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G Melfa, C Porello, G Cocorullo, C Raspanti, G Rotolo, A Attard, R Gullo, S Bonventre, G Gulotta, G Scerrino
The relationship between quality of care and provider's experience is well known in all fields of surgery. Even in thyroidectomies and parathyroidectomies, the emphasis on positive volume-outcome relationships is believed. It led us to an evaluation of volume activity's impact in terms of quality of care. A systematic narrative review was performed. According to the PRISMA criteria, we selected 87 paper and, after the study selection was performed, 22 studies were finally included in this review. All articles included were unanimous in attributing to activity volume of surgeons as well as centers a substantial importance...
January 2018: Il Giornale di Chirurgia
Sijia Li, Shuangxin Liu, Qiuhuan Chen, Pingjiang Ge, Jie Jiang, Xiaoli Sheng, Shaohua Chen
OBJECTIVE: Hyperkalaemia is one of the most common reasons for patients requiring emergency treatment. This study is to investigate the risk factors of postoperative hyperkalemia in renal failure patients undergoing parathyroidectomy with autotransplantation (PTXa). METHODS: One hundred and eight patients [ 54 men and 54 women; age, 45.1 ± 11.1 years (mean ± SD)] with secondary hyperparathyroidism undergoing parathyroidectomy with autotransplantation were involved in this study...
March 13, 2018: International Journal of Surgery
Paul Glendenning, S A Paul Chubb, Samuel Vasikaran
Bone turnover marker (BTM's) concentrations in blood and urine reflect bone-remodelling activity, and may be useful adjuncts in the diagnosis and management of metabolic bone diseases. Newer biomarkers, mainly bone regulatory proteins, are currently being investigated to elucidate their role in bone metabolism and disease and may in future be useful in clinical diagnosis and management of metabolic bone disease. BTM concentrations increase around menopause in women, and at a population level the degree of increase in BTM's reflect bone loss...
March 12, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Emanuela Traini, Rocco Bellantone, Serena Elisa Tempera, Salvatore Russo, Carmela De Crea, Celestino Pio Lombardi, Marco Raffaelli
PURPOSE: Indications and advantages of parathyroidectomy in patients with normocalcemic primary hyperparathyroidism (NHPT) are still matter of debate. We aimed to compare clinical presentation and surgical outcome between normocalcemic and hypercalcemic forms in a consecutive series of patients who underwent parathyroidectomy for primary hyperparathyroidism. METHODS: Data of 731 consecutive patients were reviewed and retrospectively compared according to normocalcemic (group A) and hypercalcemic (group B) phenotypes...
March 14, 2018: Langenbeck's Archives of Surgery
Caroline Bachmeier, Chirag Patel, Peter Kanowski, Kunwarjit Sangla
Primary hyperparathyroidism (PH) is a common endocrine abnormality and may occur as part of a genetic syndrome. Inactivating mutations of the tumour suppressor gene CDC73 have been identified as accounting for a large percentage of hyperparathyroidism-jaw tumour syndrome (HPT-JT) cases and to a lesser degree account for familial isolated hyperparathyroidism (FIHP) cases. Reports of CDC73 whole gene deletions are exceedingly rare. We report the case of a 39 year-old woman with PH secondary to a parathyroid adenoma associated with a large chromosomal deletion (2...
2018: Endocrinology, Diabetes & Metabolism Case Reports
M Rroji, G Spasovski
Secondary hyperparathyroidism (SHPT) is common among patients with end-stage renal disease (ESRD). SHPT is associated with high-turnover bone disease, interstitial and vascular calcifications, cardiovascular morbidity and mortality. The pharmacological management of SHPT has progressed in recent years. The introduction of targeted therapies, such as selective vitamin D receptors activators and calcium-sensing receptor modulators, offers an increased opportunity to adequately control elevated parathyroid hormone (PTH), especially in patients with chronic kidney disease under dialysis treatment...
