About the guideline for diagnosis and treatment of primary hyperparathyroidism in a country with endemic goiter

Ursu, H

doi:10.4183/aeb.2010.129

Cited by 3 publications

(5 citation statements)

References 19 publications

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“…Programs against iodine deficiency disorders (IDD) had clear political appeal because its human, economic and social consequences could be averted by a low-cost intervention, Universal Salt Iodization (7). Different aspects of this topic (IDD) have been published in our country (8)(9)(10)(11)(12). Endemic goiter occurred in different degrees throughout 2/3 of Romania territory, mainly in the Carpathian and sub-Carpathian areas (6).…”

Section: Introductionmentioning

confidence: 99%

Iodine Status in Pregnant Women after a Decade of Universal Salt Iodization in Romania

Podia-Igna³

et al. 2016

Acta Endo (Buc)

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objective. To assess iodine status (median urinary iodine concentration) in 118 pregnant women during the third trimester from endemic or non-endemic areas, a decade after implementation of Universal Salt Iodization in Romania.subjects and methods. One hundred and eighteen pregnant women in the third trimester were included in the study group (age range: 16 -46 years, mean age: 28.78 years). Median urinary iodine concentration (UIC) and body mass index (BMI) were evaluated. Data regarding region of provenance, smoking habits during pregnancy, education level, iodized salt intake, bread intake, iodine supplements, comorbidities (iron deficiency anemia) and birth weight were assessed. Morning urine was collected to measure median UIC. The study was approved by the Local Ethics Committee.results. Median UIC in the study group was 206 mcg/L, reflecting iodine sufficiency during pregnancy. There is a statistically significant difference between pregnant women with and without iodine supplements from rural areas (281.5 versus 196.1 mcg/L, respectively, p=0.023). In the subgroup without iodine supplementation, there was a significant difference between overweight and obese subjects vs. normal weight subjects (232.5 versus 194 mcg/L, p=0.012). Only in the subgroup with a daily intake of less than 5 slices of bread (usually containing iodized salt) we found significant differences between those with and without iodine supplements (245.2 versus 128.3 mcg/L). Iron deficiency anemia was found in 29.66% and 19.49% were current smokers during pregnancy.conclusions. Median UIC in the study group was 206 mcg/L, reflecting iodine sufficiency during pregnancy. The difference between the subgroup with iodine supplements and the subgroup without iodine supplements was not statistically significant, probably due to the excessive consumption of bread and other bakery products which is traditional in Romania.

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Section: Introductionmentioning

confidence: 99%

Iodine Status in Pregnant Women after a Decade of Universal Salt Iodization in Romania

Podia-Igna³

et al. 2016

Acta Endo (Buc)

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“…After Austrian surgeon Felix Mandl did the first parathyroidectomy in 1925, BNE (with identifying all four glands and excision of the enlarged ones) became standard of care for a long period (1). Tibblin et al (10) describes in 1982 unilateral neck exploration and parathyroidectomy, but true minimally invasive techniques spread early 90', concomitant with endoscopic parathyroidectomy and developing of imaging studies as well as ioPTH measuring (2,8,11).…”

Section: Discussionmentioning

confidence: 99%

“…Minimal invasive parathyroidectomy is the most used technique for treatment of PHPT and includes both OMIP as well as fully endoscopic or videoassisted. Even if endoscopic techniques as MIVAP (minimally invasive videoassisted parathyroidectomy) gained more use, OMIP remains the procedure of choice being easy to learn, cost-effective, with short learning curve (4,8,9). Randomized controlled trials from different endocrine surgical centers, comparing OMIP with BNE, proved certain advantages of minimally invasive technique: shorter operative time, earlier discharge, reduced postoperative pain, better cosmetic results and at least same cure rates and morbidity as BNE (6,7,12,13).…”

Section: Discussionmentioning

confidence: 99%

“…Advantages of this approach are: costeffectiveness, lower complication rate, shorter operative time and hospital stay, better cosmetic results, reduced postoperative pain, all with the same cure rate as BNE (6,7). Open minimally invasive parathyroidectomy (OMIP) is an "open" minimally invasive approach and the most used (if enlarged parathyroids localised by preoperative imaging), being easy to learn and combining all the anterior described advantages (4,8,9). OMIP is feasible under local anesthetic or sedation (6) and in most hospitals done as a day case.…”

