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Ambrish Mithal - One of the best experts on this subject based on the ideXlab platform.
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recovery pattern of patients with Osteitis Fibrosa Cystica in primary hyperparathyroidism after successful parathyroidectomy
Surgery, 2002Co-Authors: Gaurav Agarwal, Saroj Kanta Mishra, Anil Kumar Singh, Vivek Arya, Sushil Gupta, Ambrish MithalAbstract:BACKGROUND: After parathyroidectomy, recovery of Osteitis Fibrosa Cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. METHODS: We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and Osteitis Fibrosa Cystica for 9 to 124 months (median, 32 months). RESULTS: After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71%. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm--37, 28, 23, 21; lumbar spine--165, 104, 101, 106; and total hip--168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. CONCLUSIONS: After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of Osteitis Fibrosa Cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour defects and bony tumors persist, and may need corrective osteotomies.
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recovery pattern of patients with Osteitis Fibrosa Cystica in primary hyperparathyroidism after successful parathyroidectomy
Surgery, 2002Co-Authors: Gaurav Agarwal, Saroj Kanta Mishra, Anil Kumar Singh, Vivek Arya, Sushil Gupta, Dilip K Kar, Ambrish MithalAbstract:Abstract Background. After parathyroidectomy, recovery of Osteitis Fibrosa Cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. Methods. We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and Osteitis Fibrosa Cystica for 9 to 124 months (median, 32 months). Results. After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71%. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm — 37, 28, 23, 21; lumbar spine — 165, 104, 101, 106; and total hip — 168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. Conclusions. After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of Osteitis Fibrosa Cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour defects and bony tumors persist, and may need corrective osteotomies. (Surgery 2002;132:·1075-85.)
Gaurav Agarwal - One of the best experts on this subject based on the ideXlab platform.
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Oxyphilic cell adenoma of parathyroid resulting in primary hyperparathyroidism and Osteitis Fibrosa Cystica--a case report.
Indian journal of pathology & microbiology, 2006Co-Authors: Kaushal Kishore Prasad, Gaurav Agarwal, Saroj Kanta Mishra, Narendra KrishnaniAbstract:Adenomas of the parathyroid gland, the majority of which are of the solitary chief cell type, are the most frequent cause of primary hyperparathyroidism (pHPT). Parathyroid adenomas composed predominantly or exclusively of oxyphil cells are rare and most oxyphil cell adenomas of this organ remain clinically silent. We present here a case of hyperfunctioning oxyphil cell adenoma of the parathyroid gland resulting in pHPT, Osteitis Fibrosa Cystica and simultaneous bilateral fractures upper shafts of femora.
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recovery pattern of patients with Osteitis Fibrosa Cystica in primary hyperparathyroidism after successful parathyroidectomy
Surgery, 2002Co-Authors: Gaurav Agarwal, Saroj Kanta Mishra, Anil Kumar Singh, Vivek Arya, Sushil Gupta, Ambrish MithalAbstract:BACKGROUND: After parathyroidectomy, recovery of Osteitis Fibrosa Cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. METHODS: We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and Osteitis Fibrosa Cystica for 9 to 124 months (median, 32 months). RESULTS: After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71%. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm--37, 28, 23, 21; lumbar spine--165, 104, 101, 106; and total hip--168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. CONCLUSIONS: After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of Osteitis Fibrosa Cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour defects and bony tumors persist, and may need corrective osteotomies.
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recovery pattern of patients with Osteitis Fibrosa Cystica in primary hyperparathyroidism after successful parathyroidectomy
Surgery, 2002Co-Authors: Gaurav Agarwal, Saroj Kanta Mishra, Anil Kumar Singh, Vivek Arya, Sushil Gupta, Dilip K Kar, Ambrish MithalAbstract:Abstract Background. After parathyroidectomy, recovery of Osteitis Fibrosa Cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. Methods. We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and Osteitis Fibrosa Cystica for 9 to 124 months (median, 32 months). Results. After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71%. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm — 37, 28, 23, 21; lumbar spine — 165, 104, 101, 106; and total hip — 168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. Conclusions. After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of Osteitis Fibrosa Cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour defects and bony tumors persist, and may need corrective osteotomies. (Surgery 2002;132:·1075-85.)
Kumar D - One of the best experts on this subject based on the ideXlab platform.
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Renal Osteodystrophy in End Stage Renal Failure Patients on Maintenance Haemodialysis
Journal of Clinical & Experimental Nephrology, 2016Co-Authors: Mal P, Kumar DAbstract:Objective: To determine the prevalence of different patterns of renal osteodystrophy in end stage renal failure patients on maintenance haemodialysis visiting at Nephrourology Department, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan. Methodology: A cross-sectional study was conducted at Nephro-urology Department, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan from April to October 2015. Fifty-six (56) patients on maintenance hemodialysis were included through non-probability purposive sampling. Various biochemical parameters of renal osteodystrophy were included in the current study. Serum corrected calcium, phosphate, and alkaline phosphatase and iPTH levels. Chi square test was used to determined frequency of renal osteodystrophy in ESRD patients. Results: Mean age was 45.85 ± 13.5 years. 34 (61%) were male and 22 (39%) were female. Renal osteodystrophy was found in 89%. The most common type was secondary hyperparathyroidism (Osteitis Fibrosa Cystica) in 32%. Hyperphosphatemia was observed in 62% while hypercalcaemia in only 7%. Osteomalacia was common in adolescent age group (66%), Osteitis Fibrosa Cystica (OFC) in adult group (36%) while mixed variety in elder group (50%). Similarly OFC was the most common pattern in both genders. Conclusion: In the present study it was concluded that the prevalence of renal osteodystrophy was significantly increased. Secondary hyperparathyroidism (Osteitis Fibrosa Cystica) is the most common pattern of ROD followed by mixed osteodystrophy and adynamic bone disease.
