Sample records for hyperparathyroidism summary statement
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Bandeira, Francisco; Griz, Luiz; Chaves, Narriane; Carvalho, Nara Crispim; Borges, Lívia Maria; Lazaretti-Castro, Marise; Borba, Victoria; Castro, Luiz Cláudio de; Borges, João Lindolfo; Bilezikian, John
2013-08-01
To conduct a literature review on the diagnosis and management of primary hyperparathyroidism including the classical hipercalcemic form as well as the normocalcemic variant. This scientific statement was generated by a request from the Brazilian Medical Association (AMB) to the Brazilian Society for Endocrinology as part of its Clinical Practice Guidelines program. Articles were identified by searching in PubMed and Cochrane databases as well as abstracts presented at the Endocrine Society, Brazilian Society for Endocrinology Annual Meetings and the American Society for Bone and Mineral Research Annual Meeting during the last 5 years. Grading quality of evidence and strength of recommendation were adapted from the first report of the Oxford Centre for Evidence-based Medicine. All grades of recommendation, including "D", are based on scientific evidence. The differences between A, B, C and D, are due exclusively to the methods employed in generating evidence. We present a scientific statement on primary hyperparathyroidism providing the level of evidence and the degree of recommendation regarding causes, clinical presentation as well as surgical and medical treatment.
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Hyperparathyroidism in persons exposed to iodine-131 from the Hanford Nuclear Site.
Hamilton, Thomas E; Davis, Scott; Onstad, Lynn; Kopecky, Kenneth J
2005-12-01
The risk of primary hyperparathyroidism from exposure to external radiation has been well documented in the last 20 yr. However, it remains unclear whether hyperparathyroidism might also be caused by internal exposure to radioactive iodine. The objective of this study was to determine whether exposure to 131I from the Hanford Nuclear Site during 1944-1957 increased the risk of hyperparathyroidism among people living in the area. The Hanford Thyroid Disease Study was conducted as a retrospective cohort study. The study setting was the general community in Washington State. The participants were 5199 persons born to mothers with usual residence in one of seven counties in eastern Washington State, randomly selected from birth records for the years 1940-1946. Of the 5199 selected, 3440 underwent a Hanford Thyroid Disease Study clinical evaluation, including an evaluation for hyperparathyroidism. Individual thyroid radiation dose, which could be estimated for 3191 study participants, ranged from 0.0029-2823 mGy (mean, 174 mGy). Hyperparathyroidism was the main outcome measure. Of 3440 evaluable participants, we confirmed 12 cases of primary hyperparathyroidism (0.35%). We found no evidence that the cumulative incidence of hyperparathyroidism increased with increasing radiation dose. In summary, this study shows no evidence that 131I, received at young ages and at the doses and exposure conditions experienced by this cohort, increased the risk of primary hyperparathyroidism. However, the effects of different doses and conditions of exposure to 131I on the risk of hyperparathyroidism remain to be defined.
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Normocalcemic primary hyperparathyroidism
Bilezikian, John P.; Silverberg, Shonni J.
2011-01-01
SUMMARY Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed to a disorder characterized by mild hypercalcemia and the absence of classical other features of the disease. We may now be entering a 3rd era in the history of this disease in which patients are being discovered with normal total and ionized serum calcium concentrations but with parathyroid hormone levels that are consistently elevated. In this article, we describe this new entity, normocalcemic primary hyperparathyroidism, a forme fruste of the disease. PMID:20485897
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Unilateral Versus Bilateral Neck Exploration for Primary Hyperparathyroidism
Bergenfelz, Anders; Lindblom, Pia; Tibblin, Sten; Westerdahl, Johan
2002-01-01
Objective To compare unilateral and bilateral neck exploration for primary hyperparathyroidism in a prospective randomized controlled trial. Summary Background Data Based on the assumption that unilateral neck exploration for a solitary parathyroid adenoma should reduce operating time and morbidity, a variety of minimally invasive procedures have challenged the idea that bilateral neck exploration is the gold standard for the surgical treatment of primary hyperparathyroidism. However, to date, no open prospective randomized trial has been published comparing unilateral and bilateral neck exploration. Methods Ninety-one patients with the preoperative diagnosis of primary hyperparathyroidism were randomized to unilateral or bilateral neck exploration. Preoperative scintigraphy and intraoperative parathyroid hormone measurement guided the unilateral exploration. Gross morphology and frozen section determined the extent of parathyroid tissue resection in the bilateral group. The primary end-point was the use of postoperative medication for hypocalcemic symptoms. Results Eighty-eight patients (97%) were cured. Histology and cure rate did not differ between the two groups. Patients in the bilateral group consumed more oral calcium, had lower serum calcium values on postoperative days 1 to 4, and had a higher incidence of early severe symptomatic hypocalcemia compared with patients in the unilateral group. In addition, for patients undergoing surgery for a solitary parathyroid adenoma, unilateral exploration was associated with a shorter operative time. The cost for the two procedures did not differ. Conclusions Patients undergoing a unilateral procedure had a lower incidence of biochemical and severe symptomatic hypocalcemia in the early postoperative period compared with patients undergoing bilateral exploration. Unilateral neck exploration with intraoperative parathyroid hormone assessment is a valid surgical strategy in patients with primary hyperparathyroidism with distinct advantages, especially for patients with solitary parathyroid adenoma. PMID:12409657
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... hyperparathyroidism; Osteopenia - hyperparathyroidism; High calcium level - hyperparathyroidism; Chronic kidney disease - hyperparathyroidism; Kidney failure - hyperparathyroidism; Overactive parathyroid
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Davies, D. R.; Dent, C. E.; Watson, Lyal
1968-01-01
In our first 200 cases of primary hyperparathyroidism confirmed by operation 12 were also shown to have a long history either of a malabsorption syndrome or of chronic renal-glomerular failure. We consider that they first went through a phase of secondary hyperparathyroidism, during which one or more of the glands became autonomous adenamata. This then produced the biochemical changes of “primary” hyperparathyroidism, necessitating excision of the adenoma. This condition is best described as “tertiary” hyperparathyroidism. The transition from secondary to tertiary hyperparathyroidism occurred in four of the 12 patients while under our observation. We think the same process can be traced retrospectively in the other eight cases. The concept of tertiary hyperparathyroidism may help to explain the high incidence of other diseases in association with primary hyperparathyroidism. The behaviour of the parathyroid glands provides a valuable model for the investigation of tumour formation in man. All states occurred in our patients with primary hyperparathyroidism, from normal through hyperplasia to adenoma formation and finally to parathyroid carcinoma. PMID:5691200
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Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Summary. 1502.12 Section 1502.12 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.12 Summary. Each environmental impact statement shall contain a summary which adequately and accurately summarizes...
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Book, Katrin; Dinkel, Andreas; Henrich, Gerhard; Stuhr, Claudia; Peuker, Mareike; Härtl, Kristin; Brähler, Elmar; Herschbach, Peter
2013-12-01
The objective of this study is to determine whether the inclusion of a 'psychooncological statement' (PO-statement) in the discharge summary enhances patient-physician communication about psychosocial issues across the inpatient and outpatient sector. A total of 1416 cancer patients were randomly assigned to the intervention (with PO-statement in the discharge summary) or control group (discharge summary without PO-statement). Shortly before discharge from the hospital (T1), patients from the intervention group were screened for psychosocial distress. Based on the electronic clinical documentation system, screening results were subsequently integrated into the discharge summary, which automatically generated a PO-statement. To determine the effect of the PO-statement, patients as well as their primary care physicians (n = 596) were asked during follow-up care (T2) whether psychosocial distress was discussed during the last consultation. Including a PO-statement in the discharge summary did not result in more frequent discussions about psychosocial issues compared with the control group from the patients' and physicians' perspectives. Instead, discussions about psychosocial well-being were significantly associated with women of the patient (p = <0.001) and the physician (p = 0.011), medical discipline (gynecologists; p = 0.002), cancer diagnosis (gynecological cancer; p = 0.002), metastases (p = <0.001), professional training of patients (none, p = 0.026), and psychosocial qualification of physicians (p = 0.018). Written information on psychosocial distress in the discharge summary alone does not affect communication. Copyright © 2013 John Wiley & Sons, Ltd.
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Comparative characteristics of primary hyperparathyroidism in pediatric and young adult patients.
Nicholson, Kristina J; McCoy, Kelly L; Witchel, Selma F; Stang, Michael T; Carty, Sally E; Yip, Linwah
2016-10-01
Primary hyperparathyroidism is rare in pediatric patients. Our study aim was to compare primary hyperparathyroidism in pediatric (<19 years) and young adult (19-29 years) patients. A prospectively collected database from a single, high-volume institution was queried for all patients age <30 years who had initial parathyroidectomy for primary hyperparathyroidism yielding 126/4,546 (2.7%) primary hyperparathyroidism patients representing 39 pediatric and 87 young adult patients. Presenting symptoms, operative data, and postoperative course were compared for patients age 0-19 years and 20-29 years. Sporadic primary hyperparathyroidism was present in 81.7% and occurred less often in pediatric patients than young adult patients (74.4% vs 86.2%, P = .12). Among patients with hereditary primary hyperparathyroidism, multiple endocrine neoplasia type 1 was the most common type. Multiglandular disease was common in both pediatric (30.7%) and young adult (21.8%) patients. Following parathyroidectomy, 3 (2.3%) patients had permanent hypoparathyroidism and none had permanent recurrent laryngeal nerve paralysis. Biochemical cure at 6 months was equally likely in pediatric and young adult patients (97.1% vs 93.6%, P = .44) with comparable follow-up (78.4 months vs 69.1 months, P = .66) and rates of recurrent disease (5.9% vs 10.3%, P = .46). Recurrence was due to multiple endocrine neoplasia 1-related primary hyperparathyroidism in all cases. Although primary hyperparathyroidism is sporadic in most patients <19 years, they are more likely to have multiple endocrine neoplasia type 1-associated primary hyperparathyroidism (23%). Parathyroidectomy for primary hyperparathyroidism can be performed safely in pediatric patients with a high rate of cure. Follow-up for patients with hereditary disease is necessary. Copyright © 2016 Elsevier Inc. All rights reserved.
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Pandita, Kamal Kishore; Pandita, Sarla; Hassan, Tanveer
2011-01-01
Summary Hypercalcaemia is most commonly caused by primary hyperparathyroidism or malignancy. Vitamin D intoxication, also a cause of hypercalcaemia, is mostly caused by excessive administration of vitamin D-containing medications and excessive intake of foods fortified with vitamin D. We present a young cricketer, with recurrent vomiting due to hypercalcaemia and hypervitaminosis D, who used to drink large volumes of soup prepared by boiling long beef bones, for many months. This case presentation highlights the importance of in-depth dietary history for arriving at proper diagnosis. PMID:22461816
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Hendrickson, Chase D; Castro Pereira, Daniel J; Comi, Richard J
2014-08-01
Management of primary hyperparathyroidism has evolved over the past two decades, yet impaired renal function has consistently been a surgical indication. This recommendation has been based upon the historical association between primary hyperparathyroidism and renal impairment, and a review of the literature is needed to determine whether such a recommendation is warranted. PubMed was utilized to identify English-language articles published between January 1990 and February 2014 using keywords related to hyperparathyroidism and renal function. The keywords were "primary hyperparathyroidism," "surgery," "parathyroidectomy," "kidney," "renal," "glomerular filtration rate," and "creatinine." Of the 1926 articles obtained with this search, all articles germane to the topic that quantified the relationship between primary hyperparathyroidism and renal function were included. All references within these articles were investigated for inclusion. When helpful, data tables were constructed to summarize the results succinctly. A secondary elevation of PTH levels has not been consistently shown to occur at the threshold currently indicated for surgical intervention. While renal impairment is seen with more significant disease, mild asymptomatic primary hyperparathyroidism has not been conclusively associated with renal impairment. Furthermore, there is no evidence to suggest that surgically curing primary hyperparathyroidism via a parathyroidectomy has any impact upon renal function.
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Parathyroid carcinoma presenting as tertiary hyperparathyroidism.
Sherlock, D. J.; Newman, J.; Holl-Allen, R. T.
1985-01-01
A case of malignant transformation in established secondary hyperparathyroidism presenting as tertiary hyperparathyroidism is reported. Although rare, this occurrence has important medical and surgical implications. Images Figure 1 PMID:3983057
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Khalatbari, Mahmoud Reza; Hamidi, Mehrdokht; Moharamzad, Yashar; Setayesh, Ali; Amirjamshidi, Abbas
2013-01-01
Brown tumor is a bone lesion secondary to hyperparathyroidism of various etiologies. Skeletal involvement in primary hyperparathyroidism secondary to parathyroid adenoma is very uncommon and brown tumor has become extremely a rare clinical entity. Hyperparathyroidism is usually associated with high levels of serum calcium. Brown tumor as the only and initial symptom of normocalcemic primary hyperparathyroidism is extremely rare. Moreover, involvement of the skull base and the orbit is exceedingly rare. The authors would report three cases of brown tumor of the anterior skull base that were associated with true normocalcemic primary hyperparathyroidism. Clinical manifestations, neuroimaging findings, pathological findings, diagnosis and treatment of the patients are discussed and the relevant literature is reviewed.
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Improving diagnostic recognition of primary hyperparathyroidism with machine learning.
Somnay, Yash R; Craven, Mark; McCoy, Kelly L; Carty, Sally E; Wang, Tracy S; Greenberg, Caprice C; Schneider, David F
2017-04-01
Parathyroidectomy offers the only cure for primary hyperparathyroidism, but today only 50% of primary hyperparathyroidism patients are referred for operation, in large part, because the condition is widely under-recognized. The diagnosis of primary hyperparathyroidism can be especially challenging with mild biochemical indices. Machine learning is a collection of methods in which computers build predictive algorithms based on labeled examples. With the aim of facilitating diagnosis, we tested the ability of machine learning to distinguish primary hyperparathyroidism from normal physiology using clinical and laboratory data. This retrospective cohort study used a labeled training set and 10-fold cross-validation to evaluate accuracy of the algorithm. Measures of accuracy included area under the receiver operating characteristic curve, precision (sensitivity), and positive and negative predictive value. Several different algorithms and ensembles of algorithms were tested using the Weka platform. Among 11,830 patients managed operatively at 3 high-volume endocrine surgery programs from March 2001 to August 2013, 6,777 underwent parathyroidectomy for confirmed primary hyperparathyroidism, and 5,053 control patients without primary hyperparathyroidism underwent thyroidectomy. Test-set accuracies for machine learning models were determined using 10-fold cross-validation. Age, sex, and serum levels of preoperative calcium, phosphate, parathyroid hormone, vitamin D, and creatinine were defined as potential predictors of primary hyperparathyroidism. Mild primary hyperparathyroidism was defined as primary hyperparathyroidism with normal preoperative calcium or parathyroid hormone levels. After testing a variety of machine learning algorithms, Bayesian network models proved most accurate, classifying correctly 95.2% of all primary hyperparathyroidism patients (area under receiver operating characteristic = 0.989). Omitting parathyroid hormone from the model did not decrease the accuracy significantly (area under receiver operating characteristic = 0.985). In mild disease cases, however, the Bayesian network model classified correctly 71.1% of patients with normal calcium and 92.1% with normal parathyroid hormone levels preoperatively. Bayesian networking and AdaBoost improved the accuracy of all parathyroid hormone patients to 97.2% cases (area under receiver operating characteristic = 0.994), and 91.9% of primary hyperparathyroidism patients with mild disease. This was significantly improved relative to Bayesian networking alone (P < .0001). Machine learning can diagnose accurately primary hyperparathyroidism without human input even in mild disease. Incorporation of this tool into electronic medical record systems may aid in recognition of this under-diagnosed disorder. Copyright © 2016 Elsevier Inc. All rights reserved.
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Canadian Consensus on Female Nutrition: Adolescence, Reproduction, Menopause, and Beyond.
O'Connor, Deborah L; Blake, Jennifer; Bell, Rhonda; Bowen, Angela; Callum, Jeannie; Fenton, Shanna; Gray-Donald, Katherine; Rossiter, Melissa; Adamo, Kristi; Brett, Kendra; Khatri, Nasreen; Robinson, Nicole; Tumback, Lindsay; Cheung, Anthony
2016-06-01
To provide health care professionals in Canada with the basic knowledge and tools to provide nutrition guidance to women through their lifecycle. Optimal nutrition through the female lifecycle was evaluated, with specific focus on adolescence, pre-conception, pregnancy, postpartum, menopause, and beyond. The guideline begins with an overview of guidance for all women, followed by chapters that examine the evidence and provide recommendations for the promotion of healthy nutrition and body weight at each life stage. Nutrients of special concern and other considerations unique to each life stage are discussed in each chapter. Published literature, governmental and health agency reports, clinical practice guidelines, grey literature, and textbook sources were used in supporting the recommendations made in this document. The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. CHAPTER 2: GENERAL FEMALE NUTRITION: Summary Statements Recommendations CHAPTER 3: ADOLESCENCE NUTRITION: Summary Statements Recommendations CHAPTER 4: PRE-CONCEPTUAL NUTRITION: Summary Statement Recommendations CHAPTER 5: NUTRITION IN PREGNANCY: Summary Statements Recommendations CHAPTER 6: POSTPARTUM NUTRITION AND LACTATION: Summary Statements Recommendations CHAPTER 7: NUTRITION DURING MENOPAUSE AND BEYOND: Summary Statement Recommendations. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
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Janka-Zires, Marcela; Hernández-Calleros, Jorge; Gómez-Pérez, Francisco Javier; Uscanga-Domínguez, Luis Federico; Pelaez-Luna, Mario César; Almeda-Valdés, Paloma
2015-01-01
Hypercalcemia is a rare but well recognized cause of acute and chronic pancreatitis. Hypercalcemia-related pancreatitis is mainly caused by primary hyperparathyroidism. The prevalence of pancreatitis in hyperparathyroidism varies worldwide and additional disease-modifying factors may play a role in its development. In 1988 the prevalence of pancreatitis secondary to primary hyperparathyroidism at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a referral center in Mexico City, was 12.1% (95% CI: 6.7-21). To describe the current prevalence of pancreatitis secondary to primary hyperparathyroidism at the INCMNSZ. We reviewed 385 cases of primary hyperparathyroidism seen at the hospital between 1987 and 2012. 26 cases with acute or chronic pancreatitis associated with primary hyperparathyroidism were documented, with a prevalence of 6.7% (95% CI: 4.6-9.7), which was lower than the 12.1% previously reported. In the present study, 20% had a history of alcohol consumption, 10% of gallstones, and 20% of ureteral calculi, compared with the previously reported 32.0, 34.6, and 40.0%, respectively. The average calcium levels were 13.1 and 13.8 mg/dl in the previous and current series, respectively. We found a decrease in the prevalence of pancreatitis associated with primary hyperparathyroidism from 12.1% (95% CI: 6.7-21) to 6.7% (95% CI: 4.6-9.7).
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Melella, A; Basilico, L; Lupini, A; Renda, F
1978-10-31
Primary and secondary hyperparathyroidism are both marked by widespread skeletal demineralisation, subperiosteal erosion of the cortex, brown tumours, osteosclerosis, and extraosseous calcification. Differential diagnosis is guided by the different association of these findings. Brown tumours and more extensive erosion are marks of the primary form, whereas osteosclerosis and extra-osseous calcification are a prominent feature of secondary hyperparathyroidism. Radiologists, therefore, should direct their attention to features suggesting the presence of secondary forms in addition to looking for bone alterations associated with hyperparathyroidism.
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Q-Bridge environmental impact statement : executive summary
DOT National Transportation Integrated Search
1997-04-01
This Executive Summary provides a brief overview of the Final Environmental Impact Statement/Section 4(f) Evaluation (FEIS) for Interstate 95 (I-95) - Pearl Harbor Memorial Bridge (Q-Bridge) Crossing New Haven Harbor Study. The information presented ...
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Urinary calculi in hypercalcemic states.
Thomas, W C
1990-12-01
In this brief review of various hypercalcemic disorders and the likelihood of renal calculus formation, it is clearly evident that renal calculi occur much more often in hyperparathyroidism than in the other hypercalcemic states. Dystrophic calcification and nephrocalcinosis are common to all of the hypercalcemic disorders, including hyperparathyroidism, when the hypercalcemia is marked and the limit of solubility of calcium and phosphate in serum is approached. Interestingly, in sarcoidosis there are calcium oxalate crystals in variously distributed sarcoid granuloma, and the renal calculi are composed of calcium oxalate. By contrast, in hyperparathyroidism, the calculi composed of calcium phosphate predominate. This indicates a subtle and as yet undefined alteration in oxalate metabolism in sarcoidosis. An increase in urine pH occurs in hyperparathyroidism, and this enhances formation of crystalline calcium phosphate. However, the striking disparity between the frequency of calculus formation in hyperparathyroidism and that in other hypercalcemic disorders, several of which may be of relatively long duration, suggests that there indeed may be increased promoters of crystal formation in the urine of hyperparathyroid patients.
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Smith, Sherilyn; Kogan, Jennifer R; Berman, Norman B; Dell, Michael S; Brock, Douglas M; Robins, Lynne S
2016-01-01
The ability to create a concise summary statement can be assessed as a marker for clinical reasoning. The authors describe the development and preliminary validation of a rubric to assess such summary statements. Between November 2011 and June 2014, four researchers independently coded 50 summary statements randomly selected from a large database of medical students' summary statements in virtual patient cases to each create an assessment rubric. Through an iterative process, they created a consensus assessment rubric and applied it to 60 additional summary statements. Cronbach alpha calculations determined the internal consistency of the rubric components, intraclass correlation coefficient (ICC) calculations determined the interrater agreement, and Spearman rank-order correlations determined the correlations between rubric components. Researchers' comments describing their individual rating approaches were analyzed using content analysis. The final rubric included five components: factual accuracy, appropriate narrowing of the differential diagnosis, transformation of information, use of semantic qualifiers, and a global rating. Internal consistency was acceptable (Cronbach alpha 0.771). Interrater reliability for the entire rubric was acceptable (ICC 0.891; 95% confidence interval 0.859-0.917). Spearman calculations revealed a range of correlations across cases. Content analysis of the researchers' comments indicated differences in their application of the assessment rubric. This rubric has potential as a tool for feedback and assessment. Opportunities for future study include establishing interrater reliability with other raters and on different cases, designing training for raters to use the tool, and assessing how feedback using this rubric affects students' clinical reasoning skills.
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CORNECI, Marioara; STANESCU, Bogdan; TRIFANESCU, Raluca; NEACSU, Elena; CORNECI, Dan; POIANA, Catalina; HORVAT, Teodor
2012-01-01
ABSTRACT Background: In patients with hyperparathyroidism, parathyroidectomy is the only curative therapy. Anaesthetic management differs function of etiology (primary vs. secondary or tertiary hyperparathyroidism) and surgical technique (minimally invasive or classic parathyroidectomy). Objectives: To evaluate peri-operative management (focusing on hemodynamic changes, cardiac arrhythmias and patients’ awakening quality) in parathyroidectomy for hyperparathyroidism of various etiologies, in a tertiary center. Material and methods: 292 patients who underwent surgery for hyperparathyroidism between 2000-2011 were retrospectively reviewed; 96 patients (19M/77F) presented with primary hyperparathyroidism (group A) and 196 (80M/116F) with secondary and tertiary hyperparathyroidism due to renal failure (group B). Biochemical parameters (serum calcium, phosphate, creatinine) were determined by automated standard laboratory methods. Serum intact PTH was measured by ELISA (iPTH - normal range: 15-65 pg/mL). Outcomes: Median surgery duration was 30 minutes in group A (minimally invasive or classic parathyroidectomy) and 75 minutes in group B (total parathyroidectomy and re implantation of a small parathyroid fragment into the sternocleidomastoid muscle). During anaesthesia induction, arterial hypotension developed significantly more frequent in group B (57 out of 196 pts, 29.1%) than in group A (8 out of 96 pts, 8.34%), p<0.0001, especially in patients receiving Fentanyl-Propofol. During surgery and anaesthesia maintenance, bradycardia was significantly more frequent in group A (67 out of 96 pts, 69.8%) than in group B (26 out of 196 pts, 13.3%), p<0.0001, especially during searching of parathyroid glands. By contrary, ventricular premature beats were less frequent in group A (25 out of 96 pts, 25.25%) than in group B (84 out of 196 pts, 42.85%), p=0.003. There were no statistically significant differences between the studied group regarding frequency of arterial hypertension and hypotension, paroxysmal atrial fibrillation. Conclusions: anaesthetic management in parathyroid surgery may be difficult because of cardiac arrhythmias (bradycardia in primary hyperparathyroidism and ventricular premature beats in secondary and tertiary hyperparathyroidism, respectively) and arterial hypotension during anaesthesia induction in patients with secondary and tertiary hyperparathyroidism. PMID:23399537
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Interactions Between Adrenal and Calcium-Regulatory Hormones in Human Health
Brown, Jenifer M.; Vaidya, Anand
2014-01-01
Purpose of Review To summarize evidence characterizing the interactions between adrenal- and calcium-regulating hormones, and the relevance of these interactions to human cardiovascular and skeletal health. Recent Findings Human studies support the regulation of parathyroid hormone (PTH) by the renin-angiotensin-aldosterone system (RAAS): angiotensin II may stimulate PTH secretion via an acute and direct mechanism, whereas aldosterone may exert a chronic stimulation of PTH secretion. Studies in primary aldosteronism, congestive heart failure, and chronic kidney disease have identified associations between hyperaldosteronism, hyperparathyroidism, and bone loss, which appear to improve when inhibiting the RAAS. Conversely, elevated PTH and insufficient vitamin D status have been associated with adverse cardiovascular outcomes, which may be mediated by the RAAS. Studies of primary hyperparathyroidism implicate PTH-mediated stimulation of the RAAS, and recent evidence shows that the vitamin D-vitamin D receptor (VDR) complex may negatively regulate renin expression and RAAS activity. Ongoing human interventional studies are evaluating the influence of RAAS inhibition on PTH and the influence of VDR agonists on RAAS activity. Summary While previously considered independent endocrine systems, emerging evidence supports a complex web of interactions between adrenal and calcium-regulating hormones, with implications for human cardiovascular and skeletal health. PMID:24694551
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Hyperparathyroidism-jaw tumour syndrome detected by aggressive generalized osteitis fibrosa cystica.
Guerrouani, Alae; Rzin, Abdelkader; El Khatib, Karim
2013-01-01
Severe hyperparathyroidism can affect bone metabolism and be in the origine of multiple brown tumours (generalized osteitis fibrosa cystica). When associated with fibro-ossifying tumours of the jaw, it realizes a rare genetic syndrome referred as Hyperparathyroidism-jaw tumour HPT-JT. We report the case of a patient we treated for HPT-JT, and literature review.
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[Normocalcemic primary hyperparathyroidism: recommendations for management and follow-up].
Martínez Díaz-Guerra, Guillermo; Jódar Gimeno, Esteban; Reyes García, Rebeca; Gómez Sáez, José Manuel; Muñoz-Torres, Manuel
2013-10-01
To provide practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. A systematic search was made in MEDLINE (PubMed), using the terms normocalcemic primary hyperparathyroidism and primary hyperparathyroidism, for articles in English published before 22 November 2012. Literature was reviewed by 2 members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, and after development of recommendations, the manuscript was reviewed by all other members of the Group, and their suggestions were incorporated. The document provides practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. There is however little evidence available about different aspects of this disease, mainly progression rate and clinical impact. More data are therefore needed before definite recommendations may be made. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.
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Chernousov, A F; Ippolitov, L I; Musaev, G Kh; Saliba, M B
2014-01-01
Primary hyperparathyroidism is the most common disease in Russian Federation, cured by endocrine surgeons. Health status after surgical correction of primary hyperparathyroidism depends on availability of screening hypercalciemia, which is still absent in our country. Another problem is a model of surgical management of primary hyperparathyroidism (frozen section, intraoperative monitoring of parathyroid hormone, gamma-detection and so on). Although minimally invasive parathyroidectomy has become the only method of treatment in many countries, it is still crucial to identify and accurately localize parathyroid glands before bilateral neck exploration surgery. The diagnostic efficacy of the various imaging techniques is still the subject of current debate. The usefulness of preoperative parathyroid imaging with both dual scintigraphy-single-photon emission computed tomography (SPECT) Tc 99m and high-resolution ultrasonography (US) was studied in 92 patients undergoing operations for primary hyperparathyroidism. The accuracy of "integrated" ultrasonography ("check-up US", "target US" after SPECT) and "intraoperative US") of parathyroid glands was 92.9%, sensitivity - 91% and positive predictive value - 94%. This study supports an algorithm of obtaining "integrated" ultrasonography as the initial and in most cases the only preoperative localization tests for patients with primary hyperparathyroidism.
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Hyperparathyroid crisis presenting with hyperemesis gravidarum.
Yilmaz, Banu Aktaş; Altay, Mustafa; Değertekin, Ceyla Konca; Çimen, Ali Riza; Iyidir, Özlem Turhan; Biri, Aydan; Yüksel, Osman; Törüner, Füsun Baloş; Arslan, Metin
2014-10-01
Primary hyperparathyroidism during pregnancy is a rare condition, and the diagnosis may be confounded by pregnancy related conditions. Since the appropriate management reduces the maternal and fetal complications; differential diagnosis becomes quite crucial. Clinical course of a patient with hyperparathyroid crisis will be discussed with the review of the literature. A 22-year- old, (gravida 2, para 1) woman was presented with hyperparathyroid crisis at the 11th weeks' gestation. She was hospitalized twice due to hyperemesis gravidarum. When she was admitted to the hospital for the third time due to increased vomiting and weight-loss, serum biochemistry panel was performed and it revealed severe hypercalcemia that serum Ca was 17.59 mg/dl, and she was referred to our hospital as parathyroid crisis. Maternal hypercalcemia was resolved after urgent parathyroidectomy. She was diagnosed as preeclampsia at the 30 weeks' gestation and delivered a male infant weighing 1,090 g at 33 weeks' gestation with APGAR scores 6 at 1 min, and 7 at min 5, without evidence of neonatal hypocalcemia or tetany. Urgent parathyroidectomy is the definite treatment in symptomatic patients with hyperparathyroidism during pregnancy. Resolving maternal hypercalcemia prevents neonatal tetany and hypocalcemia. Hyperemesis may lead to hypercalcemic crisis in patients with hyperparathyroidism, so serum Ca level should be checked in patients with hyperemesis gravidarum especially who detoriate rapidly. Although they share some common pathogenetic mechanisms, there is not enough evidence for attributing preeclampsia to primary hyperparathyroidism.
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Diuretics, calciuria and secondary hyperparathyroidism in the Chronic Renal Insufficiency Cohort.
Isakova, Tamara; Anderson, Cheryl A M; Leonard, Mary B; Xie, Dawei; Gutiérrez, Orlando M; Rosen, Leigh K; Theurer, Jacquie; Bellovich, Keith; Steigerwalt, Susan P; Tang, Ignatius; Anderson, Amanda Hyre; Townsend, Raymond R; He, Jiang; Feldman, Harold I; Wolf, Myles
2011-04-01
Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD) that is associated with bone disease, cardiovascular disease and death. Pathophysiological factors that maintain secondary hyperparathyroidism in advanced CKD are well-known, but early mechanisms of the disease that can be targeted for its primary prevention are poorly understood. Diuretics are widely used to control volume status and blood pressure in CKD patients but are also known to have important effects on renal calcium handling, which we hypothesized could alter the risk of secondary hyperparathyroidism. We examined the relationship of diuretic treatment with urinary calcium excretion, parathyroid hormone (PTH) levels and prevalence of secondary hyperparathyroidism (PTH ≥ 65 pg/mL) in a cross-sectional study of 3616 CKD patients in the Chronic Renal Insufficiency Cohort. Compared with no diuretics, treatment with loop diuretics was independently associated with higher adjusted urinary calcium (55.0 versus 39.6 mg/day; P < 0.001), higher adjusted PTH [67.9, 95% confidence interval (CI) 65.2-70.7 pg/mL, versus 52.8, 95% CI 51.1-54.6 pg/mL, P < 0.001] and greater odds of secondary hyperparathyroidism (odds ratio 2.1; 95% CI 1.7-2.6). Thiazide monotherapy was associated with lower calciuria (25.5 versus 39.6 mg/day; P < 0.001) but only modestly lower PTH levels (50.0, 95% CI 47.8-52.3, versus 520.8, 95% CI 51.1-54.6 pg/mL, P = 0.04) compared with no diuretics. However, coadministration of thiazide and loop diuretics was associated with blunted urinary calcium (30.3 versus 55.0 mg/day; P <0.001) and odds of hyperparathyroidism (odds ratio 1.3 versus 2.1; P for interaction = 0.05) compared with loop diuretics alone. Loop diuretic use was associated with greater calciuria, PTH levels and odds of secondary hyperparathyroidism compared to no treatment. These associations were attenuated in patients who were coadministered thiazides. Diuretic choice is a potentially modifiable determinant of secondary hyperparathyroidism in CKD.
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Diuretics, calciuria and secondary hyperparathyroidism in the Chronic Renal Insufficiency Cohort
Isakova, Tamara; Anderson, Cheryl A. M.; Leonard, Mary B.; Xie, Dawei; Gutiérrez, Orlando M.; Rosen, Leigh K.; Theurer, Jacquie; Bellovich, Keith; Steigerwalt, Susan P.; Tang, Ignatius; Anderson, Amanda Hyre; Townsend, Raymond R.; He, Jiang; Feldman, Harold I.; Wolf, Myles
2011-01-01
Background. Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD) that is associated with bone disease, cardiovascular disease and death. Pathophysiological factors that maintain secondary hyperparathyroidism in advanced CKD are well-known, but early mechanisms of the disease that can be targeted for its primary prevention are poorly understood. Diuretics are widely used to control volume status and blood pressure in CKD patients but are also known to have important effects on renal calcium handling, which we hypothesized could alter the risk of secondary hyperparathyroidism. Methods. We examined the relationship of diuretic treatment with urinary calcium excretion, parathyroid hormone (PTH) levels and prevalence of secondary hyperparathyroidism (PTH ≥ 65 pg/mL) in a cross-sectional study of 3616 CKD patients in the Chronic Renal Insufficiency Cohort. Results. Compared with no diuretics, treatment with loop diuretics was independently associated with higher adjusted urinary calcium (55.0 versus 39.6 mg/day; P < 0.001), higher adjusted PTH [67.9, 95% confidence interval (CI) 65.2–70.7 pg/mL, versus 52.8, 95% CI 51.1–54.6 pg/mL, P < 0.001] and greater odds of secondary hyperparathyroidism (odds ratio 2.1; 95% CI 1.7–2.6). Thiazide monotherapy was associated with lower calciuria (25.5 versus 39.6 mg/day; P < 0.001) but only modestly lower PTH levels (50.0, 95% CI 47.8–52.3, versus 520.8, 95% CI 51.1–54.6 pg/mL, P = 0.04) compared with no diuretics. However, coadministration of thiazide and loop diuretics was associated with blunted urinary calcium (30.3 versus 55.0 mg/day; P <0.001) and odds of hyperparathyroidism (odds ratio 1.3 versus 2.1; P for interaction = 0.05) compared with loop diuretics alone. Conclusions. Loop diuretic use was associated with greater calciuria, PTH levels and odds of secondary hyperparathyroidism compared to no treatment. These associations were attenuated in patients who were coadministered thiazides. Diuretic choice is a potentially modifiable determinant of secondary hyperparathyroidism in CKD. PMID:21382989
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Blanchard, Claire; Mathonnet, Muriel; Sebag, Frédéric; Caillard, Cécile; Kubis, Caroline; Drui, Delphine; van Nuvel, Elise; Ansquer, Catherine; Henry, Jean-François; Masson, Damien; Kraeber-Bodéré, Françoise; Hardouin, Jean-Benoît; Zarnegar, Rasa; Hamy, Antoine; Mirallié, Eric
2014-10-01
The objectives of this study were to evaluate, in mild primary hyperparathyroidism (pHPT) patients, the quality of life (QoL) using the SF-36 questionnaire before and after parathyroidectomy and to detect preoperatively patients who benefit the most from surgery. Most pHPT patients present a mild pHPT defined by calcemia ≤11.4 mg/dL. For these patients, there is debate about whether they should be managed with surveillance, medical therapy, or surgery. A prospective multicenter study investigated QoL (SF-36) in patients with mild pHPT before and after parathyroidectomy in four university hospitals. Laboratory results and SF-36 scores were obtained preoperatively and postoperatively (3, 6, and 12 months). One hundred sixteen patients were included. After surgery, the biochemical cure rate was 98%. Preoperatively, the mental component summary and the physical component summary (PCS) were 38.69 of 100 and 39.53 of 100, respectively. At 1 year, the MCS and the PCS were 41.29 of 100 and 42.03 of 100. The subgroup analysis showed a more significant improvement in patients < 70 years and with calcemia ≥10.4 mg/dL. Postoperative PCS was correlated with age and preoperative PCS: variation = 32.11 - 0.21 × age - 0.4 × preoperative PCS. Men did not improve their MCS postoperatively. Only women with a preoperative MCS <43.6 of 100 showed postoperative improvement. This study showed, in patients with mild pHPT, an improvement of QoL 1 year after parathyroidectomy. Patients <70 years and with calcemia ≥10.4 mg/dL had a more significant improvement.
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Evaluation of secondary hyperparathyroidism in patients undergoing hemodialysis.
Rahimian, Mohammad; Sami, Ramin; Behzad, Fariba
2008-01-01
Renal osteodystrophy is a complication of chronic kidney disease (CKD) that present in low and high turnover patterns. This disorder has a key role in the disability of CKD patients in whom early diagnosis and treatment can result in better outcome. We studied hyperparathyroidism prevalence and its relationship with renal osteodystrophy in our advanced CKD population. We included 80 patients (of whom 44 (55%) were diabetic) during 6 months period. The patients answered a questionnaire about symptoms related to bone disease and blood levels of parathormone (PTH), calcium, phosphorus, and alkaline phosphatase were obtained, in addition to hand and skull radiographs in all the study patients. Prevalence of clinically evident hyperparathyroidism in our patients was 45%. Hyperparathyroidism had significant relationship with alkaline phosphatase and radiological findings, but did not have a significant relationship with dialysis duration, age, sex, familial history, diabetes mellitus, or hypertension. We conclude that secondary hyperparathyroidism is prevalent in our dialysis population and has high correlation with serum alkaline phosphatase levels and radiological changes.
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Mazzuoli, G.; Minisola, S.; Scarda, A.; De Matteis, A.; Tabolli, S.; Bigi, F.; Valtorta, C.; D'Erasmo, E.
1987-01-01
Three patients with recurrent hyperparathyroidism (15, 8 and 3 years respectively, after the first operation) are described in order to establish the causes and define the clinical characteristics of the disease. The observation that in the present series recurrent hyperparathyroidism was associated either with an adenoma (two cases) or a carcinoma (one case), appears to stress the possibility of the pathological involvement of one gland even though recurrent hyperparathyroidism should be considered due to the chronic extrinsic stimulation of the parathyroid glands. The severity of the clinical and metabolic picture observed at the time of the first diagnosis and/or at the time of recurrence together with the simultaneous presence of bone and stone disease in the patients described is of particular interest. The cases reported underline the importance of carrying out careful metabolic investigations in patients with hyperparathyroidism not only before but also for a prolonged period of time after operation. PMID:3671259
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Hyperparathyroidism after irradiation for childhood malignancy.
