Midori Minezaki, Yuichi Takashi, Kentaro Ochi, Ryo Mitsuoka, Yuka Yamao, Tadachika Kudo, Daiji Kawanami, Kunihisa Kobayashi, Ichiro Abe
INTRODUCTION: Cinacalcet is a calcimimetic that modulates the functions of calcium-sensing receptor and is currently used to treat patients with primary hyperparathyroidism (PHPT). Although it was reported that cinacalcet treatment reduced the size of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism, whether or not cinacalcet treatment can reduce the size of parathyroid adenomas in patients with PHPT has been unknown. MATERIALS AND METHODS: We recruited nine (male: one, female: eight) patients with PHPT due to parathyroid adenomas who did not undergo parathyroidectomy...
January 6, 2021: Journal of Bone and Mineral Metabolism
Carolyn D Seib, Insoo Suh, Tong Meng, Amber Trickey, Alexander K Smith, Emily Finlayson, Kenneth E Covinsky, Manjula Kurella Tamura, Electron Kebebew
Importance: Parathyroidectomy provides definitive management for primary hyperparathyroidism (PHPT), reducing the risk of subsequent fracture, nephrolithiasis, and chronic kidney disease (CKD), but its use among older adults in the US is unknown. Objective: To identify patient characteristics associated with the use of parathyroidectomy for the management of PHPT in older adults. Design, Setting, and Participants: This population-based, retrospective cohort study used 100% Medicare claims from beneficiaries with an initial diagnosis of PHPT from January 1, 2006, to December 31, 2016...
January 6, 2021: JAMA Surgery
Juulia K Virtanen, Sari H Mölsä, Karoliina A Hagner, Hanna M Salonen, Susanne Kilpinen
Case summary: A 16-year-old neutered female Korat cat presented with chronic vomiting, mild azotaemia and mild hypercalcaemia. Physical examination revealed bilateral palpable masses on each side of the trachea. Laboratory results were consistent with primary hyperparathyroidism, diagnostic imaging findings with cystic thyroid or parathyroid masses, and fine-needle aspiration cytology with thyroid hyperplasia or adenoma. In order to confirm whether one or two of the masses were the cause of the hyperparathyroidism, cystic fluid was aspirated from both for parathyroid hormone concentration measurement...
July 2020: JFMS Open Reports
Rahim Khan, James Martin, Gautam Das
To study impact of observation (OBV) vs parathyroidectomy (PTX) on biochemistry, bone mineral density (BMD) and fracture risk calculated by Fracture Risk Assessment (FRAX) tool in primary hyperparathyroidism (PHPT). Retrospective study of 60 patients (OBV - 26; PTX - 34 patients). Mean adjusted calcium improved in both groups [OBV - 2.76 ± 0.07 vs 2.51 ± 0.20 mmol/L; p < 0.00001, PTX - 2.87 ± 0.21 vs 2.36 ± 0.12 mmol/L; p < 0.00001]. Mean parathyroid hormone level declined in both but more in PTX group [OBV - 11...
December 15, 2020: Journal of Clinical Densitometry
Hirotaka Komaba, Markus Ketteler, John Cunningham, Masafumi Fukagawa
Disturbances in mineral and bone metabolism are common in patients with chronic kidney disease (CKD), especially those undergoing dialysis. Renal osteodystrophy, which describes an alteration of bone morphology, is an important component of this systemic disorder and may explain the elevated risk of fracture which adversely affects morbidity and mortality. The most common form of renal osteodystrophy is high-turnover bone disease (osteitis fibrosa), which is induced by secondary hyperparathyroidism (SHPT). During the past decade, there has been considerable advances in the management of SHPT, with the introduction of the calcimimetic agents, the optimized use of nutritional and active vitamin D, and the accumulated experience with surgical parathyroidectomy...
January 2, 2021: Calcified Tissue International
E Goñi-Gironés, S Fuertes-Cabero, I Blanco-Sáiz, I Casáns-Tormo, P García-Talavera San Miguel, J Martín-Gil, C Sampol-Bas, P Abreu-Sánchez, R Díaz-Expósito, S Vidal-Sicart
Parathyroidectomy has evolved over the years from bilateral neck exploration to a single gland approach using minimally invasive surgery. The precise presurgical localization of the problem gland, using functional techniques, such as double-phase scintigraphy with [99m Tc] Tc-MIBI including SPECT-CT and PET-CT with [18 F]-Choline and morphological ones, such as ultrasound have played a crucial role in this paradigm's shift. Radioguided surgery techniques have also adapted and grown with new contributions known for their indication in other fields...
December 29, 2020: Revista Española de Medicina Nuclear e Imagen Molecular
Robert Caiazzo, Camille Marciniak, Francois Pattou
No abstract text is available yet for this article.
