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Id: biblio-1148509
Autor: Lagos, Jenith; Herrera, Jorge; Lagos, Daniela; Merchán Galvis, Angela María.
Título: Tiempo óptimo para medición de paratohormona como predictor de hipocalcemia en pacientes posterior a tiroidectomía total / Optimal time for measurement of parathormone as a predictor of hypocalcemia in patients after total thyroidectomy
Fonte: Rev. colomb. cir;36(1):51-59, 20210000. tab, fig.
Idioma: es.
Resumo: Introducción. La hipocalcemia posterior a tiroidectomía total es una complicación frecuente en la cirugía de tiroides. La hormona paratiroidea ha demostrado ser un predictor confiable para detectar los pacientes con alto riesgo de hipocalcemia significativa y la consecuente necesidad de administrar suplemento de calcio. El objetivo de este estudio fue determinar el tiempo óptimo de medición de la paratohormona para dicho fin. Métodos. Estudio prospectivo realizado en dos instituciones de nivel III en Popayán, Colombia, entre abril de 2016 y febrero de 2018, en el cual se midieron niveles de paratohormona prequirúrgico, a las 0, 2, 4 y 12 horas del postoperatorio, y se compararon con los valores obtenidos a los 3 meses de seguimiento en pacientes sometidos a tiroidectomía total. Se consideró como grupos de riesgo y con necesidad de suplemento de calcio un valor de paratohormona menor de 10 pg/ml o una disminución mayor del 80 % con respecto al valor prequirúrgico. Resultados. Se incluyeron 34 pacientes intervenidos. Tomando como umbral un valor menor de 10 pg/ml, la medición de paratohormona a las 4 horas fue sensible y específica (60 y 93,1 % respectivamente). Para una disminución mayor del 80 % con respecto al valor prequirúrgico, la sensibilidad fue del 60 % y la especificidad del 96,5 %, presentando un valor predictivo positivo de 75 % y negativo del 93,3 %, con una p < 0,001. Discusión. Una disminución mayor del 80 % del valor de paratohormona prequirúrgico medida a las 4 horas después de la tiroidectomía total permite identificar aquellos pacientes con alto riesgo de hipocalcemia significativa, que requieren administración temprana de suplementos de calcio, comparado con la determinación de la disminución a las 0, 2 y 12 horas postoperatorias

Introduction.Hypocalcemia after total thyroidectomy is a common complication in thyroid surgery.Parathyroid hormone has been shown to be a reliable predictor for detectingpatients with at high risk ofsignificant hypocalcemia and the consequent need for calcium supplementation. The objective of this study was to determine the optimal time for measuring parathormone for this purpose.Methods.Prospective study carried out in two level 3 institutions in Popayán, Colombia, between April 2016 and February 2018, in which levels of preoperative parathormone were measured at 0, 2, 4 and 12 hours postoperatively, and compared with the values obtained at 3 months of follow-up in patients undergoing total thyroidectomy. A parathormone value less than 10 pg/ml or a decrease greater than 80% with respect to the pre-surgical value was considered as risk groups and in need of calcium supplementation.Results. Thirty-four operated patients were included. Taking as a threshold a value of less than 10 pg/ml, the measurement of parathormone at 4 hours was sensitive and specific (60% and 93.1%, respectively). For a decrease greater than 80% with respect to the presurgical value, the sensitivity was 60% and the specificity was 96.5%, presenting a positive predictive value of 75% and a negative predictive value of 93.3% (p <0.001).Discussion.A decrease of more than 80% in the preoperative parathyroid hormone value measured at 4 hours after total thyroidectomy allows the identification of those patients at high risk of significant hypocalcaemia, who require early administration of calcium supplements, compared with the determination of the decrease at 0, 2 and 12 hours postoperatively
Descritores: Hormônio Paratireóideo
-Tireoidectomia
Hormônios e Agentes Reguladores de Cálcio
Hipocalcemia
Limites: Humanos
Responsável: CO113


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Id: biblio-907757
Autor: Restrepo-Giraldo, Lina M; Arévalo-Novoa, Joel; Toro-Ramos, Martín.
