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Febrero B, Ruiz-Manzanera JJ, Ros-Madrid I, Vergara A, Rodríguez JM. Improvement of mood and sleep quality in patients with primary hyperparathyroidism after parathyroidectomy: A prospective case-control study. Surgery 2024; 175:1291-1298. [PMID: 38350761 DOI: 10.1016/j.surg.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/28/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Primary hyperparathyroidism can impact patient quality of life with psychopathological symptoms like mood and sleep disturbances. In the latest recommendations published according to the primary hyperparathyroidism surgical consensus, these neuropsychological symptoms continue to be excluded. This study aims to assess the negative effects of mood and sleep on patients with primary hyperparathyroidism compared to healthy controls and analyze their improvement after surgery. METHODS Prospective case-control study of patients with primary hyperparathyroidism. The Beck questionnaire and Pittsburgh Sleep Quality Index were used. The control group consisted of healthy people matched by age and sex. Preoperative results were compared with results at 3 and 12 months after surgery and compared with the control group. Statistical analysis consisted of the Kolmogorov-Smirnov test and Student's t test for correlations. RESULTS Forty-nine patients who underwent parathyroidectomy were analyzed. In relation to depression, differences were observed between the results of the preoperative period and 3 months after surgery, with a significant decrease in depression score (16.80 ± 9.98 vs 13.08 ± 10.76; P = .001). This improvement was maintained after 1 year (P < .001). Regarding the quality of sleep, there were no differences 3 months after the intervention, but there were differences at 12 months (9.48 ± 4.76 vs 8.27 ± 4.38; P = .032). The dimensions of the Pittsburgh Sleep Quality Index were analyzed, observing significant differences only in daytime dysfunction after 3 months and 12 months after surgery (1.02 ± 0.99 vs 0.69 ± 0.82; P = .01 and 1.04 ± 0.98 vs 0.60 ± 0.76; P = .004). CONCLUSION Mood changes and sleep quality improve after primary hyperparathyroidism surgery, although at different postoperative times, with this improvement being more pronounced in mood. This assessment should be taken into account in the preoperative consultation of patients with primary hyperparathyroidism.
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Affiliation(s)
- Beatriz Febrero
- Endocrine Surgery Unit, General and Digestive Surgery, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain; Murcian Institute of Biosanitary Research Pascual Parrilla (IMIB Pascual Parrilla), Murcia, Spain; University of Murcia, Murcia, Spain
| | - Juan José Ruiz-Manzanera
- Endocrine Surgery Unit, General and Digestive Surgery, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain; Murcian Institute of Biosanitary Research Pascual Parrilla (IMIB Pascual Parrilla), Murcia, Spain; University of Murcia, Murcia, Spain.
| | - Inmaculada Ros-Madrid
- University of Murcia, Murcia, Spain; Endocrinology Service, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Adrián Vergara
- Endocrine Surgery Unit, General and Digestive Surgery, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain; University of Murcia, Murcia, Spain
| | - José M Rodríguez
- Endocrine Surgery Unit, General and Digestive Surgery, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain; Murcian Institute of Biosanitary Research Pascual Parrilla (IMIB Pascual Parrilla), Murcia, Spain; University of Murcia, Murcia, Spain
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Wang Y, Xin Y, Zhao T, Shen H, Liu X, Wang J, Wang Q, Shen R, Feng D, Wei B. PTH levels, sleep quality, and cognitive function in primary hyperparathyroidism. Endocrine 2023:10.1007/s12020-023-03410-x. [PMID: 37266901 DOI: 10.1007/s12020-023-03410-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Cognitive function in patients with primary hyperparathyroidism (PHPT) may be affected and be identified to have been linked to the level of parathyroid hormone (PTH). Previous studies have suggested that patients with PHPT present poor sleep quality, which might interact with cognitive decline. The purpose of this study was to determine whether sleep quality mediates the association between PTH level and cognitive function and investigate whether surgery improves sleep quality and cognition in PHPT patients. METHODS Between June 2019 and August 2022, we recruited 146 patients diagnosed with PHPT (n = 146). We collected clinical data from medical records and evaluated sleep quality and cognition preoperatively and 2 months postoperatively by using the Pittsburgh Sleep Quality Index and Min-Mental State Examination. We examined the mediation effects of sleep disturbance and latency on correlations between PTH level and cognitive impairment by using the Bootstrap method. RESULTS The sleep quality and cognitive function were correlated with PTH level before surgery. Sleep latency or sleep disturbance exhibited a partial mediating effect on the association between PTH level and MMSE scores in PHPT patients (p < 0.05). In PHPT patients, there was a significant decline in PTH levels and an improvement in cognitive function post-surgery compared to pre-surgery, but no significant differences in sleep quality. CONCLUSION Sleep disturbance and sleep latency may mediate the association between PTH level and cognitive impairment in PHPT before surgery. The surgery could reduce PTH levels and improve cognition, but might not improve sleep quality in PHPT patients.