March 12, 2018: International Urology and Nephrology
Danica Popovik-Monevska, Suzana Bozovik-Dvojakovska, Vladimir Popovski, Alberto Benedetti, Aleksandar Grchev, Filip Koneski
BACKGROUND: The hyperparathyroidism (HPT) is a condition in which the parathyroid hormone (PTH) levels in the blood are increased. HPT is categorised into primary, secondary and tertiary. A rare entity that occurs in the lower jaw in association with HPT is the so-called brown tumour, which an osteolytic lesion is predominantly occurring in the lower jaw. It is usually a manifestation of the late stage of the disease. Osteosclerotic changes in other bones are almost always associated with renal osteodystrophy in secondary HPT and are extremely rare in primary HPT...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
(no author information available yet)
Ferrandino R, Roof S, Ma Y, et al. Unplanned 30-day readmissions after parathyroidectomy in patients with chronic kidney disease: a nationwide analysis. Otolaryngol Head Neck Surg. 2017;157:955-965. (Original DOI: 10.1177/0194599817721154) In this article, the funding information was not included. The funding source section should have read as follows: "R.F. was supported by the National Center for Advancing Translational Sciences under award 1TL1TR001434-03. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Wei Ling Lau, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Secondary hyperparathyroidism develops in CKD due to a combination of vitamin D deficiency, hypocalcemia, and hyperphosphatemia, and it exists in nearly all patients at the time of dialysis initiation. There is insufficient data on whether to prefer vitamin D analogs compared with calcimimetics, but the available evidence suggests advantages with combination therapy. Calcium derangements, patient adherence, side effects, and cost limit the use of these agents. When parathyroid hormone level persists >800 pg/ml for >6 months, despite exhaustive medical interventions, monoclonal proliferation with nodular hyperplasia is likely present along with decreased expression of vitamin D and calcium-sensing receptors...
March 9, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Antonio Bellasi, Luigi Morrone, Maria Cristina Mereu, Carlo Massimetti, Elena Pelizzaro, Giuseppe Cianciolo, Marzia Pasquali, Vincenzo Panuccio
We herein report on a nationwide survey conducted in Italy to investigate the use of parathyroidectomy (PTX). In spite of the availability of newer and more effective drugs to control chronic kidney disease mineral bone disorder (CKD-MBD) biochemical abnormalities, PTX still remains a resource for nephrologists to use. However, observational analyses suggest that in recent years there has been a constant decline in the number of patients undergoing PTX. The reasons are not clear, though the increasing age and number of comorbidities of dialysis patients may partly explain this trend...
March 7, 2018: Journal of Nephrology
Masaya Ikuno, Takayuki Yamada, Yasumoto Shinjo, Tsuyoshi Morimoto, Reiko Kumano, Kunihiro Yagihashi, Takuyuki Katabami, Yasuo Nakajima
Background: Selective venous sampling (SVS) is an invasive localization study for persistent or recurrent hyperparathyroidism. Purpose: To assess the role of SVS in addition to non-invasive imaging for primary hyperparathyroidism (pHPT). Material and Methods: This study was approved by the institutional review board and included 14 patients who underwent SVS and subsequent parathyroidectomy between January 2014 and April 2017 following a clinical diagnosis of pHPT...
February 2018: Acta Radiologica Open
Po-Sheng Yang, Chien-Liang Liu, Tsang-Pai Liu, Han-Hsiang Chen, Chih-Jen Wu, Shih-Ping Cheng
BACKGROUND: Systemic inflammation has been implicated in complications and heightened mortality of patients with secondary hyperparathyroidism. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are widely available surrogate markers of inflammation. This study sought to delineate the changes in NLR and PLR after parathyroidectomy. METHODS: A total of 213 patients undergoing initial parathyroidectomy from 2010 to 2015 for secondary hyperparathyroidism were identified from a prospectively maintained clinical database...
April 2018: Journal of Surgical Research
R J Egan, H Iliff, M J Stechman, D M Scott-Coombes
BACKGROUND: Parathyroid hormone (PTH) has a short half-life and is cleared by the liver and kidneys. This study examined whether declining estimated glomerular filtration rate (eGFR) affects application of the Miami criterion for intraoperative PTH (ioPTH) decline during parathyroidectomy for primary hyperparathyroidism (pHPT). METHODS: A retrospective review of consecutive patients undergoes parathyroidectomy for pHPT. Patients with multi-gland disease, without ioPTH, failure-to-cure and those <18 years were excluded...
March 1, 2018: World Journal of Surgery
Prateush Singh, Yehudit Bauernfreund, Pallavi Arya, Esha Singh, Justin Shute
Primary hyperparathyroidism (PHPT) can cause hypercalcaemia secondary to a pathologically high secretion of parathyroid hormone. Rarely this can first manifest as acute psychosis. It is imperative to exclude organic causes of psychosis before labelling the psychosis as primarily psychological. If hypercalcaemia is revealed, investigation is required to elucidate the underlying cause whilst instigating treatment to lower serum calcium levels. If PHPT is the underlying pathology, subsequent treatment involves surgical exploration and resection of the parathyroid adenoma or hyperplasia...
