| Screening for primary hyperparathyroidism before thyroid surgery: A prospective study. | |
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MedLine Citation:
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PMID: 11894030 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Misdiagnosed primary hyperparathyroidism (PHPT) during thyroid surgery may lead to a difficult reoperation. Because PHPT is often asymptomatic, calcium measurements have been recommended before thyroid surgery, but no study has focused on the results of a prospective PHPT screening. METHODS: The prospective study of 748 patients consisted of 2-step screening of calcium measurement in all patients (normal range, 2.2 to 2.6 mmol/L, 8.8 to 10.4 mg/dL). If the calcium level was greater than 2.49 mmol/L (9.9 mg/dL), parathyroid hormone level (PTH; normal range, 11 to 65 pg/mL) and second calcium measurements were obtained. Positive screening was defined by 2 calcium levels greater than 2.49 mmol/L (9.9 mg/dL) and PTH level greater than 49 pg/mL. In patients with negative screening, we evaluated the number of parathyroid incidentalomas. In patients with positive screening, we rated parathyroid adenomas discovered as "easily accessible" or "requiring specific dissection." We assumed that the former could have been incidentally found by a surgeon unaware of calcium value. The cost estimation was based on French national health system databases. RESULTS: In the 9 patients with positive screening, 9 had parathyroid adenomas, 3 of them requiring specific dissection. In the 739 patients with negative screening, 12 had surgical incidentalomas and 2 had postoperative PHPT diagnosis. CONCLUSIONS: Our screening was not exhaustive, but it avoided a reoperation for missed PHPT in 3 patients. Population screening cost less than 3 reoperations. Other strategies, more exhaustive and/or cost-effective, should be investigated. |
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Authors:
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Anne Denizot; Frédéric Dadoun; Anne Meyer-Dutour; Pierre Alliot; Maxime Argème |
Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Surgery Volume: 131 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 2002 Mar |
Date Detail:
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Created Date: 2002-03-14 Completed Date: 2002-04-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
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Languages: eng Pagination: 264-9 Citation Subset: AIM; IM |
Affiliation:
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Service de Chirurgie Générale and Service des maladies métaboliques et nutrition, Centre Hospitalier et Universitaire de Marseille, Marseille, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Calcium / blood Child Female Health Care Costs Humans Hyperparathyroidism / blood, diagnosis* Male Mass Screening / economics, methods*, standards* Middle Aged Postoperative Period Prospective Studies Thyroid Gland / surgery* |
| Chemical | |
Reg. No./Substance:
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7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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