Primary hyperparathyroidism is a frequent cause of hypercalcemia resulting from one or more parathyroid adenomas. We report the case of a 66-year-old female who underwent parathyroidectomy, during which intraoperative parathyroid hormone (ioPTH) levels spiked tenfold, from 197 pg/mL to 2,209 pg/mL, 10 minutes post-resection. Despite recalibration and re-sampling, ioPTH levels further increased to 3,000 pg/mL at 1 hour, prompting additional exploration and resection of a second adenoma. The patient’s serum calcium levels subsequently returned to normal postoperatively. This case highlights the importance of considering additional parathyroid adenomas in patients with unexpected spikes in ioPTH levels and underscores the need for thorough exploration rather than attributing such rises solely to laboratory error.

PURPOSE: This study aimed to determine whether a blended Infant MassageeParenting Enhancement Program (IMPEP) improved maternal psychosocial health outcomes (parenting stress, depressive symptoms, self-esteem, maternal attachment) and maternal-infant interaction among substanceaddicted mothers (SAMs) actively engaged in outpatient rehabilitation. METHODS: Designed as a randomized, three-group controlled trial testing two levels of psychoeducational intervention (IMPEP vs. PEP) and a control group (standard care parenting resources), the studywas conducted in two substance abuse centers in southeast Florida on a convenience sample of 138 recovering SAM-infant pairs. IMPEP or PEP classes were held weekly onWeeks 2e5, with data collected at baseline (Week 1),Week 6, andWeek 12 via structured interviews, observation (Observation Checklist onMaternal-Infant Interaction), and self-administered questionnaires (Abidin Parenting Stress Index, Beck Depression Inventory, Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory), analyzed descriptively and inferentially using Kruskall-Wallis analysis of variance and post hoc Wilcoxon rank sum and Mann-Whitney U tests. RESULTS: Both IMPEP and PEP groups had significantly increased Parenting Stress Index scores (decreased parenting stress) and decreased Beck Depression Inventory scores (decreased depressive symptoms) compared to controls at Week 12, whereas there were no clinically meaningful differences among study groups in Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory, or Observation Checklist on Maternal-Infant Interaction scores. Only the IMPEP group showed significant improvements in both psychological and physical (waist-hip ratio) measures of parenting stress over time. CONCLUSIONS: The findings suggest that infant massage blended into a structured parenting program has value-added effects in decreasing parenting stress and maternal depressive symptoms, but not on SAM's self-esteem, attachment, or maternal-infant interaction.
Adult ; Depressive Disorder/*prevention & control ; Female ; Florida ; Humans ; Infant ; Infant, Newborn ; Male ; Massage ; Maternal Behavior/*psychology ; Mother-Child Relations/*psychology ; Mothers/*education/*psychology ; Parenting/*psychology ; Program Evaluation ; Self Concept ; Stress, Psychological ; Substance-Related Disorders/*psychology/rehabilitation ; Young Adult