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Recent Articles

Surgical Management of Asymptomatic Hyperparathyroidism: Long-Term Follow-Up

Background: Primary hyperparathyroidism (PHPT) is a frequently diagnosed endocrine disease and nowadays it is asymptomatic in the majority of patients. The management of asymptomatic PHPT is still debated in some cases, although there are evidences that asymptomatic patients may have improved outcomes after curative surgery. In this paper we show one of the longest follow-ups of surgically treated asymptomatic PHPT, focusing on skeletal long-term effects of surgery. Methods: We included in the study 21 patients that underwent parathyroidectomy for asymptomatic PHPT at our Institution from 2006 to 2010 with a complete follow-up at 10 years. Data about age, BMI, preoperative serum and urinary calcium, vitamin D, alkaline phosphatase parathormone, bone densitometry, surgical procedure and histological examination were collected and analyzed. Results: At follow-up we observed a normalization of PTH, serum calcium and alkaline phosphatase in all patients. Moreover, in all cases the T-score at 1 year increased significantly both at lumbar spine and femoral neck and this is maintained at long-term follow-up. Conclusions: Parathyroidectomy can be proposed as a safe therapeutical option in the majority of cases of asymptomatic PHPT considering the good results of surgery in terms of bone demineralization reduction

SARS-CoV-2 Pneumonia in A Preterm New born Treated Successfully by Dexamethasone

Data on illness in preterm infants due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is limited. Duration of viral shedding and treatment options including use of dexamethasone to treat SARS-CoV-2 pneumonia in preterm newborns are scarce and not-well reported. We are reporting SARS-COV-2 positive sick preterm twins vertically infected from SARS-COV-2 positive unvaccinated mother. Twin B initially tested negative at 24 & 48 hours of life (HOL) but subsequently tested positive at 72 HOL and developed SARS-COV-2 pneumonia and required a longer duration of respiratory support. We treated her with 10 days of dexamethasone and noted a good clinical response. To our knowledge, we are first to report the use dexamethasone in a premature newborn with SARS-COV-2 pneumonia. Additionally, the duration of viral shedding in both Twin A and Twin B was between 4-5 weeks.

Case Report: De novo Ocular Myasthenia Gravis after the mRNA Vaccine for SARS-COV2

Autoimmune Myasthenia gravis is a neuromuscular junction disease caused by destruction of the acetylcholine receptor on the postsynaptic membrane, mediated by autoantibodies and clinically characterized by skeletal muscle weakness. This can be triggered by drugs, infections, and in rare cases by vaccines. During the COVID pandemic, de novo cases and exacerbations of myasthenia gravis due to viral infection have been documented. Although few cases related to COVID vaccination. A 69-year-old female patient with blurred vision, a clinic that began 10 days later after receiving first dose of COVID vaccine, and diplopia and right palpebral ptosis after the second dose, 30 days later. In the examination, Edrophonium test was clearly positive, treatment with pyridostigmine and prednisone was started and after 14 days the clinic showed improvement until the resolution of the symptoms There are few reports of exacerbations or triggers for the appearance of myasthenia gravis, a series of 27 cases has been published where there are outbreaks of immune-mediated diseases or the new appearance of autoimmune diseases, in which it is observed that the time of appearance of the outbreak was on average 4 days up to a maximum of 25 days. In conclusion, Myasthenia gravis is a rare complication of the BNT162b2 COVID-19 vaccine. Its potential severity and the current lack of knowledge of the real incidence after vaccination makes it necessary to maintain an attitude of vigilance in the face of symptoms that suggest it.

A Web-Based Nutrition Education Study in Alabama Black-Belt Counties During the Covid-19 Pandemic

Overweight and obesity continue to be health-related issues in Alabama Black-Belt Counties with rates ranging from 35 to 48%. We aimed to determine the impact of a web-based nutrition education and physical activity intervention on participants’ health in Alabama Black Belt counties during the COVID-19 pandemic. Nutrition education was delivered to participants through a zoom online platform for 12 weeks. Participants’ knowledge, attitudes, and practices as well as changes in nutrition knowledge, anthropometry, and blood pressure were determined through online surveys. Of the participants, (100%) indicated that overweight and obesity are a result of unhealthy lifestyles, whereas 90.7% reported that obesity increased the risk of high blood pressure (90.7%), diabetes (86.04%), and heart disease (90.7%). Results showed that participants’ income was a significant determinant of their perception for the role of schools in fighting obesity (χ2=0.04). Similarly, data revealed that the age of participants was a significant factor for: their desire to learn more about obesity (χ2=0.04), perception of their knowledge of overweight and obesity compared to the average person (χ2=0.01), and the perception that they had an excellent knowledge of overweight and obesity (χ2=0.05). There were significant improvements in knowledge scores. Results showed a significant decline in waist circumference (p<0.001) and hip circumference (p<0.02); 60% of the participants showed a decline in bodyweight; 43% lost more than 1-5kg, while 9.8% maintained their baseline weight. Web-based virtual interactions may effectively substitute or complement face-face nutrition education and lead to a reduction of overweight and obesity in Alabama Black-Belt counties.