Thirty-three questions
regarding preoperative localization, surgical management of RHPT, intraoperative PTH monitoring, immediate/delayed autotransplantation (AT), and parathyroid cryopreservation were sent to members of various societies of endocrine surgeons.
The data from 86 responses were analyzed, 61.6 % reported more than 50 parathyroid surgeries per year, and 62.7 % operated on less than 16 patients with RHPT per year. Subtotal or total parathyroidectomy (with/without AT) was the standard procedure Nepicastat in 98.8 % of the cases. Immediate AT was performed in 40.7 % (72.7 % in the forearm). In most patients, the onset of graft function was documented later than 1 week after AT. Cryopreservation was routinely performed in 27.4 %. In 10.7 %, replantation was performed in more than five patients (hypo- or aparathyroidism: n = 41; fresh graft failure: n = 13; reoperations: n = 9).
Intraoperative PTH monitoring (in RHPT) was routinely used in 46.2 %. Its influence on surgical strategy was confirmed in 40 %.
The survey reflects the divergent strategies applied for AT, cryopreservation, and PTH monitoring in RHPT.”
“Caesalpinia ferrea and Chrysobalanus icaco are plants commonly used by the folk medicine for the treatment of diabetes mellitus. In this work, the effects of the chronic treatment with aqueous extracts of C. ferrea (AECF) and C. icaco (AECI) on the vascular reactivity of alloxan-induced diabetic rats were evaluated. In rings of mesenteric artery, AECF and AECI were PU-H71 not able to modify the contractions induced by phenylephrine or relaxations induced by carbachol. However, treatment with AECI was able to prevent the potentiation of the relaxations induced by sodium nitroprusside in click here diabetic rats. In brief, this study found possible benefits of the treatment with C. icaco on the reactivity vascular of diabetic rats.”
“Since its registration in 2004, the calcimimetic agent cinacalcet has been established as an alternative treatment for secondary hyperparathyroidism (SHPT). Working by allosteric activation of the calcium-sensing receptor, cinacalcet
can lower parathyroid hormone (PTH) and calcium (Ca) in patients with SHPT. The influence of calcimimetics on the perioperative course has been unclear so far.
We retrospectively analyzed the data of patients with primary operation for SHPT between 2004 and 2011, comparing the perioperative course of patients with and without preoperative cinacalcet treatment.
Fifty-six patients had cinacalcet therapy, and 54 patients had no calcimimetic medication prior to surgery. Gender, age, hemodialysis, and medical treatment were similar in both groups. Also, PTH levels were similar preoperatively and postoperatively (preoperative, 1,249 +/- 676 vs. 1,196 +/- 601 pg/ml; postoperative, 86 +/- 220 vs. 62 +/- 91 pg/ml). Patients with cinacalcet preoperatively had significant lower Ca levels preoperatively (2.49 +/- 0.25 vs. 2.