Explore the vast range of titles available.

Introduction : Tertiary hyperparathyroidism develops in patients who have secondary hyperparathyroidism that persists despite successful kidney transplantation or in patients who are on chronic dialysis. Aim : This study aims to present a comparison of surgical treatments of tertiary hyperparathyroidism. Materials and methods : A systematic review of studies published in English that reported on the surgical management of tertiary hyperparathyroidism was conducted using PubMed databases in accordance with the PRISMA guidelines. Two authors independently reviewed the full text of potentially selectable articles and selected appropriate studies. Surgical treatment options were evaluated. Results : This review contains thirteen relevant studies. The treatments recommended by the studies included limited parathyroidectomy, subtotal parathyroidectomy, total parathyroidectomy with autotransplantation, and total parathyroidectomy without autotransplantation. The choice of the appropriate surgical technique demands individualization of the treatment and depends mainly on the experience of the surgeon. Conclusion : The predominant treatment options appear to be subtotal parathyroidectomy and total parathyroidectomy with autotransplantation.

Aim : To define the role of prophylactic parathyroidectomy in the surgical treatment of medullary thyroid carcinoma (MTC) in multiple endocrine neoplasia type IIa (MEN2A) syndrome through a literature review. Materials and methods : The database of PubMed was searched using the terms “parathyroidectomy” and “medullary” in the fields “Title” and “Abstract”, as well as the Google Scholar database. Articles without references to parathyroid management strategies were mainly excluded. Results : Fourteen articles were reviewed as relevant to this study regarding recommendations for the management of parathyroids during prophylactic thyroidectomy in patients with MTC in MEN2A syndrome. Three of them had the same or similar purpose to our work, and the most recent literature review did not clearly support either one of the two management strategies. References to parathyroid management were found in the rest of the articles, but their purpose was not to determine the appropriate management strategy. The majority of the authors support the preservation of macroscopically normal parathyroid glands, while one study favored routine total parathyroidectomy and autografting. Conclusions : Although there does not seem to be a gold standard, the strategy of preserving macroscopically normal parathyroid glands with routine lab testing and surgical exploration for hyperparathyroidism during thyroidectomy seems to be a safe and effective strategy.

Introduction: Concomitant surgeries have been performed previously in several centers with experience in laparoscopic surgeries. These surgeries are performed in one patient under one operation with anesthesia. Methods: We performed a retrospective unicenter study from October 2021 to December 2021 analyzing patients who underwent laparoscopic hiatal hernia repair with cholecystectomy. We extracted data from 20 patients who underwent hiatal hernia repair together with cholecystectomy. Grouping of data by hiatal hernia type showed 6 type IV hernias (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed, 19 were patients suffering from chronic cholecystitis and 1 patient presented with acute cholecystitis. The average operating time was 179 min. Minimum blood loss was achieved. Cruroraphy was performed in all cases, mesh reinforcement was added in five cases, and fundoplication was performed in all cases, with 3 Toupet, 2 Dor and 15 floppy Nissen fundoplication procedures performed. Fundopexy was routinely performed in cases of Toupet fundoplication. A total of 1 bipolar and 19 retrograde cholecystectomies were performed. Results: All patients had favorable postoperative hospitalization. Patient follow-up took place at 1 month, 3 months and 6 months, with no sign of recurrence of hiatal hernia (anatomical or symptomatic) and no symptoms of postcholecystectomy syndrome. In two patients, we had to perform colostomy. Conclusion: Concomitant laparoscopic hiatal hernia repair and cholecystectomy is safe and feasible.

(1) Background: Children are susceptible to home injuries. How prepared parents were to protect their children from accidents before and during the COVID-19 quarantine is uncertain. (2) Methods: We conducted a community-based, cross-sectional study in Greece between November and December 2021. We asked parents to complete an anonymous questionnaire voluntarily. Questions focused on accident-preventive measures taken at home during the COVID-19 quarantine. (3) Results: A greater proportion of parents took protective measures for a safer home before the lockdown than during the quarantine, while an interesting percentage of parents never utilized preventive measures for their children. Slightly more than half (58.6%) of parents did not seem to worry about a possible increase in domestic accidents during the quarantine. It was observed that those who had one or two children took more protective measures than those with more than two children. Older parents seemed to explain to their children how to access emergency services more often. Mothers stayed at home with the children more often, and their education affected the presence of some of the assessed measures. In our logistic regression modeling, parental concern about accidents was more related to the incidence of an accident during the pandemic and attendance at seminars. (4) Conclusions: Although the COVID-19 lockdowns disorganized family life, parents were aware of the importance of their parenting role in creating a safe environment for children, but according to the study, there is room for improvement.

