Recommend-Response and Complications Comparing Radiofrequency Ablation Versus Parathyroidectomy for Secondary Hyperparathyroidism in Dialysis Patients

Abstract Introduction : To compare the efficacy and safety of ultrasound(US)-guided radiofrequency ablation (RFA) and parathyroidectomy (PTX) in the treatment of secondary hyperparathyroidism (SHPT). Methods In this retrospective study, we divided patients into PTX (n=53) and RFA (n=47) groups. The primary outcomes were the proportion of patients achieved the target range of iPTH concentrations(124-558pg/mL) and the long-term prognosis. The secondary outcomes were the differences in the changes of iPTH, calcium, and phosphorus over time and the incidence of adverse events. Results There was rarely difference in baseline characteristics between the two groups. Primary outcomes: The iPTH concentrations of 25.8% of patients in the PTX group and 51.3% of the RFA group were within the recommended range at the endpoint (P=0.031). Survival analysis revealed that the difference in all-cause mortality and cumulative response rate between the two groups was not statistically significant (P=0.902, P=0.141, respectively). Secondary outcomes: The iPTH concentrations in PTX group and RFA group dropped sharply after treatment and were 82.30±163.21pg/mL and 279.96±306.57pg/mL (P<0.001). There was no difference in the trend of iPTH, calcium, and phosphorus levels between the two groups over time(P>0.05). In addition, the incidence of infection and the hospital stay in the RFA group were significantly less. And preoperative bone-specific alkaline phosphatase concentration was a risk factor for postoperative hypocalcemia. Conclusion US-guided RFA was minimally invasive and no less than PTX in terms of cumulative response rate and complications in the treatment of severe SHPT in maintenance dialysis patients and may be used as an alternative technique to PTX, which need further studies to confirm.

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Vitamin D Deficiency and Intoxication - A concern either way

JMS SKIMS ◽

10.33883/jms.v14i2.80 ◽

2011 ◽

Vol 14 (2) ◽

pp. 40-42

Author(s):

Muzafar Maqsood Wani ◽

Imtiaz Ahmed Wani

Keyword(s):

Vitamin D ◽

Cell Growth ◽

Bone Turnover ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Bone Mineralization ◽

Normal Blood ◽

Blood Levels ◽

Calcium And Phosphorus ◽

Biologic Function

Major biologic function of activated vitamin D is to maintain normal blood levels of calcium and phosphorus, thus regulating bone mineralization. Research suggests that vitamin D may help in immunomodulation, regulating cell growth and 1,4 differentiation as well as some diverse unspecified functions. Overt vitamin D deficiency leads to hypocalcaemia, secondary hyperparathyroidism and increased bone turnover, which in prolonged and severe cases may cause rickets in children and osteomalacia in elderly.... JMS 2011;14(2):40-42

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Quality of life assessments in clinical practice using either the EORTC-QLQ-C30 or the SEIOQL-DW: a randomized study

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-021-00315-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Åsa Kettis ◽

Hanna Fagerlind ◽

Jan-Erik Frödin ◽

Bengt Glimelius ◽

Lena Ring

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Significant Difference ◽

Patient Reported ◽

Health Related Qol ◽

Health Related ◽

Secondary Outcomes ◽

The Impact ◽

Over Time

Abstract Background Effective patient-physician communication can improve patient understanding, agreement on treatment and adherence. This may, in turn, impact on clinical outcomes and patient quality of life (QoL). One way to improve communication is by using patient-reported outcome measures (PROMs). Heretofore, studies of the impact of using PROMs in clinical practice have mostly evaluated the use of standardized PROMs. However, there is reason to believe that individualized instruments may be more appropriate for this purpose. The aim of this study is to compare the effectiveness of the standardized QoL-instrument, the European Organization for Research and Treatment of Cancer Quality of Life C-30 (EORTC-QOL-C30) and the individualized QoL instrument, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), in clinical practice. Methods In a prospective, open-label, controlled intervention study at two hospital out-patient clinics, 390 patients with gastrointestinal cancer were randomly assigned either to complete the EORTC-QOL-C30 or the SEIQoL-DW immediately before the consultation, with their responses being shared with their physician. This was repeated in 3–5 consultations over a period of 4–6 months. The primary outcome measure was patients’ health-related QoL, as measured by FACIT-G. Patients’ satisfaction with the consultation and survival were secondary outcomes. Results There was no significant difference between the groups with regard to study outcomes. Neither intervention instrument resulted in any significant changes in health-related QoL, or in any of the secondary outcomes, over time. This may reflect either a genuine lack of effect or sub-optimization of the intervention. Since there was no comparison to standard care an effect in terms of lack of deterioration over time cannot be excluded. Conclusions Future studies should focus on the implementation process, including the training of physicians to use the instruments and their motivation for doing so. The effects of situational use of standardized or individualized instruments should also be explored. The effectiveness of the different approaches may depend on contextual factors including physician and patient preferences.

