Materiały źródłowe

• #1

  https://journals.lww.com/co-otolaryngology/fulltext/2017/04000/hypoparathyroidism_after_thyroidectomy_.9.aspx

  Permanent hypoparathyroidism is the most common long-term complication after total thyroidectomy and it can cause significant morbidity and increased costs. Its incidence varies from 30% to 60%. […] The surgical technique and the extent of thyroidectomy are related to parathyroid injury and hypoparathyroidism. The glands should be identified in situ, carefully manipulated and preserved, as well as their vascularization. In case of incidental removal, routine autotransplantation is advocated. […] Hypoparathyroidism is the most common long-term complication after total thyroidectomy. Adequate recognition and management decrease its morbidity and costs.

• #2 Postoperative Hypoparathyroidism: Prognosis, Prevention, and Treatment (Review) – тема научной статьи по клинической медицине читайте бесплатно текст научно-исследовательской работы в электронной библиотеке КиберЛенинка

  https://cyberleninka.ru/article/n/postoperative-hypoparathyroidism-prognosis-prevention-and-treatment-review

  Postoperative Hypoparathyroidism: Prognosis, Prevention, and Treatment (Review) […] This review summarizes the results of studies concerning the problem of post-surgical hypoparathyroidism, a common complication of thyroid gland surgery, decreasing the quality of life in patients and, in some cases, leading to disability. […] Therefore, the issues of prevention and surgical correction are of particular relevance. […] Thus, the techniques for intraoperative visualization and mobilization of PTG need further improvement. […] Therefore, prevention and surgical correction of post-surgical hypoparathyroidism are of particular relevance.

• #3 Contribution of ICG Angiography in the Detection of Parathyroids and the Prevention of Hypoparathyroidism Post Total Thyroidectomy | Clinical Research Trial Listing

  https://www.centerwatch.com/clinical-trials/listings/NCT04785443/contribution-of-icg-angiography-in-the-detection-of-parathyroids-and-the-prevention-of-hypoparathyroidism-post-total-thyroidectomy

  Hypoparathyroidism is the most common complication after a total thyroidectomy surgery. It becomes permanent after 6 months. […] The intraoperative use of indocyanine green (ICG) angiography has recently been described as a reliable means of detecting parathyroidism and predicting the risk of postoperative hypoparathyroidism. […] This use could prove to be a way to preserve parathyroid in vivo and thus reduce post-operative hypoparathyroidism rates. […] The detection of parathyroid glands and the prevention of hypoparathyroidism after thyroidectomy therefore represents a major challenge. […] In addition, prior studies and intraoperative observations suggest that indocyanine green angiography during thyroid surgery may be a means of preserving parathyroid in vivo and thus reducing post-operative hypoparathyroidism rates.

• #4 American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29848235/

  Hypoparathyroidism (hypoPT) is the most common complication following bilateral thyroid operations. Thyroid surgeons must employ strategies for minimizing and preventing post-thyroidectomy hypoPT. […] Risk factors for post-thyroidectomy hypoPT include bilateral thyroid operations, autoimmune thyroid disease, central neck dissection, substernal goiter, surgeon inexperience, and malabsorptive conditions. Medical and surgical strategies to minimize perioperative hypoPT include optimizing vitamin D levels, preserving parathyroid blood supply, and autotransplanting ischemic parathyroid glands. […] Effective management of mild to moderate potential or actual postoperative hypoPT can be achieved by administering either empiric/prophylactic oral calcium and vitamin D, selective oral calcium, and vitamin D based on rapid postoperative PTH level(s), or serial serum calcium levels as a guide. […] Permanent hypoPT has long-term consequences for both objective and subjective well-being, and should be prevented whenever possible.

