What is the progression of sleep stages in a usual night of sleep? In the adult, NREM and REM sleep typically alternate in 90- to 120-minute cycles. Four to five cycles occur during a normal sleep period, depending on the length of sleep. Each cycle is identifiable with sleep onset initiating in stage N1, progressing …
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What are the stages of human sleep? Normal adult sleep is organized into rapid eye movement (REM) sleep and non–rapid eye movement (NREM) sleep, which is further divided into stages N1, N2, and N3. This final NREM stage is also called slow-wave sleep (SWS). In classic teaching, NREM was organized into four stages, but in …
Do sleep disorders cause endocrine disease or does endocrine disease cause sleep disorders? Both are true. Sleep experts have dubbed sleep symptoms as the “canary in the mine” for serious medical and psychological diseases. Sleep quality evaluation can be a tool for assessment of disease. Additionally, sleep disorders are common in many endocrine diseases. For …
What is the concern with sleep wake cycles and circadian rhythmicity? The 24-hour profile of nearly all pituitary hormones is related to the presence and quality of sleep. Stereotypical changes in nearly all hormonal and metabolic variables are observed surrounding sleep cycling and sleep–wake transitions. The absence of sleep, or the interruption of sleep, has …
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Recurrence and survival rates for parathyroid cancer Recurrence rates are high and depend on whether the patient underwent a routine parathyroidectomy for presumed benign disease (> 50% recurrence) or an en bloc resection for suspicion of cancer (10%–33%). Despite this high recurrence rate, prolonged survival is still possible. The National Cancer Database reports 5- and …
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Management of parathyroid cancer Surgery is the mainstay of treatment for parathyroid cancer because radiation and chemotherapy have shown little benefit. Local invasion and pathologic nodes should be assumed to represent cancer. Any suspicious parathyroid lesions should be carefully removed without disrupting the parathyroid capsule because this may result in tumor spillage and local recurrence. …
How can parathyroid cancer be recognized? Parathyroid cancer is the rarest of all endocrine tumors, with a reported incidence of < 1% in patients with primary HPT. It is difficult to distinguish parathyroid cancer from the more common benign causes of HPT, and the diagnosis is frequently not suspected preoperatively. Parathyroid cancer should be suspected …