hyperparathyroidism (SHPT) requiring parathyroidectomy (PTX) occurs more commonly in patients with progressive chronic kidney disease and in those on long-term lithium therapy. Successful PTX often results in a dramatic drop of parathyroid hormone level, relieves the patient from clinical symptoms, and reduces mortality. However, there is an ongoing debate on the optimal surgical treatment of SHPT. Currently, no clinical guidelines or trials have definitely answered the question of whether Total Parathyroidectomy (TPTX) is superior or equal to Total Parathyroidectomy with Autotransplantation (TPTX + AT)...
June 17, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28622150/intraoperative-hyperkalemia-and-ventricular-arrhythmia-during-parathyroidectomy-a-case-report
#3
Daniel J Rosenkrans, Lavinia M Kolarczyk
We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28620896/video-assisted-endocrine-neck-surgery-state-of-the-art
#4
REVIEW
Luca Sessa, Celestino Pio Lombardi, Carmela De Crea, Marco Raffaelli, Rocco Bellantone
During the last two decades, several minimally invasive approaches for endocrine neck surgery have been developed. Minimally invasive video-assisted approaches (minimally invasive video-assisted parathyroidectomy and minimally invasive video-assisted thyroidectomy) gained a quite large worldwide diffusion, maybe because these techniques combine the advantages related to the endoscopic magnification with those due to the close similarity with the conventional surgery that makes these surgical approaches reproducible and feasible in different surgical settings...
June 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28616866/vocal-palsy-increases-the-risk-of-lower-respiratory-tract-infection-in-low-risk-low-morbidity-patients-undergoing-thyroidectomy-for-benign-disease-a-big-data-analysis
#5
S A R Nouraei, J Allen, H Kaddour, S E Middleton, P Aylin, A Darzi, N S Tolley
OBJECTIVES: Thyroidectomy is the commonest and most rapidly-growing operation which places normally-functioning laryngeal nerves at risk of injury. Laryngeal palsy is a major risk-factor for dysphonia, dysphagia, and less commonly, airway obstruction. We investigated the association between post-thyroidectomy vocal palsy and long-term risks of pneumonia and laryngeal failure. DESIGN: An N=near-all analysis of the English administrative dataset using a previously-validated informatics algorithm to identify young and otherwise low-risk patients undergoing thyroidectomy for benign disease...
June 14, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28596785/oxidative-stress-and-angiogenesis-in-primary-hyperparathyroidism
#6
Mariusz Deska, Ewa Romuk, Oliwia Anna Segiet, Grzegorz Buła, Witold Truchanowski, Dominika Stolecka, Ewa Birkner, Jacek Gawrychowski
BACKGROUND: The inappropriate elevation of parathormone (PTH), which regulates the process of angiogenesis in parathyroid tissue, causes the changes of activity of enzymes responsible for the removal of free radicals. Parathyroidectomy (PTX) in patients with primary hyperparathyroidism (PHPT) lowers the level of PTH and leads to the reduction of risk of cardiovascular and all-cause mortality by normalization of the antioxidant status. Therefore, the aims of the study were to assess the activity of antioxidant enzymes and free radical reaction products in patients after parathyroidectomy, and to evaluate the correlation between the systemic oxidative stress and angiogenic parameters...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/28578084/a-novel-surgical-strategy-for-secondary-hyperparathyroidism-purge-parathyroidectomy
#7
Cheng-Xiang Shan, Nian-Cun Qiu, Si-Luo Zha, Miao-E Liu, Qiang Wang, Pei-Pei Zhu, Zhi-Peng Du, Chun-Yan Xia, Ming Qiu, Wei Zhang
OBJECTIVE: This study was intended to demonstrate the feasibility and efficacy of purge parathyroidectomy (PPTX) for patients with secondary hyperparathyroidism (SHPT). METHODS: The "seed, environment, and soil" medical hypothesis was first raised, following review of the literatures, to demonstrate the possible causes of persistence or recurrence of SHPT after parathyroidectomy. Subsequently, the novel surgical strategy of PPTX was proposed, which involves comprehensive resection of the fibro-fatty tissues, including visible or invisible parathyroid, within the region surrounded by the thyroid cartilage, bilateral carotid artery sheath, and the brachiocephalic artery...