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Affiliation(s)
- Yuting Wang
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yunhui Xin
- Department of Anaesthesia, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Teng Zhao
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hong Shen
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xing Liu
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiacheng Wang
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qian Wang
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Rongfang Shen
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Dalin Feng
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Bojun Wei
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
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Ionova TI, Buzanakov DM, Chernikov RA, Efremov SM, Gladkova IN, Nikitina TP, Sleptsov IV, Zolotoukho AV, Bubnov KA, Skvortsov VV, Vinogradova AA, Rusakov VF. Quality of life in patients with primary hyperparathyroidism before and after parathyroidectomy: long term single center experience. BMC Endocr Disord 2023; 23:87. [PMID: 37085858 PMCID: PMC10120198 DOI: 10.1186/s12902-023-01344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/16/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by a parathyroid tumor or hyperplasia, which is often accompanied with quality of life (QoL) impairment. A parathyroidectomy (PTX) is the preferred standard treatment for PHPT patients. In this single center study we aimed to evaluate the impact of PHPT on patient's QoL and identify QoL changes at early and long-term follow-up after surgery. METHODS All the patients underwent routine PTX with the removal of the suspected hyperparathyroid gland(s). Patients filled out generic QoL questionnaire RAND SF-36, specific questionnaire PHPQoL and specific symptom assessment questionnaire PAS upon admission to the hospital before surgery, at 3 months, 12 months and 24 months after surgery. RESULTS A total of 92 patients with PHPT (median age was 56 years, 95.7% females) were included in the study. Before PTX patient's QoL by SF-36 scores was significantly lower as compared to healthy controls (p < 0.01). Almost 40% of patients had poor or very poor QoL. The most frequent symptoms by PAS before surgery were as follows: tiredness (97.8% of patients), weakness (94.6%), forgetfulness (94.6%), mood changes (90%), feeling "blue"/depression (88%), joint pains (83.3%), headaches (80.2%), constant irritability (77.2%), bone pains (75%), thirst (70.7%) and trouble getting out of a chair (67.4%). The half of the patients had moderate-to-severe (≥ 40 scores) tiredness, weakness, joint pains, forgetfulness, as well as mood changes. Post-operative QoL changes were analysed in the group of 72 patients. After surgery there was significant improvement in QoL by all scales of SF-36 questionnaire, excluding bodily pain, and the PHPQoL total score (GEE, p < 0.01) as compared with their values before surgery. Also severity of tiredness, mood changes, weakness and forgetfulness significantly decreased after surgery as compared to their baseline values (GEE, p < 0.05). Decreased mental component of QoL by PHPQoL (OR = 0.927, 95%CI = 0.874-0.984, p = 0.013) predicted improved QoL after surgery. CONCLUSIONS Patients with PHPT demonstrated significantly impaired QoL in physical, psychological and social functioning as well experienced a wide profile of common PHPT symptoms. Successful PTX was accompanied with remarkable QoL improvement and decrease in subjective symptoms for at least 24 months after surgery.
