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Hyperparathyroid

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https://www.readbyqxmd.com/read/28828238/single-phase-computed-tomography-is-equivalent-to-dual-phase-method-for-localizing-hyperfunctioning-parathyroid-glands-in-patients-with-primary-hyperparathyroidism-a-retrospective-review
#1
Fanny Morón, Alfred Delumpa, Justin Chetta, Danielle Guffey, David Dunaway
OBJECTIVE: This study aims to compare the sensitivity of dual phase (non-contrast and arterial) versus single phase (arterial) CT for detection of hyper-functioning parathyroid glands in patients with primary hyperparathyroidism. METHODS: The CT scans of thirty-two patients who have biochemical evidence of primary hyperparathyroidism, pathologically proven parathyroid adenomas, and pre-operative multiphase parathyroid imaging were evaluated retrospectively in order to compare the adequacy of single phase vs...
2017: PeerJ
https://www.readbyqxmd.com/read/28827905/clinical-utility-of-tc-99m-mibi-spect-ct-for-preoperative-localization-of-parathyroid-lesions
#2
Zeynep Gozde Ozkan, Seher Nilgun Unal, Serkan Kuyumcu, Yasemin Sanli, Mehmet Fatih Gecer, Beyza Ozcinar, Yasemin Senyurek Giles, Yesim Erbil
We aimed to demonstrate the role of SPECT/CT in preoperative localization of parathyroid lesions in patients with hyperparathyroidism who had technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) dual-phase parathyroid scintigraphy. We evaluated retrospectively the scintigraphic data of 103 patients who had parathyroidectomy after Tc-99m MIBI dual-phase parathyroid scintigraphy with SPECT/CT. The planar and SPECT/CT images were evaluated separately to determine their efficacy in localizing parathyroid lesions...
August 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28825015/simultaneous-incidental-parathyroid-carcinoma-and-intrathyroid-parathyroid-gland-in-suspected-renal-failure-induced-hyperparathyroidism
#3
Andrew Pappa, Trevor Hackman
Hyperparathyroidism is a common disorder affecting more than hundreds of thousands of people annually. While most commonly secondary to an adenoma, it may also arise from four-gland hyperplasia or malignancy. In the case of primary hyperparathyroidism, the number of glands involved may be unknown prior to surgery. In contrast, the metabolic disorder associated with renal failure induced hyperparathyroidism ensures a hyperplasia picture. Despite the uniform hyperplasia seen in tertiary disease and the preoperative expectation for four-gland exploration, our case demonstrates the continued need for a surgeon's vigilance during dissection to identify all glands and appropriately use intraoperative parathyroid hormone (PTH) testing...
January 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28824003/men4-and-cdkn1b-mutations-the-latest-of-the-men-syndromes
#4
Rami Alrezk, Fady Hannah-Shmouni, Constantine A Stratakis
Multiple endocrine neoplasia (MEN) refers to a group of autosomal dominant disorders with generally high penetrance that lead to the development of a wide spectrum of endocrine and non-endocrine manifestations. The most frequent among these conditions is MEN type 1 (MEN1), which is caused by germline heterozygous loss-of-function mutations in the tumor suppressor gene MEN1. MEN1 is characterized by primary hyperparathyroidism (PHPT) and functional or nonfunctional pancreatic neuroendocrine tumors and pituitary adenomas...
August 19, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28823005/normocalcaemic-primary-hyperparathyroidism-a-diagnostic-and-therapeutic-algorithm
#5
Joaquín Gómez-Ramírez, Radu Mihai
In recent years, there has been increasing interest in understanding the implications of diagnosing normocalcaemic primary hyperparathyroidism (nPHPT). Many patients hope that nPHPT might explain some of their symptoms, but surgeons hesitate to offer treatment to patients whose calcium levels are normal but whose parathyroid hormone (PTH) levels are elevated in the absence of secondary causes of hyperparathyroidism. This potential new diagnosis is not well understood and may lead to inappropriate investigation and possible unnecessary operations...
