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[PMID]:29390544
[Au] Autor:Zeng H; Li Z; Zhang X; Wang N; Tian Y; Wang J
[Ad] Endereço:Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
[Ti] Título:Anesthetic management of primary hyperparathyroidism during pregnancy: A case report.
[So] Source:Medicine (Baltimore);96(51):e9390, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Primary hyperparathyroidism (PHPT) during pregnancy is rare. Nevertheless, hypercalcemia secondary to gestational PHPT may be masked by physiological changes in calcium homeostasis during pregnancy. Gestational PHPT constitutes a serious danger to mother and fetus. Surgery is the only curative treatment when conservative treatment could not control the condition. Due to the lack of guidelines concerning PHPT during pregnancy, the optimal anesthetic management of PHPT during pregnancy needs to be individualized. Patient concerns: We report a case of PHPT with successful surgical treatment under combined cervical plexus block and general anesthesia. DIAGNOSIS: She was diagnosed with hypercalcemia, PHPT, a possible parathyroid adenoma, and a 19-week intrauterine pregnancy. INTERVENTIONS: The patient underwent heparin-free hemodialysis before the surgery in the nephrology department in the presence of a cardiologist. She then received a successful parathyroidectomy under combined bilateral superficial cervical plexus block and general anesthesia in her 19th week of pregnancy. OUTCOMES: She was released from the hospital with no maternal or fetal complications on postoperative day 9. A healthy baby boy was uneventfully born at 37 weeks of gestation. LESSONS: We suggest that surgical removal of the lesion after lowering the blood calcium concentration in mid-pregnancy is currently the optimal treatment option for pregnant patients with PHPT. Furthermore, multidisciplinary perioperative management is particularly important.
[Mh] Termos MeSH primário: Adenoma/cirurgia
Anestesia Geral/métodos
Hiperparatireoidismo Primário/cirurgia
Neoplasias das Paratireoides/cirurgia
Paratireoidectomia
Complicações Neoplásicas na Gravidez/cirurgia
[Mh] Termos MeSH secundário: Adenoma/complicações
Adulto
Feminino
Seres Humanos
Hiperparatireoidismo Primário/etiologia
Neoplasias das Paratireoides/complicações
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009390


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[PMID]:29221466
[Au] Autor:Benameur Y; Guerrouj H; Ghfir I; Ben Rais Aouad N
[Ad] Endereço:Department of Nuclear Medicine, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco. Benameur.yassir@gmail.com.
[Ti] Título:Unusual pathological fracture of the clavicle revealing primary hyperparathyroidism: a case report.
[So] Source:J Med Case Rep;11(1):342, 2017 Dec 09.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary hyperparathyroidism revealed by a pathological fracture is very uncommon; in the majority of cases the discovery of lytic bone lesions on imaging examinations evokes in the clinician first a neoplastic etiology and a metabolic origin is often omitted. This case report adds to the existing literature as it describes an unusual presentation of primary hyperparathyroidism. CASE PRESENTATION: We report a case of a 50-year-old Moroccan man, without any known tumor, who presented a fracture of his left clavicle with multiple osteolytic lesions on computed tomography suggesting bone metastases. However, bone scintigraphy oriented the diagnosis to a metabolic pathology by showing a metabolic bone "super scan" with increased tracer uptake in the left clavicle; parathyroid scintigraphy was able to localize pathological right parathyroid tissue. CONCLUSIONS: Whenever multiple osteolytic lesions are found in a patient without any known tumor, metabolic bone diseases including hyperparathyroidism should be highly considered.
