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Article: Factors Predicting Positive Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer [Response to Letter].

AlSumai, Thuraya S / Alhefdhi, Amal

2023 Volume 15, Page(s) 133–134

Language	English
Publishing date	2023-02-06
Publishing country	New Zealand
Document type	Journal Article ; Comment
ZDB-ID	2520722-2
ISSN	1179-1314
ISSN	1179-1314
DOI	10.2147/BCTT.S404114
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Article: Coincidental Occurrence of Multiple Endocrine Neoplasia Type 1 and Breast Cancer in a Young Saudi Girl: A Case Study and Genetic Analysis.

Alhefdhi, Amal / Alrajhi, Reem S / Almady, Raghad A / Alzahrani, Ali S

Cureus

2023 Volume 15, Issue 11, Page(s) e48313

Abstract: Multiple Endocrine Neoplasia Type 1 (MEN-1) is an autosomal dominant familial disorder associated with tumors in both endocrine and non-endocrine organs. It is uncommon for MEN-1 to coincide with breast cancer. We present a case of a 15-year-old Saudi ... ...

Abstract	Multiple Endocrine Neoplasia Type 1 (MEN-1) is an autosomal dominant familial disorder associated with tumors in both endocrine and non-endocrine organs. It is uncommon for MEN-1 to coincide with breast cancer. We present a case of a 15-year-old Saudi girl who exhibited the classic symptoms of MEN-1 and subsequently developed breast cancer. The patient's breast cancer was diagnosed using ultrasonography and core biopsy, and she was treated with surgical interventions. Despite these treatments, her cancer progressed to a metastatic stage, and her overall health deteriorated, leading to cardiopulmonary arrest at a young age. Although the simultaneous appearance of MEN-1 and breast cancer in our patient may suggest a potential link, our comprehensive genetic analysis found no relationship between her MEN-1 mutation and the onset of breast cancer. This suggests that, in this case, the two conditions co-occurred by chance. Nonetheless, additional research is needed to explore potential associations between MEN-1 and breast cancer.
Language	English
Publishing date	2023-11-05
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.48313
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Article: Factors Predicting Positive Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer.

Alsumai, Thuraya S / Alhazzaa, Norah / Alshamrani, Abdullah / Assiri, Sarah / Alhefdhi, Amal

Breast cancer (Dove Medical Press)

2022 Volume 14, Page(s) 323–334

Abstract: Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is the standard tool to stage the axilla of breast cancer patients. This study aimed to identify the predictors of positive SLNB in patients with clinically node-negative breast cancer.: Patients and ... ...

Abstract	Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is the standard tool to stage the axilla of breast cancer patients. This study aimed to identify the predictors of positive SLNB in patients with clinically node-negative breast cancer. Patients and methods: A retrospective, single-institution cohort of patients with early-stage breast cancer without clinically identifiable axillary lymphadenopathy was chosen from January 2010 to December 2018. Logistic regression was used to identify possible predictors of positive SLNB. Results: Four hundred and seventy patients were identified; their mean age was 50±11 years. Most patients had the following characteristics: invasive ductal carcinoma (n=382, 81.3%), unilateral tumor (n=461, 98.1%), unifocal disease (n=351, 74.7%), intermediate grade (n=276, 59.0%), and estrogen and progesterone receptor positivity with human epidermal growth factor receptor 2 negativity (n=305, 64.9%). The mean size of the breast mass was 2.3±1.5 cm. SLNB was positive in 128 (27.2%) cases. The mean number of SLNs was 2±1.2. Axillary lymph node dissection was performed in 109 patients. The mean number of lymph nodes removed was 15±6. In 66 (60.6%) of the 109 patients with metastatic axillary nodes, only the SLNs were found to be positive. The number of SLNs, tumor size, tumor grade, receptor status, prominent axillary lymph nodes, and lymphovascular invasion predicted positive SLNB ( Conclusion: Our results suggest that a number of histopathological and radiological characteristics of breast cancer can predict SLNB positivity in clinically node-negative breast cancer patients.
Language	English
Publishing date	2022-10-11
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520722-2
ISSN	1179-1314
ISSN	1179-1314
DOI	10.2147/BCTT.S373005
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Article: Primary hyperparathyroidism.

Madkhali, Tarıq / Alhefdhi, Amal / Chen, Herbert / Elfenbein, Dawn

Ulusal cerrahi dergisi

2016 Volume 32, Issue 1, Page(s) 58–66

Abstract: Primary hyperparathyroidism is a common endocrine disorder caused by overactivation of parathyroid glands resulting in excessive release of parathyroid hormone. The resultant hypercalcemia leads to a myriad of symptoms. Primary hyperparathyroidism may ... ...

