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hyperparathyroidism guidelines

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https://www.readbyqxmd.com/read/28473803/contemporary-medical-management-of-primary-hyperparathyroidism-a-systematic-review
#1
REVIEW
Julius Simoni Leere, Jesper Karmisholt, Maciej Robaczyk, Peter Vestergaard
INTRODUCTION: Primary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28473363/antacid-abuse-a-rare-cause-of-severe-hypercalcaemia
#2
Ben Stoney, Gautam Bagchi
We discuss a case of an 81-year-old man who presented to hospital with a case of severe hypercalcaemia (5.07 mmol/L). The two most common causes of hypercalcaemia, making up around 90% of the cases, are malignancy and primary hyperparathyroidism. Initial investigations are guided by this knowledge. In this case, no underlying malignancy or evidence of a parathyroid adenoma causing primary hyperparathyroidism was found. Instead, on further history, it was found that this patient had troublesome dyspepsia symptoms for which he had ingested 10-12 calcium carbonate tablets a day for the preceding 2 years...
May 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28429905/maintenance-vitamin-d3-dosage-requirements-in-chinese-women-with-post-menopausal-osteoporosis-living-in-the-tropics
#3
Yogeswari Venugopal, Sharifah F Wan Muhamad Hatta, Nurbazlin Musa, Siti Abdul Rahman, Jeyakantha Ratnasingam, Sharmila Sunita Paramasivam, Lee Ling Lim, Luqman Ibrahim, Karen Choong, Alexander Tb Tan, Karuthan Chinna, Siew Pheng Chan, Shireene R Vethakkan
BACKGROUND AND OBJECTIVES: Vitamin D3 (cholecalciferol) dose required to maintain sufficiency in non- Caucasian women with postmenopausal osteoporosis (PMO) inthe tropics has not been well studied. Some guidelines mandate 800-1000 IU vitamin D/day but the Endocrine Society (US) advocates 1500-2000 IU/day to maintain 25-hydroxyvitamin-D (25(OH)D) concentration at >75 nmol/L. We aimed to establish oral cholecalciferol dose required to maintain 25(OH)D concentration at >75 nmol/L in PMO Chinese Malaysian women, postulating lower dose requirements amongst light-skinned subjects in the tropics...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28421193/molecular-abnormalities-underlying-bone-fragility-in-chronic-kidney-disease
#4
REVIEW
Yoshiko Iwasaki, Junichiro James Kazama, Masafumi Fukagawa
Prevention of bone fractures is one goal of therapy for patients with chronic kidney disease-mineral and bone disorder (CKD-MBD), as indicated by the Kidney Disease: Improving Global Outcomes guidelines. CKD patients, including those on hemodialysis, are at higher risk for fractures and fracture-related death compared to people with normal kidney function. However, few clinicians focus on this issue as it is very difficult to estimate bone fragility. Additionally, uremia-related bone fragility has a more complicated pathological process compared to osteoporosis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28102095/significance-of-the-ionized-calcium-measurement-to-assess-calcium-status-in-osteopenic-osteoporosis-postmenopausal-outpatients
#5
Letizia Guiducci, Silvia Maffei, Laura Sabatino, Luc Zyw, Debora Battaglia, Alessandro Vannucci, Pietro Di Cecco, Cristina Vassalle
INTRODUCTION: Evaluation of calcium status is important in the osteoporotic risk assessment. Although guidelines indicate total calcium (tCa) as first-line measurement, directly measured ionized calcium (m-iCa), considered as the gold standard, is more and more often required. Aim of this study is to evaluate the agreement between m-iCa, tCa and iCa calculated from a formula based on total calcium and albumin (c-iCa) in osteopenic/osteoporotic postmenopausal outpatients. METHODS: A total of 140 postmenopausal outpatients, 41 osteopenic (OPN) and 99 osteoporotic (OP) were enrolled...
January 19, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28005175/research-on-kidney-and-mineral-metabolism-in-japan-past-present-and-future
#6
REVIEW
Masahide Mizobuchi, Hiroaki Ogata, Fumihiko Koiwa, Eriko Kinugasa, Tadao Akizawa
Since the identification of the kidney was the main site for the synthesis of calcitriol (1α, 25-dihydroxycholecalciferol), research on chronic kidney disease (CKD)-associated mineral metabolism disorders and their management has made rapid progress. Various active analogues of calcitriol have clinically become available for treating secondary hyperparathyroidism (SHPT), which is a representative mineral metabolism abnormality in CKD patients. A calcimimetic compound cinacalcet hydrochloride has also been developed for the medical management of SHPT through a different mechanism involving the calcium-sensing receptor...