McMullen, Todd; Bodie, Greg; Gill, Anthony; Ihre-Lundgren, Catharina; Shun, Albert; Bergin, Mary; Stevens, Graham; Delbridge, Leigh
2009-03-15
To examine the occurrence of hyperparathyroidism in a cohort of patients undergoing combined parathyroid and thyroid surgery after previous head-and-neck irradiation for childhood malignancy. This is a retrospective cohort study for the years 1996 to 2007. The study group comprised patients undergoing surgery in the University of Sydney Endocrine Surgical Unit who had received previous head-and-neck irradiation in childhood and who were identified as having pathologic thyroid and parathyroid characteristics. A total of 53 patients were identified in whom head-and-neck irradiation for the treatment of childhood malignancy had been documented. In each of the cases, thyroid disease was the primary reason for referral for surgery. Five of these patients (10%) were found to exhibit coexisting hyperparathyroidism. The latency period for hyperparathyroidism was less than 20 years in 4 of the 5 cases. There were four conventional parathyroid adenomas and one parathyroid lipoadenoma. All patients exhibited a significant decrease in postoperative calcium levels after surgery. To our knowledge, this is the first study to document the significant risk of hyperparathyroidism after radiation exposure for childhood malignancy. The timeframe for development of disease is much shorter than that published for individuals who have undergone irradiation for benign diseases. High doses of therapeutic radiation at a young age make childhood survivors of malignancy at especially high risk for developing hyperparathyroidism.
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Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C
2018-04-01
Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P = 0.02; respectively). Systolic blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.
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Federal Register 2010, 2011, 2012, 2013, 2014
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... Resources Management Plan/Environmental Impact Statement, Mojave National Preserve, San Bernardino County... Resources Management Plan/Environmental Impact Statement for Mojave National Preserve. SUMMARY: Pursuant to... preparing a Water Resources Management Plan/Environmental Impact Statement (WRMP/EIS). This plan is intended...
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Analysis of 2000 Financial Forecasts and Annual Operating Statements. Report.
ERIC Educational Resources Information Center
Higher Education Funding Council for England, Bristol.
This report provides a summary of financial projections for the higher education sector in England covering 1999-2000 to 2003-2004 and a summary of the sector's annual operating statements for 1999-2000 and 2000-2001. It is based on information provided by higher education institutions in July 2000. These forecasts were prepared before the outcome…
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76 FR 12788 - Environmental Impact Statement for a Proposed Urban Rail system in Austin, TX
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2011-03-08
... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Environmental Impact Statement for a... Intent to Prepare an Environmental Impact Statement. SUMMARY: The Federal Transit Administration (FTA... Impact Statement (EIS) for the proposed Urban Rail system in Austin, Texas. The EIS will be prepared in...
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BARETTA, Giorgio Alfredo Pedroso; CAMBI, Maria Paula Carlini; RODRIGUES, Arieli Luz; MENDES, Silvana Aparecida
2015-01-01
Background : Bariatric surgery, especially Roux-en-Y gastric bypass, can cause serious nutritional complications arising from poor absorption of essential nutrients. Secondary hyperparathyroidism is one such complications that leads to increased parathyroid hormone levels due to a decrease in calcium and vitamin D, which may compromise bone health. Aim : To compare calcium carbonate and calcium citrate in the treatment of secondary hyperparathyroidism. Method : Patients were selected on the basis of their abnormal biochemical test and treatment was randomly done with citrate or calcium carbonate. Results : After 60 days of supplementation, biochemical tests were repeated, showing improvement in both groups. Conclusion : Supplementation with calcium (citrate or carbonate) and vitamin D is recommended after surgery for prevention of secondary hyperparathyroidism. PMID:26537273
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Soundarya, N; Sharada, P; Prakash, Nilima; Pradeep, GL
2011-01-01
Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to hyperparathyroidism, resulting in a local destructive phenomenon. The classical “brown tumor” is commonly seen in ends of long bones, the pelvis and ribs. Facial involvement is rare and, when present, usually involves the mandible. We report a case of 60-year-old male with a rare initial presentation of primary hyperparathyroidism with bilateral maxillary brown tumors. The present case represents the third report of the bilateral maxillary brown tumors in a patient with primary hyperparathyroidism. Differential diagnosis is important for the right treatment choice. It should exclude other giant cell lesions that affect the maxillae. PMID:21731279
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Primary hyperparathyroidism and proximal renal tubular acidosis: Report of two cases
Siddiqui, Abdullah A.; Wilson, Douglas R.
1972-01-01
Two cases of primary hyperparathyroidism due to single parathyroid adenomas presented with the additional feature of hyperchloremic acidosis. The defect in urinary acidification responsible was not of the distal or gradient-limited type since both patients could lower urine pH adequately. However, there was a defect of bicarbonate reabsorption, an abnormality referred to as the proximal or rate-limited type of renal tubular acidosis. It is suggested that this defect represents an exaggeration of the physiological effect of parathormone on bicarbonate reabsorption and may be responsible for the frequent finding of hyperchloremia in association with primary hyperparathyroidism as well as for the urinary bicarbonate-wasting associated with a variety of causes of secondary hyperparathyroidism. PMID:5012229
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Treatment of Autonomous Hyperparathyroidism in Post Renal Transplant Recipients
2017-02-07
Chronic Allograft Nephropathy; Chronic Kidney Disease; Chronic Renal Failure; Disordered Mineral Metabolism; End Stage Renal Disease; Hyperparathyroidism; Hypophosphatemia; Kidney Disease; Kidney Transplantation; Post Renal Transplantation
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Secondary hyperparathyroidism and its relationship with sarcopenia in elderly women.
de Souza Genaro, Patrícia; de Medeiros Pinheiro, Marcelo; Szejnfeld, Vera Lúcia; Martini, Lígia Araújo
2015-01-01
Low dietary intake of calcium and poor vitamin D status during aging can result in mild secondary hyperparathyroidism, which may be associated with low muscle mass and reduced strength in the elderly. The aim of this study was to investigate whether low vitamin D, high parathormone (PTH), or both, are associated with sarcopenia. A total of 105 women, 35 with sarcopenia and 70 without sarcopenia, were enrolled in the present study. Body composition measurements were performed by DXA and sarcopenia was defined as skeletal muscle mass index<5.45 kg/m2 and grip strength lower than 20 kg. Three-day dietary records were taken and adjustments for energy intake made. The estimated average requirement (EAR) method was adopted as a cut-off point for estimating the prevalence of inadequate intake. Serum total calcium, phosphorus, creatinine, intact PTH, and 25(OH)D were measured. Only 1% of the patients met the daily adequate intake for vitamin D and 11% met the daily adequate intake for calcium. Notably, the prevalence of sarcopenia was higher in hyperparathyroidism (25(OH)D<20 ng/mL and PTH>65 pg/dL) than in the absence of hyperparathyroidism (41.2 vs 16.2%, respectively; p=0.046). The odds ratio for sarcopenia in hyperparathyroidism cases was 6.81 (95%CI 1.29-35.9) compared with participants who had low PTH and a high 25(OH)D concentration. The present study showed that vitamin D insufficiency associated with secondary hyperparathyroidism increased the risk of sarcopenia, suggesting that the suppression of hyperparathyroidism by ensuring adequate calcium and vitamin D intake should be considered in interventional studies to confirm potential benefits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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76 FR 84 - Notice of Environmental Impact Statement; Withdrawal
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-03
... DEPARTMENT OF AGRICULTURE Forest Service Notice of Environmental Impact Statement; Withdrawal... statement. SUMMARY: The United States Department of Agriculture, Forest Service, Prescott National Forest... that significant impacts to the environment would be highly unlikely, and therefore an Environmental...
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Hyperparathyroidism: retrospect and prospect.
Taylor, S.
1976-01-01
The history of hyperparathyroidism is outlined and the diagnosis and treatment of its various causes reviewed with reference to a series of 153 patients operated on for hyperparathyroidism in the past 20 years. In 119 cases the condition was primary, being due to a tumour or hyperplasia. Future developments in this field are briefly considered. Images Fig. 1 Fig. 3 Fig. 4 Fig. 2 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 PMID:782326
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Hyperparathyroidism After Irradiation for Childhood Malignancy
DOE Office of Scientific and Technical Information (OSTI.GOV)
McMullen, Todd; Bodie, Greg; Gill, Anthony
Purpose: To examine the occurrence of hyperparathyroidism in a cohort of patients undergoing combined parathyroid and thyroid surgery after previous head-and-neck irradiation for childhood malignancy. Methods and Materials: This is a retrospective cohort study for the years 1996 to 2007. The study group comprised patients undergoing surgery in University of Sydney Endocrine Surgical Unit who had received previous head-and-neck irradiation in childhood and who were identified as having pathologic thyroid and parathyroid characteristics. Results: A total of 53 patients were identified in whom head-and-neck irradiation for the treatment of childhood malignancy had been documented. In each of the cases, thyroidmore » disease was the primary reason for referral for surgery. Five of these patients (10%) were found to exhibit coexisting hyperparathyroidism. The latency period for hyperparathyroidism was less than 20 years in 4 of the 5 cases. There were four conventional parathyroid adenomas and one parathyroid lipoadenoma. All patients exhibited a significant decrease in postoperative calcium levels after surgery. Conclusions: To our knowledge, this is the first study to document the significant risk of hyperparathyroidism after radiation exposure for childhood malignancy. The timeframe for development of disease is much shorter than that published for individuals who have undergone irradiation for benign diseases. High doses of therapeutic radiation at a young age make childhood survivors of malignancy at especially high risk for developing hyperparathyroidism.« less
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-21
... DEPARTMENT OF ENERGY Notice of Intent To Prepare a Programmatic Environmental Impact Statement for...: Notice of intent to prepare a programmatic environmental impact statement for the DOE Uranium Leasing Program. SUMMARY: DOE announces its intent to prepare a Programmatic Environmental Impact Statement (PEIS...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-11
... Environmental Impact Statement; West Waukesha Bypass, Waukesha County, WI AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent to prepare an Environmental Impact Statement. SUMMARY: The FHWA is issuing this notice to advise the public that an Environmental Impact Statement (EIS) will be prepared for...
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75 FR 22577 - Proposed Privacy Policy Statement
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2010-04-29
... ELECTION ASSISTANCE COMMISSION Proposed Privacy Policy Statement AGENCY: U.S. Election Assistance Commission. ACTION: Notice and request for public comment on Proposed Privacy Policy Statement. SUMMARY: The U.S. Election Assistance Commission (EAC) seeks public comment on the Proposed Privacy Policy...
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Muthu, John; Ali, Mir
2016-01-01
Patients with sickle cell disease have high morbidity and healthcare utilization due to repeated painful crises. Some coexisting conditions which cause pain similar to sickle cell disease may go undiagnosed in these patients. We report two adults with concurrent hyperparathyroidism who experienced significant improvement in sickle cell pain following parathyroidectomy thereby pointing to hyperparathyroidism as the principal causative factor for their pain. Meticulous evaluation for parathyroid disorders can be rewarding in sickle cell disease.
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Muthu, John
2016-01-01
Patients with sickle cell disease have high morbidity and healthcare utilization due to repeated painful crises. Some coexisting conditions which cause pain similar to sickle cell disease may go undiagnosed in these patients. We report two adults with concurrent hyperparathyroidism who experienced significant improvement in sickle cell pain following parathyroidectomy thereby pointing to hyperparathyroidism as the principal causative factor for their pain. Meticulous evaluation for parathyroid disorders can be rewarding in sickle cell disease. PMID:27579039
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The calcium receptor and calcimimetics.
Wada, M; Nagano, N; Nemeth, E F
1999-07-01
Parathyroid cells can sense small changes in plasma Ca2+ levels by virtue of a cell surface Ca2+ receptor. Calcimimetics are newly synthesized compounds that act as agonists or positive allosteric modulators at the Ca2+ receptor and can suppress parathyroid hormone secretion. The first-generation calcimimetic, NPS R-568, has undergone clinical trials in primary hyperparathyroidism and in hyperparathyroidism secondary to chronic renal insufficiency. The data accumulated so far demonstrate that calcimimetics have potential as therapeutic agents for hyperparathyroidism and related bone diseases such as osteitis fibrosa.
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Vysetti, Suneetha; Sridhar, Preethi; Theckedath, Boby; Gilden, Janice L; Morawiecki, Peter
2012-10-01
The occurrence of a papillary thyroid carcinoma in a patient with primary hyperparathyroidism is rare. Awareness of this condition will enable clinicians to evaluate for possible thyroid pathology in patients with primary hyperparathyroidism. Both of these endocrine conditions could then be managed with a single surgery involving concomitant resection of the thyroid and parathyroid glands. We report a case of a 53-year-old woman with a parathyroid adenoma and a unilateral papillary thyroid carcinoma, and detail the clinical features, diagnosis, and management.
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78 FR 63380 - Farm Credit Administration Board Policy Statements
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2013-10-24
... FARM CREDIT ADMINISTRATION 12 CFR Chapter VI Farm Credit Administration Board Policy Statements AGENCY: Farm Credit Administration. ACTION: Notice of policy statements and index. SUMMARY: The Farm Credit Administration (FCA), as part of its annual public notification process, is publishing for notice...
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78 FR 20714 - Environmental Impact Statement: Cook County, Illinois
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2013-04-05
... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement: Cook... Department of Transportation, is preparing an environmental impact statement (EIS) on a proposal to improve.... SUMMARY: The FHWA is issuing this revised notice of intent to advise the public that an environmental...
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Intrinsic Limitations to Unilateral Parathyroid Exploration
Moore, Francis D.; Mannting, Finn; Tanasijevic, Milenko
1999-01-01
Objective To evaluate a method of limited parathyroid exploration for primary hyperparathyroidism. Summary Background Data Although preoperative localization of parathyroid adenomas has become sensitive enough for clinical practice, it has not achieved success as the basis for limited parathyroid exploration, because multiglandular disease is routinely underdiagnosed. The rapid intraoperative parathyroid hormone assay is sensitive for multiglandular disease, because hormone levels will not fall within 10 minutes of adenoma removal if additional abnormal tissue is present. A combination technique in which the exploration is limited according to the localization studies and the success is confirmed with the parathyroid hormone assay has promise for producing a high rate of curative limited parathyroid explorations. Methods Forty-eight consecutive patients with primary hyperparathyroidism and indications for surgery underwent preoperative localization. After tests, 45 patients underwent unilateral parathyroid exploration and confirmation of the success of unilateral exploration during surgery using the rapid parathyroid hormone assay. The intraoperative management of these patients and their follow-up to 3 months was recorded. Results Thirty-two of the 48 patients (67%) had successful unilateral exploration as gauged by a marked drop in parathyroid hormone levels during the procedure and by 3-month clinical follow-up. Of the 16 patients who ultimately underwent bilateral exploration, 7 had parathyroid hormone levels that did not fall after adenoma removal. Of these seven, five were found to have a second adenoma and two had slow metabolism of hormone with no additional abnormal tissue found. In 5 of the 16 patients, bilateral exploration was performed for erroneous localization. Four additional patients underwent bilateral exploration for improved exposure or negative results on localization tests. Conclusions These results show that unilateral parathyroid exploration is limited by the intrinsic 15% rate of multiglandular primary hyperparathyroidism, combined with the imperfections of preoperative localizing techniques. Although an 85% rate of unilateral exploration can theoretically be obtained for unselected cases, the other vagaries of the technique make a 70% rate a more reasonable expectation. PMID:10493485
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ERIC Educational Resources Information Center
Charbonneau, Gary; And Others
This paper describes some of the problems encountered and the resolutions reached in converting Indiana University Libraries serials holdings information to the format specified in the 1980 American National Standard for Serial Holdings Statements at the Summary Level (ANSI). It is noted that this project was part of the development--by OCLC--of…
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Qaseem, Amir; Snow, Vincenza; Owens, Douglas K; Shekelle, Paul
2010-08-03
The American College of Physicians (ACP) established its evidence-based clinical practice guidelines program in 1981. The ACP's Guidelines Committee and the staff of the Clinical Programs and Quality of Care Department develop the clinical recommendations. The ACP develops 2 different types of clinical recommendations: clinical practice guidelines and clinical guidance statements. The ACP clinical practice guidelines and guidance statements follow a multistep development process that includes a systematic review of the evidence, deliberation of the evidence by the committee, summary recommendations, and evidence and recommendation grading. All ACP clinical practice guidelines and clinical guidance statements, if not updated, are considered automatically withdrawn or invalid 5 years after publication or once an update has been issued.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-14
... and Draft Environmental Impact Statement: Highway 35, Between Norfolk and South Sioux City, NE AGENCY... Environmental Impact Statement. SUMMARY: The FHWA is issuing this notice to advise the public that we are rescinding the Notice of Intent (NOI) and Draft Environmental Impact Statement (DEIS) for improvements that...
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Oyama, Yuko; Kazama, J James; Maruyama, Hiroki; Narita, Ichiei; Kanbayashi, Chizuko; Koyama, Yu; Omori, Tsukasa; Hatakeyama, Katsuyoshi; Gejyo, Fumitake
2003-06-01
Therapy combining radioguided parathyroidectomy (PTx) followed by intravenous maxacalcitol was given to a 50-year-old Japanese man referred for treatment of uraemic secondary hyperparathyroidism. After laboratory and radiological examinations, the patient underwent uncomplicated, successful surgery, but glands that had not been detected radiologically before the procedure became apparent with a scintillation counter immediately after the removal of the swollen gland. To prevent relapse of secondary hyperparathyroidism in the remaining glands, 10 microg of maxacalcitol was injected intravenously after each dialysis session. Following a minimally invasive radioisotope-guided PTx, the potential risk of relapse in the remaining glands has to be considered and intensive medical therapy should be instituted immediately after the operation. Further study needs to elucidate whether this treatment strategy can improve the long-term prognosis of patients with secondary hyperparathyroidism
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Heist, Brian S; Kishida, Naoki; Deshpande, Gautam; Hamaguchi, Sugihiro; Kobayashi, Hiroyuki
2016-02-01
In Western clinical training, formulation of a summary statement (SS) is a core exercise for articulation, evaluation, and improvement of clinical reasoning (CR). In Japanese clinical training, structured guidance in developing CR, including opportunity for SS practice, is uncommon, and the present status of case summarization skills is unclear. We used Virtual Patients (VPs) to explore Japanese junior residents' SS styles and the effectiveness of VPs on improving SS quality. All first-year junior resident physicians at 4 residency programs (n = 54) were assigned randomized sequences of 5 VP modules, rolled out at 6 day intervals. During each module, participants free-texted a case summary and then reviewed a model summary. Thematic analysis was used to identify SS styles and each SS was categorized accordingly. Frequency of SS styles, and SS CR quality determined by 1) an internally developed Key Feature rubric and 2) demonstration of semantic qualification, were compared across modules. Four SS styles were identified: numbered features matched to differential diagnoses, differential diagnoses with supportive comments, feature listing, and narrative summarization. From module #1 to #5, significant increases in the narrative summarization SS style (p = 0.016), SS CR quality score (p = 0.021) and percentage of semantically driven SS (p = 0.003) were observed. Our study of Japanese junior residents identified distinct clinical case summary statement styles, and observed adoption of the narrative summarization style and improvement in the CR quality of summary statements during a series of VP cases.
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ERIC Educational Resources Information Center
Casper Coll., WY.
These three brief documents, a policy statement, a summary of pertinent laws on alcohol and illegal drugs, and a substance addiction specialist curriculum description, taken together describe the Casper College (Wyoming) drug and alcohol abuse prevention program. The policy statement briefly summarizes the health risks associated with drug and…
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Rodríguez, Mariano; Goodman, William G; Liakopoulos, Vassilios; Messa, Piergiorgio; Wiecek, Andrzej; Cunningham, John
2015-01-01
Until the discovery of calcimimetics, the management of secondary hyperparathyroidism (SHPT) relied exclusively on treatment with phosphate binders, vitamin D derivatives or surgical parathyroidectomy with limited success. The therapeutic use of calcimimetic agents, together with a better understanding of the pivotal role of the calcium-sensing receptor (CaSR) in the physiological regulation of parathyroid gland function, substantially advanced the management of hyperparathyroidism in dialysis practice. Calcimimetics bind selectively to the CaSR receptor in parathyroid tissue and enhance the inhibitory effect of extracellular calcium ions on parathyroid hormone (PTH) secretion, thereby reducing PTH levels even when serum calcium concentrations are normal or low. The availability of calcimimetic agents for clinical use has opened a new era in the management of patients with SHPT. Indeed, calcimimetic compounds have been shown to reduce PTH levels and to lower serum calcium concentrations in all forms of hyperparathyroidism, including primary hyperparathyroidism (PHPT) and parathyroid carcinoma. Such findings underscore the critical importance of the CaSR as a therapeutic target in this family of clinical disorders. New calcimimetic agents are being developed that have the potential to offer improved efficacy and safety compared with currently available calcimimetic compounds. © 2015 Wiley Periodicals, Inc.
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Primary hyperparathyroidism associated with a giant cell tumor: One case in the distal radius.
Ouzaa, M R; Bennis, A; Iken, M; Abouzzahir, A; Boussouga, M; Jaafar, A
2015-10-01
Hyperparathyroidism can present itself as brown tumors (or osteolytic expansive lesions) that usually disappear after normalization of calcium and phosphate levels. It rarely occurs simultaneously with a giant cell tumor. The authors report one case of a localized form at the distal radius in a patient being followed for primary hyperparathyroidism. The diagnostic challenges related to the clinical and radiological similarities of these two pathological entities are discussed, as they can lead to delays in therapeutic management. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-14
...] Supplemental Environmental Impact Statement for Replacement of NOAA National Marine Fisheries Service Southwest... and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of intent to prepare a Supplemental Environmental Impact Statement (SEIS); request for comments. SUMMARY: NOAA announces its intention to prepare an...
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Skelly, Andrea C; Hashimoto, Robin E; Norvell, Daniel C; Dettori, Joseph R; Fischer, Dena J; Wilson, Jefferson R; Tetreault, Lindsay A; Fehlings, Michael G
2013-10-15
Review of methods. To provide a detailed description of the methods undertaken in the articles in this focus issue pertaining to cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) and to describe the process used to develop summary statements and clinical recommendations regarding factors associated with the mechanisms, diagnosis, progression, and treatment of CSM and OPLL. We present methods used in conducting the systematic, evidence-based reviews and development of expert panel summary statements and clinical recommendations of the mechanisms, diagnosis, progression, and treatment of CSM and OPLL. Our intent is that clinicians will combine the information from these systematic reviews, narrative reviews, and primary research studies with an understanding of their own capacities and experience to better manage patients with CSM or OPLL and consider future research for the diagnosis and treatment of these diseases. For the systematic reviews, which make up the bulk of the studies in this focus issue, a systematic search and critical review of the English language literature was undertaken for articles published on the mechanisms, diagnosis, progression, and treatment of CSM and OPLL. Articles were screened for relevance using a priori criteria and relevant articles were critically reviewed. Whether an article was included for review depended on whether the study question was descriptive, one of therapy, or one of prognosis. The strength of evidence for the overall body of literature in each topic area was determined by 2 independent reviewers considering risk of bias, consistency, directness, and precision of results using a modification of the Grading of Recommendation Assessment, Development and Evaluation criteria. Disagreements were resolved by consensus. Findings from articles meeting inclusion criteria were summarized. From these summaries, summary statements or clinical recommendations were formulated among subject experts through a modified Delphi process using the Grading of Recommendation Assessment, Development and Evaluation approach. Methods for the 2 primary research studies and the narrative reviews are also reviewed. Because of the nature of questions that needed to be addressed, not all studies in this focus issue were amenable to systematic review. As a result, this focus issue consists of several different article types, including 1 research protocol, 2 primary research studies, 2 narrative literature reviews, 7 systematic reviews, and 3 articles that combine a systematic review component with either a narrative section (n = 2) or a provider survey (n = 1). In general, the strength of evidence ratings ranged from insufficient to moderate. Summary statements or clinical recommendations were made according to available evidence and study type: 16 summary statements were made across 8 articles, and 17 clinical recommendations were made across 9 articles. Three articles had both summary statements and clinical recommendations, 5 had summary statements only, 6 had clinical recommendations only, and 1 (the research protocol) was not amenable to either. Systematic reviews, narrative reviews, and primary research studies were undertaken to understand the mechanisms, diagnosis, progression, and treatment of CSM and OPLL and to provide summary statements and clinical recommendations. This article reports the methods used in the studies in this focus issue. SUMMARY STATEMENTS: The objectives of this focus issue were met using a variety of article and study designs, each of which has some unique methodological aspects associated with it. The reader should refer to the full article in this issue for additional details specific to that topic. The methods for systematic review follow accepted standards for rigor and, together with the application of Grading of Recommendation Assessment, Development and Evaluation, are intended to allow for transparency in the process for creating the clinical recommendation.
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2014-07-14
Chronic Kidney Disease; End Stage Renal Disease; Coronary Artery Calcification; Vascular Calcification; Calcification; Cardiovascular Disease; Chronic Renal Failure; Hyperparathyroidism; Kidney Disease; Nephrology; Secondary Hyperparathyroidism
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Federal Register 2010, 2011, 2012, 2013, 2014
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... to prepare an environmental impact statement. SUMMARY: The Ashley National Forest in cooperation with... analysis must be received by August 5, 2010. The draft environmental impact statement is expected February 2011 and the final environmental impact statement is expected June 2011. ADDRESSES: Send written...
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...; Klamath County, Oregon; Marsh Project Environmental Impact Statement AGENCY: Forest Service, USDA. ACTION: Notice of intent to prepare an environmental impact statement. SUMMARY: The USDA, Forest Service, will prepare an environmental impact statement (EIS) for a project called Marsh, in the southwestern portion of...
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77 FR 66480 - Final Environmental Impact Statement, Narrows Project, Sanpete County, Utah
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... DEPARTMENT OF ENERGY Western Area Power Administration Notice of Cancellation of Environmental...: Western Area Power Administration, DOE. ACTION: Cancellation of Environmental Impact Statement. SUMMARY... notice to advise the public that it is cancelling the preparation of an environmental impact statement...
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Herber, Oliver Rudolf; Bücker, Bettina; Metzendorf, Maria-Inti; Barroso, Julie
2017-12-01
Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary. The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques. Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies. Meta-summary techniques include: (1) extraction of relevant statements of findings from each report; (2) reduction of these statements into abstracted findings and (3) calculation of effect sizes. Databases were searched systematically for qualitative studies published between January 2010 and July 2015. Out of 2264 papers identified, 31 reports based on the accounts of 814 patients were included in the meta-summary. A total of 37 statements of findings provided a comprehensive inventory of findings across all reports. Out of these statements of findings, 21 were classified as barriers, 13 as facilitators and three were classed as both barriers and facilitators. The main themes relating to barriers and facilitators to self-care were: beliefs, benefits of self-care, comorbidities, financial constraints, symptom recognition, ethnic background, inconsistent self-care, insufficient information, positive and negative emotions, organizational context, past experiences, physical environment, self-initiative, self-care adverse effects, social context and personal preferences. Based on the meta-findings identified in this study, future intervention development could address these barriers and facilitators in order to further enhance self-care abilities in heart failure patients.
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12 CFR 708b.106 - Approval of the merger proposal by members.
Code of Federal Regulations, 2010 CFR
2010-01-01
... summary of the merger plan, including, but not necessarily limited to, current financial statements for each credit union, a consolidated financial statement for the continuing credit union, analyses of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-25
... environment. Affected Federal, state, or local agencies, affected Indian tribes, and other interested private... Environmental Impact Statement for Update of the Shoreline Management Plan and Supplement to the Master Plan... intent. SUMMARY: The purpose of the Environmental Impact Statement (EIS) is to address alternatives and...
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... interchange at Seltice. Impacts to the social, economic, and natural environment were minimal. After receiving... to Prepare an Environmental Impact Statement (EIS), Kootenai County, ID AGENCY: Federal Highway Administration. ACTION: Rescind Notice of Intent to prepare an Environmental Impact Statement. SUMMARY: The FHWA...
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2011-09-12
... Environmental Impact Statement for General Management Plan for Golden Gate National Recreation Area and Muir... Management Plan for Golden Gate National Recreation Area and Muir Woods National Monument. SUMMARY: In accord... Environmental Impact Statement (Draft EIS) for the updating the General Management Plan (GMP) for Golden Gate...
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78 FR 71435 - Policy Statement on the Scenario Design Framework for Stress Testing
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-29
... Statement III. Summary of Comments A. Design of Stress Test Scenarios B. Additional Variables C. Severely... policy statement and its overall organization. A. Design of Stress Test Scenarios Commenters suggested a variety of ways for the Board to alter or improve the design of stress test scenarios, including by making...
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2012-06-01
... of Intent To Prepare Environmental Impact Statement for Alcatraz Ferry Embarkation Site, Golden Gate.... ACTION: Notice of Intent to Prepare an Environmental Impact Statement for Alcatraz Ferry Embarkation Site. SUMMARY: In accordance with Sec. 102(2)(C) of the National Environmental Policy Act (NEPA) of 1969, and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-25
... DEPARTMENT OF THE INTERIOR National Park Service [NPS-PWR-PWRO--0315-696; 8145-8B90-SZM] Dog... Impact Statement/Dog Management Plan, Golden Gate National Recreation Area. SUMMARY: The National Park Service has prepared a Draft Dog Management Plan and Environmental Impact Statement (Plan/DEIS). The Plan...
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Clinical and computed tomography features of secondary renal hyperparathyroidism
Vanbrugghe, Benoît; Blond, Laurent; Carioto, Lisa; Carmel, Eric Norman; Nadeau, Marie-Eve
2011-01-01
An atypical case of secondary renal hyperparathyroidism was diagnosed in a 9-year-old miniature schnauzer after a skull computed tomography (CT) showed the presence of 2 bilateral and symmetrical soft tissue maxillary masses, and osteopenia of the skull. PMID:21532826
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Pino Rivero, V; Pantoja Hernández, C G; González Palomino, A; Trinidad Ruíz, G; Marcos García, M; Keituqwa Yáñez, T; Pardo Romero, G; Blasco Huelva, A
2005-01-01
Sonnography and Tc-99m sestamibi scintigraphy are the most requested preoperative imaging tests nowdays in the surgery of hyperparathyroidism. The aim of our article is to know if Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) are useful as a location study and in which cases it would be more justified to ask these radiologic techniques. For that we report our results with 29 patients at all diagnosed as hyperparathyroidism (26 primary forms and 3 secondary ones) and operated by our E.N.T. Department later. On 20 of them a cervical CT was asked before the parathyroidectomy and on the rest 9, a MRI with sensitivities of 65% and 88.9% respectively. We think both complementary explorations must not be solicited by routine but they can represent a help in the cases in that sonnography and scintigraphy are not able to show the possible adenoma or hiperplasia, particularly in recurrent hyperparathyroidisms, reinterventions or suspect of parathyroid glands in an atypical location.
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Hypercalcemic crisis: a clinical review.
Ahmad, Shazia; Kuraganti, Gayatri; Steenkamp, Devin
2015-03-01
Hypercalcemia is a common metabolic perturbation. However, hypercalcemic crisis is an unusual endocrine emergency, with little clinical scientific data to support therapeutic strategy. We review the relevant scientific English literature on the topic and review current management strategies after conducting a PubMed, MEDLINE, and Google Scholar search for articles published between 1930 and June 2014 using specific keywords: "hypercalcemic crisis," "hyperparathyroid crisis," "parathyroid storm," "severe primary hyperparathyroidism," "acute hyperparathyroidism," and "severe hypercalcemia" for articles pertaining to the diagnosis, epidemiology, clinical presentation, and treatment strategies. Despite extensive clinical experience, large and well-designed clinical studies to direct appropriate clinical care are lacking. Nonetheless, morbidity and mortality rates have substantially decreased since early series reported almost universal fatality. Improved outcomes can be attributed to modern diagnostic capabilities, leading to earlier diagnosis, along with the recognition that primary hyperparathyroidism is the most common etiology for hypercalcemic crisis. Hypercalcemic crisis is an unusual endocrine emergency that portends excellent outcomes if rapid diagnosis, medical treatment, and definitive surgical treatment are expedited. Copyright © 2015 Elsevier Inc. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Eftekhari, F.; Yousefzadeh, D.K.
Two cases of primary infantile hyperparathyroidism (PIH) are reported. In both cases the diagnosis was initially suspected from chest radiographs which were obtained to assess the etiology of fever and respiratory distress in one case and heart murmur in another. The first case responded well to subtotal parathyroidectomy. The second case had many unique features. (1) She never became overtly symptomatic. (2) She displayed a constellation of findings that are not yet emphasized. (3) Her indisputable radiographic findings of hyperparathyroidism vanished spontaneously by two months of age, whereas her biochemical alterations have persisted up to now, 2 1/2 years aftermore » birth. (4) Three members of her family have subclinical hyperparathyroidism (elevated serum parathormone, hypercalcemia, and hypophosphatemia). Our review of 19 more cases showed that PIH has no specific clinical symptoms and/or signs. Of the laboratory findings, hypercalcemia was most consistantly encountered. The radiographic findings, although not identical to those described in hyperparathyroid adults, had the greatest diagnostic specificity. The disorder carried a grave prognosis if not diagnosed promptly and managed surgically.« less
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Rare Skeletal Complications in the Setting of Primary Hyperparathyroidism
Sabanis, Nikos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Papanikolaou, Dimitrios; Ioannidou, Pinelopi; Vasileiou, Sotirios
2015-01-01
Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations which vary from asymptomatic patients to severe complications of hypercalcemia or parathyrotoxicosis while skeletal involvement is rather common. Herein we aimed at presenting a unique case of a young patient with rare aggressive skeletal complications of parathyroid cancer that initially were misdiagnosed. Ossification of the cervical ligamentum flavum and skull tumor illustrates erosive bonny lesions of hyperparathyroidism that in association with previous medical history of recurrent nephrolithiasis and biochemical findings guide the diagnosis. We suggest that increased awareness and holistic approach are needed in order to recognize and further investigate signs and symptoms of hyperparathyroidism. PMID:26664767
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Rare Skeletal Complications in the Setting of Primary Hyperparathyroidism.
Sabanis, Nikos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Papanikolaou, Dimitrios; Ioannidou, Pinelopi; Vasileiou, Sotirios
2015-01-01
Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations which vary from asymptomatic patients to severe complications of hypercalcemia or parathyrotoxicosis while skeletal involvement is rather common. Herein we aimed at presenting a unique case of a young patient with rare aggressive skeletal complications of parathyroid cancer that initially were misdiagnosed. Ossification of the cervical ligamentum flavum and skull tumor illustrates erosive bonny lesions of hyperparathyroidism that in association with previous medical history of recurrent nephrolithiasis and biochemical findings guide the diagnosis. We suggest that increased awareness and holistic approach are needed in order to recognize and further investigate signs and symptoms of hyperparathyroidism.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-09
...] Notice of Availability of the Draft Environmental Impact Statement for the Ochoa Mine Project in Lea County, New Mexico AGENCY: Bureau of Land Management, Interior. ACTION: Notice of availability. SUMMARY... Draft Environmental Impact Statement (EIS) for the Ochoa Mine Project (Project) and by this notice is...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-17
... Environmental Impact Statement for the Silver Strand Training Complex AGENCY: Department of the Navy, DoD. ACTION: Notice. SUMMARY: A notice of availability was published by the U.S. Environmental Protection... (SSTC) Draft Environmental Impact Statement (EIS). The public review period ended on March 8, 2010. This...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-17
... Agency meetings were held on November 8, 2007 and December 11, 2008. Environmental scans and screening... To Prepare an Environmental Impact Statement, Ada and Canyon Counties, ID AGENCY: Federal Highway Administration. ACTION: Rescind Notice of Intent to prepare an Environmental Impact Statement. SUMMARY: The FHWA...
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1986-05-05
AVF-VSR-36.0187 Ada" COMPILER VALIDATION SUMMARY REPORT: International Business Machines Corporation IBM Development System for the Ada Language for...withdrawn from ACVC Version 1.7 were not run. The compiler was tested using command scripts provided by International Business Machines Corporation. These...APPENDIX A COMPLIANCE STATEMENT International Business Machines Corporation has submitted the following compliance statement concerning the IBM
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Lerma, Elisabet; Molas, M Ema; Montero, M Milagro; Guelar, Ana; González, Alicia; Villar, Judith; Diez, Adolf; Knobel, Hernando
2012-01-01
Vitamin D deficiency is an important problem in patients with chronic conditions including those with human immunodeficiency virus (HIV) infection. The aim of this cross-sectional study was to identify the prevalence and factors associated with vitamin D deficiency and hyperparathyroidism in HIV patients attended in Barcelona. Cholecalciferol (25OH vitamin D3) and PTH levels were measured. Vitamin D insufficiency was defined as 25(OH) D < 20 ng/mL and deficiency as <12 ng/mL. Hyperparathyroidism was defined as PTH levels >65 pg/mL. Cases with chronic kidney failure, liver disease, treatments or conditions potentially affecting bone metabolism were excluded. Among the 566 patients included, 56.4% were exposed to tenofovir. Vitamin D insufficiency was found in 71.2% and 39.6% of those had deficiency. PTH was measured in 228 subjects, and 86 of them (37.7%) showed high levels. Adjusted predictors of vitamin D deficiency were nonwhite race and psychiatric comorbidity, while lipoatrophy was a protective factor. Independent risk factors of hyperparathyroidism were vitamin D < 12 ng/mL (OR: 2.14, CI 95%: 1.19-3.82, P: 0.01) and tenofovir exposure (OR: 3.55, CI 95%: 1.62-7.7, P: 0.002). High prevalence of vitamin deficiency and hyperparathyroidism was found in an area with high annual solar exposure.