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Affiliation(s)
- T I Ionova
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - D M Buzanakov
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - R A Chernikov
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - S M Efremov
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia.
| | - I N Gladkova
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - T P Nikitina
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - I V Sleptsov
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - A V Zolotoukho
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - K A Bubnov
- Saint-Petersburg State University, Saint-Petersburg, Russia
| | - V V Skvortsov
- Saint-Petersburg State University, Saint-Petersburg, Russia
| | | | - V F Rusakov
- Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
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Influence of Parathyroidectomy on Sleep Quality in Primary Hyperparathyroidism. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021. [PMID: 33713328 DOI: 10.1007/5584_2021_628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
We investigated the impact of parathyroidectomy on sleep quality in patients with primary hyperparathyroidism (pHPT). Thirty consecutive patients with pHPT were enrolled in the study within 1 year. pHPT was diagnosed by typical symptoms accompanied by an elevated level of parathormone. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of sleep 1 day before and 6 months after parathyroidectomy. The mean total PSQI score was elevated to 6.8 ± 0.6 points before surgery, which was in the pathological cut-off of greater than ≥5, indicating impaired sleep quality. After parathyroidectomy, the total score declined insignificantly, amounting to 5.6 ± 0.4 (p > 0.05). Nevertheless, the number of patients with a score of ≥5 before surgery decreased from 21 (70%) to 16 (53%) after surgery. There also was a significant improvement in sleep latency (p = 0.05) and sleep efficiency (p = 0.02) domains of PSQI. We conclude that 70% of patients with untreated pHPT suffered from sleep disorders that improved after parathyroidectomy. The clinical consequence is that patients with pHPT should be questioned about having sleep disorders, which might influence the decision-making concerning parathyroidectomy. With the relation reversed, patients without pHPT but suffering from sleep disturbance should be tested for pHPT.
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Somuncu E, Kara Y. The effect of parathyroidectomy on quality of life in primary hyperparathyroidism: evaluation with using sf-36 and phpqol questionnaire. Endocr J 2021; 68:87-93. [PMID: 32879163 DOI: 10.1507/endocrj.ej20-0417] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Quality of life (QoL) typically improves with a parathyroidectomy (PTx) in cases of primary hyperparathyroidism (PHPT), but the effect of surgery on QoL is not yet fully understood. This study evaluated the impact of PTx on health-related QoL (HRQoL). Patients who underwent PTx for PHPT between January 2016 and December 2019 were asked to complete the 36-Item Short Form Health Survey (SF-36) and the Primary Hyperparathyroidism Quality of Life (PHPQoL) questionnaire before surgery and 1 year later. A 5-point Likert scale was used: negative responses received a lower score and positive responses scored high. Forty-one of 50 patients completed the questionnaires before and 12 months after the surgery. The median patient age was 64 years (min-max: 32-83 years). In the study group, 33 were female, and 8 were male. The SF-36 results indicated that significant improvements had been observed in all 8 domains a year after surgery, particularly in the physical functioning and role, general health, energy, and mental health scales. The PHPQoL scores also improved significantly after PTx (p < 0.05). The improvement in the physical and mental health components was 50% and 76%, respectively. In conclusion, this study demonstrated that PTx for PHPT improved QoL.
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Affiliation(s)
- Erkan Somuncu
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Yasin Kara
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
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Quality of Life in Patients With Asymptomatic Primary Hyperparathyroidism After Parathyroidectomy: A 3-Year Longitudinal Study. Endocr Pract 2021; 27:716-722. [PMID: 33640325 DOI: 10.1016/j.eprac.2021.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Impaired quality of life (QoL) is considered as a nonclassical manifestation of primary hyperparathyroidism (PHPT). This study aimed to detect and compare changes in the QoL of patients with asymptomatic PHPT who had successful curative parathyroidectomy (PTX) 3 months and 3 years after the procedure. METHODS Patients with diagnosed PHPT were eligible for the study. There were 2 groups: the PTX group, with patients who underwent PTX, and the non-PTX group, with patients who were treated conservatively. QoL was assessed using Pasieka's Parathyroid Assessment of Symptoms Questionnaire (PAS-Q) at baseline, 3 months, and 3 years. RESULTS Thirty-eight patients were included in the study: 18 in the PTX group and 20 in the non-PTX group. In the PTX group, the mean PAS-Q total score before PTX was 518, which was reduced significantly at the 3-month (P = .003) and 3-year assessments (P = .001). However, in the non-PTX group, the mean PAS-Q total score was 326 at baseline and increased continuously for 3 years (P = .019). At the 3-year evaluation, the mean total score was significantly higher compared to that of the PTX group (P = .021). Finally, there was a positive correlation between total serum calcium and PAS-Q score in the non-PTX group (r = 0.524, P = .018). CONCLUSION QoL of patients with PHPT improved significantly compared to that in conservative surveillance as early as 3 months after successful, curative PTX, and remained improved for 3 years. This finding strengthens, even more, the hypothesis that PTX contributes to better QoL, suggesting that the derangement of QoL may be considered as an individual indication for surgery.