March 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28003569/assessment-criteria-for-vitamin-d-deficiency-insufficiency-in-japan-proposal-by-an-expert-panel-supported-by-research-program-of-intractable-diseases-ministry-of-health-labour-and-welfare-japan-the-japanese-society-for-bone-and-mineral-research-and-the-japan
#7
Ryo Okazaki, Keiichi Ozono, Seiji Fukumoto, Daisuke Inoue, Mika Yamauchi, Masanori Minagawa, Toshimi Michigami, Yasuhiro Takeuchi, Toshio Matsumoto, Toshitsugu Sugimoto
Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world...
January 30, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28001017/improvement-of-bone-turnover-markers-and-bone-mineral-density-following-treatment-of-primary-aldosteronism
#8
Huai H Loh, Nor A Kamaruddin, Rozman Zakaria, Norlela Sukor
BACKGROUND: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension. METHODS: This was an open-label, prospective, case-controlled study, conducted over 12 months. Fifty-two consecutive patients referred for secondary hypertension were screened...
December 20, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27914693/high-prevalence-of-osteoporosis-and-morphometric-vertebral-fractures-in-indian-males-aged-60-years-and-above-should-age-for-screening-be-lowered
#9
Khurshid A Bhat, Manisha Kakaji, Ashish Awasthi, Manoj Shukla, Manoj Dubey, Rajesh Srivastava, Uttam Singh, Sushil K Gupta
Current guidelines recommend bone mineral density (BMD) measurement in asymptomatic men above age 70 years and vertebral fracture (VF) assessment above 80 years with T-score <-1.0 with risk factors. We studied the prevalence of osteoporosis and morphometric VF in asymptomatic males aged 60 years and above in North India. Free-living community-dwelling men (n = 241, age: mean ± standard deviation 68.0 ± 6.2 years) underwent a detailed history, physical examination, biochemical evaluation, and BMD measurements at 3 sites: lumbar spine, total hip (TH), and femoral neck (FN)...
November 30, 2016: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/27882481/assessment-criteria-for-vitamin-d-deficiency-insufficiency-in-japan-proposal-by-an-expert-panel-supported-by-the-research-program-of-intractable-diseases-ministry-of-health-labour-and-welfare-japan-the-japanese-society-for-bone-and-mineral-research-and-the
#10
Ryo Okazaki, Keiichi Ozono, Seiji Fukumoto, Daisuke Inoue, Mika Yamauchi, Masanori Minagawa, Toshimi Michigami, Yasuhiro Takeuchi, Toshio Matsumoto, Toshitsugu Sugimoto
Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by a low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world...
January 2017: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27863777/concentration-of-serum-calcium-is-not-correlated-with-symptoms-or-severity-of-primary-hyperparathyroidism-an-examination-of-20-081-consecutive-adults
#11
Deva Boone, Douglas Politz, Jose Lopez, Jamie Mitchell, Kevin Parrack, James Norman
BACKGROUND: Guidelines for operative treatment of primary hyperparathyroidism include calcium levels >1 mg/dL above normal. We sought to determine whether greater calcium concentrations were associated with increased symptoms or disease severity. METHODS: A retrospective review of a prospectively maintained database of adults undergoing parathyroidectomy for primary hyperparathyroidism, grouped according to greatest preoperative calcium level: those patients with calcium concentrations between 10...
January 2017: Surgery
https://www.readbyqxmd.com/read/27863776/parathyroidectomy-prior-to-kidney-transplant-decreases-graft-failure
#12
Glenda G Callender, Jennifer Malinowski, Mahsa Javid, Yawei Zhang, Huang Huang, Courtney E Quinn, Tobias Carling, Ricarda Tomlin, J Douglas Smith, Sanjay Kulkarni
BACKGROUND: Uncorrected uremic hyperparathyroidism is associated with delayed graft function after kidney transplantation. The current guidelines of the Kidney Disease Improving Global Outcomes recommend maintaining parathyroid hormone ≤9x normal in patients pre-kidney transplantation. This study explores the effect of increased levels of serum parathyroid hormone and preoperative parathyroidectomy on outcomes after kidney transplantation. METHODS: A retrospective review was performed of adult patients who underwent kidney transplantation between January 1, 2005, and December 31, 2014, at a single institution...
January 2017: Surgery
https://www.readbyqxmd.com/read/27836213/parathyroidectomy-for-asymptomatic-primary-hyperparathyroidism-a-revised-cost-effectiveness-analysis-incorporating-fracture-risk-reduction
#13
Kyle A Zanocco, James X Wu, Michael W Yeh
BACKGROUND: Recent data demonstrate decreased fracture risk after operation for asymptomatic primary hyperparathyroidism. We performed a revised cost-effectiveness analysis comparing parathyroidectomy versus observation while incorporating fracture risk reduction. METHODS: A Markov transition-state model was created comparing parathyroidectomy and guideline-based medical observation for a 60-year-old female patient with mild asymptomatic primary hyperparathyroidism...