May 31, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28572230/hypercalcaemia-presentation-and-management%C3%A2
#8
Jeremy J O Turner
Hypercalcaemia is a common disorder normally caused by primary hyperparathyroidism (PHPT) or malignancy. A proportion of cases present as an emergency, which carries a significant mortality. Emergency management of hypercalcaemia is based on intravenous rehydration with normal saline but when this is inadequate, bisphosphonate therapy is used; more recently the novel anti-resorbtive agent denosumab has been shown to have a useful role in treatment. It is estimated that up to 10% of all cases of PHPT presenting under the age of 45 years have an underlying genetic predisposition; nine potentially causative genes are now recognised and may be screened in routine clinical practice...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28571792/papillary-carcinoma-of-the-thyroid-in-patients-with-primary-hyperparathyroidism-is-there-a-link
#9
M Beebeejaun, E Chinnasamy, P Wilson, A Sharma, N Beharry, G Bano
Primary hyperparathyroidism (PHPT) is present in up to 0.1% of the general population. The incidence is higher in women and increases with age. The majority of the cases is asymptomatic and up to 85% are due to single gland adenoma. Parathyroidectomy is the treatment of choice after localization of the hyperactive gland. Papillary Thyroid Carcinoma (PTC) is the most common cancer of the thyroid and constitutes more than 70% of thyroid malignancies. PTC can present as a single nodule or can be Multifocal. The incidence is higher in women...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28558417/imaging-of-parathyroid-glands-in-end-stage-renal-disease
#10
Jyotirmay Sharma, Raghuveer Halkar, Collin J Weber
Secondary hyperparathyroidism from chronic renal failure often requires a parathyroidectomy for correction. A successful parathyroidectomy often relies upon localization of all parathyroid tumors. Although most of the tumors are localized during a neck exploration, preoperative localization studies can help identify ectopic and supernumerary tumors. Three of the most common localization studies are radionuclide imaging, ultrasound, and CT scanning. Utility of these studies is strongly dependent on local institutional practice...
May 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28556955/complete-reversal-of-bone-marrow-fibrosis-after-parathyroidectomy-for-secondary-hyperparathyroidism
#11
Paula D G G Azevedo, Patrícia S R Cardoso, Kátia de P Farah, Frederico H C de Melo, Suely M Rezende
No abstract text is available yet for this article.
May 30, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28553700/minimally-invasive-radioguided-parathyroid-surgery-using-low-dose-tc-99m-mibi-comparison-with-standard-high-dose
#12
Ali Jangjoo, Ramin Sadeghi, Zohreh Mousavi, Masoud Mohebbi, Mahtab Khaje, Mehdi Asadi
BACKGROUND: Surgery remains the most effective treatment for primary hyperparathyroidism (PHPT). Minimally invasive radioguided parathyroidectomy (MIRP) is a common technique for detecting and excising abnormal parathyroid glands. The aim of this study was to compare injections of low-dose and high-dose (99m) Tc methoxy isobutyl isonitrile (MIBI) for intraoperative localisation of parathyroid adenomas by means of a gamma probe in patients with primary hyperparathyroidism (PHPT). MATERIAL AND METHODS: Thirty patients with PHPT and a preoperative diagnosis of parathyroid adenoma were enrolled between 2010 and 2012...
May 29, 2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28550080/two-phosphate-targets-in-end-stage-renal-disease-trial-target-a-randomized-controlled-trial
#13
Ron Wald, Christian G Rabbat, Louis Girard, Amit X Garg, Karthik Tennankore, Jessica Tyrwhitt, Andrew Smyth, Andrea Rathe-Skafel, Peggy Gao, Andrea Mazzetti, Jackie Bosch, Andrew T Yan, Patrick Parfrey, Braden J Manns, Michael Walsh
BACKGROUND AND OBJECTIVES: Hyperphosphatemia is common among recipients of maintenance dialysis and is associated with a higher risk of mortality and cardiovascular events. A large randomized trial is needed to determine whether lowering phosphate concentrations with binders improves patient-important outcomes. To inform such an effort we conducted a pilot randomized controlled trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a randomized controlled trial of prevalent hemodialysis recipients already receiving calcium carbonate as a phosphate binder at five Canadian centers between March 31, 2014 and October 2, 2014...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28543873/effect-of-surgery-vs-observation-skeletal-5-year-outcomes-in-a-randomized-trial-of-patients-with-primary-hpt-the-siph-study
#14
Karolina Lundstam, Ansgar Heck, Kristin Godang, Charlotte Mollerup, Marek Baranowski, Ylva Pernow, Turid Aas, Ola Hessman, Thord Rosén, Jörgen Nordenström, Svante Jansson, Mikael Hellström, Jens Bollerslev
Mild primary hyperparathyroidism (PHPT) is known to affect the skeleton, even though patients usually are asymptomatic. Treatment strategies have been widely discussed. However, long-term randomized studies comparing parathyroidectomy to observation are lacking. The objective was to study the effect of parathyroidectomy (PTX) compared to observation (OBS) on bone mineral density (BMD) in g/cm(2) and T-scores, and on biochemical markers of bone turnover (P1NP and CTX-1), in a prospective randomized controlled study of patients with mild PHPT after 5 years of follow-up...
