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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of thyroid, parathyroid, and salivary abnormalities was determined in 91 women who received an average of 112 fluoroscopic chest examinations during pneumothorax treatment for tuberculosis more than 40 yr previously and in 72 women treated for tuberculosis by other modalities. Thyroid abnormalities were determined by physical examination, scintiscans, and measurements of serum free T4 index, TSH, and thyroid microsomal antibodies. Thyroid nodules were diagnosed in 7.7% of the exposed and 4.2% of the comparison group (prevalence ratio, 1.8; 90% confidence interval 0.6-5.7). Autoimmune thyroid disease was diagnosed in 15.2% of the exposed and 6.9% of the comparison group (prevalence ratio, 2.2; 95% confidence interval, 0.8-6.2). No salivary tumors were detected. Two exposed women and 1 comparison woman had primary hyperparathyroidism. Although absorbed dose to the thyroid could not be precisely determined, approximately 60 rads would be expected to yield the observed excess of thyroid nodules. While the prevalence ratios were not significantly increased in the exposed group, the results suggest that susceptibility of the thyroid to nodules from cumulative radiation doses of this magnitude could be increased even when the doses are accumulated over years and that such x-ray exposure of the thyroid gland may predispose the patient to the development of autoimmune disease.
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PMID:Thyroid, parathyroid, and salivary gland evaluations in patients exposed to multiple fluoroscopic examinations during tuberculosis therapy: a pilot study. 333 10

The gold standard for the surgical treatment of primary hyperparathyroidism has traditionally been bilateral neck exploration with identification of all four parathyroid glands. However, because of the increasing sensitivity and accuracy of preoperative imaging techniques, including ultrasound and sestamibi scanning, and the introduction of intraoperative parathyroid hormone monitoring, unilateral neck exploration has become more widely used. We describe two cases of pneumothorax following minimally invasive parathyroidectomy. The pneumothorax in the first case was thought to be due to the position of the parathyroid adenoma in the mediastinum and thus its close proximity to the lung pleura. In the second case, the patient had a history of emphysema, and the pneumothorax was most likely due to a rupture of a bleb. With prompt diagnosis and early treatment of this potential complication, morbidity can be decreased.
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PMID:Pneumothorax: an uncommon complication of minimally invasive parathyroidectomy. 1571 57

The traditional approach to primary hyperparathyroidism has been a bilateral neck exploration for evaluation of all four parathyroid glands. With the advent of minimally invasive surgery, minimally invasive parathyroidectomy has become a popular approach for the treatment of parathyroid adenomas. Though exceedingly rare, pneumothorax formation is a potential complication following this procedure. In this paper, we report four cases of pneumothorax following minimally invasive parathyroidectomies. The commonality in all these cases was positioning with extreme neck hyperextension. Additional risks in three patients were dissection in the superior mediastinum, traction on the thyrothymic ligament, and a low-lying inferior parathyroid gland. One patient developed a pneumothorax prior to dissection along the superior mediastinum. This suggests that further risk factors may be heat conduction from the electrocautery and total intravenous anesthesia with spontaneously breathing of the patient.
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PMID:Minimally invasive parathyroidectomy complicated by pneumothoraces: a report of 4 cases. 1746 11