January 2017: Surgery
https://www.readbyqxmd.com/read/27769660/rates-of-secondary-hyperparathyroidism-after-bypass-operation-for-super-morbid-obesity-an-overlooked-phenomenon
#14
Michael G White, Marc A Ward, Megan K Applewhite, Harry Wong, Vivek Prachand, Peter Angelos, Edwin L Kaplan, Raymon H Grogan
BACKGROUND: With over 110,000 bariatric operations performed in the United States annually, it is important to understand the biochemical abnormalities causing endocrine dysfunction associated with these procedures. Here we compare 2 malabsorptive procedures, duodenal switch and Roux-en-Y gastric bypass, to determine the role malabsorption plays in secondary hyperparathyroidism in this population. METHODS: Data from all super-obese patients undergoing duodenal switch or Roux-en-Y gastric bypass between August 2002 and October 2005 were prospectively collected...
October 18, 2016: Surgery
https://www.readbyqxmd.com/read/27696297/how-the-reference-values-for-serum-parathyroid-hormone-concentration-are-or-should-be-established
#15
REVIEW
J-C Souberbielle, F Brazier, M-L Piketty, C Cormier, S Minisola, E Cavalier
Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria for this population can be defined as any situation possibly inducing an increase or a decrease in PTH concentration. As recommended in the recent guidelines on the diagnosis and management of asymptomatic primary hyperparathyroidism, PTH reference values should be established in vitamin D-replete subjects with a normal renal function with possible stratification according to various factors such as age, gender, menopausal status, body mass index, and race...
October 1, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27613721/primary-hyperparathyroidism-review-and-recommendations-on-evaluation-diagnosis-and-management-a-canadian-and-international-consensus
#16
REVIEW
A A Khan, D A Hanley, R Rizzoli, J Bollerslev, J E M Young, L Rejnmark, R Thakker, P D'Amour, T Paul, S Van Uum, M Zakaria Shrayyef, D Goltzman, S Kaiser, N E Cusano, R Bouillon, L Mosekilde, A W Kung, S D Rao, S K Bhadada, B L Clarke, J Liu, Q Duh, E Michael Lewiecki, F Bandeira, R Eastell, C Marcocci, S J Silverberg, R Udelsman, K Shawn Davison, J T Potts, M L Brandi, J P Bilezikian
The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH)...
January 2017: Osteoporosis International
https://www.readbyqxmd.com/read/27589344/screening-for-hyperparathyroidism-by-measurement-of-calcium-in-patients-undergoing-thyroid-surgery-a-prospective-study
#17
P W Rosário, G F Mourão, M R Calsolari
This study screened for asymptomatic primary hyperparathyroidism (PHPT) by measuring calcium (Ca) before thyroid surgery. The study was prospective. A total of 676 patients without a suspicion of PHPT were studied. PHPT was defined as elevated Ca (in 2 measurements) in the presence of PTH>25 pg/ml and in the absence of hypocalciuria. PHPT was diagnosed in 5 patients (0.74%), all of them women. One of the 5 patients with PHPT had no indication for parathyroidectomy (PTx) according to current guidelines...
September 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/27532368/the-american-association-of-endocrine-surgeons-guidelines-for-definitive-management-of-primary-hyperparathyroidism
#18
Scott M Wilhelm, Tracy S Wang, Daniel T Ruan, James A Lee, Sylvia L Asa, Quan-Yang Duh, Gerard M Doherty, Miguel F Herrera, Janice L Pasieka, Nancy D Perrier, Shonni J Silverberg, Carmen C Solórzano, Cord Sturgeon, Mitchell E Tublin, Robert Udelsman, Sally E Carty
Importance: Primary hyperparathyroidism (pHPT) is a common clinical problem for which the only definitive management is surgery. Surgical management has evolved considerably during the last several decades. Objective: To develop evidence-based guidelines to enhance the appropriate, safe, and effective practice of parathyroidectomy. Evidence Review: A multidisciplinary panel used PubMed to review the medical literature from January 1, 1985, to July 1, 2015...
October 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27508075/primary-hyperparathyroidism
#19
REVIEW
Leonardo Bandeira, John Bilezikian
Over the past several generations, primary hyperparathyroidism (PHTP) has undergone a change in its clinical presentation in many countries from a symptomatic disease to an asymptomatic one. The reasons for this change in clinical presentation are related to the widespread use of biochemical screening tests, to the measurement of PTH more routinely in the evaluation of metabolic bone disease and to the status of vitamin D sufficiency in the population. Along with recognition of a broader clinical spectrum of disease, including a more recently recognized normocalcemic variant, has come an appreciation that the evaluation of classic target organs that can be affected in PHPT, such as the skeleton and the kidneys, require more advanced imaging technology for complete evaluation...
2016: F1000Research
https://www.readbyqxmd.com/read/27479950/hyperparathyroidism-of-renal-disease
#20
REVIEW
Noah K Yuen, Shubha Ananthakrishnan, Michael J Campbell
Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, < 60 mL/min/1...
2016: Permanente Journal
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