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Lerma, Elisabet; Molas, M. Ema; Montero, M. Milagro; Guelar, Ana; González, Alicia; Villar, Judith; Diez, Adolf; Knobel, Hernando
2012-01-01
Vitamin D deficiency is an important problem in patients with chronic conditions including those with human immunodeficiency virus (HIV) infection. The aim of this cross-sectional study was to identify the prevalence and factors associated with vitamin D deficiency and hyperparathyroidism in HIV patients attended in Barcelona. Cholecalciferol (25OH vitamin D3) and PTH levels were measured. Vitamin D insufficiency was defined as 25(OH) D < 20 ng/mL and deficiency as <12 ng/mL. Hyperparathyroidism was defined as PTH levels >65 pg/mL. Cases with chronic kidney failure, liver disease, treatments or conditions potentially affecting bone metabolism were excluded. Among the 566 patients included, 56.4% were exposed to tenofovir. Vitamin D insufficiency was found in 71.2% and 39.6% of those had deficiency. PTH was measured in 228 subjects, and 86 of them (37.7%) showed high levels. Adjusted predictors of vitamin D deficiency were nonwhite race and psychiatric comorbidity, while lipoatrophy was a protective factor. Independent risk factors of hyperparathyroidism were vitamin D < 12 ng/mL (OR: 2.14, CI 95%: 1.19–3.82, P: 0.01) and tenofovir exposure (OR: 3.55, CI 95%: 1.62–7.7, P: 0.002). High prevalence of vitamin deficiency and hyperparathyroidism was found in an area with high annual solar exposure. PMID:24052874
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Genetics Home Reference: hyperparathyroidism-jaw tumor syndrome
... M, Davie MW, Dudley N, Leite V, Sadler GP, Seller A, Thakker RV. Parafibromin mutations in hereditary hyperparathyroidism syndromes and parathyroid tumours. Clin Endocrinol (Oxf). 2006 Mar;64(3):299-306. Citation on PubMed Iacobone M, Masi G, Barzon L, Porzionato A, Macchi V, Ciarleglio FA, Palù G, ...
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Genetics Home Reference: familial isolated hyperparathyroidism
... MA, Christie PT, Fratter C, Dudley NE, Sadler GP, Thakker RV. Familial isolated primary hyperparathyroidism caused by mutations of the MEN1 gene. Nat Clin Pract Endocrinol Metab. 2008 Jan;4(1):53-8. Citation on PubMed Masi G, Barzon L, Iacobone M, Viel G, Porzionato A, Macchi V, ...
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75 FR 21145 - Availability of the Draft Environmental Impact Statement
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2010-04-22
... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Availability of the Draft... availability of the Draft Environmental Impact Statement. SUMMARY: The FHWA, on behalf of the California Department of Transportation (Caltrans), announces the availability of the Draft Environmental Impact...
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76 FR 79714 - Premium Changes Based On Recharacterization of Contributions
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... PENSION BENEFIT GUARANTY CORPORATION Premium Changes Based On Recharacterization of Contributions AGENCY: Pension Benefit Guaranty Corporation. ACTION: Policy statement. SUMMARY: This policy statement..., Legislative and Regulatory Department, Pension Benefit Guaranty Corporation, 1200 K Street NW., Washington DC...
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77 FR 35031 - 4 OTC, Inc.; Decision and Order
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2012-06-12
...-captioned matter. [ALJ Exhibit Exh. 3]. On May 24, 2010, the Government filed a Motion For Summary Judgment And To Stay The Dates For The Parties To Submit Prehearing Statements (``Motion for Summary Judgment... its response to the Government's Motion for Summary Judgment. Therein, the Respondent stated that it...
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Management of Hypoparathyroidism: Summary Statement and Guidelines.
Brandi, Maria Luisa; Bilezikian, John P; Shoback, Dolores; Bouillon, Roger; Clarke, Bart L; Thakker, Rajesh V; Khan, Aliya A; Potts, John T
2016-06-01
Hypoparathyroidism is a rare disorder characterized by hypocalcemia and absent or deficient PTH. This report presents a summary of current information about epidemiology, presentation, diagnosis, clinical features, and management and proposes guidelines to help clinicians diagnose, evaluate, and manage this disorder. Participants in the First International Conference on the Management of Hypoparathyroidism represented a worldwide constituency with acknowledged interest and expertise in key basic, translational, and clinical aspects of hypoparathyroidism. Three Workshop Panels were constituted to address questions for presentation and discussion at the Conference held in Florence, Italy, May 7-9, 2015. At that time, a series of presentations were made, followed by in-depth discussions in an open forum. Each Workshop Panel also met in closed sessions to formulate the three evidence-based reports that accompany this summary statement. An Expert Panel then considered this information, developed summaries, guidelines, and a research agenda that constitutes this summary statement. Preceding the conference, each Workshop Panel conducted an extensive literature search as noted in the individual manuscripts accompanying this report. All presentations were based upon the best peer-reviewed information taking into account the historical and current literature. This report represents the Expert Panel's synthesis of the conference material placed in a context designed to be relevant to clinicians and those engaged in cutting-edge studies of hypoparathyroidism. This document not only provides a summary of our current knowledge but also places recent advances in its management into a context that should enhance future advances in our understanding of hypoparathyroidism.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-02
..., Statement of Non-Receipt of a Passport, 1405-0146 ACTION: Notice of request for public comments. SUMMARY... Reduction Act of 1995. Title of Information Collection: Statement of Non-Receipt of a Passport. OMB Control... received the passport for which they originally applied. Estimated Number of Respondents: 12,755 per year...
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NASA Technical Reports Server (NTRS)
Kurylo, M. J.; Kaye, J. A.; Decola, P. L.; Friedl, R. R.; Peterson, D. B.
1997-01-01
This document is issued in response to the Clean Air Act Amendment of 1990, Public Law 101-549, which mandates that the National Aeronautics and Space Administration (NASA) and other key agencies submit triennial report to congress and the Environmental Protection Agency. NASA is charged with the responsibility to report on the state of our knowledge of the Earth's upper atmosphere, particularly the Stratosphere. Part 1 of this report summarizes the objectives, status, and accomplishments of the research tasks supported under NASA's Upper Atmosphere Research Program and Atmospheric Chemistry Modeling and Analysis Program for the period of 1994-1996. Part 2 (this document) presents summaries of several scientific assessments, reviews, and summaries. These include the executive summaries of two scientific assessments: (Section B) 'Scientific Assessment of Ozone Depletion: 1994'; (Section C) 'l995 Scientific Assessment of the Atmospheric Effects of Stratospheric Aircraft); end of mission/series statements for three stratospherically-focused measurement campaigns: (Section D) 'ATLAS End-of-Series Statement'; (Section E) 'ASHOE/MAESA End-of-Mission Statement'; (Section F) 'TOTE/VOTE End-of-Mission Statement'; a summary of NASA's latest biennial review of fundamental photochemical processes important to atmospheric chemistry 'Chemical Kinetics and Photochemical Data for Use in Stratospheric Modeling'; and (Section H) the section 'Atmospheric Ozone Research" from the Mission to Planet Earth Science Research Plan, which describes NASA's current and future research activities related to both tropospheric and stratospheric chemistry.
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Osteo-Renal Regulation of Systemic Phosphate Metabolism
Razzaque, Mohammed Shawkat
2011-01-01
Summary Impaired kidney function and subsequent skeletal responses play a critical role in disrupting phosphate balance in chronic kidney disease (CKD) patients with mineral and bone disorder (CKD-MBD). In patients with CKD-MBD, the inability of the kidney to maintain normal mineral ion balance affects bone remodeling to induce skeletal fracture and extraskeletal vascular calcification. In physiological conditions, bone-derived fibroblast growth factor 23 (FGF23) acts on the kidney to reduce serum phosphate and 1,25-dihydroxyvitamin D levels. In humans, increased bioactivity of FGF23 leads to increased urinary phosphate excretion, which induces hypophosphatemic diseases (e.g., rickets/osteomalacia). However, reduced FGF23 activity is associated with hyperphosphatemic diseases (e.g., tumoral calcinosis). In patients with CKD, high serum levels of FGF23 fail to reduce serum phosphate levels and lead to numerous complications, including vascular calcification, one of the important determinants of mortality of CKD-MBD patients. Of particular significance, molecular, biochemical and morphological changes in patients with CKD-MBD are mostly due to osteo-renal dysregulation of mineral ion metabolism. Furthermore, hyperphosphatemia can partly contribute to the development of secondary hyperparathyroidism in patients with CKD-MBD. Relatively new pharmacological agents including sevelamer hydrochloride, calcitriol analogs and cinacalcet hydrochloride are used either alone, or in combination, to minimize hyperphosphatemia and hyperparathyroidism associated complications to improve morbidity and mortality of CKD-MBD patients. This article will briefly summarize how osteo-renal miscommunication can induce phosphate toxicity, resulting in extensive tissue injuries. PMID:21438115
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Sampanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Vasileiou, Sotirios
2016-01-01
Summary Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations. Herein we aimed at presenting an unique case of a young patient with late manifestations of parathyroid cancer and reviewing the relevant literature. A 45-year-old male patient presented in the Outpatient Clinic with an episode of nephrolithiasis. His personal medical history includes: recurrent episodes of nephrolithiasis, laminectomy in the cervical spine due to ossification of the cervical ligamentum flavum and surgical resection of a giant cell tumor of the brain. Laboratory testing revealed findings of primary hyperparathyroidism (serum calcium 16,0 mmol/l phosphorus 1,46 mg/dl and parathyroid hormone/PTH 8560 pg/ml). Neck ultrasound and technetium-99 m sestamibi scan were performed showing a parathyroid tumor. Due to the persistently high serum calcium and PTH levels, the high alkaline phosphatase levels (440 IU/L) and the late manifestations of HPT, surgical excision of the tumor was performed. The tumor was identified as parathyroid carcinoma. Immediately after surgery serum calcium and phosphorus levels were normalized. The patient is on a regular follow-up program with no signs of recurrence or metastasis one year after the excision. We describe the coexistence of rare late manifestations of HPT, which had not been adequately investigated at their onset in this young patient. Therefore, increased awareness is needed in order to recognize and further investigate signs or symptoms of HPT. PMID:27252748
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The role of radionuclide imaging in the surgical management of primary hyperparathyroidism.
Hindié, Elif; Zanotti-Fregonara, Paolo; Tabarin, Antoine; Rubello, Domenico; Morelec, Isabelle; Wagner, Tristan; Henry, Jean-François; Taïeb, David
2015-05-01
Primary hyperparathyroidism is a frequent and potentially debilitating endocrine disorder for which surgery is the only curative treatment. The modalities of parathyroid surgery have changed over the last 2 decades, as conventional bilateral neck exploration is no longer the only surgical approach. Parathyroid scintigraphy plays a major role in defining the surgical strategy, given its ability to orient a targeted (focused) parathyroidectomy and to recognize ectopic locations or multiglandular disease. This review, which represents a collaborative effort between nuclear physicians, endocrinologists, and endocrine surgeons, emphasizes the importance of performing imaging before any surgery for primary hyperparathyroidism, even in the case of conventional bilateral neck exploration. We discuss the advantages and drawbacks of targeted parathyroidectomy and the performance of various scintigraphic protocols to guide limited surgery. We also discuss the optimal strategy to localize the offending gland before reoperation for persistent or recurrent hyperparathyroidism. Finally, we describe the potential applications of novel PET tracers, with special emphasis on (18)F-fluorocholine. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
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Hyperparathyroidism during Pregnancy- A Diagnostic and Therapeutic Challenge
Sharma, Richa; Bhanupriya; Guleria, Kiran; Suneja, Amita
2017-01-01
Primary Hyperparathyroidism (PHP) is a rare event in pregnancy; Maternal complications in PHP patients can be as high as 67%. It can be overlooked easily because of many similar complaints shared by hyperparathyroidism and pregnancy such as nausea and vomiting, gastritis, bone aches, easy fatigability. Hypercalcemic crisis can develop resulting in coma and death. Neonatal effects are tetany and death in about 80% of cases. We report a case, of an antenatal woman at 30 weeks gestation with complains of painful swelling in left lower jaw and below right knee, pain over right hip joint and frequent episodes of gastritis. She was finally diagnosed to have primary hyperparathyroidism and brown tumour due to parathyroid adenoma. The baby was kept in Neonatal Intensive Care Unit (NICU) for three weeks, in view of prematurity with respiratory distress and later developed sepsis with DIC. The patient’s signs and symptoms regressed after parathyroid surgery and the baby was healthy at the time of discharge. This case highlights the progressive deterioration of the patient because of lack of awareness of this disease process and its impact on maternal and foetal morbidity. PMID:29207788
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Habibollahi, Peiman; Shin, Benjamin; Shamchi, Sara P; Wachtel, Heather; Fraker, Douglas L; Trerotola, Scott O
2018-01-01
Parathyroid venous sampling (PAVS) is usually reserved for patients with persistent or recurrent hyperparathyroidism after parathyroidectomy with inconclusive noninvasive imaging studies. A retrospective study was performed to evaluate the diagnostic efficacy of super-selective PAVS (SSVS) in patients needing revision neck surgery with inconclusive imaging. Patients undergoing PAVS between 2005 and 2016 due to persistent or recurrent hyperparathyroidism following surgery were reviewed. PAVS was performed in all patients using super-selective technique. Single-value measurements within central neck veins performed as part of super-selective PAVS were used to simulate selective venous sampling (SVS) and allow for comparison to data, which might be obtained in a non-super-selective approach. 32 patients (mean age 51 ± 15 years; 8 men and 24 women) met inclusion and exclusion criteria. The sensitivity and positive predictive value (PPV) of SSVS for localizing the source of elevated PTH to a limited area in the neck or chest was 96 and 84%, respectively. Simulated SVS, on the other hand, had a sensitivity of 28% and a PPV of 89% based on the predefined gold standard. SSVS had a significantly higher sensitivity compared to simulated SVS (p < 0.001). SSVS is highly effective in localizing the source of hyperparathyroidism in patients undergoing revision surgery for hyperparathyroidism in whom noninvasive imaging studies are inconclusive. SSVS data had also markedly higher sensitivity for localizing disease in these patients compared to simulated SVS.
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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis Executive Summary.
Orlandi, Richard R; Kingdom, Todd T; Hwang, Peter H
2016-02-01
The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). This executive summary consolidates the findings of the ICAR:RS document. ICAR:RS presents over 140 topics in the forms of evidence-based reviews with recommendations (EBRRs) and evidence-based reviews (EBR). The structured recommendations of the EBRR sections are summarized in this executive summary. This summary compiles the EBRRs regarding medical and surgical management of acute RS (ARS) and chronic RS with and without nasal polyps (CRSwNP and CRSsNP). This ICAR:RS Executive Summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS. © 2016 ARS-AAOA, LLC.
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NASA Technical Reports Server (NTRS)
1976-01-01
Enabling technology needs and other requirements to support space industrialization include: large space structures; fabrication and joining processes; single stage to orbit and heavy lift launch vehicles; nuclear and solar space power systems; robotics, manipulators, and teleoperators; biotechnology in space; artificial gravity; the utilization of lunar materials for construction; and the extraction of oxygen and metals from lunar resources. New initiatives (FY 1978) directly supportive or partly related to space industrialization are listed.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-03
... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Termination of... Aviation Administration (FAA), Department of Transportation (DOT). ACTION: Notice. SUMMARY: The Federal Aviation Administration (FAA) announces its decision to terminate the Environmental Impact Statement (EIS...
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75 FR 4417 - Wind Cave National Park, Custer County, SD
Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-27
... DEPARTMENT OF THE INTERIOR Wind Cave National Park, Custer County, SD AGENCY: National Park... Final Environmental Impact Statement, Wind Cave National Park, Custer County, South Dakota. SUMMARY... Management Plan and Final Environmental Impact Statement (Plan), Wind Cave National Park, Custer County...
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77 FR 30046 - Environmental Impact Statement: Wiscasset and Edgecomb, Lincoln County, ME
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-21
... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement: Wiscasset and Edgecomb, Lincoln County, ME AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent to Terminate (Withdraw) EIS. SUMMARY: The FHWA is issuing this notice to advise the...
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75 FR 54220 - Environmental Impact Statement: Skowhegan and Madison, Somerset County, ME
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-03
... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement: Skowhegan and Madison, Somerset County, ME AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent to Terminate (Withdraw) EIS. SUMMARY: The FHWA is issuing this notice to advise the...
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77 FR 30304 - Merchant Marine Personnel Advisory Committee: Intercessional Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-22
... Committee Working Group Meeting. SUMMARY: A working group of the Merchant Marine Personnel Advisory Committee (MERPAC) will meet to discuss Task Statement 76, ``Review of Performance Measures (Assessment Criteria);'' and Task Statement 77, ``Development of Performance Measures (Assessment Criteria).'' This...
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75 FR 5371 - Environmental Impact Statement: Cumberland, Harnett and Wake Counties, NC
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-02
... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement... of Intent. SUMMARY: The FHWA is issuing this notice to advise the public that an environmental impact... INFORMATION CONTACT: Mr. Clarence W. Coleman, P.E., Director of Preconstruction and Environment, Federal...
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... NATIONAL SCIENCE FOUNDATION Notice Regarding Changed Venue for Public Hearing On a Draft Programmatic Environmental Impact Statement/Overseas Environmental Impact Statement (PEIS) AGENCY: National Science Foundation. ACTION: Notice regarding changed venue for public hearing. SUMMARY: The National...
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77 FR 38751 - Codification of Animal Testing Policy
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-29
... Animal Testing Policy AGENCY: Consumer Product Safety Commission. ACTION: Proposed Statement of Policy on Animal Testing SUMMARY: The Consumer Product Safety Commission (CPSC or Commission) proposes to codify its statement of policy on animal testing, as amended, which was previously published in the Federal...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-29
... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Annual Financial Statement of Surety Companies--Schedule F AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management...
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12 CFR 708b.103 - Preparation of merger plan.
Code of Federal Regulations, 2011 CFR
2011-01-01
... includes: (1) Current financial statements for both credit unions; (2) Current delinquent loan summaries and analyses of the adequacy of the Allowance for Loan and Lease Losses account; (3) Consolidated financial statements, including an assessment of the generally accepted accounting principles (GAAP) net...
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12 CFR 708b.103 - Preparation of merger plan.
Code of Federal Regulations, 2010 CFR
2010-01-01
... includes: (1) Current financial statements for both credit unions; (2) Current delinquent loan summaries and analyses of the adequacy of the Allowance for Loan and Lease Losses account; (3) Consolidated financial statements, including an assessment of the generally accepted accounting principles (GAAP) net...
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75 FR 22723 - Stream Protection Rule; Environmental Impact Statement
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-30
... DEPARTMENT OF THE INTERIOR Office of Surface Mining Reclamation and Enforcement 30 CFR Parts 780... of Surface Mining Reclamation and Enforcement, Interior. ACTION: Proposed rule; notice of intent to prepare an environmental impact statement. SUMMARY: We, the Office of Surface Mining Reclamation and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
... for Unemployment Compensation for Federal Employees and Ex-Servicemembers ACTION: Notice. SUMMARY: The... Funds for Unemployment Compensation for Federal Employees and Ex-Servicemembers,'' (Reporting Form ETA... Collection: Statement of Expenditures and Financial Adjustment of Federal Funds for Unemployment Compensation...
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ERIC Educational Resources Information Center
Congress of the U.S., Washington, DC. Senate Committee on Appropriations.
This Congressional Hearing focuses on protecting children from exploitation on the Internet. Opening remarks of Senator Gregg, statements of Senator Hollings, and Senator Mikulski, and statement and summary statement of Hon. Louis J. Freeh, Director of the Federal Bureau of Investigation, Department of Justice, are provided at the beginning of the…
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Deficiencies in FY 1998 DOD Financial Statements and Progress Toward Improved Financial Reporting
1999-11-26
DEFICIENCIES IN FY 1998 DOD FINANCIAL STATEMENTS AND PROGRESS TOWARD IMPROVED FINANCIAL REPORTING Report No. D-2000-041 November 26, 1999 Office... Financial Reporting (Report No. D-2000-041) We are providing this audit report for information and use. It identifies and summarizes the major...8FI-2025.02) Deficiencies in FY 1998 DoD Financial Statements and Progress Toward Improved Financial Reporting Executive Summary Introduction
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Chappell, V. A.; Fenton, S. E.; Flaws, J. A.; Nadal, A.; Prins, G. S.; Toppari, J.; Zoeller, R. T.
2015-01-01
This Executive Summary to the Endocrine Society's second Scientific Statement on environmental endocrine-disrupting chemicals (EDCs) provides a synthesis of the key points of the complete statement. The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems. EDCs such as bisphenol A, phthalates, pesticides, persistent organic pollutants such as polychlorinated biphenyls, polybrominated diethyl ethers, and dioxins were emphasized because these chemicals had the greatest depth and breadth of available information. The Statement also included thorough coverage of studies of developmental exposures to EDCs, especially in the fetus and infant, because these are critical life stages during which perturbations of hormones can increase the probability of a disease or dysfunction later in life. A conclusion of the Statement is that publications over the past 5 years have led to a much fuller understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability. These findings will prove useful to researchers, physicians, and other healthcare providers in translating the science of endocrine disruption to improved public health. PMID:26414233
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Vitamin D, secondary hyperparathyroidism, and preeclampsia123
Scholl, Theresa O; Chen, Xinhua; Stein, T Peter
2013-01-01
Background: Secondary hyperparathyroidism, which is defined by a high concentration of intact parathyroid hormone when circulating 25-hydroxyvitamin D [25(OH)D] is low, is a functional indicator of vitamin D insufficiency and a sign of impaired calcium metabolism. Two large randomized controlled trials examined effects of calcium supplementation on preeclampsia but did not consider the vitamin D status of mothers. Objective: We examined the association of secondary hyperparathyroidism with risk of preeclampsia. Design: Circulating maternal 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone were measured at entry to care (mean ± SD: 13.7 ± 5.7 wk) using prospective data from a cohort of 1141 low-income and minority gravidae. Results: Secondary hyperparathyroidism occurred in 6.3% of the cohort and 18.4% of women whose 25(OH)D concentrations were <20 ng/mL. Risk of preeclampsia was increased 2.86-fold (95% CI: 1.28-, 6.41-fold) early in gestation in these women. Gravidae with 25(OH)D concentrations <20 ng/mL who did not also have high parathyroid hormone and women with high parathyroid hormone whose 25(OH)D concentrations were >20 ng/mL were not at increased risk. Intact parathyroid hormone was related to higher systolic and diastolic blood pressures and arterial pressure at week 20 before clinical recognition of preeclampsia. Energy-adjusted intakes of total calcium and lactose and circulating 25(OH)D were correlated inversely with systolic blood pressure or arterial pressure and with parathyroid hormone. Conclusion: Some women who are vitamin D insufficient develop secondary hyperparathyroidism, which is associated with increased risk of preeclampsia. PMID:23885046
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Gomes, Letícia da Silva; Kulak, Carolina A M; Costa, Tatiana Munhoz da Rocha Lemos; Vasconcelos, Evandro Cezar Guerreiro; Carvalho, Maurício de; Borba, Victoria Zeghbi Cochenski
2015-02-01
Hypercalcemia is found frequently in patients with cancer. Besides the etiology related to the malignancy, other causes should be considered in the differential diagnostic, as primary hyperparathyroidism, granulomatous diseases and the use of thiazide diuretics. We present a case report of a severe hypercalcemia due to a rare association and review the relevant literature. A female patient, 57 years old, sent to the Endocrinology Service of Hospital das Clínicas da Universidade do Paraná (SEMPR) in order to investigate severe hypercalcemia with frequent need of hospitalization. The patient was in chemotherapy treatment for recurrence of clear cell renal cancer. During the investigation she presented high level of parathyroid hormone (PTH) and parathyroid scintigraphy suggestive of hyperplasia/ adenoma of parathyroid, histopathological diagnosis was confirmed after parathyroidectomy. After surgery the patient presented undetectable levels of PTH. However, she continued with progressive increase of serum calcium, with no signs of bone metastases or change in vitamin D metabolism. The investigation showed high levels of PTH-related protein (PTHrP), leading us to the diagnosis of hypercalcemia of malignancy. The patient presented severe hypercalcemia due to the rare association of primary hyperparathyroidism and humoral hypercalcemia of malignancy due to secretion of PTHrP by tumor cells. The presence of isolated primary hyperparathyroidism, as a cause of hypercalcemia in cancer patients, has been described in approximately 5-10% of the patients. However, the association of primary hyperparathyroidism and humoral hypercalcemia of malignancy (which means with concomitant elevation of PTH and PTHrP) is rare, only three cases have been described in the literature.
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The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report.
Rock, Kathy; Fattah, Nariman; O'Malley, Diarmuid; McDermott, Enda
2010-01-29
Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism. We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma. In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.
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76 FR 23337 - Record of Decision
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-26
... Environmental Impact Statement for the Tamiami Trail Modifications: Next Steps Project. SUMMARY: Pursuant to 42... Decision (ROD) for the Final Environmental Impact Statement (FEIS) for the Tamiami Trail (U.S. Highway 41...) to construct modifications to U.S. Highway 41 (Tamiami Trail) that were approved in the 2008 Limited...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-26
... DEPARTMENT OF THE INTERIOR National Park Service Coral Reef Restoration Plan, Draft Programmatic... Coral Reef Restoration Plan, Biscayne National Park. SUMMARY: Pursuant to the National Environmental... availability of a Draft Programmatic Environmental Impact Statement (DEIS) for the Coral Reef Restoration Plan...
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76 FR 36613 - Environmental Impact Statement; Nueces County, TX
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-22
... County, TX AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent (NOI). SUMMARY... (TxDOT) are issuing this notice to advise the public that an environmental impact statement (EIS) will...--Texas Division, 300 East 8th Street, Austin, Texas 78701. Telephone: 512-536-5960. SUPPLEMENTARY...
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These reports provide summaries of the scoping meetings as part of the Supplemental Environmental Impact Statement (SEIS) process for the designation of dredged material disposal sites in Eastern Long Island Sound.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-18
... DEPARTMENT OF THE INTERIOR National Park Service Grand Ditch Breach Restoration Environmental... Restoration, Rocky Mountain National Park, Colorado. SUMMARY: Pursuant to the National Environmental Policy... Statement for the Grand Ditch Breach Restoration, Rocky Mountain National Park, Colorado. This effort will...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-04
... DEPARTMENT OF THE INTERIOR National Park Service Jackson Hole Airport Agreement Extension, Final Environmental Impact Statement, Grand Teton National Park, Wyoming AGENCY: National Park Service, Department of... Jackson Hole Airport Agreement Extension, Grand Teton National Park. SUMMARY: Pursuant to the National...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-28
... Statement, Stehekin River Corridor Implementation Plan, North Cascades National Park Service Complex; Chelan... public comment period. SUMMARY: The National Park Service, in cooperation with the Federal Highway Administration, has prepared a combined Stehekin River Corridor Implementation Plan, Lake Chelan National...
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77 FR 29750 - Notice of Intent To Prepare an Environmental Impact Statement: Milwaukee County
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-18
... Environmental Impact Statement: Milwaukee County AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent. SUMMARY: The FHWA is issuing this notice to advise the public that an Environmental... Milwaukee County, Wisconsin. FOR FURTHER INFORMATION CONTACT: Bethaney Bacher-Gresock, Environmental Major...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-05
... DEPARTMENT OF AGRICULTURE Forest Service Salmon-Challis National Forest, Butte, Custer and Lemhi Counties, ID, Supplemental Environmental Impact Statement to the 2009 Salmon- Challis National Forest... of intent to prepare a supplemental environmental impact statement. SUMMARY: The Salmon-Challis...
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Hyperparathyroidism Mimicking Metastatic Bone Disease: A Case Report and Review of Literature.
Gupta, Monica; Singhal, Lalita; Kumar, Akshay
2018-06-01
Multiple osteolytic lesions are usually associated with metastatic involvement of the bone; however, metabolic bone diseases should also be included in the differential diagnosis. In this study, we describe a case of primary hyperparathyroidism (PHPT) with multiple osteolytic lesions that was diagnosed initially as having metastatic bone involvement. The laboratory results showed hypercalcemia and raised alkaline phosphatase along with fibrosis in the bone marrow biopsy with no increase in tumor markers and normal serum protein electrophoresis. The parathyroid hormone levels were high, which pointed toward a diagnosis of PHPT. Sestamibi scan revealed uptake at the level of the left inferior pole of the thyroid gland, which was suggestive of parathyroid adenoma. The possibility of hyperparathyroidism should be kept in mind when a patient presents with multiple osteolytic lesions and hypercalcemia.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-14
... DEPARTMENT OF THE INTERIOR National Park Service [7700-1104-SZS] Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact Statement, National Trails Intermountain Region, NM... Environmental Impact Statement for the Long Walk National Historic Trail Feasibility Study. SUMMARY: Pursuant to...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-29
... DEPARTMENT OF THE INTERIOR National Park Service [2310-0003-422] Coral Reef Restoration Plan... for the Coral Reef Restoration Plan, Biscayne National Park. SUMMARY: Pursuant to the National... availability of a Final Programmatic Environmental Impact Statement for the Coral Reef Restoration Plan (Plan...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-26
... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Intent To Prepare a... AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of Intent to Prepare a Supplemental Environmental Impact Statement. SUMMARY: The Northwest Mountain Region of the Federal Aviation Administration...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-13
... Representative in Appealed Case, VA Form 646. OMB Control Number: 2900-0042. Type of Review: Extension of a... (Statement of Accredited Representative in Appealed Case) Activities Under OMB Review AGENCY: Board of Veterans' Appeals, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-18
... guidance to park management for administration, development, and interpretation of park resources over the... General Management Plan for Harpers Ferry National Historical Park. SUMMARY: Pursuant to the National... availability of a Final Environmental Impact Statement for the General Management Plan for Harpers Ferry [[Page...
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78 FR 39200 - Authentication of Electronic Signatures on Electronically Filed Statements of Account
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-01
... LIBRARY OF CONGRESS Copyright Office 37 CFR Part 201 [Docket No. 2013-5] Authentication of Electronic Signatures on Electronically Filed Statements of Account AGENCY: U.S. Copyright Office, Library of Congress. ACTION: Notice of proposed rulemaking; correction. SUMMARY: The U.S. Copyright Office published a...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-15
... Hatteras National Seashore Off-Road Vehicle Management Plan AGENCY: National Park Service, Interior. ACTION... Off-Road Vehicle Management Plan. SUMMARY: Pursuant to the National Environmental Policy Act of 1969... environmental impact statement (FEIS) for the proposed Cape Hatteras National Seashore (Seashore) Off-Road...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-05
... DEPARTMENT OF THE INTERIOR National Park Service Fire Management Plan, Final Environmental Impact... Statement for the Fire Management Plan, Grand Canyon National Park. SUMMARY: Pursuant to the National... the Record of Decision for the Fire Management Plan, Grand Canyon National Park, Arizona. On January...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-21
... Park Service, Interior. ACTION: Notice of Availability. SUMMARY: The National Park Service announces the availability of the draft environmental impact statement for the Susquehanna to Roseland 500-kilovolt transmission line, which will affect the Appalachian National Scenic Trail, Delaware Water Gap...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-27
... DEPARTMENT OF THE INTERIOR National Park Service Backcountry Management Plan, Environmental Impact Statement, Grand Canyon National Park, Arizona AGENCY: National Park Service, Department of the Interior..., Grand Canyon National Park. SUMMARY: Pursuant to the National Environmental Policy Act of 1969 (42 U.S.C...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-22
... DEPARTMENT OF THE INTERIOR National Park Service [NPS-IMR-YELL-12081; PPWONRADE2, PMP00EI05.YP0000] Winter Use Plan, Supplemental Environmental Impact Statement, Yellowstone National Park AGENCY: National Park Service, Interior. ACTION: Notice of Availability. SUMMARY: Pursuant to the National Environmental...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-21
... DEPARTMENT OF THE INTERIOR National Park Service [NPS-MWR-CUVA-10100; 6065-4000-409] Draft Trail Management Plan and Environmental Impact Statement for Cuyahoga Valley National Park, Ohio AGENCY: National Park Service, Interior. ACTION: Notice of Availability. SUMMARY: The National Park Service (NPS...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-27
... Operations Final Environmental Impact Statement, Wayne N. Aspinall Unit, Colorado River Storage Project... SUMMARY: The Bureau of Reclamation (Reclamation), the Federal agency responsible for operation of the... Aspinall Unit operations, Gunnison and Montrose Counties, Colorado. DATES: Reclamation will not make a...
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32 CFR 1633.8 - Basis of classification.
Code of Federal Regulations, 2011 CFR
2011-07-01
... of the official forms of the Selective Service System and other written information in his file, oral statements, if made by the registrant at his personal appearance before the board, and oral statements, if made by the registrant's witnesses at his personal appearance. Any information in any written summary...
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32 CFR 1633.8 - Basis of classification.
Code of Federal Regulations, 2010 CFR
2010-07-01
... of the official forms of the Selective Service System and other written information in his file, oral statements, if made by the registrant at his personal appearance before the board, and oral statements, if made by the registrant's witnesses at his personal appearance. Any information in any written summary...
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Summary of Policies: What the Association Thinks To Help You Plan, Teach, Negotiate, Manage.
ERIC Educational Resources Information Center
Association for Science Education, Herts (England).
This document contains a summary of the policies adopted by the Association for Science Education (ASE). These policies are applicable to teachers of science at all levels in all formal places of learning in Great Britain. Summaries of policy statements pertaining to quality in science education, a flowchart that provides an overview of these…
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Bergenfelz, Anders; Lindblom, Pia; Tibblin, Sten; Westerdahl, Johan
2002-11-01
To compare unilateral and bilateral neck exploration for primary hyperparathyroidism in a prospective randomized controlled trial. Based on the assumption that unilateral neck exploration for a solitary parathyroid adenoma should reduce operating time and morbidity, a variety of minimally invasive procedures have challenged the idea that bilateral neck exploration is the gold standard for the surgical treatment of primary hyperparathyroidism. However, to date, no open prospective randomized trial has been published comparing unilateral and bilateral neck exploration. Ninety-one patients with the preoperative diagnosis of primary hyperparathyroidism were randomized to unilateral or bilateral neck exploration. Preoperative scintigraphy and intraoperative parathyroid hormone measurement guided the unilateral exploration. Gross morphology and frozen section determined the extent of parathyroid tissue resection in the bilateral group. The primary end-point was the use of postoperative medication for hypocalcemic symptoms. Eighty-eight patients (97%) were cured. Histology and cure rate did not differ between the two groups. Patients in the bilateral group consumed more oral calcium, had lower serum calcium values on postoperative days 1 to 4, and had a higher incidence of early severe symptomatic hypocalcemia compared with patients in the unilateral group. In addition, for patients undergoing surgery for a solitary parathyroid adenoma, unilateral exploration was associated with a shorter operative time. The cost for the two procedures did not differ. Patients undergoing a unilateral procedure had a lower incidence of biochemical and severe symptomatic hypocalcemia in the early postoperative period compared with patients undergoing bilateral exploration. Unilateral neck exploration with intraoperative parathyroid hormone assessment is a valid surgical strategy in patients with primary hyperparathyroidism with distinct advantages, especially for patients with solitary parathyroid adenoma.
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Verheyen, Nicolas; Fahrleitner-Pammer, Astrid; Belyavskiy, Evgeny; Gruebler, Martin R; Dimai, Hans Peter; Amrein, Karin; Ablasser, Klemens; Martensen, Johann; Catena, Cristiana; Pieske-Kraigher, Elisabeth; Colantonio, Caterina; Voelkl, Jakob; Lang, Florian; Alesutan, Ioana; Meinitzer, Andreas; März, Winfried; Brussee, Helmut; Pieske, Burkert; Pilz, Stefan; Tomaschitz, Andreas
2017-01-01
Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the "Eplerenone in Primary Hyperparathyroidism" (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e', diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone-specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e' (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e'. CTX showed no correlations with LVEF or e'. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies.
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Mendonça, Maira L.; Batista, Sérgio L.; Nogueira-Barbosa, Marcello H.; Salmon, Carlos E.G.; de Paula, Francisco J.A.
2016-01-01
OBJECTIVES: Bone marrow adipose tissue has been associated with low bone mineral density. However, no data exist regarding marrow adipose tissue in primary hyperparathyroidism, a disorder associated with bone loss in conditions of high bone turnover. The objective of the present study was to investigate the relationship between marrow adipose tissue, bone mass and parathyroid hormone. The influence of osteocalcin on the homeostasis model assessment of insulin resistance was also evaluated. METHODS: This was a cross-sectional study conducted at a university hospital, involving 18 patients with primary hyperparathyroidism (PHPT) and 21 controls (CG). Bone mass was assessed by dual-energy x-ray absorptiometry and marrow adipose tissue was assessed by 1H magnetic resonance spectroscopy. The biochemical evaluation included the determination of parathyroid hormone, osteocalcin, glucose and insulin levels. RESULTS: A negative association was found between the bone mass at the 1/3 radius and parathyroid hormone levels (r = -0.69; p<0.01). Marrow adipose tissue was not significantly increased in patients (CG = 32.8±11.2% vs PHPT = 38.6±12%). The serum levels of osteocalcin were higher in patients (CG = 8.6±3.6 ng/mL vs PHPT = 36.5±38.4 ng/mL; p<0.005), but no associations were observed between osteocalcin and insulin or between insulin and both marrow adipose tissue and bone mass. CONCLUSION: These results suggest that the increment of adipogenesis in the bone marrow microenvironment under conditions of high bone turnover due to primary hyperparathyroidism is limited. Despite the increased serum levels of osteocalcin due to primary hyperparathyroidism, these patients tend to have impaired insulin sensitivity. PMID:27626477
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[Parathyroid disease: The full spectrum, from adenoma to carcinoma. Report of 3 cases].
Stoopen-Margain, Enrique; Valanci-Aroesty, Sofía; Castañeda-Martínez, Leopoldo; Baquera-Heredia, Javier; Sainz-Hernández, Juan Carlos
Primary hyperparathyroidism is a disease characterised by the autonomous production of parathyroid hormone. The most common cause is an adenoma, followed by hyperplasia, and rarely carcinoma. Three cases are presented. The first case is associated with a brown tumour that was diagnosed as hyperplasia after study and surgery. The second case was related to pathological fractures, and a lower right adenoma 236 times bigger than a normal parathyroid was excised. The last case presented with abdominal pain and heartburn. Histopathology reported a carcinoma, which was removed using surgery en bloc. All patients have improved. Hyperparathyroidism symptoms are very difficult to identify and diagnose, thus a detailed and broad approach is needed when hyperparathyroidism is suspected. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-13
... DEPARTMENT OF THE INTERIOR Bureau of Land Management Notice of Intent To Prepare an Environmental Impact Statement for the Restoration Design Energy Project and Possible Land Use Plan Amendment AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent. SUMMARY: In compliance with the National...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-13
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLAZ910000.L13400000.DT0000.LXSS058A0000] Notice of Availability of the Final Environmental Impact Statement for the Restoration Design Energy... Management, Interior. ACTION: Correction. SUMMARY: This notice corrects acreages and information referenced...
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A Summary of the Major Documents Signed at the Earth Summit and the Global Forum.
ERIC Educational Resources Information Center
Parson, Edward A.; And Others
1992-01-01
Describes documents produced at the United Nations Conference and the Global Forum: The Rio Declaration, a statement of broad principles to guide national conduct on environmental protection and development; treaties on climate change and biodiversity; forest principles statement; and Agenda 21, a presentation of work plans for sustainable…
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Horry-Georgetown Technical College Summary Report on Institutional Effectiveness.
ERIC Educational Resources Information Center
Wilson, H. Neyle
This document is the Horry-Georgetown Technical College comprehensive assessment of missions, goals, and objectives. The assessment addressed the mission statement of the college as well as its long-term goals. The mission statement was unchanged. In regards to long-term goals for the college, the college deleted one goal that had already been…
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Federal Register 2010, 2011, 2012, 2013, 2014
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... DEPARTMENT OF THE INTERIOR National Park Service Intent To Prepare an Environmental Impact Statement for the New Merced Wild and Scenic River Comprehensive Management Plan Yosemite National Park, Mariposa and Madera Counties, CA ACTION: Notice of second extension of public scoping period. SUMMARY...