December 23, 2020: Annals of Surgery
K M M Vishvak Chanthar, Gaurav Agarwal
No abstract text is available yet for this article.
December 23, 2020: Annals of Surgery
Maxime Damien, Alexandra Rodriguez, Pierre Kleynen, Didier Dequanter, Cyril Bouland
Intrathyroidal parathyroid carcinoma is an extremely rare cause of primary hyperparathyroidism. We reported a 51-year old woman who presented symptoms of hypercalcemia. 99mTc sestamibi single-photon emission computed tomography/computed tomography (CT) revealed a large hypermetabolic nodule in the left thyroid lobe suggestive of hyperfunctioning parathyroid tissue. 11C-methionine positron emission tomography/computed tomography (PET/CT) and 18F-fluorocholine PET/CT confirmed the nodule in the left thyroid lobe and also revealed a hypermetabolic activity on the posterior surface of the lower left pole...
December 28, 2020: Ear, Nose, & Throat Journal
Natalia Carrillo-López, Laura Martínez-Arias, Cristina Alonso-Montes, Beatriz Martín-Carro, Julia Martín-Vírgala, Marta Ruiz-Ortega, José Luis Fernández-Martín, Adriana S Dusso, Minerva Rodriguez-García, Manuel Naves-Díaz, Jorge B Cannata-Andía, Sara Panizo
BACKGROUND: In chronic kidney disease, serum phosphorus (P) elevations stimulate parathyroid hormone (PTH) production, causing severe alterations in the bone-vasculature axis. PTH is the main regulator of the receptor activator of nuclear factor κB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) system, which is essential for bone maintenance and also plays an important role in vascular smooth muscle cell (VSMC) calcification. The discovery of a new RANKL receptor, leucine-rich repeat-containing G-protein-coupled receptor 4 (LGR4), which is important for osteoblast differentiation but with an unknown role in vascular calcification (VC), led us to examine the contribution of LGR4 in high P/high PTH-driven VC...
December 26, 2020: Nephrology, Dialysis, Transplantation
Milou E Noltes, Stephan Brands, Rudi A J O Dierckx, Pieter L Jager, Wendy Kelder, Adrienne H Brouwers, Anne Brecht Francken, Schelto Kruijff
Objective: The aim of this study was to determine the adherence to consensus guidelines on preoperative imaging of patients with primary hyperparathyroidism (pHPT) in real local practice. Methods: This was a retrospective multicenter cohort study of 411 patients undergoing parathyroidectomy for pHPT from 2007 to 2017 in three referral centers. Results: In 286/411 patients (69%) the preoperative imaging workup adhered to guidelines (utilizing ultrasound and parathyroid scintigraphy)...
December 2020: Laryngoscope Investigative Otolaryngology
Megan L Crenshaw, Dana Goldenberg, Darrin V Bann
Current treatment guidelines recommend surgical excision of papillary thyroid carcinoma. However, the precise surgical treatment, including thyroid lobectomy, total thyroidectomy, and the need for neck dissection, is dictated by disease extent and tumor cytology. Incidental papillary thyroid carcinoma discovered during another surgery therefore presents a surgical conundrum due to lack of information. Surgeons must consider short- and long-term surgical morbidities, as well as individual patient factors, when deciding how to treat an unexpected thyroid carcinoma...
December 22, 2020: Ear, Nose, & Throat Journal
Sara Dias Leite, Carolina Câmara Ormonde, Mariana Câmara Ormonde, Joana Teresa Botelho Vasconcelos Raposo, Joana Isabel Nunes Sampaio, Bruna Carina da Silva Melo
Primary hyperparathyroidism is an endocrine disorder characterized by hypercalcemia and elevated or inappropriately normal levels of parathyroid hormone. The diagnosis is based on a biochemical evaluation, and a neck ultrasound is the first choice during pregnancy to access the parathyroid glands. Manifestations during pregnancy are rare and can be present with life-threatening complications, so the diagnosis is challenging. The conservative treatment is limited, and there is not enough data about its safety and efficacy during pregnancy...
December 2020: Revista Brasileira de Ginecologia e Obstetrícia
E A Dobreva, E E Bibik, A K Eremkina, A R Ajnetdinova, L V Nikankina, N M Malysheva, N G Mokrysheva
AIM: To study an activity of the Renin-Angiotensin-Aldosterone System (RAAS) components in patients with primary hyperparathyroidism (PHPT) before and after parathyroidectomy (PTE). MATERIALS AND METHODS: A comparative study of patients with PHPT and control group. The first stage of the study included 56 patients with PHPT (group 1) before and on the third day after PTE. The second stage was carried out in 27 patients with remission of PHPT (group 2). All patients and healthy volunteers were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin activity PRA, serum aldosterone, angiotensin II AT II)...
