Pitfalls of using denosumab preoperatively to treat refractory severe hypercalcaemia.

A 40-year-old man, with a history of metastatic parathyroid carcinoma, status post primary tumour resection and lung metastasectomy, was hospitalised for persistent severe hypercalcaemia and elevated parathyroid hormone levels despite conventional management and escalating doses of cinacalcet. A single dose (120 mg) of denosumab was given and his calcium level plummeted from 14.8 mg/dL to 5.

Management of hyperglycemia in the non-intensive care patient: featuring subcutaneous insulin protocols.

Objective: To provide insulin protocols and adjustment guidance for management of hyperglycemia in common inpatient clinical scenarios.

Methods: We performed a PubMed search of pertinent existing literature from 1980 to 2010.

Results: Hyperglycemia is frequently encountered in general medical and surgical wards and has been linked to adverse clinical outcomes, prolonged hospital length of stay, and increased institutional care needs after discharge.

The cost-effectiveness of iodine 131 scintigraphy, ultrasonography, and fine-needle aspiration biopsy in the initial diagnosis of solitary thyroid nodules.

Objective: To compare the cost-effectiveness of fine-needle aspiration biopsy, iodine 131 scintigraphy, and ultrasonography for the initial diagnostic workup of a solitary palpable thyroid nodule.

Design: A deterministic cost-effectiveness analysis was conducted using a decision tree to model the diagnostic strategies.

Setting: A single, mid-Atlantic academic medical center.

Surgical management of amiodarone-induced thyrotoxicosis.

Objective: Amiodarone can cause thyroid dysfunction in patients with or without previous thyroid disease. With increased use from its placement in advanced cardiac life support guidelines and cardiac transplant programs, the incidence of amiodarone-induced thyrotoxicosis (AIT) will likely increase. Medical management is complex and nonuniform and frequently fails.