Late-onset postsurgical hypoparathyroidism following parathyroidectomy for recurrent primary hyperparathyroidism : a case report and literature review

Purpose: Previously in 1987, a 21-year-old-male was diagnosed with primary hyperparathyroidism (PHPT) when a right inferior parathyroid adenoma was removed. PHPT recurred after three and six years and on both occasions was cured by resection of parathyroid adenomas. At 52-years-of-age, the patient developed a late-onset hypoparathyroidism (HP), even though postsurgical HP typically occurs as a transient or permanent form soon after neck surgery. The purpose of this work was to report the follow-up of the patient and to review prior cases of late-onset postsurgical HP. Methods: Prior cases of late-onset postsurgical HP were searched and reviewed focusing on clinical and biochemical features. Results: The patient’s asymptomatic hypocalcemia with total serum calcium at 8.2 mg/dL was initially documented in September 2018; PTH was inappropriately low at 15 ng/mL. In February 2020, a mild hypocalcemia was confirmed with low-normal PTH at 15 ng/mL. Autoimmune and familial causes of HP were ruled out including the presence of stimulating autoantibodies against calcium-sensing receptor. Instead, a progressive damage or atrophy of the parathyroid gland(s) ensuing years after surgery is believed to have led to the patient’s hypocalcemia. All 19 previously reported cases of late-onset postsurgical HP occurred after thyroid surgery, with no examples of the condition being found following parathyroidectomy. Conclusions: The case highlights the rare occurrence of late-onset postsurgical HP in a patient who had had multiple parathyroidectomies for PHPT. Thus, monitoring serum calcium, phosphate and PTH during follow-up of such patients is recommended

Analysis of Gene Order Conservation in Eukaryotes Identifies Transcriptionally and Functionally Linked Genes

The order of genes in eukaryotes is not entirely random. Studies of gene order conservation are important to understand genome evolution and to reveal mechanisms why certain neighboring genes are more difficult to separate during evolution. Here, genome-wide gene order information was compiled for 64 species, representing a wide variety of eukaryotic phyla. This information is presented in a browser where gene order may be displayed and compared between species. Factors related to non-random gene order in eukaryotes were examined by considering pairs of neighboring genes. The evolutionary conservation of gene pairs was studied with respect to relative transcriptional direction, intergenic distance and functional relationship as inferred by gene ontology. The results show that among gene pairs that are conserved the divergently and co-directionally transcribed genes are much more common than those that are convergently transcribed. Furthermore, highly conserved pairs, in particular those of fungi, are characterized by a short intergenic distance. Finally, gene pairs of metazoa and fungi that are evolutionary conserved and that are divergently transcribed are much more likely to be related by function as compared to poorly conserved gene pairs. One example is the ribosomal protein gene pair L13/S16, which is unusual as it occurs both in fungi and alveolates. A specific functional relationship between these two proteins is also suggested by the fact that they are part of the same operon in both eubacteria and archaea. In conclusion, factors associated with non-random gene order in eukaryotes include relative gene orientation, intergenic distance and functional relationships. It seems likely that certain pairs of genes are conserved because the genes involved have a transcriptional and/or functional relationship. The results also indicate that studies of gene order conservation aid in identifying genes that are related in terms of transcriptional control

Contribuição da reabilitação vestibular na melhora do zumbido: um resultado inesperado Contribution of vestibular rehabilitation in tinnitus recovery: a surprising result

INTRODUÇÃO: A tontura e o zumbido são sintomas comuns na prática clínica que podem ocorrer simultânea ou independentemente. Ambos podem ter etiologia indefinida ou múltipla, ser agravados por fatores emocionais e limitar as atividades rotineiras do indivíduo. OBJETIVO: avaliar os resultados da reabilitação vestibular (RV) enfocando a melhora dos acúfenos. FORMA DE ESTUDO: Coorte longitudinal. MÉTODO: após a observação clínica da melhora (não intencional) do zumbido com a RV realizamos o levantamento dos prontuários dos pacientes submetidos à terapia. RESULTADOS: Após a RV 100% dos sujeitos relataram melhora da tontura, 58% tiveram redução do zumbido e 75% relataram melhora da hipersensibilidade auditiva. A comparação da diferença entre os valores pós e pré-tratamento dos índices da escala análogo visual (0 a 5) de cada paciente evidenciou melhora da tontura (2,42), do zumbido (1,17) e da hipersensibilidade auditiva (1,00). CONCLUSÕES: A RV pode interferir positivamente no zumbido em alguns casos. Tais resultados abrem discussões a respeito das correlações e interferências entre os dois sintomas.<br>INTRODUCTION: Dizziness and tinnitus are common symptoms on clinical practice that can occur simultaneous or independently. Both can have multiple or unknown etiology, and can be worsen by emotional factors and limit day-by-day activities. AIM: evaluate the results of vestibular rehabilitation (VR) focusing on tinnitus recovery. STUDY DESIGN: Longitudinal cohorte. METHOD: after the clinical observation of the non-intentional tinnitus recovery with the VR we studied the patients' files with dizziness and tinnitus that underwent the therapy. RESULTS: After VR 100% of the subjects recovered from dizziness, 58% had tinnitus reduction and 75% had reduction on hypersensitivity to sound. The comparison of the difference between post and pre treatment values of the analog visual scale (0 a 5) of each patient showed the following: 2,42 for dizziness 1,17 for tinnitus and 1,00 for hypersensitivity to sound. CONCLUSION: The VR may have a positive interference on tinnitus

The use of spatial intensity distribution analysis to examine G protein-coupled receptor oligomerization

Spatial Intensity Distribution Analysis (SpIDA) is a new approach for detecting protein oligomerization states that can be applied not only to live cells but also fixed cells and native tissue. This approach is based on the generation of pixel-integrated fluorescence intensity histograms from laser scanning fluorescence microscopy images. These histograms are then fit with super-Poissonian distribution functions to obtain density maps and quantal brightness values of the fluorophore that are used to determine the proportions of monomer and dimers/oligomers of the fluorophore-tagged protein. In this chapter we describe SpIDA and highlight its advantages compared to other biochemical or biophysical approaches. We provide guidelines that should be useful to readers who wish to perform SpIDA measurements and describe the application of SpIDA as a post-acquisition imaging histogram analysis software tool to investigate the oligomeric state of G protein-coupled receptors (GPCRs) at the surface of mammalian cells in order to define the steady-state proportion of monomeric and dimeric/oligomeric forms and how this may be regulated by cellular challenges such as ligand treatment

Pilgrims’ Acceptance of a Mobile App for the Camino de Santiago

This study aims to identify which factors affect pilgrim’s intentions to use a pilgrimage app, based on the extended unified theory of acceptance and use of technology (UTAUT2).The empirical results were obtained from a sample of 222 pilgrims of the Camino de Santiago (Saint James’s Way). Partial Least Squares Structural Equation Modelling was applied to test the hypothesized relationships of the proposed model. The results indicate that the most important factor affecting intentions to use the app is performance expectancy. Effort expectancy, social influence and hedonic motivations are other determinants of intentions to use a pilgrimage app. Facilitating conditions and habit do not affect intentions to use the app. The results of this study are valuable for a successfully implementation of pilgrimage apps, providing useful insights for pilgrimage app designers