May 25, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28543268/sensitivity-of-3-dimensional-sonography-in-preoperative-evaluation-of-parathyroid-glands-in-patients-with-primary-hyperparathyroidism
#15
Susan J Frank, Adam E Goldman-Yassen, Tova Koenigsberg, Steven K Libutti, Mordecai Koenigsberg
OBJECTIVES: Preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism facilitates targeted surgery. We assessed the sensitivity of 3-dimensional (3D) sonography for preoperative localization of abnormal parathyroid glands. METHODS: We conducted a retrospective review of patients who underwent parathyroidectomy for primary hyperparathyroidism at a single site at our institution. We compared preoperative 2-dimensional (2D) sonography, 3D sonography, and sestamibi scans with final gland localization at surgery...
May 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28533644/atypical-parathyroid-adenoma-with-multiple-brown-tumors-as-initial-presentation-a-rare-entity
#16
V S Krishna Mohan, Manishi L Narayan, Arun Mukka, Bharath Bachimanchi, Amit Kumar Chowhan, B Vijayalakshmi Devi, Suresh Vaikkakara, Alok Sachan
Brown tumors seen in hyperparathyroidism are rare, non-neoplastic lesions because of abnormal bone metabolism, and they can mimic benign bone tumors or malignancy. Although biopsy is considered as the gold standard for diagnosis, it can be inconclusive. As the diagnosis of brown tumors is often challenging, a high index of suspicion is essential for diagnosis. We present a case of 21-year-old woman who presented with multiple painful bony lesions, which were initially misdiagnosed as fibrous dysplasia. Due to persistent bone pain and deterioration in her physical mobility, she was referred to tertiary care centre...
April 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28530313/-minimally-invasive-parathyroidectomy-mip-under-local-anesthesia-for-treatment-of-primary-hyperparathyroidism-phpt-caused-by-a-single-adenoma
#17
Michael M Krausz, Orwa Younis, Ahmad Mahamid, Miri Bidder, Ricardo Alfici
INTRODUCTION: Minimally Invasive Parathyroidectomy (MIP) has become the treatment of choice of Primary Hyperparathyroidism (PHPT) caused by an adenoma. In the present investigation we describe our experience with MIP performed under local anesthesia. METHODS: MIP was performed on 454 of 496 patients (91.5%) with PHPT. In 170 patients (37.4%), MIP was accomplished under local anesthesia. This procedure was elected when the medical condition prohibited general anesthesia, or in accordance with the patient's request...
January 2017: Harefuah
https://www.readbyqxmd.com/read/28527123/clinical-profile-of-juvenile-primary-hyperparathyroidism-a-prospective-study
#18
Federica Saponaro, Claudio Marcocci, Federica Cacciatore, Mario Miccoli, Elena Pardi, Simona Borsari, Gabriele Materazzi, Paolo Miccoli, Filomena Cetani
INTRODUCTION: Juvenile primary hyperparathyroidism is uncommon and more symptomatic than the adult counterpart. The aim of this prospective monocentric study, conducted in a tertiary referral center, was to evaluate the clinical, biochemical, and densitometric data, and the outcome of a series of patients with juvenile primary hyperparathyroidism. MATERIAL AND METHODS: The study group included 154 patients with sporadic and familial juvenile primary hyperparathyroidism, aged ≤40 years...
May 20, 2017: Endocrine
https://www.readbyqxmd.com/read/28522130/primary-hyperparathyroidism-hypercalciuria-and-bone-recovery-after-parathyroidectomy
#19
Inga-Lena Nilsson, Sophie Norenstedt, Jan Zedenius, Ylva Pernow, Robert Bränström
BACKGROUND: In primary hyperparathyroidism, successful parathyroidectomy leads to improved bone mineral density in the majority of cases. Our aim was to further explore the relationship between hypercalciuria, kidney function, and bone recovery after parathyroidectomy. METHODS: Bone mineral density, estimated glomerular filtration rate, and 24-hour urinary calcium were analyzed before and one year after parathyroidectomy in a cohort of 150 primary hyperparathyroidism patients (119 women; median age 60 [range 30-80] years) taking part in a clinical trial...
May 15, 2017: Surgery
https://www.readbyqxmd.com/read/28518414/systematic-review-of-surgical-and-medical-treatment-for-tertiary-hyperparathyroidism
#20
REVIEW
R R Dulfer, G J H Franssen, D A Hesselink, E J Hoorn, C H J van Eijck, T M van Ginhoven
BACKGROUND: A significant proportion of patients with chronic kidney disease and secondary hyperparathyroidism (HPT) remain hyperparathyroid after kidney transplantation, a state known as tertiary HPT. Without treatment, tertiary HPT can lead to diminished kidney allograft and patient survival. Parathyroidectomy was commonly performed to treat tertiary HPT until the introduction of the calcimimetic drug, cinacalcet. It is not known whether surgery or medical treatment is superior for tertiary HPT...
June 2017: British Journal of Surgery
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