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Federal Register 2010, 2011, 2012, 2013, 2014
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... Impact Statements To Incorporate Greater Sage-grouse Conservation Measures Into Land Use Plans and Land Management Plans AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Correction. SUMMARY: The BLM... Supplemental EISs, extends the scoping period, and adds 11 Forest Service Land Management Plans (LMPs) to this...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-13
...] DEPARTMENT OF AGRICULTURE Forest Service Notice of Intent To Prepare an Environmental Impact Statement for... Management, Interior; U.S. Forest Service, Agriculture. ACTION: Notice of Intent. SUMMARY: Notice is hereby... the U.S. Department of Agriculture, Forest Service (FS), Caribou-Targhee National Forest, will jointly...
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Federal Register 2010, 2011, 2012, 2013, 2014
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... in Appealed Case, VA Form 646. OMB Control Number: 2900-0042. Type of Review: Extension of a... (Statement of Accredited Representative in Appealed Case, VA Form 646) Activity: Comment Request AGENCY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Board of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-20
... Environmental Impact Statement, New Mexico AGENCY: Bureau of Land Management, Interior. ACTION: Notice of availability. SUMMARY: In accordance with the National Environmental Policy Act of 1969, as amended, and the... prepared a Draft Resource Management Plan (RMP) and Draft Environmental Impact Statement (EIS) for the...
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2013-07-16
... Prepare a Supplemental Environmental Impact Statement (EIS) SUMMARY: Consistent with the regulations... 248; Central Planning Area (CPA) Lease Sales 227, 231, 235, 241, and 247, Final Environmental Impact... Supplemental Environmental Impact Statement (OCS EIS/EA BOEM 2013-0118) (WPA 233/CPA 231 Supplemental EIS). The...
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... NUCLEAR REGULATORY COMMISSION [NRC-2011-0183] Request for Comments on the Draft Policy Statement on Volume Reduction and Low-Level Radioactive Waste Management AGENCY: Nuclear Regulatory Commission. ACTION: Request for public comment. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) is revising its...
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7 CFR 1951.220 - General servicing actions.
Code of Federal Regulations, 2010 CFR
2010-01-01
... statement period is from January 1 through December 31. The Finance Office forwards to field offices a copy...) Quarterly Forms FmHA or its successor agency under Public Law 103-354 1951-9 are retained in the Finance... for Loan Summary Statement,” to the Finance Office. (3) The servicing office will provide a copy of...
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2012-01-25
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-750] Certain Mobile Devices and Related Software; Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY: Notice is hereby given that the presiding administrative law judge has issued a Final...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-30
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-750] Certain Mobile Devices and Related Software Corrected Notice of Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Correction to Notice. SUMMARY: This Notice corrects the notice in the same matter...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-09
..., USDA. ACTION: Notice of intent to prepare an Environmental Impact Statement (EIS). SUMMARY: The Forest Service will prepare an environmental impact statement on a proposal to use multiple vegetation treatments... that reduces potential for high severity wildfire near at-risk communities and in the wildland-urban...
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Current Assessment of Marihuana: A Rebuttal
ERIC Educational Resources Information Center
Fulton, Gere B.
1973-01-01
A rebuttal of statements made in an article on ...summary of the most current findings related to marihuana'' which was published in the September issue of The Journal of School Health. It is the author's contention that quality of the data and the validity of the approach were too faulty to fortify the statements made. (JC)
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-28
... traditional steam turbine generators. The Project would contain the central receiver or tower, a solar field... the Final Environmental Impact Statement for the Quartzsite Solar Energy Project and the Yuma Field...: Notice of Availability. SUMMARY: Quartzsite Solar Energy (QSE) has requested to interconnect the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-23
... DEPARTMENT OF AGRICULTURE Forest Service Lost River and Challis-Yankee Fork Ranger Districts... AGENCY: Forest Service, USDA. ACTION: Withdrawal of notice of intent to prepare an environmental impact statement. SUMMARY: The Forest Service proposed to prepare an Environmental Impact Statement for the Lost...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-18
... Statement for the General Management Plan (DEIS/GMP), Canaveral National Seashore, FL AGENCY: National Park... General Management Plan (DEIS/GMP), Canaveral National Seashore (Seashore). SUMMARY: Pursuant to 42 U.S.C... DEIS/GMP for Canaveral National Seashore, Florida. The document provides a framework for management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-10
..., 2013). Dated: April 5, 2013. Helen M. Golde, Acting Director, Office of Protected Resources, National.... ACTION: Extension of comment period. SUMMARY: On March 29, 2013, notice was published in the Federal... and written statements must be postmarked no later than Thursday, June 27, 2013. ADDRESSES: The...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-05
...; MO 4500051040; TAS: 14X5017] Notice of Availability of the Draft Supplemental Environmental Impact... Availability. SUMMARY: In accordance with the National Environmental Policy Act of 1969, as amended (NEPA), and...) has prepared a Draft Supplemental Environmental Impact Statement (EIS) for the Ruby Pipeline Project...
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Parathyroid Gland Function in Primary Aldosteronism.
Asbach, E; Bekeran, M; Reincke, M
2015-12-01
Primary aldosteronism (PA) is the most frequent cause of secondary arterial hypertension. Beyond its effects on intravascular volume and blood pressure, PA causes metabolic alterations and a higher cardiovascular morbidity, which is reduced by PA-directed therapy. Experimental studies demonstrated that mineralocorticoid excess may also influence mineral homeostasis. A role in cardiovascular disease has also been attributed to parathyroid hormone (PTH). Increasing evidence supports a bidirectional interaction between aldosterone and PTH.Primary hyperparathyroidism is associated with arterial hypertension and an increased cardiovascular morbidity and mortality, which might be associated to higher aldosterone values; parathyreoidectomy results in lowered aldosterone and blood pressure levels. PA leads to secondary hyperparathyroidism, which is reversible by PA-directed therapy. A lower bone mineral density and a higher fracture rate were also shown to be reversible by PA-directed therapy. There is a suspicion of a bidirectional interaction between aldosterone and PTH, which might lead to a higher cardiovascular risk. There are more and more reports about coincident PA and primary hyperparathyroidism. From a pathophysiologic point of view this constellation is best characterized as tertiary hyperparathyroidism. Future aspects should further clarify the extent of these endocrine interactions and analyze the influence of this interplay on cardiovascular morbidity and mortality and bone health. © Georg Thieme Verlag KG Stuttgart · New York.
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Familial isolated hyperparathyroidism is linked to a 1.7 Mb region on chromosome 2p13.3–14
Warner, J; Nyholt, D R; Busfield, F; Epstein, M; Burgess, J; Stranks, S; Hill, P; Perry‐Keene, D; Learoyd, D; Robinson, B; Teh, B T; Prins, J B; Cardinal, J W
2006-01-01
Bachground Familial isolated hyperparathyroidism (FIHP) is an autosomal dominantly inherited form of primary hyperparathyroidism. Although comprising only about 1% of cases of primary hyperparathyroidism, identification and functional analysis of a causative gene for FIHP is likely to advance our understanding of parathyroid physiology and pathophysiology. Methods A genome‐wide screen of DNA from seven pedigrees with FIHP was undertaken in order to identify a region of genetic linkage with the disorder. Results Multipoint linkage analysis identified a region of suggestive linkage (LOD score 2.68) on chromosome 2. Fine mapping with the addition of three other families revealed significant linkage adjacent to D2S2368 (maximum multipoint LOD score 3.43). Recombination events defined a 1.7 Mb region of linkage between D2S2368 and D2S358 in nine pedigrees. Sequencing of the two most likely candidate genes in this region, however, did not identify a gene for FIHP. Conclusions We conclude that a causative gene for FIHP lies within this interval on chromosome 2. This is a major step towards eventual precise identification of a gene for FIHP, likely to be a key component in the genetic regulation of calcium homeostasis. PMID:16525030
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Crowley, Rachel K; Kilbane, Mark; King, Thomas Fj; Morrin, Michelle; O'Keane, Myra; McKenna, Malachi J
2014-03-04
This is the first report of which the authors are aware to describe this c.2166delinsGG mutation in X-linked hypophosphataemia and to describe normalisation of renal threshold for phosphate excretion after parathyroidectomy for tertiary hyperparathyroidism in X-linked hypophosphataemia. We present the case of a 34-year-old Caucasian woman with X-linked hypophosphataemia. She developed tertiary hyperparathyroidism with markedly high bone turnover requiring total parathyroidectomy and had prolonged requirement for intravenous calcium infusion after surgery. She had a novel mutation in her phosphate-regulating gene with homologies to endopeptidases on the X-chromosome and had an unusual degree of dependence on phosphate supplementation. Prior to operative intervention she had a trial of cinacalcet that improved bone turnover markers when used in isolation but which led to a paradoxical rise in parathyroid hormone levels when given with phosphate supplementation. After correction of hungry bone syndrome, the renal phosphorus threshold normalised as a manifestation of hypoparathyroid state despite marked elevation in level of fibroblast growth factor 23. This case illustrates the risk of tertiary hyperparathyroidism as a complication of treatment for hypophosphataemia; it highlights the morbidity associated with hungry bone syndrome and provides novel insight into renal handling of phosphorus.
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Systems Analysis Directorate Activities Summary, May 1976
1976-06-01
approach is to assume an attack by force is made on a fixed facility with the intent to remove certain materials or perform sabotage of some portion of...IBPS/»-«/, and DATA ACTL/*--/ in main program at statement numbers TAT00500-550, and move them into a BLOCK DATA subroutine as shown below: 0001...NPQ-••). The variables JJ and IIA are common variables and should not be transferred in a subroutine call statement. (7) Statement numbers 0N2211
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Remarkable Retellings, Super Summaries
ERIC Educational Resources Information Center
Reading Teacher, 2010
2010-01-01
Retelling and summarizing are great ways to get children involved in what they're reading--and thinking about what they understand in texts. Summarizing is a more complex task than retelling. Creating a formal summary usually involves reducing a text by about a third, writing a topic statement, eliminating redundant and unimportant details, and…
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The Arts Educator and Children with Special Needs: Conference Report.
ERIC Educational Resources Information Center
CEMREL, Inc., St. Louis, MO.
The document contains eight summaries of position statements and a summary of strategies to develop personnel preparation programs arising from a national symposium on arts education for children with handicaps. Symposium participants devised five approaches for expanding the development of programs to train arts personnel to teach handicapped…
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Gross, Itai; Siedner-Weintraub, Yael; Simckes, Ari; Gillis, David
2015-07-01
Antenatal type I Bartter syndrome (ABS) is usually identified by the presence of polyhydramnios, premature delivery, hypokalemia, metabolic alkalosis, hypercalciuria, and nephrocalcinosis caused by mutations in the Na-K-2Cl cotransporter (NKCC2)-encoding SLC12A1 gene. In this report, we describe a novel presentation of this syndrome with hypercalcemic hypercalciuric hyperparathyroidism, and review the literature of the variable atypical presentations of ABS.
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Brown tumours of the tibia and second metacarpal bone in a woman with severe vitamin D deficiency.
Al-Sharafi, Butheinah A; Al-Imad, Shafiq A; Shamshair, Amani M; Al-Faqeeh, Derhim H
2015-08-03
Brown tumours caused by vitamin D deficiency are rare. Most cases are caused by primary hyperparathyroidism, and are rarely caused by secondary hyperparathyroidism in cases of renal failure. We present a case of Brown tumours of the tibia and second metacarpal bone in a 50-year-old woman who had a low dietary intake of vitamin D and had worn a veil for most of her adult life. The Brown tumours were caused by vitamin D deficiency and secondary hyperparathyroidism. The patient improved on treatment with vitamin D3 and calcium supplements. This is a rare case and the first, to our knowledge, with a Brown tumour of the tibia caused by vitamin D deficiency due to decreased dietary intake and decreased exposure to sunlight. The course of treatment and investigations of the patient are described. 2015 BMJ Publishing Group Ltd.
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USACE AIS Transmit Technical Support Summary Report
2014-09-01
the TAG block for the correct transmitters, and then send to the USACE AIS network. B. Outbound openings in the USCG firewall for the USCG Message...USACE AIS Transmit Technical Support Summary Report Distribution Statement A: Approved for public release; distribution is unlimited...September 2014 Report No. CD-D-09-15 USACE AIS Transmit Technical Support Summary Report ii UNCLAS//Public | CG-926 RDC | I. Gonin et al. Public
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-06
... Statement. SUMMARY: The Stanislaus National Forest proposes to remove hazard trees and dead trees within the... trees which pays for their removal from the woods and potentially other future restoration treatments... varied from low to high, but many areas contain trees killed or so severely damaged that they are not...
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76 FR 69712 - U.S. Air Force Scientific Advisory Board; Notice of Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-09
...: Meeting notice. SUMMARY: Due to difficulties, beyond the control of the U.S. Air Force Scientific Advisory... Scientific Advisory Board should submit a written statement in accordance with 41 CFR 102-3.140(c) and.... Written statements can be submitted to the Designated Federal Officer at the address detailed below at any...
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78 FR 44102 - Record of Decision for F35A Training Basing Final Environmental Impact Statement
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-23
... DEPARTMENT OF DEFENSE Department of the Air Force Record of Decision for F35A Training Basing Final Environmental Impact Statement ACTION: Notice of Availability (NOA). SUMMARY: On June 26, 2013... Fornof, 266 F Street West, Building 901, Randolph AFB, 78150-4319, (210) 652-1961, [email protected]us.af...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-23
... Prepare a Supplemental Environmental Impact Statement (EIS). SUMMARY: Consistent with the regulations... Supplemental EIS will update the environmental and socioeconomic analyses in the Gulf of Mexico OCS Oil and Gas... Area Lease Sales 227, 231, 235, 241, and 247, Final Environmental Impact Statement (OCS EIS/EA BOEM...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-30
... Park. SUMMARY: Pursuant to the National Environmental Policy Act of 1969, 42 U.S.C. 4332(2)(C), the... Protection Agency of the Notice of Availability of the Final Environmental Impact Statement. ADDRESSES... fan area and in the Lulu City wetland. Actions would be conducted to stabilize limited areas of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-24
... Interpretations of Travel Time Involving Signal Employees I. Executive Summary of the Second Interim Statement of..., however, that many of FRA's longstanding interpretations of travel time for signal employees are unchanged... Duty at the Home Terminal During Which Time the Employee Is Unavailable for Service for Any Railroad A...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-10
...] Notice of Intent To Prepare a Draft Environmental Impact Statement for a Proposed Land Exchange Between.... ACTION: Notice of intent. SUMMARY: In compliance with the National Environmental Policy Act of 1969 (NEPA... Land Management (BLM) Palm Springs-South Coast Field Office intends to prepare a Draft Environmental...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-03
...: The Abbreviated Final General Management Plan and Environmental Impact Statement (GMP/EIS) will remain... Site. SUPPLEMENTARY INFORMATION: We, the National Park Service, prepared a draft GMP/EIS for the park... summaries of the draft GMP/EIS. In addition to the distribution, the draft GMP/EIS was also made available...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-21
... DEPARTMENT OF DEFENSE Department of the Army Draft Environmental Impact Statement for the Disposition of Hangars 2 and 3, Fort Wainwright, Alaska AGENCY: Department of the Army, DoD. ACTION: Notice of availability. SUMMARY: The Department of the Army announces the availability of the Draft Environmental Impact...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-30
...; 13-08807; MO 4500049868; TAS: 14X5017] Notice of Intent To Prepare a Draft Supplemental Environmental...: Notice of Intent. SUMMARY: As directed by the United States Court of Appeals for the Ninth Circuit, the Bureau of Land Management (BLM) is preparing a Draft Supplemental Environmental Impact Statement (EIS...
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Secondary Hyperparathyroidism in Patients with Endemic Skeletal Fluorosis
Teotia, S. P. S.; Teotia, Mohini
1973-01-01
Investigation of 20 patients with skeletal fluorosis showed that five had clear evidence of secondary hyperparathyroidism. The hyperactivity of the parathyroid glands in skeletal fluorosis in the presence of decreased solubility of the bone mineral (fluoroapatite) strongly suggests that it is a compensatory attempt to maintain a normal extracellular ionized calcium equilibrium. Further study of the parathyroid glands and of bone lesions in skeletal fluorosis is in progress. ImagesFIG. 1FIG. 2FIG. 3FIG. 4 PMID:4692708
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Management of hyperparathyroidism (PHP) in MEN2 syndromes in Europe.
Alevizaki, Maria
2013-03-14
Hyperparathyroidism occurs in 20-30% of MEN2A syndrome patients. It is usually associated with mild disease and is frequently asymptomatic, especially in younger age. There is genotype/phenotype association and PHP is usually associated with codon 634 mutations; however association with more "rare" mutations has also been reported. The pathology of the parathyroid glands includes hyperplasia, adenoma or a combination of the two. The optimal surgical management of this entity has not been defined yet.
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17 CFR 210.12-15 - Summary of investments-other than investments in related parties.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Summary of investments-other than investments in related parties. 210.12-15 Section 210.12-15 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION FORM AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES...
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17 CFR 210.12-15 - Summary of investments-other than investments in related parties.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Summary of investments-other than investments in related parties. 210.12-15 Section 210.12-15 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION FORM AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES...
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17 CFR 210.12-15 - Summary of investments-other than investments in related parties.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Summary of investments-other than investments in related parties. 210.12-15 Section 210.12-15 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION FORM AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES...
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17 CFR 210.12-15 - Summary of investments-other than investments in related parties.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Summary of investments-other than investments in related parties. 210.12-15 Section 210.12-15 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION FORM AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES...
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This document is a summary statement of the outcome from the meeting: “Bisphenol A: An Examination of the Relevance of Ecological, In vitro and Laboratory Animal Studies for Assessing Risks to Human Health” sponsored by the NIEHS and NIDCR, NIH/DHHS on the estrogenic environmenta...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-02
... alternative would continue current management of vehicle use on the park road. In addition to a seasonal limit... Impact Statement for the Denali Park Road Vehicle Management Plan. SUMMARY: Pursuant to Sec. 102(2)(C... end of the Savage River Bridge (mile 14.8) and continues to the former Mt. McKinley National Park...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-30
....19b-4. \\3\\ The text of the proposed rule change is attached as Exhibit 5 to NSCC's filing, which is... any comments it received on the proposed rule change. The text of these statements may be examined at... the text of the summaries prepared by NSCC. (A) Self-Regulatory Organization's Statement of the...
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2016-01-01
Summary This statement outlines interim recommendations intended for use during yellow fever vaccine shortages only. The recommendations differ from the standard recommendations for yellow fever vaccination in the Canadian Immunization Guide and in the Committee to Advise on Tropical Medicine and Travel (CATMAT) Statement for Travellers and Yellow Fever. PMID:29770023
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NPS TINYSCOPE Program Management
2010-09-01
SMDC - Space and Missile Defense Command SOW - Statement of Work STEM - Science, Technology, Engineering and Mathematics STP - Space Test Program...the project. A statement of work ( SOW ) is typically used to document broad responsibilities, deliverables, and the work activities required in a...given project. The SOW acts as a guideline Summary of TINYSCOPE and Argus Requirements Requirement Threshold Objective Mission IOC Sep 2011 ASAP
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-29
...] Availability of a Draft Environmental Impact Statement To Consider Issuance of a Department of the Army Permit Pursuant to Section 404 of the Clean Water Act for the Sabine Mining Company's Proposal To Construct... the Army, U.S. Army Corps of Engineers, DoD. ACTION: Notice of availability. SUMMARY: In accordance...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-26
... DEPARTMENT OF DEFENSE Department of the Army, Corps of Engineers Notice of Intent To Prepare A Draft Environment Impact Statement for the Proposed Ray Mine Tailings Storage Facility in Pinal County, Arizona AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Notice of Intent. SUMMARY: The U.S. Army Corps...
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1988-05-31
COLUMBIA RIVER ’ WENATCHEE , WASH., TO INTERNATIONAL SOUNDRYJ COEUR DfALENE LAKE............................................................ 39,625...1986 ............ .............................. 28 8 Comparative Statement of Traffic on the Mississippi River System, 1975-1986. 29 9 Comparative...Statement of Traffic on the Mississippi River from Minneapolis, Minn., to the Mouth of Passes, 1975 - 1986 ... .............. . 29 10 Domestic Barge
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75 FR 9635 - Cancellation of Environmental Impact Statement; Harris and Brazoria Counties, TX
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-03
...: Cancellation of SH 35 EIS. SUMMARY: In Vol. 68, No. 210/Thursday, October 30, 2003/Notices, FHWA issued a... proposed SH 35 roadway between Bellfort Road and FM 1462 in Harris and Brazoria Counties, Texas. The use of Federal funding for this project is no longer proposed and a State Environmental Impact Statement will be...
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Dear, J D; Kass, P H; Della Maggiore, A M; Feldman, E C
2017-03-01
Development of hypocalcemia after treatment of hyperparathyroidism results in increased costs and risk of poorer outcomes. Previous studies have shown conflicting data about predictors of hypocalcemia after these procedures. The objective of this study was to investigate whether ionized calcium (iCa) concentrations before treatment are predictive of hypocalcemia or its clinical signs after surgical removal or heat ablation in dogs with primary hyperparathyroidism. Fifty-four dogs with primary hyperparathyroidism (29 female, 25 male; 49 retrospective, 5 prospective). Dogs were enrolled if they met the inclusion criteria: persistent hypercalcemia (iCa >1.41 mmol/L) due to primary hyperparathyroidism and absence of preemptive calcitriol treatment. All dogs were treated with parathyroidectomy (n = 37) or percutaneous ultrasound-guided heat ablation (n = 17). After treatment, iCa was monitored twice daily until plateau or intervention. There was a moderate correlation between before-treatment hypercalcemia and after-treatment hypocalcemia. The prospective study was terminated due to ethical concerns given findings in the retrospective section. All dogs were placed into groups according to their pretreatment iCa: 1.46-1.61 mmol/L, 1.62-1.71 mmol/L, iCa 1.72-1.81 mmol/L, or >1.81 mmol/L. After treatment, the mean lowest iCa for each group, respectively, was 1.19, 1.18, 1.13, and 1.01 mmol/L. There was a significant association between higher group and proportion of dogs with iCa <1.00 mmol/L (P = .014). This study demonstrates a moderate correlation between iCa concentration before treatment and hypocalcemia after treatment. Dogs with higher initial iCa concentrations should be treated to prevent rapid decline and development of clinical hypocalcemia. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Khan, Aysha Habib; Naureen, Ghazala; Iqbal, Romaina; Dar, Farhan Javed
2013-01-01
Bone health assessed in three towns of Karachi, Pakistan in females showed poor calcium intake, vitamin D deficiency, secondary hyperparathyroidism, and high bone turnover. Correlates of high bone turnover included females residing in Saddar Town, underweight females less than 30 years of age from low socio-economic status, and secondary hyperparathyroidism. To assess bone health and association of dietary calcium and 25 hydroxy vitamin D with bone turnover in the community-dwelling females of Karachi. Bone health was assessed in three randomly selected towns of Karachi, Pakistan. One premenopausal female fulfilling the inclusion criteria from each household was included in the study. Dietary calcium was assessed through a food frequency questionnaire and biochemical markers including calcium, phosphates, albumin, magnesium, creatinine, and SGPT, intact parathyroid hormone, 25 hydroxy vitamin D, and N-telopeptide of type I collagen were measured to assess the bone health. Three hundred and five females were included from three towns. Overall, 90.5% of females had vitamin D deficiency with 42.6 and 23.3% having secondary hyperparathyroidism and high bone turn over respectively. Prevalence of vitamin D deficiency, secondary hyperparathyroidism, and high bone turnover was significantly different among towns. Mean vitamin D levels were significantly low and iPTH levels significantly high in females with high bone turnover. Calcium intake was not significantly different among females with normal, high, and low bone turnover. Correlates of high bone turnover included females residing in Saddar Town, underweight females less than 30 years of age belonging to low socio-economic status, and secondary hyperparathyroidism. Compromised bone health is seen in community-dwelling females of Karachi. There is a need to perform large-scale community-based studies in all age groups to understand the interplay of markers in our population to understand the impact of these variables translating into the risk of osteoporosis.
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Hyperparathyroidism in pregnancy: options for localization and surgical therapy.
McMullen, Todd P W; Learoyd, Diana L; Williams, David C; Sywak, Mark S; Sidhu, Stan B; Delbridge, Leigh W
2010-08-01
Hyperparathyroidism in pregnancy is a threat to the health of both mother and fetus. The mothers suffer commonly from nephrolithiasis, hyperemesis, or even hypercalcemic crisis. Untreated disease will commonly complicate fetal development and fetal death is a significant risk. Treatment options, including medical and surgical therapy, are debated in the literature. This is a case series comprising seven patients with primary hyperparathyroidism in pregnancy. Data collected included symptoms at diagnosis, biochemical abnormalities, pathologic findings, treatment regimes, and subsequent maternal and fetal outcomes. Seven women, aged 20 to 39 years, presented with hyperparathyroidism during pregnancy. The earliest presented at 8 weeks and the latest at 38 weeks. Four of seven patients experienced renal calculi. Calcium levels were 2.7-3.5 mmol/l. All were found to have solitary parathyroid adenomas, of which two were in ectopic locations. Fetal complications included three preterm deliveries and one fetal death with no cases of neonatal tetany. Maternal and fetal complications could not be predicted based on duration or severity of hypercalcemia. Three patients were treated during pregnancy with surgery, and two of these had ectopic glands that required reoperations with a novel approach using Tc-99m sestamibi scanning during pregnancy to assist in localizing the abnormal gland. Four cases were treated postpartum with a combination of open and minimally invasive approaches after localization. No operative complications or fetal loss related to surgery were observed in this cohort. Primary hyperparathyroidism in pregnancy represents a significant risk for maternal and fetal complications that cannot be predicted by duration of symptoms or serum calcium levels. Surgical treatment should be considered early, and a minimally invasive approach with ultrasound is best suited to mitigating risk to mother and fetus. Equally important, Tc-99m sestamibi imaging may be used safely for localization of the parathyroids after negative cervical explorations.
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Tal, Moran; Parr, Jacqueline M; MacKenzie, Shawn; Verbrugghe, Adronie
2018-01-01
A 6-month-old intact female giant schnauzer dog fed a nutritionally unbalanced homemade diet was evaluated because of a 1-month history of lameness and difficulty walking. Abnormalities identified on ancillary tests, in conjunction with the dog's clinical improvement following diet change, suggested a diagnosis of vitamin D deficiency and nutritional secondary hyperparathyroidism. This report underlines the importance of appropriate feeding management, especially during the vulnerable growth phase.
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Code of Federal Regulations, 2011 CFR
2011-04-01
..., risk factors, and ratio of earnings to fixed charges. 229.503 Section 229.503 Commodity and Securities... Registration Statement and Prospectus Provisions § 229.503 (Item 503) Prospectus summary, risk factors, and... executive offices. (c) Risk factors. Where appropriate, provide under the caption “Risk Factors” a...
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Code of Federal Regulations, 2010 CFR
2010-04-01
..., risk factors, and ratio of earnings to fixed charges. 229.503 Section 229.503 Commodity and Securities... Registration Statement and Prospectus Provisions § 229.503 (Item 503) Prospectus summary, risk factors, and... executive offices. (c) Risk factors. Where appropriate, provide under the caption “Risk Factors” a...
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17 CFR 270.8b-24 - Summaries or outlines of documents.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Summaries or outlines of documents. 270.8b-24 Section 270.8b-24 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... statement shall be made, in succinct and condensed form, as to the most important provisions of the document...
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Hawaii energy strategy: Executive summary, October 1995
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
This is an executive summary to a report on the Hawaii Energy Strategy Program. The topics of the report include the a description of the program including an overview, objectives, policy statement and purpose and objectives; energy strategy policy development; energy strategy projects; current energy situation; modeling Hawaii`s energy future; energy forecasts; reducing energy demand; scenario assessment, and recommendations.
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Crea, Nicola; Pata, Giacomo; Casella, Claudio; Cappelli, Carlo; Salerni, Bruno
2012-03-01
Hypocalcaemia is a complication of parathyroidectomy. We retrospectively analyzed data on patients who underwent parathyroidectomy for primary hyperparathyroidism (pHPT) to identify predictive factors for severe postoperative hypocalcaemia. Since 2004 we performed 87 parathyroidectomies for pHPT. We divided the patients into two groups: subjects who presented with postoperative hypocalcaemia (group B) or otherwise (group A). We looked for a correlation between several variables and the incidence of postoperative hypocalcaemia. The median calcemia in group B (19 patients) was 6.9 mg/dL on the first postoperative day and 7.6 mg/dL on the third day. We observed hypocalcemia related clinical symptoms in every patient. In all 19 cases the reduction of intraoperative parathyroid hormone above 85 per cent after parathyroidectomy was related to the development of severe postoperative hypocalcaemia (P = 0.042). We found that the reduction of intraoperative parathyroid hormone over 85 per cent after parathyroidectomy can be considered a reliable predictive factor of postoperative hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.
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[Primary hyperparathyroidism - new clinical forms of the disease].
Zajíčková, Kateřina
Primary hyperparathyroidism (PHPT) has been increasingly diagnosed incidentally in its asymptomatic form owing to calcium screening tests. This form of PHPT represents 80% in developed countries. Although PHPT patients are asym-ptomatic, target organ (bone and kidney) involvement is frequently observed. Mild PHPT is associated with a reduction of bone mineral densityand, moreover, with increased risk of vertebral fractures. The extent of a patient evaluation and indications for parathyroidectomy are based on expert guidelines from 2014. Normocalcemic variant of PHPT has been recently recognized, possibly with higher prevalence in general population than the hypercalcemic form of PHPT. Normal but with respect to hypercalcemia inadequately high parathormon levels characterize normohormonal PHPT. If a hereditary form of PHPT is suspected, genetic testing is recommended. Although there are new clinical forms of PHPT, parathyroidectomy still represents the only curative approach to PHPT followed by substantial osteoprotective effect.Key words: asymptomatic form - normocalcemic form - normohormonal form - parathyroidectomy - primary hyperparathyroidism - recent guidelines for the management PHPT.
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He, Yayi; Liu, Shu; Guo, Hui; Shi, Bingyin
2014-01-01
The simultaneous occurrence of hyperthyroidism and hyperparathyroidism was previously reported to be rare, but it was recognised more and more clearly by effective evaluations. Recent studies also mentioned the coexistence of parathyroid adenoma and papillary thyroid carcinoma (PTC). The potential mechanism is still unknown. We report a case of a 46-year-old man coexisted with primary hyperparathyroidism, Graves’ hyperthyroidism and occult PTC. The patient had a 6-month history of polyphagia and irritability. Blood examinations showed elevated serum calcium and parathyroid hormone levels. Serum phosphate was lower. Thyroid function evaluation indicted Graves’ hyperthyroidism. Ultrasound showed a solitary hyperchoic thyroid nodule in the right gland. Parathyroid radioisotope scanning found a mild enhancement of 99mTc absorption in the lower part of the right parathyroid gland. A surgical exploration was carried out and the parathyroid adenoma resection was performed. An occult micro-PTC with BRAFV600E mutation was also detected. PMID:24879726
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Primary hyperparathyroidism may masquerade as rickets-osteomalacia in vitamin D replete children.
Ganie, Mohd Ashraf; Raizada, Nishant; Chawla, Himika; Singh, Arun Kumar; Aggarwala, Sandeep; Bal, Chandra Sekhar
2016-10-01
Primary hyperparathyroidism, typically a disease of the middle aged and the old, is less commonly seen in children. In children the disease has a bimodal age distribution with calcium sensing receptor mutation presenting in infancy as hypercalcemic crises and parathyroid adenoma or hyperplasia presenting later in childhood with bone disease. The childhood parathyroid adenomas are often familial with multiglandular disease and manifest with severe bone disease unlike adults. We report a series of four male patients with juvenile primary hyperparathyroidism, three of whom presented with bone disease masquerading as rickets-osteomalacia. One patient had asymptomatic hypercalcemia with short stature. Parathyroid adenoma was detected in all the four cases and all of them underwent resection of parathyroid adenomas confirmed on histopathology. Post-surgery all the cases had initial hypocalcaemia followed by normocalcemia. One case developed pancreatitis after surgery even after achieving normocalcemia. We conclude that parathyroid adenomas, although uncommon in children, are an important cause of skeletal disease that may initially be confused with hypovitaminosis D.
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[Dropped head syndrome as first manifestation of primary hyperparathyroid myopathy].
Ota, Kiyobumi; Koseki, Sayo; Ikegami, Kenji; Onishi, Iichiroh; Tomimitsu, Hiyoryuki; Shintani, Shuzo
2018-03-28
75 years old woman presented with 6-month history of progressive dropped head syndrome. Neurological examination revealed moderate weakness of flexor and extensor of neck and mild weakness of proximal appendicular muscles with normal deep tendon reflexes. The needle electromyography showed short duration and low amplitude motor unit potential. No fibrillation potentials or positive sharp waves were seen. Biopsy of deltoid muscle was normal. Laboratory studies showed elevated levels of serum calcium (11.8 mg/dl, upper limit of normal 10.1) and intact parathyroid hormone (104 pg/ml, upper limit of normal 65), and decreased level of serum phosphorus (2.3 mg/dl, lower limit of normal 2.7). Ultrasonography and enhanced computed tomography revealed a parathyroid tumor. The tumor was removed surgically. Pathological examination proved tumor to be parathyroid adenoma. Dropped head and weakness of muscles were dramatically improved within a week after the operation. Although hyperparathyroidism is a rare cause of dropped head syndrome, neurologists must recognize hyperparathyroidism as a treatable cause of dropped head syndrome.
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Feline chronic renal failure: calcium homeostasis in 80 cases diagnosed between 1992 and 1995.
Barber, P J; Elliott, J
1998-03-01
Eighty cats with chronic renal failure (CRF) were evaluated in a prospective study to investigate the prevalence and aetiopathogenesis of renal secondary hyperparathyroidism (RHPTH), using routine plasma biochemistry and assays of parathyroid hormone (PTH), blood ionised calcium and 1,25 dihydroxycholecalciferol (1,25[OH]2D3). Hyperparathyroidism was a frequent sequela of CRF, affecting 84 per cent of cats with CRF, the severity and prevalence of RHPTH increasing with the degree of renal dysfunction. Compared with an age-matched control population, plasma concentrations of phosphate and PTH were significantly higher and 1,25(OH)2D3 concentrations were significantly lower in the two groups of cats presenting with clinical signs of CRF. Significant ionised hypocalcaemia was present only in cats with end-stage renal failure. However, a number of cats were hyperparathyroid in the absence of abnormalities in the parameters of calcium homeostasis measured in this study. There was a significant correlation between plasma phosphate and PTH concentrations.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-14
.... \\1\\ 15 U.S.C. 78s(b)(1). \\2\\ 17 CFR 240.19b-4. I. Self-Regulatory Organization's Statement of the...). II. Self-Regulatory Organization's Statement of the Purpose of, and Statutory Basis for, the Proposed... self-regulatory organization has prepared summaries, set forth in Sections A, B and C below, of the...
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Vascular endothelium summary statement II: Cardiovascular disease prevention and control.
Mensah, George A; Ryan, Una S; Hooper, W Craig; Engelgau, Michael M; Callow, Allan D; Kapuku, Gaston K; Mantovani, Alberto
2007-05-01
The prevention and control of cardiovascular disease (CVD), principally ischemic heart disease and stroke, are a major clinical and public health challenge. Worldwide, CVD accounts for substantial morbidity and mortality. The major modifiable CVD risk factors are known and all of them cause endothelial activation and dysfunction. Preventing and controlling the established risk factors are associated with preserved endothelial function and reduced risk of CVD. Research advances that improve our understanding of strategies to preserve endothelial function or make the endothelial cells resilient to environmental insults may help improve our preventive interventions. This summary statement addresses the current state of the science with respect to endothelial dysfunction and CVD pathogenesis, diagnostic evaluation, and suggested strategies for public health practice and research.
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Krishnamurthy, Vikram D; Sound, Sara; Okoh, Alexis K; Yazici, Pinar; Yigitbas, Hakan; Neumann, Donald; Doshi, Krupa; Berber, Eren
2017-06-01
We analyzed the utility of repeated sestambi scans in patients with primary hyperparathyroidism and its effects on operative referral. We carried out a retrospective review of patients with primary hyperparathyroidism who underwent repeated sestambi scans exclusively within our health system between 1996-2015. Patient demographic, presentation, laboratory, imaging, operative, and pathologic data were reviewed. Univariate analysis with JMP Pro v12 was used to identify factors associated with conversion from an initial negative to a subsequent positive scan. After exclusion criteria (including reoperations), we identified 49 patients in whom 59% (n = 29) of subsequent scans remained negative and 41% (n = 20) converted to positive. Factors associated with an initial negative to a subsequent positive scan included classic presentation and second scans with iodine subtraction (P = .04). Nonsurgeons were less likely to order an iodine-subtraction scan (P < .05). Fewer patients with negative imaging were referred to surgery (33% vs 100%, P = .005), and median time to operation after the first negative scan was 25 months (range 1.4-119). Surgeon-performed ultrasonography had greater sensitivity and positive predictive value than repeated sestamibi scans. Negative sestambi scans decreased and delayed operative referral. Consequently, we identified several process improvement initiatives, including education regarding superior institutional imaging. Combining all findings, we created an algorithm for evaluating patients with primary hyperparathyroidism after initially negative sestamibi scans, which incorporates surgeon-performed ultrasonography. Copyright © 2016 Elsevier Inc. All rights reserved.
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Shi, Yuhong; Azimzadeh, Pedram; Jamingal, Sarada; Wentworth, Shannon; Ferlitch, Janice; Koh, James; Balenga, Nariman; Olson, John A
2018-01-01
Parathyroid tumors are mostly considered monoclonal neoplasms, the rationale for focused parathyroidectomy in primary hyperparathyroidism. We reported that flow sorting parathyroid tumor cells and methylation-sensitive polymerase chain reaction (me-PCR) of polymorphic human androgen receptor gene and phosphoglycerate kinase gene alleles in deoxyribonucleic acid reveals that ≤35% of parathyroid tumors are polyclonal. We sought to confirm these findings and assess for clinical relevance. Parathyroid tumors from 286 female primary hyperparathyroidism patients were analyzed for clonal status. Tumor clonal status was compared with clinical variables and operative findings. Statistical analysis was performed and significance was established at P < .05. In the study, 176 (62%) patients were informative for human androgen receptor gene and/or phosphoglycerate kinase gene. Assignment of clonal status was made in 119 (68%) tumors, of which 64 (54%) were monoclonal and 55 (46%) were polyclonal. Comparison of tumor clonal status to clinical variables in patients with complete operative data (N = 82) showed that while clinical features were the same between tumor types, patients with polyclonal tumors more often had multiple gland disease (risk ratio 4.066, confidence interval, 1.016-16.26; P = .039) potentially missed at unilateral neck exploration. This work confirms that primary hyperparathyroidism is often the result of polyclonal tumors and that parathyroid tumor clonal status may be associated with multiple gland disease. Copyright © 2017 Elsevier Inc. All rights reserved.
