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hyperparathyroidism guidelines

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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
#1
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
#2
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...
November 23, 2016: 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
#3
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...
November 15, 2016: Surgery
https://www.readbyqxmd.com/read/27863776/parathyroidectomy-prior-to-kidney-transplant-decreases-graft-failure
#4
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...
November 15, 2016: Surgery
https://www.readbyqxmd.com/read/27836213/parathyroidectomy-for-asymptomatic-primary-hyperparathyroidism-a%C3%A2-revised-cost-effectiveness-analysis-incorporating-fracture-risk-reduction
#5
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...
November 8, 2016: Surgery
https://www.readbyqxmd.com/read/27769660/rates-of-secondary-hyperparathyroidism-after-bypass-operation-for-super-morbid-obesity-an-overlooked-phenomenon
#6
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
#7
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
#8
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)...
September 9, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27589344/screening-for-hyperparathyroidism-by-measurement-of-calcium-in-patients-undergoing-thyroid-surgery-a-prospective-study
#9
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
#10
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...
August 10, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27508075/primary-hyperparathyroidism
#11
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
#12
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
https://www.readbyqxmd.com/read/27402205/unilateral-clearance-for-primary-hyperparathyroidism-in-selected-patients-with-multiple-endocrine-neoplasia-type-1
#13
Wouter P Kluijfhout, Toni Beninato, Frederick Thurston Drake, Menno R Vriens, Jessica Gosnell, Wen T Shen, Insoo Suh, Chienying Liu, Quan-Yang Duh
BACKGROUND: Primary hyperparathyroidism is the most common manifestation of multiple endocrine neoplasia type 1 (MEN1). Guidelines advocate subtotal parathyroidectomy (STP) or total parathyroidectomy with autotransplantation due to high prevalence of multiglandular disease; however, both are associated with a significant risk of permanent hypoparathyroidism. More accurate imaging and use of intraoperative PTH levels may allow a less extensive initial parathyroidectomy (unilateral clearance, removing both parathyroids with cervical thymectomy) in selected MEN1 patients with primary hyperparathyroidism...
December 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27272731/chronic-kidney-disease-mineral-and-bone-disorder-guidelines-for-diagnosis-treatment-and-management
#14
Carla Moschella
Chronic kidney disease affects 23 million Americans and is associated with many complications, one of the most complex of which is mineral and bone disorder. Pathophysiologic mechanisms begin to occur early in CKD but when the glomerular filtration rate declines to <50% of normal, biochemical and bone matrix abnormalities, which vary and are multifactorial, begin to be clinically apparent. Mainstays of treatment remain management of hyperphosphatemia and prevention or treatment of secondary hyperparathyroidism...
July 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27198205/impact-of-parathyroidectomy-for-primary-hyperparathyroidism-on-quality-of-life-a-case-control-study-using-short-form-health-survey-36
#15
Roderick Dulfer, Wanda Geilvoet, Annelien Morks, Esther M M van Lieshout, Casper P C Smit, Els J M Nieveen van Dijkum, Klaas In't Hof, Frits van Dam, Casper H J van Eijck, Peter W de Graaf, Tessa M van Ginhoven
BACKGROUND: Physical and mental complaints are common in patients with primary hyperparathyroidism (PHPT) and negatively impact quality of life (QOL). Subjective symptoms in current guidelines are not considered an indication for surgery. The purpose of this study was to assess the effect of parathyroidectomy on QOL in patients with PHPT. METHODS: This multicenter case-control study investigated preoperative and postoperative QOL scores in patients operated for PHPT, measured with the Short Form Health Survey-36 (SF-36) questionnaire...
