Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 74-year-old woman was hospitalised for pleuro-pneumonia of the right base. The chest x-ray showed the presence of a right paratracheal opacity which persisted during the course of the infectious episode. A computed tomographic scan of the thorax showed a voluminous anterior mediastinal mass which compressed the trachea without invading it. Surgical excision enabled the ablation of a tumour which was haemorrhagic and the histological examination established a diagnosis of cystic parathyroid adenoma. At anytime did the patient present either clinical symptoms or biochemical signs suggesting primary hyperparathyroidism.
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PMID:[Asymptomatic mediastinal parathyroid adenoma]. 949 10

The objective of this study was to examine the complications encountered in a series of 150 consecutive thyroid and parathyroid procedures performed by a single surgeon in a rural community hospital setting. The goal was to demonstrate that these procedures may be performed safely and with outcomes equivalent to those of academic hospitals in major metropolitan areas despite the lack of availability of specific technologies that are being increasingly used for these procedures in tertiary care settings. Specifically, these include intraoperative parathyroid hormone measurements, intraoperative recurrent laryngeal nerve monitoring, and the use of the gamma probe for detection of parathyroid adenoma. A retrospective chart review was conducted on a series of 150 patients undergoing any thyroid or parathyroid operation by a single surgeon in a rural setting over a 4-year period. Data was reported regarding success at achieving the goal of the operation and any perioperative complications such as recurrent laryngeal nerve injury, permanent hypoparathyroidism, wound hematoma, infection, or pneumonia. One hundred thirty-one thyroid procedures were performed (71 lobectomies, 60 total or near total procedures) for a diverse range of patholological conditions: multinodular goiter, 76 (50.7%) patients, follicular adenoma, 9 (6.0%) patients, Hashimoto's thyroiditis, 13 (8.7%) patients, papillary carcinoma, 14 (9.3%) patients, follicular carcinoma, 5 (3.3%) patients, follicular variant of papillary carcinoma, 13 (8.7%) patients, and medullary carcinoma, 1 (0.7%) patient. Nineteen successful parathyroid explorations were performed for primary hyperparathyroidism. The overall incidence of recurrent nerve injury was 1.33 per cent overall (0.99% for each nerve encountered). The incidence of transient postoperative hypocalcemia was 13 per cent, with one patient suffering permanent hypoparathyroidism (0.8%). Two patients developed wound hematomas requiring evacuation. The overall complication rate with respect to recurrent laryngeal nerve injury and permanent hypoparathyroidism was consistent with or below that that in recent large series, despite the absence of specialized equipment for nerve monitoring. The success of identifying parathyroid adenoma was 100 per cent, despite the absence of intraoperative parathormone assays, and the decision not to perform radio-guided parathyroidectomy. We conclude that outcomes and complications in thyroid and parathyroid surgical procedures are largely dependent on surgeon skill and experience, and can be performed safely in the community setting by an experienced general surgeon despite the absence of advanced technology in this setting. We encourage all surgeons to continually examine their operative results with all technically demanding procedures when deciding the composition of their individual practices.
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PMID:Complications of thyroidectomy and parathyroidectomy in the rural community hospital setting. 1743 23

Neonatal primary hyperparathyroidism (NPHP) is a rare disease that presents in the first 6 months of life. It is almost invariably fatal unless a prompt diagnosis is made and urgent surgical intervention is instituted. Patients with hyperparathyroidism require special preoperative considerations. They require proper work-up from cardiac, renal and neurological point of view, correction of intravenous volume and electrolytes irregularities. We are presenting a case of an infant who started to have cyanosis and lethargy at 21st day of life. Initial diagnosis of pneumonia was made but later on diagnosed as hyperparathyroidism. He was planned for parathyroidectomy under general anaesthesia. He was induced with sevoflurane followed by fentanyl and atracurium and intubated with size 3.5 mm endotracheal tube (ETT). Later, he was maintained with isoflurane and O2/NO2. He was successfully extubated at the end of operation and was shifted to intensive care unit (ICU) for close monitoring.
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PMID:Anaesthetic management of neonatal primary hyperparathyroidism. 2386 56