title: Do patients undergoing parathyroidectomy for primary hyperparathyroidism in San Francisco, CA, and Bursa, Turkey, differ?
abstract: BACKGROUND
  To compare the preoperative clinical symptoms and associated conditions and findings in operations in age- and sex-matched patients with primary hyperparathyroidism (PHPT) living in the two different regions of the world to determine whether PHPT differs in various countries.
  
  
  METHODS
  Fifty-two patients from Bursa, Turkey were matched with 52 age and sex matched patients from San Francisco, USA. Patients' preoperative symptoms, biochemical and radiologic findings and surgical procedures were documented.
  
  
  RESULTS
  More patients in the American Group (15%) had preoperatively persistant or recurrent hyperparathyroidism, P = 0.016. Serum parathyroid hormone levels were higher in Turkish group (546 +/- 75.33 pg/mL) than in American group (146 +/- 75.33 pg/mL). More Turkish patients had osteoporosis (P < 0.05). The size of parathyroid adenomas was significantly greater in Turkish patients (25.2 +/- 1.18 mm) than in American patients (17.5 +/- 1.18 mm), P < 0.001.
  
  
  CONCLUSIONS
  Patients with PHPT from Bursa, Turkey have higher plasma parathyroid hormone levels, larger parathyroid adenomas and more severe bone disease than in age and sex matched patients with PHPT in San Francisco.
authors.affiliation: Department of Surgery, University of California at San Francisco/Mount Zion Medical Center, San Francisco, CA, USA. tkirdak@uludag.edu.tr
authors.forename: Turkay
authors.initials: T
authors.lastname: Kirdak
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
authors.forename: Electron
authors.initials: E
authors.lastname: Kebebew
authors.forename: Orlo Herrick
authors.initials: OH
authors.lastname: Clark
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000768:Anesthesia, General / Q000706:statistics & numerical data; D000772:Anesthesia, Local / Q000706:statistics & numerical data; D002118:Calcium / Q000097:blood / Q000652:urine; D002140:California / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009377:Multiple Endocrine Neoplasia / Q000453:epidemiology; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy; D010758:Phosphorus / Q000097:blood; D011859:Radiography; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D003404:Creatinine; D000469:Alkaline Phosphatase; D002118:Calcium