Injury to the recurrent laryngeal nerve (RLN) is a well known, though less frequent, complication of parathyroid surgery. In recent years, the use of intraoperative nerve monitoring (IONM) has gained popularity amongst surgeons when operating on thyroid gland; however, its utilization in parathyroid surgery is not established. This trend continues to rise, despite multiple studies documenting no statistically significant difference that IONM decreases the incidence of RLN injury. Most surgeons use this technology as an adjunct to visualization alone for identification of RLN. The purpose of this review is to discuss the possible role of IONM in parathyroid surgery with regards to the accuracy, efficacy, and recent trends in the utilization of this technology. There is insufficient evidence that IONM reduces the risk of RLN injury in parathyroidectomy. Although IONM may decrease the likelihood of nerve injury by helping to identify and map the RLN during thyroidectomy, we did not find studies exclusive to parathyroid surgery to see if its use can be supported for parathyroidectomy. Despite this lack of evidence, we believe that IONM is a promising adjunct to visualization alone in detecting nerve structures during neck dissection, but more clinical trials are warranted to establish its role in preventing nerve injury in parathyroid surgery.

The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

Cancer and atherosclerotic cardiovascular disease (ASCVD) represent two of the leading causes of death worldwide. Increasingly, these two are being recognized as biologically related conditions rather than entirely segregated disease states. In addition to traditional risk factors such as aging, smoking, and obesity, chronic inflammation may be a key factor connecting the two illnesses. Endothelial dysfunction, oxidative stress, plaque progression, and thrombosis are all facilitated by inflammatory signaling in ASCVD. Similar pathways are known to contribute to cancer growth and invasion. Emerging epidemiologic data demonstrate increased cancer incidence among patients with cardiovascular disease, while cancer survivors and recipients of cardiotoxic therapies exhibit accelerated vascular disease. This narrative review aims to describe the bidirectional relationship between ASCVD and cancer. Targeting shared pathways using statins, colchicine, canakinumab, IL-6 inhibition, and lifestyle modification may provide dual benefits. Future biomarker-guided trials with integrated cardiovascular and oncologic endpoints are needed to clarify causality and optimize prevention and management.

Background: Secondary pulmonary hypertension (SPH) predicts poor outcomes in obstructive sleep apnea (OSA) patients. This study examines sex/racial disparities, predictors, and inpatient mortality in SPH-related OSA hospitalizations. Methods: We used the National Inpatient Sample (2019) and ICD-10 codes to identify OSA-related hospitalizations with SPH. The burden of SPH and disparities by sex/race were assessed. We also compared the odds and predictors of in-hospital mortality in OSA patients with vs. without SPH. Results: Of total adult OSA hospitalizations (n = 2,317,136, median age of 66 [56–74] years, and males: 57.2%), 9.4% (218,795/2,317,136) had SPH. Females vs. males (11.3% vs. 8.1%) and Blacks vs. other race groups (13.5%) with OSA had a higher prevalence of SPH. The SPH cohort often consisted of females (51 vs. 41.9%), Blacks (20.9 vs. 14.0%), Medicare-insured (73.4 vs. 60.6%), and non-elective admissions (89.2 vs. 74.4%) vs. the non-SPH cohort. The SPH cohort also had a higher burden of complicated HTN (52.9 vs. 36.3%), DM with complications (42.7 vs. 32.4%), COPD (52.5 vs. 36.9%), history of prior MI (11.4 vs. 9.6%), and venous thromboembolism (10.4 vs. 8.4%). However, in-hospital mortality was more likely to be in males (OR 1.12; 95%CI 1.00–1.25, p = 0.048) vs. females, and OSA patients with metastatic cancer (OR 2.73; 95%CI 2.04–3.65) and solid non-metastatic tumors (OR 1.65; 95%CI 1.26–2.15) (p < 0.001). Conclusions: The prevalence of SPH with OSA was greater in females and Blacks, whereas males and Whites had higher subsequent inpatient mortality. More prospective studies are needed to understand the role of comorbidities on survival outcomes.