November 24, 2020: Terapevticheskiĭ Arkhiv
Serkan Akbulut, Ozgun Erten, Mehmet Gokceimam, Yoo S Kim, Vikram Krishnamurthy, Katherine Heiden, Judy Jin, Allan Siperstein, Eren Berber
BACKGROUND: Intraoperative near-infrared imaging (NIFI) of parathyroid glands (PG) by first-generation technology had limited image quality and depth penetration. Second-generation NIFI has recently been introduced. Our aim was to compare (1) capability to detect PG and (2) image quality between older and newer technologies. METHODS: Accurately detecting PG, as well as, quality of autofluorescence (AF) was compared between an older charge-coupled device (CCD) camera and a newer complementary metal-oxide semiconductor (CMOS)...
December 17, 2020: Journal of Surgical Oncology
Kelsey Casano, C Ron Cannon, Ralph Didlake, William R Replogle, Robert Cannon
OBJECTIVES: Thyroidectomy and parathyroidectomy using the nerve integrity monitor (NIM) require proper placement of the endotracheal tube with electrodes aligned correctly within the larynx. The purpose of this study is to determine the percentage of patients who require positional adjustments of the endotracheal tube prior to beginning surgery and to understand the value of using the GlideScope to assure proper NIM tube placement within the larynx. METHODS: This prospective study examines operative data from 297 patients who underwent NIM thyroidectomy and parathyroidectomy...
December 14, 2020: Ear, Nose, & Throat Journal
Fikri Okan Falay, Orhan Agcaoglu, Salih Nafiz Karahan, Sinan Deniz, Ozan Gökler, Yeliz Aydemir, Orhun Çığ Taşkin, Serdar Tezelman, Mehmet Onur Demirkol
OBJECTIVE: Geriatric patients are often reluctant to undergo parathyroid surgery under general anesthesia because of the major comorbidities. The use of minimally invasive techniques for parathyroid lesions under local anesthesia have been published. Radioguided lesion localization has been known to decrease operative time and reduce the occurrence of positive margins in breast cancer surgery. We hypothesize that it could also be effectively used in focused parathyroid surgery in geriatric patients with in history of thyroid surgery...
December 14, 2020: Hellenic Journal of Nuclear Medicine
Berfu Korucu, Fatma Ajlan TÜkÜn, Özant Helvaci, Haci Hasan Yeter, Sevİm GÖnen, Galİp GÜz, Selİm Turgay Arinsoy
BACKGROUND/AIM: Bone disease is one of the most prominent complications after kidney transplantation. Bone diseases include osteoporosis, persistent secondary hyperparathyroidism, and avascular necrosis (AVN). We investigated the relationship between the polymorphisms of the vitamin D receptor (VDR) gene and bone diseases occurring after kidney transplantation. MATERIALS AND METHODS: The study consists of 234 kidney allograft recipients with a minimum follow-up of five years after kidney transplantation...
December 11, 2020: Turkish Journal of Medical Sciences
Prabir Kumar Kundu, Satyaki Basu, Uddalak Chakraborty, Atanu Chandra
Hyperparathyroidism leading to hypercalcaemia is a rare cause of acute pancreatitis with debatable association. The diagnosis of hyperparathyroidism is frequently overlooked or delayed as symptoms are non-specific and serum calcium is not routinely measured in acute pancreatitis. Early diagnosis and treatment of hyperparathyroidism may reduce the chances of complications. We report a 35-year-old woman, who was admitted with recurrent episodes of acute pancreatitis. She was previously diagnosed with gall-stone induced acute pancreatitis, had undergone laparoscopic cholecystectomy, but the recurrence of acute pancreatitis suggested an alternative aetiology and provoked extensive investigations...
December 10, 2020: BMJ Case Reports
Murilo Catafesta das Neves, Augusto Riedel Abrahão, Marcio Abrahão, Marcello Rosano, Lillian Andrade da Rocha, Hanna Karla Andrade Guapyassu Machado, Rodrigo Oliveira Santos
INTRODUCTION: Surgical treatment of hyperparathyroidism related to chronic kidney disease is a real challenge for Brazilian public health care. High cost medications and long waiting lines to perform preoperative exams, especially technetium Tc 99m Sestamibi (MIBI) are some of the reasons. Despite the reality that the aid of localization exams are questionable in this scenario, doctors are too apprehensive in performing surgery without it. OBJECTIVE: The study aimed at evaluating the efficacy of surgery for renal hyperparathyroidism without preoperative MIBI...
November 16, 2020: Brazilian Journal of Otorhinolaryngology
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