Título: Metabolismo mineral y óseo: visióngeneral y sus métodos de medición / Bone and mineral metabolism: overview and methods of measurement
Fonte: Med. lab;21(11-12):511-538, 2015. ilus, tab.
Idioma: es.
Resumo: Resumen: las concentraciones plasmáticas de calcio, fósforo y magnesio dependen del balance neto del depósito mineral óseo y su resorción, la absorción intestinal y la excreción renal. Estos iones son importantes para muchas funciones biológicas y celulares como la señalización intracelular, la transmisión neural y la contracción muscular. Las principales hormonas que regulan la homeostasis de estos procesos son la hormona paratiroidea (PTH), la calcitonina, la 1,25-dihidroxi vitamina D y el factor de crecimiento fibroblástico-23 (FGF- 23). A través de sus acciones e interacciones sobre el hueso, el riñón y el tracto gastrointestinal las hormonas calciotrópicas (la hormona paratiroidea, la calcitonina y los metabolitos de la vitamina D, especialmente la 1,25-dihidroxi vitamina D) actúan para mantener la calcemia dentro de un rango normal, lo que permite el funcionamiento óptimo de muchos procesos fisiológicos dependientes de calcio. Los avances en las técnicas de análisis de los diferentes componentes del metabolismo mineral y óseo son útiles en la comprensión de su papel en la salud y la enfermedad. En este artículo se ofrece una revisión de los aspectos fisiológicos, clínicos y analíticos de estos protagonistas en el metabolismo óseo y mineral.

Abstract: the plasma concentrations of calcium, phosphate, and magnesium are dependent on the net balance of bone mineral deposition and resorption, intestinal absorption, and renal excretion. These ions are important for many biologic and cellular functions such as intracellular signaling, neural transmission, and muscle contraction. The principal hormones regulating the homeostasis of these processes are parathyroid hormone (PTH), calcitonin, 1.25-dihydroxy vitamin D and fibroblast growth factor-23 (FGF-23). Through their actions on bone, kidney and the gastrointestinal tract, the calciotropic hormones (parathyroid hormone, calcitonin, and vitamin D metabolites, especially the 1.25-dihydroxy vitamin D) act to maintain serum calcium within a normal range, that allows the optimally function of many calcium-requiring physiological functions. The improved procedures for the assays of different components of mineral and bone metabolism are useful in understanding their role in health and disease. This paper provides a review of the physiology, clinical and analytic aspects of these protagonists in bone and mineral metabolism.
Descritores: Remodelação Óssea
Reabsorção Óssea
Calcitonina
Carbonato de Cálcio
Hormônio Paratireóideo
Fósforo
Distúrbios do Metabolismo do Fósforo
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CO373.9 - EDIMECO - Editora Médica Colombiana S.A.


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Id: biblio-1140152
Autor: Ramírez Stieben, Luis Agustín; Pellizzon, Noelia Andrea.
Título: Hipoparatiroidismo y calcificaciones cerebrales: reporte de caso / Hypoparathyroidism and brain calcifications: a case report
Fonte: Actual. osteol;16(1):77-82, Ene - abr. 2020. ilus.
Idioma: es.