August 2016: Head & Neck
https://www.readbyqxmd.com/read/27190392/con-nutritional-vitamin-d-replacement-in-chronic-kidney-disease-and-end-stage-renal-disease
#16
Rajiv Agarwal, Panagiotis I Georgianos
Insufficiency of 25-hydroxyvitamin D [25(OH)D] is highly prevalent among patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) and is a critical component in the pathogenesis of secondary hyperparathyroidism. Accordingly, current National Kidney Foundation-Kidney Disease Outcomes Quality Initiative and Kidney Disease: Improving Global Outcomes guidelines recommend the correction of hypovitaminosis D through nutritional vitamin D replacement as a first-step therapeutic approach targeting secondary hyperparathyroidism...
May 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27070376/forearm-dxa-increases-the-rate-of-patients-with-asymptomatic-primary-hyperparathyroidism-meeting-surgical-criteria
#17
Elena Castellano, Roberto Attanasio, Laura Gianotti, Flora Cesario, Francesco Tassone, Giorgio Borretta
INTRODUCTION: A reduction in bone mineral density (BMD) is common in primary hyperparathyroidism (PHPT), above all at cortical sites. Guidelines for the management of asymptomatic PHPT (aPHPT) recommend a BMD evaluation at the lumbar spine, hip, and forearm. Surgery is recommended for patients with a T-score less than or equal to -2.5 at any of these sites. However, a BMD evaluation at the forearm is not routinely performed. AIM: To evaluate the impact of measuring forearm BMD in the clinical management of aPHPT...
July 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27062486/vitamin-d-in-patients-with-chronic-kidney-disease-a-position-statement-of-the-working-group-trace-elements-and-mineral-metabolism-of-the-italian-society-of-nephrology
#18
REVIEW
Luigi Francesco Morrone, Pergiorgio Bolasco, Corrado Camerini, Giuseppe Cianciolo, Adamasco Cupisti, Andrea Galassi, Sandro Mazzaferro, Domenico Russo, Luigi Russo, Mario Cozzolino
In the late 1970s, calcitriol was introduced into clinical practice for the management of secondary renal hyperparathyroidism in chronic kidney disease (CKD). Since then, the use of calcifediol or other native forms of vitamin D was largely ignored until the publication of the 2009 Kidney Disease Improving Global Outcomes (KDIGO) recommendations. The guidelines suggested that measurement of circulating levels of 25(OH)D (calcifediol) and its supplementation were to be performed on the same basis as for the general population...
June 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27043778/the-relationship-of-parathyroidectomy-and-bisphosphonates-with-fracture-risk-in-primary-hyperparathyroidism-an-observational-study
#19
Michael W Yeh, Hui Zhou, Annette L Adams, Philip H G Ituarte, Ning Li, In-Lu Amy Liu, Philip I Haigh
BACKGROUND: The comparative effectiveness of surgical and medical treatments on fracture risk in primary hyperparathyroidism (PHPT) is unknown. OBJECTIVE: To measure the relationship of parathyroidectomy and bisphosphonates with skeletal outcomes in patients with PHPT. DESIGN: Retrospective cohort study. SETTING: An integrated health care delivery system. PARTICIPANTS: All enrollees with biochemically confirmed PHPT from 1995 to 2010...
June 7, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27038806/successful-conversion-from-parenteral-paricalcitol-to-pulse-oral-calcitriol-for-the-management-of-secondary-hyperparathyroidism-in-hemodialysis-patients
#20
Jennifer Kumar, Ngoc-Tram Gia Tran, John Schomberg, Elani Streja, Kamyar Kalantar-Zadeh, Madeleine Pahl
OBJECTIVE: The management of hyperparathyroidism in hemodialysis patients involves the administration of phosphate binders, vitamin D receptor activators, and calcimimetics. Intravenous paricalcitol has been preferred over oral calcitriol as it may cause less hypercalcemia and hyperphosphatemia. However, there is little data looking at the efficacy and tolerability of oral calcitriol in the calcimimetic era particularly in a real practice-based experience. The University of California, Irvine free-standing dialysis center converted from routine intravenous paricalcitol to oral calcitriol due to pharmacy purchasing preferences...
July 2016: Journal of Renal Nutrition
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