February 2018: Journal of Surgical Case Reports
Elin Isaksson, Martin Almquist, Astrid Seeberger, Gunnar Sterner
BACKGROUND: Secondary hyperparathyroidism and altered levels of parathyroid hormone (PTH) are associated with vascular events in chronic kidney disease. After renal transplantation, this association is not clear. Pre-transplant parathyroidectomy (PTX) is common, but post-transplant data are scarce. We aimed to study the effect of PTH at the time of transplantation on risk of post-transplant vascular events in renal transplant recipients with and without pre-transplant PTX. METHODS: 258 patients from two Swedish transplant units were followed for 6 years...
February 24, 2018: Clinical and Experimental Nephrology
Antonio Matrone, Alessandro Brancatella, Piero Marchetti, Enrico Vasile, Ugo Boggi, Rossella Elisei, Filomena Cetani, Claudio Marcocci, Paolo Vitti, Francesco Latrofa
Absence of neoplastic disease in the organ-recipient is required in order to allow organ transplantation. Due to its rarity, no data regarding management of patients with Multiple endocrine neoplasia type 1 (MEN1) and end-stage renal failure candidates for kidney transplantation are available. A 36 year-old man was referred to the present hospital with MEN1, with a neuroendocrine pancreatic tumor and primary hyperparathyroidism and associated Alport syndrome with end stage renal failure. The present study aimed to establish the eligibility of the patient for a kidney transplantation...
March 2018: Molecular and Clinical Oncology
Guoqi Wang, Hongyan Liu, Chengzhi Wang, Xiaojian Ji, Weijun Gu, Yiming Mu
To assess the efficacy and safety of cinacalcet on secondary hyperparathyroidism in patients with chronic kidney disease, Pubmed, Embase, and the Cochrane Central Register of Controlled Trials were searched until March 2016. Trial sequential analysis (TSA) was conducted to control the risks of type I and II errors and calculate required information size (RIS). A total of 25 articles with 8481 participants were included. Compared with controls, cinacalcet administration did not reduce all-cause mortality (RR = 0...
February 15, 2018: Scientific Reports
Tibor Fülöp, Christian A Koch, Abdeen R Farah Musa, Christopher M Clark, Kamel A Gharaibeh, Zsolt Lengvársky, Mehrdad Hamrahian, Karen T Pitman, Mehul P Dixit
BACKGROUND: The long-term results of surgical parathyroidectomy (PTX) in end-stage renal disease (ESRD) patients are less well known in the modern era of newer activated vitamin-D analogs, calcimimetics and intraoperative monitoring of parathyroid hormone (PTH). METHODS: We performed a retrospective chart review of all ESRD patients undergoing PTX at the University of Mississippi Medical Center between January 2005 and August 2011, with follow-up data as available up to 4 years...
February 15, 2018: Hemodialysis International
Se Hyun Paek, Su-Jin Kim, June Young Choi, Kyu Eun Lee
Purpose: The availability of intraoperative parathyroid hormone (IOPTH) monitoring allows successful focused parathyroidectomy for primary hyperparathyroidism (pHPT). The objective of this study was to report our initial experience in IOPTH monitoring during parathyroid surgery for primary hyperparathyroidsim. Methods: Between May 2011 and February 2013, 37 patients underwent focused parathyroidectomy due to pHPT. IOPTH monitoring based on Miami criteria was used to confirm complete excision of hyperfunctioning parathyroid gland during surgery...
February 2018: Annals of Surgical Treatment and Research
Keith E Eidman, James B Wetmore
Secondary hyperparathyroidism (SHPT) is common in patients receiving maintenance hemodialysis and is associated with adverse outcomes. Currently, SHPT is managed by reducing circulating levels of phosphate with oral binders and parathyroid hormone (PTH) with vitamin D analogs and/or the calcimimetic cinacalcet. Etelcalcetide, a novel calcimimetic administered intravenously (IV) at the end of a hemodialysis treatment session, effectively reduces PTH in clinical trials when given thrice weekly. Additional clinical effects include reductions in circulating levels of phosphate and FGF-23 and an improved profile of markers of bone turnover...
2018: International Journal of Nephrology and Renovascular Disease
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