Context: It is unclear whether patients with asymptomatic primary hyperparathyroidism (PHPT) do better with parathyroidectomy (PTx) as compared with conservative medical management. Objective: The aim of the study was to evaluate the beneficial effect of PTx vs. conservative management in patients with mild asymptomatic PHPT. Design: We conducted a prospective, randomized study. Setting: The study took place at a referral center. Patients: We studied 50 patients who did not meet any guidelines for parathyroid surgery as recommended by the National Institutes of Health Consensus Development Conference on Asymptomatic PHPT. Intervention: Patients were randomly assigned to PTx or no PTx and were evaluated at 6 months and at 1 yr. Main Outcome Measures: We compared changes (percentage of basal) of lumbar spine bone mineral density (BMD) between the two groups at 1 yr. Results: The change in BMD at lumbar spine was greater after PTx (+4.16 ± 1.13 for PTx vs. −1.12 ± 0.71 for no PTx; P = 0.0002). The change in BMD at the total hip was also significantly greater in the PTx group (+2.61 ± 0.71 for PTx vs. −1.88 ± 0.60 for no PTx; P = 0.0001). There was no difference in BMD after 1 yr between both groups at the one-third radius site. In comparison with those who did not undergo surgery, the PTx subjects, after 1 yr, showed significant differences in four quality of life measures as determined by the 36-item short form health survey scale: bodily pain (P = 0.001), general health (P = 0.008), vitality (P = 0.003), and mental health (P = 0.017). Conclusions: In patients with mild asymptomatic PHPT, successful PTx is followed by an improvement in BMD and quality of life. Most patients followed without surgery did not show evidence of progression.

This study examined the prevalence of Axis I and II psychopathology and its relationship with quality of life in candidates for bariatric surgery.

Recent studies indicate that the prevalence and 12-month incidence of mental disorders during pregnancy are similar to those of age-matched nonpregnant women. The aim of this study is to assess the prevalence, sociodemographic correlates, and functional impairment associated with Axis I disorders in women at the third month of pregnancy. 1066 women presenting at the Department of Obstetrics and Gynecology of the Azienda Ospedaliera Universitaria Pisana (Pisa, Italy) for the first ultrasound examination between the 12th and the 15th gestational weeks were recruited for participation in the Program "Perinatal Depression-Research and Screening Unit (PND-ReScU)" and were administered the Structured Clinical Interview for DSM-IV Axis I Disorders and the Work and Social Adjustment Scale. Study recruitment began in February 2004 and ended in March 2007. The prevalence of lifetime Axis I disorders at the third month of pregnancy was 50.4%. 255 women (23.9%) had 2 or more lifetime comorbid disorders. 26.3% met criteria for current Axis I disorders. Current comorbidity between depressive and anxiety disorders was found in 47 women (4.4%). One in 5 women presented with a current Axis I disorder, and a higher percentage met criteria for a lifetime Axis I disorder. Early detection of psychopathology at the beginning of pregnancy may help to plan an adequate treatment in order to achieve a better postpartum adjustment and to reduce the risk of adverse obstetrical and psychopathological outcome.