[Mh] Termos MeSH primário: Adenoma/diagnóstico por imagem
Neoplasias Ósseas/diagnóstico
Clavícula/diagnóstico por imagem
Fraturas Espontâneas/diagnóstico por imagem
Hiperparatireoidismo Primário/diagnóstico
Neoplasias das Paratireoides/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adenoma/complicações
Neoplasias Ósseas/secundário
Clavícula/lesões
Diagnóstico Diferencial
Fraturas Espontâneas/etiologia
Seres Humanos
Hiperparatireoidismo Primário/etiologia
Masculino
Meia-Idade
Neoplasias das Paratireoides/complicações
Cintilografia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171210
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1509-7


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[PMID]:29254595
[Au] Autor:Shi Y; Azimzadeh P; Jamingal S; Wentworth S; Ferlitch J; Koh J; Balenga N; Olson JA
[Ad] Endereço:Division of General and Oncologic Surgery, Department of Surgery, University of Maryland, School of Medicine, Baltimore, MD.
[Ti] Título:Polyclonal origin of parathyroid tumors is common and is associated with multiple gland disease in primary hyperparathyroidism.
[So] Source:Surgery;163(1):9-14, 2018 Jan.
[Is] ISSN:1532-7361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Parathyroid tumors are mostly considered monoclonal neoplasms, the rationale for focused parathyroidectomy in primary hyperparathyroidism. We reported that flow sorting parathyroid tumor cells and methylation-sensitive polymerase chain reaction (me-PCR) of polymorphic human androgen receptor gene and phosphoglycerate kinase gene alleles in deoxyribonucleic acid reveals that ≤35% of parathyroid tumors are polyclonal. We sought to confirm these findings and assess for clinical relevance. METHODS: Parathyroid tumors from 286 female primary hyperparathyroidism patients were analyzed for clonal status. Tumor clonal status was compared with clinical variables and operative findings. Statistical analysis was performed and significance was established at P < .05. RESULTS: In the study, 176 (62%) patients were informative for human androgen receptor gene and/or phosphoglycerate kinase gene. Assignment of clonal status was made in 119 (68%) tumors, of which 64 (54%) were monoclonal and 55 (46%) were polyclonal. Comparison of tumor clonal status to clinical variables in patients with complete operative data (N = 82) showed that while clinical features were the same between tumor types, patients with polyclonal tumors more often had multiple gland disease (risk ratio 4.066, confidence interval, 1.016-16.26; P = .039) potentially missed at unilateral neck exploration. CONCLUSION: This work confirms that primary hyperparathyroidism is often the result of polyclonal tumors and that parathyroid tumor clonal status may be associated with multiple gland disease.
[Mh] Termos MeSH primário: Adenoma/etiologia
Hiperparatireoidismo Primário/etiologia
Neoplasias das Paratireoides/etiologia
[Mh] Termos MeSH secundário: Adenoma/patologia
Adenoma/cirurgia
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Meia-Idade
Glândulas Paratireoides/patologia
Neoplasias das Paratireoides/patologia
Neoplasias das Paratireoides/cirurgia
Paratireoidectomia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:29245309
[Au] Autor:Li W; Zhu Q; Lai X; Sun J; Jiang Y; Ren X; Zhang Q; Meng Z; Li J; Dai Q
[Ad] Endereço:aDepartment of UltrasoundbDepartment of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
[Ti] Título:Value of preoperative ultrasound-guided fine-needle aspiration for localization in Tc-99m MIBI-negative primary hyperparathyroidism patients.