Section: Introductionmentioning

confidence: 99%

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A Comparative Analysis of the Initial East European Center Experience with a Western High-volume Center for Open Minimally Invasive Parathyroidectomy (OMIP) as Treatment of Primary Hyperparathyroidism

et al. 2016

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objective. To compare results of treatment of primary hyperparathyroidism (PHPT) in two teaching hospitals (eastern and western Europe) and to establish conclusions regarding quality of surgery for PHPT in Romania.methods. We reviewed two prospectively collected databases of patients submitted to open minimally invasive parathyroidectomy (OMIP) for symptomatic PHPT in two centers from Romania and the United Kingdom (UK). We included patients with biochemically proven PHPT and positive pre-operative localization studies. We excluded patients with negative localization studies, suspected multiglandular disease, concomitant thyroid disorders and chronic renal failure.results. 60 patients were included, 27 in group A (Romanian cohort) and 33 in group B (UK cohort). We noted significant differences between groups in pre-operative serum calcium and phosphorus levels (p<0.5). There were no differences between groups regarding the presence of symptoms; in group A we had significantly more patients with renal calculi history (p=0.02), digestive symptoms (p=0.006) and osteitis fibrosa cystica (p=0.01). Two patients from the UK group had lithium associated hyperparathyroidism and 2 patients had genetic disease. Intraoperative parathyroid hormone measurement (ioPTH) was available only for group B and frozen sections were selectively used in both groups. Both the adenoma size and weights were significantly higher in group A. The median operative time was significantly longer in Romanian group (p=0.001); in this group we noted the single conversion to traditional cervicotomy (3.7%) from all studied patients. In group A we noted two patients (7.4%) with failed parathyroidectomy and persistent PHPT; the cure rate was 92.5% for Romanian group and 97% for the UK group.conclusions. OMIP can be performed safe with a high cure rate in "small" volume endocrine centres with results comparable to western experienced endocrine centres. Romanian patients presented with more severe PHPT with more frequent end-organ damage, due probably to late diagnosis.

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“…Hyperparathyroidism (HPT) is a generalized disturbance of calcium (Ca) and phosphate metabolism that occurs as a result of the oversecretion of parathyroid hormone (PTH), and it can involve many of the organs and systems within the human body. The underlying cause of the hypersecretion allows HPT to be subdivided into primary hyperparathyroidism (PHPT), secondary hyperparathyroidism (SHPT), and tertiary hyperthyroidism (THPT) ( 1 ). The majority of PHPT cases (95%) occur sporadically, approximately 85% of PHPT patients is caused by a solitary adenoma, and about 15-20% are caused by multiple gland disease ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

Wang

Liu

et al. 2023

Front. Endocrinol.

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ObjectiveTo investigate the differences in biochemical marker levels and the extent of lesion visualization on technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) imaging between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT).MethodsNineteen patients with PHPT and 14 patients with SHPT were enrolled in the study, all of whom underwent routine 99mTc-MIBI dual-phase planar imaging, single-photon emission computed tomography combined with computed tomography (SPECT/CT fusion) imaging, and serum biochemical and hormonal investigations prior to surgery. The target-to-non-target (T/NT) ratios were calculated based on images from the early and delayed phases of 99mTc-MIBI planar imaging and also based on SPECT/CT fusion imaging. The volume of the parathyroid glands was measured following their excision.ResultsA total of 62 parathyroid glands were removed: 14 parathyroid adenomas and five parathyroid carcinomas in PHPT patients; and 18 parathyroid adenomas, 17 parathyroid hyperplasia lesions, and eight instances of nodular hyperplasia with adenoma in SHPT patients. The median volume of the lesions in PHPT and SHPT was 1.69 cm3 and 0.52 cm3 respectively, and the difference between them was statistically significant (P = 0.001). The median T/NT ratios calculated at the early phase of 99mTc-MIBI planar imaging, the delayed phase of 99mTc-MIBI planar imaging, and the subsequent SPECT/CT fusion imaging were 1.51, 1.34, and 2.75, respectively, in PHPT, and 1.46, 1.30, and 1.38, in SHPT, respectively. The T/NT ratio difference between PHPT and SHPT on the SPECT/CT fusion imaging was statistically significant (P = 0.002). The histopathology subtypes of the lesions were associated with significant differences in two areas: the T/NT ratios on the SPECT/CT fusion imaging and the volume of the lesions (P=0.002, P<0.001).ConclusionThe proportion of positive findings on 99mTc-MIBI dual-phase planar imaging and the T/NT ratios of 99mTc-MIBI SPECT/CT fusion imaging were higher in PHPT than in SHPT. The volume of parathyroid lesions in SHPT was smaller than in PHPT.

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About the guideline for diagnosis and treatment of primary hyperparathyroidism in a country with endemic goiter

Cited by 3 publications

References 19 publications

Iodine Status in Pregnant Women after a Decade of Universal Salt Iodization in Romania

Iodine Status in Pregnant Women after a Decade of Universal Salt Iodization in Romania

A Comparative Analysis of the Initial East European Center Experience with a Western High-volume Center for Open Minimally Invasive Parathyroidectomy (OMIP) as Treatment of Primary Hyperparathyroidism

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

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