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Risk factors and clinical course of hungry bone syndrome after total parathyroidectomy in dialysis patients with secondary hyperparathyroidism

BMC Nephrology ◽

10.1186/s12882-016-0421-5 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 36

Author(s):

Lo-Yi Ho ◽

Ping-Nam Wong ◽

Ho-Kwan Sin ◽

Yuk-Yi Wong ◽

Kwok-Chi Lo ◽

...

Keyword(s):

Risk Factors ◽

Secondary Hyperparathyroidism ◽

Clinical Course ◽

Total Parathyroidectomy ◽

Dialysis Patients ◽

Hungry Bone Syndrome ◽

Hungry Bone

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Sa1462 Correlation Between Endoscopist Radiofrequency Ablation Volume and Response Rate in the Treatment of Barrett's Esophagus

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.03.513 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB215 ◽

Cited By ~ 1

Author(s):

David I. Fudman ◽

Charles J. Lightdale ◽

John M. Poneros ◽

Gregory G. Ginsberg ◽

Gary W. Falk ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Response Rate ◽

Ablation Volume

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Treatment of secondary hyperparathyroidism of dialysis patients with calcimimetics as a valuable addition to established therapeutic means

Pediatric Nephrology ◽

10.1007/s00467-004-1745-0 ◽

2005 ◽

Vol 20 (3) ◽

pp. 399-403 ◽

Cited By ~ 12

Author(s):

Tilman B. Dr�eke

Keyword(s):

Secondary Hyperparathyroidism ◽

Dialysis Patients ◽

Valuable Addition

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Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes

Kidney International ◽

10.1046/j.1523-1755.2002.00096.x ◽

2002 ◽

Vol 61 (1) ◽

pp. 239-248 ◽

Cited By ~ 89

Author(s):

Anne B. Bakewell ◽

Rob M. Higgins ◽

Mair E. Edmunds

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Clinical Outcomes ◽

Dialysis Patients ◽

Over Time

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Sequential transarterial chemoembolization and early radiofrequency ablation improves clinical outcomes for early-intermediate hepatocellular carcinoma in a 10-year single-center comparative study

BMC Gastroenterology ◽

10.1186/s12876-021-01765-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liangliang Yan ◽

Yanqiao Ren ◽

Kun Qian ◽

Xuefeng Kan ◽

Hongsen Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Combination Therapy ◽

Clinical Outcomes ◽

Transarterial Chemoembolization ◽

Response Rate ◽

Multivariable Analysis ◽

Complication Rates ◽

Tace Treatment

Abstract Background Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatment methods for unresectable hepatocellular carcinoma (HCC). However, there is still a lack of clinical research on whether early sequential RFA, compared with late combination therapy, can improve the long-term efficacy of initial TACE treatment. Methods This retrospective study investigated a cohort of patients who underwent combination therapy using TACE and RFA (TACE followed by RFA) from January 2010 to January 2020 at our medical centre. A total of 96 patients underwent TACE combined with early RFA (usually during the first hospitalization), which was called TACE + eRFA. Thirty-four patients received 1–2 palliative TACE treatments first and then underwent TACE treatment combined with late RFA (TACE + lRFA). All patients continued to receive palliative TACE treatments after intrahepatic lesion progression until reaching intolerance. The overall survival (OS) rate, time to tumour progression (TTP), tumour response rate and major complication rates were compared between the two groups. Results There were significant differences in the median OS (46 months vs 33 months; P = 0.013), median TTP (28 months vs 14 months; P < 0.00), objective response rate (ORR) (89.6% vs 61.8%, P = 0.000) and disease control rate (DCR) (94.8% vs 73.5% P = 0.002) between the two groups. Multivariable analysis revealed that the Barcelona Clinic Liver Cancer stage was an independent risk factor for OS. Meanwhile, multivariable analysis revealed that TACE + eRFA was associated with an enhanced TTP. Conclusion Early sequential RFA treatment in patients with early-intermediate HCC can improve local tumour control and clinical outcomes while reducing the frequency of TACE treatment. In clinical practice, in HCC patients initially treated with TACE, it is recommended to combine RFA as soon as possible to obtain long-term survival.

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