\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[T2A]{fontenc}
\usepackage[polish,ngerman,english]{babel}



\usepackage{float}








\begin{document}

\title{CDKN1B Mutation Analyses and Biochemical Characteristics in Patients
with Symptomatic or asymptomatic Primary Hyperparathyroidism: A
Prospective Single-Centre Study}



\author[1]{Gamze Akkuş}%
\author[2]{sinem  sengoz}%
\author[2]{barıs karagün}%
\author[2]{mehtap evran}%
\author[1]{Murat Sert}%
\author[1]{Tamer Tetiker}%
\affil[1]{Cukurova University}%
\affil[2]{Çukurova Üniversitesi Tıp Fakültesi}%


\vspace{-1em}



  
  \date{May 18, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Background: The clinical phenotype of PHPT changed from overt bone and
renal involvement to asymptomatic hypercalcaemia. Patients with
symptomatic hyperparathyroidism should be referred for surgery, and
asymptomatic patients' management have still a clinical bias. Clinical
variability can be linked to specific mutated gene including CDKN1B.
Material-Methods: In this prospective study 80 patients (66 women and 14
men, mean age 50.8 \selectlanguage{ngerman}± 12.01 years) with PHPT were enrolled between 2018
and 2020. Biochemical and clinical information were collected on
patients' sex, age, biochemical examination and radiological findings
(nuclear 99 mTc sestamibi scans scintigraphy, cervical ultrasound).
CDKN1B sequencing, and DNA isolation was performed by using GeneMATRIX
Quick Blood DNA Purification Kit. Selected primer of CDKN1BF
(rs786201010, c.-456\_-453delCCTT) (CAGGTTTGTTGGCAGCAGTA) and CDKN1BR
(rs786201010, c.-456\_-453delCCTT) (GGAGCCAAAAGACACAGACC) were amplified
by polymerase chain reaction (PCR) (Solis Biodyne, Estonia). Results: 22
of all patients were also symptomatic. Serum calcium and 24-hour calcium
excretion were significantly increased in patients with symptomatic PHTP
(p = 0.009, p = 0.00). Serum PTH levels were similar between the two
group (p = 0.667). With regards to classical manifestations of PHPT,
bone diseases (p = 0.04) and nephrolithiasis (p = 0.03) were more common
in patients with symptomatic PHPT. CC genotype was detected in all
patients with PHPT in rs786201010. c.-456\_-453delCCTT was not detected
in any patients. Conclusion: We emphasized that patients with
symptomatic PHPT had more increased serum calcium levels and calciuria.
Independent of PTH levels, clinical signs and symptoms could be related
with serum calcium parameters in these patients.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy


\textbf{Hosted file}

\verb`PTH manuscript latest1.docx`  available at \url{https://authorea.com/users/352266/articles/709557-cdkn1b-mutation-analyses-and-biochemical-characteristics-in-patients-with-symptomatic-or-asymptomatic-primary-hyperparathyroidism-a-prospective-single-centre-study}

\textbf{Hosted file}

\verb`figure PTH.docx`  available at \url{https://authorea.com/users/352266/articles/709557-cdkn1b-mutation-analyses-and-biochemical-characteristics-in-patients-with-symptomatic-or-asymptomatic-primary-hyperparathyroidism-a-prospective-single-centre-study}

\textbf{Hosted file}

\verb`Table PTH.docx`  available at \url{https://authorea.com/users/352266/articles/709557-cdkn1b-mutation-analyses-and-biochemical-characteristics-in-patients-with-symptomatic-or-asymptomatic-primary-hyperparathyroidism-a-prospective-single-centre-study}

\selectlanguage{english}
\FloatBarrier
\end{document}