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Magalhães, Patrícia Künzle Ribeiro; Antonini, Sonir Roberto Rauber; de Paula, Francisco José Albuquerque; de Freitas, Luiz Carlos Conti; Maciel, Léa Maria Zanini
2011-05-01
Primary hyperparathyroidism occurs in only 10%-30% of patients with multiple endocrine neoplasia type 2A (MEN2A), rarely as the sole clinical manifestation, and is usually diagnosed after the third decade of life. A 5-year-old girl was referred for prophylactic thyroidectomy as she carried the p.C634R RET mutation. She was clinically asymptomatic, with a normally palpable thyroid and with the cervical region free of lymphadenopathy or other nodules. Preoperative tests revealed hypercalcemia associated with elevation of parathyroid hormone (PTH) (calcium = 11.2 mg/dL, calcium ion = 1.48 mmol/L, phosphorus = 4.0 mg/dL, alkaline phosphatase = 625 U/L, parathyroid hormone (PTH) PTH = 998 pg/mL). A thyroid ultrasound was normal and parathyroid scintigraphy with (99m)Tc-Sestamibi revealed an area of radioconcentration in the upper half of the left thyroid lobe suggesting hyperfunctioning parathyroid tissue. She underwent total thyroidectomy and parathyroidectomy and developed hypocalcemia. The anatomopathological examination showed no histopathological changes in the thyroid tissue and an adenoma of the parathyroid gland, confirming the diagnosis of hyperparathyroidism. Primary hyperparathyroidism can be a precocious manifestation of MEN2A. This case report highlights that asymptomatic hypercalcemia should be scrutinized in children related to patients with MEN2A who carry a mutation in the RET proto-oncogene, especially mutations in the codon 634, before the currently recommended age of 8 years.
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van der Toolen, Yaloe; Vrij, Aldert; Arntz, Arnoud; Verschuere, Bruno
2018-01-01
Summary Recently, verbal credibility assessment has been extended to the detection of deceptive intentions, the use of a model statement, and predictive modeling. The current investigation combines these 3 elements to detect deceptive intentions on a large scale. Participants read a model statement and wrote a truthful or deceptive statement about their planned weekend activities (Experiment 1). With the use of linguistic features for machine learning, more than 80% of the participants were classified correctly. Exploratory analyses suggested that liars included more person and location references than truth‐tellers. Experiment 2 examined whether these findings replicated on independent‐sample data. The classification accuracies remained well above chance level but dropped to 63%. Experiment 2 corroborated the finding that liars' statements are richer in location and person references than truth‐tellers' statements. Together, these findings suggest that liars may over‐prepare their statements. Predictive modeling shows promise as an automated veracity assessment approach but needs validation on independent data. PMID:29861544
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Climate Change and Greenhouse Gases
NASA Technical Reports Server (NTRS)
Ledley, Tamara S.; Sundquist, Eric; Schwartz, Stephen; Hall, Dorothy K.; Fellows, Jack; Killeen, Timothy
1999-01-01
The American Geophysical Union (AGU), as a scientific organization devoted to research on the Earth and space sciences, provides current scientific information to the public on issues pertinent to geophysics. The Council of the AGU approved a position statement on Climate Change and Greenhouse Gases in December 1998. The statement, together with a short summary of the procedures that were followed in its preparation, review, and adoption were published in the February 2, 1999 issue of Eos ([AGU, 1999]. The present article reviews scientific understanding of this issue as presented in peer-reviewed publications that serves as the underlying basis of the position statement.
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Summary report for the Engineering Script Language (ESL)
NASA Technical Reports Server (NTRS)
1990-01-01
The following subject areas are covered: ESL methodology concept; ESL specification; user interface description; engineering scripting language command statements specification; and recommendations for further research and development.
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Pavement markings and safety : tech transfer summary.
DOT National Transportation Integrated Search
2010-11-01
Objective: This study explores the statistical relationship between crash occurrence probability and longitudinal pavement marking retroreflectivity. : Problem Statement: Previous research on pavement markings, from a safety perspective, tackled vari...
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32 CFR 806b.1 - Summary of revisions.
Code of Federal Regulations, 2011 CFR
2011-07-01
... are new or have major changes; changes appeal processing from Air Force Communications and Information... procedures on complaints; and provides guidance on recall rosters; social rosters; consent statements...
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Automatic Generation of Conditional Diagnostic Guidelines.
Baldwin, Tyler; Guo, Yufan; Syeda-Mahmood, Tanveer
2016-01-01
The diagnostic workup for many diseases can be extraordinarily nuanced, and as such reference material text often contains extensive information regarding when it is appropriate to have a patient undergo a given procedure. In this work we employ a three task pipeline for the extraction of statements indicating the conditions under which a procedure should be performed, given a suspected diagnosis. First, we identify each instance in the text where a procedure is being recommended. Next we examine the context around these recommendations to extract conditional statements that dictate the conditions under which the recommendation holds. Finally, corefering recommendations across the document are linked to produce a full recommendation summary. Results indicate that each underlying task can be performed with above baseline performance, and the output can be used to produce concise recommendation summaries.
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Massironi, Sara; Cavalcoli, Federica; Rossi, Roberta Elisa; Conte, Dario; Spampatti, Matilde Pia; Ciafardini, Clorinda; Verga, Uberta; Beck-Peccoz, Paolo; Peracchi, Maddalena
2013-05-01
The coexistence of chronic autoimmune atrophic gastritis (CAAG) and primary hyperparathyroidism (PHPT) has been described previously, even if its extent and underlying mechanisms remain poorly understood. We therefore prospectively evaluated this association in two series of patients, one with CAAG and the other with sporadic PHPT. From January 2005 to March 2012, 107 histologically confirmed CAAG patients and 149 PHPT patients were consecutively enrolled. Routine laboratory assays included serum calcium, parathyroid hormone (PTH), plasma gastrin and chromogranin A (CgA). In CAAG patients with high PTH levels, ionized calcium and 25(OH)-vitamin D were evaluated. All CAAG and hypergastrinemic PHPT patients received an upper gastrointestinal endoscopy. Exclusion criteria were familial PHPT, MEN1 syndrome, treatment with proton pump inhibitor drugs, Helicobacter pylori infection and renal failure. Of the 107 CAAG patients, nine (8.4%) had PHPT and 13 (12.1%) had secondary hyperparathyroidism stemming from vitamin D deficiency. Among the 149 PHPT patients, 11 (7.4%) had CAAG. Gastrin and CgA levels were similar in the CAAG patients with vs those without hyperparathyroidism (either primary or secondary), and calcium and PTH levels were similar in the PHPT patients with vs those without CAAG. This study confirms a non-casual association between PHPT and CAAG. The prevalence of PHPT in CAAG patients is threefold that of the general population (8.4 vs 1-3%), and the prevalence of CAAG in PHPT patients is fourfold that of the general population (7.4 vs 2%). The mechanisms underlying this association remain unknown, but a potential role for autoimmunity is suggested.
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Expression of TRAIL and Fas in Primary Hyperparathyroidism.
Segiet, Oliwia Anna; Deska, Mariusz; Mielańczyk, Łukasz; Brzozowa-Zasada, Marlena; Buła, Grzegorz; Gawrychowski, Jacek; Wojnicz, Romuald
2017-08-01
Differentiating between parathyroid lesions is still difficult and ambiguous. In cases of primary hyperparathyroidism, appropriate and prompt diagnosis is of great importance for effective treatment and follow-up. A great amount of mechanisms contribute to the pathogenesis of primary hyperparathyroidism, such as disturbance in balance between pro- and anti-apoptotic factors. Therefore, we examined whether immunohistochemical expression of apoptotic factors, TNF-related apoptosis-inducing ligand (TRAIL) and Fas, could have clinical utility as a marker of proliferative lesions of parathyroid gland. Parathyroid specimens of 58 consecutive patients who had undertaken surgery due to primary hyperparathyroidism were incubated with purified mouse monoclonal antihuman antibodies: anti-TRAIL and anti-Fas. Staining was considered positive when at least 5% of the cells showed immunoreactivity. The percentage of cells which were positively stained for TRAIL in parathyroid hyperplasia was 9.65%, in parathyroid adenoma 8.31%, and in normal controls 2.24%. Immunoreactivity for TRAIL was detected in 91.89% of parathyroid hyperplasias, 85.71% of parathyroid adenomas, and none in healthy glands. The percentage of cells with a positive reaction to Fas in parathyroid hyperplasia was 8.92%, in parathyroid adenoma 8.09%, and in normal tissue 1.9%. The expression of Fas was found in 94.59% of parathyroid hyperplasias, 90.48% of parathyroid adenomas, and none in healthy glands. In our study, hyperplasias demonstrated the highest expression of TRAIL and Fas, whereas in adenomas it was increased compared to normal tissue, but lower than in hyperplasias. These factors could be an additive tool in the differential diagnosis of parathyroid lesions.
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The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements.
Dixon, Lisa B; Dickerson, Faith; Bellack, Alan S; Bennett, Melanie; Dickinson, Dwight; Goldberg, Richard W; Lehman, Anthony; Tenhula, Wendy N; Calmes, Christine; Pasillas, Rebecca M; Peer, Jason; Kreyenbuhl, Julie
2010-01-01
The Schizophrenia Patient Outcomes Research Team (PORT) psychosocial treatment recommendations provide a comprehensive summary of current evidence-based psychosocial treatment interventions for persons with schizophrenia. There have been 2 previous sets of psychosocial treatment recommendations (Lehman AF, Steinwachs DM. Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophr Bull. 1998;24:1-10 and Lehman AF, Kreyenbuhl J, Buchanan RW, et al. The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003. Schizophr Bull. 2004;30:193-217). This article reports the third set of PORT recommendations that includes updated reviews in 7 areas as well as adding 5 new areas of review. Members of the psychosocial Evidence Review Group conducted reviews of the literature in each intervention area and drafted the recommendation or summary statement with supporting discussion. A Psychosocial Advisory Committee was consulted in all aspects of the review, and an expert panel commented on draft recommendations and summary statements. Our review process produced 8 treatment recommendations in the following areas: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. Reviews of treatments focused on medication adherence, cognitive remediation, psychosocial treatments for recent onset schizophrenia, and peer support and peer-delivered services indicated that none of these treatment areas yet have enough evidence to merit a treatment recommendation, though each is an emerging area of interest. This update of PORT psychosocial treatment recommendations underscores both the expansion of knowledge regarding psychosocial treatments for persons with schizophrenia at the same time as the limitations in their implementation in clinical practice settings.
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1983-01-01
project area. The following summary taken from the final environmental impact statement prepared by the St. Paul District in 1974, serves well to...Archeologist 62 (2): 168-205. U.S. ARMY CORPS OF ENGINEERS 1974 Final Environmental Impact Statement: Operation and Maintenance, 9 Foot Navigation Channel...Spring Hollow Rock Shelter No. 2; Elephant Site; Waterville Rock Shelter; Jeffey Edwards Creek Rock Shelter; Pufahl Site, Allamakee County; Gingerstairs
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Lorenzoni, Valentina; Trieste, Leopoldo; Turchetti, Giuseppe
2015-01-01
The present review aims to assess the state-of-the-art regarding cost-effectiveness of therapy for secondary hyperparathyroidism in order to identify the best treatment and review methodological issues. PubMed and the Cochrane Library were searched to identify papers performing comparative analysis of costs and effects of treatment for secondary hyperparathyroidism in adult patients. Among the 66 papers identified, only 10 were included in the analysis. Treatment strategies evaluated in the selected papers were: cinacalcet in addition to vitamin D and phosphate binders versus vitamin D and phosphate binders only (seven papers), paricalcitol versus non-selective vitamin D (two papers), early and late introduction of cinacalcet in addition to vitamin D and phosphate binders (one paper) and paricalcitol versus cinacalcet (one paper). The high degree of heterogeneity among alternative treatments and methodological limits related to cost items considered, resource valuation methods and so on, make it unfeasible to reach a definite conclusion regarding cost-effectiveness but allow for future research opportunities.
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The effect of primary hyperparathyroidism on pancreatic exocrine function.
Sisman, P; Avci, M; Akkurt, A; Sahin, A B; Gul, O O; Ersoy, C; Erturk, E
2018-03-01
Elastase-1 is a proteolytic enzyme secreted by pancreatic acinar cells, and measurements of the concentration this enzyme are used to evaluate pancreatic exocrine function. We aimed to determine whether pancreatic exocrine function declines due to chronic hypercalcemia by measuring fecal elastase levels. 75 patients with primary hyperparathyroidism (18 men and 47 women) and 30 healthy subjects (11 men and 19 women) participated in this study. Renal function tests, lipid parameters, bone mineral density, and serum calcium, phosphorus, vitamin D, parathormone, glucose, and thyroid stimulating hormone levels as well as fecal elastase concentrations, were determined in these patients and controls. The mean fecal elastase level was 335.3 ± 181.4 μg/g in the PHPT group and 317.4 ± 157.3 μg/g in the control group. There was no significant difference in fecal elastase levels between the two groups (p = 0.5). Chronic hypercalcemia in primary hyperparathyroidism did not decrease the fecal elastase level, which is an indirect indicator of chronic pancreatitis; therefore, chronic hypercalcemia in PHPT may not cause chronic pancreatitis.
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Marques, Thyciara Fontenele; Vasconcelos, Renata; Diniz, Erik; Rêgo, Daniela; Griz, Luiz; Bandeira, Francisco
2015-01-01
Objective To describe the characteristics of normocalcemic primary hyperparathyroidism (NPHPT) in patients seen for osteoporosis evaluation. Patients and methods We examined the records of 156 women who came to the hospital to be screened for osteoporosis. Measurements of total calcium, PTH, 25-hydroxy vitamin D, and β-C-telopeptide were recorded. Bone mineral density and T-scores were evaluated by densitometry of the lumbar spine, femoral neck and distal one-third of the radius. The latter was only measured in patients with primary hyperparathyroidism. Nephrolithiasis and bone fractures were documented by a review of the medical records. Results We identified 14 patients with NPHPT, accounting for 8.9% of the population studied. In the medical records, the occurrence of kidney stones was reported in 28.6% of the patients with NPHPT, in contrast with only 0.7% of the noncarriers. Regarding the presence of general fractures, 21.4% of the patients with NPHPT were affected versus 16.2% of noncarriers. Conclusion Data from our study suggest that NPHPT has a diverse phenotypic presentation, implying that this may not be an “indolent” disease. PMID:21881813
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The Great Nuclear Power Debate (1)--A Summary
ERIC Educational Resources Information Center
Douglas, John H.
1976-01-01
Five issues concerning nuclear power--economics, danger from accidents, environmental effects, terrorism, and alternatives are debated, with one paragraph statements from opponents and advocates on each of the topics. (CP)
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Farinola, N; Kanjanapan, Y
2013-11-01
Denosumab, an anti-resorptive treatment for osteoporosis and skeletal metastases from solid tumours, can cause hypocalcaemia. The incidence may be higher than previously reported due to varying serum calcium cut-off and timing of measurement. The following cases illustrate patients at risk of hypocalcaemia despite supplementation. These populations, with underlying high bone turnover from metastatic bone disease or secondary hyperparathyroidism due to renal failure, may require closer monitoring of calcium levels post-denosumab administration. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Prinz, R.A.; Barbato, A.L.; Braithwaite, S.S.
1982-03-01
Twelve patients with coexistent well-differentiated thyroid carcinoma and primary hyperparathyoidism were studied to determine the frequency of previous radiation exposure. Eight were found to have received prior irradiation. External radiation was administered to the head and neck region for benign conditions such as tonsillar enlargement, acne, scrofula, and thyroid enlargement. One patient received 131I therapy for carcinoma of the thyroid. The observation that 67% of the patients in this series had previous radiation to the head and neck strongly implicates radiation exposure in the development of coexistent well-differentiated thyroid carcinoma and hyperparathyroidism.
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The Pathophysiology and Clinical Aspects of Hypercalcemic Disorders
Lee, David B. N.; Zawada, Edward T.; Kleeman, Charles R.
1978-01-01
For the purposes of this review, the vast and increasingly complex subject of hypercalcemic disorders can be broken down into the following categories: (1) Physiochemical state of calcium in circulation. (2) Pathophysiological basis of hypercalcemia. (3) Causes of hypercalcemia encountered in clinical practice: causes indicated by experience at the University of California, Los Angeles; neoplasia; hyperparathyroidism; nonparathyroid endocrinopathies; pharmacological agents; possible increased sensitivity to vitamin D; miscellaneous causes. (4) Clinical manifestations and diagnostic considerations of hypercalcemic disorders. (5) The management of hypercalcemic disorders: general measures; measures for lowering serum calcium concentration; measures for correcting primary causes—the management of asymptomatic hyperparathyroidism. PMID:362722
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[Severe macrocytic anaemia and secondary hyperparathyroidism in a vegan].
Førland, Elizabeth Siren Bjerga; Lindberg, Mats Jacob Hermansson
2015-08-10
Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet.
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Hyperparathyroidism in black patients: an update.
Yates, W. D.; Chatman, D. M.; Rogers, N.; Chung, E. B.; Nunez, A.; Leffall, L. D.
1992-01-01
Cervical exploration with removal of the pathologic gland or glands is effective treatment for parathyroid adenomas and hyperplasia. This article reports the results of a retrospective study of 41 patients who underwent elective cervical exploration for primary hyperparathyroidism at Howard University Hospital between 1974 and 1989. Preoperative localization studies for primary neck exploration consisted of an ultrasound of the neck. Removing the diseased gland/glands resulted in the resolution of the patients' symptoms and the return of calcium levels to normal. Complications included transient hypocalcemia, a wound hematoma, and a postoperative death. Images Figure 1 Figure 2 Figure 3 PMID:1507262
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1994-01-01
In accordance with the Department of Energy`s National Environmental Policy Act implementing procedures in Volume 10 of the Code of Federal Regulations, Section 1021,312, the Environmental Restoration and Waste Management Programmatic Environmental Impact Statement Implementation Plan has two primary purposes: to provide guidance for the preparation of the Programmatic Environmental Impact Statement and to record the issues resulting from the scoping and the extended public participation process. The Implementation Plan identifies and discusses the following: background of Environmental Restoration and Waste Management activities, the purpose of the Programmatic Environmental Impact Statement, and the relationship of the Programmatic Environmental Impact Statementmore » to other Departmental initiatives (Chapter 1); need and purposes for action (Chapter 2); scoping process and results of the public participation program in defining the scope of the Programmatic Environmental Impact Statement, including a summary of the comments received and their disposition (Chapter 3); planned scope and content of the Programmatic Environmental Impact Statement (Chapter 4); consultations with other agencies and the role of cooperating agencies (Chapter 5); planned schedule of major Programmatic Environmental Impact Statement milestones (Chapter 6); and responsibilities for preparation of the Programmatic Environmental Impact Statement (Chapter 7).« less
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32 CFR 1656.17 - Administrative complaint process.
Code of Federal Regulations, 2011 CFR
2011-07-01
... within ten days after the interview their personal written statements concerning the problem; (4) Place... information relevant to the problems or complaints; (2) Place a written summary of each interview in the ASW's...
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ERIC Educational Resources Information Center
Iowa Univ., Iowa City. Audiovisual Center.
This summary report of the annual conference includes statements of participant concerns prepared for the planning committee, the keynote address on the impact of mass media on education by Nicholas Johnson with responses by Minaruth Galey and Jon Dunn, and reports from the groups which studied the seven subtopics identified in general sessions:…
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National Lipid Association Annual Summary of Clinical Lipidology 2016.
Bays, Harold E; Jones, Peter H; Orringer, Carl E; Brown, W Virgil; Jacobson, Terry A
2016-01-01
The National Lipid Association (NLA) Annual Summary of Clinical Lipidology is a yearly updated summary of principles important to the patient-centered evaluation, management, and care of patients with dyslipidemia. This summary is intended to be a "living document," with future annual updates based on emerging science, clinical considerations, and new NLA Position, Consensus, and Scientific Statements, thus providing an ongoing resource that applies the latest in medical science towards the clinical management of patients with dyslipidemia. Topics include the NLA Recommendations for Patient-Centered Management of Dyslipidemia, genetics, Familial Hypercholesterolemia, secondary causes of dyslipidemia, biomarkers and advanced lipid testing, nutrition, physical activity, obesity, adiposopathy, metabolic syndrome, diabetes mellitus, lipid pharmacotherapy, lipid-altering drug interactions, lipoprotein apheresis, dyslipidemia management and treatment based upon age (children, adolescents, and older individuals), dyslipidemia considerations based upon race, ethnicity and gender, dyslipidemia and human immune virus infection, dyslipidemia and immune disorders, adherence strategies and collaborative care, and lipid-altering drugs in development. Hyperlinks direct the reader to sentinel online tables, charts, and figures relevant to lipidology, access to online atherosclerotic cardiovascular disease risk calculators, worldwide lipid guidelines, recommendations, and position/scientific statements, as well as links to online audio files, websites, slide shows, applications, continuing medical education opportunities, and patient information. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.
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Bhargav, P R K; Sabaretnam, M; Amar, V; Devi, N Vimala
2018-05-04
Primary hyperparathyroidism is one of the most common endocrine disorders requiring surgical parathyroidectomy for its definitive treatment. Surgical exploration is traditionally performed through conventional open neck approach. A wide range of minimal access and minimally invasive endoscopic techniques (gas less and with gas) have been attempted in the past two decades. In this context, we evaluated the feasibility and safety of an innovative transoral endoscopic parathyroidectomy (EP) technique, which represents a paradigm shift in transluminal endocrine surgery. This is a prospective study conducted at a tertiary care Endocrine Surgery Department in South India between May 2016 and August 2017. We employed a novel transoral, lower vestibular route for EP. All the clinical, investigative, operative, pathological and post-operative data were collected from our prospectively filled database. Statistical analysis was performed with SPSS 20.0 version. Under inhalational general anaesthesia, access to the neck was obtained with 3 ports (central frenulotomy and two lateral port sites), dissected in subplatysmal plane and insufflated with 6 mm Hg CO 2 for working space. Rest of surgical steps is similar to conventional open parathyroidectomy. Out of the 38 hyperparathyroidism cases operated during the study, 12 (32%) were operated by this technique. Mean operative time was 112 ± 15 min (95-160). The post-operative course was uneventful with no major morbidity, hypocalcemia or recurrent laryngeal nerve palsy. Cure and diagnosis were confirmed by> 50% fall in intraoperative parathyroid hormone levels and histopathology (all were benign solitary adenomas). Through this study, we opine that this novel transoral vestibular route parathyroidectomy is a feasibly applicable approach for primary sporadic hyperparathyroidism, especially with solitary benign adenomas.
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Measurement of intraoperative parathyroid hormone predicts long-term operative success.
Westerdahl, Johan; Lindblom, Pia; Bergenfelz, Anders
2002-02-01
A decrease in the intraoperative parathyroid hormone (PTH) level predicts long-term operative success. A case series of consecutive patients undergoing parathyroidectomy with intraoperative PTH measurement. A university hospital. One hundred two patients with sporadic primary hyperparathyroidism underwent parathyroidectomy according to the principles of unilateral exploration with intraoperative PTH measurement. Longitudinal effects on levels of serum calcium and PTH. In 94 of 98 patients who underwent primary exploration because of a solitary adenoma, intraoperative PTH decreased at least 60% 15 minutes after gland excision. The 4 cases in which PTH fell to less than 60% were classified as false negatives. Patients examined for multiglandular disease (n = 4) were correctly predicted not to have an adenoma. Twenty-two patients (22%) were unavailable for 5-year follow-up. These patients were followed up for 2 months to 48 months (median, 24 months), and none developed recurrent primary hyperparathyroidism. Of the remaining 80 patients (78%), all but 1 patient had normal or slightly decreased serum calcium levels (mean +/- SD, 9.24 +/- 0.4 mg/dL [2.31 +/- 0.10 mmol/L]) at 5-year follow-up. One patient with hypercalcemia (10.6 mg/dL [2.65 mmol/L]) was interpreted to have developed renal failure with secondary hyperparathyroidism. Thirty-four patients had elevated serum PTH levels at least once during the postoperative study period, with normal or slightly decreased calcium concentrations. The prediction of late postoperative normocalcemia by means of intraoperative PTH measurement had an overall accuracy of 95%. The measurement of intraoperative PTH during surgery for primary hyperparathyroidism accurately differentiates between single- and multiple-gland disease and ensures good long-term results.
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Effects of thyroid cystectomy for primary hyperparathyroidism on immune function.
Yin, Xiangdang; Hu, Liang; Wang, Xiaochun
2016-01-01
To evaluate the effects of thyroid cystectomy for primary hyperparathyroidism on immune function. Ninety-two patients with parathyroid cysts complicated with primary hyperparathyroidism were randomly divided into a treatment group and a control group (n=46). The treatment group received endoscopic thyroidectomy through the anterior chest wall via the areolar approach, and the control group was treated with conventional open thyroidectomy. The two groups had similar immune function indices as well as thyroid hormone, serum calcium and phosphorus levels before surgery (P>0.05). After surgery, FT3 and FT4 levels significantly increased in both groups, whereas that of TSH significantly decreased (P<0.05). The levels of the two groups differed significantly on the postoperative 5th day (P<0.05). NK%, CD3+%, CD4+% and CD8+%, which significantly fluctuated on the postoperative 1st day in both groups (P<0.05), were basically recovered on the postoperative 5th day in the treatment group that had significantly different outcomes from those of the control group (P<0.05). On the postoperative 1st and 5th days, the treatment group had significantly lower serum calcium level and significantly higher serum phosphorus level than those of the control group (P<0.05). The surgeries were successfully performed for all patients. During three months of follow-up, the treatment group was significantly less prone to complications such as surgical site infection, recurrent laryngeal nerve injury, parathyroid crisis and hoarseness than the control group (P<0.05). For treatment of primary hyperparathyroidism, endoscopic thyroidectomy through the anterior chest wall via the areolar approach decreased the incidence rate of complications, as well as promoted the recovery of serum calcium and phosphorous levels, probably by only mildly affecting immune function and thyroid hormone levels.
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Di Monaco, Marco; Castiglioni, Carlotta; Tappero, Rosa
2016-10-01
Hip-fracture patients with vitamin D deficiency can have either secondary hyperparathyroidism or normal levels of parathyroid hormone (PTH). We hypothesized that bone mineral density (BMD) could be lower in patients with high PTH levels than in those with normal levels of PTH, irrespectively of the severity of vitamin D depletion. In this cross-sectional study, we examined 405 women who had serum 25-hydroxyvitamin D below 12ng/ml 20.0 ± 5.9 (mean ± SD) days after a hip-fracture. PTH was assessed by a chemiluminescent immunometric assay and BMD by dual-energy x-ray absorptiometry at the unfractured femoral neck. BMD was significantly lower in the 148 women with secondary hyperparathyroidism than in the 257 with normal PTH levels: the mean T-score (SD) was -2.88 (0.93) and -2.65 (0.83), respectively, in the two groups (mean difference 0.23; 95% CI 0.05 - 0.41; P = 0.010). The association between PTH status and BMD persisted after adjustment for age, body mass index, phosphate, albumin-adjusted total calcium, 25-hydroxyvitamin D, estimated glomerular filtration rate, and magnesium (P=0.01). The presence of secondary hyperparathyroidism was significantly associated with a femoral neck T-score lower than -2.5. The adjusted odds ratio was 1.81 (95% CI 1.11 - 2.95; P=0.017). Our results show that PTH levels in the presence of severe vitamin D deficiency were significantly associated with femoral BMD in women with hip-fracture. Prevention and treatment of vitamin D deficiency may be particularly relevant in women who develop secondary hyperparathyroidism.
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Ferraresi, Martina; Pia, Anna; Guzzo, Gabriella; Vigotti, Federica Neve; Mongilardi, Elena; Nazha, Marta; Aroasio, Emiliano; Gonella, Cinzia; Avagnina, Paolo; Piccoli, Giorgina Barbara
2015-10-01
Severe hyperparathyroidism is a challenge on hemodialysis. The definition of dialysate calcium (Ca) is a pending issue with renewed importance in cases of individualized dialysis schedules and of portable home dialysis machines with low-flow dialysate. Direct measurement of calcium mass transfer is complex and is imprecisely reflected by differences in start-to-end of dialysis Ca levels. The study was performed in a dialysis unit dedicated to home hemodialysis and to critical patients with wide use of daily and tailored schedules. The Ca-phosphate (P)-parathyroid hormone (PTH) profile includes creatinine, urea, total and ionized Ca, albumin, sodium, potassium, P, PTH levels at start, mid, and end of dialysis. "Severe" secondary hyperparathyroidism was defined as PTH > 300 pg/mL for ≥3 months. Four schedules were tested: conventional dialysis (polysulfone dialyzer 1.8-2.1 m(2) ), with dialysate Ca 1.5 or 1.75 mmol/L, NxStage (Ca 1.5 mmol/L), and NxStage plus intradialytic Ca infusion. Dosages of vitamin D, calcium, phosphate binders, and Ca mimetic agents were adjusted monthly. Eighty Ca-P-PTH profiles were collected in 12 patients. Serum phosphate was efficiently reduced by all techniques. No differences in start-to-end PTH and Ca levels on dialysis were observed in patients with PTH levels < 300 pg/mL. Conversely, Ca levels in "severe" secondary hyperparathyroid patients significantly increased and PTH decreased during dialysis on all schedules except on Nxstage (P < 0.05). Our data support the need for tailored dialysate Ca content, even on "low-flow" daily home dialysis, in "severe" secondary hyperparathyroid patients in order to increase the therapeutic potentials of the new dialysis techniques. © 2015 International Society for Hemodialysis.
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Prolonged hypophosphatemia following parathyroidectomy in chronic hemodialysis patients.
Altun, Eda; Paydas, Saime; Kaya, Bulent; Balal, Mustafa
2015-09-01
Secondary hyperparathyroidism (SHPT) is a common problem in patients with end-stage renal disease. In cases with severe and resistant SHPT, surgical parathyroidectomy (PTX) is recommended. Hungry bone syndrome (HBS) following surgical PTX is most often associated with hypocalcemia and hypophosphatemia. The mechanisms for the HBS are not clear, and a method for its prevention has not been established. We present three hemodialysis patients with persistant hypophosphatemia after PTX. In our parathyroidectomized patients, hypocalcemia could be corrected with calcium and vitamin D treatment, but hypophosphatemia continued for eight months in one patient and in two other patients until the last visit (10 and 2 months, respectively). Predisposing factors such as old age, diabetes mellitus and parathyroid adenoma were not found in our patients. All three patients were younger (<35 years old) and anuric. Hemodialysis durations were seven, three and two years. In summary, HBS presented with hypocalcemia, and especially hypophosphatemia cannot be developed uncommonly and may persist for a long time following PTX in HD patients.
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The NASA role in major areas of human concern: Transportation
NASA Technical Reports Server (NTRS)
1973-01-01
After introducing some of the general factors that have affected progress in the transportation area, NASA program elements are examined to illustrate relevant points of contact. Interpretive steps are taken throughout the statement to show a few of the more important ways people's lives have been affected as a result of the work of NASA and other organizations functioning in this area. The principal documents used and interviews conducted are identified after the conclusion of this statement. This statement, it should be noted, is incomplete in many respects, primarily because it reflects only a small number of the technical, economic, and social forces affecting American life. Taken as a summary statement, however, it hopefully will provide a useful basis for better understanding NASA's role in the national attempt to upgrade the quality of transportation services.
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Design data needs modular high-temperature gas-cooled reactor. Revision 2
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1987-03-01
The Design Data Needs (DDNs) provide summary statements for program management, of the designer`s need for experimental data to confirm or validate assumptions made in the design. These assumptions were developed using the Integrated Approach and are tabulated in the Functional Analysis Report. These assumptions were also necessary in the analyses or trade studies (A/TS) to develop selections of hardware design or design requirements. Each DDN includes statements providing traceability to the function and the associated assumption that requires the need.
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Endocrine causes of calcium disorders.
Greco, Deborah S
2012-11-01
Endocrine diseases that may cause hypercalcemia and hypocalcemia include hyperparathyroidism, hypoparathyroidism, thyroid disorders, hyperadrenocorticism, hypoadrenocorticism, and less commonly pheochromocytoma and multiple endocrine neoplasias. The differential diagnosis of hypercalcemia may include malignancy (lymphoma, anal sac carcinoma, and squamous cell carcinoma), hyperparathyroidism, vitamin D intoxication, chronic renal disease, hypoadrenocorticism, granulomatous disorders, osteolysis, or spurious causes. Hypocalcemia may be caused by puerperal tetany, pancreatitis, intestinal malabsorption, ethlyene glycol intoxication, acute renal failure, hypopararthyroidism, hypovitaminosis D, hypomagnesemia, and low albumin. This article focuses on the endocrine causes of calcium imbalance and provides diagnostic and therapeutic guidelines for identifying the cause of hypercalcemia and hypocalcemia in veterinary patients. Copyright © 2012 Elsevier Inc. All rights reserved.
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Hypercalcemia: an unusual etiology of a common menopausal symptom.
Roark, Abrea; Wilson, Brian P; Eyster, Kathleen M; Timmerman, Gary L; Allard, Brandon L; Hansen, Keith A
2011-06-01
To describe atypical vasomotor symptoms that were secondary to primary hyperparathyroidism. Case report. University medical center. A 57-year-old, postmenopausal woman with recalcitrant hot flushes. Parathyroid adenomectomy. Vasomotor symptom relief. Postoperative relief of atypical vasomotor symptoms. A patient 17 years postmenopause presented with atypical vasomotor symptoms that did not respond to hormone therapy and proved to be due to hypercalcemia secondary to primary hyperparathyroidism. An atypical manifestation of a common condition or an uncharacteristic therapeutic response should alert health care providers to the possibility of a different diagnosis. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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Primary hyperparathyroidism with classic and severe skeletal involvement.
Sandoval, Mark Anthony S; Paz-Pacheco, Elizabeth
2010-08-26
A 63-year-old woman has had multiple repeated fractures. A diagnosis of primary hyperparathyroidism (PHPT) was made after she was found to be hypercalcaemic with an elevated level of intact parathyroid hormone (iPTH). Radiographs revealed classic and severe bone findings in PHPT, features which were common in the past but are thought to be rare at this modern age. She also had nephrolithiasis and osteoporosis. An enlarged parathyroid gland was seen on ultrasound and CT scan, and hyperfunction was demonstrated by scintigraphy. Parathyroidectomy was performed. Histopathologic analysis revealed a parathyroid adenoma. She developed the hungry-bone syndrome 7 days postoperatively, which resolved with with administration of calcium and calcitriol.
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Ribot, C; Dutau, G; Manelfe, C; Bouissou, H; Rochiccioli, P
1977-02-01
A parathyroid adenoma is reported in a girl aged 12 years in whom hypercalcaemia was discovered by chance. Investigation of calcium metabolism suggested the diagnosis of hyperparathyroidism and studies of the urinary cyclic AMP and determination of the plasma parathyroid hormone concentration further added to the evidence. The diagnosis of parathyroid adenoma was made after determination of the parathyroid hormone concentration at various sights during selective catheterization of the tyroid veins. This was confirmed at surgery. In this patient the place of catheterization of the inferior thyroid veins in the early diagnosis of primary hyperparathyroidism is discussed.
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Wallace, Eric; Day, Matthew; Fadare, Oluwole; Schaefer, Heidi
2013-02-01
Vitamin D-resistant rickets is the common clinical outcome of multiple genetic mutations that alter the regulation of phosphorus and vitamin D metabolism, mainly through their effects on fibroblast growth factor 23 (FGF-23). These diseases typically present in childhood with the classic physical examination finding of nutritional rickets, such as genu varum/valgum and rachitic rosary. Treatment, which is aimed at improving severe bone disease with vitamin D and phosphorus supplementation, can cause secondary hyperparathyroidism and/or kidney failure from nephrocalcinosis over the life of the patient. Although FGF-23 has been shown to downregulate parathyroid hormone in vitro, its effect on parathyroid secretion in disease states such as chronic kidney disease and X-linked hypophosphatemic rickets is unclear because elevations in FGF-23 and parathyroid hormone levels characterize both of these disease states. We describe a case of vitamin D-resistant rickets that presented with a femur fracture through a brown tumor. Radiographs show the combination of severe bony abnormalities associated with both long-standing hyperparathyroidism and vitamin D-resistant rickets. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Sormaz, Ismail Cem, E-mail: icsormaz@gmail.com; Poyanlı, Arzu, E-mail: arzupoyanli@yahoo.com; Açar, Sami, E-mail: acarrsami@gmail.com
BackgroundThe aim of the study was to evaluate the results of ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) in hyperparathyroid patients who refused surgery or had high surgical risks.Patients and MethodsFive patients with hyperparathyroidism (HPT) underwent US-guided RFA for a single hyperfunctioning parathyroid lesion. Post-ablation serum calcium and parathormone (PTH) assays were performed. All patients underwent imaging studies 6 months after the ablation to visualize the post-ablation change in the size of the treated parathyroid lesions.ResultsAll patients were normocalcemic on the post-ablation 1st day and 6th month. The post-ablation PTH levels were normal in three patients but remained elevated in two patients.more » The size of the parathyroid lesion was ≥30 mm in the two patients with elevated PTH, whereas the lesion was smaller than 30 mm in those with normal post-ablation PTH values.ConclusionAlthough this is a limited case series, it demonstrates the potential feasibility of RFA for HPT. Benefits were achieved particularly in patients with small parathyroid lesions.« less
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Irondequoit Creek Watershed New York, Final Feasibility Report and Environmental Impact Statement.
1982-03-01
National Flood Insurance Program 58 8 System of Accounts 95 9 Summary of Benefits and Costs 96 10 Summary of Average Annual Benefits - Selected Plan 112...material, velocity distribution, vegetation, soil type, topography, and especially rainfall regime, where a few intense storms can account for severe...Alternative B is described later in this report. Flood Insurance - Flood insurance provides some financial protection to vic- tims of flood related
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Defining a Bobath clinical framework - A modified e-Delphi study.
Vaughan-Graham, Julie; Cott, Cheryl
2016-11-01
To gain consensus within the expert International Bobath Instructors Training Association (IBITA) on a Bobath clinical framework on which future efficacy studies can be based. A three-round modified e-Delphi approach was used with 204 full members of the IBITA. Twenty-one initial statements were generated from the literature. Consensus was defined a priori as at least 80% of the respondents with a level of agreement on a Likert scale of 4 or 5. The Delphi questionnaire for each round was available online for two weeks. Summary reports and subsequent questionnaires were posted within four weeks. Ninety-four IBITA members responded, forming the Delphi panel, of which 68 and 66 responded to Rounds Two and Three, respectively. The 21 initial statements were revised to 17 statements and five new statements in Round Two in which eight statements were accepted and two statements were eliminated. Round Three presented 12 revised statements, all reaching consensus. The Delphi was successful in gaining consensus on a Bobath clinical framework in a geographically diverse expert association, identifying the unique components of Bobath clinical practice. Discussion throughout all three Rounds revolved primarily around the terminology of atypical and compensatory motor behavior and balance.
