Pediatric Primary Hyperparathyroidism

a.lsfakia shared this article with you from Inoreader Pediatric Primary Hyperparathyroidism: Experience in a Tertiary Care Referral Center in a Developing Country Over Three Decades. Via World Journal of Endocrine Surgery Pediatric Primary Hyperparathyroidism: Experience in a Tertiary Care Referral Center in a Developing Country Over Three Decades. World J Surg. 2020 Oct 12;: Authors: Sharanappa V, Mishra A, Bhatia V, Mayilvagnan S, Chand G, Agarwal G, Agarwal A, Mishra SK Abstract BACKGROUND: There is limited experience in managing pediatric primary hyperparathyroidism (PHPT). The aim of this study was to analyze the clinical presentation and outcome of surgery in children with PHPT managed at a tertiary referral center. METHODS: This retrospective study (September 1989-August 2019) consisted of 35 pediatric PHPT patients (< 18 years) who underwent parathyroidectomy. Clinico-pathologic profile and outcome were noted. RESULTS: The mean age of cohort was 15.2±2.9 years and girls outnumbered boys (M:F = 1:1.9). Familial and symptomatic disease was noted in 8.5 and 94.3% cases, respectively. Skeletal manifestations (83%) were the commonest followed by renal (29%). Fifty-four percent children had skeletal fractures, and 23% were bed-ridden. Among rare manifestations, hypercalcemic crisis, recurrent pancreatitis and stigmata of rickets were observed in 2.8, 11.4 and 14.2% children, respectively. Mean calcium concentration was 12.1 ± 2.0 mg/dl and PTH 91.8 ± 66.5 pmol/L. The sensitivity of preoperative imaging in parathyroid localization was 91.4%. Minimally invasive parathyroidectomy (MIP) was performed in 40% cases. Parathyroid adenoma was observed in 91.4% patients, whereas remaining had hyperplasia. Thirty-four percent suffered from Hungry bone syndrome in postoperative period. The cure rate following primary surgery was 97%. One child with persistent PHPT had s uccessful re-operation. Median follow-up was 5 (1-17) years, and no recurrence or familial disease was revealed during this period. CONCLUSION: Majority of pediatric patients present with symptomatic PHPT. Despite relatively high incidence of familial disease select pediatric patients can undergo successful MIP. PMID: 33047232 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Effect of Wheel Exercise on Functional Indices of Cachexia

a.lsfakia shared this article with you from Inoreader The Effect of Wheel Exercise on Functional Indices of Cachexia in Tumor-bearing Mice Via Medicine & Science in Sports & Exercise - Featured Articles - Featured Articles Introduction Cancer-related fatigue and muscle wasting have received significant attention over the last few decades with the goal of establishing interventions that can improve cancer patient life quality and survival. Increased physical activity has shown to reduce cancer-associated fatigue and has been proposed as a promising therapeutic to attenuate cancer-induced wasting. However, significant gaps remain in our understanding of how physical activity affects the compositional and functional changes that initiate muscle wasting. The purpose of the current study was to determine the effect of wheel exercise on body composition and functional indices of cancer cachexia before the development of significant wasting. Methods Thirteen-week-old male ApcMin/+ (MIN) and C57BL/6 (B6) mice were given free wheel access (W) or a locked wheel (Sed) for 5 wk. Results Wheel activity was reduced in the MIN compared with B6; however, wheel access increased complex II expression in isolated skeletal muscle mitochondria regardless of genotype. Wheel access had no effect on tumor burden or plasma interleukin-6 in the MIN. MIN-W increased body weight and lean mass compared with MIN-Sed, and there was a direct correlation between wheel distance and lean mass change. MIN-W increased grip strength and treadmill time to fatigue compared with MIN-Sed. Within MIN-W mice, skeletal muscle fatigability was only improved in high runners (>60 min·d−1). Conclusions Our results suggest that there were therapeutic benefits of increased activity related to body composition, behavior, and whole-body function that were not dependent on exercise duration; however, there was an exercise threshold needed to improve skeletal muscle fatigability in tumor-bearing mice. Interestingly, wheel access was able to improve compositional and functional outcomes without mitigating tumor number or size. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Respiratory Muscle Fatigue Alters Cycling Performance and Locomotor Muscle Fatigue

a.lsfakia shared this article with you from Inoreader Respiratory Muscle Fatigue Alters Cycling Performance and Locomotor Muscle Fatigue Via Medicine & Science in Sports & Exercise - Featured Articles - Featured Articles Purpose This study aimed to determine if preexisting respiratory muscle fatigue (RMF) alters motoneuronal output, locomotor muscle fatigue, and cycling performance. Methods Eight trained male cyclists performed 5-km cycling time trials after a resistive breathing task that induced RMF and under control conditions (CON). Motoneuronal output was estimated using vastus lateralis surface electromyography, and locomotor muscle fatigue was quantified as the change in potentiated quadriceps twitch force from preexercise to postexercise. Results Time to complete the time trial was 1.9% ± 0.9% longer in RMF compared with CON (P View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

PLCD1: A Potential Therapeutic Target in the Treatment of Esophageal Squamous Cell Carcinoma?

