Understanding delays to parathyroidectomy: A mixed-methods approach.

Background: Patients from ethnic and racial minority groups with primary hyperparathyroidism may have greater time delays to curative parathyroidectomy. Contributing factors are unclear.

Methods: This was a sequential mixed-methods study.

Endocrine Patients' Views on Transoral Endoscopic Thyroidectomy via Vestibular Approach (TOETVA).

TOETVA's adoption has been slow in the Western hemisphere. Our study aimed to evaluate how endocrine patients in the United States perceive the risks and benefits of TOETVA. This was a cross-sectional study where a de novo survey was sent via email to patients seen from 2018 to 2020.

Improved sexual function after parathyroidectomy in women with primary hyperparathyroidism.

Background: The study aimed to evaluate whether women with primary hyperparathyroidism (PHPT) experience improvement in their sexual function after parathyroidectomy.

Methods: Women with PHPT or benign thyroid nodules (controls) undergoing surgery were administered the validated Parathyroidectomy Assessment Score (PAS), Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) and Female Sexual Function Index (FSFI) pre-operatively, at 3 months and 6 months postoperatively.

Results: Of the 26 PHPT and 18 control patients, PHPT patients were older (53.

Efficacy of machine learning to identify clinical factors influencing levothyroxine dosage after total thyroidectomy.

Background: We employed Machine Learning (ML) to evaluate potential additional clinical factors influencing replacement dosage requirements of levothyroxine.

Method: This was a retrospective study of patients who underwent total or completion thyroidectomy with benign pathology. Patients who achieved an euthyroid state were included in three different ML models.

Social Determinants of Health and Quality of Life in Endocrine Surgery Patients.

Introduction: Quality of life (QoL) of endocrine surgery patients is an important patient outcome but the role of social determinants of health (SDH) on preoperative QoL is understudied.

Methods: This study used preoperative data of 233 endocrine surgery patients participating in a longitudinal QoL study to examine the influence of SDH (patient-level and environmental) on preoperative QoL. Patient-level SDH was assessed with structured survey questions and environmental SDH with the Social Vulnerability Index.

A comparison of NSQIP and CESQIP in data quality and ability to predict thyroidectomy outcomes.

Background: The Collaborative Endocrine Surgery Quality Improvement Program tracks thyroidectomy outcomes with self-reported data, whereas the National Surgical Quality Improvement Program uses professional abstractors. We compare completeness and predictive ability of these databases at a single-center and national level.

Method: Data consistency in the Collaborative Endocrine Surgery Quality Improvement Program and the National Surgical Quality Improvement Program at a single institution (2013-2020) was evaluated using McNemar's test.

Clinical Factors Predictive of Lymph Node Metastasis in Thyroid Cancer Patients: A Multivariate Analysis.

Background: Early-stage thyroid cancers have excellent survival. However, lymph node metastases (LNM) confer a worse prognosis and are not always known preoperatively. Therefore, investigation on the clinical and histological factors predictive of LNM in thyroid cancers was conducted to tailor the extent of surgery and radioactive iodine therapy.

The Case for Integrating Medical-Legal Partnerships Into Trauma Care.

Introduction: Medical-legal needs are health-harming adverse social conditions with a legal remedy. Medical-legal partnerships in primary care settings have been proposed to address these needs for at-risk patients already seeking medical care. Our hypothesis is that trauma patients represent a unique population that may be more likely to have baseline medical-legal needs.

Comparing the rate and extent of malignancy in surgically excised thyroid nodules across race and ethnicity.

Background: Few studies have compared the features of thyroid cancer among races and ethnicities. We hypothesized that race and ethnicity may influence the frequency and features of thyroid malignancy in thyroid nodules.

Method: This was a retrospective chart review of patients between 2013 and 2020 who underwent thyroidectomy.

Endocrine Surgery Patients' and Providers' Perceptions of Telemedicine in the COVID Era.

Background: Telemedicine has become a key modality for health care delivery during the COVID-19 pandemic, including for endocrine surgery. Little data exists on patients' and referring endocrinologists' perspectives of its use. The study aimed to assess and compare endocrine surgery patients' attitudes about telemedicine to that of referring endocrinologists.

Differentiated thyroid cancer and Hashimoto thyroiditis: Utility of the Afirma gene expression classifier.

Background And Objectives: The Afirma gene expression classifier (AGEC) has not been tested or validated in a high-risk group, such as patients with Hashimoto's thyroiditis (HT). We hypothesized that AGEC would perform worse in patients with HT.

Methods: A retrospective review of patient charts in a single academic institution who underwent thyroidectomy between 2012 and 2017 was conducted.

Evaluation of Thyroid Hormone Replacement Dosing in Overweight and Obese Patients After a Thyroidectomy.

Initiation of thyroid hormone replacement (THR) after a total thyroidectomy has traditionally relied on the weight of the patient, regardless of the patient's body mass index (BMI). Current literature suggests that THR in obese patients differs from nonobese patients. This can lead to overdosing of levothyroxine (LT4) and delay in achievement of euthyroid state.

Safety of Thyroid Surgery in the Elderly: A Propensity Score Matched Cohort Study.

