geoffrey modest medical blogs

  A recent article found that patients with primary hyperparathyroidism have reduced type II diabetes if they had parathyroidectomy over medical therapy, in this retrospective cohort study from Israel (see   hyperparathyroid surgery dec diabetes  in dropbox, or doi:10.1001/jamanetworkopen.2025.46222)   Details : -- 50,199 patients who were diagnosed with primary hyperparathyroidism  (pHPT)  from 2000-2024 in the Clalit Health Services database, a nationwide databank of Israel’s largest healthcare organizations. These patients were compared to 150,265 controls who were matched for age, sex, and socioeconomic status. Those having secondary hyperparathyroidism were excluded     -- the Clalit database includes information on diagnoses, hospitalizations, clinical visits, demographic characteristics, laboratory values, and medications. this database has a remarkably low patient turnover rate (1%), allowing for long-term follow-up -- 6654 of these p...

  A recent long-term follow-up study suggested that observation was as good as parathyroidectomy in patients with mild primary hyperparathyroidism (see hyperparathyroid surgery no better AIM2022 in dropbox or doi:10.7326/M21-4416 )   Details:  -- 191 patients with mild hyperparathyroidism in eight Scandinavian referral centers were randomly assigned to parathyroidectomy (PTX) versus observation (OBS), from 1998 to 2005 -- baseline: mean age 63, 83% women, BP 140/80, prevalent vertebral fractures 7%, history of peripheral fractures 25% -- history of cardiovascular disease 13%/cancer 4%/kidney stone 3%, mean corrected calcium 10.6 mg/dL, mean PTH 91 ng/L, mean creatinine 0.9 mg/dL (no comment on phosphate level) -- data and causes of death were obtained from the Swedish and Norwegian registries 10 years after randomization and also after an extended observation period lasting to 2018; morbidity events were prospectively registered annually -- inclusion criter...