Resumo: Introducción. El hipoparatiroidismo es una enfermedad caracterizada por la ausencia o concentraciones inadecuadamente bajas de hormona paratiroidea (PTH), que conduce a hipocalcemia, hiperfosfatemia y excreción fraccional elevada de calcio en la orina. Las calcificaciones del sistema nervioso central son un hallazgo frecuente en estos pacientes. Caso clínico. Mujer de 56 años con antecedente de hipotiroidismo, que ingresó por un cuadro de 6 días de evolución caracterizado por astenia, parestesias periorales y movimientos anormales de manos y pies. Las pruebas de laboratorio demostraron hipocalcemia, hiperfosfatemia y niveles bajos de hormona paratiroidea. Se realizó una tomografía computarizada de cráneo que mostró áreas bilaterales y simétricas de calcificaciones en hemisferios cerebelosos, ganglios basales y corona radiata. No se evidenciaron trastornos en el metabolismo del cobre y hierro. Se estableció el diagnóstico del síndrome de Fahr secundario a hipoparatiroidismo y se inició tratamiento con suplementos de calcio y vitamina D con evolución satisfactoria. Discusión. El síndrome de Fahr es un trastorno neurológico caracterizado por el depósito anormal de calcio en áreas del cerebro que controlan la actividad motora. Se asocia a varias enfermedades, especialmente, hipoparatiroidismo. La suplementación con calcio y vitamina D con el objetivo de normalizar los niveles plasmáticos de estos cationes es el tratamiento convencional. (AU)

Introduction. Hypoparathyroidism is a disease characterized by absence or inappropriately low concentrations of circulating parathyroid hormone, leading to hypocalcaemia, hyperphosphataemia and elevated fractional excretion of calcium in the urine. Central nervous system calcifications are a common finding in these patients. Case report. 56-year-old woman with a history of hypothyroidism who was admitted for a 6-day course of illness characterized by asthenia, perioral paresthesias, and abnormal movements of the hands and feet. Laboratory tests showed hypocalcemia, hyperphosphatemia, and low parathyroid hormone levels. A cranial computed tomography was performed. It showed bilateral and symmetrical areas of calcifications in the cerebellar hemispheres, basal ganglia, and radiata crown. No disorders of copper or iron metabolism were evident. The diagnosis of Fahr syndrome secondary to hypoparathyroidism was established and treatment with calcium and vitamin D supplements was started with satisfactory evolution. Discussion. Fahr's syndrome is a neurological disorder associated with abnormal calcium deposition in areas of the brain that control motor activity. It is associated with various diseases, especially hypoparathyroidism. The conventional treatment is supplementation with calcium and vitamin D, with the aim of normalizing their plasma levels. (AU)
Descritores: Calcinose/diagnóstico por imagem
Hipoparatireoidismo/diagnóstico
Doenças do Sistema Nervoso/diagnóstico por imagem
-Hormônio Paratireóideo/sangue
Calcinose/complicações
Calcinose/tratamento farmacológico
Calcitriol/administração & dosagem
Carbonato de Cálcio/administração & dosagem
Gluconato de Cálcio/administração & dosagem
Cálcio/administração & dosagem
Hiperfosfatemia/sangue
Hipocalcemia/sangue
Hipoparatireoidismo/etiologia
Hipoparatireoidismo/tratamento farmacológico
Doenças do Sistema Nervoso/complicações
Doenças do Sistema Nervoso/tratamento farmacológico
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: AR2.1 - Biblioteca Central


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Texto completo SciELO Chile
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Id: biblio-1094171
Autor: Ojeda, Dagoberto; Cabezón, Mariana; Agurto, Mariela; Oviedo, Sofía; Vega, Carlos; Daza, Ximena; Demetrio, Beatriz; Carrasco, Cecilia; Cisternas, Patricia.
Título: Niveles de vitamina D en médicos: ¿son los anestesiólogos el único grupo de riesgo? / Vitamin D levels among anesthesiologists and other physicians
Fonte: Rev. méd. Chile;147(11):1415-1422, nov. 2019. tab, graf.
Idioma: es.
Resumo: Background Sun exposure is the main source of 25-hydroxy-vitamin D. Since anesthesiologists work inside operating rooms, they are identified as a deficiency risk group. As medical activity in general occurs indoors, added to the work excess and sedentary lifestyle, physicians in general have low sun exposure. Aim To investigate the determinants of vitamin D levels in physicians. Material and Methods Anesthesiologists and physicians not working in operating rooms were included. A survey that comprised working hours, diet, skin color, sunscreen use and outdoor activities was also applied. Measurements of vitamin D and parathormone levels in blood were performed. Results We analyzed samples from 81 volunteers. Median vitamin D values of the whole sample were in the range of insufficiency (25.3 [interquartile range 12.4] ng/ml). Multiple linear regression analysis detected no differences between anesthesiologists and non-anesthesiologists. A higher body mass index was a risk factor for vitamin D deficiency, (p = 0.025). The only protective factor was the intake of a vitamin D supplement (p < 0.01). Conclusions Anesthesiologists and other specialists were both at risk for vitamin D deficiency. Obesity was a risk factor and the use of a vitamin D supplement was the only protective factor.
