age 5 years in MEN 2A and FMTC, and before age 1 year in MEN 2B.[12] Total thyroidectomy with central lymph node dissection and autotransplantation of parathyroid glands into the neck or nondominant forearm following positive testing for RET mutations is a preventive option for all subtypes of MEN 2. Postoperatively, all patients will need thyroid hormone replacement therapy and monitoring for possible hypoparathyroidism. Although thyroidectomy prior to biochemical evidence of disease may reduce the risk of recurrent disease, continued monitoring with calcitonin levels for residual or recurrent MTC is still recommended.

For HPT, surgical excision of only enlarged glands, similar to surgical management of primary sporadic HPT, is indicated.

For unilateral pheochromocytoma, adrenalectomy, preferably laparoscopic, is indicated. Cortical-sparing adrenalectomy to avoid adrenal insufficiency should be considered in patients with bilateral pheochromocytomas. Long-term follow-up, with periodic surveillance (serum or urinary catecholamine measurements), is recommended as contralateral pheochromocytoma or recurrence may develop many years after the initial operation.

members, while informative, its usefulness is controversial because it rarely mandates therapeutic intervention because of lack of consensus on prophylactic interventions and the inability to predict the extent, spectrum, or clinical onset of future disease.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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