a.lsfakia shared this article with you from Inoreader PLCD1: A Potential Therapeutic Target in the Treatment of Esophageal Squamous Cell Carcinoma? Via Latest Results for Digestive Diseases and Sciences View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Apical pelvic organ prolapse repair via vaginal‐assisted natural orifice transluminal endoscopic surgery: Initial experience from a tertiary care hospital

a.lsfakia shared this article with you from Inoreader Apical pelvic organ prolapse repair via vaginal‐assisted natural orifice transluminal endoscopic surgery: Initial experience from a tertiary care hospital Via Asian Journal of Endoscopic Surgery Abstract Introduction Natural orifice transluminal endoscopic surgery has been used for gynecologic operations in recent years. The aim of the study is to describe our initial experience using vaginal‐assisted natural orifice transluminal endoscopic surgery (vNOTES) for apical pelvic organ prolapse repair. Methods After patients underwent vaginal hysterectomy, vNOTES sacrocolpopexy (n = 4) or vNOTES high uterosacral ligament suspension (n = 7) were performed to treat symptomatic apical pelvic organ prolapse. Sociodemographic and clinical characteristics, Pelvic Organ Prolapse Quantification results, and recorded surgical data (eg, duration of surgery, intraoperative complications, additional prolapse and incontinence surgeries) were obtained from patient files and the hospital's database. Information from postoperative follow‐up visits, including complications and anatomical results, were also recorded. Results The mean age of the patients was 60.7 ± 9.1 years. The mean total operative time was 121.3 ± 22.7 minutes. The mean operative time for vaginal hysterectomy, vNOTES sacrocolpopexy, and vNOTES uterosacral ligament suspension was 46 ± 11.9, 65 ± 38, 25 ± 8.2 minutes, respectively. There were no intraoperative and postoperative complications observed. The mean postoperative 24‐hour visual analog scale score was 3.5 ± 1.9 for vNOTES sacrocolpopexy patients and 3.2 ± 0.9 for vNOTES uterosacral ligament suspension patients. Only one patient in the vNOTES sacrocolpopexy group had a recurrence; she experienced stage 2 anterior compartment prolapse 8 months after surgery. Conclusion As a treatment for apical pelvic organ prolapse, vNOTES is a feasible approach in both sacrocolpopexy and uterosacral ligament suspension. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single‐incision laparoscopic full‐thickness anterior abdominal wall repair of a Morgagni hernia using a suture‐assisting needle in a child: A case report

a.lsfakia shared this article with you from Inoreader Single‐incision laparoscopic full‐thickness anterior abdominal wall repair of a Morgagni hernia using a suture‐assisting needle in a child: A case report Via Asian Journal of Endoscopic Surgery Abstract Single‐incision laparoscopic repair of a congenital Morgagni diaphragmatic hernia using a suture‐assisting needle was performed in a 1‐year‐old boy. Three ports were inserted through a single umbilical incision to repair the 2.5 × 2.3‐cm defect. The full‐thickness muscle layer of the anterior abdominal wall and the posterior rim of the defect were penetrated with the suture‐assisting needle holding a thread, which was then released. The needle tip was pulled back over the muscle layer, shifted laterally, and again passed through the muscle layer and the posterior rim. The thread was then captured by the needle and pulled out through the anterior abdominal wall. Five mattress sutures were placed in this way and tied subcutaneously. The postoperative course was uneventful, and the cosmetic outcome was favorable. A suture‐assisting needle is useful for completing full‐thickness anterior abdominal wall repair, which is important for preventing the recurrence of a congenital Morgagni diaphragmatic hernia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does the time from symptom onset to surgery affect the outcomes of patients with acute appendicitis? A prospective cohort study of 255 patients

a.lsfakia shared this article with you from Inoreader Does the time from symptom onset to surgery affect the outcomes of patients with acute appendicitis? A prospective cohort study of 255 patients Via Asian Journal of Endoscopic Surgery Abstract Introduction The objective of this study was to evaluate the impact of operative timing on outcomes of acute appendicitis. Methods This study examined adult patients who had presented to the hospital with acute appendicitis and had undergone appendectomy from December 2017 to February 2019. Time delay and outcomes of perforated and non‐perforated appendicitis were compared. Patients were classified into five groups based on the period from symptom onset to operation: group 1, <24 hours; group 2, ≥24 and <48 hours; group 3, ≥48 and <72 hours; group 4, ≥72 and <96 hours; and group 5, ≥96 hours. The five groups were compared, with risk of perforation assessed in particular. Results A total of 255 patients were included in the analysis. Symptom duration, operative time, and length of postoperative hospital stay (P < .001) were significantly longer in the perforated group (n = 49) than in the non‐perforated group (n = 206). The perforated group also had a higher conversion rate to open procedures (P = .002) and a higher rate of wound infection (P = .034). Group 1 had 53 patients, group 2 had 95 patients, group 3 had 57 patients, group 4 had 32 patients, and group 5 had 18 patients. The incidence of appendiceal perforation and median operative time progressively increased along with symptom duration in the five groups. In multivariate analyses, independent risk factors for appendiceal perforation were male gender (odds ratio = 2.33, 95% confidence interval [CI]: 1.07‐5.08) and symptom duration ≥48 hours (relative to ≥24 and <48 hours) (odds ratio = 4.64, 95%CI: 1.76‐12.27). Patients with symptom duration ≥72 ho urs had a significantly longer operative time than those with symptom duration ≥48 and <72 hours (β = 21.38, 95%CI: 5.66‐37.11, P = .008). Conclusion The risk of perforation increased significantly 48 hours after the onset of appendicitis. Symptoms duration ≥72 hours was associated with a longer operative time. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.