[So] Source:Medicine (Baltimore);96(49):e9051, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To evaluate the value of preoperative ultrasound-guided fine-needle aspiration (UG-FNA) of ultrasound-detected suspicious parathyroid nodules for localization in Tc-99m MIBI-negative primary hyperparathyroidism patients.From May 2008 to December 2016, Tc-99m MIBI-negative primary hyperparathyroidism patients with ultrasound-detected suspicious cervical nodules underwent UG-FNA. The sample obtained from the solid component of the nodule was subjected to cytological evaluation and immunohistochemical staining. The sample obtained from the cystic component of the nodule or solid nodules was subjected to parathyroid hormone determination. After aspiration, the nodules underwent surgical resection or follow-up.Fifteen nodules (5 cystic, 5 cystic and solid, and 5 solid) from 15 patients were subjected to UG-FNA. Aspirate samples were obtained from 12 of the nodules, and the parathyroid hormone (PTH) levels of these samples were markedly elevated (range: 302- >2500 pg/mL). The samples obtained from the solid components of the 4 cystic and solid and 4 solid nodules were subjected to cytological evaluation, and parathyroid cells were identified in 5 of them. Of these 5 cases, 4 were subjected to immunohistochemical staining, which revealed PTH positivity in the cell block. The UG-FNA results suggested that the suspicious nodules were all parathyroid lesions. The surgical pathology results of 13 cases confirmed the UG-FNA results; the follow-up of 2 cases did not reveal any significant change.The cytological evaluation, immunohistochemical staining, and aspirate fluid PTH determination of UG-FNA were helpful for preoperative localization in Tc-99m MIBI-negative primary hyperparathyroidism patients with ultrasound-detected suspicious parathyroid nodules and can be applied selectively or in combination. Aspirate sample PTH determination should be preferred for nodules with cystic components. Further prospective study with large population is needed to confirm our conclusions.
[Mh] Termos MeSH primário: Biópsia por Agulha Fina/métodos
Hiperparatireoidismo Primário/cirurgia
Paratireoidectomia/métodos
Cuidados Pré-Operatórios/métodos
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Hiperparatireoidismo Primário/diagnóstico por imagem
Masculino
Meia-Idade
Glândulas Paratireoides/diagnóstico por imagem
Glândulas Paratireoides/patologia
Glândulas Paratireoides/cirurgia
Hormônio Paratireóideo/análise
Cintilografia/métodos
Compostos Radiofarmacêuticos
Tecnécio Tc 99m Sestamibi
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Parathyroid Hormone); 0 (Radiopharmaceuticals); 971Z4W1S09 (Technetium Tc 99m Sestamibi)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009051


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[PMID]:29189860
[Au] Autor:Paillahueque G; Massardo T; Barberán M; Ocares G; Gallegos I; Toro L; Araya AV
[Ad] Endereço:Sección Medicina Nuclear, Hospital Clínico, Universidad de Chile, Santiago, Chile.
[Ti] Título:[False negative spect parathyroid scintigraphy with sestamibi in patients with primary hyperparathyroidism].
[Ti] Título:Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario..
[So] Source:Rev Med Chil;145(8):1021-1027, 2017 Aug.
[Is] ISSN:0717-6163
[Cp] País de publicação:Chile
[La] Idioma:spa
[Ab] Resumo:BACKGROUND: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. AIM: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. MATERIAL AND METHODS: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. RESULTS: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. CONCLUSIONS: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.
[Mh] Termos MeSH primário: Hiperparatireoidismo Primário/diagnóstico por imagem
Glândulas Paratireoides/diagnóstico por imagem
Compostos Radiofarmacêuticos
Tecnécio Tc 99m Sestamibi
Tomografia Computadorizada de Emissão de Fóton Único/métodos
[Mh] Termos MeSH secundário: Adenoma/diagnóstico por imagem
Adenoma/patologia
Adulto
Idoso
Carcinoma/diagnóstico por imagem
Carcinoma/patologia
Reações Falso-Negativas
Feminino
Seres Humanos
Hiperparatireoidismo Primário/patologia
Hiperplasia/diagnóstico por imagem
Hiperplasia/patologia
Masculino
Meia-Idade
Glândulas Paratireoides/patologia
Neoplasias das Paratireoides/diagnóstico por imagem
Neoplasias das Paratireoides/patologia
Padrões de Referência
Valores de Referência
Estudos Retrospectivos
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 971Z4W1S09 (Technetium Tc 99m Sestamibi)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171218
[Lr] Data última revisão:
171218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:28745704
[Au] Autor:Kurganov IA; Emel'yanov SI; Bogdanov DY; Matveyev NL; Lukyanchenko DV; Mamistvalov MS; Agafonov OA; Rutenburg GM; Guslev AB
[Ad] Endereço:Department of Endoscopic Surgery, Yevdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
[Ti] Título:[The minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism].