Background: Thyroid surgery is becoming more common in the elderly as elderly population continues to grow. We aim to evaluate the relative risk of morbidity from thyroidectomy in patients greater than 75 y of age.

Methods: A retrospective analysis was performed for patients who were undergoing thyroidectomy between 2001 and 2018 in a multihospital network.

Is 30-Day Posthospitalization Mortality Lower Among Racial/Ethnic Minorities?: A Reexamination.

Background: Multiple studies have reported that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition are lower among blacks compared with whites.

Objective: To examine if previously reported lower mortality for minorities, relative to whites, is accounted for by adjustment for do-not-resuscitate status, potentially unconfirmed admission diagnosis, and differential risk of hospitalization.

Research Design: Using inpatient discharge and vital status data for patients aged 18 and older in California, we examined all admissions from January 1, 2010 to June 30, 2011 for acute myocardial infarction, heart failure, pneumonia, acute stroke, gastrointestinal bleed, and hip fracture and estimated relative risk of mortality for Hispanics, non-Hispanic blacks, non-Hispanic Asians, and non-Hispanic whites.

Prophylactic Central Compartment Neck Dissection in Papillary Thyroid Cancer and Effect on Locoregional Recurrence.

Background: Prophylactic central compartment neck dissection (pCCND) in addition to total thyroidectomy (TT) includes removal of central compartment lymph nodes in the absence of clinical involvement on preoperative and intraoperative evaluation. The data regarding the influence of pCCND on oncologic outcomes and surgical complication rates is mixed and, therefore, is the focus of this analysis.

Methods: A systematic review of the literature on total thyroidectomy with prophylactic central compartment neck dissection (TT + pCCND) from January 1990 to October 2017 identified 221 abstracts of which 17 met inclusion criteria and were reviewed (1 randomized-control trial, 13 retrospective cohort studies, and 3 meta-analyses).

Racial/ethnic disparities among Asian Americans in inpatient acute myocardial infarction mortality in the United States.

Background: Acute myocardial infarction (AMI) is a common high-risk disease with inpatient mortality of 5% nationally. But little is known about this outcome among Asian Americans (Asians), a fast growing racial/ethnic minority in the country. The objectives of the study are to obtain near-national estimates of differences in AMI inpatient mortality between minorities (including Asians) and non-Hispanic Whites and identify comorbidities and sociodemographic characteristics associated with these differences.

Disparities in Potentially Preventable Hospitalizations: Near-National Estimates for Hispanics.

Objective: To obtain near-national rates of potentially preventable hospitalization (PPH)-a marker of barriers to outpatient care access-for Hispanics; to examine their differences from other race-ethnic groups and by Hispanic national origin; and to identify key mediating factors.

Data Sources/study Setting: Data from all-payer inpatient discharge databases for 15 states accounting for 85 percent of Hispanics nationally.

Study Design: Combining counts of inpatient discharges with census population for adults aged 18 and older, we estimated age-sex-adjusted PPH rates.

Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey.

Background: Social and economic conditions that affect one's ability to satisfy life's most basic needs such as lack of affordable housing, restricted access to education and employment, or inadequate income are increasingly well-documented barriers to optimal health. The burden of these challenges among vulnerable patients accessing cancer care services is unknown.

Methods: We conducted a cross-sectional survey of patients presenting for ambulatory cancer care services (screening and treatment) at an urban safety-net hospital to assess socio-legal concerns (social problems related to meeting life's basic needs supported by public policy or programming and potentially remedied through legal advocacy/action).

Understanding the Role of the Professional Practice Environment on Quality of Care in Magnet® and Non-Magnet Hospitals.

Objective: The aim of this study was to explore the relationship between Magnet RecognitionA and nurse-reported quality of care.

Background: MagnetA hospitals are recognized for nursing excellence and quality patient outcomes; however, few studies have explored contributing factors for these superior outcomes.

Methods: This was a secondary analysis of linked nurse survey data, hospital administrative data, and a listing of American Nurses Credentialing Center Magnet hospitals.

Medullary thyroid cancer: an update for surgeons.

Medullary thyroid carcinoma is uncommon but accounts for approximately 4 to 5 per cent of all thyroid cancers. Although most cases are sporadic, close to one-fourth of cases result from germline mutations in the RET proto-oncogene. These mutations are clinically important because they predict the earliest age of medullary thyroid cancer diagnosis and clinical aggressiveness, which guide individualized management.

Primer on outcomes research.

Outcomes research uses diverse inputs to examine innovative end results aimed to deliver quality patient care. Yet defining "outcomes research" remains a challenge, and its interpretation is often nuanced. In this review, we discuss the definition of outcomes research in the context of its historical evolution along with the rise of other similar types of research.

Artificial hand for minimally invasive surgery: design and testing of initial prototype.

Background: Compared with traditional open surgery, minimally invasive surgery may improve recovery and patient satisfaction while maintaining surgical principles. Laparoscopic, single incision, natural orifice, and robotic approaches hold their own appeal. However, they lack the ability to manipulate organs as easily as the human hand.