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La J, Wang TS, Hammad AY, Burgardt L, Doffek K, Carr AA, Shaker JL, Carroll TB, Evans DB, Yen TW. Parathyroidectomy for primary hyperparathyroidism improves sleep quality: A prospective study. Surgery 2017; 161:25-34. [DOI: 10.1016/j.surg.2016.05.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/13/2016] [Accepted: 05/05/2016] [Indexed: 10/20/2022]
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Dulfer R, Geilvoet W, Morks A, van Lieshout EM, Smit CP, Nieveen van Dijkum EJ, in't Hof K, van Dam F, van Eijck CH, de Graaf PW, van Ginhoven TM. Impact of parathyroidectomy for primary hyperparathyroidism on quality of life: A case-control study using Short Form Health Survey 36. Head Neck 2016; 38:1213-20. [DOI: 10.1002/hed.24499] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Roderick Dulfer
- Department of Surgery; Erasmus MC; Rotterdam The Netherlands
| | - Wanda Geilvoet
- Department of Surgery; Erasmus MC; Rotterdam The Netherlands
| | - Annelien Morks
- Department of Surgery; Groene Hart Ziekenhuis; Gouda The Netherlands
| | | | - Casper P.C Smit
- Department of Surgery; Reinier de Graaf Groep (RDGG) Hospital; Delft The Netherlands (retired)
| | | | - Klaas in't Hof
- Department of Surgery; Flevoziekenhuis; Almere The Netherlands
| | | | | | - Peter W. de Graaf
- Department of Surgery; Reinier de Graaf Groep (RDGG) Hospital; Delft The Netherlands (retired)
| | - Tessa M. van Ginhoven
- Department of Surgery; Reinier de Graaf Groep (RDGG) Hospital; Delft The Netherlands (retired)
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Abstract
Primary hyperparathyroidism (PHPT) is a common disorder in which parathyroid hormone (PTH) is excessively secreted from one or more of the four parathyroid glands. A single benign parathyroid adenoma is the cause in most people. However, multiglandular disease is not rare and is typically seen in familial PHPT syndromes. The genetics of PHPT is usually monoclonal when a single gland is involved and polyclonal when multiglandular disease is present. The genes that have been implicated in PHPT include proto-oncogenes and tumour-suppressor genes. Hypercalcaemia is the biochemical hallmark of PHPT. Usually, the concentration of PTH is frankly increased but can remain within the normal range, which is abnormal in the setting of hypercalcaemia. Normocalcaemic PHPT, a variant in which the serum calcium level is persistently normal but PTH levels are increased in the absence of an obvious inciting stimulus, is now recognized. The clinical presentation of PHPT varies from asymptomatic disease (seen in countries where biochemical screening is routine) to classic symptomatic disease in which renal and/or skeletal complications are observed. Management guidelines have recently been revised to help the clinician to decide on the merits of a parathyroidectomy or a non-surgical course. This Primer covers these areas with particular attention to the epidemiology, clinical presentations, genetics, evaluation and guidelines for the management of PHPT.
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Zanocco K, Butt Z, Kaltman D, Elaraj D, Cella D, Holl JL, Sturgeon C. Improvement in patient-reported physical and mental health after parathyroidectomy for primary hyperparathyroidism. Surgery 2015; 158:837-45. [DOI: 10.1016/j.surg.2015.03.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 03/02/2015] [Accepted: 03/18/2015] [Indexed: 11/27/2022]
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Cosci F, Fava GA, Sonino N. Mood and anxiety disorders as early manifestations of medical illness: a systematic review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2015; 84:22-9. [PMID: 25547421 DOI: 10.1159/000367913] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 08/27/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a systematic review of the literature with qualitative data synthesis. METHODS MEDLINE, PsycINFO, EMBASE, Cochrane, and ISI Web of Science were systematically searched from inception to February 2014. Search terms were 'prodrome/early symptom', combined using the Boolean 'AND' operator with 'anxiety/depression/mania/hypomania/irritability/irritable mood/hostility', combined with the Boolean 'AND' operator with 'medical illness/medical disorder'. PRISMA guidelines were followed. RESULTS A total of 21 studies met the inclusion criteria and were analyzed. Depression was found to be the most common affective prodrome of medical disorders and was consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS. Mania, anxiety and irritability were less frequent. CONCLUSIONS Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.
