Please select the eligibility criteria that correspond to the clinical trial below.
Title: Primary Hyperparathyroidism: Short-term Calcimimetics Treatment - Relevance for Parathyroid Surgery Decisions?
Brief Summary: Patients with primary hyperparathyroidism (pHPT) often present with fatigue, psychological and cognitive symptoms. Improvement in these symptoms after parathyroid adenomectomy (PTX) has been reported. But physicians lack a method to attribute the symptoms to pHPT and to predict the reversibility after PTX.

This study aims to evaluate short-term calcimimetic treatment as a tool for predicting the outcome of PTX on muscle strength, quality of life, psychological symptoms, and cognitive function in patients with pHPT.

Material and Methods: 118 patients scheduled for PTX at Karolinska University Hospital, Sweden, will have a four week treatment with calcimimetics (Mimpara®) before undergoing surgery. Biochemicals, muscle strength, quality of life, psychological symptoms and cognitive function will be analysed at baseline, after four week follow-up and postoperatively.

Hypothesis: The outcome of short-term calcimimetic treatment can predict the outcome of PTX on muscle strength, quality of life, psychological symptoms, and cognitive function in patients with pHPT


Options:
A: Inclusion Criteria:

* Primary hyperparathyroidism
* Referred to Aarhus University Hospital with the diagnose; primary hyperparathyroidism
* Participant is over 18 years old, able to understand and sign consent form

Exclusion Criteria:

* Familial hypocalciuric hypercalcaemia
* Multiple endocrine neoplasia (MEN)
* Parathyroid cancer
* Renal disease - GFR \< 60 ml/min
* Major heart surgery
* Known coronary heart disease
* NYHA III-IV
* Known with pacemaker
* Arrhythmia e.g. atrial fibrillations or flutter, Second- and third-degree atrioventricular block, sinoatrial depolarization of \< 40 or \> 160 beats per minute.
* Ongoing treatment with beta-blockers
* Severe manifest osteoporosis with multiple fractures
* Severe hypercalcemia: p-ionised calcium \> 1.70 mmol/L
B: Inclusion Criteria:

* Primary hyperparathyroidism subjected to parathyroid surgery

Exclusion Criteria:

* Renal insufficiency
* Severe osteoporosis
* Pregnancy
C: Inclusion Criteria:

* Primary hyperparathyroidism
* Scheduled for parathyroid surgery
* Age \>40
* Ability to participate in all tests included in the study model
* Signed consent

Exclusion Criteria:

* Pregnancy
* Breast feeding
* Fertile woman not using contraceptives (IUD or pills)
* Impaired kidney function, GFR \< 40 ml/min
* Intolerance to Mimpara®
* Previously treated with Mimpara®
* Participating in other ongoing clinical study
* Epilepsy
* Severe hepatic impairment
* Hypotension
* Heart failure (NYHA class 3-4, symptoms with minimal exertion)
* Medication with ketoconazole (oral) or tricyclic antidepressants
D: Inclusion Criteria:

* Untreated, asymptomatic pHPT
* 2.60\>S-Ca\<2.85 mmol/liter
* Age between 50 and 80 yr
* No medications interfering with Ca-metabolism
* Informed consent

Exclusion Criteria:

* Hyperparathyroid bone disease
* Previous operation in the neck
* Impaired kidney function
* Kidney stones
* Complicating medical conditions
* Psychiatric disorders
* Multiple endocrine neoplasia,
* Familial hypocalcuric hypercalcemia
* Familial HPT

Answer: C