Thrombophlebitis und Magnet]
  • Thrombosis und Thrombophlebitis der unteren Extremitäten: Ätiologie, Diagnostik und Therapie von

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    What are the parathyroid glands? The parathyroid glands are four, small, pea-shaped glands that are located in the neck on either side of the Thrombophlebitis und Magnet the main airway and next to the thyroid gland. In most cases there are two glands on each side of the trachea, an inferior and a superior gland.

    Fewer than four or more than four glands may be present, and sometimes a gland s may be in an unusual location. The function of the parathyroid glands is to produce parathyroid hormone PTHa hormone that helps regulate calcium within the body. What is a parathyroidectomy? Parathyroidectomy is the removal of one or more of the parathyroid glands, Thrombophlebitis und Magnet, and it is used to treat hyperparathyroidism.

    Hyperparathyroidism is a condition in which the parathyroid glands produce too much PTH. If there Salbe mit trophischen Geschwüren des diabetischen Fußes too much PTH, calcium is removed from the bones and goes into the blood, Thrombophlebitis und Magnet, and there is increased absorption of calcium from the intestine into the blood.

    This results in increased levels of calcium in the blood and an excess of calcium in the urine. In more serious cases, the bone density will diminish and kidney stones can form. Other non-specific symptoms of hyperparathyroidism include depressionmuscle weaknessand fatigue. Every effort is made to medically treat or control these conditions prior to surgery. These efforts include avoiding calcium rich foods, Thrombophlebitis und Magnet, proper hydration intake of fluidsand medications to avoid osteoporosis.

    There are two types of hyperparathyroidism, primary and secondary. The most common disorder of the parathyroid glands and one that causes primary hyperparathyroidism, is a small, tumor called a parathyroid adenoma. A parathyroid adenoma is a benign condition in which one parathyroid gland increases in size and produces PTH in excess.

    As opposed to parathyroid adenoma, it should be noted that malignant tumors of the parathyroid glands, that is, canceris very rare, Thrombophlebitis und Magnet.

    In most situations patients are unaware of the adenoma, and they are found when routine blood test results show Thrombophlebitis und Magnet elevated blood calcium and PTH level.

    Less commonly, Thrombophlebitis und Magnet, primary hyperparathyroidism may be caused by overactivity of all of the parathyroid glands, referred to as parathyroid hyperplasia. With secondary hyperparathyroidism, the secretion of PTH is caused by a nonparathyroid disease, usually kidney failure. When is a parathyroidectomy necessary and how is it performed?

    Parathyroidectomy is necessary Thrombophlebitis und Magnet calcium levels are elevated, if there is a complication of hyperparathyroidism such as kidney stones, osteoporosisor bone fracturesor if a patient is relatively young.

    Tests such as a high-resolution ultrasound or a nuclear medicine scan called a sestamibi scan help to direct the approach preoperatively or intra-operatively by identifying the location of the overactive, enlarged gland. During a parathyroidectomy, the surgeon delicately removes one or more of the tiny parathyroid glands. In some situations, both sides of the neck are explored, while in other cases a direct approach is made through a small incision referred to as a minimally invasive parathyroidectomy.

    In rare situations, the offending gland cannot be found. A portion of a gland also may be transplanted to another site in the neck or the arm to preserve parathyroid Thrombophlebitis und Magnet. Whereas preoperative tests help to identify hyperparathyroidism and to direct the surgical approach, PTH levels obtained during parathyroidectiomy help to guarantee the successful resection of the abnormal gland by demonstrating a return of the PTH levels to normal after the suspected parathyroid adenoma is removed, Thrombophlebitis und Magnet.

    Using this method, a PTH determination is obtained immediately prior to the resection Thrombophlebitis und Magnet compared to a PTH determination done ten minutes after the resection. What are the risks of parathyroidectomy? The anatomy of the parathyroid glands is Thrombophlebitis und Magnet by two important structures: The recurrent laryngeal nerve is a very important nerve that runs very close to or through the thyroid Thrombophlebitis und Magnet next to the parathyroid glands.

    This nerve controls movement of the vocal cord on that side of the larynx, and damage to the nerve can weaken or paralyze the vocal cord. Weakness or paralysis of one vocal cord causes a breathy weak voice, and difficulty swallowing thin liquids. Weakness or paralysis of both vocal cords causes difficulty breathing.

    In most situations, a special breathing tube is used that rests in the larynx voice box between the vocal cords and is designed to allow for the continued monitoring of their function. In rare situations, Thrombophlebitis und Magnet, the parathyroid adenoma is found within the thyroid gland, and it is necessary to remove the thyroid gland as well. The main goal of the parathyroidectomy operation is to remove the offending gland s while protecting the remaining normal parathyroid glands as well as the recurrent laryngeal nerves and the thyroid gland.

    Surgery may be unsuccessful, that is, the hyperparathyroidism may not be cured and there may be complications of the surgery. Because individuals differ Thrombophlebitis und Magnet their response to surgery, their reaction to the anesthetic and their healing following surgery, there can be no guarantee made as to the results or the lack of complications.

    Furthermore, the outcome of surgery may depend on preexisting or concurrent medical conditions. What are the possible complications of parathyroidectomy? The following complications have been reported in Thrombophlebitis und Magnet medical literature.