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Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
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Tsukahara K, Nakamura K, Motohashi R, Sato H, Endo M, Katsube Y, Ueda Y, Suzuki M. Antiemetic therapy of fosaprepitant, palonosetron, and dexamethasone combined with cisplatin-based chemotherapy for head and neck carcinomas. Acta Otolaryngol 2014; 134:1198-204. [PMID: 25315920 DOI: 10.3109/00016489.2014.913314] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Concomitant antiemetic therapy comprising fosaprepitant, palonosetron, and dexamethasone is effective for head and neck carcinoma. OBJECTIVE A patient diary was constructed to determine the effectiveness of concomitant antiemetic therapy with a neurokinin-1 receptor antagonist (fosaprepitant), 5-hydroxytryptamine receptor antagonist (palonosetron), and dexamethasone in accordance with guidelines. METHODS Subjects comprised 41 patients who received 71 courses of chemotherapy, along with fosaprepitant, palonosetron, and dexamethasone. A patient diary was compiled concerning the presence/absence of vomiting, vomiting episodes, presence/absence of rescue therapy, food intake, presence/absence of nausea, and general condition. RESULTS The frequency of the primary end point of complete response in the overall phase was 69.0%. The proportion of patients with no vomiting in the overall phase was 90.1%. In the acute phase, the proportion of no nausea and slight nausea together was 91.5%, no change in and slightly reduced food intake together was 87.3%, and the proportion of good general condition and relatively good general condition was 85.9%. In the delayed phase, the proportion of no nausea and slight nausea together was 56.3%, no change in and slightly reduced food intake together was 43.7%, and the proportion of good general condition and relatively good general condition together was 53.5%.
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Affiliation(s)
- Kiyoaki Tsukahara
- Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center , Tokyo
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Crouzeix G, Kerlan V. Hyperparathyroïdie primaire : nouveaux concepts, nouvelles recommandations. ANNALES D'ENDOCRINOLOGIE 2014; 75 Suppl 1:S21-36. [DOI: 10.1016/s0003-4266(14)70024-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Murray SE, Pathak PR, Schaefer SC, Chen H, Sippel RS. Improvement of sleep disturbance and insomnia following parathyroidectomy for primary hyperparathyroidism. World J Surg 2014; 38:542-8. [PMID: 24142330 PMCID: PMC3945278 DOI: 10.1007/s00268-013-2285-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of the present study was to investigate the incidence of sleep disturbance and insomnia in patients with primary hyperparathyroidism (PHPT), and to evaluate the effect of parathyroidectomy. METHODS A questionnaire was prospectively administered to adult patients with PHPT who underwent curative parathyroidectomy over an 11-month period. The questionnaire, administered preoperatively and 6 months postoperatively, included the Insomnia Severity Index (ISI) and eight additional questions regarding sleep pattern. Total ISI scores range from 0 to 28, with >7 signifying sleep difficulties and scores >14 indicating clinical insomnia. RESULTS Of 197 eligible patients undergoing parathyroidectomy for PHPT, 115 (58.3 %) completed the preoperative and postoperative questionnaires. The mean age was 60.0 ± 1.2 years and 80.0 % were women. Preoperatively, 72 patients (62.6 %) had sleep difficulties, and 29 patients (25.2 %) met the criteria for clinical insomnia. Clinicopathologic variables were not predictive of clinical insomnia. There was a significant reduction in mean ISI score after parathyroidectomy (10.3 ± 0.6 vs 6.2 ± 0.5, p < 0.0001). Postoperatively, 79 patients (68.7 %) had an improved ISI score. Of the 29 patients with preoperative clinical insomnia, 21 (72.4 %) had resolution after parathyroidectomy. Preoperative insomnia patients had an increase in total hours slept after parathyroidectomy (5.4 ± 0.3 vs 6.1 ± 0.3 h, p = 0.02), whereas both insomnia patients and non-insomnia patients had a decrease in the number of awakenings (3.7 ± 0.4 vs 1.9 ± 0.2 times, p = 0.0001). CONCLUSIONS Sleep disturbances and insomnia are common in patients with PHPT, and the majority of patients will improve after curative parathyroidectomy.