• #5 SciELO Brazil – Predictive factors for permanent hypoparathyroidism following total thyroidectomy: A retrospective cohort study of 5,671 cases Predictive factors for permanent hypoparathyroidism following total thyroidectomy: A retrospective cohort study

  https://www.scielo.br/j/aem/a/cGZPmMpzRx6pW6hVVS4GYNf/?lang=en

  The incidence of permanent hypoparathyroidism was closely associated with the extent of level VI dissection, particularly regarding the number of lymph nodes removed and whether the dissection was bilateral. […] The severity of post-operative hypocalcemia was demonstrated by the decrease in PTH levels, as well as the need for and duration of intravenous calcium supplementation. […] Thus, analyzing the predictive factors for permanent hypoparathyroidism is invaluable in clinical practice to identify patient subgroups that may benefit from early intervention, thereby minimizing the long-term morbidity associated with the disease. […] The logistic regression model for permanent hypoparathyroidism identified sex, age, BMI, cT classification, and preoperative lymph node metastasis location as significant predictors.

• #6

  https://www.diva-portal.org/smash/record.jsf?pid=diva2%3A1738821

  Hypoparathyroidism is the most common complication after thyroid surgery and associated with short- and long-term consequences. […] The study showed that patients with preoperative treatment had a lower risk of early hypocalcemia and a reduced length of stay in hospital, compared to patients without treatment. […] In conclusion, the use of preoperative active vitamin D may be useful as a tool to lower the risk of early hypocalcemia. The risk of permanent hypoparathyroidism after total thyroidectomy is high and there is a need for improved follow up. […] Prophylactic preoperative alfacalcidol was associated with reduced biochemical hypocalcaemia and duration of hospital stay following TT. […] The risk of permanent hypoparathyroidism after total thyroidectomy was high and associated with parathyroid autotransplantation, higher age, female sex and surgery at a low volume center.

• #7

  https://journals.lww.com/co-otolaryngology/fulltext/2017/04000/hypoparathyroidism_after_thyroidectomy_.9.aspx

  Permanent hypoparathyroidism is the most common long-term complication after total thyroidectomy and it can cause significant morbidity and increased costs. Its incidence varies from 30% to 60%. […] The surgical technique and the extent of thyroidectomy are related to parathyroid injury and hypoparathyroidism. The glands should be identified in situ, carefully manipulated and preserved, as well as their vascularization. In case of incidental removal, routine autotransplantation is advocated. […] Hypoparathyroidism is the most common long-term complication after total thyroidectomy. Adequate recognition and management decrease its morbidity and costs.

• #8 Risk Factors and Prevention (New Technology) for Hypoparathyroidism after Thyroidectomy

  https://www.ijthyroid.org/journal/view.html?volume=15&number=2&spage=68

  Risk Factors and Prevention (New Technology) for Hypoparathyroidism after Thyroidectomy Int J Thyroidol 2022;15(2):68-73 Published online November 30, 2022; https://doi.org/10.11106/ijt.2022.15.2.68 2022 Korean Thyroid Association. […] The purpose of this article is to review the risk factors for hypoparathyroidism after total thyroidectomy and how to prevent it. […] In order to preserve the function of parathyroid gland, the parathyroid gland should be identified, and the parathyroid gland and its blood vessels should be well preserved. […] If the parathyroid gland is unintentionally removed or the perfusion of parathyroid gland is poor, there is high possibility of permanent hypoparathyroidism after surgery, so autotransplantation of the parathyroid gland is necessary. […] New technology for reducing hypoparathyroidism after thyroidectomy.

• #9 Hypoparathyroidism after thyroidectomy: prevention, assessment and management

  https://ouci.dntb.gov.ua/en/works/9GXXONJ7/

  Permanent hypoparathyroidism is the most common long-term complication after total thyroidectomy and it can cause significant morbidity and increased costs. Its incidence varies from 30% to 60%. […] The surgical technique and the extent of thyroidectomy are related to parathyroid injury and hypoparathyroidism. The glands should be identified in situ, carefully manipulated and preserved, as well as their vascularization. In case of incidental removal, routine autotransplantation is advocated. […] Adequate recognition and management decrease its morbidity and costs.

