Biomedical subjects

J M Nottingham

Publications and source records attributed to J M Nottingham.

4 recordsLinked to original sources

PubMed2004

Chloride/phosphate ratio in primary hyperparathyroidism.

The chloride/phosphate (Cl:PO4) ratio is known to help distinguish between the hypercalcemia of primary hyperparathyroidism (HPT) and hypercalcemia from other causes. The Cl:PO4 ratio of 106 patients with surgically proven primary HPT was compared with that of 126 normocalcemic healthy outpatients to examine its usefulness as a confirmatory test for primary HPT. The Cl:PO4 ratio was significantly higher in patients with HPT (42.5 +/- 7.0) compared with healthy controls (28.7 +/- 4.6). Patients with HPT and mild renal insufficiency (serum creatinine, 1.5-2.4 mg/dL) also showed a significant increase in the Cl:PO4 ratio (37.3 +/- 6.6) as did those with HPT with borderline elevations in serum calcium (calcium < 11; Cl:PO4, 40.3 +/- 5.6). A Cl:PO4 ratio > or = 33 is a reliable diagnostic test for primary HPT when compared with a normal population. The Cl:PO4 ratio is also of value in the evaluation of the patient with suspected HPT and borderline calcium elevation and those with mild renal impairment. These data suggest that an inexpensive Cl:PO4 ratio might replace serum parathormone assay as a confirmatory test in the evaluation of suspected primary HPT, especially for those patients in whom a localizing study (sestamibi scan) is obtained before neck exploration.

Chlorides↗

PubMed2001

Amyand's hernia: a case report of an incarcerated and perforated appendix within an inguinal hernia and review of the literature.

Appendicitis within an Amyand's hernia is rare; when it occurs it is often misdiagnosed as a strangulated inguinal hernia. We present a case report of such a case and a review of the literature. It is our recommendation that repair should be undertaken without the use of synthetic mesh through a properitoneal incision that gives access to the peritoneal cavity and the inguinal regions.

Aged↗

PubMed1993

Bilateral neck exploration for primary hyperparathyroidism.

Controversy about the operative approach for primary hyperparathyroidism has prompted a review of our operative experience since 1980. We treated 73 patients with primary hyperparathyroidism during this 10-year period, all of whom underwent bilateral neck exploration in which the surgeons attempted to locate all parathyroid tissue. Thirty-eight patients (52%) were found to have a solitary adenoma, while 35 (48%) patients had multiple gland pathology. There were two cases of persistent hypercalcemia because of a synchronous parathyroid hormone-secreting malignancy in one patient and aberrant fifth gland adenoma in the other patient. Without bilateral neck exploration, about one-half of the patients in our series would not have been cured of primary hyperparathyroidism. Because of the high incidence of multiple parathyroid gland involvement, we conclude that thorough bilateral neck exploration must be considered the goal for surgical treatment of primary hyperparathyroidism.

Adenoma↗

PubMedDate not supplied

Isolated popliteal vein entrapment by a fibrous band--a case report.

Popliteal vein entrapment is commonly associated with popliteal artery entrapment, whereas isolated popliteal vein entrapment is a less common entity. The authors present a case of isolated popliteal vein entrapment caused by a fibrous band.

Constriction, Pathologic↗