[Ti] Título:Miniinvazivnaia videoassistirovannaia paratireoidéktomiia pri pervichnom giperparatireoze..
[So] Source:Khirurgiia (Mosk);(7):33-39, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To study feasibility, effectiveness and safety of minimally invasive video-assisted parathyroidectomy in patients with primary hyperparathyroidism; to define the advantages and disadvantages of this technique compared with conventional open surgery. MATERIAL AND METHODS: The study includes the results of 33 minimally invasive video-assisted parathyroidectomies performed in patients with primary hyperparathyroidism. The control group included 36 patients who underwent conventional open surgery. RESULTS: There were significantly increased time of surgery in the main group (41.2±12.7 min vs. 28.4±10.9 min, p<0.05), decreased need for postoperative analgesia (1,2±0.3 vs. 1.9±0.5 days, p<0.05) and significantly longer postoperative scar (1.8±0.2 vs. 6.2±0.5 cm, p<0.01). Incidence of complications was similar in both groups (6.1% vs. 8.3%, p>0.05). CONCLUSION: Minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism is feasible, safe and effective intervention that improves early postoperative course and cosmetic outcomes.
[Mh] Termos MeSH primário: Hiperparatireoidismo Primário/cirurgia
Procedimentos Cirúrgicos Minimamente Invasivos
Glândulas Paratireoides/cirurgia
Paratireoidectomia
Cirurgia Vídeoassistida
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Hiperparatireoidismo Primário/diagnóstico
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Duração da Cirurgia
Avaliação de Processos e Resultados (Cuidados de Saúde)
Glândulas Paratireoides/patologia
Paratireoidectomia/efeitos adversos
Paratireoidectomia/métodos
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Federação Russa
Cirurgia Vídeoassistida/efeitos adversos
Cirurgia Vídeoassistida/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017733-39


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[PMID]:28877925
[Au] Autor:Kaderli RM; Riss P; Dunkler D; Pietschmann P; Selberherr A; Scheuba C; Niederle B
[Ad] Endereço:Section of Endocrine SurgeryDivision of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria reto.kaderli@insel.ch.
[Ti] Título:The impact of vitamin D status on hungry bone syndrome after surgery for primary hyperparathyroidism.
[So] Source:Eur J Endocrinol;178(1):1-9, 2018 Jan.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Prolonged hypocalcemia but normal intact parathyroid hormone (iPTH) levels after surgery for primary hyperparathyroidism (PHPT) are referred to as 'hungry bone syndrome' (HBS). The aim was to evaluate preoperative risk factors for HBS with a focus on the impact of 25-hydroxyvitamin D (25(OH)D) deficiency. DESIGN: Patients having undergone initial successful surgery for sporadic PHPT within 6 years were considered for retrospective analysis. METHODS: A total of 385 patients were evaluated, of whom 33 (8.6%) developed HBS influencing negatively the postoperative bone metabolism. All patients underwent biochemical evaluations two days before parathyroid surgery and were followed biochemically on a daily basis in the first postoperative week and thereafter at 8 weeks and 6 months. CONCLUSIONS: No relationship was established between preoperative 25(OH)D deficiency and HBS. The only significant risk factor for HBS in multivariable analysis was high levels of preoperative iPTH. As HBS therefore cannot be predicted preoperatively, we recommend a consistent postoperative calcium and vitamin D supplementation to improve the bone metabolism.
[Mh] Termos MeSH primário: Hiperparatireoidismo Primário/sangue
Hiperparatireoidismo Primário/cirurgia
Hipocalcemia/sangue
Complicações Pós-Operatórias/sangue
Deficiência de Vitamina D/sangue
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/sangue
Feminino
Seres Humanos
Hiperparatireoidismo Primário/diagnóstico
Hipocalcemia/diagnóstico
Masculino
Meia-Idade
Hormônio Paratireóideo/sangue
Complicações Pós-Operatórias/diagnóstico
Estudos Prospectivos
Estudos Retrospectivos
Vitamina D/sangue
Deficiência de Vitamina D/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Parathyroid Hormone); 1406-16-2 (Vitamin D)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0416


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[PMID]:27771850
[Au] Autor:Ward AF; Lee T; Ogilvie JB; Patel KN; Hiotis K; Bizekis C; Zervos M
[Ad] Endereço:Division of Thoracic Surgery, NYU Langone Medical Center, 530 First Avenue, Suite 9V, New York, NY, 10016, USA.
