Background: Hypoparathyroidism with hypocalcemia is the most frequent complication after thyroid surgery. Many risk factors have been involved in the development of this complication, with conflicting results. Incidental parathyroidectomy (IP) may be a frequent cause of postoperative hypocalcemia. In this study, we have evaluated the risk factors associated with the IP in a single-center cohort of patients undergoing thyroid surgery. Patients and methods: The incidence and the risk factors for IP were evaluated in 799 patients scheduled for surgical treatment for thyroid disease between January 2018 and December 2023. Parathyroid hormone levels and serum calcium levels, together with the histological specimens, were evaluated in all patients. Results: Post-operative temporary hypocalcemia was present in 239 (29.9%) patients. A total of 144 patients (21.9%) had an incidental parathyroidectomy. Younger patients (<40 years) had the highest risk of having an incidental parathyroidectomy (RR 1.53 (95% CI 1.084–2.161), OR 1.72 (95% CI 1.091–2.710), p = 0.014). Moreover, thyroid cancer (RR 1.4 (95 CI 1.114–1.882) OR 1.68 (95% CI 1.145–2.484), p < 0.05) and the neck dissection (RR 1.75 (95% CI 1.409–2.198) OR 2.38 (95% CI 1.644–3.460), p < 0.001) were strongly associated with the risk of incidental parathyroidectomy. Conclusions: Younger female patients with thyroid cancer and neck dissection were at the highest risk of incidental parathyroidectomy. A meticulous surgical dissection, together with imaging methods for the detection of the parathyroid glands, may reduce the incidence of this complication.

Background: Kidney transplantation outcomes are correlated to many factors, including the socioeconomics conditions and the educational level. Methods: We evaluated the role of educational level on patient and graft survival in a population of 456 kidney transplant recipients. Patients were divided into two groups on the basis of their pre-transplant educational status: patients with primary education (elementary or middle school, as low education) were compared with patients with a secondary school education (high school or a university degree, as high education). Results: Among the 456 patients considered for this analysis, 161 patients had a low educational status, and 295 had a high educational status. Patients with a low educational status were more rarely employed (66.1% vs. 32.5%, p < 0.001), with a high rate of retired patients compared to high-educational status patients (35.6% vs. 10.6%, p < 0.001). Although the educational status did not influence the graft function, the 1-year (88.1% vs. 96.2%, p = 0.0008), 5-year (77.6% vs. 88.8%, p = 0.001), and 10-year (62.1% vs. 75%, p = 0.003) graft survival rates were significantly lower in patients with low educational status compared with high-educational status patients, respectively. Patient survival at 1-year (94.4% vs. 97.6%, p = 0.073), 5-year (85% vs. 92.5%, p = 0.011), and 10-year (75.7% vs. 83.4%, p = 0.042) follow-up was significantly lower in patients with low educational status. Conclusions: Low socioeconomic conditions and educational level had a negative impact on kidney transplant outcomes. Improving access to education and providing targeted educational support and health literacy could enhance treatment adherence and reduce disparities in transplant outcomes.

CircRNAs are a class of non-coding RNAs able to regulate gene expression at multiple levels. Their involvement in physiological processes, as well as their altered regulation in different human diseases, both tumoral and non-tumoral, is well documented. However, little is known about their involvement in female reproduction. This study aims to identify circRNAs potentially involved in reproductive women’s health. Candidate circRNAs expressed in ovary and sponging miRNAs, already known to be expressed in the ovary, were selected by a computational approach. Using real time PCR, we verified their expression and identified circPUM1 as the most interesting candidate circRNA for further analyses. We assessed the expression of circPUM1 and its linear counterpart in all the follicle compartments and, using a computational and experimental approach, identified circPUM1 direct and indirect targets, miRNAs and mRNAs, respectively, in cumulus cells. We found that both circPUM1 and its mRNA host gene are co-expressed in all the follicle compartments and proposed circPUM1 as a potential regulator of PTEN, finding a strong positive correlation between circPUM1 and PTEN mRNA. These results suggest a possible regulation of PTEN by circPUM1 in cumulus cells and point out the important role of circRNA inside the pathways related to follicle growth and oocyte maturation.