Patients who have been successfully operated on with total parathyroidectomy for symptomatic secondary hyperparathyroidism and their PTH levels are below 72 pg/dL within one week after surgery.

Patients who have had regular dialysis and their iPTH levels are around 500 pg/dL

Secondary Hyperparathyroidism Due to Renal Causes

Patients should receive total parathyroidectomy plus bilateral thymectomy and autotransplantation

parathyroidectomy plus bilateral thymectomy and autotransplantation

Fong-Fu Chou

Pulmonary Function, Voice and Swallowing Symptoms After Parathyroidectomy

Changes of Pulmonary Function, Voice and Swallowing Symptoms After Total Parathyroidectomy for Secondary Hyperparathyroidism in the Presence of Intact Recurrent Laryngeal Nerve

After successful surgery, patients were recruited in the study, and we excluded patients with a surgical failure.

speech impairment and speech quality were evaluated with GRBAS on a scale (0-3), VHI-10 (>11, abnormal) and (EAT-10) (≥ 3, abnormal) .
*GRBAS (grade, roughness, breathiness, asthenia, strain) scale grades hoarseness, roughness, breathiness, aesthenia (weakness), and strain on a scale of 0-3 0 = normal, 1 = mild degree, 2 = moderate degree, and 3 = high degree

speech impairment and speech quality were evaluated with voice handicap index (VHI-10) (>11, abnormal) 0-4 Rating Scale 0 = Normal
= Almost Normal
= Sometimes
= Abnormal
= Always

speech impairment and speech quality were evaluated with EAT-10 (≥ 3, abnormal) .
*eating assessment tool (EAT-10) 0 - 4 Rating Scale 0 = No problem
= Mild Problem
= Mild to moderate
= Moderate problem
= Severe problem

mean frequency (F0, Hz); Noise-to-Harmonic Ratio (NHR), jitter(%), and shimmer (%)

The maximal phonation time (sec) and s/z ratio were measured with circumferentially vented pneumotachography mask and differential transducers of the Aerophone system .

Vocal cord mobility, vocal cord closure (complete or incomplete), airway invasion during swallowing were inspected with fiber-optic endoscopy to show premature spillage, penetration-aspiration scale levels . The Yale pharyngeal residue severity rating scale for vallecula and pyriform sinus (0-4) (non-trace-mild-moderate-severe) and pyriform sinus (0-4) were also performed.

Forced vital capacity (FVC) (L), forced expiratory volume in 1 second (FEV1), bronchodilator test (BDT) (a positive response to BDT defined by the American Thoracic Society as an increase in FEV1 or FVC ≥ 12% and 200 ml), total lung capacity (TLC) (L), and alveolar volume (VA) using MasterScope (Jaeger, VIASYS healthcare GmbH, Höchberg, Germany), and diffusion capacity of the lung for carbon monoxide (DLCO) (%) using Vmax Autobox (SensorMedics, a subsidiary of VIASYS healthcare, California, USA).

The 6 minutes walking test (6MWT) was also performed to evaluate distance (meter) and O2 desaturation (differences of O2 saturation between pre- and post-tests) (defined as positive if O2 desaturation ≧ 4%).

Chou Fong-Fu

Consultant professor

Chang Gung Memorial Hospital

Hemodialysis Complication

Hemodialysis

Saint-Georges Hospital

Twice Against Thrice-weekly Hemodialysis

Twice-Against Thrice-weekly Hemodialysis: the TATH Trial

Rate of supplementary hemodialysis sessions for pulmonary oedema or hyperkalemia

Rate of uncontrolled hypertension, Uncontrolled hypertension is defined as a pre-dialysis BP > 160/90 in more than 2/3 of the sessions.

Mabel Aoun

Dr Mabel Aoun. Head of the Department of Nephrology, Saint-Georges Hospital Ajaltoun

Saint-Joseph University

The group who receive spironolactone, the dose employed will be 25 mg each other day and titrated to 25 mg daily according to potassium.

Renal Failure

Spironolactone

Hospital of the Medical School of Botucatu

Effects of Spironolactone in Dialysis

Assessment of the Effects of the Combination of Spironolactone to Conventional Pharmacotherapy in Dialysis Patients

The reduction of left ventricular hypertrophy will be measured by echocardiography, blood pressure monitoring residential and pulse wave velocity.

Measurement of serum potassium and other routine laboratory parameters pertaining to the hemodialysis unit of the Hospital of the Medical School of Botucatu - UNESP.

arteriovenous fistula/phosphatase

Pulmonary Function, Voice and Swallowing Symptoms After Parathyroidectomy

Twice Against Thrice-weekly Hemodialysis

Effects of Spironolactone in Dialysis

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