[Ti] Título:Robot-assisted complete thymectomy for mediastinal ectopic parathyroid adenomas in primary hyperparathyroidism.
[So] Source:J Robot Surg;11(2):163-169, 2017 Jun.
[Is] ISSN:1863-2491
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:One to two percent of ectopic parathyroid adenomas are found in the lower mediastinum and often these are best accessed via a sternotomy or thoracotomy. Video-assisted thoracoscopic surgery (VATS) is an alternative approach with less surgical trauma, decreased morbidity, shorter hospital stays, and superior cosmetic results. Ten years after the first VATS resection of an ectopic mediastinal parathyroid, a robot-assisted thoracoscopic approach was described. Here we describe a series of five robot assisted complete thymectomies in patients with primary hyperparathyroidism due to mediastinal ectopic parathyroid adenomas. A single surgeon, single institution case series of five consecutive robotic-assisted mediastinal parathyroidectomies was performed between March 2013 and September 2015. The patients' ages ranged from 31 to 65, 80 % were female, and all had primary hyperparathyroidism due to an ectopic parathyroid located in the lower mediastinum. Pre-operative imaging workup included Technetium 99-sestimibi parathyroid scan and CT scan of the chest. An ectopic parathyroid adenoma was successfully removed in all five cases, with intraoperative iOPTH decreasing ~50 % from baseline after 10 minutes. A hypercellular parathyroid was confirmed on pathologic exam in all specimens. Post-operative discharge and follow up calcium levels all returned to normal. There were no intraoperative complications, including no recurrent laryngeal nerve injuries, no postoperative morbidity, and no mortalities. This case series demonstrates that a robot-assisted complete thymectomy for mediastinal parathyroid adenomas causing primary hyperparathyroidism provides excellent visualization of the mediastinum, is effective at reducing PTH and calcium levels, and is safe with no morbidity or mortality.
[Mh] Termos MeSH primário: Adenoma/cirurgia
Coristoma/cirurgia
Hiperparatireoidismo Primário/cirurgia
Doenças do Mediastino/cirurgia
Neoplasias das Paratireoides/cirurgia
Procedimentos Cirúrgicos Robóticos/métodos
Timectomia/métodos
[Mh] Termos MeSH secundário: Adenoma/patologia
Adulto
Idoso
Coristoma/patologia
Feminino
Seres Humanos
Laparoscopia/métodos
Masculino
Meia-Idade
Neoplasias das Paratireoides/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1007/s11701-016-0637-1


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[PMID]:29095277
[Au] Autor:Gao Y; Yu C; Xiang F; Xie M; Fang L
[Ad] Endereço:Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
[Ti] Título:Acute pancreatitis as an initial manifestation of parathyroid carcinoma: A case report and literature review.
[So] Source:Medicine (Baltimore);96(44):e8420, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Parathyroid carcinoma is a rare endocrine malignancy. Acute pancreatitis as an initial manifestation of parathyroid carcinoma has been rarely reported. PATIENT CONCERNS: A 22-year-old woman was admitted to emergency room with a sudden attack of severe epigastric pain. DIAGNOSES: Acute pancreatitis was diagnosed as elevated levels of serum amylase. During the work-up for acute pancreatitis, patient's abnormally increased serum calcium and bones destruction revealed by abdominal computed tomography (CT) scan raised the suspicion of hyperparathyroidism or malignancy. Elevated serum parathyroid hormone (PTH) levels, parathyroid ultrasound and scintigraphy gave rise to the diagnosis of primary hyperparathyroidism (PHPT) due to a left parathyroid tumor. INTERVENTIONS: The patient was given a complete tumor excision. After the surgery, parathyroid carcinoma with capsular and vascular invasion was confirmed histologically. A second surgery was then performed, including resection of the ipsilateral thyroid lobe and anterior cervical nodes. OUTCOMES: Serum calcium and PTH levels returned to normal postoperatively. LESSONS: Acute pancreatitis accompanied with hypercalcemia should always raise the suspicion of PHPT. The spicule sign, which always suggests the infiltrating pattern growth of tumor, was neglected at first and was observed during a second review of the ultrasound images postoperatively. This specific feature may be predictive for the preoperative diagnosis of parathyroid carcinoma or at least suspicion of malignancy.
