scholarly journals Recent advances in the understanding and management of primary hyperparathyroidism

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 143 ◽  
Author(s):  
Melanie Goldfarb ◽  
Frederick R. Singer
Keyword(s):  
Primary Hyperparathyroidism ◽  
Near Infrared ◽  
Disease Process ◽  
The United States ◽  
Parathyroid Hormone Monitoring ◽  
Parathyroid Disease ◽  
Asymptomatic Primary Hyperparathyroidism ◽  
Focused Parathyroidectomy ◽  
Cure Rates

Primary hyperparathyroidism is a hormonal disorder whose prevalence is approximately 1–2% in the United States of America. The disease has become more recognizable to clinicians in an earlier phase and, at present, patients can be diagnosed with “classic”, “normocalcemic”, “normohormonal”, or “mild, asymptomatic” primary hyperparathyroidism. Surgery, with a focused parathyroidectomy when possible, or a four-gland exploration, is the only way to cure the disease. Cure is determined by use of intra-operative parathyroid hormone monitoring with long-term cure rates ranging from 90–95%. Newer adjuncts to surgery include CT or PET imaging and near-infrared immunofluorescence. This article highlights updates in parathyroid disease and advances in parathyroid surgery; it does not provide a comprehensive summary of the disease process or a review of surgical indications, which can be found in the AAES guidelines or NIH Symposium on primary hyperparathyroidism.

Near-infrared Imaging in Stroke Research

1997 ◽  
Vol 3 (S2) ◽  
pp. 829-830
Author(s):  
R.J. Dempsey ◽  
R.G. Buice ◽  
W.C. Symons ◽  
R.A. Lodder
Keyword(s):  
Near Infrared ◽  
Carotid Atherosclerosis ◽  
Infrared Imaging ◽  
Disease Process ◽  
Stroke Research ◽  
Collateral Growth ◽  
Life Threatening ◽  
Long Term Prognosis ◽  
Lipoprotein Composition

Accurate and nondestructive measurement of different lipoproteins simultaneously in carotid plaque in stroke patients using near-infrared (IR) imaging spectrometry seems possible for research. The lipoprotein composition of the plaque appears to have an impact on the outcome of the disease process. Carotid atherosclerosis without associated thrombosis is frequently a benign disease that is asymptomatic, although TIAs may be present in other cases. Many patients with carotid atherosclerosis can be treated surgically by endarterectomy with high initial success and favorable long-term prognosis. The acute manifestation of carotid atherosclerosis - stroke - arises when thrombus or ulceration develop. This potentially life-threatening complication probably develops at the site of plaque fissure or rupture. Recent research by others indicates that it is not the severity of stenosis (plaque volume) that determines the outcome: it is the type of stenosis (plaque chemical composition) and the extent of collateral growth.

scholarly journals (1) Genetic Diversity of Cowpea [Vigna unguiculata (L.) Walp.] Breeding Lines from Different Countries Determined by AFLP Markers

HortScience ◽  
2005 ◽  
Vol 40 (4) ◽  
pp. 998A-998 ◽  
Author(s):  
Jinggui Fang ◽  
Panchanoor S. Devanand ◽  
Chih Cheng T. Chao ◽  
Philip A. Roberts ◽  
Jeff D. Ehlers
Keyword(s):  
Genetic Diversity ◽  
South America ◽  
Near Infrared ◽  
Genetic Relationships ◽  
The United States ◽  
Aflp Markers ◽  
Sub Saharan Africa ◽  
Breeding Programs ◽  
Breeding Lines

Cowpea (2n=2x=22) is a high protein, short-cycle, and essential legume food crop of the tropics, especially in the low input agricultural areas of sub-Saharan Africa, Asia, and South America. Lack of genetic diversity within breeding programs can limit long-term gains from selection. The cowpea gene pool is thought to be narrow and the genetic diversity within breeding programs could be even less diverse. Genetic relationships among 87 cowpea accessions, including 60 advanced breeding lines from six breeding programs in Africa and the United States, and 27 accessions from Africa, Asia, and South America were examined using amplified fragment length polymorphism (AFLP) markers with six near-infrared fluorescence labeled EcoR I + 3/Mse I + 3 primer sets. A total of 382 bands were scored among the accessions with 207 polymorphic bands (54.2%). Overall, the 87 cowpea accessions have narrow genetic basis and they shared minimum 86% genetic similarities. The data also show that the advanced breeding lines of different programs have higher genetic affinities with lines from the same program but not with lines from other programs. The results suggest that there is a need to incorporate additional germplasm of different genetic background into these breeding lines and to ensure the long-term genetic gains of the programs.

