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The rPTH assay is a highly accurate and effective tool for predicting symptomatic hypocalcemia immediately after thyroidectomy. Routine utilization of this assay is recommended, because it will allow safe and timely discharge of normocalcemic patients and the early identification of patients requiring treatment of postthyroidectomy hypocalcemia.

The da Vinci Surgi cal System is a new and exc iting entrant into thefi eldof robotic technology. This sys tem is undergoing considerable research and is being pra ctically appli ed in general surgery, cardiothoracic surgery, urology, and gyneco logy. Wehave previo usly described our experience with the da Vinci sys tem in the laboratory selling, and we have revieweditspotential app licatio ns in otolaryngology. Here we present a case report ofthefirs t da Vinci-assisted excision of a vallecular cyst in a human. Although we initially encountered some difficulties in the setup , we were able to perform the proc edure with moderate ease and without complication. The p otential of the da Vinci sys tem in otolaryngology is prom ising. Further research is needed to exp lore all of its p ossible uses in ourfield.

Serum creatinine alone can be difficult to interpret as a measure of kidney function such that chronic kidney disease might be under-recognized in the general population. In the province of Ontario, Canada, all outpatient laboratories now report estimated glomerular filtration rate (eGFR) in addition to serum creatinine. To determine the impact of this reporting on clinical practice, we linked health administrative data for more than 8 million adults of age 25 years or older over an almost 10-year period and conducted a population-based intervention analysis with seasonal time-series modeling to determine overall trends in the number and type of patients seen by nephrologists. Compared to the period when only serum creatinines were reported, the number of patients seen in consultation by nephrologists increased after eGFR reporting by an average of 24% (an absolute increase of 2.9 consults per 100,000 adults), an increase of about 23 consults per nephrologist per year. The greatest increases were seen in women (39% increase) and those 80 years of age and older (58% increase). Our study found that eGFR reporting was associated with a sudden increase in the number of nephrology consults. However, it remains to be seen whether the routine reporting of eGFR results in improved treatment and outcomes for those with chronic kidney disease.

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