Michael A Levine - One of the best experts on this subject based on the ideXlab platform.
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pseudohypoparathyroidism with Osteitis Fibrosa Cystica direct demonstration of skeletal responsiveness to parathyroid hormone in cells cultured from bone
Journal of Bone and Mineral Research, 2009Co-Authors: T. M. Murray, Minmin Wong, Robert Mcbroom, Fred Rosen, James P Waddell, Michael A LevineAbstract:: A young girl had tibial osteotomies at age 14 for genu valgum and then had recurrent tibial cysts over a number of years. Hypocalcemia and hyperphosphatemia were first noted at age 21. The diagnosis of pseudohypoparathyroidism was made at age 28, when elevated plasma PTH was detected. Clinical and biochemical features, including a PTH response test and assay of RBC Gs, established the diagnosis of pseudohypoparathyroidism type 1b. Failure to suppress plasma PTH with vitamin D therapy led to an exacerbation of her cystic bone disease; there were widespread lytic lesions radiologically, most of which took up [99mTc]diphosphonate on bone scan. Microradioscopy revealed evidence of resorption of phalangeal tufts. Bone biopsy showed Osteitis Fibrosa Cystica. During an orthopedic procedure, trabecular bone fragments were taken from her right humerus, and bone-derived cells cultured using an explant technique. The cultured cells were osteoblast-like in morphology, fully responsive to PTH, cholera toxin, forskolin, and PGE1 in vitro, and had an alkaline phosphatase and osteocalcin response to 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. Following this examination of skeletal responsiveness, attempts were made to suppress the elevated plasma PTH levels and symptomatic bone disease by optimizing therapy with oral 1,25-(OH)2D3. When bone pain associated with the cystic bone disease failed to resolve, the patient underwent total parathyroidectomy, following which the bone pain gradually resolved. This is the first direct demonstration of PTH responsiveness in cultured bone cells in the syndrome of pseudohypoparathyroidism with Osteitis Fibrosa Cystica.
Saroj Kanta Mishra - One of the best experts on this subject based on the ideXlab platform.
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Oxyphilic cell adenoma of parathyroid resulting in primary hyperparathyroidism and Osteitis Fibrosa Cystica--a case report.
Indian journal of pathology & microbiology, 2006Co-Authors: Kaushal Kishore Prasad, Gaurav Agarwal, Saroj Kanta Mishra, Narendra KrishnaniAbstract:Adenomas of the parathyroid gland, the majority of which are of the solitary chief cell type, are the most frequent cause of primary hyperparathyroidism (pHPT). Parathyroid adenomas composed predominantly or exclusively of oxyphil cells are rare and most oxyphil cell adenomas of this organ remain clinically silent. We present here a case of hyperfunctioning oxyphil cell adenoma of the parathyroid gland resulting in pHPT, Osteitis Fibrosa Cystica and simultaneous bilateral fractures upper shafts of femora.
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recovery pattern of patients with Osteitis Fibrosa Cystica in primary hyperparathyroidism after successful parathyroidectomy
Surgery, 2002Co-Authors: Gaurav Agarwal, Saroj Kanta Mishra, Anil Kumar Singh, Vivek Arya, Sushil Gupta, Ambrish MithalAbstract:BACKGROUND: After parathyroidectomy, recovery of Osteitis Fibrosa Cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. METHODS: We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and Osteitis Fibrosa Cystica for 9 to 124 months (median, 32 months). RESULTS: After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71%. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm--37, 28, 23, 21; lumbar spine--165, 104, 101, 106; and total hip--168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. CONCLUSIONS: After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of Osteitis Fibrosa Cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour defects and bony tumors persist, and may need corrective osteotomies.
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recovery pattern of patients with Osteitis Fibrosa Cystica in primary hyperparathyroidism after successful parathyroidectomy
Surgery, 2002Co-Authors: Gaurav Agarwal, Saroj Kanta Mishra, Anil Kumar Singh, Vivek Arya, Sushil Gupta, Dilip K Kar, Ambrish MithalAbstract:Abstract Background. After parathyroidectomy, recovery of Osteitis Fibrosa Cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. Methods. We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and Osteitis Fibrosa Cystica for 9 to 124 months (median, 32 months). Results. After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71%. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm — 37, 28, 23, 21; lumbar spine — 165, 104, 101, 106; and total hip — 168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. Conclusions. After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of Osteitis Fibrosa Cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour defects and bony tumors persist, and may need corrective osteotomies. (Surgery 2002;132:·1075-85.)