Primary Hyperparathyroidism

2019 ◽  
Author(s):  
Anna C Beck ◽  
Sonia L Sugg
Keyword(s):  
Primary Hyperparathyroidism ◽  
Imaging Techniques ◽  
Laboratory Examination ◽  
Hypercalcemic Crisis ◽  
Parathyroid Hormone Monitoring ◽  
Sestamibi Scan ◽  
Asymptomatic Primary Hyperparathyroidism ◽  
Diagnostic Work ◽  
Intraoperative Parathyroid Hormone ◽  
Work Up

Primary hyperparathyroidism is defined. Key components of the diagnostic work-up including symptoms, family history, laboratory examination, and imaging techniques are reviewed. Indications for surgery, including a discussion of the latest guidelines, are emphasized. Controversies such as when to operate on asymptomatic primary hyperparathyroidism are discussed. This review contains 4 figures, 1 table, and 29 references. Key Words: hypercalcemia, hypercalcemic crisis, intraoperative parathyroid hormone monitoring, multiple endocrine neoplasia, normocalcemic primary hyperparathyroidism, parathyroid adenoma, parathyroid hyperplasia, primary hyperparathyroidism, sestamibi scan

Primary Hyperparathyroidism

2019 ◽  
Author(s):  
Anna C Beck ◽  
Sonia L Sugg
Keyword(s):  
Primary Hyperparathyroidism ◽  
Imaging Techniques ◽  
Laboratory Examination ◽  
Hypercalcemic Crisis ◽  
Parathyroid Hormone Monitoring ◽  
Sestamibi Scan ◽  
Asymptomatic Primary Hyperparathyroidism ◽  
Diagnostic Work ◽  
Intraoperative Parathyroid Hormone ◽  
Work Up

Primary hyperparathyroidism is defined. Key components of the diagnostic work-up including symptoms, family history, laboratory examination, and imaging techniques are reviewed. Indications for surgery, including a discussion of the latest guidelines, are emphasized. Controversies such as when to operate on asymptomatic primary hyperparathyroidism are discussed. This review contains 4 figures, 1 table, and 29 references. Key Words: hypercalcemia, hypercalcemic crisis, intraoperative parathyroid hormone monitoring, multiple endocrine neoplasia, normocalcemic primary hyperparathyroidism, parathyroid adenoma, parathyroid hyperplasia, primary hyperparathyroidism, sestamibi scan

scholarly journals Should Symptoms Be Considered an Indication for Parathyroidectomy in Primary Hyperparathyroidism?

2018 ◽  
Vol 11 ◽  
pp. 117955141878513 ◽  
Author(s):  
Alexandria D McDow ◽  
Rebecca S Sippel
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Disease ◽  
Primary Hyperparathyroidism ◽  
Kidney Stones ◽  
Burden Of Disease ◽  
Disease Process ◽  
Asymptomatic Primary Hyperparathyroidism ◽  
Definition Of

Asymptomatic primary hyperparathyroidism is a very common endocrine condition, yet management of this disease process remains controversial. Primary hyperparathyroidism can lead to a myriad of symptoms which not only decreases the quality of life of patients but also increases the risk of cardiovascular disease, osteoporosis, and kidney stones. Parathyroidectomy is the only known cure for the disease. This review explores the definition of asymptomatic primary hyperparathyroidism, the burden of disease, and the overwhelming benefits of parathyroidectomy.

Robotic Assistive Device for Phlebotomy

2015 ◽  
Author(s):  
Paulo Carvalho ◽  
Anurag Kesari ◽  
Sean Weaver ◽  
Patrick Flaherty ◽  
Gregory S. Fischer
Keyword(s):  
Near Infrared ◽  
Force Feedback ◽  
Point Of Care ◽  
Healthcare Delivery ◽  
The United States ◽  
Assistive Device ◽  
Sample Collection ◽  
Major Step ◽  
Proper Diagnosis

