[Low-dose cinacalcet reduces serum calcium in patients with primary hyperparathyroidism not eligible for surgery].

We present our experience with low-dose cinacalcet to normalize serum calcium in patients with primary hyperparathyroidism (PHPT) not eligible for surgery. We analyzed the impact of this drug on various parameters of calcium-phosphorus metabolism and its tolerability profile. We recruited 17 patients diagnosed with PHPT who had hypercalcemia and also met one or more of the following inclusion criteria: elevated risk for parathyroidectomy, persistent/recurrent PHPT after previous parathyroid surgery or refusal to undergo surgery.

99MTc-sestamibi as sole technique in selection of primary hyperparathyroidism patients for unilateral neck exploration.

Background: Unilateral neck exploration (UNE) is becoming the procedure of choice for treatment of primary hyperparathyroidism (PHPT). The aim of this study was to evaluate the role of (99m)Tc-sestamibi (MIBI) parathyroid scintigraphy as the sole technique in selecting patients for UNE.

Method: We selected 136 consecutive PHPT patients who had only 1 solitary uptake at a MIBI were for UNE.

[New approaches in obesity treatment: the gastrointestinal tract as an endocrine organ].

The gastrointestinal tract, besides digesting and processing nutrients, is now regarded as an endocrine organ able to modulate appetite, satiety, and carbohydrate metabolism. Several enteroendocrine cells produce numerous peptides codifying either orexigenic (ghrelin, orexins) or anorexigenic signals (pancreatic polypeptide, peptide YY, cholecystokinin, amylin, bombesin homologs, apolipoprotein A-IV, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, oxyntomodulin), which interact in a complex network with other peripheral signals of energy balance and with different neuropeptides involved in the central control of appetite and energy homeostasis. The growing knowledge of the actions of these gastrointestinal peptides on appetite regulation and carbohydrate metabolism, and subsequent synthesis of analogs, particularly those derived from amylin and incretins, herald a new era in the therapy of 2 closely related diseases, obesity and type 2 diabetes mellitus.

Dilated cardiomyopathy as a presenting feature of Cushing's syndrome.

Patients with Cushing's syndrome can rarely present with systolic heart failure as the mainstay feature. In these patients, heart failure is usually secondary to left ventricular hypertrophy (LVH) and not to dilated cardiopathy. We herewith report a patient with Cushing's syndrome, who presented with systolic ventricular failure secondary to dilated myocardiopathy and signs of proximal myopathy as predominant features.

Acute pancreatitis, hepatic cholestasis, and erythema nodosum induced by carbimazole treatment for Graves' disease.

A 33-year old female was diagnosed as Graves' disease and started on carbimazole. One month later when she was already euthyroid only on carbimazole therapy, she developed acute pancreatitis associated with mild cholestatic hepatitis and erythema nodosum. Carbimazole therapy was interrupted, pancreatic and liver function gradually improved and became normalized two weeks later.