• #10 Hypoparathyroidism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/symptoms-causes/syc-20355375

  There are no specific actions to prevent hypoparathyroidism. However, if you’re scheduled to have thyroid or neck surgery, talk to your surgeon about the risk of damage to your parathyroid glands during the procedure. Your health care provider may choose to test your calcium, parathyroid hormone and vitamin D levels and have you begin taking supplements if needed before surgery. […] Parathyroid autotransplantation may be an option to reduce the chances of postoperative hypoparathyroidism. The surgeon works to preserve parathyroid tissue in the neck during the procedure. However, occasionally the surgeon may need to move parathyroid tissue to another area of the body, such as the arm or the chest muscle. Transplanted parathyroid tissue does not always function. […] If you’ve had surgery or radiation involving your thyroid or neck, watch for signs and symptoms that could indicate hypoparathyroidism, such as a tingling or burning sensation in your fingers, toes or lips, or muscle twitching or cramping. If they occur, your health care provider might recommend prompt treatment with calcium and vitamin D to minimize the effects of the disorder.

• #11 Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery | Scientific Reports

  https://www.nature.com/articles/s41598-021-91277-1

  We aimed to investigate the prevalence of postoperative hypoparathyroidism (PoH), the relevant factors, and predictors of transient or permanent hypoparathyroidism. […] PoH development was not significantly correlated with nodule size as measured by preoperative thyroid ultrasonography (p=0.944). […] Parathyroid autotransplantation can prevent the development of PoH. […] In order to prevent permanent hypoparathyroidism, it is recommended to confirm the presence of the parathyroid glands after thyroidectomy and to autotransplant any unintentionally excised glands. […] The in situ preservation of the parathyroid glands is of critical importance in preventing permanent PoH after total thyroidectomy. […] In our study, PTH levels of patients who developed PoH returned to normal within 28 days on average. […] Measuring PTH levels during the postoperative 46 h can allow early discharge of patients at low risk of developing hypoparathyroidism and the early treatment of high-risk patients. […] A postoperative 46-h PTH level of 5.95 pmol/L was found to be an early predictor of permanent PoH.

• #12 Hypoparathyroidism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/symptoms-causes/syc-20355375

  There are no specific actions to prevent hypoparathyroidism. However, if you’re scheduled to have thyroid or neck surgery, talk to your surgeon about the risk of damage to your parathyroid glands during the procedure. Your health care provider may choose to test your calcium, parathyroid hormone and vitamin D levels and have you begin taking supplements if needed before surgery. […] Parathyroid autotransplantation may be an option to reduce the chances of postoperative hypoparathyroidism. The surgeon works to preserve parathyroid tissue in the neck during the procedure. However, occasionally the surgeon may need to move parathyroid tissue to another area of the body, such as the arm or the chest muscle. Transplanted parathyroid tissue does not always function. […] If you’ve had surgery or radiation involving your thyroid or neck, watch for signs and symptoms that could indicate hypoparathyroidism, such as a tingling or burning sensation in your fingers, toes or lips, or muscle twitching or cramping. If they occur, your health care provider might recommend prompt treatment with calcium and vitamin D to minimize the effects of the disorder.

• #13

  https://www.diva-portal.org/smash/record.jsf?pid=diva2%3A1738821

  Hypoparathyroidism is the most common complication after thyroid surgery and associated with short- and long-term consequences. […] The study showed that patients with preoperative treatment had a lower risk of early hypocalcemia and a reduced length of stay in hospital, compared to patients without treatment. […] In conclusion, the use of preoperative active vitamin D may be useful as a tool to lower the risk of early hypocalcemia. The risk of permanent hypoparathyroidism after total thyroidectomy is high and there is a need for improved follow up. […] Prophylactic preoperative alfacalcidol was associated with reduced biochemical hypocalcaemia and duration of hospital stay following TT. […] The risk of permanent hypoparathyroidism after total thyroidectomy was high and associated with parathyroid autotransplantation, higher age, female sex and surgery at a low volume center.

