Publications by authors named "Julie A Miller"
Article Synopsis
- This study assesses the outcomes of adrenalectomy for pheochromocytoma in obese versus nonobese patients, using data from 46 centers from 2012 to 2022.
- It finds that while obesity does not significantly increase the rate of complications or comprehensive complication index (CCI), it does lead to a longer hospital stay for patients.
- Furthermore, minimally invasive surgical techniques, like laparoscopic and robotic surgeries, are associated with less morbidity in obese patients, and a retroperitoneal approach may provide additional benefits.
Background: Posterior retroperitoneoscopic adrenalectomy (PRA) for isolated adrenal metastasis is minimally invasive, may prolong survival and improve quality of life. The current evidence base is scant.
Methods: A multi-site retrospective analysis of all cases of PRA for adrenal metastasis between 2011 and 2023, by four high-volume adrenal surgeons was performed.
Background And Objective: Robotic adrenalectomy (RA) has attracted interest as an alternative to laparoscopic adrenalectomy (LA) for patients with pheochromocytoma, although its beneficial effects are uncertain. Our aim was to compare RA and LA outcomes for these patients.
Methods: Data for patients who underwent RA or LA for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed.
Objectives: The study aims to investigate the perceptions of patients with thyroid cancer on the potential impact of diagnosis and treatment delays during the COVID-19 pandemic.
Design: This study involved qualitative semi-structured telephone interviews. The interviews were transcribed verbatim, analysed using the thematic framework analysis method and reported using the Consolidated Criteria for Reporting Qualitative Research.
Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospective, multicentric, international study, according to the WHO classification, we identified the South East Asian Region (SEAR), the Americas Region (AMR), the Eastern Mediterranean Region (EMR), the Europe Region (EUR), and the Western Pacific Region (WPR).
View Article and Find Full Text PDFBackground: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours.
Methods: In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021.
Article Synopsis
- Pheochromocytomas and paragangliomas are rare neuroendocrine tumors linked to autonomic nerves, and this study uses advanced gene sequencing to analyze their cellular composition compared to normal adrenal tissues.* -
- The research identifies seven distinct gene-expression subtypes of PCPG, correlating them with specific genetic mutations and clinical characteristics, particularly highlighting the role of hypoxia and neoangiogenesis in tumors with certain mutations.* -
- The findings reveal that while the tumor cells show characteristics of mature chromaffin cells, some PCPG subtypes also exhibit early-stage chromaffin and neuroblast markers, and they suggest potential therapeutic targets like GPR139 for treatment.*
Article Synopsis
- - The study aimed to evaluate how Graves' disease (GD) is diagnosed and treated by clinicians across Asia and the Pacific, and to compare these practices with those in North America and Europe.
- - A survey collected responses from 542 clinicians, revealing that the majority preferred anti-thyroid drugs as the first-line treatment, and there were notable differences in diagnostic methods and treatments used compared to clinicians in Europe and North America.
- - Findings showed a predominant use of TSH-receptor autoantibody testing and anti-thyroid medications, with less reliance on nuclear medicine scans, highlighting distinct approaches within the APAC region in managing GD.
Article Synopsis
- The objective of the study was to create clinical recommendations for diagnosing and managing primary hyperparathyroidism (PHPT) in adults, based on evidence and expert consensus from Australia and New Zealand.
- The results emphasize the importance of measuring serum calcium and other related markers in patients with symptoms, reduced bone mineral density, or kidney stones, with parathyroidectomy being the only definitive treatment recommended for symptomatic cases.
- The conclusions aim to enhance clinical practice guidelines for PHPT management, ultimately improving health outcomes and reducing costs for the community.
Objective: To develop evidence-based recommendations to guide the surgical management and postoperative follow-up of adults with primary hyperparathyroidism.
Methods: Representatives from relevant Australian and New Zealand Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing eight key questions.
Results: Diagnostic imaging does not determine suitability for surgery but can guide the planning of surgery in suitable candidates.
Background: Minimally invasive adrenalectomy and advances in anaesthetic techniques have transformed surgery for phaeochromocytoma. This 17-year review describes the evolution of phaeochromocytoma care in our unit.
Methods: We performed a retrospective cohort review of all patients who underwent adrenalectomy for phaeochromocytoma from 2000 to 2016.
Background: Excessive waiting times for cancer elective surgery are a concern in publicly funded healthcare systems. Several countries including Australia have introduced healthcare reforms involving time-based targets and public performance reporting (PPR) of hospital data. However, there is mixed evidence of their benefits.
View Article and Find Full Text PDFBackground: Post-operative management after phaeochromocytoma resection includes monitoring of blood pressure and blood sugar, and vigilance for haemorrhage. Guidelines recommend 24 h of continuous blood pressure monitoring, usually necessitating HDU/ICU admission. We hypothesised that most patients undergoing phaeochromocytoma resection do not require post-operative HDU/ICU admission.
View Article and Find Full Text PDFBackground: The 2009 American Thyroid Association (ATA) three-tiered risk stratification, and its updated version in 2015, provided clearer guidance on the use of radioactive iodine (RAI) ablation in differentiated thyroid cancer (DTC) patients. This study examines the impact of these guidelines on RAI use in our institution.
Methods: Patients diagnosed with DTC during three different time periods (group 1: 2002-2006, group 2: 2010-2014 and group 3: 2017-2018) were identified and risk stratified according to the ATA guidelines.
Background: Practice variations exist amongst parathyroid surgeons depending on their expertise and resources. Our study aims to elucidate the choice of surgical techniques and adjuncts used in parathyroid surgery by surgeons in the Asia-Pacific region.
Methods: A 25-question online survey was sent to members of five endocrine surgery associations.
Introduction: The occurrence of thyroid cancer is increasing throughout the developed world and since the 1990s has become the fastest increasing malignancy. In 2014, a total of 2693 Australians and 302 New Zealanders were diagnosed with thyroid cancer, with this number projected to rise to 3650 in 2018. The purpose of this protocol is to establish a binational population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand.
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