Descritores: Hormônio Paratireóideo/sangue
Vitamina D/análogos & derivados
Vitamina D/sangue
Deficiência de Vitamina D/diagnóstico
Suplementos Nutricionais
Anestesiologistas/estatística & dados numéricos
-Vitamina D/administração & dosagem
Deficiência de Vitamina D/sangue
Índice de Massa Corporal
Estudos Transversais
Fatores de Risco
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Tipo de Publ: Estudo Observacional
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1101255
Autor: XU, Lin; MEI, Li; ZHAO, Rui; YI, Jianru; JIANG, Yixuan; LI, Ruomei; ZHAO, Youliang; PI, Li; LI, Yu.
Título: The effects of intro-oral parathyroid hormone on the healing of tooth extraction socket: an experimental study on hyperglycemic rats
Fonte: J. appl. oral sci;28:e20190690, 2020. graf.
Idioma: en.
Projeto: National Undergraduate Training Program for Innovation and Entrepreneurship of Sichuan University; . Science and Technology Department of Sichuan Province; . National Natural Science Foundation of China.
Resumo: Abstract Objective To investigate the effects of intro-oral injection of parathyroid hormone (PTH) on tooth extraction wound healing in hyperglycemic rats. Methodology 60 male Sprague-Dawley rats were randomly divided into the normal group (n=30) and DM group (n=30). Type 1 diabetes mellitus (DM) was induced by streptozotocin. After extracting the left first molar of all rats, each group was further divided into 3 subgroups (n=10 per subgroup), receiving the administration of intermittent PTH, continuous PTH and saline (control), respectively. The intermittent-PTH group received intra-oral injection of PTH three times per week for two weeks. A thermosensitive controlled-release hydrogel was synthesized for continuous-PTH administration. The serum chemistry was determined to evaluate the systemic condition. All animals were sacrificed after 14 days. Micro-computed tomography (Micro-CT) and histological analyses were used to evaluate the healing of extraction sockets. Results The level of serum glucose in the DM groups was significantly higher than that in the non-DM groups (p<0.05); the level of serum calcium was similar in all groups (p>0.05). Micro-CT analysis showed that the DM group had a significantly lower alveolar bone trabecular number (Tb.N) and higher trabecular separation (Tb.Sp) than the normal group (p<0.05). The histological analyses showed that no significant difference in the amount of new bone (hard tissue) formation was found between the PTH and non-PTH groups (p>0.05). Conclusions Bone formation in the extraction socket of the type 1 diabetic rats was reduced. PTH did not improve the healing of hard and soft tissues. The different PTH administration regimes (continuous vs. intermittent) had similar effect on tissue healing. These results demonstrated that the metabolic characteristics of the hyperglycemic rats produced a condition that was unable to respond to PTH treatment.
Descritores: Hormônio Paratireóideo/farmacologia
Extração Dentária/métodos
Cicatrização/efeitos dos fármacos
Alvéolo Dental/efeitos dos fármacos
Diabetes Mellitus Experimental/fisiopatologia
-Osteogênese/efeitos da radiação
Osteogênese/fisiologia
Glicemia/análise
Distribuição Aleatória
Cálcio/sangue
Ratos Sprague-Dawley
Hidrogéis
Ferida Cirúrgica/tratamento farmacológico
Limites: Animais
Masculino
Ratos
Tipo de Publ: Estudo de Avaliação
Responsável: BR28.1 - Serviço de Biblioteca e Documentação Professor Doutor Antônio Gabriel Atta


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Id: lil-242593
Autor: Dackiewicz, N; Hammermuller, E; Macchi, A; Martinitto, R; Lorusso, A; Caletti, G; Delgado, N.
