Search Results (3)

Background: Vitamin D deficiency is highly prevalent in individuals with severe obesity and may worsen after malabsorptive bariatric procedures. Adolescence represents a critical period of skeletal and metabolic maturation and may influence mineral–hormonal adaptation after Roux-en-Y gastric bypass (RYGB). Objective: To investigate whether developmental stage influences longitudinal mineral–hormonal adaptation after RYGB in adolescents and adults with severe obesity. Methods: This prospective observational cohort study included 120 participants undergoing RYGB: 60 adolescents (15–19 years) and 60 adults (20–49 years) with a history of severe obesity. Assessments were performed preoperatively and at 6 and 12 months postoperatively. Serum 25-hydroxyvitamin D, ionized calcium, phosphorus, and parathyroid hormone (PTH) were measured. Group comparisons were performed using non-parametric tests within a translational life-course framework. Results: Vitamin D inadequacy (<30 ng/mL) was highly prevalent at baseline in both groups (78.3% vs. 85.0%). Despite substantial weight loss in both cohorts, adolescents exhibited higher frequencies of hypocalcaemia and hypophosphataemia (p < 0.001), progressive elevation of PTH levels, and a higher prevalence of secondary hyperparathyroidism at 12 months. Adults showed a comparatively less pronounced endocrine–mineral response but also experienced persistent increases in PTH throughout follow-up. Vitamin D inadequacy remained highly prevalent in both groups despite standardized supplementation. Conclusions: Postoperative mineral–hormonal adaptation after RYGB differs according to developmental stage. Adolescents exhibited greater endocrine–mineral vulnerability during a critical period of skeletal maturation, suggesting that biological stage may influence postoperative adaptation beyond anthropometric response alone. These findings support developmental stage-specific monitoring and individualized postoperative management after metabolic surgery. Full article

The aim of this study was to analyse and evaluate our 5-year experience in paediatric thyroid surgery, as well as the specificities of this kind of surgery in the literature. This retrospective study was based on 19 operations in 17 patients aged from 5 to 17 years who were operated on due to thyroid pathology from 2017 until 2022. We presented data on surgical procedures and complications following surgery. Most of the patients were adolescent girls. The most common clinical presentations included enlarged thyroid gland, followed by thyroid nodules and hyperthyroidism. Eight total thyroidectomies, five left lobectomies, five right lobectomies, and three central neck dissections were performed. The most common histopathological diagnosis was hyperplastic diffuse colloid goitre, followed by papillary carcinoma, cystic nodule, follicular adenoma, Hashimoto thyroiditis and toxic adenoma. Postoperative course was uneventful, with four mild complications (one wound infection, one manifest hypocalcaemia, and two transitory recurrent laryngeal nerve paralysis). In our literature review, eighteen full-text articles were included and analysed. This study demonstrated that thyroid surgery in paediatric population is a safe and efficient procedure. Thyroid pathology in children significantly differs from that in the adults, and paediatric surgeons should be included into the team managing such cases. Full article

Permanent hypoparathyroidism, a feared thyroidectomy complication, leads to significant patient morbidity, medical treatment, and monitoring. This study explores whether preoperative high-dose vitamin D loading decreases the incidence of permanent hypoparathyroidism. In a subgroup analysis, the study examines the predictive utility of day 1 parathyroid hormone (PTH) in permanent hypoparathyroidism. Patients (n = 150) were previously recruited in the VItamin D In Thyroidectomy (VIDIT) trial, a multicentre, randomised, double blind, placebo-controlled trial evaluating the role of 300,000 IU cholecalciferol administered orally a week before total thyroidectomy. Patients were contacted postoperatively beyond six months through a telephonic questionnaire. The primary outcome was permanent hypoparathyroidism, strictly defined as the need for activated vitamin D six months postoperatively. Out of 150 patients, 130 (86.7%) were contactable. Permanent hypoparathyroidism occurred in 11/130 (8.5%) patients, with a lower incidence of 5.3% (3/57) in the cholecalciferol group compared to 11% (8/73) in the placebo group; however, this was non-significant (p = 0.34). In a subgroup analysis, no relationship between day 1 PTH level and the incidence of permanent hypoparathyroidism was found (p ≥ 0.99). There was a lower rate of permanent hypoparathyroidism in the cholecalciferol group, which was not significant. The predictive utility of day 1 postoperative PTH levels may be limited to transient hypoparathyroidism. Full article