August 19, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28822386/the-sestamibi-paradox-improving-intraoperative-localization-of-parathyroid-adenomas
#6
Jessica L Buicko, Kandace M Kichler, Julia R Amundson, Stephanie Scurci, Robert A Kozol
Accurate localization of parathyroid adenomas allows for minimally invasive parathyroidectomy. This results in a shorter length of stay and increased patient satisfaction. Preoperative Technetium (99mTc) sestamibi scans accurately localize parathyroid adenomas in 70 to 85 per cent of cases. If a patient has a negative scan, it is logical to believe that with a preoperative sestamibi injection, the gamma probe may fail to help find an adenoma. We hypothesized that the gamma probe would not be useful intraoperatively for patients with primary hyperparathyroidism (PHPTH) and a negative sestamibi scan...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28819506/-parathyroid-carcinoma-about-a-case-and-review-of-the-literature
#7
Naourez Kolsi, Sondos Jellali, Jamel Koubaa
Parathyroid carcinoma is a very rare malignant tumor of the parathyroid gland. Clinically, this cancer is characterized by the presence of severe primary hyperparathyroidism. Diagnosis is based on histological examination but is not always easy. Surgery is the treatment of choice. We report the case of a 59-year old woman with a personal history of arterial hypertension and of recurrent renal lithiasis, presenting with diffuse bone pain associated with asthenia. Neck examination showed hard basi-cervical swelling with nonpalpable lower edge...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28816531/prevalence-and-predictors-of-primary-hyperparathyroidism-amongpatients-with-urolithiasis
#8
S Sharma, A Rastogi, S K Bhadada, P Singh, S Varshney, A Behera, A Bhansali, S K Singh, D S Rao
BACKGROUND: Urolithiasis may be the only presenting manifestation of primary hyperparathyroidism (PHPT), and early detection of PHPT in such patients may prevent future urolithiasis and other PHPT complications. OBJECTIVES: To study the prevalence and predictors of PHPT in patients presenting with urolithiasis. SUBJECTS & METHODS: Consecutive patients presenting with urolithiasis were evaluated for clinical and biochemical manifestations of PHPT with serum and urine calcium, serum intact parathyroid hormone and 25 (OH) vitamin D...
August 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28815282/correction-of-vitamin-d-status-by-calcidiol-pharmacokinetic-profile-safety-and-biochemical-effects-on-bone-and-mineral-metabolism-of-daily-and-weekly-dosage-regimens
#9
S Minisola, L Cianferotti, P Biondi, C Cipriani, C Fossi, F Franceschelli, F Giusti, G Leoncini, J Pepe, H A Bischoff-Ferrari, M L Brandi
RATIONALE: Calcidiol can be employed to correct vitamin D deficiency. MAIN RESULTS: Calcidiol administered at daily and weekly regimens over a period of 3 months was able to successfully raise 25-hydroxyvitamin D levels without altering other markers related to bone and mineral metabolism. SIGNIFICANCE: Calcidiol supplementation is effective and safe. INTRODUCTION: The correction of vitamin D status is necessary to maintain an optimal mineral and skeletal homeostasis...