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Affiliation(s)
- Sara E Murray
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, K3/704 Clinical Science Center, 600 Highland Avenue, Madison, WI, 53792, USA,
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Webb SM, Puig-Domingo M, Villabona C, Muñoz-Torres M, Farrerons J, Badia X. Development of a new tool for assessing health-related quality of life in patients with primary hyperparathyroidism. Health Qual Life Outcomes 2013; 11:97. [PMID: 23777622 PMCID: PMC3710251 DOI: 10.1186/1477-7525-11-97] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 05/27/2013] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Several studies in recent years have evaluated Health Related Quality of Life (HRQoL) of patients with primary hyperparathyroidism (PHPT). No disease specific questionnaires are available to assess the impact of the disease. The aim of this research is to describe the development of a new disease specific Quality of Life (QoL) questionnaire for use specifically with PHPT patients. METHODS A conceptual model was developed describing the impact of the disease and its symptoms on QoL domains. A literature review was conducted to identify the most relevant domains. A focus group with experts was used to validate the domains; 24 patients were also interviewed to complement the information from the patient's perspective. A content analysis of the interviews was performed to identify items related with the impact of the disease, leading to PHPQoL-V.1 which was presented to a sample of 67 patients. Reliability was assessed by Cronbach's coefficient alpha and item-total score correlations. Validity was assessed by a factor analysis performed to determine the number of domains. Rasch analysis was carried out in order to refine the questionnaire items. RESULTS 259 items were extracted from the interviews that were subsequently reduced to 34 items. Cronbach's coefficient alpha was 0.92. The factor analysis extracted two domains (physical and emotional). After Rasch analysis the questionnaire PHPQoL-V.2 kept 16 items (9 physical and 7 emotional). The questionnaire was developed in a Spanish population and the final version was translated to English through translation and back-translation. CONCLUSION The first disease specific HRQoL questionnaire for PHPT patients (PHPQoL-16) has been developed. Validation studies designed to assess measurement properties of this tool are currently underway.
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Affiliation(s)
- Susan M Webb
- Department of Medicine/Endocrinology, Hospital Sant Pau, Pare Claret 167, Barcelona, 08025, Spain
- Centro de Investigación Biomédica de Enfermedades Raras (CIBER_ER Unit 747), Instituto de Salud Carlos III Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Puig-Domingo
- Service of Endocrinology and Nutrition, Hospital Universitary Germans Trias i Pujol Crtra, Canyet, Badalona, 08916, Spain
| | - Carles Villabona
- Service of Endocrinology and Nutrition, Hospital Universitary Bellvitge, C/ de la Feixa Llarga, L'Hospitalet de Llobregat, 08907, Spain
| | - Manuel Muñoz-Torres
- Service of Endocrinology and Nutrition, Hospital Universitary San Cecilio, C/ Doctor Oloriz, 16, Granada, 18012, Spain
| | - Jordi Farrerons
- Department of Medicine/Internal Medicine, Unidad de Metabolismo Minero-cálcico. Hospital Sant Pau, Pare Claret, 167, Barcelona, 08025, Spain
| | - Xavier Badia
- IMS Health, C/ Dr. Ferrán, 25-27, 2nd floor, Barcelona, 08034, Spain
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16
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Affiliation(s)
- Joel T Adler
- Intern in General Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
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17
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Adler JT, Sippel RS, Schaefer S, Chen H. Preserving function and quality of life after thyroid and parathyroid surgery. Lancet Oncol 2008; 9:1069-75. [PMID: 19012855 DOI: 10.1016/s1470-2045(08)70276-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Endocrine disease has been recognised for thousands of years, but surgical treatment of endocrine disorders has only been widely used in the past century. Surgery is an effective treatment for hyperfunctioning glands and benign and malignant tumours. Advances in surgical technique have led to the development of short and safe operations with a high cure rate, and recent studies have not only assessed the success of the operations but also have focused on how these diseases affect patient-reported quality of life before and after surgery. In this Review, we summarise current approaches to surgical treatment of thyroid and parathyroid disease, focusing on how these approaches both preserve function and improve quality of life after surgery.
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Affiliation(s)
- Joel T Adler
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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