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... Process Research Training & Career Development Funded Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive ...
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75 FR 60651 - Corporate Credit Unions
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-01
... for the corporate credit union and availability of proposed financial services from alternative depository institutions); Summary of survey results and/or customer base analysis; Proposed financial...; Semiannual pro-forma financial statements for the first three years, [[Page 60653
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Collins, Michael W.; Kontos, Anthony P.; Okonkwo, David O.; Almquist, Jon; Bailes, Julian; Barisa, Mark; Bazarian, Jeffrey; Bloom, O. Josh; Brody, David; Cantu, Robert; Cardenas, Javier; Clugston, Jay; Cohen, Randall; Echemendia, Ruben; Elbin, R.J.; Ellenbogen, Richard; Fonseca, Janna; Gioia, Gerard; Guskiewicz, Kevin; Heyer, Robert; Hotz, Gillian; Iverson, Grant L.; Jordan, Barry; Manley, Geoffrey; Maroon, Joseph; McAllister, Thomas; McCrea, Michael; Mucha, Anne; Pieroth, Elizabeth; Podell, Kenneth; Pombo, Matthew; Shetty, Teena; Sills, Allen; Solomon, Gary; Thomas, Danny G.; Valovich McLeod, Tamara C.; Yates, Tony; Zafonte, Ross
2016-01-01
Background Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. Objective To describe the current landscape of treatment for concussion and provide summary agreements related to treatment in order to assist clinicians in the treatment of concussion. Methods On October 14–16, 2015, the Targeted Evaluation & Active Management (TEAM) Approaches To Treating Concussion meeting was convened in Pittsburgh, Pennsylvania, USA. 37 concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research, and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. Results A total of 16 statements of agreement were supported covering: 1) Summary of the Current Approach to Treating Concussion, 2) Heterogeneity and Evolving Clinical Profiles of Concussion, 3) Targeted Evaluation and Active Management Approach to Concussion Treatment: Specific Strategies, and 4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97–100%. Conclusion Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies based on modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery following concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. PMID:27741219
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Bays, Harold E; Jones, Peter H; Jacobson, Terry A; Cohen, David E; Orringer, Carl E; Kothari, Shanu; Azagury, Dan E; Morton, John; Nguyen, Ninh T; Westman, Eric C; Horn, Deborah B; Scinta, Wendy; Primack, Craig
2016-01-01
Bariatric procedures often improve lipid levels in patients with obesity. This 2-part scientific statement examines the potential lipid benefits of bariatric procedures and represents contributions from authors representing the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and the Obesity Medicine Association. The foundation for this scientific statement was based on data published through June 2015. Part 1 of this 2-part scientific statement provides an overview of: (1) adipose tissue, cholesterol metabolism, and lipids; (2) bariatric procedures, cholesterol metabolism, and lipids; (3) endocrine factors relevant to lipid influx, synthesis, metabolism, and efflux; (4) immune factors relevant to lipid influx, synthesis, metabolism, and efflux; (5) bariatric procedures, bile acid metabolism, and lipids; and (6) bariatric procedures, intestinal microbiota, and lipids, with specific emphasis on how the alterations in the microbiome by bariatric procedures influence obesity, bile acids, and inflammation, which in turn, may all affect lipid levels. Included in part 2 of this comprehensive scientific statement will be a review of: (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on cardiovascular disease; and finally (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies that may occur after bariatric procedures. This document represents the executive summary of part 1. Copyright © 2016 National Lipid Association. All rights reserved.
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Chestnut, Eleanor K; Markman, Ellen M
2018-06-28
Although "Girls are as good as boys at math" explicitly expresses equality, we predict it could nevertheless suggest that boys have more raw talent. In statements with this subject-complement structure, the item in the complement position serves as the reference point and is thus considered more typical and prominent. This explains why "Tents are like houses," for instance, sounds better than "Houses are like tents"-people generally think of houses as more typical. For domains about ability, the reference point should be the item that is typically more skilled. We further propose that the reference point should be naturally more skilled. In two experiments, we presented adults with summaries of actual scientific evidence for gender equality in math (Experiment 1) or verbal ability (Experiment 2), but we manipulated whether the reference point in the statements of equality in the summaries (e.g., "Boys' verbal ability is as good as girls'") was girls or boys. As predicted, adults attributed more natural ability to each gender when it was in the complement rather than subject position. Yet, in Experiment 3, we found that when explicitly asked, participants judged that such sentences were not biased in favor of either gender, indicating that subject-complement statements must be transmitting this bias in a subtle way. Thus, statements such as "Girls are as good as boys at math" can actually backfire and perpetuate gender stereotypes about natural ability. © 2018 Cognitive Science Society, Inc.
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ERIC Educational Resources Information Center
Texas Education Agency, Austin.
This summary highlights implementation strategies from the full report for restructuring middle grade education in Texas. The task force was guided by a central theme--a vision of Texas schools using each other as resources and the campus planning process as a vehicle for implementing research-based concepts and practices in the middle grades.…
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ERIC Educational Resources Information Center
Cassidy, Kevin, Ed.
This document consists of three parts. Part I is a summary report of the Fourth Annual Non-Governmental Organizations/United Nations Fund for Population Activities (NGO/UNFPA) Consultation on Population. It includes: an opening statement by David Poindexter; presentations by Bradman Weerakoon ("Opportunities for Action") and Sheldon Segal ("Global…
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Mu, Alex; Weinberg, Erica; Moulin, Dwight E; Clarke, Hance
2017-11-01
To provide family physicians with a practical clinical summary of the Canadian Pain Society (CPS) revised consensus statement on the pharmacologic management of neuropathic pain. A multidisciplinary interest group within the CPS conducted a systematic review of the literature on the current treatments of neuropathic pain in drafting the revised consensus statement. Gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors are the first-line agents for treating neuropathic pain. Tramadol and other opioids are recommended as second-line agents, while cannabinoids are newly recommended as third-line agents. Other anticonvulsants, methadone, tapentadol, topical lidocaine, and botulinum toxin are recommended as fourth-line agents. Many pharmacologic analgesics exist for the treatment of neuropathic pain. Through evidence-based recommendations, the CPS revised consensus statement helps guide family physicians in the management of patients with neuropathic pain. Copyright© the College of Family Physicians of Canada.
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Commercial aviation : a framework for considering federal financial assistance
DOT National Transportation Integrated Search
2001-01-01
This is the statement of David M. Walker, Comptroller General of the United States, before the Committee on Commerce, Science, and Transportation, U.S. Senate regarding provision of financial assistance to the airlines. In summary, the government nee...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-29
...: Notice. SUMMARY: Pursuant to the National Environmental Policy Act of 1969, the General Services... of Entry. On July 21, 2011, the Acting Regional Administrator, Pacific Rim Region, approved the ROD...
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78 FR 14806 - Health Resources and Services Administration
Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-07
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice; correction. SUMMARY: HRSA published a document in the Federal...
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Terrestrial Laser Scanning-Based Bridge Structural Condition Assessment : Tech Transfer Summaries
DOT National Transportation Integrated Search
2016-05-01
Problem Statement : While several state departments of transportation (DOTs) have used : terrestrial laser scanning (TLS) in the project planning phase, limited : research has been conducted on employing laser scanners to detect : cracks for bridge c...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... available to the public as provided in 40 CFR 1502.19 and 1506.6. A summary may be circulated in lieu of the EIS, as provided in 40 CFR 1502.19, if the statement is unusually long. These documents will normally...
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75 FR 11882 - Environmental Impact Statements and Regulations; Availability of EPA Comments
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-12
... Status, Implementation, United States. Summary: EPA does not object to the proposed project. Rating LO.... Rating LO. EIS No. 20100010, ERP No. D-COE-E39079-NC, Surf City and North Topsail Beach Project, To...
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ERIC Educational Resources Information Center
Piedmont Virginia Community Coll., Charlottesville, VA.
Presents Piedmont Virginia Community College's (PVCC's) strategic plan. Contains the following chapters: (1) introduction; (2) statement of mission; (3) summary of the college's strategic initiatives: funding, organization, faculty and staff, curriculum and instruction, enrollment management, students and student services, facilities, technology,…
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76 FR 80342 - Coastal Zone Management Program: Illinois
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-23
... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Coastal Zone Management Program: Illinois AGENCY: Office of Ocean and Coastal Resource Management (OCRM), National Oceanic and... Environmental Impact Statement. SUMMARY: NOAA's Office of Ocean and Coastal Resource Management (OCRM) announces...
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Hypercalcemic crisis and primary hyperparathyroidism: Cause of an unusual electrical storm.
Guimarães, Tatiana; Nobre Menezes, Miguel; Cruz, Diogo; do Vale, Sónia; Bordalo, Armando; Veiga, Arminda; Pinto, Fausto J; Brito, Dulce
2017-12-01
Hypercalcemia is a known cause of heart rhythm disorders, however its association with ventricular arrhythmias is rare. The authors present a case of a fifty-three years old male patient with a ischemic and ethanolic dilated cardiomyopathy, and severely reduced ejection fraction, carrier of cardiac resynchronization therapy (CRT) with cardioverter defibrillator (ICD), admitted in the emergency department with an electrical storm, with multiple appropriated ICD shocks, refractory to antiarrhythmic therapy. In the etiological investigation was documented severe hypercalcemia secondary to primary hyperparathyroidism undiagnosed until then. Only after the serum calcium level reduction ventricular tachycardia was stopped. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.
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International consensus statement on allergy and rhinology: allergic rhinitis-executive summary.
Wise, Sarah K; Lin, Sandra Y; Toskala, Elina
2018-02-01
The available allergic rhinitis (AR) literature continues to grow. Critical evaluation and understanding of this literature is important to appropriately utilize this knowledge in the care of AR patients. The International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR) has been produced as a multidisciplinary international effort. This Executive Summary highlights and summarizes the findings of the comprehensive ICAR:AR document. The ICAR:AR document was produced using previously described methodology. Specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus. Over 100 individual topics related to AR diagnosis, pathophysiology, epidemiology, disease burden, risk factors, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR were addressed in the comprehensive ICAR:AR document. Herein, the Executive Summary provides a synopsis of these findings. In the ICAR:AR critical review of the literature, several strengths were identified. In addition, significant knowledge gaps exist in the AR literature where current practice is not based on the best quality evidence; these should be seen as opportunities for additional research. The ICAR:AR document evaluates the strengths and weaknesses of the AR literature. This Executive Summary condenses these findings into a short summary. The reader is also encouraged to consult the comprehensive ICAR:AR document for a thorough description of this work. © 2018 ARS-AAOA, LLC.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-09
... (NRC) Regulatory Issue Summary 2003-18 Supplement 2, ``Use of Nuclear Energy Institute (NEI) 99-01... with 10 CFR 51.22. Therefore, pursuant to 10 CFR 51.22(b), no environmental impact statement or...
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Debris mitigation methods for bridge piers : tech transfer summary.
DOT National Transportation Integrated Search
2012-06-01
Problem statement: Debris accumulation on bridge piers is an on-going national problem that can obstruct waterway openings at bridges and also result in significant erosion of stream banks and scour at abutments and piers. : In some cases, debris acc...
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Minimally invasive videoscopic parathyroidectomy: a feasibility study in dogs and humans.
Norman, J; Albrink, M H
1997-10-01
With increasing experience using preoperative sestamibi nuclear scanning, several reports have shown that selective unilateral neck exploration is sufficient in most patients with primary hyperparathyroidism. The current study was undertaken to determine the feasibility of videoscopic parathyroidectomy as a means to decrease scar size while allowing adequate exposure for the identification of normal parathyroid glands and removal of those glands that are enlarged. Eight mongrel dogs underwent removal of all parathyroid glands and both lobes of the thyroid using videoscopic techniques. Once the technical aspects of the operation were established, four patients with primary hyperparathyroidism underwent sestamibi-directed unilateral videoscopic neck exploration with attempted parathyroid removal. All thyroid and parathyroid tissues were removed from each dog without complications. Maintenance of an adequate working space proved to be the major difficulty that necessitated placement of a small mechanical retractor. This problem was even more severe in humans, which prevented the identification of one of four adenomas and three of four normal glands. Although videoscopic surgery is possible within the loose connective tissues of the canine neck, the inability to establish an adequate working space within the neck of humans and the location of parathyroid glands behind the thyroid precludes the use of this technique for patients with hyperparathyroidism.
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Bone changes in hypercalcemia of malignancy in dogs.
Norrdin, R W; Powers, B E
1983-08-15
Bone was collected for trabecular bone morphometry from 6 dogs with hypercalcemia of malignancy. Five of the dogs had lymphosarcoma and 1 had an anal sac apocrine gland carcinoma with vertebral metastases. Parathyroid gland weights varied around normal, with those for 1 dog being slightly low and those for another dog being moderately increased. As a group, the dogs had decreased bone volume, with increased resorption surfaces and increased numbers of osteoclasts. In 4 dogs, osteoid seams and osteoblasts were limited in extent and this distinguished them from dogs with hyperparathyroidism. Although most dogs had received corticosteroids, chemotherapy, or radiation treatment, the bone changes in these dogs were similar to 1 dog that had not received treatment. Also, the changes could not be related to uremia or renal mineralization that had developed in 2 of the dogs. Two of the dogs had somewhat greater amounts of osteoid-covered surface and slightly widened osteoid seams, ie, findings more like those of hyperparathyroidism. One of these dogs had anal sac apocrine gland carcinoma and the other had lymphosarcoma in which there was invasion of the bone cortex at the sampling site. It was concluded that bone remodeling changes do occur in hypercalcemia of malignancy and that these changes are varied and often are not those of hyperparathyroidism.
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Lithium-associated primary hyperparathyroidism complicated by nephrogenic diabetes insipidus.
Aksakal, Nihat; Erçetin, Candaş; Özçınar, Beyza; Aral, Ferihan; Erbil, Yeşim
2015-01-01
Lithium-associated hyperparathyroidism is the leading cause of hypercalcemia in lithium-treated patients. Lithium may lead to exacerbation of pre-existing primary hyperparathyroidism or cause an increased set-point of calcium for parathyroid hormone suppression, leading to parathyroid hyperplasia. Lithium may cause renal tubular concentration defects directly by the development of nephrogenic diabetes insipidus or indirectly by the effects of hypercalcemia. In this study, we present a female patient on long-term lithium treatment who was evaluated for hypercalcemia. Preoperative imaging studies indicated parathyroid adenoma and multinodular goiter. Parathyroidectomy and thyroidectomy were planned. During the postoperative course, prolonged intubation was necessary because of agitation and delirium. During this period, polyuria, severe dehydration, and hypernatremia developed, which responded to controlled hypotonic fluid infusions and was unresponsive to parenteral desmopressin. A diagnosis of nephrogenic diabetes insipidus was apparent. A parathyroid adenoma and multifocal papillary thyroid cancer were detected on histopathological examination. It was thought that nephrogenic diabetes insipidus was masked by hypercalcemia preoperatively. A patient on lithium treatment should be carefully followed up during or after surgery to prevent life-threatening complications of previously unrecognized nephrogenic diabetes insipidus, and the possibility of renal concentrating defects on long-term lithium use should be sought, particularly in patients with impaired consciousness.
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Bhadada, Sanjay K; Palnitkar, Saroj; Qiu, Shijing; Parikh, Nayana; Talpos, Gary B; Rao, Sudhaker D
2013-11-01
Tumor-induced osteomalacia (TIO) is an acquired hypophosphatemic metabolic bone disorder that can be cured by removing or ablating the offending tumor. However, when the tumor cannot be localized, lifelong therapy with oral phosphate and calcitriol or cinacalcet with close monitoring is required. A 56-year-old man was diagnosed with TIO in 1990. Initial therapy consisted of oral phosphate and calcitriol with symptomatic and biochemical improvement and healing of osteomalacia. Eight years later, hypercalcemic hyperparathyroidism developed, requiring subtotal parathyroidectomy with a transient increase in serum phosphate and normalization of serum calcium and PTH. Recurrent hypercalcemic hyperparathyroidism developed after 10 years of medical therapy. A deliberate total parathyroidectomy produced a prompt rise in serum phosphate into the normal range > 3.0 mg/dL and remained normal during the next 4 years of follow-up, despite continued very high serum fibroblast growth factor-23 levels throughout the 23-year follow-up. We report an unusual case of a TIO patient with long-term follow-up who developed recurrent hypercalcemic hyperparathyroidism on long-term oral phosphate therapy. Deliberate total parathyroidectomy normalized serum phosphate despite persistently elevated fibroblast growth factor-23 levels. Total parathyroidectomy offers a potentially novel therapy in some patients with TIO in whom medical therapy is not feasible or the tumor is unresectable.
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Morón, Fanny; Delumpa, Alfred; Guffey, Danielle; Dunaway, David
2017-01-01
Objective This study aims to compare the sensitivity of dual phase (non-contrast and arterial) versus single phase (arterial) CT for detection of hyper-functioning parathyroid glands in patients with primary hyperparathyroidism. Methods The CT scans of thirty-two patients who have biochemical evidence of primary hyperparathyroidism, pathologically proven parathyroid adenomas, and pre-operative multiphase parathyroid imaging were evaluated retrospectively in order to compare the adequacy of single phase vs. dual phase CT scans for the detection of parathyroid adenomas. Results The parathyroid adenomas were localized in 83% of cases on single arterial phase CT and 80% of cases on dual phase CT. The specificity for localization of parathyroid tumor was 96% for single phase CT and 97% for dual phase CT. The results were not significantly different (p = 0.695). These results are similar to those found in the literature for multiphase CT of 55–94%. Conclusions Our study supports the use of a single arterial phase CT for the detection of hyperfunctioning parathyroid adenomas. Advances in knowledge: a single arterial phase CT has similar sensitivity for localizing parathyroid adenomas as dual phase CT and significantly reduces radiation dose to the patient. PMID:28828238
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[Acute pancreatitis associated with hypercalcaemia].
Tun-Abraham, Mauro Enrique; Obregón-Guerrero, Gabriela; Romero-Espinoza, Larry; Valencia-Jiménez, Javier
2015-01-01
Hypercalcaemia due to primary hyperparathyroidism is a rare cause of acute pancreatitis, with a reported prevalence of 1.5 to 8%. There is no clear pathophysiological basis, but elevated parathyroid hormone and high serum calcium levels could be responsible for calcium deposit in the pancreatic ducts and activation of pancreatic enzymes, which may be the main risk factor for developing acute pancreatitis. The aim of this report is to describe four cases. Four cases are reported of severe pancreatitis associated with hypercalcaemia secondary to primary hyperparathyroidism; three of them with complications (two pseudocysts and one pancreatic necrosis). Cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, studies showed the parathyroid adenoma. Surgical resection was the definitive treatment in all four cases. None of the patients had recurrent acute pancreatitis events during follow-up. Acute pancreatitis secondary to hypercalcaemia of primary hyperparathyroidism is rare; however, when it occurs it is associated with severe pancreatitis. It is suspected in patients with elevated serum calcium and high parathyroid hormone levels. Imaging techniques such as cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, should be performed, to confirm clinical suspicion. Surgical resection is the definitive treatment with excellent results. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
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Cinacalcet in peritoneal dialysis patients: one-center experience.
Conde, Sara Querido; Branco, Patrícia; Sousa, Henrique; Adragão, Teresa; Gaspar, Augusta; Barata, José Diogo
2017-03-01
Secondary hyperparathyroidism is the target of several therapeutic strategies, including the use of cinacalcet. Most studies were done only in hemodialysis patients, with few data from peritoneal dialysis patients. The aim of our work was to evaluate the effectiveness of cinacalcet in secondary hyperparathyroidism in a one-center peritoneal dialysis patients. A retrospective study was performed in 27 peritoneal dialysis patients with moderate to severe secondary hyperparathyroidism (PTHi > 500 pg/mL with normal or elevated serum calcium levels) treated with cinacalcet. Demographic, clinical and laboratory parameters at the beginning of cinacalcet therapy, second, fourth, sixth months after and at the time it was finished were analyzed. Patients were under peritoneal dialysis at 30.99 ± 16.58 months and were treated with cinacalcet for 15.6 ± 13.4 months; 21 (77.8%) patients showed adverse gastrointestinal effects; PTHi levels at the beginning of cinacalcet therapy were 1145 ± 449 pg/mL. The last PTHi levels under cinacalcet therapy was 1131 ± 642 pg/mL. PTHi reduction was statistically significant at 2 months after the beginning of cinacalcet (p = 0.007) but not in the following evaluations. It is necessary the development of new forms of cinacalcet presentation, in order to avoid gastrointestinal effects adverse factors and to improve therapeutic adherence.
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Hypercalcemic Disorders in Children
Stokes, Victoria J; Nielsen, Morten F; Hannan, Fadil M
2017-01-01
ABSTRACT Hypercalcemia is defined as a serum calcium concentration that is greater than two standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms. The causes of hypercalcemia in children can be classified as parathyroid hormone (PTH)‐dependent or PTH‐independent, and may be congenital or acquired. PTH‐independent hypercalcemia, ie, hypercalcemia associated with a suppressed PTH, is commoner in children than PTH‐dependent hypercalcemia. Acquired causes of PTH‐independent hypercalcemia in children include hypervitaminosis; granulomatous disorders, and endocrinopathies. Congenital syndromes associated with PTH‐independent hypercalcemia include idiopathic infantile hypercalcemia (IIH), William's syndrome, and inborn errors of metabolism. PTH‐dependent hypercalcemia is usually caused by parathyroid tumors, which may give rise to primary hyperparathyroidism (PHPT) or tertiary hyperparathyroidism, which usually arises in association with chronic renal failure and in the treatment of hypophosphatemic rickets. Acquired causes of PTH‐dependent hypercalcemia in neonates include maternal hypocalcemia and extracorporeal membrane oxygenation. PHPT usually occurs as an isolated nonsyndromic and nonhereditary endocrinopathy, but may also occur as a hereditary hypercalcemic disorder such as familial hypocalciuric hypercalcemia, neonatal severe primary hyperparathyroidism, and familial isolated primary hyperparathyroidism, and less commonly, as part of inherited complex syndromic disorders such as multiple endocrine neoplasia (MEN). Advances in identifying the genetic causes have resulted in increased understanding of the underlying biological pathways and improvements in diagnosis. The management of symptomatic hypercalcemia includes interventions such as fluids, antiresorptive medications, and parathyroid surgery. This article presents a clinical, biochemical, and genetic approach to investigating the causes of pediatric hypercalcemia. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc. PMID:28914984
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Hypercalcemic Disorders in Children.
Stokes, Victoria J; Nielsen, Morten F; Hannan, Fadil M; Thakker, Rajesh V
2017-11-01
Hypercalcemia is defined as a serum calcium concentration that is greater than two standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms. The causes of hypercalcemia in children can be classified as parathyroid hormone (PTH)-dependent or PTH-independent, and may be congenital or acquired. PTH-independent hypercalcemia, ie, hypercalcemia associated with a suppressed PTH, is commoner in children than PTH-dependent hypercalcemia. Acquired causes of PTH-independent hypercalcemia in children include hypervitaminosis; granulomatous disorders, and endocrinopathies. Congenital syndromes associated with PTH-independent hypercalcemia include idiopathic infantile hypercalcemia (IIH), William's syndrome, and inborn errors of metabolism. PTH-dependent hypercalcemia is usually caused by parathyroid tumors, which may give rise to primary hyperparathyroidism (PHPT) or tertiary hyperparathyroidism, which usually arises in association with chronic renal failure and in the treatment of hypophosphatemic rickets. Acquired causes of PTH-dependent hypercalcemia in neonates include maternal hypocalcemia and extracorporeal membrane oxygenation. PHPT usually occurs as an isolated nonsyndromic and nonhereditary endocrinopathy, but may also occur as a hereditary hypercalcemic disorder such as familial hypocalciuric hypercalcemia, neonatal severe primary hyperparathyroidism, and familial isolated primary hyperparathyroidism, and less commonly, as part of inherited complex syndromic disorders such as multiple endocrine neoplasia (MEN). Advances in identifying the genetic causes have resulted in increased understanding of the underlying biological pathways and improvements in diagnosis. The management of symptomatic hypercalcemia includes interventions such as fluids, antiresorptive medications, and parathyroid surgery. This article presents a clinical, biochemical, and genetic approach to investigating the causes of pediatric hypercalcemia. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.
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Enevoldsen, Lotte Hahn; Heaf, James; Højgaard, Liselotte; Zerahn, Bo; Hasbak, Philip
2017-03-01
In bone scan patients with dialysis-treated chronic kidney disease (CKD) and hyperparathyroidism, soft tissue accumulation of technetium-99 m hydroxy/methylene diphosphonate (Tc-99 m-HDP/MDP) has been reported primarily in case reports and usually explained by hypercalcaemia and/or hyperphosphataemia. As human vascular smooth muscle cells produce hydroxyapatite during cell culture with increased phosphate levels and as Tc-99 m-HDP/MDP primarily binds to hydroxyapatite, we hypothesized that soft tissue accumulation would be found in patients with hyperphosphataemia. We identified 63 CKD patients diagnosed with secondary hyperparathyroidism admitted for Tc-99 m-HDP bone scan. Baseline characteristics and mean concentrations of biochemical markers (including P-calcium and P-phosphate) taken 0-3 months prior to the bone scans were collected. Soft tissue uptake was detected on bone scans in 37 of 63 (59%) patients. Primary locations were in the heart (27/37 = 73%), muscles (12/37 = 32%), lung (9/37 = 24%) and gastrointestinal tract (6/37 = 16%), and 13 of 37 (35%) patients had simultaneous uptake in more than one location. Regarding biochemical markers, patients with soft tissue uptake only differed from patients without in terms of plasma phosphate levels (1·95 ± 0·15 (n = 37) versus 1·27 ± 0·08 (n = 26), P = 0·0012). All patients with myocardial uptake (n = 27) had a coronary arteriography-verified history of coronary artery disease (CAD), whereas CAD was only present in six of the 36 patients without myocardial uptake. In conclusion, dialysis-treated CKD patients with secondary hyperparathyroidism have a high incidence of soft tissue uptake, and this finding is strongly correlated with elevated phosphate, but not calcium values. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.
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Hip fracture patients in India have vitamin D deficiency and secondary hyperparathyroidism.
Dhanwal, D K; Sahoo, S; Gautam, V K; Saha, R
2013-02-01
This study evaluated the parameters of bone mineral homeostasis including 25(OH)D and PTH in 90 Indian patients with hip fracture and 90 controls. Hypovitaminosis D, secondary hyperparathyroidism, and biochemical osteomalacia was present in 77, 69, and 50 % patients, respectively, significantly higher compared to controls. Vitamin D deficiency is an important risk factor for hip fracture. The prevalence of vitamin D deficiency is not well known in hip fracture patients from India. Therefore, the present study was conducted to evaluate the parameters of bone mineral homeostasis including 25(OH)D and intact PTH in hip fracture from North India. Ninety consecutive patients with hip fracture and similar number of age- and sex-matched controls were enrolled in the study. The fasting venous samples were analyzed for 25-hydroxyvitamin D (25-OHD), intact parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphorus. Vitamin D deficiency was defined as serum 25-OHD of <20 ng/dl. The mean age of hip fracture subjects was 65.9 ± 12.6 which was comparable in men and women. Majority of study subjects were women (70 women and 20 men). The serum 25(OH)D and calcium levels were significantly lower, whereas the intact PTH and ALP levels were significantly higher in patients compared to controls. There was significant negative correlation between serum 25(OH)D and PTH. In the hip fracture group, 76.7 % of the subjects had vitamin D deficiency, and 68.9 % had secondary hyperparathyroidism. In the control group, vitamin D deficiency and elevated PTH levels were seen in 32.3 and 42.2 %, respectively. About three fourths of hip fracture patients have vitamin D deficiency, and two thirds have secondary hyperparathyroidism. Therefore, the serum 25-OHD level may be a useful index for the assessment of risk of hip fracture in India.
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Cognitive changes after parathyroidectomy in patients with secondary hyperparathyroidism.
Chou, Fong-Fu; Chen, Jin-Bor; Hsieh, Kun-Chou; Liou, Chia-Wei
2008-04-01
Cognitive impairment was frequently reported in uremic patients with dialysis, but improvements of cognition after parathyroidectomy for symptomatic secondary hyperparathyroidism have never been reported before. Thirty-nine patients, who were successfully operated on with total parathyroidectomy plus autotransplantation were enrolled. Twenty-three dialysis patients, age >50 years, who had a serum level of intact parathyroid hormone (iPTH) greater than 650 pg/ml, and who did not undergo parathyroidectomy were selected as the control group. The mini-mental state examination (MMSE) and the clinical dementia rating (CDR) test were administered to all patients. Before the operation, educational level, symptoms of bone pain, skin itching, general weakness and insomnia were recorded and serum levels of calcium, phosphorus, alkaline phosphatase (Alk-ptase), iPTH, aluminum, and hemoglobin were measured in the study and control groups. At 12-week postoperatively, serum levels of calcium, phosphorus, Alk-ptase, iPTH, and aluminum were measured again and at 16-week postoperatively, the MMSE and the CDR test were administered again. In the control group, both MMSE and CDR test were administered again after the period or 16-week. Serum calcium level was only significant difference (p = 0.002), whereas clinical symptoms, gender, etiologies of secondary hyperparathyroidism, duration of dialysis, educational level, age, and serum levels of phosphorus, Alk-ptase, iPTH, aluminum, and hemoglobin were not significantly different between the two groups. The educational level was the only factor affecting MMSE scores (p = 0.003). In the study group, at 12-week postoperatively, symptoms improved significantly, serum levels of calcium, phosphorus, Alk-ptase, iPTH, and aluminum decreased significantly, and at 16-week postoperatively, MMSE scores increased from 25 +/- 5 (mean +/- SD) to 26 +/- 5 (p < 0.001) and CDR scales decreased significantly (p < 0.001). Neither MMSE scores nor CDR scales of the control group changed significantly after the 16-week period. Parathyroidectomy for symptomatic secondary hyperparathyroidism can improve cognition.
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40 CFR Table 5 to Subpart Ffff of... - Model Rule-Summary of Reporting Requirements
Code of Federal Regulations, 2010 CFR
2010-07-01
....3050 and 60.3051. v. If no deviations or malfunctions were reported, a statement that no deviations... 60.3053. v. Dates, times, and causes for monitor downtime incidents; §§ 60.3052 and 60.3053. vi...
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40 CFR Table 5 to Subpart Ffff of... - Model Rule-Summary of Reporting Requirements
Code of Federal Regulations, 2011 CFR
2011-07-01
....3050 and 60.3051. v. If no deviations or malfunctions were reported, a statement that no deviations... 60.3053. v. Dates, times, and causes for monitor downtime incidents; §§ 60.3052 and 60.3053. vi...
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77 FR 14440 - Notice of Information Collection
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-09
... INFORMATION: I. Abstract To ensure accurate reporting of Government-owned, contractor-held property on the financial statements and to provide information necessary for effective property management, NASA obtains summary data annually from the official Government property records maintained by its contractors, on the...
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77 FR 39518 - Notice of Information Collection
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-03
... INFORMATION: I. Abstract To ensure accurate reporting of Government-owned, contractor-held property on the financial statements and to provide information necessary for effective property management, NASA obtains summary data annually from the official Government property records maintained by its contractors, on the...
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75 FR 70298 - Notice of Information Collection
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-17
... INFORMATION: I. Abstract To ensure accurate reporting of Government-owned, contractor-held property on the financial statements and to provide information necessary for effective property management, NASA obtains summary data annually from the official Government property records maintained by its contractors, on the...
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75 FR 16787 - Environmental Impact Statements and Regulations; Availability of EPA Comments
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-02
... improve environmental resources in the project area. Rating LO. EIS No. 20090451, ERP No. D-FHW-F40451-FL..., WA, OR and CA. Summary: EPA does not object to the proposed action. Rating LO. EIS No. 20100027, ERP...
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40 CFR Table 5 to Subpart Ffff of... - Model Rule-Summary of Reporting Requirements
Code of Federal Regulations, 2012 CFR
2012-07-01
....3050 and 60.3051. v. If no deviations or malfunctions were reported, a statement that no deviations... 60.3053. v. Dates, times, and causes for monitor downtime incidents; §§ 60.3052 and 60.3053. vi...
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40 CFR Table 5 to Subpart Ffff of... - Model Rule-Summary of Reporting Requirements
Code of Federal Regulations, 2013 CFR
2013-07-01
....3050 and 60.3051. v. If no deviations or malfunctions were reported, a statement that no deviations... 60.3053. v. Dates, times, and causes for monitor downtime incidents; §§ 60.3052 and 60.3053. vi...
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40 CFR Table 5 to Subpart Ffff of... - Model Rule-Summary of Reporting Requirements
Code of Federal Regulations, 2014 CFR
2014-07-01
....3050 and 60.3051. v. If no deviations or malfunctions were reported, a statement that no deviations... 60.3053. v. Dates, times, and causes for monitor downtime incidents; §§ 60.3052 and 60.3053. vi...
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Mn and Btex Reference Value Arrays (Final Reports)
These final reports are a summary of reference value arrays with critical supporting documentation for the chemicals manganese, benzene, toluene, ethylbenzene, and xylene. Each chemical is covered in a separate document, and each is a statement of the status of the available inha...
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77 FR 29393 - Product List Changes
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-17
... POSTAL REGULATORY COMMISSION [Docket Nos. MC2012-18 and CP2012-24; Order No. 1341] Product List Changes AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a... changes in the Mail Classification Schedule with the addition underlined; Attachment D--a Statement of...
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75 FR 13275 - Environmental Impact Statements and Regulations; Availability of EPA Comments
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-19
... Designation, Motorized Travel Management, (Formerly Motorized Route Designation), Implementation, Siskiyou... travel management planning process and season of use and wet weather closures, and recommended the action... Yosemite Institute Environment Education Campus, Implementation, Mariposa County, CA. Summary: No formal...
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77 FR 1976 - Release of Waybill Data
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-12
... DEPARTMENT OF TRANSPORTATION Surface Transportation Board Release of Waybill Data AGENCY: Surface Transportation Board, DOT. ACTION: Release of Waybill Data; Correction. SUMMARY: This document corrects a notice... certain data from the Board's 2009 Carload Waybill Sample.'' The statement should read ``[t]he Surface...
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Use of Convexity in Ostomy Care
Salvadalena, Ginger; Pridham, Sue; Droste, Werner; McNichol, Laurie; Gray, Mikel
2017-01-01
Ostomy skin barriers that incorporate a convexity feature have been available in the marketplace for decades, but limited resources are available to guide clinicians in selection and use of convex products. Given the widespread use of convexity, and the need to provide practical guidelines for appropriate use of pouching systems with convex features, an international consensus panel was convened to provide consensus-based guidance for this aspect of ostomy practice. Panelists were provided with a summary of relevant literature in advance of the meeting; these articles were used to generate and reach consensus on 26 statements during a 1-day meeting. Consensus was achieved when 80% of panelists agreed on a statement using an anonymous electronic response system. The 26 statements provide guidance for convex product characteristics, patient assessment, convexity use, and outcomes. PMID:28002174
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... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...
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Mamun-TKC parathyroid retractor: Parathyroid glands squashed or scooped!
Mahmud, Syed Mamun
2015-03-01
Parathyroid gland by its physiologic and anatomic diversity has interestingly been dealt by multiple specialties, including Urology. Besides primary hyperparathyroidism, urologists in close working relationship with nephrologists, tend to get referrals for tertiary hyperparathyroidism. Data from 1999 to 2012 was retrieved for all parathyroidectomies. Medical record of only cases undergoing parathyroidectomy utilising the instrument Mamun-TKC Parathyroid Retractor were reviewed. It is a metal body surgical instrument resembling Gil Vernet retractor having functional flat metal head attached to solid long handle, designed in two forms; one 'Straight' and other 'Angled' at 30°. During the period, 28 cases of parathyroidectomies were performed. The instrument was used in two cases. It was found to facilitate dissection, retraction and pedicle ligation of parathyroid gland by a-traumatic handling.
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Major Changes in Governmental GAAP.
ERIC Educational Resources Information Center
Piotrowski, Craig L.
1988-01-01
The Governmental Accounting Standards Board (GASB) is the standard-setting body for establishing generally accepted accounting principles for school systems and all state and local governments. A brief summary of a statement prepared by GASB's staff outlines the proposed changes in school accounting and financial reporting. (MLF)
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Marinelli, Kathleen A; Moren, Kathleen; Taylor, Julie Scott
2013-02-01
The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection, and support of breastfeeding and human lactation. Our mission is to unite into one association members of the various medical specialties with this common purpose.
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75 FR 55269 - Telemarketing Sales Rule Fees
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-10
... FEDERAL TRADE COMMISSION 16 CFR Part 310 RIN 3084-AA98 Telemarketing Sales Rule Fees AGENCY: Federal Trade Commission. ACTION: Policy statement. SUMMARY: The Federal Trade Commission (the ``Commission'' or ``FTC'') is giving notice that there will be no increase in the fees charged to entities...
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76 FR 31676 - Environmental Impact Statements: National Summary of Rescinded Notices of Intent
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-01
.../2006 2/10/2011 Dock) in Seattle. WA Forest Road 56 in King County..... 4/27/2001 2/28/2011 (Catalog of... CE. The Forest Road 56 improvement project in King County, Washington, has been reduced in scope and...
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75 FR 39241 - Hooper Springs Project
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-08
... Power Administration (BPA), Department of Energy (DOE). ACTION: Notice of Intent to prepare an Environmental Impact Statement (EIS) and notice of floodplain and wetlands involvement. SUMMARY: BPA intends to... (collectively referred to as the Hooper Springs Project). The new BPA substation would be called Hooper Springs...
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75 FR 48741 - Open Meeting of the President's Economic Recovery Advisory Board
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-11
... DEPARTMENT OF THE TREASURY Open Meeting of the President's Economic Recovery Advisory Board AGENCY: Departmental Offices. ACTION: Notice of Open Meeting. SUMMARY: The President's Economic Recovery Advisory Board... statements in triplicate to Emanuel Pleitez, Designated Federal Officer, President's Economic Recovery...
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77 FR 4617 - Environmental Impact Statement: Pennington County, SD
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-30
...: Pennington County, SD AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent. SUMMARY..., Suite A, Pierre, SD 57501, (605) 226-7326; Mr. Terry Keller, Environmental Supervisor, Project Development, South Dakota Department of Transportation, 700 E. Broadway Avenue, Pierre, SD 57501, (605) 773...
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NASA Technical Reports Server (NTRS)
1984-01-01
An introduction to the overall AgRISTARS program, a general statement on progress, and separate summaries of the activities of each project, with emphasis on the technical highlights are presented. Organizational and management information on AgRISTARS is included in the appendices, as is a complete bibliography of publication and reports.