• #14

  https://www.ijorl.com/index.php/ijorl/article/view/3199

  Prevention of hypoparathyroidism with the use of calcium-rich foods in the total thyroidectomy pre-operative period […] Background: Transient hypocalcemia after total thyroidectomy (TT) is a common surgical complication. […] The objectives of this study were to evaluate the incidence of hypoparathyroidism with the use of calcium-rich foods in the pre-operative period of TT, followed by a measurement of PTH performed 12 hours after such procedure. […] Methods: A preliminary study with 31 patients earmarked for TT. Patients were divided into two groups: (A) without calcium-rich foods intake in the TT pre-operative period; and (B) with the intake of calcium-rich foods, in the TT pre-operative period. […] Beginning of the use of these foods has been standardized as being seven days before surgery, due to the slower calcium intestinal absorption process. […] Results: Group B, when compared to A, showed a significant difference between PTH values, before and after surgery (p value 0.001). […] Conclusions: Calcium-rich foods intake in the conditions reported may be associated with lower rates of hypoparathyroidism.

• #15 Prevention of hypoparathyroidism: A step-by-step near-infrared autofluorescence parathyroid identification method

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9922903/

  Hypoparathyroidism is an important factor that seriously affects the quality of life of patients after thyroidectomy. […] The step-by-step NIRAF parathyroid identification method can effectively locate the parathyroid gland and protect its function. […] Clinical research reports and meta-analyses have confirmed its value in thyroid surgery and can increase the recognition rate of parathyroid glands and reduce the incidence of postoperative hypoparathyroidism and hypocalcemia. […] The incidence of postoperative temporary parathyroidism and hypocalcemia in the NIRAF group was also lower than that in the control group, and postoperative PTH recovery in the NIRAF group was faster than that in the control group. […] The step-by-step near-infrared autofluorescence parathyroid identification method can be used to effectively locate parathyroid glands and protect their function. This method may improve the in situ preservation rate of parathyroid glands and further reduce the occurrence of temporary parathyroidism after surgery.

• #16 Contribution of ICG Angiography in the Detection of Parathyroids and the Prevention of Hypoparathyroidism Post Total Thyroidectomy | Clinical Research Trial Listing

  https://www.centerwatch.com/clinical-trials/listings/NCT04785443/contribution-of-icg-angiography-in-the-detection-of-parathyroids-and-the-prevention-of-hypoparathyroidism-post-total-thyroidectomy

  Hypoparathyroidism is the most common complication after a total thyroidectomy surgery. It becomes permanent after 6 months. […] The intraoperative use of indocyanine green (ICG) angiography has recently been described as a reliable means of detecting parathyroidism and predicting the risk of postoperative hypoparathyroidism. […] This use could prove to be a way to preserve parathyroid in vivo and thus reduce post-operative hypoparathyroidism rates. […] The detection of parathyroid glands and the prevention of hypoparathyroidism after thyroidectomy therefore represents a major challenge. […] In addition, prior studies and intraoperative observations suggest that indocyanine green angiography during thyroid surgery may be a means of preserving parathyroid in vivo and thus reducing post-operative hypoparathyroidism rates.

• #17 Hypocalcemia posthyroidectomy: prevention, diagnosis and management

  https://www.oatext.com/hypocalcemia-posthyroidectomy-prevention-diagnosis-and-management.php

  Hypocalcemia is a frequent complication in patients undergoing thyroid surgery. It increases the hospitalized time and costs, decreasing the quality of life and the risk of death. Recommendations are given for the prevention, diagnosis and treatment of hypoparathyroidism in patients undergoing total thyroidectomy. […] Initiating prophylactic oral elemental calcium, the first day after surgery can reduce the incidence of postoperative hypocalcemia, the length of hospital stay and the need for parenteral calcium. The prescription of vitamina D (VD) is also recommended. […] Early diagnosis by assessing predictive factors can prevent hypocalcemia and decrease mobility and mortality. Early evaluation of iPTH and corrected serum calcium (CSC) after neck surgery, are the most appropriate tests to diagnose transitory and permanent hypoparathyroidism.

