Objective: Primary hyperparathyroidism (PHPT) occurs as a result of hyperfunctional parathyroid glands resulting in an elevation of serum calcium levels. The association between hypoparathyroidism and parkinsonism have been frequently reported in the literature, while evidence of hyperparathyroidism associated with parkinsonism is rare. Methods: The present study reports a case of a patient that had PHPT and developed symptoms of parkinsonism. Results: A 75-year-old female patient with a history of diabetes mellitus, dyslipidemia, and systemic arterial hypertension presented to the emergency room due to unexplained drowsiness. Her serum calcium at the time was 14.2 mg/dL. A cervical ultrasound was performed, and the presence of a 2.5 × 1.9-cm nodule in the left lower parathyroid region was identified. Three days later, scintigraphy with the use of sestamibi showed an increased capture of the marker in the same region, suggesting parathyroid hyperfunction. During hospitalization, the patient developed symptoms of parkinsonism. A left inferior parathyroidectomy was performed, with normalization of serum calcium levels and a remission of drowsiness, in addition to a significant improvement in parkinsonian symptoms. The patient remained free of parkinsonism over 3 years of follow up. Conclusion: Parathyroidectomy can provide a significant remission of parkinsonism in a patient with PHPT. Even though it is rare, the relation between parkinsonism and PHPT exists. (AACE Clinical Case Rep.

Objective: We sought to re-explore the association between well-known prognostic factors and recurrence in presumed early-stage low-risk endometrial cancer (EC). Methods: A retrospective cohort study was carried out on patients who underwent surgical treatment by the same surgeon for presumed early-stage low-risk EC between September 2003 to August 2017. The prognostic value of well-known clinicopathological factors for diseasefree survival (DFS) was reviewed by univariate log-rank test. Results: One hundred and five patients fit the criteria for this analysis. These patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with no lymph nodes dissection (10.5%) or with a sampling dissection alone (89.5%). Adjuvant therapies were applied in 52 (40.1%) of them as pelvic radiotherapy (29.5%) or chemoradiation (11.4%). Our cumulative 3y-DFS and OS were 88.1% and 97.7%, respectively. The univariate survival analysis confirmed histological grade 3 (3y-DFS of 89.9% vs. 33.3%, p=0.004), MMI ≥50% (3y-DFS of 95.2% vs. 71.3%, p=0.003), lymph node metastasis (3y-DFS of 88.3% vs. 60%; p=0.028) and more advanced pathological stages (3y-DFS of 91.2% vs. 56.3; p<0.001) as significantly associated to recurrences. Conclusion: We confirmed the association of classical prognostic factors such as high histological grade, deeper MMI, lymph node metastasis and more advanced pathological stages with disease recurrence in this cohort of patients from Northeast Brazil. Further efforts are needed to avoid overtreatment in patients with low risk of relapses.

Background: The transradial approach is currently the first option for percutaneous coronary procedures, whether diagnostic or therapeutic, particularly in patients with acute coronary syndromes. However, there is limited data in the literature comparing the use of a universal catheter from a radial approach versus the transfemoral approach. The purpose of this study was to demonstrate the feasibility of the single-catheter radial approach compared with the transfemoral approach. Methods: A retrospective assessment of cases of acute coronary syndrome undergoing invasive risk stratification and ad hoc percutaneous coronary intervention by transradial or transfemoral approach. In the transradial group, we selected cases in which one single guiding catheter was used in the procedure. Results: Between November 2011 and January 2013, we investigated 198 patients who met the selection criteria. Except for the higher mean age observed in the transradial group (63.5 vs. 59.2; p=0.002), there were no differences in clinical characteristics. In addition, there were no differences in clinical presentation, culprit vessel, number and size of the stents used, or final angiographic success rate. The number of vascular complications was higher, particularly hematomas <5cm, in the transfemoral group. Conclusion: The use of single-catheter transradial approach is feasible, safe and effective in managing patients with acute coronary syndrome.