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78 FR 73816 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-09
... Survey. OMB Control Number: 0535-0220. Summary of Collection: Primary function of the National..., filing of petitions and applications and agency #0;statements of organization and functions are examples... the proper performance of the functions of the agency, including whether the information will have...
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7 CFR 210.15 - Reporting and recordkeeping.
Code of Federal Regulations, 2010 CFR
2010-01-01
... AGRICULTURE CHILD NUTRITION PROGRAMS NATIONAL SCHOOL LUNCH PROGRAM Requirements for School Food Authority.... (a) Reporting summary. Participating school food authorities are required to submit forms and reports... between the school food authority and the State agency, and a Free and Reduced Price Policy Statement as...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-01
... experience at Tumacacori by developing access to these associated mission resources. A general management... DEPARTMENT OF THE INTERIOR National Park Service Draft General Management Plan Amendment... Management Plan, Tumacacori National Historical Park, in favor of an Environmental Assessment. SUMMARY: The...
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Into the 80s: Our Schools and Their Purposes.
ERIC Educational Resources Information Center
South Australia Education Dept., Adelaide.
Complementing existing regulations, this policy statement for South Australian schools presents educational goals and priorities for the decade and general implications for classroom, curriculum, and resource allocation. Background discussion covers factors influencing recent developments in South Australian education, a summary of the role of…
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76 FR 31571 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-01
..., filing of petitions and applications and agency #0;statements of organization and functions are examples... Title: Healthy Incentives Pilot Evaluation. OMB Control Number: 0584-NEW. Summary of Collection: The... legislative authority, the Food and Nutrition Service (FNS) designed the Healthy Incentives Pilot (HIP) and...
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An introduction to high speed aircraft noise prediction
NASA Technical Reports Server (NTRS)
Wilson, Mark R.
1992-01-01
The Aircraft Noise Prediction Program's High Speed Research prediction system (ANOPP-HSR) is introduced. This mini-manual is an introduction which gives a brief overview of the ANOPP system and the components of the HSR prediction method. ANOPP information resources are given. Twelve of the most common ANOPP-HSR control statements are described. Each control statement's purpose and format are stated and relevant examples are provided. More detailed examples of the use of the control statements are presented in the manual along with ten ANOPP-HSR templates. The purpose of the templates is to provide the user with working ANOPP-HSR programs which can be modified to serve particular prediction requirements. Also included in this manual is a brief discussion of common errors and how to solve these problems. The appendices include the following useful information: a summary of all ANOPP-HSR functional research modules, a data unit directory, a discussion of one of the more complex control statements, and input data unit and table examples.
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Garber, Alan J; Abrahamson, Martin Julian; Barzilay, Joshua I; Blonde, Lawrence; Bloomgarden, Zachary T; Bush, Michael A; Dagogo-Jack, Samuel; Davidson, Michael B; Einhorn, Daniel; Garber, Jeffrey R; Garvey, W Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B; Jellinger, Paul S; McGill, Janet B; Mechanick, Jeffrey I; Rosenblit, Paul David; Umpierrez, Guillermo E
2015-12-01
This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
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Collins, Michael W; Kontos, Anthony P; Okonkwo, David O; Almquist, Jon; Bailes, Julian; Barisa, Mark; Bazarian, Jeffrey; Bloom, O Josh; Brody, David L; Cantu, Robert; Cardenas, Javier; Clugston, Jay; Cohen, Randall; Echemendia, Ruben; Elbin, R J; Ellenbogen, Richard; Fonseca, Janna; Gioia, Gerard; Guskiewicz, Kevin; Heyer, Robert; Hotz, Gillian; Iverson, Grant L; Jordan, Barry; Manley, Geoffrey; Maroon, Joseph; McAllister, Thomas; McCrea, Michael; Mucha, Anne; Pieroth, Elizabeth; Podell, Kenneth; Pombo, Matthew; Shetty, Teena; Sills, Allen; Solomon, Gary; Thomas, Danny G; Valovich McLeod, Tamara C; Yates, Tony; Zafonte, Ross
2016-12-01
Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. ARS, audience response systemCDC, Centers for Disease Control and PreventionDoD, Department of DefensemTBI, mild traumatic brain injuryNCAA, National Collegiate Athletic AssociationNFL, National Football LeagueNIH, National Institutes of HealthRCT, randomized controlled trialRTP, return to playSRC, sport- and recreation-related concussionTBI, traumatic brain injuryTEAM, Targeted Evaluation and Active Management.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-30
... Management Project AGENCY: Forest Service, USDA. ACTION: Notice of intent to prepare an environmental impact statement. SUMMARY: The project proposes to salvage by clearcut harvest dead and lodgepole pine infested or... [email protected] , please indicate Boulder River Project in the...
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75 FR 76077 - Information Collection Available for Public Comments and Recommendations
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-07
... from that office. SUPPLEMENTARY INFORMATION: Title of Collection: Uniform Financial Reporting... Office of Management and Budget. Summary of Collection of Information: The Uniform Financial Reporting Requirements are used as a basis for preparing and filing semi-annual and annual financial statements with the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-24
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-847] Certain Electronic Devices, Including Mobile Phones and Tablet Computers, and Components Thereof; Notice of Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY: Notice is...
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78 FR 53731 - North Pacific Fishery Management Council; Notice of Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-30
... meetings. SUMMARY: The North Pacific Fishery Management Council (Council) Ecosystem Committee will meet in... agenda will be as follows: Development of Ecosystem-based management (EMB) vision statement; Operationalizing EBM in Council projects, including the Aleutian Islands Fishery Ecosystem Plan, the Arctic Fishery...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-20
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-860] Certain Optoelectronic Devices for Fiber Optic Communications, Components Thereof, and Products Containing the Same; Notice of Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY...
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Data Release Summary Statement
Atmospheric Science Data Center
2016-11-14
... of the CALIPSO data products includes new versions of its standard Level1 and Level2 lidar data. The V4.10 CALIOP Level 2 data products ... essential ancillary data sets. The GTOPO30 Digital Elevation Model (DEM) used in V4.00 has been replaced by a substantially more accurate ...
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77 FR 11142 - Merchant Marine Personnel Advisory Committee: Intercessional Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-24
... Committee working group meeting. SUMMARY: The Merchant Marine Personnel Advisory Committee (MERPAC) will conduct an intercessional meeting so that a working group may discuss Task Statement 76, entitled ``Review of Performance Measures (Assessment Criteria).'' This meeting will be open to the public. DATES: A...
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Directory of Child Advocacy Programs.
ERIC Educational Resources Information Center
Administration for Children, Youth, and Families (DHEW), Washington, DC.
This directory lists 107 child advocacy programs in 37 states, the District of Columbia and the Virgin Islands. Each entry includes project title, address, telephone number, contact person, a statement of purpose and a summary of current advocacy activities. Entries are indexed under the following terms: adolescent parenthood,…
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75 FR 877 - Cancellation of the South Valley Facilities Expansion Project-Clark County, NV
Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-06
... DEPARTMENT OF INTERIOR Bureau of Reclamation Cancellation of the South Valley Facilities Expansion Project-- Clark County, NV AGENCY: Bureau of Reclamation, Interior. ACTION: Cancellation of Notice of Intent to prepare the Environmental Impact Statement. SUMMARY: The Bureau of Reclamation, together with...
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Easing Your Pain: A Method for Evaluating Research Writing from Students
ERIC Educational Resources Information Center
Jensen, Barbara E.; Martin, Kathleen A.; Mann, Betty L.; Fogarty, Tracey
2004-01-01
Throughout their undergraduate and graduate careers, students are assigned various types of papers that require scientific writing style. The scope of these assignments include laboratory reports that require only graphing and statements of findings; abstract assignments with critical summaries included; abbreviated research papers, including…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-09
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-756] Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same; Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY: Notice is hereby given that the...
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32 CFR 1656.17 - Administrative complaint process.
Code of Federal Regulations, 2010 CFR
2010-07-01
... within ten days after the interview their personal written statements concerning the problem; (4) Place... shall take necessary action to: (1) Interview, as appropriate, all parties concerned to obtain information relevant to the problems or complaints; (2) Place a written summary of each interview in the ASW's...
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29 CFR 2520.102-3 - Contents of summary plan description.
Code of Federal Regulations, 2012 CFR
2012-07-01
... following statement: Your pension benefits under this plan are insured by the Pension Benefit Guaranty... disabled before the plan terminates; and (3) certain benefits for your survivors. The PBGC guarantee... in an early retirement monthly benefit greater than your monthly benefit at the plan's normal...
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29 CFR 2520.102-3 - Contents of summary plan description.
Code of Federal Regulations, 2014 CFR
2014-07-01
... following statement: Your pension benefits under this plan are insured by the Pension Benefit Guaranty... disabled before the plan terminates; and (3) certain benefits for your survivors. The PBGC guarantee... in an early retirement monthly benefit greater than your monthly benefit at the plan's normal...
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29 CFR 2520.102-3 - Contents of summary plan description.
Code of Federal Regulations, 2013 CFR
2013-07-01
... following statement: Your pension benefits under this plan are insured by the Pension Benefit Guaranty... disabled before the plan terminates; and (3) certain benefits for your survivors. The PBGC guarantee... in an early retirement monthly benefit greater than your monthly benefit at the plan's normal...
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Pretolesi, F; Silvestri, E; Di Maio, G; Martinoli, C; Onetto, F; Sala, P; Derchi, L E
1997-01-01
The aim of this study was to evaluate the changes in volume, structure, and flow pattern of parathyroid glands in uremic patients with secondary hyperparathyroidism treated with long-term intravenous calcitriol (CTL) therapy. Ultrasonography was used to follow-up volume changes occurring in 18 enlarged glands in 11 patients during an 18-month period; in 6 of these cases, 11 glands were followed-up also with color-Doppler to monitor variations in flow pattern. Vascularization was classified using three grades: grade 0 = no color signal; grade I = vessels covering less than 50 % of glandular cross-sectional area; grade II = vascular signals covering more than 50 % of glandular cross-sectional area. No significant changes in volume were demonstrated during the 18 months of follow-up. On the contrary, significant decrease in flow was observed with almost complete disappearance of color-Doppler signals. This finding related well with the observed decrease in parathormone blood levels. Lack of volume changes during medical therapy demonstrates the inability of US alone to monitor the effect of this treatment on the parathyroid glands. Conversely, the observed intraglandular flow reduction indicates the possibility to use color Doppler to monitor the effects of CLT in uremic hemodialyzed patients with secondary hyperparathyroidism. This imaging procedure can be proposed for follow-up of the response of the parathyroid glands to therapy.
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Matrone, Antonio; Brancatella, Alessandro; Marchetti, Piero; Vasile, Enrico; Boggi, Ugo; Elisei, Rossella; Cetani, Filomena; Marcocci, Claudio; Vitti, Paolo; Latrofa, Francesco
2018-03-01
Absence of neoplastic disease in the organ-recipient is required in order to allow organ transplantation. Due to its rarity, no data regarding management of patients with Multiple endocrine neoplasia type 1 (MEN1) and end-stage renal failure candidates for kidney transplantation are available. A 36 year-old man was referred to the present hospital with MEN1, with a neuroendocrine pancreatic tumor and primary hyperparathyroidism and associated Alport syndrome with end stage renal failure. The present study aimed to establish the eligibility of the patient for a kidney transplantation. The neuroendocrine tumor had been treated with duodenopancreatectomy two years earlier and hyperparathyroidism by parathyroidectomy. The review of the literature did not provide data regarding the eligibility for kidney transplantation of patients harboring a neuroendocrine pancreatic tumor in the context of MEN1. Due to the end-stage renal failure, neuroendocrine markers were unreliable and the investigation therefore relied on imaging studies, which were unremarkable. Young age, low-grade tumor, low expression of Ki67, absence of metastatic lymph nodes, onset in the setting of a MEN1 were all positive prognostic factors of the neuroendocrine tumor. Normal serum calcium ruled out persistent primary hyperparathyroidism. Overall, hemodyalisis is known to significantly reduce life expectancy. Benefits of kidney transplantation overcome the risk of neuroendocrine tumor recurrence in a young patient bearing MEN1.
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Nordenström, Erik; Westerdahl, Johan; Bergenfelz, Anders
2009-05-01
Primary hyperparathyroidism (pHPT) is associated with decreased bone density and increased fracture risk. A significant number of pHPT patients have low calcium intake and suffer from vitamin deficiency. Thus, we adopted a policy of postoperative supplements with calcium and vitamin D after parathyroid surgery. In this study, we investigated if this policy enhanced the postoperative increase in bone density. Forty-two consecutive patients (83% female) were studied. The first 21 patients received no supplements, whereas the following 21 patients received 1,000 g calcium and 800 IU hydroxy D: -vitamin daily (Ca-D group) for 1 year postoperatively. The patients were monitored with bone density and biochemistry pre- and at 1 year postoperatively. Preoperatively, the patients without vitamin D supplementation (non-Ca-D group) did neither differ in biochemistry, clinical features, nor in bone density from patients in Ca-D group. Postoperatively, there was a tendency that patients in Ca-D group increased their bone density, at all sites measured, in a greater extent than patients that did not receive calcium and vitamin D supplementation. In conclusion, based on our results, it is difficult to give a recommendation of vitamin D supplementation in routine use following surgery for primary hyperparathyroidism. Based on the present data, a calculation of sample size for a future randomized controlled trial is presented.
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Calcimimetic and Calcilytic Drugs: Feats, Flops, and Futures.
Nemeth, E F; Goodman, W G
2016-04-01
The actions of extracellular Ca(2+) in regulating parathyroid gland and kidney functions are mediated by the extracellular calcium receptor (CaR), a G protein-coupled receptor. The CaR is one of the essential molecules maintaining systemic Ca(2+) homeostasis and is a molecular target for drugs useful in treating bone and mineral disorders. Ligands that activate the CaR are termed calcimimetics and are classified as either agonists (type I) or positive allosteric modulators (type II); calcimimetics inhibit the secretion of parathyroid hormone (PTH). Cinacalcet is a type II calcimimetic that is used to treat secondary hyperparathyroidism in patients receiving dialysis and to treat hypercalcemia in some forms of primary hyperparathyroidism. The use of cinacalcet among patients with secondary hyperparathyroidism who are managed with dialysis effectively lowers circulating PTH levels, reduces serum phosphorus and FGF23 concentrations, improves bone histopathology, and may diminish skeletal fracture rates and the need for parathyroidectomy. A second generation type II calcimimetic (AMG 416) is currently under regulatory review. Calcilytics are CaR antagonists that stimulate the secretion of PTH. Several calcilytic compounds have been evaluated as orally active anabolic therapies for postmenopausal osteoporosis but clinical development of all of them has been abandoned because they lacked clinical efficacy. Calcilytics might be repurposed for new indications like autosomal dominant hypocalcemia or other disorders beyond those involving systemic Ca(2+) homeostasis.
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Parathyroid hormone (PTH) blood test
... PTH) intact molecule; Intact PTH; Hyperparathyroidism - PTH blood test; Hypoparathyroidism - PTH blood test ... drinking for some period of time before the test. Most often, you will not need to fast ...
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Kearns, Katherine D; Sullivan, Carol Subiño
2011-06-01
Graduate students and postdoctoral fellows currently encounter requests for a statement of teaching philosophy in at least half of academic job announcements in the United States. A systematic process for the development of a teaching statement is required that integrates multiple sources of support, informs writers of the document's purpose and audience, helps writers produce thoughtful statements, and encourages meaningful reflection on teaching and learning. This article for faculty mentors and instructional consultants synthesizes practices for mentoring graduate students, postdoctoral fellows, and junior faculty members as they prepare statements of teaching philosophy. We review background information on purposes and audiences, provide writing resources, and synthesize empirical research on the use of teaching statements in academic job searches. In addition, we integrate these resources into mentoring processes that have helped graduate students in a Health Sciences Pedagogy course to collaboratively and critically examine and write about their teaching. This summary is intended for faculty mentors and instructional consultants who want to refine current resources or establish new mentoring programs. This guide also may be useful to graduate students, postdoctoral fellows, and junior faculty members, especially those who lack mentoring or who seek additional resources, as they consider the many facets of effective teaching.
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Delirium: Issues for Older Adults
... healthcare provider promptly. Hyperparathyroidism is more common in women, especially those over the age of 65 years. Updated: September 2017 Posted: March 2012 © 2018 Health in Aging. All rights reserved. ...
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Pharmacologic management of chronic neuropathic pain
Mu, Alex; Weinberg, Erica; Moulin, Dwight E.; Clarke, Hance
2017-01-01
Abstract Objective To provide family physicians with a practical clinical summary of the Canadian Pain Society (CPS) revised consensus statement on the pharmacologic management of neuropathic pain. Quality of evidence A multidisciplinary interest group within the CPS conducted a systematic review of the literature on the current treatments of neuropathic pain in drafting the revised consensus statement. Main message Gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors are the first-line agents for treating neuropathic pain. Tramadol and other opioids are recommended as second-line agents, while cannabinoids are newly recommended as third-line agents. Other anticonvulsants, methadone, tapentadol, topical lidocaine, and botulinum toxin are recommended as fourth-line agents. Conclusion Many pharmacologic analgesics exist for the treatment of neuropathic pain. Through evidence-based recommendations, the CPS revised consensus statement helps guide family physicians in the management of patients with neuropathic pain. PMID:29138154
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Use of Convexity in Ostomy Care: Results of an International Consensus Meeting.
Hoeflok, Jo; Salvadalena, Ginger; Pridham, Sue; Droste, Werner; McNichol, Laurie; Gray, Mikel
Ostomy skin barriers that incorporate a convexity feature have been available in the marketplace for decades, but limited resources are available to guide clinicians in selection and use of convex products. Given the widespread use of convexity, and the need to provide practical guidelines for appropriate use of pouching systems with convex features, an international consensus panel was convened to provide consensus-based guidance for this aspect of ostomy practice. Panelists were provided with a summary of relevant literature in advance of the meeting; these articles were used to generate and reach consensus on 26 statements during a 1-day meeting. Consensus was achieved when 80% of panelists agreed on a statement using an anonymous electronic response system. The 26 statements provide guidance for convex product characteristics, patient assessment, convexity use, and outcomes.
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Indications for Surgical Management of Hyperparathyroidism: A Review.
Stephen, Antonia E; Mannstadt, Michael; Hodin, Richard A
2017-09-01
Primary hyperparathyroidism (pHPT) is a common clinical entity, with approximately 100 000 new cases diagnosed each year in the United States. Most patients with pHPT have a relatively mild form of the disease and present with few if any overt signs or symptoms. This has led to a dilemma regarding which patients should be considered for parathyroid surgery. In this article, we review the established literature on the indications for surgery in asymptomatic pHPT and discuss the most recent consensus conference guidelines. The reviewed literature suggests that there were improved outcomes among patients with asymptomatic pHPT who underwent curative surgery. Most patients with pHPT should be considered for parathyroidectomy. More randomized clinical trials are needed to strongly support a surgical recommendation for all asymptomatic patients with pHPT.
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76 FR 29786 - Environmental Impact Statement for the Big Cypress National Preserve Addition, Florida
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-23
... Cypress National Preserve Addition. SUMMARY: Pursuant to the National Environmental Policy Act of 1969... February 4, 2011, the Regional Director, Southeast Region, approved the ROD for the project. SUPPLEMENTARY... 1506.6. The responsible official for this Record of Decision is the Regional Director, Southeast Region...
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48 CFR 22.406-8 - Investigations.
Code of Federal Regulations, 2013 CFR
2013-10-01
... statements taken during an investigation or the employee's identity to anyone other than an authorized... Investigation Summary Sheet, is the first page of the report; and (2) The agency head must process the report as... Act; (E) Corrective measures taken; and (F) Any information that may be necessary to review any...
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48 CFR 22.406-8 - Investigations.
Code of Federal Regulations, 2010 CFR
2010-10-01
... statements taken during an investigation or the employee's identity to anyone other than an authorized... Investigation Summary Sheet, is the first page of the report; and (2) The agency head must process the report as... Act; (E) Corrective measures taken; and (F) Any information that may be necessary to review any...
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48 CFR 22.406-8 - Investigations.
Code of Federal Regulations, 2014 CFR
2014-10-01
... statements taken during an investigation or the employee's identity to anyone other than an authorized... Investigation Summary Sheet, is the first page of the report; and (2) The agency head must process the report as... and Safety Standards statute; (E) Corrective measures taken; and (F) Any information that may be...
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AB 1725: A Comprehensive Analysis.
ERIC Educational Resources Information Center
California Community Colleges, Sacramento. Board of Governors.
A summary and analysis is provided of California Assembly Bill (AB) 1725, a reform bill that provides new direction and support for the state's community colleges. The analysis addresses each of the eight sections of the bill: (1) mission, highlighting reforms related to mission statements, transfer core curriculum, remedial limits, articulation…
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Social Studies: It's a Family Affair.
ERIC Educational Resources Information Center
Melendez, Ruth
1999-01-01
Describes an elementary-level family tree project for social studies classes that teaches students about their personal history and the country's diverse culture. Children complete a family tree chart, then the class creates visual presentations using a world map and bar graph. Finally, students write summary statements based on the family trees,…
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Civil Rights Issues Facing Arab Americans in Michigan.
ERIC Educational Resources Information Center
Michigan State Advisory Committee to the U.S. Commission on Civil Rights.
This report is a summary statement of the Michigan Advisory Committee's study on civil rights issues facing Arab American communities in Michigan. It is based on information received by the Committee at a community forum held in Dearborn, Michigan, in 1999. Six sections focus on: (1) "Introduction," including Arab American demographics…
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-01
... on Women in the Services (DACOWITS) AGENCY: Department of Defense. ACTION: Notice. SUMMARY: On... Department Advisory Committee on Women in the Services (DACOWITS). The following information contains updates... statement for consideration by the Defense Department Advisory Committee on Women in the Services...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-09
...; Lonesome Wood Vegetation Management Project 2 AGENCY: Forest Service, USDA. ACTION: Notice of Intent to prepare an Environmental Impact Statement. SUMMARY: This integrated forest vegetation management project... comments to Gallatin National Forest, Attn: Lonesome Wood Vegetation Management Project 2, Bozeman Ranger...
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Level Descriptions and Teacher Assessment in England: Towards a Community of Assessment Practice.
ERIC Educational Resources Information Center
Hall, Kathy; Harding, Austin
2002-01-01
Interviews with 48 British elementary teachers and assessment coordinators about level descriptions to evaluate students (summary statements of performance on the National Curriculum) found that communities of assessment practice have developed within schools but not more widely. Factors inhibiting growth include lesser status of teacher…
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77 FR 37659 - Procurement List; Proposed Additions
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-22
... additions to the procurement list. SUMMARY: The Committee is proposing to add products and services to the...- 598-5067 and 1670-01-598-5071 to its Procurement List. The Coverage statement associated with this... connection with the products and services proposed for addition to the Procurement List. Comments on this...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-17
... Technology ACTION: Notice. SUMMARY: The Office of the National Coordinator for Health Information Technology... Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and... Services, Chapter AR, Office of the National Coordinator for Health Information Technology (ONC), as...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-20
... Technology ACTION: Notice. SUMMARY: The Office of the National Coordinator for Health Information Technology... Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and... and Human Services, Chapter AR, Office of the National Coordinator for Health Information Technology...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-15
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-752] Certain Gaming and Entertainment Consoles, Related Software, and Components Thereof; Notice of Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY: Notice is hereby given that the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-06
... Folsom DS/FDR EIS/EIR considered several methods to modify MIAD to achieve Reclamation's risk standards... availability of the Final Supplemental Environmental Impact Statement/Environmental Impact Report (EIS/EIR). SUMMARY: Pursuant to the National Environmental Policy Act and the California Environmental Quality Act...
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75 FR 72784 - Helena National Forest; Montana; Blackfoot Travel Plan EIS
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-26
... DEPARTMENT OF AGRICULTURE Forest Service Helena National Forest; Montana; Blackfoot Travel Plan... Impact Statement for the Blackfoot Travel Plan. SUMMARY: This notice extends the comment period for the Blackfoot Travel Plan from November 30, 2010 to January 7, 2011. This extension is a result of several...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-07
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-772] Certain Polyimide Films, Products Containing Same, and Related Methods; Notice of Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY: Notice is hereby given that the presiding...
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ERIC Educational Resources Information Center
Colorado State Dept. of Education, Denver. Div. of Special Education Services.
Summaries are provided of classroom research projects undertaken by Colorado teachers of students with learning disabilities. For each project, the document supplies the project title, researcher, school, problem statement, objective, population, assessment, procedures, evaluation, implications, and resources used. Project titles and researchers…
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75 FR 38188 - Closed Meeting of the OTS Mutual Savings Association Advisory Committee
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-01
... DEPARTMENT OF THE TREASURY Office of Thrift Supervision [Docket ID OTS-2010-0021] Closed Meeting... of Thrift Supervision. ACTION: Notice of Closed Meeting. SUMMARY: The OTS Mutual Savings Associations... Supervision, 1700 G Street, NW., Washington, DC 20552. The public is invited to submit written statements to...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... otherwise, to establish the validity and competence of his estimates. He must familiarize himself with basic..., 1971, dictates that written statement of, and summary of the basis for, the amount of the estimate of... Appraisers which sets out market value “as the highest price estimated in terms of money which a property...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... otherwise, to establish the validity and competence of his estimates. He must familiarize himself with basic..., 1971, dictates that written statement of, and summary of the basis for, the amount of the estimate of... Appraisers which sets out market value “as the highest price estimated in terms of money which a property...
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Code of Federal Regulations, 2013 CFR
2013-07-01
... otherwise, to establish the validity and competence of his estimates. He must familiarize himself with basic..., 1971, dictates that written statement of, and summary of the basis for, the amount of the estimate of... Appraisers which sets out market value “as the highest price estimated in terms of money which a property...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... otherwise, to establish the validity and competence of his estimates. He must familiarize himself with basic..., 1971, dictates that written statement of, and summary of the basis for, the amount of the estimate of... Appraisers which sets out market value “as the highest price estimated in terms of money which a property...
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Code of Federal Regulations, 2011 CFR
2011-07-01
... otherwise, to establish the validity and competence of his estimates. He must familiarize himself with basic..., 1971, dictates that written statement of, and summary of the basis for, the amount of the estimate of... Appraisers which sets out market value “as the highest price estimated in terms of money which a property...
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78 FR 70588 - STP Nuclear Operating Company; South Texas Project
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-26
... efficiency; (8) wind power; (9) solar power; (10) hydroelectric power; (11) ocean wave and current energy... generic environmental impact statement for license renewal of nuclear plants; issuance. SUMMARY: Notice is hereby given that the U.S. Nuclear Regulatory Commission (NRC) has published the final, plant-specific...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-13
...) solar power; (9) wind power; (10) biomass waste; (11) hydroelectric power; (12) ocean wave and current... Nuclear Plants AGENCY: Nuclear Regulatory Commission. ACTION: Final Supplement 47 to the Generic Environmental Impact Statement for License Renewal of Nuclear Plants; issuance. SUMMARY: Notice is hereby given...
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17 CFR 256.01-10 - Billing procedures.
Code of Federal Regulations, 2010 CFR
2010-04-01
... accounts prescribed by the regulatory authorities to which it is subject. Each month a statement shall be rendered to the associate company containing a summary of the accounts by work order by which the charges...) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY...
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77 FR 6675 - Premium Penalty Relief for Certain Delinquent Plans
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-09
... Delinquent Plans AGENCY: Pension Benefit Guaranty Corporation. ACTION: Policy statement. SUMMARY: Executive... limited window for covered plans that have never paid required premiums to pay past-due premiums without... Security Act of 1974 (ERISA). Under sections 4006 and 4007 of ERISA, plans covered by title IV must pay...
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75 FR 22892 - Environmental Impact Statement: Salt Lake County, UT
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-30
... Lake County, UT AGENCY: Federal Highway Administration (FHWA), USDOT. ACTION: Notice of Intent. SUMMARY... be prepared for a proposed transportation improvement project in Salt Lake County, Utah. FOR FURTHER... 4700 South, Suite 9A, Salt Lake City, UT 84118, telephone (801) 963-0182, e-mail [email protected
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75 FR 9476 - Environmental Impact Statement: Salt Lake County, UT
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-02
... Lake County, UT AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of intent. SUMMARY... be prepared for a proposed transportation improvement project in Salt Lake County, Utah. FOR FURTHER... 9A, Salt Lake City, UT 84118, Telephone: (801) 963-0182, E-mail: [email protected] . The Utah...
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32 CFR 1651.4 - Review by district appeal board.
Code of Federal Regulations, 2011 CFR
2011-07-01
... personal appearance and such summary shall be placed in the registrant's file. (n) A district appeal board... registrant's file; and (2) Oral statements by the registrant during the registrant's personal appearance; and... compensated employee authorized to perform the administrative duties of the board shall review the file to...
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75 FR 71179 - Environmental Impact Statement: San Diego County, CA
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-22
... Diego County, CA AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of intent. SUMMARY... a proposed highway project in San Diego County, California. DATES: Public Scoping Meeting: January 12, 2011; 5 p.m. to 8 p.m. ADDRESSES: Sherman Heights Community Center, 2258 Island Avenue, San Diego...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-26
... DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management, Regulation and Enforcement Outer... Ocean Energy Management, Regulation and Enforcement, Interior. ACTION: Notice of Availability of a Final Supplemental Environmental Impact Statement SUMMARY: The Bureau of Ocean Energy Management, Regulation and...
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75 FR 62627 - Environmental Impact Statement; Davis County, UT
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-12
... County, UT AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent. SUMMARY: FWHA is... cooperation with the Utah Department of Transportation (UDOT), will prepare an EIS on a proposal to address... and need and are based on agency and public input. These alternatives include: (1) Taking no action...
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75 FR 4810 - Environmental Impact Statements and Regulations; Availability of EPA Comments
Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-29
..., City and County Denver, CO. Summary: EPA expressed environmental concern about air quality impacts. EPA... TMDL preparation in the watershed of the water quality impaired Fisher River. Rating EC2. EIS No... impacts to water quality, aquatic habitat, aquatic ecological functions, and recommended additional...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-04
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2008-D-0406...--Statement of Investigator (Form FDA 1572); Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of an information...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-13
... DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a Final Environmental Impact Statement. SUMMARY: Notice is hereby given that the Rural...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-16
... DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a Draft Environmental Impact Statement and Notice of Public Hearings. SUMMARY: Notice is hereby...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-17
... DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of intent to extend public comment period for a Draft Environmental Impact Statement. SUMMARY: Notice is...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-19
... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-841] Certain Computers and Computer Peripheral Devices and Components Thereof and Products Containing the Same Request for Statements on the Public Interest AGENCY: U.S. International Trade Commission. ACTION: Notice. SUMMARY: Notice is hereby...
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77 FR 11171 - License Renewal Application for Callaway Plant, Unit 1, Union Electric Company
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-24
... Callaway Plant, Unit 1, Union Electric Company AGENCY: Nuclear Regulatory Commission. ACTION: Intent to prepare environmental impact statement and conduct scoping process. SUMMARY: Union Electric Company, a..., MO. The current operating license for Callaway expires on October 18, 2024. DATES: The public scoping...
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32 CFR 651.43 - Format of the EIS.
Code of Federal Regulations, 2010 CFR
2010-07-01
... ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.43 Format of the EIS. The... following (detailed content is discussed in appendix E of this part): (a) Cover sheet. (b) Summary. (c) Table of contents. (d) Purpose of and need for the action. (e) Alternatives considered, including...
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Dixit, Vivek; Tripathi, R L; Dhanwal, Dinesh Kumar
2018-05-27
This study shows a high 25-hydroxyvitamin D deficiency among postmenopausal women accompanying secondary hyperparathyroidism. However, a sizable number of subjects did not have secondary hyperparathyroidism despite having low 25-hydroxyvitamin D levels. This condition arises a research question in clinical practice needed to be addressed in the future. The present study was attempted to determine the prevalence of secondary hyperparathyroidism and also to analyze the mean value (cutoff) of 25-hydroxyvitamin D from where the PTH begins to rise in Indian postmenopausal women. A cross-sectional study including 334 postmenopausal women attending the outpatient department (MOPD) of Lok Nayak Hospital, New Delhi, between July 2008 and June 2010. Institutional ethical approval was obtained for this study. The apparently healthy postmenopausal women and attendees of the patients were included in the study. Post-thyroidectomy, thyroid illness, pregnant women, subjects taking drugs that can affect bone mineral metabolism, such as glucocorticoids, antitubercular therapy, antiepileptic, and 25-hydroxyvitamin D supplement were excluded from the study. BMD parameters such as PTH and 25(OH)D were measured by using commercial kits from DiaSorin, USA, and blood chemistry was evaluated by standard methods from the central facility of the center. Dietary calcium was analyzed by applying a food frequency questionnaire by a trained dietician. Mean (SD) age of the subjects was 56.4 ± 7.7 years. The mean BMI was 24.7 ± 5.5 kg/m 2 . The baseline biochemical investigations such as total bilirubin, liver function test (LFT), kidney function test (KFT), calcium, phosphorous, total protein, and serum albumin were in reference range except alkaline phosphatase (ALP). The mean values of 25(OH)D and PTH were 12.95 ± 8.08 ng/ml and 91.60 ± 75.56 pg/ml respectively. The 24-h dietary calcium intake was 487.06 ± 239.36 mg/24 h. 25-hydroxyvitamin D deficiency was found in 277 subjects (82.93%) and was inversely related to PTH. Forty-three subjects had 25-hydroxyvitamin D levels between 20 and 29 ng/ml (12.87%), and only 14 subjects (4.19%) had optimum 25-hydroxyvitamin D levels. Secondary hyperparathyroidism was found in 235 (70.35%) subjects; however, it was not found in 30%. Majority of postmenopausal women of India had 25-hydroxyvitamin D deficiency with raised PTH levels. The cutoff point of 25-hydroxyvitamin D at which PTH began to rise was found at 25 ng/ml which seems similar to that of the Caucasians.
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Biological and Chemical Technologies Research at OIT: Annual Summary Report, FY 1997
DOE Office of Scientific and Technical Information (OSTI.GOV)
Peterson, G.
1998-03-01
The annual summary report presents the fiscal year (FY) 1 997 research activities and accomplishments for the United States Department of Energy (DOE) Biological and Chemical Technologies Research (BCTR) Program. This BCTR program resides within the Office of Industrial Technologies (OIT) of the Office of Energy Efficiency and Renewable Energy (EE). The annual summary report for 1997 (ASR 97) contains the following: program description (including BCTR program mission statement, historical background, relevance, goals and objectives); program structure and organization; selected technical and programmatic highlights for 1 997; detailed descriptions of individual projects; and a listing of program output, including amore » bibliography of published work, patents, and awards arising from work supported by the program.« less
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... different views of the bone may be uncomfortable. Why the Test is Performed A bone x-ray ... neoplasia (MEN) II Multiple myeloma Osgood-Schlatter disease Osteogenesis imperfecta Osteomalacia Paget's disease Primary hyperparathyroidism Rickets Risks There ...
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Meurisse, M; Hamoir, E; Defechereux, T; Gollogly, L; Derry, O; Postal, A; Joris, J; Faymonville, M E
1999-01-01
OBJECTIVE: The authors review their experience with initial bilateral neck exploration under local anesthesia and hypnosedation for primary hyperparathyroidism. Efficacy, safety, and cost effectiveness of this new approach are examined. BACKGROUND: Standard bilateral parathyroid exploration under general anesthesia is associated with significant risk, especially in an elderly population. Image-guided unilateral approaches, although theoretically less invasive, expose patients to the potential risk of missing multiple adenomas or asymmetric hyperplasia. Initial bilateral neck exploration under hypnosedation may maximize the strengths of both approaches while minimizing their weaknesses. METHODS: In a consecutive series of 121 initial cervicotomies for primary hyperparathyroidism performed between 1995 and 1997, 31 patients were selected on the basis of their own request to undergo a conventional bilateral neck exploration under local anesthesia and hypnosedation. Neither preoperative testing of hypnotic susceptibility nor expensive localization studies were done. A hypnotic state (immobility, subjective well-being, and increased pain thresholds) was induced within 10 minutes; restoration of a fully conscious state was obtained within several seconds. Patient comfort and quiet surgical conditions were ensured by local anesthesia of the collar incision and minimal intravenous sedation titrated throughout surgery. Both peri- and postoperative records were examined to assess the safety and efficacy of this new approach. RESULTS: No conversion to general anesthesia was needed. No complications were observed. All the patients were cured with a mean follow-up of 18 +/- 12 months. Mean operating time was <1 hour. Four glands were identified in 84% of cases, three glands in 9.7%. Adenomas were found in 26 cases; among these, 6 were ectopic. Hyperplasia, requiring subtotal parathyroidectomy and transcervical thymectomy, was found in five cases (16.1%), all of which had gone undetected by localization studies when requested by the referring physicians. Concomitant thyroid lobectomy was performed in four cases. Patient comfort and recovery and surgical conditions were evaluated on visual analog scales as excellent. Postoperative analgesic consumption was minimal. Mean length of hospital stay was 1.5 +/- 0.5 days. CONCLUSIONS: Initial bilateral neck exploration for primary hyperparathyroidism can be performed safely, efficiently, and cost-effectively under hypnosedation, which may therefore be proposed as a new standard of care. PMID:10077053
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Sackschewsky, Michael R.; Downs, Janelle L.
2007-05-31
This review provides an evaluation of potential impacts of actions that have been proposed under various alternatives to support the closure of the high level waste tanks on the Hanford Site. This review provides a summary of data collected in the field during the spring of 2007 at all of the proposed project sites within 200 East and 200 West Areas, and at sites not previously surveyed. The primary purpose of this review is to provide biological data that can be incorporated into or used to support the Tank Closure and Waste Management Environmental Impact Statement.
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VanScoy, Rachel M; DeMartini, Julie K; Casa, Douglas J
2016-05-01
Exertional heat illnesses (EHI) occur in various populations and settings. Within a school setting, there are student athletes who take part in physical activity where the risk of EHI is increased. The National Athletic Trainers' Association (NATA) released an updated position statement on EHI in September of 2015. This article is a summary of the position statement. The sports medicine team, including school nurses and athletic trainers, provides quality health care to these physically active individuals. Thus, it is important for school nurses to understand the prevention, recognition, and treatment of EHI. © 2016 The Author(s).
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-12-01
The first section of this volume summarizes the content of the draft environmental impact statement (DEIS) and this Addendum, which together constitute the final environmental impact statement (FEIS) prepared on the decommissioning of eight surplus plutonium production reactors at Hanford. The FEIS consists of two volumes. The first volume is the DEIS as written. The second volume (this Addendum) consists of a summary; Chapter 9, which contains comments on the DEIS and provides DOE`s responses to the comments; Appendix F, which provides additional health effects information; Appendix K, which contains costs of decommissioning in 1990 dollars; Appendix L, which containsmore » additional graphite leaching data; Appendix M, which contains a discussion of accident scenarios; Appendix N, which contains errata; and Appendix 0, which contains reproductions of the letters, transcripts, and exhibits that constitute the record for the public comment period.« less
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Canadian Academy of Sport and Exercise Medicine position statement: athletes at high altitude.
