Normocalcaemic primary hyperparathyroidism (NPHPT) is often under-recognised in clinical practice.
To determine the prevalence and clinical significance of NPHPT in an unselected sample in an acute ...hospital setting.
Patients aged >18 years who had measurement of an elevated serum parathyroid hormone (PTH ≥ 7 pmol/L) during 12 months from 1 January 2017 to 31 December 2017 were retrospectively studied. NPHPT was defined by the presence of elevated serum PTH with normal albumin-corrected serum calcium on two or more occasions after excluding secondary causes. Patients were followed up for 2 years. Relevant data were collected by review of electronic medical records.
Of the 2593 patients who had PTH measured during the study period, 1278 had serum PTH ≥ 7 pmol/L. Hypercalcaemic primary hyperparathyroidism (PHPT) was diagnosed in 174 patients. Secondary causes for elevated serum PTH were identified in 993 patients: 815 (chronic kidney disease - estimated glomerular filtration rate < 60 mL/min/1.73 m
or renal transplant), 98 (vitamin D deficiency - 25(OH)D < 50 nmol/L), 28 (gastric bypass surgery), 38 (medications), 13 (malabsorption or post-thyroidectomy) and 1 (hypercalciuria). Data were incomplete for 80 patients. The prevalence of NPHPT with and without the exclusion of hypercalciuria was 0.19% (5) and 0.39% (10) respectively. The prevalence of nephrolithiasis in NPHPT was higher than PHPT (100% vs 15% among five patients (P < 0.001) and 50% vs 15% among 10 patients (P = 0.014)). The prevalence of osteoporosis was not significantly different between NPHPT and PHPT (20% vs 45% among five patients (P = 0.389) and 30% vs 45% among 10 patients (P = 0.518)).
These findings give further credence to the diagnosis of NPHPT as a clinical entity. Nephrolithiasis may be a greater problem than osteoporosis in NPHPT compared with PHPT. This needs prospective evaluation.
Monolithic Silicon Photonics Letavic, T.; Sorbara, Massimo; Geiwont, Ken ...
2023 IEEE BiCMOS and Compound Semiconductor Integrated Circuits and Technology Symposium (BCICTS),
2023-Oct.-16
Conference Proceeding
This paper details a monolithic approach to the integration of photonic systems. Polarization diverse photonic components are fabricated in a 45nm silicon-on-insulator microelectronics process flow ...which includes digital and RFCMOS, high performance analog mixed signal, mmWave components, electro-thermal and electro-optic control elements, and fiber and laser attach. This results in a single chip optical transceiver solution.
We report the hybrid flip-chip integration of III-V laser on a monolithic silicon photonics (SiPh) platform. Wafer-scale laser attach was demonstrated with the assistance of a laser cavity on a Si ...substrate. The attach process was accomplished through precise optical and mechanical alignment features on the laser and SiPh wafer. Efficient laser-to-photonic integrated circuit (PIC) butt-coupling with optical power up to 11 dBm was achieved through a combination of precise mechanical stops and optical alignment features. Key laser performance metrics such as mode hopping and relative intensity noise (RIN) vs. reflectivity were also studied. The impact of laser-PIC alignment on the coupling efficiency was studied through comprehensive two-dimensional (2D) and three-dimensional (3D) numerical modeling. Simulations were also performed to explore different coupler designs for optimized laser coupling performance.
We report a hybrid flip-chip-integrated laser attach technology on a monolithic SiPh platform. Efficient laser-to-PIC butt-coupling with optical power up to 11dBm was demonstrated through a ...combination of precise mechanical stops and optical alignment features.
