Reducing pain by using venous blood gas instead of arterial blood gas (VEINART): a multicentre randomised controlled trial.

Introduction: Venous sampling for blood gas analysis has been suggested as an alternative to arterial sampling in order to reduce pain. The main objective was to compare pain induced by venous and arterial sampling and to assess whether the type of sampling would affect clinical management or not.

Methods: We performed an open-label randomised multicentre prospective study in four French EDs during a 4-week period.

[Limits of parathyroid scintigraphy before surgery for hyperparathyroidism of renal origin].

Aim Of The Study: To evaluate the results of parathyroid scinti scans (sestamibi or tetrofosmin) for detection of hyperplastic parathyroid glands responsible for renal hyperparathyroidism.

Methods: Injection of 15 mCi sestamibi or tetrofosmin and gammacamera acquisition of images focused on neck and mediastinum, 20 minutes and 2 hours thereafter. Injection of 150 mCi Iodine 123, acquisition of images 2 hours afterwards and visual subtraction.

Late outcome of 304 consecutive patients with multiple gland enlargement in primary hyperparathyroidism treated by conservative surgery.

The aim of this study was to assess the late outcome of patients with primary hyperparathyroidism and multiple gland enlargement (MGE) treated by conservative surgery. MGE in primary hyperparathyroidism is the presence of two or more enlarged glands weighing more than 50 mg. Conservative surgery consists in resecting the grossly enlarged glands without biopsying the normal glands.

Pancreatitis and primary hyperparathyroidism: forty cases.

Background: Pancreatitis is associated with primary hyperparathyroidism (PHPT) in 1.5-7% of cases. The relationship of cause and effect between the two diseases has been debated.

Improvements in parathyroid surgery in the intact 1-84 PTH assay era.

Background: Measurement of intact 1-84 parathormone (PTH) level by immunometric assays has been an important tool in the medical management of hypercalcaemia. The aim of the present study was to evaluate its practical contribution in the diagnosis and surgical treatment of primary hyperparathyroidism.

Methods: The results of surgery were compared (number of failed and inadequate cervicotomies, number of overlooked cervical glands) in two groups of primary hyperparathyroid patients operated on without (group I, n = 624) and with (group II, n = 360) intact PTH evaluation.

Localization of abnormal parathyroid glands with jugular sampling for parathyroid hormone, and subtraction scanning with sestamibi or tetrofosmine.

Background: Accurate pre-operative localization of abnormal parathyroid glands is an essential prerequisite for elective surgical approaches such as the unilateral approach for treatment of primary hyperparathyroidism.

Methods: In 175 patients undergoing a bilateral neck exploration for primary hyperparathyroidism, localization of abnormal parathyroid glands was performed with jugular venous sampling for parathyroid hormone (PTH, n = 75), subtraction scan with iodine 123 and technetium-99m-sestamibi (MIBI, n = 50), or tetrofosmine (TTF, n = 50). The results of these localization studies were compared with operative findings.

Parathyroid incidentalomas in normocalcemic patients during thyroid surgery.

The aim of this study was to compare the clinical, biochemical, and pathologic findings of normocalcemic patients with macroscopically enlarged parathyroid tissue identified at thyroid surgery with those of patients treated surgically for preoperatively proved primary hyperparathyroidism (PHPT). The records of 28 patients with incidental parathyroid enlargement and 533 patients with PHPT were reviewed to compare age, sex, serum calcium and phosphate, intact parathyroid hormone (iPTH), parathyroid weight, number of diseased glands, cell and histologic types, PTH content, and cure rate. Incidentally found lesions were lighter and developed in younger patients.