Koehle, Michael S; Cheng, Ivy; Sporer, Benjamin
2014-03-01
Many sports incorporate training at altitude as a key component of their athlete training plan. Furthermore, many sports are required to compete at high altitude venues. Exercise at high altitude provides unique challenges to the athlete and to the sport medicine clinician working with these athletes. These challenges include altitude illness, alterations in training intensity and performance, nutritional and hydration difficulties, and challenges related to the austerity of the environment. Furthermore, many of the strategies that are typically utilized by visitors to altitude may have implications from an anti-doping point of view.This position statement was commissioned and approved by the Canadian Academy of Sport and Exercise Medicine. The purpose of this statement was to provide an evidence-based, best practices summary to assist clinicians with the preparation and management of athletes and individuals travelling to altitude for both competition and training.
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Arias, Elber Alberto Soler; Castillo, Victor Alejandro; Trigo, Roberto Hector
2017-01-01
A 12-year old dog with a 9-year history of primary adrenal insufficiency was referred to the service for hyporexia, muscle weakness, polyuria and polydipsia. Ultrasound examination showed an unresectable mass in the left adrenal gland, with local vascular invasion, which prompted the euthanasia of the animal. Additionally, necropsy revealed a nodular lesion in the right adrenal gland and enlargement of one of the four parathyroid glands. Parathyroid hormone levels were elevated, but ionized and total calcium levels were normal. Histopathology supported the diagnosis of parathyroid chief cell adenoma and bilateral pheochromocytoma. Immunohistochemical staining was positive for synaptophysin, and negative for Melan-A and calretinin, which confirmed the diagnosis of pheochromocytoma. This case highlights an unusual presentation of multiple endocrine neoplasias within the context of primary adrenal insufficiency and normocalcemic primary hyperparathyroidism. PMID:29296592
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Parathyroid Hormone, Calcitonin, and Vitamin D
NASA Technical Reports Server (NTRS)
Potts, J. T.
1972-01-01
Analyses of secretion of parathyroid hormone during tests of stimulation and suppression of hormone-secretory activity using infusions of EDTA and calcium, respectively, have established that, in contrast to previous views, secretion of the hormone is not autonomous in many patients that have adenomatous hyperparathyroidism, but is responsive to changes in blood-calcium concentration. These findings have led to a new understanding of the pathophysiology of hormone production in hyperparathy-roidism. A related application of the diagnostic use of the radioimmunoassay is the preoperative localization of parathyroid tumors and the distinction between adenomas and chief-cell hyperplasia. Work involving catheterization and radioimmunoassay of blood samples obtained from the subclavin and innominate veins and the venae cavae, led to localization in a high percentage of patients. However, this procedure has been adopted recently to detect hormone concentration in the small veins directly draining the parathyroid glands.
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Arias, Elber Alberto Soler; Castillo, Victor Alejandro; Trigo, Roberto Hector
2017-01-01
A 12-year old dog with a 9-year history of primary adrenal insufficiency was referred to the service for hyporexia, muscle weakness, polyuria and polydipsia. Ultrasound examination showed an unresectable mass in the left adrenal gland, with local vascular invasion, which prompted the euthanasia of the animal. Additionally, necropsy revealed a nodular lesion in the right adrenal gland and enlargement of one of the four parathyroid glands. Parathyroid hormone levels were elevated, but ionized and total calcium levels were normal. Histopathology supported the diagnosis of parathyroid chief cell adenoma and bilateral pheochromocytoma. Immunohistochemical staining was positive for synaptophysin, and negative for Melan-A and calretinin, which confirmed the diagnosis of pheochromocytoma. This case highlights an unusual presentation of multiple endocrine neoplasias within the context of primary adrenal insufficiency and normocalcemic primary hyperparathyroidism.
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Noninvasive diagnosis of uremic osteodystrophy: uses and limitations.
Heaf, J G; Joffe, P; Pødenphant, J; Andersen, J R
1987-01-01
45 bone biopsies from patients with chronic uremia were reviewed to define which noninvasive investigations were of value in predicting the histological diagnosis and to quantify the spectrum of uremic bone disease at a center that has consistently used an aluminum-free dialysis bath. 17 biopsies were taken postmortem. 15 patients received conservative treatment, the rest were on maintenance dialysis. 13 patients had symptomatic bone disease. Virtually all patients with a uremia duration greater than 3 years had uremic osteodystrophy. All patients with clinical bone disease, hypercalcemia or raised alkaline phosphatase activity had osteodystrophy, but the specific histology was not indicated. Greatly raised parathyroid levels suggested secondary hyperparathyroidism, but the test was only 100% specific when 20 times normal. Total aluminum consumption was highly indicative of bone aluminum concentration (p less than 0.0001) and aluminum-related osteomalacia (5 cases), suggesting that a considerable proportion of uremic bone disease is iatrogenic. Serum aluminum was of some use in the diagnosis of aluminum-related osteomalacia, but was not wholly reliable. Bone mineral content (BMC) using both forearm measurements and total body bone mineral levels (TBBM) were assessed in 32 patients and were found to be reduced in 12, with a preponderance of secondary hyperparathyroidism. BMC and TBBM were negatively correlated to resorbing surfaces and bone formation rate, suggesting that secondary hyperparathyroidism is the uremic bone disease that represents the greatest threat to bone mass. It is concluded that while noninvasive investigations give considerable information, reliable diagnosis requires the use of histological methods.
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[Differential diagnosis of hypercalcemia--a retrospective study of 46 dogs].
Uehlinger, P; Glaus, T; Hauser, B; Reusch, C
1998-01-01
The case records of 46 dogs with hypercalcemia were studied retrospectively. The most common cause of hypercalcemia was malignancy, of which the majority were diagnosed as having lymphosarcoma (LSA, n = 23). Interestingly only 15 had palpable lymphadenopathy. Other neoplasia were apocrine adenocarcinoma of the anal sac (n = 4), mammary adenocarcinoma (n = 2), anaplastic carcinoma (n = 1), and malignant histiocytosis (n = 1). Non-neoplastic reasons for hypercalcemia were hypoadrenocorticism (n = 5), acute renal failure (n = 2), chronic renal failure (n = 2), hypervitaminosis D (n = 1), and primary hyperparathyroidism (n = 1). In 4 cases no definitive diagnosis could be obtained. Moderate to marked hyperphosphatemia and azotemia was found in all dogs with primary renal failure and in 4 of 5 dogs with hypoadrenocorticism. In contrast only 4 of 31 dogs with neoplasia showed (mild) hyperphosphatemia and 20 showed mild to moderate azotemia. Elevated PTH levels were found in dogs with primary chronic renal failure and with primary hyperparathyroidism, but also in one dog with neoplasia. Low PTH concentrations were measured in the dog with hypervitaminosis D and in 8 cases with neoplasia. Additional three cases with neoplasia had values in the reference range. 1. The most common cause of hypercalcemia is LSA. Absence of palpable lymphadenopathy does not exclude LSA and further diagnostic steps may be necessary 2. The combination of moderate to marked hyperphosphatemia suggests primary renal failure or hypoadrenocorticism. 3. An elevated PTH level is consistent with primary hyperparathyroidism, but does not exclude other causes of hypercalcemia.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-12
..., Yellowstone National Park. SUMMARY: Pursuant to Sec. 102(2)(C) of the National Environmental Policy Act of... Wyoming. On December 3, 2012, the Regional Director, Intermountain Region, approved the Amended Record of... online at http://parkplanning.nps.gov/yell . Dated: December 2, 2012. John Wessels, Regional Director...
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ERIC Educational Resources Information Center
Meszaros, Bonnie; Saunders, Phillip
The guide is designed to accompany fifteen 20-minute economic education film/television programs for ages nine to 13. The emphasis is on economic decision making and problem solving. A statement of key concepts, suggestions for introducing the program, a summary, questions to help students resolve the problem posed at the end of the program, and…
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FOREIGN LANGUAGE NEEDS OF MUNICIPAL EMPLOYEES IN TEN METROPOLITAN AREAS.
ERIC Educational Resources Information Center
WELLEMEYER, JOHN F.
VARIOUS AGENCIES IN CITIES WITH PROBLEMS OF NON-ENGLISH SPEAKING RESIDENTS WERE SURVEYED. THE CITIES WERE BOSTON, BUFFALO, CHICAGO, CLEVELAND, DETROIT, LOS ANGELES, NEW YORK, PHILADELPHIA, SAN ANTONIO, AND TAMPA. SUMMARY STATEMENTS WERE USED TO CONSOLIDATE THE MORE SIGNIFICANT ITEMS INCLUDED IN THE DETAILED FULL REPORTS OF THE INDIVIDUAL CITIES.…
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-29
... license to include inter alia conditions for fish passage facilities and authorization to construct the... originally opposed Tacoma's Cultural Resource Summary Report, and cultural resource protection became a... in the MOA. The MOA includes a Treatment Plan that Tacoma must follow to protect cultural resources...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-22
... DEPARTMENT OF AGRICULTURE Forest Service Six Rivers National Forest, Mad River Ranger District, Ruth, CA, Beaverslide Timber Sale and Fuel Treatment Project AGENCY: Forest Service, USDA. ACTION: Notice of intent to prepare a supplemental environmental impact statement. SUMMARY: The Forest Service is...
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17 CFR 240.17a-12 - Reports to be made by certain OTC derivatives dealers.
Code of Federal Regulations, 2010 CFR
2010-04-01
... by a certified public accountant. Reports filed pursuant to this paragraph (b) shall be as of the... consolidated statement of financial condition reported on by the certified public accountant. The summary... following requirements: (1) An audit shall be conducted by a certified public accountant who shall be in...
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76 FR 23354 - Notice of Request for the Extension of Currently Approved Information Collection
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-26
... Administration (FTA), DOT. ACTION: Notice of Request for Comments. SUMMARY: In accordance with the Paperwork... electronic docket site. (Note: -The U.S. Department of Transportation's (DOT's) electronic docket is no....gov . You may review DOT's complete Privacy Act Statement in the Federal Register published April 11...
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77 FR 40409 - Notice of Request for the Extension of a Currently Approved Information Collection
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-09
... Administration (FTA), DOT. ACTION: Notice of request for comments. SUMMARY: In accordance with the Paperwork.... Government electronic docket site. (Note: The U.S. Department of Transportation's (DOT's) electronic docket... . You may review DOT's complete Privacy Act Statement in the Federal Register published April 11, 2000...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-25
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCOS05000 2009] Notice of Intent To Prepare a Resource Management Plan for the Uncompahgre Field Office and Associated Environmental Impact Statement AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent. SUMMARY: In compliance with...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-02
...; Arizona; Bradshaw Vegetation Management Project AGENCY: Forest Service, USDA. ACTION: Notice of intent to prepare an environmental impact statement. SUMMARY: This project is a proposal to improve the health of.... The project area encompasses about 55,554 acres. Within the project area, the proposal is to...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-21
...) Project, San Bernardino County, CA AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Correction. SUMMARY: The Bureau of Land Management published a Notice of Availability of the Draft... DEPARTMENT OF THE INTERIOR Bureau of Land Management [CACA 49537, LLCAD08000, L51030000.FX0000...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-03
... received many applications and is still considering all applications received to date, the Agency is... broader applicant pool to reflect greater ethnic, gender, and industry diversity. The requirements for... following materials: (1) Resume, (2) personal statement of interest, including a summary of how the nominee...
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CET and IT in Education and Training. CET Information Sheet 2.
ERIC Educational Resources Information Center
Burton, Jane; Morris, Judith
This summary of Council for Educational Technology (CET) activities begins with a definition of educational technology and a brief statement on its importance in the learning process. Activities, including involvement in both CET and cooperative projects, are then briefly described in 16 areas: (1) instructional technology (IT) in the curriculum;…
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-03
... Management Plan Amendment for the Proposed Modification to the Thompson Creek Mine Plan of Operations... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLIDI03000.L71220000.EX0000.XXXX... AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent. SUMMARY: In compliance with the...
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McChord AFB, Washington Revised Uniform Summary of Surface Weather Observations (RUSSWO). Parts A-F.
1984-04-01
SECURITY CLASS. (of ISIS e.po,t) UNCLASSIFIED I5s. DECLASSIFICATION ’DDBNGRADING SCHEDULE IA DISTRIBUTION STATEMENT (of tis Repo.13 Approved for public ...FW.,S ,b J 290320 l 51861 SS.1 3. I 31 13 93 I ’ . , _ . - - .. , - , -, ., ,L - -+- +. .: .. +. ... ’ ’ - - . _,r;,, - -" -. I
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-17
... environmental impact statement (DEIS). SUMMARY: NMFS, Southeast Region, in collaboration with the South Atlantic... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-BD77 Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Snapper-Grouper Fishery Off the South Atlantic...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-21
... connection with the Susquehanna to Roseland 500kV Transmission Line. SUMMARY: Pursuant to National... Recreational River, and Appalachian National Scenic Trail, in connection with the proposed Susquehanna (Berwick... expand the width of the transmission line right-of-way beyond the Applicant's current holdings. The...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-14
... building and ancillary support buildings; and (d) incorporation of the principles of sustainable design through the Leadership in Energy and Environmental Design Green Building Rating System of the U.S. Green...: Public Buildings Service, GSA. ACTION: Notice of availability. SUMMARY: In accordance with the National...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-01
... following disciplines will be involved in the planning process: Range management, wildlife biology... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLIDT020000.L10200000.EE0000.241A.00] Notice... AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent. SUMMARY: In compliance with the...
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ERIC Educational Resources Information Center
Aubry, Mark; Cantu, Robert; Dvorak, Jiri; Graf-Baumann, Toni; Johnston, Karen; Kelly, James; Lovell, Mark; McCrory, Paul; Meeuwisse, Willem; Schamasch, Patrick
2002-01-01
An international group of concussion experts met in 2001 to discuss the most recent research and findings and to establish guidelines for clinical practice. They addressed such issues as epidemiology, basic and clinical science, grading systems, cognitive assessment, new research methods, protective equipment, management, prevention, and long-term…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-22
... Floodplain and Wetlands Involvement. SUMMARY: Western Area Power Administration (Western) is a power... floodplains and wetlands, so this Notice of Intent (NOI) also serves as a notice of proposed floodplain or wetland action in accordance with DOE floodplain and wetland environmental review requirements. DATES...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-23
... of Wetlands Involvement AGENCY: National Nuclear Security Administration (NNSA), U.S. Department of... scoping meeting, and notice of wetlands involvement. SUMMARY: Pursuant to the National Environmental... BFC known as the Kansas City Plant (KCP), consisting of approximately 122 acres and 38 buildings. GSA...
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Alternative Scenarios of the American Future: 1980-2000.
ERIC Educational Resources Information Center
Glover, Robert
This report is a summary of the findings of the societal trends survey completed at the National Forum on Learning and The American Future, which focused on factors influencing the future of adult learning. The survey questionnaire and results consist of 120 societal trend statements organized into sixteen different content areas: demography;…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-07
... Committee Working Group Meeting. SUMMARY: A working group of the Merchant Marine Personnel Advisory Committee (MERPAC) will meet to work on Task Statement 77 concerning the development of new performance...-Technical Ratings. This meeting will be open to the public. DATES: A MERPAC working group will meet on...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-13
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [CACA 048810, LLCAD06000, L51010000.FX0000... of Land Management, Interior. ACTION: Notice of Availability. SUMMARY: In accordance with the... are designed to generate in total approximately 500 megawatts (MW) of electricity at full development...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-24
... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Notice of Intent To Prepare an Environmental... Reclamation, Interior. ACTION: Notice of intent. SUMMARY: The Bureau of Reclamation (Reclamation) intends to... plan, design, and construct the Pojoaque Basin Regional Water System in accordance with the Settlement...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-19
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLNVSO3100 L5101000.ER0000 LVRWF09F8590 241A... Land Management, Interior. ACTION: Notice of availability. SUMMARY: In accordance with the National... exchangers, ultimately generating electricity. The project's proposed facility design includes solar fields...
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75 FR 17763 - Arctic National Wildlife Refuge, Fairbanks, AK
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-07
... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R7-R-2009-N260; 70133-1265-0000-S3] Arctic National Wildlife Refuge, Fairbanks, AK AGENCY: U.S. Fish and Wildlife Service, Interior. ACTION... statement; request for comment. SUMMARY: We, the U.S. Fish and Wildlife Service (Service), will be...
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Research studies with the International Ultraviolet Explorer
NASA Technical Reports Server (NTRS)
1991-01-01
The IUE research studies comprises 118 separate research programs involving observations, data analysis, and research conducted of the IUE satellite and the NASA Astrophysics Data Program. Herein are presented 92 programs. For each program there is a title, program ID, name of the investigator, statement of work, summary of results, and list of publications.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-16
... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2013-0042... AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice. SUMMARY: We are announcing to the public that the Animal and Plant Health Inspection Service (APHIS) intends to prepare an...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-15
... DEPARTMENT OF DEFENSE Department of the Army, Corps of Engineers Intent To Prepare a Draft and... of the Army, U.S. Army Corps of Engineers, DOD. ACTION: Notice of intent. SUMMARY: The Jacksonville District, U.S. Army Corps of Engineers (Corps) [[Page 11165
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-28
...-Stewardship/Environmental-Assessment/NEPA/nepaprocess.aspx . Comments: Federal, State, and local government... Assessment Section, Office of Environment (GM 623E), Bureau of Ocean Energy Management, Gulf of Mexico OCS... (NOA) of the Draft Supplemental Environmental Impact Statement (EIS) and Public Meetings. SUMMARY: BOEM...
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Using Pictures to Assist in Comprehension and Recall.
ERIC Educational Resources Information Center
Rich, Rebecca Z.; Blake, Sylvia
1994-01-01
This article describes a picture drawing strategy to enhance the comprehension of fourth- and fifth-grade students with language and reading problems. Students used adhesive notes to draw pictures of main ideas as they read aloud or listened. Students learned the strategy rapidly and were able to use the pictures to generate summary statements.…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-29
...: National Park Service, Interior. ACTION: Notice of Intent to Prepare an Environmental Impact Statement. SUMMARY: Pursuant to Sec. 102(2)(C) of the National Environmental Policy Act of 1969 (NEPA), and pursuant to the Council on Environmental Quality Regulations (40 CFR part 1500-08), the National Park Service...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-04
... DEPARTMENT OF ENERGY Amended Record of Decision: Idaho High-Level Waste and Facilities Disposition Final Environmental Impact Statement Revised by State 12/ 21/09 AGENCY: Department of Energy. ACTION: Amended Record of Decision. SUMMARY: The U.S. Department of Energy (DOE) is amending its initial Record of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-28
... Petroleum Reserve-- Alaska AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent. SUMMARY... Petroleum Reserve-Alaska (NPR-A) planning area. This notice announces the beginning of the scoping period to... acres underlying Native Corporation-owned surface lands. The Naval Petroleum Reserves Production Act (42...
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Oak Ridge National Laboratory Institutional Plan, FY 1995--FY 2000
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1994-11-01
This report discusses the institutional plan for Oak Ridge National Laboratory for the next five years (1995-2000). Included in this report are the: laboratory director`s statement; laboratory mission, vision, and core competencies; laboratory plan; major laboratory initiatives; scientific and technical programs; critical success factors; summaries of other plans; and resource projections.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-25
...: Notice of Intent. SUMMARY: Pursuant to Section 211 of the Water Resources Development Act of 1996, the... Water Resources Development Act of 1996, to investigate measures to alleviate flooding in the study area... commercial fisheries, wildlife resources, water quality, air quality, threatened or endangered species...
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75 FR 19627 - Meeting of the Chief of Naval Operations (CNO) Executive Panel
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-15
... DEPARTMENT OF DEFENSE Department of the Navy Meeting of the Chief of Naval Operations (CNO) Executive Panel AGENCY: Department of the Navy, DoD. ACTION: Notice of open meeting. SUMMARY: The CNO... interested groups may submit written statements for consideration by the Chief of Naval Operations Executive...
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75 FR 7453 - Notice of Open Meeting of the Chief of Naval Operations (CNO) Executive Panel
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-19
... DEPARTMENT OF DEFENSE Department of the Navy Notice of Open Meeting of the Chief of Naval Operations (CNO) Executive Panel AGENCY: Department of the Navy, DoD. ACTION: Notice. SUMMARY: The CNO... interested groups may submit written statements for consideration by the Chief of Naval Operations Executive...
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Dynamics explorer: Interface definition study, volume 1
NASA Technical Reports Server (NTRS)
1978-01-01
Work done in response to the work statement wherein a specific deliverable was not identified but where design and analysis tasks were identified is reported. The summary and baseline change list is included along with design notes for the spacecraft system, thermal subsystem, power subsystem, communications subsystem, plasma wave instrument interface definition, and the structure.
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78 FR 37652 - Environmental Impact Statements; National Summary of Rescinded Notices of Intent
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-21
.... No further Federal resources will be expended on these projects; the environmental review process has been terminated. Four projects are being reassessed and may be reconsidered in whole or in part, by the... projects that are no longer a priority or that lack financial resources should be [[Page 37653
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-02
... DEPARTMENT OF THE INTERIOR Minerals Management Service Notice of Intent To Prepare and Scope an...-2017 AGENCY: Minerals Management Service, Interior. ACTION: Notice of intent and request for comments. SUMMARY: Pursuant to the National Environmental Policy Act (NEPA), the Minerals Management Service (MMS...
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Youth Unemployment--Time to Do Something About It.
ERIC Educational Resources Information Center
Department of Labor, Washington, DC.
Presented in this summary document are 17 charts and statements concerning youth unemployment. Topics covered include: (1) the ratio of teenage to adult unemployment rates, (2) the population explosion, (3) effects of staying in school, (4) state minimum wage patterns, and (5) the effects of a differential on family income. A recommended course of…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-20
... DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management Notice of Public Scoping Meetings on...), Interior. ACTION: Notice of public scoping meetings and request for comments. SUMMARY: The Proposed Outer... Congressionally-mandated leasing moratorium. This notice describes the public scoping process that BOEM is...
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4 CFR 22.6 - Motions, Briefs, and Other Statements [Rule 6].
Code of Federal Regulations, 2010 CFR
2010-01-01
..., in its discretion, may shorten or lengthen the time for the response and reply based on the nature of the motion, the nature and timing of the case, and the scheduling needs of the Board. The Board may... motion, for summary judgment, the Board will consider the pleadings, depositions, answers to...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-19
... environmental impact statement or environmental assessment need be prepared for these amendments. If the... authorization to upgrade selected Emergency Action Levels based on Nuclear Energy Institute (NEI) 99-01... of NRC Regulatory Issue Summary 2003-18, Supplement 2, ``Use of Nuclear Energy Institute (NEI) 99-01...
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Top Level Summary of Technologies
NASA Technical Reports Server (NTRS)
Craig, Douglas, A.
2009-01-01
This document is a chart that reviews the technology of various NASA projects. Included in the chart is the title, a brief description of the technology, the funding status, a statement of the benefits, the date required, how the element connects to the Constellation project architecture, and how critical the technology is to the Constellation project.
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76 FR 21345 - Environmental Impacts Statements;
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-15
...'Driscoll 1-866- 208-3372. EIS No. 20110112, Draft EIS, BLM, NM, HB In-Situ-Solution Mining Project.../08/2011 Pursuant to 40 CFR 1506.9. Notice In accordance with Section 309(a) of the Clean Air Act, EPA... summary of EPA's comment letters, in the Federal Register. Since February 2008, EPA has included its...
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Dental Hygienists Licensed in Washington.
ERIC Educational Resources Information Center
Washington State Dept. of Social and Health Services, Olympia. Health Manpower Project.
Beginning with a statement on the profession of dental hygiene and the two types of professional preparation available in the field, the pilot study then presents a two-part summary of its findings and an explanation of the methodology employed. Part I of the main portion of the report concerns employment characteristics (status, age, residence,…
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1973 Maryland Rural Manpower Report. Report No. MA 5-79.
ERIC Educational Resources Information Center
Maryland State Dept. of Employment and Social Services, Baltimore. Employment Security Administration.
Prepared by the State Department of Employment and Social Services (Research and Analysis Division) and the Rural Manpower Staff, this 1973 annual report provides a summary and review of the activities of Maryland's Rural Manpower Services Program. The report briefly gives: (1) a statement on the program's administrative organization and…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-01
... DEPARTMENT OF ENERGY [OE Docket No. PP-362] Notice of Availability for the Draft Environmental.... SUMMARY: The U.S. Department of Energy (DOE) announces the availability of the ``Draft Environmental... EIS. The Draft EIS evaluates the environmental impacts of DOE's proposed Federal action of issuing a...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-10
... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5408-N-03] Notice of Availability of... of the Assistant Secretary for Community Planning and Development, HUD. ACTION: Notice. SUMMARY: The Department of Housing and Urban Development (HUD) gives notice to the public, agencies, and Indian Tribes...
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78 FR 39057 - Environmental Impact Statement: T.F. Green Airport, Warwick, Rhode Island
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-28
... of Availability. SUMMARY: The FAA is issuing this notice to advise the public that a Written Re..., Burlington, MA 01803, (781) 238-7613, or at [email protected]gov . SUPPLEMENTARY INFORMATION: The FAA has issued a Written Re-Evaluation and Record of Decision, which evaluates an updated noise mitigation...
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Evaluation of Title I ESEA Projects, 1977-1978: Technical Reports. Report Number 7877.
ERIC Educational Resources Information Center
Philadelphia School District, PA. Office of Research and Evaluation.
Technical reports of projects funded under the Elementary and Secondary Education Act Title I and summer components of the projects in the Philadelphia, Pennsylvania school system are presented. Following a summary statement, each project is described separately and contains information on the project's rationale, expected outcomes, mode of…
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-19
... South Coast Field Office, Bureau of Land Management, 1201 Bird Center Drive, Palm Springs, California... DEPARTMENT OF THE INTERIOR Bureau of Land Management [CACA 048880, LLCAD06000, L51010000.FX0000... Plan Amendment AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Availability. SUMMARY: In...
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17 CFR 240.17a-12 - Reports to be made by certain OTC derivatives dealers.
Code of Federal Regulations, 2012 CFR
2012-04-01
... by a certified public accountant. Reports filed pursuant to this paragraph (b) shall be as of the... consolidated statement of financial condition reported on by the certified public accountant. The summary... following requirements: (1) An audit shall be conducted by a certified public accountant who shall be in...
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17 CFR 240.17a-12 - Reports to be made by certain OTC derivatives dealers.
Code of Federal Regulations, 2013 CFR
2013-04-01
... by a certified public accountant. Reports filed pursuant to this paragraph (b) shall be as of the... consolidated statement of financial condition reported on by the certified public accountant. The summary... following requirements: (1) An audit shall be conducted by a certified public accountant who shall be in...
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17 CFR 240.17a-12 - Reports to be made by certain OTC derivatives dealers.
Code of Federal Regulations, 2014 CFR
2014-04-01
... by a certified public accountant. Reports filed pursuant to this paragraph (b) shall be as of the... consolidated statement of financial condition reported on by the certified public accountant. The summary... following requirements: (1) An audit shall be conducted by a certified public accountant who shall be in...
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NASA Technical Reports Server (NTRS)
1976-01-01
Major strategies for exploring the solar system focus on the return of information and the return of matter. Both the planetary exploration facility, and an orbiting automated space station, and the sample return and exploration facility have similar requirements. The single most essential need to enable intensive study of the outer solar system is nuclear propulsion and power capability. New initiatives in 1978 related to the reactor, data and sample acquisition and return, navigation, and environmental protection are examined.
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NASA Technical Reports Server (NTRS)
1976-01-01
A long-lived space-based system that converts on-orbit solar and/or nuclear energy to a suitable form for distribution to using space systems is described. Mission applications, requirements, issues, problems, benefits, and technology thrusts are identified for the multipurpose power platform. Power levels of at least 10-100Kw are required for space manufacturing, satellites, and space station operations. Two Mw are needed for a proposed passive radar system. Propulsion system requirements are in the 100Kw-100Mw range.
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Sinclair, A J; Abdelhafiz, A; Dunning, T; Izquierdo, M; Rodriguez Manas, L; Bourdel-Marchasson, I; Morley, J E; Munshi, M; Woo, J; Vellas, B
2018-01-01
The International Position Statement provides the opportunity to summarise all existing clinical trial and best practice evidence for older people with frailty and diabetes. It is the first document of its kind and is intended to support clinical decisions that will enhance safety in management and promote high quality care. The Review Group sought evidence from a wide range of studies that provide sufficient confidence (in the absence of grading) for the basis of each recommendation. This was supported by a given rationale and key references for our recommendations in each section, all of which have been reviewed by leading international experts. Searches for any relevant clinical evidence were generally limited to English language citations over the previous 15 years. The following databases were examined: Embase, Medline/PubMed, Cochrane Trials Register, Cinahl, and Science Citation. Hand searching of 16 key major peer-reviewed journals was undertaken by two reviewers (AJS and AA) and these included Lancet, Diabetes, Diabetologia, Diabetes Care, British Medical Journal, New England Journal of Medicine, Journal of the American Medical Association, Journal of Frailty and Aging, Journal of the American Medical Directors Association, and Journals of Gerontology - Series A Biological Sciences and Medical Sciences. Two scientific supporting statements have been provided that relate to the area of frailty and diabetes; this is accompanied by evidence-based decisions in 9 clinical domains. The Summary has been supported by diagrammatic figures and a table relating to the inter-relations between frailty and diabetes, a frailty assessment pathway, an exercise-based programme of intervention, a glucose-lowering algorithm with a description of available therapies. We have provided an up to date evidence-based approach to practical decision-making for older adults with frailty and diabetes. This Summary document includes a user-friendly set of recommendations that should be considered for implementation in primary, community-based and secondary care settings.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Petersen, G.; Bair, K.; Ross, J.
1994-03-01
The annual summary report presents the fiscal year (FY) 1993 research activities and accomplishments for the United States Department of Energy (DOE) Biological and Chemical Technologies Research (BCTR) Program of the Advanced Industrial Concepts Division (AICD). This AICD program resides within the Office of Industrial Technologies (OIT) of the Office of Energy Efficiency and Renewable Energy (EE). The annual summary report for 1993 (ASR 93) contains the following: A program description (including BCTR program mission statement, historical background, relevance, goals and objectives), program structure and organization, selected technical and programmatic highlights for 1993, detailed descriptions of individual projects, a listingmore » of program output, including a bibliography of published work, patents, and awards arising from work supported by BCTR.« less
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Borrego Utiel, Francisco José; Bravo Soto, Juan Antonio; Merino Pérez, María José; González Carmelo, Isabel; López Jiménez, Verónica; García Álvarez, Teresa; Acosta Martínez, Yelenei; Mazuecos Blanca, María Auxiliadora
2015-01-01
Secondary hyperparathyroidism is highly prevalent in kidney transplant recipients, and commonly results in hypercalcaemia; an association to osteopenia and bone fractures has also been observed. Paricalcitol has proved effective to control secondary hyperparathyroidism in chronic kidney disease in both dialysed and non-dialysed patients, with a low hypercalcaemia incidence. Currently available experience on paricalcitol use in kidney transplant recipients is scarce. Our main aim was to show the effect of paricalcitol on mineral bone metabolism in kidney transplant recipients with secondary hyperparathyroidism. A retrospective multicentre study in kidney transplant recipients aged>18 years with a 12-month or longer post-transplantation course, stable renal function, having received paricalcitol for more than 12 months, with available clinical follow-up for a 24-month period. A total of 69 patients with a 120 ± 92-month post-transplantation course were included. Baseline creatinine was 2.2 ± 0.9 mg/dl y GFR-MDRD was 36 ± 20 ml/min/1.73 m(2). Paricalcitol doses were gradually increased during the study: baseline 3.8 ± 1.9 μg/week, 12 months 5.2 ± 2.4 μg/week; 24 months 6.0 ± 2.9 μg/week (P<.001). Serum PTH levels showed a significant fast decline: baseline 288 ± 152 pg/ml; 6 months 226 ± 184 pg/ml; 12 months 207 ± 120; 24 months 193 ± 119 pg/ml (P<.001). Reduction from baseline PTH was ≥30% in 42.4% of patients at 12 months y in 65.2% of patients at 24 months. Alkaline phosphatase showed a significant decrease in first 6 months followed by a plateau: baseline 92 ± 50 IU/l; 6 months 85 ± 36 IU/l, 12 months 81 ± 39 IU/l (P<.001). Overall, no changes were observed in serum calcium and phosphorus, and in urine calcium excretion. PTH decline was larger in patients with higher baseline levels. Patients with lower baseline calcium levels showed significantly increased levels (mean increase was 0.5-0.6 mg/dl) but still within normal range, whereas patients with baseline calcium>10mg/dl showed gradually decreasing levels. Fifteen (21.7%) patients had received prior calcitriol therapy. When shifted to paricalcitol, such patients required paricalcitol doses significantly larger than those not having received calcitriol. Paricalcitol was used concomitantly to cinacalcet in 11 patients with significant PTH reductions being achieved; clinical course was similar to other patients and paricalcitol doses were also similar. Paricalcitol is an effective therapy for secondary hyperparathyroidism in kidney transplant recipients. Overall, no significant changes were observed in calcium and phosphorus levels or urinary excretion. Patients having previously received calcitriol required higher paricalcitol doses. When used in patients receiving cinacalcet, paricalcitol results in a significant PTH fall, with paricalcitol doses being similar to those used in patients not receiving cinacalcet. Copyright © 2015 The Authors. Published by Elsevier España, S.L.U. All rights reserved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-06
... DEPARTMENT OF DEFENSE Department of the Air Force Record of Decision for the Air Space Training Initiative Shaw Air Force Base, South Carolina Final Environmental Impact Statement ACTION: Notice of Availability (NOA) of a Record of Decision (ROD). SUMMARY: On December 9, 2011, the United States Air Force...
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Spaceship Earth, A Look Ahead to a Better Life.
ERIC Educational Resources Information Center
Fletcher, James C.
This pamphlet presents the statement of Dr. James C. Fletcher, administrator, National Aeronautics and Space Administration, made before the Committee on Aeronautical and Space Sciences, U. S. Senate. It is an attempt to give some idea of how space and aeronautics will affect mankind in the year 1985. A summary of what has been going on the last…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-29
... independent public accountant. If a carrier does not have an annual audit, the carrier must file a statement... (BTS), DOT. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act of 1995, Public Law 104-13, the Bureau of Transportation Statistics invites the general public, industry and other...
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77 FR 40406 - Environmental Impact Statements: National Summary of Rescinded Notices of Intent
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-09
... downloaded by accessing the Federal Register's home page at: http://www.archives.gov and the Government... 31676 (June 1, 2011). As always, FHWA encourages State DOTs to work with their FHWA Division Office to..., New York, will be divided into separate projects, and new NOIs will be issued as needed. Finally, one...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-03
... Development and Distribution of Annual Stress Test Scenarios AGENCY: Federal Deposit Insurance Corporation... (``covered banks'') to conduct annual stress tests, report the results of such stress tests to the... summary of the results of the stress tests. On October 15, 2012, the FDIC published in the Federal...
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Report on Fiscal and Compliance Accountability: Fiscal Year 1990-91. Report 92-2.
ERIC Educational Resources Information Center
California Community Colleges, Sacramento. Office of the Chancellor.
A summary of the results of various California community college financial audits and reviews for fiscal year (FY) 1990-91 are presented in this report. Section I explains the scope, purpose, and procedures of annual financial and compliance audits which are conducted to evaluate financial statements, encourage sound fiscal management practices,…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-24
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLNVCO0000.L16100000.DO0000.LXSS155F0000; 12... Resource Management Plan and Associated Environmental Impact Statement, Nevada AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Intent. SUMMARY: In compliance with the National Environmental Policy...
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ERIC Educational Resources Information Center
National Rural Health Care Association, Kansas City, MO.
The estimated three million United States migrant and seasonal farmworkers and their families suffer from a variety of occupational hazards and ailments exacerbated by limited, or nonexistent, health care services. Although existing migrant and seasonal farmworker health data is incomplete, general statements can be made about the health risks…
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Monotone Properties of a General Diagnostic Model. Research Report. ETS RR-07-25
ERIC Educational Resources Information Center
Xu, Xueli
2007-01-01
Monotonicity properties of a general diagnostic model (GDM) are considered in this paper. Simple data summaries are identified to inform about the ordered categories of latent traits. The findings are very much in accordance with the statements made about the GPCM (Hemker, Sijtsma, Molenaar, & Junker, 1996, 1997). On the one hand, by fitting a…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-08
.... Accordingly, comments submitted in the EIS process also informed RUS's decision making in the Section 106... of Availability of a Record of Decision. SUMMARY: The Rural Utilities Service (RUS) has issued a Record of Decision (ROD) for the Environmental Impact Statement (EIS) related to providing financial...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-21
... and Eastern Clean Line Transmission Project and Notice of Potential Floodplain and Wetland Involvement... and Notice of Potential Floodplain and Wetland Involvement. SUMMARY: The U.S. Department of Energy... of the proposed project may affect floodplains and/or wetlands. This NOI, therefore, also serves as a...
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Urban Options Solar Greenhouse Demonstration Project. Final report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cipparone, L.
1980-10-15
The following are included: the design process, construction, thermal performance, horticulture, educational activities, and future plans. Included in appendices are: greenhouse blueprints, insulating curtain details, workshop schedules, sample data forms, summary of performance calculations on the Urban Options Solar Greenhouse, data on vegetable production, publications, news articles on th Solar Greenhouse Project, and the financial statement. (MHR)
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-25
...-highway vehicle use contribute to habitat decline in the absence of active management, maintenance and... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLNVB00000.LF31020NW.JQ0000.LF.HF.JF500000... of Land Management, Interior. ACTION: Notice of intent. SUMMARY: In compliance with the National...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-31
... of these statements.\\3\\ \\3\\ The Commission has modified the text of the summaries prepared by FICC... with Basel Accord Standards relating to netting. Specifically, firms are able to calculate their...., Washington, DC 20549-1090, on official business days between the hours of 10 am and 3 p.m. Copies of such...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-19
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLNML00000 L16100000.DS0000] Notice of Intent To Prepare a Supplement to the Tri-County Draft Resource Management Plan and Environmental Impact Statement, New Mexico AGENCY: Bureau of Land Management, Interior. ACTION: Notice of intent. SUMMARY: In...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-18
... DEPARTMENT OF DEFENSE Department of the Army, Corps of Engineers Notice of Availability of the... AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Notice of availability. SUMMARY: The U.S. Army Corps of Engineers (USACE) is issuing this notice to advise the public that a Draft Environmental Impact...
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Implications of Computer Technology. Harvard University Program on Technology and Society.
ERIC Educational Resources Information Center
Taviss, Irene; Burbank, Judith
Lengthy abstracts of a small number of selected books and articles on the implications of computer technology are presented, preceded by a brief state-of-the-art survey which traces the impact of computers on the structure of economic and political organizations and socio-cultural patterns. A summary statement introduces each of the three abstract…