I reinterventi nell’iperparatiroidismo

reinterventi in chirurgia paratiroidea rappresentano una sfida impegnativa per il chirurgo che deve valutare attentamente i dati operatori e istologici del primo intervento, usare una diagnostica accurata preoperatoria con ecografia e scintigrafia con sestamibi e avere ben presente l’anatomia e l’embriologia delle ghiandole paratiroidee. Elementi fondamentali per ottenere un successo chirurgico sono l’uso del dosaggio intraoperatorio del paratormone e una grande esperienza del chirurgo. Seguendo tali principi si arriva a ottenere una remissione del quadro iperparatiroideo nell’85-90% per l’HPT I e nel 70% per l’HPT II e III. Gli Autori presentano la loro casistica di 75 reinterventi dopo HPT I e di 85 reinterventi dopo HPT II e III, su una casistica totale di 2072 interventi di paratiroidectomia eseguiti fra gennaio 1975 e ottobre 2009

A structural equation model to assess the pathways of body adiposity and inflammation status on dysmetabolic biomarkers via red cell distribution width and mean corpuscular volume: a cross-sectional study in overweight and obese subjects

Background A study has been performed in overweight and obese subjects to assess the effects of adiposity and inflammation indicators on dysmetabolic biomarkers via red cell distribution width (RDW) and mean corpuscular volume (MCV), taking into account pro-antioxidant balance. Methods Data from 166 overweight subjects were analyzed by a path analysis model using structural equation modelling (SEM) to evaluate the direct and indirect pathway effects of adiposity, measured by body mass index (BMI) and waist circumference (WC), and inflammation status, measured by pro-antioxidant balance [reactive oxygen species (ROS)], lag-time and slope and C-reactive protein (CRP) values on dysmetabolic biomarkers, via RDW and MCV. Results BMI was strongly linked to CRP and ROS levels. Moreover, there was a significant negative decrease of MCV (1.546 femtoliters) linked to BMI indirectly via high CRP levels. Furthermore, WC affected RDW, indicating a possible mediatory role for RDW in relation to the relationship between WC and homeostatic model assessment (HOMA), insulin and high density lipoprotein (HDL), respectively. This was evident by the elevated HOMA and insulin levels and the decreased levels of HDL. Finally, ROS-related markers did not affect directly RDW and MCV. Conclusion The reported outcomes suggest that RDW might play a mediatory role in the relationship between WC and the dysmetabolic outcomes in overweight and obese individuals. CRP seems to modulate the linkage between BMI and MCV. This study provides the backbone structure for future scenarios and lays the foundation for further research on the role of RDW and MCV as suitable biomarkers for the assessment of cardiovascular disease (HDL-cholesterol), inflammatory bowels and insulin resistance

Food Pyramid for Subjects with Chronic Obstructive Pulmonary Diseases

Nutritional problems are an important part of rehabilitation for chronic obstructive pulmonary disease (COPD) patients. COPD patients often present with malnutrition, sarcopenia, and osteoporosis with possible onset of cachexia, with an inadequate dietary intake and a poor quality of life. Moreover, diet plays a pivotal role in patients with COPD through three mechanisms: regulation of carbon dioxide produced/oxygen consumed, inflammation, and oxidative stress. A narrative review based on 99 eligible studies was performed to evaluate current evidence regarding optimum diet therapy for the management of COPD, and then a food pyramid was built accordingly. The food pyramid proposal will serve to guide energy and dietary intake in order to prevent and treat nutritionally related COPD complications and to manage progression and COPD-related symptoms. The nutrition pyramid described in our narrative review is hypothetical, even in light of several limitations of the present review; the main limitation is the fact that to date there are no randomized controlled trials in the literature clearly showing that improved nutrition, via the regulation of carbon dioxide produced/oxygen consumed, inflammation and oxidative stress, improves symptoms and/or progression of COPD. Even if this nutritional pyramid is hypothetical, we hope that it can serve the valuable purpose of helping researchers focus on the often-ignored possible connections between body composition, nutrition, and COPD

HD 17156b: A Transiting Planet with a 21.2 Day Period and an Eccentric Orbit

We report the detection of transits by the 3.1 M_Jup companion to the V=8.17 G0V star HD 17156. The transit was observed by three independant observers on Sept. 9/10, 2007 (two in central Italy and one in the Canary Islands), who obtained detections at confidence levels of 3.0 sigma, 5.3 sigma, and 7.9 sigma, respectively. The observations were carried out under the auspices of the Transitsearch.org network, which organizes follow-up photometric transit searches of known planet-bearing stars during the time intervals when transits are expected to possibly occur. Analyses of the 7.9 sigma data set indicates a transit depth d=0.0062+/-0.0004, and a transit duration t=186+/-5 min. These values are consistent with the transit of a Jupiter-sized planet with an impact parameter b=a*cos(i)/R_star ~ 0.8. This planet occupies a unique regime among known transiting extrasolar planets, both as a result of its large orbital eccentricity (e=0.67) and long orbital period (P=21.2 d). The planet receives a 26-fold variation in insolation during the course of its orbit, which will make it a useful object for characterization of exoplanetary atmospheric dynamics.Comment: Accepted for publication to A&A, 4 pages, 2 figure

Parathyroid Retrospective Analysis of Neoplasms Incidence (pTRANI Study): An Italian Multicenter Study on Parathyroid Carcinoma and Atypical Parathyroid Tumour

Background: Parathyroid cancer (PC) is a rare sporadic or hereditary malignancy whose histologic features were redefined with the 2022 WHO classification. A total of 24 Italian institutions designed this multicenter study to specify PC incidence, describe its clinical, functional, and imaging characteristics and improve its differentiation from the atypical parathyroid tumour (APT). Methods: All relevant information was collected about PC and APT patients treated between 2009 and 2021. Results: Among 8361 parathyroidectomies, 351 patients (mean age 59.0 ± 14.5; F = 210, 59.8%) were divided into the APT (n = 226, 2.8%) and PC group (n = 125, 1.5%). PC showed significantly higher rates (p < 0.05) of bone involvement, abdominal, and neurological symptoms than APT (48.8% vs. 35.0%, 17.6% vs. 7.1%, 13.6% vs. 5.3%, respectively). Ultrasound (US) diameter >3 cm (30.9% vs. 19.3%, p = 0.049) was significantly more common in the PC. A significantly higher frequency of local recurrences was observed in the PC (8.0% vs. 2.7%, p = 0.022). Mortality due to consequences of cancer or uncontrolled hyperparathyroidism was 3.3%. Conclusions: Symptomatic hyperparathyroidism, high PTH and albumin-corrected serum calcium values, and a US diameter >3 cm may be considered features differentiating PC from APT. 2022 WHO criteria did not impact the diagnosis

Erratum to nodal management and upstaging of disease. Initial results from the Italian VATS Lobectomy Registry

[This corrects the article DOI: 10.21037/jtd.2017.06.12.]