Título: Hiperparatiroidismo en la insuficiencia renal aguda: estudio prospectivo / Hyperparathyroidism in acute renal failure: a prospective study
Fonte: Med. infant;6(1):16-20, mar. 1999. tab.
Idioma: es.
Resumo: El rol del hiperparatiroidismo en la insuficiencia renal crónica (IRC) está bien estudiado, pero existe muy poca información en la insuficiencia renal aguda (IRA) en pediatría. Se realizó un estudio prospectivo en pacientes con IRA secundaria a Síndrome Urémico-Hemolítico (SUH) moderado o grave internados en el Hospital de Pediatría Juan P. Garrahan desde febrero de 1995 hasta abril de 1996. Los objetivos fueron: documentar las alteraciones del metabolismo fosfo-cálcico, determinar los niveles de PTH y evaluar los cambios en relación con el tratamiento de quelantes del fósforo (P). Se analizaron 19 pacientes con edad x de 21.5 meses, 9 niñas y 10 niños. El laboratorio solicitado en el comienzo de la IRA (T1), durante la situación de IRA prolongada (T2) al normalizar la función renal en el control ambulatorio (T3) fue el siguiente: PTH, calcio (Ca) (corregido pr albúmina sérica), P, creatinina y estado ácido-base. La población se dividió en 2 grupos al azar: Grupo A: tratados con hidróxido de aluminio y Grupo B: sin tratamiento quelante. Todos recibieron el tratamiento habitual para IRA. Se llevó a cabo el procesamiento de datos mediante el Test de U de Mann Whitney y el Test de Friedman. Los resultados fueron: la x de los niveles de Ca fue normal en los 3 tiempos de observación en ambos grupos, pero con diferencias significativas entre T1 y T3 en el grupo A. Los valores de P de T1 y T2 fueron altos en ambos grupos, con normalización en T3, pero al comparar ambos grupos, la x de P de T2 fue significativamente menor en el grupo tratado. Los dosajes de PTH fueron elevados en ambos grupos en T1 y T2 y todos volvieron a la normalidad en T3, pero en el grupo tratado los niveles alcanzados fueron menores. Conclusión: es necesaria la prevención del aumento exagerado en la PTH y el consiguiente disturbio del metabolismo Ca-P por lo que se aconseja la indicación precoz de quelantes de P en la IRA prolongada, con el objeto de evitar los síntomas y signos indeseables que provoca el hiperparatiroidismo secundario.
Descritores: Hormônio Paratireóideo
Parathyreoidinum
Lesão Renal Aguda/diagnóstico
Lesão Renal Aguda/terapia
Hiperparatireoidismo/diagnóstico
Hiperparatireoidismo/terapia
Síndrome Hemolítico-Urêmica/complicações
-Argentina
Cálcio
Fósforo
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Tipo de Publ: Relatos de Casos
Responsável: AR305.1 - SID - Servicio de Información y Documentación


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Id: lil-785233
Autor: Shinkov, Alexander; Borissova, Anna-Maria; Dakovska, Lilia; Vlahov, Jordan; Kassabova, Lidia; Svinarov, Dobrin; Krivoshiev, Stefan.
Título: Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly
Fonte: Arch. endocrinol. metab. (Online);60(3):217-222tab.
Idioma: en.
Resumo: ABSTRACT Objective To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Materials and methods Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. Results In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). Conclusion The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.
Descritores: Vitamina D/análogos & derivados
Deficiência de Vitamina D/epidemiologia
Vida Independente/estatística & dados numéricos
Fraturas do Quadril/epidemiologia
Instituição de Longa Permanência para Idosos/estatística & dados numéricos
Casas de Saúde/estatística & dados numéricos
-Hormônio Paratireóideo/sangue
Estações do Ano
Vitamina D/sangue
Vitamina D/uso terapêutico
Deficiência de Vitamina D/complicações
Deficiência de Vitamina D/tratamento farmacológico
Vitaminas/uso terapêutico
Bulgária/epidemiologia
Cálcio/sangue
Prevalência
Estudos Transversais
Fraturas do Quadril/etiologia
Hiperparatireoidismo Secundário/etiologia
Hiperparatireoidismo Secundário/epidemiologia
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Tipo de Publ: Estudo Comparativo
Responsável: BR1.1 - BIREME


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Id: lil-798179
Autor: Kaya, Cafer; Tam, Abbas Ali; Dirikoç, Ahmet; Kılıçyazgan, Aylin; Kılıç, Mehmet; Türkölmez, Şeyda; Ersoy, Reyhan; Çakır, Bekir.
