Clinical endocrinology
-
Clinical endocrinology · Jun 2007
Multicenter Study Clinical TrialA prospective, multicentre study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting repeatable octreotide) in the primary therapy of patients with acromegaly.
To evaluate the efficacy, safety and tolerability of octreotide LAR (long-acting repeatable octreotide) in the primary therapy of acromegaly. ⋯ Octreotide LAR represents a viable alternative to surgery for primary treatment of acromegaly leading to a progressive regression of tumour volume, a sustained control of biochemical abnormalities and an adequate relief of symptoms of the disease.
-
Clinical endocrinology · Jun 2007
Clinical TrialIntraoperative parathyroid hormone assay improves outcomes of minimally invasive parathyroidectomy mainly in patients with a presumed solitary parathyroid adenoma and missing concordance of preoperative imaging.
Intraoperative parathyroid hormone assay (IOPTH) is often used during minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, several investigators have reported conflicting outcomes, throwing doubt on the real influence of this adjunct on surgical decision-making. The aim of this study was to determine the impact of routine use of IOPTH on the success rate of MIP as the primary outcome, and whether it value-added to surgical decision-making during the operations at our institution. ⋯ Routine use of IOPTH significantly improves cure rates of MIP in comparison to open image-guided UNE without IOPTH. It is a valuable adjunct in surgical decision-making, allowing for intraoperative recognition and resection of additional hyperfunctioning parathyroid tissue missed by preoperative imaging studies. IOPTH offers substantial value-adding to surgical decision-making, particularly in patients with only one positive imaging study result, and significantly improves the success rate of MIP in these patients. However, in patients with concordant results of two imaging studies, the assay offers significantly lower value-adding to surgical decisions, as a vast majority of patients are cured after removal of a two-image-indexed parathyroid lesion. Despite this, we strongly advocate routine use of IOPTH in all patients undergoing MIP, as this adjunct offers maximum safety for the patient and confidence for the surgeon.
-
Clinical endocrinology · Jun 2007
Quality of life and psychiatric sequelae following aneurysmal subarachnoid haemorrhage: does neuroendocrine dysfunction play a role?
Patients who have sustained aneurysmal subarachnoid haemorrhage (SAH) often suffer persistent impairments in their quality of life (QoL) and psychological disturbances despite a good neurological outcome. In the light of the high prevalence of partial hypopituitarism in SAH survivors demonstrated in recent investigations, we aimed to determine whether neuroendocrine dysfunction has an impact on QoL and neurobehavioural symptoms in these patients. ⋯ Our results provide preliminary data that neuroendocrine disturbances contribute to disturbed QoL, depression and sleeping disturbances in SAH patients.