    This list is not meant to be inclusive of every possible complication. They are listed here for your information only, not to frighten you, Thrombophlebitis und Magnet, but to make you aware and more knowledgeable concerning parathyroidectomy.

    Although many of these complications are rare, all have occurred at one time or another in the hands of experienced surgeons practicing community standards of care. Anyone who is contemplating surgery must weigh the potential risks and complications against the potential benefits of the surgery or any alternative to surgery.

    What else do you need to know before parathyroidectomy? Parathyroidectomy usually takes up to three hours. In most situations, the surgery is performed at a hospital or at an outpatient surgery center. An anesthesiologist provides anesthesia and monitors patients throughout the surgery.

    The anesthesiologist calls the night before surgery to review each patient's medical history or talks to the patient on the morning of the surgery. If preoperative laboratory studies are ordered, they are done several days before the surgery to allow enough time for the results to be obtained and sent to the surgeon and anesthesiologist.

    Most patients are told not take aspirin or any product containing aspirin for 10 days prior to surgery in order to prevent aspirin from increasing bleeding at the time of surgery. It is important to note that many over-the-counter products contain aspirin or ibuprofen, so it is important that patients carefully check all medications that they are taking. If there is any question about a medication, patients should call their doctor's office or consult with their pharmacist. Tylenol is an acceptable pain reliever if a pain reliever is needed prior Thrombophlebitis und Magnet surgery.

    Doctors often give patients their prescriptions for postoperative medications at the preoperative visit so that they may have them filled prior to the surgery, Thrombophlebitis und Magnet. Surgeons may advise purchasing calcium-containing antacids such as Tums -Extra Strength tablets in case the blood calcium drops after surgery and calcium supplements are needed. The amount and duration of supplementation is determined by the surgeon.

    Patients do not eat or drink anything for approximately six hours prior to the time of surgery. This includes even water, candy, or chewing gum. Anything in the stomach increases the chances of an Thrombophlebitis und Magnet complication.

    Smokers should make every effort to stop smoking or at least reduce the number of daily cigarettes. This may improve the healing process and reduce postoperative coughing and bleeding. What about care after parathyroidectomy?

    After surgery, patients go to the recovery room where nurses monitor them for about one hour. In most situations patients spend one night in the hospital, although some patients undergoing a minimally invasive parathyroidectomy may go home the same day.

    A friend or family member usually is required to pick patients up from the surgical facility if they are going directly home.

    It is a good idea for someone to be at home with the patient for the first night. Patients' necks may be swollen and bruised after surgery, and in most instances there will be a bandage wrapped around the neck. Bandages usually are removed one or two days following surgery.

    There may be a Thrombophlebitis und Magnet plastic drain exiting through the skin. If so, the drainage of fluid from the drain will be monitored in the recovery room or hospital, Thrombophlebitis und Magnet. Sometimes patients may even go home with a drain in place after the nursing staff teaches them how to manage the drain.

    Sutures taped to the neck should not be cut or trimmed. Starting several hours after surgery and possibly for several days, blood calcium levels usually are monitored.

    It is not uncommon for there to be a fall in the blood Thrombophlebitis und Magnet level following surgery. The remaining parathyroid glands are "sleepy" following surgery. As a result, patients may need to take supplemental oral calcium for several days or weeks following surgery. Permanent calcium problems are rare. If patients experience numbness and tingling of the lips, arms, or feet, Thrombophlebitis und Magnet, and or twitching of the muscles--symptoms of low blood calcium--they should contact their surgeon or endocrinologist immediately.

    In most situations in which these symptoms occur, surgeons will ask patients to take supplemental calcium, such as in Tums-Extra Strength, Thrombophlebitis und Magnet, after surgery, Thrombophlebitis und Magnet.

    This helps to replenish calcium that is moving back into the bones. Numbness, slight swelling, Thrombophlebitis und Magnet, tingling, discoloration, bumpiness, Thrombophlebitis und Magnet, hardness, crusting, tightness, and a small amount of redness around Thrombophlebitis und Magnet incision are a normal findings after surgery and should improve with time, Thrombophlebitis und Magnet. It is usually alright for patients to wash their face, neck, and hair after the bandages have been removed.

    Excessive scrubbing of the wound should be avoided, and Krampfbeinschmerzen gentle soap and shampoo should be used. In the hospital and after going home, patients generally lie in bed and rest with their head elevated on pillows.

    By keeping their head elevated above their heart, Thrombophlebitis und Magnet of the neck due to edema may be lessened. Patients get out of bed with assistance to use the bathroom, however. It is good to avoid straining when Thrombophlebitis und Magnet a bowel movement, and, if constipation is a problem, a stool softener or a gentle laxative is a good idea.

    It may be better to eat a light, soft, Thrombophlebitis und Magnet, and cool diet as tolerated after recovery from the anesthetic. Even though patients may be hungry immediately after surgery, it may be best to go slowly to Thrombophlebitis und Magnet postoperative nausea and vomiting.

    Occasionally, patients may vomit one or two times immediately after surgery. If vomiting persists, the doctor may prescribe medications to settle the stomach, Thrombophlebitis und Magnet. A good overall diet with ample rest promotes healing.

    Antibiotics often are prescribed after surgery. Patients should finish all the pills that have been ordered.

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