• #18 New Hypoparathyroidism Guidelines and Emerging PTH Replacement Therapies for Improved Patient Outcomes – UCSF MedConnection

  https://medconnection.ucsfhealth.org/news/new-hypoparathyroidism-guidelines-and-emerging-pth-replacement-therapies-for-improved-patient-outcomes

  New guidelines from the Second International Workshop on the Evaluation and Management of Hypoparathyroidism provide clinicians with the latest evidence-based recommendations for the prevention, diagnosis and management of this rare disease. […] The guidelines include recommendations for minimizing the risk of permanent postsurgical hypoparathyroidism. […] We determined when to measure PTH and calcium after a thyroidectomy and what action to take based on the levels, Shoback said. […] The guidelines recommend using PTH measurements 12 to 24 hours after total thyroidectomy. […] The guidelines provide a framework for patients who arent well controlled on conventional management and who might be candidates for injectable PTH therapy, Shoback said.

• #19 Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery | Scientific Reports

  https://www.nature.com/articles/s41598-021-91277-1

  We aimed to investigate the prevalence of postoperative hypoparathyroidism (PoH), the relevant factors, and predictors of transient or permanent hypoparathyroidism. […] PoH development was not significantly correlated with nodule size as measured by preoperative thyroid ultrasonography (p=0.944). […] Parathyroid autotransplantation can prevent the development of PoH. […] In order to prevent permanent hypoparathyroidism, it is recommended to confirm the presence of the parathyroid glands after thyroidectomy and to autotransplant any unintentionally excised glands. […] The in situ preservation of the parathyroid glands is of critical importance in preventing permanent PoH after total thyroidectomy. […] In our study, PTH levels of patients who developed PoH returned to normal within 28 days on average. […] Measuring PTH levels during the postoperative 46 h can allow early discharge of patients at low risk of developing hypoparathyroidism and the early treatment of high-risk patients. […] A postoperative 46-h PTH level of 5.95 pmol/L was found to be an early predictor of permanent PoH.

• #20 Hypocalcemia posthyroidectomy: prevention, diagnosis and management

  https://www.oatext.com/hypocalcemia-posthyroidectomy-prevention-diagnosis-and-management.php

  The insufficiency or deficiency of VD is an independent preoperative predictor, contributing to postsurgical hypocalcemia. Its measurement is suggested routinely as a first step in preventing post-operative hipocalcemia. […] Prophylactic supplementation of oral calcium from day 1 postoperative reduces the incidence of postoperative symptomatic hypocalcemia, length of hospital stays and the need for using parenteral calcium in the different schemes. […] It is a known fact to every surgeon that in order to prevent postoperative hypoparathyroidism while performing thyroid surgeries, the best effort must be made to avoid any kind of damage, either directly to the glands or to the blood supply of the parathyroids. […] Based in the findings described above, many groups have developed protocols that include perioperative iPTH and calcium serum levels in order to classify their patients within risk groups and allowing either an early discharge or the establishing of an early in-hospital treatment for thyroidectomized patients using calcium supplements and adjusting surveillance. This has reduced emergency room readmissions as well as prolonged unjustified hospitalizations, improving the quality of life and therefore reducing costs.

• #21 American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29848235/

  Hypoparathyroidism (hypoPT) is the most common complication following bilateral thyroid operations. Thyroid surgeons must employ strategies for minimizing and preventing post-thyroidectomy hypoPT. […] Risk factors for post-thyroidectomy hypoPT include bilateral thyroid operations, autoimmune thyroid disease, central neck dissection, substernal goiter, surgeon inexperience, and malabsorptive conditions. Medical and surgical strategies to minimize perioperative hypoPT include optimizing vitamin D levels, preserving parathyroid blood supply, and autotransplanting ischemic parathyroid glands. […] Effective management of mild to moderate potential or actual postoperative hypoPT can be achieved by administering either empiric/prophylactic oral calcium and vitamin D, selective oral calcium, and vitamin D based on rapid postoperative PTH level(s), or serial serum calcium levels as a guide. […] Permanent hypoPT has long-term consequences for both objective and subjective well-being, and should be prevented whenever possible.