August 16, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28815093/a-case-of-hyperparathyroidism-due-to-a-large-intrathyroid-parathyroid-adenoma-with-recurrent-episodes-of-acute-pancreatitis
#10
Kazunori Kageyama, Noriko Ishigame, Aya Sugiyama, Akiko Igawa, Takashi Nishi, Satoko Morohashi, Hiroshi Kijima, Makoto Daimon
We report a case of a 66-year-old woman who developed hyperparathyroidism due to a large intrathyroid parathyroid adenoma with episodes of acute pancreatitis. She had previously been treated for acute pancreatitis twice. Serum calcium was 12.4 mg/dL, and intact parathyroid hormone was 253 pg/dL. Ultrasonography and computed tomography of the neck with contrast enhancement revealed a soft tissue mass (28 mm transverse diameter) within the left lobe of the thyroid. (99m)Tc-MIBI scintigraphy demonstrated focal accumulation due to increased radiotracer uptake in the left thyroid lobe...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28814738/identification-of-novel-non-secosteroidal-vitamin-d-receptor-agonists-with-potent-cardioprotective-effects-and%C3%A2-%C3%AF-%C3%AF-devoid-of-hypercalcemia
#11
Santosh A Khedkar, Mohammed A Samad, Sangita Choudhury, Ji Yoo Lee, Dongsheng Zhang, Ravi I Thadhani, S Ananth Karumanchi, Alan C Rigby, Peter M Kang
Vitamin D regulates many biological processes, but its clinical utility is limited by its hypercalcemic effect. Using a virtual screening platform to search novel chemical probes that activate the vitamin D signaling, we report discovery of novel non-steroidal small-molecule compounds that activate the vitamin D receptor (VDR), but are devoid of hypercalcemia. A lead compound (known as VDR 4-1) demonstrated potent transcriptional activities in a VDR reporter gene assay, and significantly ameliorated cardiac hypertrophy in cell culture studies and in animal models...
August 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28811539/intraoperative-parathyroid-localization-with-near-infrared-fluorescence-imaging-using-indocyanine-green-during-total-parathyroidectomy-for-secondary-hyperparathyroidism
#12
Le Cui, Yang Gao, Heping Yu, Min Li, Birong Wang, Tao Zhou, Qinggang Hu
The detection of all glands during total parathyroidectomy (TPTX) in secondary hyperparathyroidism (SHPT) patients is often difficult due to their variability in number and location. The objective of this study was to evaluate the feasibility of near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG) for intraoperative parathyroid gland (PTG) localization in SHPT patients. Twenty-nine patients with SHPT were divided into two groups with or without intraoperative NIRF imaging. ICG was administered in patients undergoing intraoperative imaging, and the fluorescence of PTGs was assessed...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28809753/an-occult-ectopic-parathyroid-adenoma-in-a-pediatric-patient-a-case-report-and-management-algorithm
#13
Brent D Bauman, Maria Evasovich, Amanda Louiselle, Eugene Zheng, Kevin Goodwin, Miroslav Sekulic, Faqian Li, Raphael Andrade, Bradley J Segura
BACKGROUND: Hyperparathyroidism (HPT) is a rare disease in the pediatric population, and optimal management may be unclear if it is due to an occult parathyroid adenoma. We present a case report of a pediatric patient with an occult, ectopic, supernumerary, parathyroid adenoma. CASE PRESENTATION: A 13-year-old female who initially presented with anxiety was diagnosed with HPT. Preoperative imaging and bilateral neck exploration with four-gland biopsy were negative for any parathyroid adenoma...
August 15, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28808512/a-case-of-hypercalcemia-with-double-pathology
#14
Ahmed Abdalla, Ghassan Bachuwa, Samer Al Hadidi
Hypercalcemia has many causes including primary hyperparathyroidism, malignancy, and other rare etiologies. In most of the cases, hypercalcemia is secondary to one etiology. In this case, we are reporting hypercalcemia with two causes. The initial workup showed primary hyperparathyroidism due to parathyroid adenoma. But because all features were not fully explained by primary hyperparathyroidism, further work-up revealed multiple myeloma. This case represents coexistence of two different diseases, which was rarely reported in the literature previously...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28808443/angiotensin-converting-enzyme-inhibition-and-parathyroid-hormone-secretion
#15
Sarah Zaheer, Jenifer M Brown, Molly Connors, Jonathan S Williams, Gail K Adler, Anand Vaidya
BACKGROUND: Prior studies suggest that renin-angiotensin-aldosterone system (RAAS) inhibitors decrease parathyroid hormone (PTH) secretion. OBJECTIVE: To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEi) on serum PTH in participants with and without primary hyperparathyroidism (P-HPT). METHODS: An open-label, single-arm, pilot study whereby participants with and without P-HPT had PTH were evaluated before and after 1 week of maximally tolerated lisinopril therapy...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28807955/bilateral-pathologic-mid-tibial-stress-fractures-initial-presentation-of-mild-primary-hyperparathyroidism
#16
Fahim Merali, Mark Leung
No abstract text is available yet for this article.