Abstract	Primary hyperparathyroidism is a common endocrine disorder caused by overactivation of parathyroid glands resulting in excessive release of parathyroid hormone. The resultant hypercalcemia leads to a myriad of symptoms. Primary hyperparathyroidism may increase a patient's morbidity and even mortality if left untreated. During the last few decades, disease presentation has shifted from the classic presentation of severe bone and kidney manifestations to most patients now being diagnosed on routine labs. Although surgery is the only curative therapy, many advances have been made over the past decades in the diagnosis and the surgical management of primary hyperparathyroidism. The aim of this review is to summarize the characteristics of the disease, the work up, and the treatment options.
Language	English
Publishing date	2016-03-01
Publishing country	Turkey
Document type	Journal Article ; Review
ZDB-ID	1394172-0
ISSN	1300-0705
ISSN	1300-0705
DOI	10.5152/UCD.2015.3032
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Article ; Online: Use of Adjunctive Therapy to Achieve Preoperative Euthyroidism in Graves' Disease: A Case Report.

Abdulghani Alghanim, Noor / Alkahtani, Shymaa M / Assari, Fatimah S / Alnosaier, Sarah W / Bader, Reham M / Elmahi, Isra E / Hendaz, Mariam M / Alhefdhi, Amal

The American journal of case reports

2020 Volume 21, Page(s) e923342

Abstract: BACKGROUND Graves' disease is an autoimmune disease of the thyroid gland and it is considered the most common cause of hyperthyroidism. It is characterized by particular eye manifestations, skin changes, and pretibial myxedema in addition to the signs ... ...

Abstract	BACKGROUND Graves' disease is an autoimmune disease of the thyroid gland and it is considered the most common cause of hyperthyroidism. It is characterized by particular eye manifestations, skin changes, and pretibial myxedema in addition to the signs and symptoms of hyperthyroidism. Graves' disease can be diagnosed based on clinical presentation and low thyroid stimulating hormone (TSH) and elevated free T4 (FT4) levels. Presence of TSH receptor antibody (TRAb) in the serum confirms the diagnosis of Graves' disease. Imaging studies like radioactive iodine scan will show a high and diffuse uptake. Graves' disease can be managed with three different treatment modalities: antithyroid medications, radioactive iodine, or surgical removal of the thyroid gland. Whenever surgery is indicated, careful preoperative management to achieve euthyroidism is needed to optimize the surgical outcome. CASE REPORT This is a case of a 37-year-old Saudi male known to have Graves' disease for 2 years who presented to the endocrine surgery clinic with neck swelling, difficulty breathing, and change in voice. After multiple attempts to control his fluctuating thyroid levels, the team eventually managed to achieve a euthyroid state in the patient with the addition of saturated solution of potassium iodide (SSKI), and thus rendering him eligible for urgent surgery. CONCLUSIONS We report this case to show that SSKI can be used as adjunctive therapy to achieve a preoperative euthyroid state in refractory Graves' disease.
MeSH term(s)	Adult ; Antithyroid Agents/therapeutic use ; Graves Disease/complications ; Humans ; Iodine Radioisotopes ; Male ; Thyroid Neoplasms
Chemical Substances	Antithyroid Agents ; Iodine Radioisotopes
Language	English
Publishing date	2020-08-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.923342
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Book ; Online: Adversarial Patch Generation for Automated Program Repair

Alhefdhi, Abdulaziz / Dam, Hoa Khanh / Le-Cong, Thanh / Le, Bach / Ghose, Aditya

2020

Abstract: Automated Program Repair has attracted significant research in recent years, leading to diverse techniques that focus on two main directions: search-based and semantic-based program repair. The former techniques often face challenges due to the vast ... ...

Abstract	Automated Program Repair has attracted significant research in recent years, leading to diverse techniques that focus on two main directions: search-based and semantic-based program repair. The former techniques often face challenges due to the vast search space, resulting in difficulties in identifying correct solutions, while the latter approaches are constrained by the capabilities of the underlying semantic analyser, limiting their scalability. In this paper, we propose NEVERMORE, a novel learning-based mechanism inspired by the adversarial nature of bugs and fixes. NEVERMORE is built upon the Generative Adversarial Networks architecture and trained on historical bug fixes to generate repairs that closely mimic human-produced fixes. Our empirical evaluation on 500 real-world bugs demonstrates the effectiveness of NEVERMORE in bug-fixing, generating repairs that match human fixes for 21.2% of the examined bugs. Moreover, we evaluate NEVERMORE on the Defects4J dataset, where our approach generates repairs for 4 bugs that remained unresolved by state-of-the-art baselines. NEVERMORE also fixes another 8 bugs which were only resolved by a subset of these baselines. Finally, we conduct an in-depth analysis of the impact of input and training styles on NEVERMORE's performance, revealing where the chosen style influences the model's bug-fixing capabilities.
Keywords	Computer Science - Software Engineering
Subject code	006
Publishing date	2020-12-20
Publishing country	us
Document type	Book ; Online
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Article ; Online: Role of postoperative vitamin D and/or calcium routine supplementation in preventing hypocalcemia after thyroidectomy: a systematic review and meta-analysis.

