{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:52:50Z","timestamp":1783745570452,"version":"3.55.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:00:00Z","timestamp":1636848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Normocalcemic primary hyperparathyroidism (NCpHPT) and normohormonal primary hyperparathyroidism (NHpHPT) are recently recognized variants of primary hyperparathyroidism. Current guidelines for the management hyperparathyroidism recognize NCpHPT as one of the areas that are recommended for more research due to limited available data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of patients who had parathyroidectomy between 2014 and 2019. We excluded patients with multiple endocrine neoplasia syndromes and secondary and tertiary hyperparathyroidism. Included patients were classified based on the biochemical profile into classic or normocalcemic hyperparathyroidism group. Collected data included demographics, preoperative localizing imaging, intraoperative parathyroid hormone levels, and postoperative cure rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>261 patients were included: 160 patients in the classic and 101 patients in the normocalcemic group. Patients in the normocalcemic group had significantly more negative sestamibi scans (n = 58 [8.2%] vs 78 [51.3%], P = &lt;.01), smaller parathyroid glands (mean weight 436.0 \u00b1 593.0 vs 742.4 \u00b1 1109.0\u00a0mg, P = .02), higher parathyroid hyperplasia rates (n = 51 [50.5%] vs 69 [43.1%]), and significantly higher intraoperative parathyroid hormone at 10\u00a0minutes (78.1 \u00b1 194.6\u00a0vs 43.9 \u00b1 62.4 1, P = .04). Positive predictive value of both intraoperative parathyroid hormone and cure rate was lower in the normocalcemic group (84.2% vs 95.7%) and (80.5% vs 95%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Normocalcemic hyperparathyroidism is a challenging disease. Surgeons should be aware of the lower cure rate in this group, interpret intraoperative parathyroid hormone with caution, and have a lower threshold for bilateral neck exploration and 4 glands visualization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348211048844","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T22:50:51Z","timestamp":1636930251000},"page":"873-879","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Effects of Parathyroidectomy on Normocalcemic Primary Hyperparathyroidism and the Role of Intraoperative PTH Measurement"],"prefix":"10.1177","volume":"88","author":[{"given":"Ehab","family":"Alameer","sequence":"first","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"},{"name":"Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Hoof","sequence":"additional","affiliation":[{"name":"Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosam","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdelgawad","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Texas at Tyler, Tyler, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghassan","family":"Zora","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Shama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Kandil","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,11,14]]},"reference":[{"key":"bibr1-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1179-3"},{"key":"bibr2-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1590\/0004-2730000003367"},{"key":"bibr3-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818793879"},{"key":"bibr4-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021404"},{"key":"bibr5-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-012-1438-y"},{"key":"bibr6-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.07.031"},{"key":"bibr7-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-019-01128-0"},{"key":"bibr8-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1159\/000502578"},{"key":"bibr9-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-019-05157-x"},{"key":"bibr10-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.10.032"},{"key":"bibr11-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.09.017"},{"key":"bibr12-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1413"},{"key":"bibr13-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-3190-4"},{"key":"bibr14-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.06.043"},{"key":"bibr15-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-019-01782-1"},{"key":"bibr16-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-4512-2"},{"key":"bibr17-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.2310"},{"key":"bibr18-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0699-7"},{"key":"bibr19-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181859f71"},{"key":"bibr20-00031348211048844","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6998-0"}],"container-title":["The 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