• #22 Establishing a predictive model of hypoparathyroidism after total thyroidectomy and central lymph node dissection for postoperative calcium supplementation selectively

  https://atm.amegroups.org/article/view/97392/html

  However, prophylactic calcium supplementation is not recommended for patients with PTC with a score of less than 5; if the patient develops hypocalcemia at the later stage, therapeutic calcium supplementation can then be implemented. […] For patients with PTC with a score of 5, routine prophylactic calcium supplementation is recommended even if no hypoparathyroidism is found after surgery. However, prophylactic calcium supplementation is not recommended for patients with PTC with a score of less than 5; if the patient develops hypocalcemia at the later stage, therapeutic calcium supplementation can then be implemented to improve their prognosis.

• #23 Establishing a predictive model of hypoparathyroidism after total thyroidectomy and central lymph node dissection for postoperative calcium supplementation selectively

  https://atm.amegroups.org/article/view/97392/html

  The core goal of this article is to find some meaningful risk factors that can affect the postoperative hypoparathyroidism of thyroid cancer, create an effective prediction model on this basis, and use it to selectively implement routine prophylactic calcium supplementation for patients after thyroid carcinoma surgery. […] A previous study has shown that prophylactic calcium supplementation after surgery can reduce the risk of hypoparathyroidism and hypocalcemia, thus reducing the incidence of postoperative complications related to thyroid carcinoma. […] Therefore, it is particularly important to clarify the risk factors of hypoparathyroidism after thyroid carcinoma surgery. […] Routine prophylactic calcium supplementation is recommended for PTC patients with a score greater than or equal to 5, although there are no clinical symptoms of postoperative hypocalcemia caused by hypoparathyroidism.

• #24 Parathyroid Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0815/p249.html

  Hypoparathyroidism most commonly occurs after inadvertent damage or removal of parathyroid glands during neck surgery. […] Most head and neck surgeons carefully track this complication with intra- and postoperative monitoring of calcium and PTH levels. […] It is important to ensure repletion to normal levels of vitamin D and magnesium in these patients. […] Long-term management of hypoparathyroidism should include at least initial involvement of an endocrinologist. Vitamin D analogues are essential (e.g., calcitriol [Rocaltrol]), and thiazide diuretics and dietary modification are typically used as well.

• #25 Hypoparathyroidism – MD Searchlight

  https://mdsearchlight.com/hormones-and-body-chemistry/hypoparathyroidism/

  People suffering from hypoparathyroidism need to understand the importance of regularly taking calcium and calcitriol supplements. Hypoparathyroidism is a condition that causes low levels of parathyroid hormone, which plays a key role in regulating your body’s calcium levels. Calcitriol is a form of vitamin D used to treat and prevent low levels of calcium in the blood. […] These individuals also need to regularly get blood tests for calcium, phosphorus, and kidney function. Periodic monitoring is a medical term for getting regular check-ups. This is important to ensure the body is reacting well to the supplements and is maintaining the right levels of these substances. The goal of this is to keep their calcium levels within a low-normal range to manage their symptoms and avoid a condition known as hypercalciuria. […] By taking their medications as directed and getting regular check-ups, patients can control their symptoms and avoid potential complications.

• #26 Post-surgical hypoparathyroidism: a condition of growing interest among endocrinologists | Endocrinología, Diabetes y Nutrición (English ed.)

  https://www.elsevier.es/en-revista-endocrinologia-diabetes-nutricion-13-articulo-post-surgical-hypoparathyroidism-condition-growing-interest-S2530018019301027

  The authors recommend treatment with oral calcium salts and active vitamin D analogs. […] Although recombinant human PTH (rhPTH [184]) is not recommended in the routine treatment of hypoparathyroidism, as stated in the consensus document, several American and European drug agencies have approved its use in selected patients with chronic hypoparathyroidism who cannot be adequately controlled with standard treatment. […] This consensus document and the other recently published guides coincide on most of the key points referring to the prevention and treatment of hypoparathyroidism.

