Recent advances in preoperative and intraoperative nuclear medicine procedures in patients with primary hyperparathyroidism

Although bilateral neck exploration is traditionally considered as the treatment of choice in patients with primary hyperparathyroidism (HPT), several surgical techniques of limited neck exploration have been proposed over the last 10 years in primary HPT patients with a high probability to be affected by a solitary parathyroid adenoma. The availability in recent years of highly sensitive and accurate preoperative imaging modalities, particularly the parathyroid scintigraphy with 99mTc-MIBI and high resolution neck ultrasonography, allowed to increase the rate of primary HPT patients as candidates to a selective parathyroidectomy. One of the most innovative techniques for limited surgery is the minimally invasive radio-guided parathyroidectomy that is based on the intraoperative detection of the parathyroid adenoma under the guidance of a gamma probe allowing the removal of the parathyroid adenoma through a small 2-cm skin incision. However, if a minimally invasive parathyroidectomy is taken into consideration, accurate preoperative imaging is mandatory not only to distinguish patients with a solitary parathyroid adenoma from those with multi-glandular disease but also to diagnose patients with concomitant thyroid nodule(s) that can cause false-positive results at radio-guided surgery. In the present study the most recent advances reached with preoperative localizing imaging of parathyroid adenomas are reviewed and the techniques proposed to perform a minimally invasive radio-guided surgery are discussed with particular regard to the therapeutic efficacy and cost-effectiveness analysis.     

Recent advances in neuroanaesthesia

In order to provide optimum intracranial operating conditions for neurosurgery, anaesthetists must have a thorough understanding of brain physiology and how this is affected by pathology and anaesthetic drugs and techniques. This article discusses the current understanding of cerebral vascular physiology and how novel neuroanaesthetic drugs and techniques affect it.     

Recent advances in chlamydia trachomatis

Chlamydia trachomatis is an obligate intracellular energy parasitic bacterium with a genome of 660 × 10⁶ daltons, possessing a plasmid and unique life cycle which includes the differentiation of the infective elementary body to a replicative reticulate body. C. trachomatis is the etiological agent of trachoma, which affects approximately 500 million people in developing countries. Recently it became evident that in industrialised Western nations certain strains of C. trachomatis are the most common cause of sexually transmitted infections such as non-gonoccocal urethritis, cervicitis, endometritis, salpingitis and subsequent ectopic pregnancies or infertility, perihepatitis, neonatal conjunctivitis and pneumonia, adult conjunctivitis and epididymitis. Since C. trachomatis infections are often asymptomatic, widespread screening of sexually active young people is needed in order to initiate early antibiotic treatment which may prevent serious complications such as ectopic pregnancies and infertility. Development of sensitive and simple techniques for mass screening for detection of Chlamydia in excretions as well as techniques for detection of specific markers of chronic internal infections (such as Chlainydia specific IgA antibodies) is of great importance.     

Recent advances in hearing restoration

This review is based on Pubmed, Medline and Internet literature searches, supplemented by knowledge from textbooks, conference presentations, and personal communications with experts in the field of hearing restoration and patients. We have not specifically selected a time limit for our literature searches; however, the majority are articles from the past 5 years.     

甜菜碱研究新进展

全面综述甜菜碱在防治高同型半胱氨酸血症、心血管疾病和肝脏疾病、抑制脂肪合成、促进脂肪分解及代谢、抑制肿瘤类疾病及其他有益人体健康方面的研究进展。     

Recent advances in khat research

Khat leaves are widely used as a stimulant in East Africa andthe Arabian Peninsula and the effect of the material was formerlybelieved to be due to its content of norpseudoephed-rine. Recently,however, a new alkaloid, cathinone, has been discovered in khat,and this substance was found to be a potent compound with apharmacological profile closely resembling that of amphetamine.It was also found that cathinone has the same mechanism of actionas amphetamine, i.e. that it causes release at physiologicalcatecholamine storage sites. The present report summarizes thepharmacology of cathinone and shows that this alkaloid mustbe considered to be the main active constituent of khat.