| Medication discontinuation after curative surgery for sporadic primary hyperparathyroidism. | |
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MedLine Citation:
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PMID: 21134541 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although parathyroidectomy (Ptx) for sporadic primary hyperparathyroidism (PH) improves comorbidities and symptoms, routine Ptx for minimally symptomatic PH remains controversial. Whether successful Ptx translates into discontinuation or dose-reduction of prescribed medications is unknown. METHODS: Consecutive patients undergoing curative Ptx for sporadic PH from January 2007 to April 2009 were compared to patients undergoing thyroidectomy (Tx). We reviewed patient demographics, symptoms, comorbid conditions, and pre- and postoperative medications utilizing the Fisher exact test and t test for comparisons. RESULTS: Compared to 176 Tx patients, 260 Ptx patients were older (P < .001), more commonly men (P = .006), and had higher preoperative prevalences of every examined PH symptom and comorbid condition. Postoperatively, even minimal PH symptoms improved after Ptx. The mean number of preoperative medications was higher in Ptx patients (4 vs 2.8, P < .001). Discontinuation or dose-reduction of medication occurred in 28 (11%) Ptx patients vs 7 (4%) Tx patients (P = .01). After Ptx, symptom improvement was the predominant reason for beneficial medication changes, and the most common beneficial effect was discontinuation or dose-reduction of chronic analgesics (33%). CONCLUSION: PH symptoms are numerous and improve after curative Ptx. Medication use for related symptoms can be beneficially reduced by surgery. Drug profiles should be routinely reviewed and adjusted after parathyroidectomy. |
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Authors:
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Adrienne L Melck; Michaele J Armstrong; Michael T Stang; Sally E Carty; Linwah Yip |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgery Volume: 148 ISSN: 1532-7361 ISO Abbreviation: Surgery Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-07 Completed Date: 2011-01-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
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Languages: eng Pagination: 1113-8; discussion 1118-9 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Section of Endocrine Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anxiety / etiology Bone Diseases, Metabolic / etiology Comorbidity / trends Depression / etiology Drug Therapy / methods* Female Follow-Up Studies Gastroesophageal Reflux / epidemiology Humans Hyperlipidemias / etiology Hyperparathyroidism, Primary / classification, drug therapy, surgery* Hypertension / etiology Male Middle Aged Osteoporosis / etiology Prospective Studies Retrospective Studies Sex Characteristics Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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