Alhefdhi, Amal / Mazeh, Haggi / Chen, Herbert

The oncologist

2013 Volume 18, Issue 5, Page(s) 533–542

Abstract: Background: Transient hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We performed a systematic review ... ...

Abstract	Background: Transient hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We performed a systematic review to assess the effectiveness of this intervention. The primary aim was to evaluate the efficacy of routine postoperative oral calcium and vitamin D supplementation in preventing symptomatic post-thyroidectomy hypocalcemia. The second aim was to draw clear guidelines regarding prophylactic calcium and/or vitamin D therapy for patients after thyroidectomy. Methods: We identified randomized controlled trials comparing the administration of vitamin D or its metabolites to calcium or no treatment in adult patients after thyroidectomy. The search was performed in PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and Web of Knowledge databases. Patients with a history of previous neck surgery, calcium supplementation, or renal impairment were excluded. Results: Nine studies with 2,285 patients were included: 22 in the vitamin D group, 580 in the calcium group, 792 in the vitamin D and calcium group, and 891 in the no intervention group, with symptomatic hypocalcemia incidences of 4.6%, 14%, 14%, and 20.5%, respectively. Subcomparisons demonstrated that the incidences of postoperative hypocalcemia were 10.1% versus 18.8% for calcium versus no intervention and 6.8% versus 25.9% for vitamin D and calcium versus no intervention. The studies showed a significant range of variability in patients' characteristics. Conclusions: A significant decrease in postoperative hypocalcemia was identified in patients who received routine supplementation of oral calcium or vitamin D. The incidence decreased even more with the combined administration of both supplements. Based on this analysis, we recommend oral calcium for all patients following thyroidectomy, with the addition of vitamin D for high-risk individuals.
MeSH term(s)	Calcium, Dietary/administration & dosage ; Dietary Supplements ; Humans ; Hypocalcemia/complications ; Hypocalcemia/diet therapy ; Hypocalcemia/pathology ; Parathyroid Hormone ; Postoperative Period ; PubMed ; Randomized Controlled Trials as Topic ; Thyroidectomy ; Treatment Outcome ; Vitamin D/administration & dosage
Chemical Substances	Calcium, Dietary ; Parathyroid Hormone ; Vitamin D (1406-16-2)
Language	English
Publishing date	2013-05-01
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	1409038-7
ISSN	1549-490X ; 1083-7159
ISSN (online)	1549-490X
ISSN	1083-7159
DOI	10.1634/theoncologist.2012-0283
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Zs.A 4845: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Impact of the COVID-19 pandemic on the practice of endocrine surgery.

Beninato, Toni / Laird, Amanda M / Graves, Claire E / Drake, F Thurston / Alhefdhi, Amal / Lee, James A / Kuo, Jennifer H / Grubbs, Elizabeth G / Wang, Tracy S / Pasieka, Janice L / Lubitz, Carrie C

American journal of surgery

2021 Volume 223, Issue 4, Page(s) 670–675

Abstract: Background: This study investigates the impact of the COVID-19 pandemic on endocrine surgeons.: Methods: A survey on the professional, educational, and clinical impact was sent to active and corresponding members of the American Association of ... ...

Abstract	Background: This study investigates the impact of the COVID-19 pandemic on endocrine surgeons. Methods: A survey on the professional, educational, and clinical impact was sent to active and corresponding members of the American Association of Endocrine Surgeons (AAES) in September 2020. Chi-square and paired t-test were used for analysis. Results: 77 surgeons responded (14.8 %). All reported suspension of elective surgeries; 37.7 % were reassigned to other duties during this time. The median number of cases backlogged was 30 (IQR 15-50). Most surgeons reported decreased clinical volume (74.6 %). The use of virtual platforms for clinical and educational purposes increased from pre-COVID-19 levels (all p < 0.001). Use of in-office procedures (p < 0.001) and length of observation prior to discharge for thyroid surgery (p < 0.05) decreased. Conclusion: The COVID-19 pandemic led to suspension of operations and decreased practice volume for endocrine surgeons. Surgeons increased use of virtual platforms, decreased in-office procedures, and decreased duration of observation for thyroid surgery in response.
MeSH term(s)	COVID-19/epidemiology ; Endocrine Surgical Procedures ; Humans ; Pandemics ; SARS-CoV-2 ; Surgeons ; Surveys and Questionnaires ; United States/epidemiology
Language	English
Publishing date	2021-07-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2021.07.009
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Article ; Online: Intraoperative Parathyroid Hormone Levels at 5 min Can Identify Multigland Disease.

