The Time Has Come to Redefine the Classic Symptoms of Primary Hyperparathyroidism: Comment on “Parathyroidectomy, Elevated Depression Scores, and Suicidal Ideation in Patients With Primary Hyperparathyroidism”.

The time has come to redefine the classic symptoms of primary hyperparathyroidism: comment on “parathyroidectomy, elevated depression scores, and suicidal ideation in patients with primary hyperparathyroidism”.

JAMA Surg. 2013 Feb; 148(2): 115-6
Pasieka JL

HubMed – depression


Parathyroidectomy, elevated depression scores, and suicidal ideation in patients with primary hyperparathyroidism: results of a prospective multicenter study.

JAMA Surg. 2013 Feb; 148(2): 109-15
Weber T, Eberle J, Messelhäuser U, Schiffmann L, Nies C, Schabram J, Zielke A, Holzer K, Rottler E, Henne-Bruns D, Keller M, von Wietersheim J

To assess anxiety and depression symptoms, suicidal ideation, and health-related quality of life (HRQOL) in a large series of consecutive patients with primary hyperparathyroidism (pHPT) before and after parathyroidectomy.This prospective multicenter study investigated preoperative and postoperative depression, anxiety, suicidal ideation, and HRQOL in patients with pHPT and compared these variables with a control group with nontoxic thyroid nodules.The study included 194 patients with pHPT and 186 control subjects.Depression was evaluated with the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire-9, which also assessed suicidal ideation. Anxiety was evaluated with the HADS. Health-related quality of life was measured with the 36-Item Short Form survey.Parathyroidectomy achieved a 98% cure rate. Preoperatively, severe depression (HADS score ? 11) was seen in 20% of the pHPT group and 9% of the control group. The Patient Health Questionnaire-9 detected moderate to severe depression in 17% of the patients with pHPT and 7% of the control subjects. Patients with pHPT had higher HADS anxiety scores (mean, 7.7) than control subjects (P < .01) or the German normative sample (P < .001). Compared with control subjects, patients with pHPT had significantly lower 36-Item Short Form survey preoperative physical and mental health summary scores (42.7 vs 49.5 and 41.2 vs 46.8, respectively; P = .001 for both comparisons). At 12 months follow-up, depression and anxiety decreased significantly in patients with pHPT; the prevalence of suicidal ideation was more than halved from the baseline (10.7% vs 22%; P = .008). Both physical and mental health scores (45.7 and 47.7, respectively) improved in patients with pHPT (P < .001 each) but not in control subjects.Depression, anxiety, and decreased HRQOL appear to be related to pHPT. Successful parathyroidectomy seems to reduce psychopathologic symptoms and improve HRQOL in this setting. HubMed – depression


Factors associated with poor sleep quality in primary care.

Korean J Fam Med. 2013 Mar; 34(2): 107-14
Kang JM, Lee JA, Jang JW, Kim YS, Sunwoo S

Sleep disorder is a common problem in adults and affects physical and mental health. We investigated factors associated with poor sleep quality in Korean primary care.A total of 129 couples (129 husbands and 129 wives) aged 30 to 79 years were included in this study from March, 2009 to February, 2010. The subjects were surveyed using a specific questionnaire. Sleep disorder was defined by a Pittsburgh Sleep Quality Index global score greater than 5 (poor sleepers). The subjects were divided into a group of good sleepers (n = 160) and a group of poor sleepers (n = 98). Socio-demographic and clinical covariates including age, sex, depression, spouse sleep disorder, and spouse depression were reported.Poor sleep quality was present in 38.0% of total subjects. According to chi-square test results, female, patients with depression, and low sleep quality of spouse were significantly associated with sleep disorder. In multivariate logistic regression analysis, depression increased the risk of poor sleep quality (odds ratio [OR], 7.775; 95% confidence interval [CI], 2.555 to 23.661), and non-risky drinking decreased the risk of poor sleep quality (OR, 0.343; 95% CI, 0.128 to 0.924).In our study, more than one-third of participants had poor sleep quality. Depression was a strong independent factor associated with sleep problems. HubMed – depression


Drug overdose due to malfunction of a patient-controlled analgesia machine -A case report-.

Korean J Anesthesiol. 2013 Mar; 64(3): 272-5
Yi Y, Kang S, Hwang B

Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future. HubMed – depression