[Mh] Termos MeSH primário: Hiperparatireoidismo Primário/etiologia
Pancreatite/etiologia
Neoplasias das Paratireoides/complicações
[Mh] Termos MeSH secundário: Doença Aguda
Amilases/sangue
Cálcio/sangue
Feminino
Seres Humanos
Hiperparatireoidismo Primário/sangue
Hiperparatireoidismo Primário/diagnóstico por imagem
Pancreatite/sangue
Pancreatite/diagnóstico por imagem
Glândulas Paratireoides/diagnóstico por imagem
Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/sangue
Neoplasias das Paratireoides/diagnóstico por imagem
Cintilografia
Ultrassonografia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Parathyroid Hormone); EC 3.2.1.- (Amylases); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171103
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008420


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[PMID]:29068975
[Au] Autor:Best CAE; Krishnan R; Malvankar-Mehta MS; MacNeil SD
[Ad] Endereço:aNorthern Ontario School of Medicine, Sudbury bDepartment of Epidemiology and Biostatistics, Western University, London cDepartment of Ophthalmology, Department of Epidemiology and Biostatistics, Western University, London dLondon Health Sciences Center, Western University, London, ON, Canada.
[Ti] Título:Echocardiogram changes following parathyroidectomy for primary hyperparathyroidism: A systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(43):e7255, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the study is to systematically review the evidence on post parathyroidectomy (PTX) changes as measured by echocardiogram (ECHO) in patients with primary hyperparathyroidism (PHPT).PHPT may increase risk of cardiovascular morbidity/mortality. Conclusions of studies assessing ECHO changes, pre versus post PTX, are inconsistent.A systematic literature search was conducted to locate published and unpublished studies. Randomized control trials, nonrandomized control trials, and observational studies were included. Variables were reported as means and standard deviations. An inverse variance statistical method, with random-effects analysis model, was applied to continuous data. The effect measure was standardized mean difference, confidence interval of 95%. Primary outcome measure was left ventricular ejection fraction (LVEF). Secondary outcome measures were left ventricular mass index (LVMI), peak early over peak late diastolic velocity ratio (E/A ratio), isovolumetric relaxation time (IVRT), intraventricular septal thickness (IVST), and posterior wall thickness (PWT).Fourteen studies were included. Follow-up time ranged 3 to 67 months. No significant differences (P > .05) in primary outcome measure LVEF (SMD = -0.03, CI = -0.24, 0.19), or secondary outcome measures E/A Ratio (SMD = -0.05, CI = -0.24, 0.14), IVST (SMD = 0, CI = 0.31, 0.32), PWT (SMD = 0.01, CI = -0.38, 0.39), LVMI (SMD = -0.18, CI = -0.74, 0.38), and IVRT (SMD = -0.84, CI = -1.83, 0.14) were observed.There was no significant difference in LVEF pre to post PTX. Due to heterogeneity of current literature, we were unable to determine if other outcome measures of cardiac function are affected after PTX in patients with PHPT. We recommend a randomized control trial be conducted to make concrete conclusions.
[Mh] Termos MeSH primário: Ecocardiografia
Hiperparatireoidismo Primário/diagnóstico por imagem
Hiperparatireoidismo Primário/cirurgia
Paratireoidectomia
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Seres Humanos
Hiperparatireoidismo Primário/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007255



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