Alhefdhi, Amal / Ahmad, Kamal / Sippel, Rebecca / Chen, Herbert / Schneider, David F

Annals of surgical oncology

2017 Volume 24, Issue 3, Page(s) 733–738

Abstract: Background: Intraoperative parathyroid hormone (IOPTH) monitoring is crucial in the treatment of primary hyperparathyroidism (PHPT). Often, the 5 min IOPTH levels fall, but not by the requisite 50 %. In such cases, the surgeon must decide whether to ... ...

Abstract	Background: Intraoperative parathyroid hormone (IOPTH) monitoring is crucial in the treatment of primary hyperparathyroidism (PHPT). Often, the 5 min IOPTH levels fall, but not by the requisite 50 %. In such cases, the surgeon must decide whether to wait for additional levels or to continue exploration. This study aimed to evaluate the 5 min drop in IOPTH for distinguishing single adenomas (SA) from multigland disease. Methods: A retrospective analysis of a prospectively collected database was performed on PHPT patients who underwent initial curative parathyroidectomy between 2001 and 2013. Those with familial disease and those taking lithium or undergoing concomitant thyroidectomy were excluded from the analysis. For cases of double adenomas (DA) or hyperplasia (HA), the IOPTH values indicating additional glands were analyzed. Results: The inclusion criteria were met by 1021 patients: 817 patients with SA (82.2 %), 99 patients with DA (10 %), and 78 with HA (7.9 %). The SA patients exhibited a 56.6 ± 4.9 % decline in IOPTH at 5 min compared with 21.3 ± 4.5 % of the DA patients and 22.5 ± 4.3 % of the HA patients (p < 0.01). Post hoc comparisons showed that the 5 min decrease in the SA group was significantly greater than in either the DA group or the HA group (p < 0.01). A 5 min percentage decline of 35 % best distinguished SA from multiglandular disease (85.3 vs. 24.9 %). Conclusion: The data suggest that when IOPTH level does not drop by at least 35 % at 5 min after excision, the surgeon should consider further exploration rather than wait for additional levels.
Language	English
Publishing date	2017-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-016-5617-1
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Article ; Online: Recurrent and persistence primary hyperparathyroidism occurs more frequently in patients with double adenomas.

Alhefdhi, Amal / Schneider, David F / Sippel, Rebecca / Chen, Herbert

The Journal of surgical research

2014 Volume 190, Issue 1, Page(s) 198–202

Abstract: Introduction: The incidence of recurrent primary hyperparathyroidism (PHPT) had been reported to be between 1% and 10%. The purpose of this study was to examine if patients with multigland disease have a different recurrence rate.: Methodology: A ... ...

Abstract	Introduction: The incidence of recurrent primary hyperparathyroidism (PHPT) had been reported to be between 1% and 10%. The purpose of this study was to examine if patients with multigland disease have a different recurrence rate. Methodology: A retrospective analysis of a prospectively collected database was performed on patients with PHPT who underwent parathyroidectomy at one institution between 2001 and 2013. Patients who underwent initial parathyroidectomy with at least 6 mo of follow-up were included and were divided into three groups according to operative notes: single adenoma (SA), double adenoma (DA), and hyperplasia (HP). An elevated postoperative serum calcium level within 6 mo of surgery was defined as a persistent disease, whereas an elevated calcium after 6 mo was defined as a recurrence. Results: In total, 1402 patients met inclusion criteria, and the success rate of parathyroidectomy was 98.4%. The mean age was 60±14 y and 78.5% were female. Among them, 1097 patients (78%) had SA, 124 patients (9%) had DA, and 181 patients had HP (13%). The rate of persistent PHPT was higher among patients with DA (4%) versus SA (1.3%) and HP (2.2%) (P=0.0049). Moreover, the recurrence rate was higher among patients with DA (7.3%) versus SA (1.7%) and HP (4.4%) (P=0.0005) with identical median follow-up time. The median of the follow-up was 11 mo for patients with SA, 12.5 for patients with DA, and 12 for patients with HP (P=0.1603). Conclusions: Recurrent and persistent PHPT occur more frequently in patients with DA. These data suggest that DA in some cases could represent asymmetric or asynchronous hyperplasia. Therefore, patients with DA may warrant more rigorous intraoperative scrutiny and more vigilant monitoring after parathyroidectomy.
MeSH term(s)	Adenoma/complications ; Adult ; Aged ; Aged, 80 and over ; Calcium/blood ; Female ; Humans ; Hyperparathyroidism, Primary/blood ; Hyperparathyroidism, Primary/etiology ; Hyperparathyroidism, Primary/surgery ; Male ; Middle Aged ; Parathyroid Neoplasms/complications ; Recurrence ; Retrospective Studies
Chemical Substances	Calcium (SY7Q814VUP)
Language	English
Publishing date	2014-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2014.02.024
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