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hyperparathyroidism guidelines

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https://www.readbyqxmd.com/read/28677243/parathyroidectomy-a-last-resort-for-hyperparathyroidism-in-dialysis-patients
#1
EDITORIAL
Amr El-Husseini, Kevin Wang, Adeleye Annick Edon, B Peter Sawaya
Despite advancements in the medical management of secondary hyperparathyroidism, parathyroidectomy is still necessarily in some patients. However, patients' selection, optimal surgical intervention and long-term outcome are still not well-defined and very challenging for the practicing nephrologists. In this manuscript we will attempt to answer several questions related to parathyroidectomy in dialysis patients. We will discuss the indications, the appropriate parathyroidectomy surgical techniques and current guidelines for parathyroidectomy...
July 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28658490/indications-for-surgical-management-of-hyperparathyroidism-a-review
#2
Antonia E Stephen, Michael Mannstadt, Richard A Hodin
Importance: Primary hyperparathyroidism (pHPT) is a common clinical entity, with approximately 100 000 new cases diagnosed each year in the United States. Most patients with pHPT have a relatively mild form of the disease and present with few if any overt signs or symptoms. This has led to a dilemma regarding which patients should be considered for parathyroid surgery. In this article, we review the established literature on the indications for surgery in asymptomatic pHPT and discuss the most recent consensus conference guidelines...
June 28, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28634117/to-assess-the-effects-of-parathyroidectomy-tptx-versus-tptx-at-for-secondary-hyperparathyroidism-in-chronic-renal-failure-a-meta-analysis
#3
REVIEW
Nian-Cun Qiu, Si-Luo Zha, Miao-E Liu, Zhi-Peng Du, Yi-Fan Wang, Qiang Wang, Qi Chen, Ying Jiang, Cheng-Xiang Shan, Ming Qiu
BACKGROUND: Secondary Hyperparathyroidism (SHPT) requiring parathyroidectomy (PTX) occurs more commonly in patients with progressive chronic kidney disease and in those on long-term lithium therapy. Successful PTX often results in a dramatic drop of parathyroid hormone level, relieves the patient from clinical symptoms, and reduces mortality. However, there is an ongoing debate on the optimal surgical treatment of SHPT. Currently, no clinical guidelines or trials have definitely answered the question of whether Total Parathyroidectomy (TPTX) is superior or equal to Total Parathyroidectomy with Autotransplantation (TPTX + AT)...
June 17, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28616750/systematic-review-of-oral-manifestations-related-to-hyperparathyroidism
#4
REVIEW
Benjamin Palla, Egon Burian, Riham Fliefel, Sven Otto
OBJECTIVES: We sought to identify oral symptoms found in hyperparathyroidism and compare their rate of occurrence, as well as potential variations in sequelae between primary, secondary, and tertiary hyperparathyroidism. MATERIALS AND METHODS: Database searches were performed through EMBASE and PubMed, with a continual handsearch for relevant articles. PRISMA guidelines were followed. RESULTS: Two hundred five articles including 245 patients were analyzed with data extraction...
June 14, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28580574/primary-hyperparathyroidism-in-pregnancy-a-review-of-literature
#5
Hanna Komarowska, Barbara Bromińska, Bartosz Luftmann, Marek Ruchała
Hyperparathyroidism during pregnancy is diagnosed in 0.5-1.4% women and poses a serious challenge. Symptoms of primary hyperparathyroidism (PHP), namely fatigue, lethargy and proximal muscle weakness, are unspecific and could be mistaken as complaints naturally present during pregnancy. Thus, diagnosis is usually delayed. Moreover, the complications of PHP are very common. They occur in 67% of mothers and even in up to 80% of progeny. Appropriate management is a matter of debate. According to clinical symptoms, biochemical evaluation and trimester of pregnancy an operation or conservative management should be introduced...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28473803/contemporary-medical-management-of-primary-hyperparathyroidism-a-systematic-review
#6
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
#7
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
#8
RANDOMIZED CONTROLLED TRIAL
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
COMPARATIVE STUDY
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
#17
COMPARATIVE STUDY
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
#18
REVIEW
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
#19
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...
March 2017: Surgery
https://www.readbyqxmd.com/read/27696297/how-the-reference-values-for-serum-parathyroid-hormone-concentration-are-or-should-be-established
#20
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
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