Background and Objectives: Video laryngoscopy has been proven useful under difficult airway scenarios, but it is unclear whether anticipated improvement of visualization is related to specific difficult intubation prognostic factors. The present study evaluated the change in laryngoscopic view between conventional and C-MAC® laryngoscopy and the presence of multiple difficult intubation risk factors. Materials and Methods: Patients scheduled for elective surgery with >2 difficult intubation factors, (Mallampati, thyromental distance (TMD), interinscisor gap, buck teeth, upper lip bite test, cervical motility, body mass index (BMI)) were eligible. Patients underwent direct laryngoscopy (DL) followed by C-MAC™ laryngoscopy (VL) and intubation. Change of view between DL and VL, time for best view, intubation difficulty scale (IDS) and correlation between prognostic factors, laryngoscopic view improvement, and IDS were measured. Results: One-hundred and seventy-six patients completed the study. VL lead to fewer Cormarck–Lehane (C/L) III-IV, compared to DL (13.6% versus 54.6%, p < 0.001). The time to best view was also shorter (VL: 10.82 s, DL: 12.08 s, p = 0.19). Mallampati III-IV and TMD ≤ 6 cm were related to improvement of C/L between DL and VL. Logistic regression showed these two factors to be a significant risk factor of the glottis view change (p = 0.006, AUC-ROC = 0.57, 95% CI: 0.47–0.66). 175/176 patients were intubated with VL. 108/176 were graded as 0 < IDS ≤ 5 and 12/176 as IDS > 5. IDS was only correlated to the VL view (p < 0.0001). Conclusion: VL improved laryngoscopic view in patients with multiple factors of difficult intubation. Mallampati and TMD were related to the improved view. However, intubation difficulty was only related to the VL view and not to prognostic factors.

Traditionally, tissue availability from rebiopsy is a prerequisite for adequate sequencing of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in therapy for advanced-stage lung cancer. Tissue biopsy truly is the gold standard for genetic analyses, but in some cases, such as with inadequate localization of the lesion or a patient’s inadequate performance status, comorbidities, or unwillingness to undergo an invasive procedure, liquid biopsy-based ctDNA analysis can be a noninvasive alternative approach. However, in some cases the gold standard might not shine that much. It is known that tumor heterogeneity or an inadequate amount of tissue might significantly interfere with the results of testing. In this paper, we present cases of patients with a negative tissue biopsy but a positive liquid biopsy which identified coexisting T790M mutation. These results enabled adequate sequencing and treatment with third-line EGFR-TKIs. Such possibilities stress the need to individualize testing for driver mutations in cases where it is clinically highly indicated.

Background Tc-sestamibi is the most frequently used radionuclide agent for the detection of parathyroid adenomas in the clinical setting. However, Tc-tetrofosmin is another such agent that may be used for this purpose. This case report presents the significance and practicality of 99m Tc-tetrofosmin for the diagnosis of parathyroid adenomas with probable high p-glycoprotein levels. Case presentation A 45-year-old woman was referred to our Nuclear Department with a palpable neck nodule suspicious for parathyroid adenoma. She had no significant medical history or other accompanying symptoms. Blood examination results were normal with the exception of the parathormone level which was high at 167.2 pg/ml. Neck ultrasonography revealed a hypoechoic mass near the lower pole of the thyroid gland. 99m Tc-tetrofosmin dual-phase scintigraphy with early and delayed images was performed and the results supported the presupposition of parathyroid adenoma as shown by increased radiopharmaceutical levels near the lower left thyroid gland on the early image that disappeared on the delayed image. Moreover, TcO 4 − thyroid scintigraphy results excluded thyroid pathology. Two months after the diagnosis, parathyroidectomy was successfully performed without postoperative complications. The pathology report and clinical response to a gradual decrease of parathormone confirmed the initial diagnosis. Conclusion We strongly recommend the use of reverse 99m Tc-tetrofosmin scintigraphy as a useful and safe examination technique for the diagnosis of parathyroid adenomas.

Temozolomide is an imidazotetrazine with a long history in oncology especially for the high grade malignant glioma and metastatic melanoma. However, last year's new indications for its use are added. Its optimum pharmacodynamic profile, its ability to penetrate the blood-brain barrier, the existence of methylation of MGMT in solid tumors which enhances its efficacy, the identification of new agents that can overcome temozolomide's resistance, the promising role of temozolomide in turning immune cold tumors to hot ones, are leading to expand its use in other solid tumors, giving oncologists an additional tool for the treatment of advanced and aggressive neoplasms.

