Talk:Primary hyperparathyroidism
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Cause Mortality?
editCould someone please clarify the phrase "cause mortality", or "increased cause mortality"? I am a student of veterinary medicine and I know of morbidity, mortality and incidence as well-defined terms in the field of health care research and statistics; however, I have never heard of the above mentioned phrase before. —Preceding unsigned comment added by 78.50.212.40 (talk) 13:36, 17 June 2010 (UTC)
There's a NEWER consensus statement than the 2002 one "A consensus statement in 2002 recommended the following indications for surgery in asymptomatic hyperparathyroidism[11]:" that came out in the last couple of years. Maybe update the wiki? —Preceding unsigned comment added by 160.94.47.16 (talk) 14:37, 14 January 2011 (UTC)
It is not "cause" mortality. It is "all-cause" mortality, meaning death from any reason. Franklinjefferson (talk) 06:00, 13 April 2011 (UTC)
Quality of life
editSome explanation of the meaning of "quality of life improvement" might be a good idea in the asymptomatic surgery section. If the patient is asymptomatic, why would you expect any quality of life improvement?--Mongreilf (talk) 15:39, 2 October 2011 (UTC)
Management
editJCEM has a string of articles about this. The key document is doi:10.1210/jc.2014-1413 - guidelines management of asymptomatic disease. JFW | T@lk 20:20, 3 September 2014 (UTC)
- Entire TOC lists the several articles relevant here TOC. JFW | T@lk 22:03, 4 October 2014 (UTC)
Severity
editdoi:10.1210/jc.2014-2268 (meta-analysis) - in young patients the hypercalcaemia & -uria is more severe for the same elevations of PTH. JFW | T@lk 12:56, 7 September 2014 (UTC)
Moved as ancient
editI have removed the following two paragraphs as they are based on either anecdotal or ancient evidence:
- The serum chloride/phosphate ratio is 33 or more in most patients with primary hyperparathyroidism. However, usage of thiazide medications have been reported to causes ratios above 33.[1] Studies without any usage of thiazide diuretics have estimated a serum chloride/phosphate ratio to have a sensitivity of 94%[2] or 95%[3][4] and a specificity of 96%[2] or 100%.[3]
- Recently fine needle aspiration of suspicious lesions seen on ultrasonography neck and estimation of parathyroid hormone levels in the aspirate has been shown to be a very useful test in localizing parathyroid lesions in patients of primary hyperparathyroidism with normal Tc99 sestamibi scan. Needle aspirate parathyroid hormone estimation has been demonstrated to have nearly 100% specificity and 100% positive predictive value in localizing culprit parathyroid lesions not picked up on Tc99 sestamibi imaging.[5][6]
Happy to reinsert content if better sources are presented. JFW | T@lk 11:31, 11 October 2015 (UTC)
References
- ^ Lawler FH, Janssen HP (1983). "Chloride:phosphate ratio with hypercalcemia secondary to thiazide administration". The Journal of family practice. 16 (1): 153–4. PMID 6848626.
- ^ a b Reeves CD, Palmer F, Bacchus H, Longerbeam JK (1975). "Differential diagnosis of hypercalcemia by the chloride/phosphate ratio". Am. J. Surg. 130 (2): 166–71. doi:10.1016/0002-9610(75)90365-7. PMID 1155729.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ a b Palmer FJ, Nelson JC, Bacchus H (1974). "The chloride-phosphate ratio in hypercalcemia". Ann. Intern. Med. 80 (2): 200–4. doi:10.7326/0003-4819-80-2-200. PMID 4405880.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Broulík PD, Pacovský V (1979). "The chloride phosphate ratio as the screening test for primary hyperparathyroidism". Horm. Metab. Res. 11 (10): 577–9. doi:10.1055/s-0028-1092784. PMID 521012.
- ^ Dutta D, Maisnam I, Selvan C, Ghosh S, Mukhopadhyay S, Chowdhury S. Role of parathyroidhormone estimation in needle washing of parathyroid aspiration biopsy in localizing 99mTc-sestamibi negative primary hyperparathyroidism: A series of seventeen patients. Clinical Otolaryngology 2014; 39: 174-197 doi:10.1111/coa.12248 PMID 24779646
- ^ Dutta D, Selvan C, Kumar M, Datta S, Das RN, Ghosh S, Mukhopadhyay S, Chowdhury S. Needleaspirate PTH in diagnosis of primary hyperparathyroidism due to intrathyroidal parathyroid cyst. Endocrinol Diabetes Metab Case Rep. 2013;2013:130019. doi:10.1530/EDM-13-0019 PMID 24616763
LV mass
editMeta-analysis of LV mass in treatment of primary hyperparathyroidism: doi:10.1210/jc.2015-3202 JFW | T@lk 11:32, 11 October 2015 (UTC)