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28807325/radioguided-surgery-in-primary-hyperparathyroidism-results-and-correlation-with-intraoperative-histopathologic-diagnosis
#17
Juan P Suárez, María L Domínguez, Francisco J de Santos, José M González, Nuria Fernández, Fidel J Enciso
INTRODUCTION AND OBJECTIVES: Radioguided surgery is a minimally invasive surgical technique for the treatment of primary hyperparathyroidism. The goals of our study were to evaluate the rate of success and compare the results with intraoperative histological analysis. METHODS: We retrospectively studied 84 patients with primary parathyroidism who had undergone radioguided surgery. All the patients had a positive parathyroid scintigraphy prior to surgery. An intravenous injection of Tc-99m sestamibi was administered before surgery, and radioguided location of the pathologic parathyroid tissue was performed using an intraoperative gamma probe, applying the "20% rule"...
August 11, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28806349/dual-phase-99mtc-mibi-imaging-and-the-expressions-of-p-gp-gst-%C3%AF-and-mrp1-in-hyperparathyroidism
#18
Jianjun Xue, Yan Liu, Danrong Yang, Yan Yu, Qianqian Geng, Ting Ji, Lulu Yang, Qi Wang, Yuanbo Wang, Xueni Lu, Aimin Yang
OBJECTIVE: The aim of this study was to further elucidate the mechanisms of dual-phase technetium-99m methoxyisobutylisonitrile (Tc-MIBI) parathyroid imaging by exploring the association between early uptake results (EUR), delayed uptake results (DUR), and the retention index (RI) in dual-phase Tc-MIBI parathyroid imaging and P glycoprotein (P-gp), multidrug resistance-associated protein 1 (MRP1), and glutathione S-transferase-π (GST-π) expression in hyperparathyroidism (HPT). PATIENTS AND METHODS: Preoperative dual-phase (early and delayed) Tc-MIBI imaging was performed on 74 patients undergoing parathyroidectomy for HPT...
August 11, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28806302/surgery-for-primary-hyperparathyroidism-adherence-to-consensus-guidelines-in-an-academic-health-system
#19
Eric J Kuo, Mostafa A Al-Alusi, Lin Du, Albert Shieh, Masha J Livhits, Angela M Leung, Michael W Yeh
OBJECTIVE: To determine the extent to which consensus guidelines for surgery in patients with primary hyperparathyroidism (PHPT) are followed within an academic health system. BACKGROUND: Previous studies have shown that adherence to consensus guidelines in community practice is low. METHODS: Adults with biochemically confirmed PHPT who received primary care within an academic health system were identified from 2005 to 2015. Multivariable logistic regression was used to analyze predictors of parathyroidectomy (PTx)...
August 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28806048/electrolytes-calcium-disorders
#20
Craig Barstow
A normal serum calcium level is 8 to 10 mg/dL. The diagnosis of hypercalcemia (ie, levels 10.5 mg/dL or greater) should be confirmed with an albumin-adjusted or ionized calcium level. The two most common causes of hypercalcemia are hyperparathyroidism and malignancy. Drugs, notably lithium and thiazide diuretics, also can cause hypercalcemia. Patients with severe or symptomatic hypercalcemia should be treated initially with hydration to decrease calcium levels. The evaluation should include a parathyroid hormone (PTH) level...
August 2017: FP Essentials
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