I4enb: ()itpc;i.c;tii'ii> b itpi><|)ii;taK'in>tccKi>ii itapa™pci>ii;i,')K'ii>Mnn itpn xnpypnrtccKoM actcnnn Mcayaapnoro TtipeotiflHoro paKa (MTP) nprt crtHHpoMe Miio/Kcc'i ticmion shhokpmhhom HeonnaartM Tuna Ila (MEN2A) nyTCM oóaopa TiMTepaTypbi. MaiepuaJlbl U MeiOflbi: Houck npoBOHrracM b óaae naHHMX PubMed c McnoTibaoBaHMeM TepMMHOB „napaTMpeoMHOKTOMJWi\" m „mcayaaapinan\" b tnvuix „I laaiiannc\" n „PetJjepaT\", a TaioKe b base namnax Google Scholar. Caaabn 6e3 ccmxok na ca paacrnn ncncnna napaniMTOBMHHOM xeneabi b ochobhom HCKnioHanHCb. Resyjlbiaibi: HeTbipnaniiaib eraren óbuirt paccMorpenbi KaK MMeronine orHomenne k naHHOMy rtcoieHOBaHwo OTHOCHreabHO peKOMeHHaiiHH no Tienenjík> napaniHTOBHHHbixiKenea bo BpeMM npotjiHnaKTHHecKOH THpeoHHOKioMHH y naiirtenroB c MTP npn cnnnpoMe MEN2A. Tpn H3 hhx MMenn ry tace mjim ÓJinsKyio pejib, nro m ñama paóora, m caMbiü nocnejiHMM 0630p aHreparypbi ne noHTBepHHn OHHOsnanno hh o^ny H3 HByx crpareritM ynpaBTienmi. CcbuiKM na nenenne napaniHTOBHHHOH aceneabi óbinn naHHenbi b ocraabnbix crarbax, no hx ncniao ne óbino onpcacncnnc cooiBercTByionieM crparermi nenenna. BoabninncrBO aBropoB noajlcp/KiniaioT coxpanenne MaKpocKonnnecKH nopMaabnbix napaniHTOBHHHbix acenea, b to BpeMM KaK ohho HccneflOBanHe or^aer npennonrenite pymHnoH rorajibnoií napaTHpeoHHOKTOMHH m ayiorpaHcnnaHiaiiMH. SaK/HOMenue: Xot;i sotiototo crannapra ne cymecTByer, crparermi coxpanenmi MaKpocKonnnecKH nopMaabnbix napaniHTOBHHHbix acenea c noMonibio pyrunnbix Tiaóoparopnbix nccncaoiiannn m XHpyprnnecKoro nccnc/toiianna riniepnapaTJipeoaa bo Bpcvui THpeoHHoktomhh KaaceTCM óeaonacnoH m stjxjjeKTHBHOH crpareriteM. Aim: To define the role of prophylactic parathyroidectomy in the surgical treatment of medullary thyroid carcinoma (MTC) in multiple endocrine neoplasia type Ila (MEN2A) syndrome through a literature review. Materials and methods: The database of PubMed was searched using the terms \"parathyroidectomy\" and \"medullary\" in the fields \"Title\" and \"Abstract\", as well as the Google Scholar database. Articles without references to parathyroid management strategies were mainly excluded. Results: Fourteen articles were reviewed as relevant to this study regarding recommendations for the management of parathyroids during prophylactic thyroidectomy in patients with MTC in MEN2A syndrome. Three of them had the same or similar purpose to our work, and the most recent literature review did not clearly support either one of the two management strategies. References to parathyroid management were found in the rest of the articles, but their purpose was not to determine the appropriate management strategy. The majority of the authors support the preservation of macroscopically normal parathyroid glands, while one study favored routine total parathyroidectomy and autografting. Conclusions: Although there does not seem to be a gold standard, the strategy of preserving macroscopically normal parathyroid glands with routine lab testing and surgical exploration for hyperparathyroidism during thyroidectomy seems to be a safe and effective strategy.

Focal nodular hyperplasia (FNH) is the second most common benign hepatic tumor and can rarely present as an exophytic solitary mass attached to the liver by a stalk. Most FNH cases are usually detected as incidental findings during surgery, imaging or physical examination and have a high female predominance. However, the pedunculated forms of FNH are particularly rare and commonly associated with severe complications and diagnostic challenges. Hence, our study aims to provide a comprehensive summary of the available data on the pedunculated FNH cases among adults and children. Furthermore, we will highlight the role of different therapeutic options in treating this clinical entity. The use of imaging techniques is considered a significant addition to the diagnostic toolbox. Regarding the optimal treatment strategy, the main indications for surgery were the presence of symptoms, diagnostic uncertainty and increased risk of complications, based on the current literature. Herein, we also propose a management algorithm for patients with suspected FNH lesions. Therefore, a high index of suspicion and awareness of this pathology and its life-threatening complications, as an uncommon etiology of acute abdomen, is of utmost importance in order to achieve better clinical outcomes.