Surgery for primary hyperparathyroidism: are the consensus guidelines being followed?

Annals of Surgery
Michael W YehPhilip I Haigh

Abstract

To determine parathyroidectomy (PTx) rates in patients who satisfy the consensus guidelines for surgical treatment of primary hyperparathyroidism (PHPT). Surgery for PHPT is recommended for all symptomatic patients and select asymptomatic patients meeting established consensus criteria. Adherence to the consensus guidelines has not been examined systematically, because of inadequate information regarding patients managed nonoperatively. All nonuremic patients with PHPT during the period 1995-2008 were identified using the Kaiser Permanente-Southern California laboratory database, encompassing 3.5 million individuals annually. Multivariate logistic regression was used to examine predictors of PTx. We found 3388 patients with PHPT, of whom 265 (8%) were symptomatic (nephrolithiasis). Nephrolithiasis was predictive of PTx (OR 2.94 vs asymptomatic), with 51% of symptomatic patients undergoing surgery. Among asymptomatic patients, the proportion meeting consensus criteria was 39% during the early period (1995-2002) and 51% during the late period (2003-2008). The PTx rate for these patients exceeded that for asymptomatic patients not meeting consensus criteria but remained low (early 44% vs 19%, P < 0.0001; late 39% vs 16%, P < 0.000...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Jan 24, 1980·The New England Journal of Medicine·H HeathM A Kennedy
Dec 6, 2002·The Journal of Clinical Endocrinology and Metabolism·John P BilezikianSamuel A Wells
Jan 13, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Parthiv J MahadeviaNeil R Powe
Oct 26, 2005·Annals of Surgery·Laura H CokerNancy Perrier
Dec 16, 2005·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Robert A WermersL Joseph Melton
Feb 13, 2007·Langenbeck's Archives of Surgery·T ClericiM Brändle
Jun 28, 2007·JAMA : the Journal of the American Medical Association·UNKNOWN Writing Group for the SEARCH for Diabetes in Youth Study GroupBeth Waitzfelder
Mar 4, 2008·Obstetrics and Gynecology·Jean M LawrenceKarl M Luber
Jun 12, 2008·The Journal of Clinical Endocrinology and Metabolism·Mishaela R RubinShonni J Silverberg
Aug 1, 1948·The Journal of Clinical Endocrinology and Metabolism·F ALBRIGHT
Feb 6, 2009·The Journal of Clinical Endocrinology and Metabolism·John P BilezikianUNKNOWN Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism
Jul 9, 2010·The Journal of Clinical Endocrinology and Metabolism·Bian WuMichael W Yeh

❮ Previous
Next ❯

Citations

Nov 8, 2012·Langenbeck's Archives of Surgery·Lars RolighedPeer Christiansen
Feb 19, 2013·The Journal of Clinical Endocrinology and Metabolism·Michael W YehAnnette L Adams
Jan 31, 2017·Endocrinology and Metabolism Clinics of North America·Kyle A Zanocco, Michael W Yeh
Apr 5, 2018·Journal of Endocrinological Investigation·F SaponaroC Marcocci
Dec 24, 2018·British Medical Bulletin·Zaki K Hassan-SmithNeil J L Gittoes
Feb 6, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Michael W YehPhilip I Haigh
Apr 25, 2014·The Journal of Clinical Endocrinology and Metabolism·Chase D HendricksonRichard J Comi
Jul 16, 2019·JAMA Internal Medicine·Elizabeth A AloreKonstantinos I Makris
Sep 12, 2014·International Journal of Hematology·Afif N KulaylatBrian D Saunders
May 8, 2018·Annals of Surgical Treatment and Research·Jong-Kyu KimKyu Eun Lee
Dec 29, 2020·Laryngoscope Investigative Otolaryngology·Milou E NoltesSchelto Kruijff

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Wiener medizinische Wochenschrift
Peter Pietschmann
Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Cristina Ogrin
© 2021 Meta ULC. All rights reserved