• #27 WHRY Researchers Advance Their Work on HIV/AIDS Prevention, Hypoparathyroidism, and Colon Cancer < Yale School of Medicine

  https://medicine.yale.edu/news-article/whry-researchers-advance-their-work-on-hiv-aids-prevention-hypoparathyroidism-and-colon-cancer/

  Dr. Diane Krause has leveraged a pair of WHRY pilot grants in taking major steps toward inducing stem cells to become parathyroid-like cells. Most recently, she secured a substantial two-year grant from the National Cancer Institute to advance progress toward her goal of making up for missing or malfunctioning parathyroid glands, a condition mostly found in women. This research presents a promising opportunity to achieve a long-sought cure for hypoparathyroidism, in which patients lack the hormone produced by the parathyroid gland, leading to calcium deficiency and many health problems, from painful muscle spasms to heart failure. […] In a paper recently featured in the journal Endocrinology, Dr. Krause described how her team has successfully created a stem cell that can produce the same RNA as a parathyroid gland, a significant milestone along the path toward creating a cell that can produce the hormones of a parathyroid gland to relieve the suffering of many women.

• #28 Top 5 Things to Know About Hypoparathyroidism

  https://www.parathyroid.com/blog/top-5-things-to-know-about-hypoparathyroidism

  World Hypoparathyroidism Awareness Day, observed on June 1 each year, brings increased awareness of hypoparathyroidism and the need for improvements in education, prevention, and treatment for this poorly understood condition. […] The most important way to avoid hypoparathyroidism is to find an experienced surgeon to perform your parathyroid or thyroid surgery. The „acceptable” rate of a surgeon causing hypoparathyroidism during an operation on the thyroid or parathyroid glands is about 1% or less, as reported in the medical literature. […] Ultimately, reducing the incidence of hypoparathyroidism lies in the hands of the patients. People should be educated about hypoparathyroidism as a life-changing complication prior to undergoing surgery on their thyroid or parathyroid glands. People should check on the experience of their surgeons.

• #29 Nursing Care Plan (NCP) for Hypoparathyroidism | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-ncp-for-hypoparathyroidism

  Patient Education: Educate about the importance of medication adherence, dietary modifications, and recognizing symptoms of hypocalcemia. […] Rationale: Informed patients are more likely to adhere to treatment and recognize when to seek medical attention. […] This care plan provides a structured approach to managing a patient with hypoparathyroidism, emphasizing the maintenance of electrolyte balance, prevention of complications, patient education, and emotional support.

• #30 American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29848235/

  Hypoparathyroidism (hypoPT) is the most common complication following bilateral thyroid operations. Thyroid surgeons must employ strategies for minimizing and preventing post-thyroidectomy hypoPT. […] Risk factors for post-thyroidectomy hypoPT include bilateral thyroid operations, autoimmune thyroid disease, central neck dissection, substernal goiter, surgeon inexperience, and malabsorptive conditions. Medical and surgical strategies to minimize perioperative hypoPT include optimizing vitamin D levels, preserving parathyroid blood supply, and autotransplanting ischemic parathyroid glands. […] Effective management of mild to moderate potential or actual postoperative hypoPT can be achieved by administering either empiric/prophylactic oral calcium and vitamin D, selective oral calcium, and vitamin D based on rapid postoperative PTH level(s), or serial serum calcium levels as a guide. […] Permanent hypoPT has long-term consequences for both objective and subjective well-being, and should be prevented whenever possible.

• #31 Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery | Scientific Reports

  https://www.nature.com/articles/s41598-021-91277-1

  We aimed to investigate the prevalence of postoperative hypoparathyroidism (PoH), the relevant factors, and predictors of transient or permanent hypoparathyroidism. […] PoH development was not significantly correlated with nodule size as measured by preoperative thyroid ultrasonography (p=0.944). […] Parathyroid autotransplantation can prevent the development of PoH. […] In order to prevent permanent hypoparathyroidism, it is recommended to confirm the presence of the parathyroid glands after thyroidectomy and to autotransplant any unintentionally excised glands. […] The in situ preservation of the parathyroid glands is of critical importance in preventing permanent PoH after total thyroidectomy. […] In our study, PTH levels of patients who developed PoH returned to normal within 28 days on average. […] Measuring PTH levels during the postoperative 46 h can allow early discharge of patients at low risk of developing hypoparathyroidism and the early treatment of high-risk patients. […] A postoperative 46-h PTH level of 5.95 pmol/L was found to be an early predictor of permanent PoH.

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