Título: Hypocalcemia development in patients operated for primary hyperparathyroidism: Can it be predicted preoperatively?
Fonte: Arch. endocrinol. metab. (Online);60(5):465-471, Oct. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Objective Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Postoperative hypocalcemia is a morbidity of parathyroid surgeries, and it may extend hospitalization durations. The purpose of this study is to determine the predictive factors related to the development of hypocalcemia and hungry bone syndrome (HBS) in patients who underwent parathyroidectomy for PHP. Materials and methods Laboratory data comprising parathyroid hormone (PTH), calcium, phosphate, 25-OHD, albumin, magnesium, alkaline phosphatase (ALP), blood urea nitrogen (BUN), and thyroid stimulating hormone (TSH) of the patients were recorded preoperatively, on the 1st and 4th days postoperatively, and in the 6th postoperative month, and their neck ultrasound (US) and bone densitometry data were also recorded. Results Hypocalcemia was seen in 63 patients (38.4%) on the 1st day after parathyroidectomy. Ten patients (6.1%) had permanent hypocalcemia in the 6th month after surgery. Out of the patients who underwent parathyroidectomy for PHP, 22 (13.4%) had HBS. The incidence of postoperative hypocalcemia was higher in patients who underwent parathyroidectomy for PHP, who had parathyroid hyperplasia, and who had osteoporosis. Preoperative PTH, ALP, and BUN values were higher in those patients who developed HBS. Furthermore, HBS was more common in patients who had osteoporosis, who had parathyroid hyperplasia, and who underwent thyroidectomy simultaneously with parathyroidectomy. Conclusions As a result, patients who have the risk factors for development of hypocalcemia and HBS should be monitored more attentively during the perioperative period.
Descritores: Complicações Pós-Operatórias/etiologia
Paratireoidectomia/efeitos adversos
Hiperparatireoidismo/cirurgia
Hiperparatireoidismo/complicações
Hipocalcemia/etiologia
-Hormônio Paratireóideo/sangue
Fosfatos/sangue
Período Pós-Operatório
Valores de Referência
Fatores de Tempo
Nitrogênio da Ureia Sanguínea
Calcifediol/sangue
Cálcio/sangue
Valor Preditivo dos Testes
Medição de Risco/métodos
Fosfatase Alcalina/sangue
Magnésio/sangue
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Vieira, José Gilberto Henriques
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Id: lil-798183
Autor: Bonanséa, Teresa Cristina P; Ohe, Monique Nakayama; Brandão, Cynthia; Ferrer, Cláudia de Francischi; Santos, Lívia Marcela; Lazaretti-Castro, Marise; Vieira, José Gilberto Henriques.
