Navegando por Palavras-chave "hormônio paratireóideo"

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    Definição de valores de corte para medida de PTH intraoperatório no tratamento cirúrgico do hiperparatiroidismo secundário e terciário
    (Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2013-08-01) Ohe, Monique Nakayama [UNIFESP]; Santos, Rodrigo Oliveira [UNIFESP]; Kunii, Ilda Sizue [UNIFESP]; Carvalho, Aluizio Barbosa de [UNIFESP]; Abrahão, Márcio [UNIFESP]; Neves, Murilo Catafesta das [UNIFESP]; Lazaretti-Castro, Marise [UNIFESP]; Cervantes, Onivaldo [UNIFESP]; Vieira, Jose Gilberto Henriques [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    In order to improve success rates in surgery of renal hyperparathyroidism, we evaluated intraoperative PTH (IOPTH) measurement utility. METHOD: 86 patients underwent total parathyroidectomy with intramuscular presternal autotransplantation from 04/2000 to 10/2009 and were followed for 26.5 months on average (prospective cohort). Patients were divided in secondary (SHPT) and tertiary hyperparathyroidism (THPT). SHPT group was composed by patients under dialysis treatment, THPT group included renal grafted ones. IOPTH (Elecsys-PTH-Immunoassay/Roche) was measured at anesthesia induction (IOPTH-0') and 20 minutes (IOPTH-20') after parathyroidectomy. RESULTS: 80.2% (69/86) presented with 80% decrease or more in the IOPTH-20' and all were cured. In 11/86 patients (12.7%), a lower IOPTH-20' drop (70-79%) was observed, and 2 of them (18.1%) failed to cure. 6/86 (6.9%) patients presented IO-PTH-20' decrease of less than 70%: two were cured, in three a supernumerary/ectopic parathyroid was found and removed, and in one of these six patients, surgery was finished after 4-gland excision and the patient failure to cure. CONCLUSION: IOPTH-20' decrease of 80% or more compared to IOPTH-0' predicts cure in all renal patients throughout follow-up. A decay of less than 70% points to missed or hyperfunctioning supernumerary gland and is predictive of surgical failure in 66.6%. A marginal IOPTH drop of 70-79% leaves the decision whether or not surgery should be continued up to the experienced surgeon.
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    Dosagem do paratormônio: predizendo o risco de hipocalcemia sintomática após tiroidectomia total
    (Universidade Federal de São Paulo (UNIFESP), 2014-05-28) Vanderlei, Felipe Augusto Brasileiro [UNIFESP]; Abrahão, Marcio [UNIFESP] ; Universidade Federal de São Paulo (UNIFESP)
    Hypocalcemia is the most frequent complication after total thyroidectomy. We developed a method, using peri-operative parathyroid hormone (PTH) measure, which can identify patients with increased risk of developing symptoms of hypocalcemia. The purpose of this study is to validate our method evaluating the development of hypocalcemia symptoms after total thyroidectomy in patients treated or not with calcium and vitamin D based on the PTH value measured one hour after the surgery. Methods: Two hundreds ninety eight total thyroidectomy patients with or without central neck dissection were evaluated prospectively. PTH was measures one hour after the surgery (PTH1). If the value of PTH1 ? 12.1 pg/mL the patient was observed, if PTH1 < 12,1 pg/mL the patient was treated with calcium and vitamin D supplementation. All the patients were evaluated for symptoms of hypocalcemia. Results: One hundred ninety six patients had PTH1 ? 12.1 pg/mL and among them 183 (94,4%) had no symptoms. Our test managed right all but eleven patients (96,3%). None of these eleven patients had severe symptoms nor needed further hospitalization demonstrating the security of the test. Our rate of transient hypocalcemia among the patients studied was 31.5% and 6.5% for persistent hypocalcemia. The value of PTH1 ? 9.5 pg/mL had a sensitivity of 78% and specificity of 100% for the non-development of persistent hypoparathyroidism. Conclusion: PTH measured one hour after surgery is safe, reliable and can successfully identify patients most likely to develop symptoms of hypocalcemia after total thyroidectomy.
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    Fórum nacional de discussão das diretrizes do KDIGO para o distúrbio mineral e ósseo da doença renal crônica (DMO-DRC): uma análise crítica frente à relidade Brasileira
    (Sociedade Brasileira de Nefrologia, 2010-09-01) Moysés, Rosa Maria Affonso; Cancela, Ana Ludimila Espada; Gueiros, José Edvanilson Barros; Barreto, Fellype Carvalho; Neves, Carolina Lara; Canziani, Maria Eugênia Fernandes [UNIFESP]; Oliveira, Rodrigo Bueno de; Jorgetti, Vanda; Carvalho, Aluizio Barbosa de [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de Pernambuco Hospital das Clínicas; Universidade de Picardie; Universidade Federal da Bahia; Universidade Federal de São Paulo (UNIFESP)
    On November 14th, 2009, the Brazilian Society of Nephrology coordinated the Brazilian Discussion Meeting on the new KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. The purpose of this meeting, which was attended by 64 nephrologists, was to discuss these new guidelines from the Brazilian perspective. This meeting was supported by an unrestricted grant of the biotechnology company Genzyme, which did not have access to the meeting room or to the discussion sections. This article brings a summary of the KDIGO guidelines and of the discussions by the attendees.