Phlebotomy is a routine task, performed over a billion times annually in the United States alone, that is essential for proper diagnosis and treatment. We designed and constructed Phlebot, a robotic assistive device that uses a novel combination of near-infrared (NIR) monocular imaging and force-feedback to guide a needle into a forearm vein for blood sample collection or intravenous catheterization. Through initial validation on phantoms, we show that our approach offers a feasible and reliable method to automate phlebotomy. We envision the device to be a first major step towards more affordable point-of-care testing and diagnostic healthcare systems. In the long term, we expect that Phlebot will expedite healthcare delivery and drastically reduce needle stick injuries, instances of hemolysis, and infections caused by blood-borne pathogens.

scholarly journals Retrospective analysis of the role of intra-operative parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism; a single center experience over 2 decades

2021 ◽  
Author(s):  
Yehonatan Adler ◽  
Sharon Tzelnick ◽  
Yoni Shopen ◽  
Ella Reifen ◽  
Gideon Bachar ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Retrospective Analysis ◽  
Operating Room ◽  
Parathyroid Hormone Monitoring ◽  
Significant Difference ◽  
Cure Rates ◽  
Room Time ◽  
Operating Room Time

Background: The role of intra-operative parathyroid hormone (IOPTH) monitoring during parathyroidectomy for primary hyperparathyroidism has long been debated. Objectives: Our main goal was to investigate the cure rates of parathyroidectomy for primary hyperparathyroidism with and without IOPTH monitoring. Our secondary goal was to investigate if operating room time can be saved when not using IOPTH monitoring. Design: A retrospective analysis of patients who underwent parathyroidectomy for PHPT for a single adenoma between 2004-2019 was performed. Cure rates and operating room time were compared. Results: 423 patients were included. IOPTH was used in 248 patients (59%). Four patients were not cured, two from each group, with no significant difference between the groups (98.8% vs. 99.1%, p=0.725). Surgery time was significantly longer in the IOPTH group, p<0.001. Conclusions: There is no advantage for using IOPTH during parathyroidectomy in suitable clinical setting. A focused procedure may be safely performed without IOPTH while achieving non-inferior success rates and reducing operative time.

Focused parathyroidectomy with intraoperative parathyroid hormone monitoring in patients with lithium-associated primary hyperparathyroidism

Surgery ◽  
2013 ◽  
Vol 153 (5) ◽  
pp. 718-722 ◽  
Author(s):  
Thomas J. Wade ◽  
Tina W.F. Yen ◽  
Amanda L. Amin ◽  
Douglas B. Evans ◽  
Stuart D. Wilson ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Hormone Monitoring ◽  
Focused Parathyroidectomy ◽  
Intraoperative Parathyroid Hormone

Focused parathyroidectomy without intra-operative parathyroid hormone monitoring for primary hyperparathyroidism: results in a low-volume hospital

2015 ◽  
Vol 129 (8) ◽  
pp. 788-794 ◽  
Author(s):  
T-L Chow ◽  
C-Y Choi ◽  
S-H Lam
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Vocal Fold ◽  
Surgical Complication ◽  
High Volume ◽  
Parathyroid Hormone Monitoring ◽  
Vocal Fold Palsy ◽  
Focused Parathyroidectomy ◽  
Sporadic Primary Hyperparathyroidism ◽  
Low Volume

AbstractBackground:The role of routine intra-operative parathyroid hormone monitoring for sporadic primary hyperparathyroidism is contentious. Satisfactory results can be achieved in high-volume centres. The results of low-volume hospitals are rarely studied.Methods:A retrospective, non-comparative study was conducted. From November 2002 to October 2012, 105 patients with clinically sporadic primary hyperparathyroidism underwent focused parathyroidectomy without intra-operative parathyroid hormone monitoring. Single adenoma was localised on pre-operative ultrasonography or sestamibi scan. The cure rate, surgical complication rate and pathology findings were evaluated.Results:Most of the operations (63.8 per cent) were performed under local anaesthesia. All but two patients (98.1 per cent) were cured after surgery. There was only one case of double adenomas. No recurrent hyperparathyroidism was observed after a mean follow up of 56.9 months. Surgical complications comprised two cases (1.9 per cent) of transient vocal fold palsy and one case (1.0 per cent) of permanent vocal fold palsy. Seven patients (6.7 per cent) suffered temporary hypocalcaemia.Conclusion:Satisfactory results of focused parathyroidectomy without routine intra-operative parathyroid hormone monitoring for appropriately selected primary hyperparathyroidism cases can be attained in a low-volume hospital.

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