From: "Jeffrey E." <jeevacation@gmail.com>
To: Bruce Moskowitz
Subject:
Date: Tue, 14 Aug 2018 13:04:56 +0000
EVIDENCE SYNTHESIS The surgical group concluded that many patients with "asymptomatic" PHPT
have neurocognitive symptoms that may be unmasked after successful parathyroidectomy. Furthermore,
reduced bone density and increased fracture risk can be improved with parathyroidectomy. When PHPT is
symptomatic, it may be associated with nephrolithiasis, increased cardiovascular disease, and decreased
survival. Preoperative imaging studies should only be performed to help plan the operation, and negative
imaging should never preclude surgical referral. Noninvasive localization studies including ultrasound and
sestamibi scans are often employed, especially in anticipation of focused explorations. Invasive
localization studies should be reserved for remedial explorations where noninvasive imaging has been
unsuccessful.
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