Parathyroid Hormone-Mediated Hypercalcemia With Remarkable Bone Mineral Density Recovery After Multiple Zoledronic Acid Infusions.

This case report describes a remarkable improvement in bone mineral density (BMD) in a 95-year-old female with parathyroid hormone (PTH)-mediated hypercalcemia following treatment with zoledronic acid. Despite her complex medical history, including chronic kidney disease (CKD) and osteoporosis, the patient experienced a significant increase in bone density, particularly in the left femoral neck, while maintaining stable renal function. This case highlights the efficacy and safety of zoledronic acid in elderly patients with osteoporosis and hypercalcemia, emphasizing the importance of careful monitoring to prevent renal complications.

Emerging Technologies in Endocrine Drug Delivery: Innovations for Improved Patient Care.

Recent advancements in drug delivery systems for endocrine disorders have significantly improved patient outcomes by addressing the limitations of traditional methods such as oral tablets and injections. These innovations include non-invasive alternatives like inhaled insulin, which provides rapid absorption and better patient compliance, and robotic pills that deliver drugs directly to specific gastrointestinal sites, enhancing absorption and reducing side effects. Wearable artificial pancreas systems have revolutionized diabetes management by integrating continuous glucose monitoring with insulin pumps to automate blood glucose control.

Rare Presentation of Thyrotoxicosis Defying Methimazole Treatment: A Case Series.

Thyrotoxicosis, also known as hyperthyroidism, is a condition characterized by the excessive production of thyroid hormones by the thyroid gland. Besides Graves' disease, other common causes of thyrotoxicosis include toxic multinodular goiter, toxic adenoma, and subacute thyroiditis. The treatment of thyrotoxicosis depends on the underlying cause and may include medications (e.

To B or not to B: the application of uterine compression sutures to reduce blood loss after myomectomy.

Introduction: The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy.

Material And Methods: In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12-22 weeks. There were two groups of women.

Evaluation of serum level of C-reactive protein (CRP) and its correlation with fetal ultrasound parameters in the prediction of threatened miscarriage in the first trimester.

Background: Pregnancy loss occurring before 20 weeks gestation is referred to as miscarriage. Various clinical presentations of miscarriage include threatened, inevitable, incomplete, complete, septic, and missed miscarriage. Early-stage threatened miscarriage may manifest with symptoms such as abdominal discomfort and vaginal bleeding.

Weight Loss Effect of GLP-1 RAs With Endoscopic Bariatric Therapy and Bariatric Surgeries.

Background: Different treatment modalities are available for obesity management, including lifestyle changes, pharmacotherapy, endoscopic interventions, and surgeries. Limited evidence is available on the weight loss effect of combining glucagon-like peptide 1 receptor agonists (GLP-1 RAs) with endoscopic bariatric therapy (EBT) and bariatric surgeries (BS).

Objectives: In this systematic review, we compared the weight loss effect and metabolic changes of combining GLP-1 RAs with EBT and BS.

Discrimination, reliability, sensitivity, and specificity of metric-based assessment of an unstable pertrochanteric 31A2 intramedullary nailing procedure performed by experienced and novice surgeons.

Introduction: Identifying objective performance metrics for surgical training in orthopedic surgery is imperative for effective training and patient safety. The objective of this study was to determine if an internationally agreed, metric-based objective assessment of video recordings of an unstable pertrochanteric 31A2 intramedullary nailing procedure distinguished between the performance of experienced and novice orthopedic surgeons.

Materials And Methods: Previously agreed procedure metrics (i.

Traumatic sacralization of L5 vertebra with severe extension type spinopelvic dissociation: A case report.

Background: Spinopelvic dissociation is considered a very complex orthopedic injury. The presence of intrapelvic displacement and L5 traumatic sacralization makes our report a very rare presentation.

The Case: A 60-year-old gentleman presented with a rare traumatic fracture dislocation of the lumbosacral complex with intrapelvic displacement and L5 sacralization; treated with two surgical stages: 1) pelvic external fixation and posterior pelvic tension band plate, and 2) T10 to pelvis posterior fixation.

Does delay in surgical debridement increase the risk of infection in open tibia fractures in Saudi patients? A retrospective cohort study.

Background: Infection is the most common and devastating complication of open fractures, with a reported incidence of 3-40%. Tibia bone along its anteromedial surface has relatively thin soft tissue coverage; hence the open tibia fracture incidence rate ranges from 49.4% to 63.

AO international consensus panel for metrics on a closed reduction and fixation of a 31A2 pertrochanteric fracture.

Background: The foundations of an effective and evidence-based training program are the metrics, which characterize optimal performance.

Purposes: To develop, operationally define, and seek consensus from procedure experts on the metrics that best characterize a reference approach to the performance of a closed reduction and internal fixation of a 31A2 unstable pertrochanteric fracture with a cephalomedullary nail with distal locking through the proximal guide.

Methods: A Metrics Group consisting of 3 senior orthopaedic surgeons, a surgeon/medical scientist, an education expert and a behavioural scientist deconstructed the performance of the selected fixation procedure and defined performance metrics.

International needs analysis in orthopaedic trauma for practising surgeons with a 3-year review of resulting actions.

: To ensure best-quality education in orthopaedic trauma, the AOTrauma Education Commission conducted a Global Needs Analysis with practising surgeons worldwide. : During July to November 2012, an email invitation to complete an online set of 30 questions in eight languages was sent to our members and associates in all countries through AOTrauma's regional networks. Non-members were invited to participate through collaboration with orthopaedic societies.

Atrial fibrillation and hyperthyroidism: A literature review.

Atrial fibrillation is the most common arrhythmia worldwide with increasing frequency noted with age. Hyperthyroidism is a well-known cause of atrial fibrillation with a 16%-60% prevalence of atrial fibrillation in patients with known hyperthyroidism Ross et al. (2016).

Low urine calcium excretion in African American patients with primary hyperparathyroidism.

Objective: To evaluate the prevalence of low urine calcium excretion in African American patients with primary hyperparathyroidism (PHPT), a common disorder associated with bone and renal complications, and to assess the distinction between PHPT and familial hypocalciuric hypercalcemia (FHH), a rare benign genetic disease.

Methods: We conducted a retrospective study on a cohort of 1,297 patients in whom a 24-hour urine study was performed for measurement of urine calcium and creatinine. PHPT was diagnosed if the serum calcium concentration was ≥10.

Traumatic brain injury: neuroprotective anaesthetic techniques, an update.

Traumatic brain injuries remain an area of great challenge to both neurosurgeons and neuroanaesthesiologists. The management of these injuries starts at the scene of the accident. However, strategies for preventing secondary brain injury and its sequelae are continuing to evolve.

Advanced trauma life support, 8th edition, the evidence for change.

The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the course content.