Título: Experience with a third-generation parathyroid hormone assay (BIO-PTH) in the diagnosis of primary hyperparathyroidism in a Brazilian population
Fonte: Arch. endocrinol. metab. (Online);60(5):420-425, Oct. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To evaluate the usefulness of a third-generation PTH assay in the diagnosis of primary hyperparathyroidism (PHPT). Subjects and methods Forty-one PHPT patients (4 men and 37 women) with 61.2 ± 10.9 (mean ± SD) years, were studied and had PTH levels measured with two different methods using the same immunochemiluminescent assay plataform (Elecsys 2010 System, Roche). We compared a second-generation assay (I-PTH) with a third-generation PTH assay (Bio-PTH). Two populations of 423 and 120 healthy adults with serum 25OHD levels above 25 ng/mL were used to define normal values in the I-PTH and Bio-PTH assays respectively. Results Normal PTH values based in the healthy adults population were 24.2-78.0 pg/mL for the I-PTH assay and 19.9-58.5 pg/mL for Bio-PTH assay. In PHPT patients, PTH values ranged from 67 to 553 pg/mL (median: 168 pg/mL) using the I-PTH assay and from 55 to 328 pg/mL (median: 111 pg/mL) using the Bio-PTH assay. Results obtained with the Bio-PTH assay were significantly lower (p < 0.0001, Wilcoxon). In general I-PTH and Bio-PTH showed highly significant correlation (r = 0.952, p < 0.0001). Passing–Bablok analysis gave a regression equation of Bio PTH = 13.44 + 0.59 x intact PTH. PHPT patients had 25OHD levels ranging from 4 to 36 ng/mL (mean 16.2 ng/mL); 35 subjects (85.3%) had values bellow 25 ng/mL. Conclusion Our results demonstrate that both second and third generation PTH methods are strongly correlated in PHPT patients and control subjects. Lower results with Bio-PTH tests are expected in function of the assay specificity determined by the amino-terminal antibody used.
Descritores: Hormônio Paratireóideo/sangue
Fragmentos de Peptídeos/sangue
Hiperparatireoidismo Primário/diagnóstico
Hiperparatireoidismo Primário/sangue
-Padrões de Referência
Valores de Referência
Brasil
Imunoensaio/métodos
Biomarcadores/sangue
Estudos de Casos e Controles
Reprodutibilidade dos Testes
Estatísticas não Paramétricas
Medições Luminescentes/métodos
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Id: biblio-827783
Autor: Cakir, Bekir; Polat, Sefika Burcak; Kilic, Mehmet; Ozdemir, Didem; Aydin, Cevdet; Süngü, Nuran; Ersoy, Reyhan.
Título: Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?
Fonte: Arch. endocrinol. metab. (Online);60(6):537-544, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective Parathyroid cancer (PC) represents < 1% of cases of PHPT. Tumors demonstrating atypical histopathologic features and don’t fulfill criteria for carcinoma are classified as atypical adenomas (APA). The purpose of this study was to determine a biochemical or ultrasonographic feature that can predict aggressive disease requiring more extensive surgery and closer follow-up. Subjects and methods Twenty eight patients operated for PHPT and diagnosed with atypical adenoma (23 patients) or carcinoma (5 patients) were enrolled in this study. The control group consisted of 102 patients operated between the same dates and diagnosed with classical PA. Classical adenomas, atypical adenomas, and carcinomas were compared according to their biochemical and ultrasonographic parameters. Results Serum Ca levels were significantly higher in the PC group compared with the APA and classical PA groups. Serum median PTH, Serum ALP and UCa was significantly higher in the APA and carcinoma groups compared to the classical PA group. ROC analysis was made to determine the best cut off values for predicting aggressive disease were 12.45 mg/dL, 265.05 pg/mL, 154.5 IU/l, 348.5 mg/day and 21.5 mm for Ca, PTH, ALP, UCa and the adenoma diameter, respectively. Multivariate analysis showed that serum Ca, ALP and isoechoic/cystic appearance were independent predictors for aggressive disease. Conclusion Preoperatively high PTH, ALP, and UCa levels and large lesions with isoechoic or cystic appearances may be predictive of atypical adenoma or carcinoma in patients being evaluated for PHPT. In such cases, surgeons may prefer en bloc parathyroidectomy to minimally invasive surgery.
Descritores: Neoplasias das Paratireoides/sangue
Neoplasias das Paratireoides/diagnóstico por imagem
Biomarcadores Tumorais/sangue
Adenoma/cirurgia
Adenoma/patologia
Adenoma/sangue
Adenoma/diagnóstico por imagem
-Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/cirurgia
Neoplasias das Paratireoides/patologia
Cuidados Pré-Operatórios
Estudos de Casos e Controles
Cálcio/urina
Cálcio/sangue
Valor Preditivo dos Testes
Ultrassonografia/métodos
Fosfatase Alcalina/sangue
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME



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