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Pasquier P, Ficko C, Mérens A, Dubost C. Preparing an ICU room to welcome a critically ill patient with Ebola virus disease. Intensive Care Med 2014; 41:118-9. [PMID: 25431367 DOI: 10.1007/s00134-014-3562-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 11/10/2014] [Indexed: 11/30/2022]
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Pasquier P, Dubost C, Boutonnet M, Chrisment A, Villevieille T, Batjom E, Bordier E, Ausset S, Puidupin M, Martinez JY, Bay C, Escarment J, Pons F, Lenoir B, Mérat S. Predeployment training for forward medicalisation in a combat zone: the specific policy of the French Military Health Service. Injury 2014; 45:1307-11. [PMID: 24952973 DOI: 10.1016/j.injury.2014.05.037] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 05/22/2014] [Accepted: 05/28/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION To improve the mortality rate on the battlefield, and especially the potentially survivable pre-Medical Treatment Facility deaths, Tactical Combat Casualty Care (TCCC) is now considered as a reference for management of combat casualty from the point of injury to the first medical treatment facility. TCCC comprises of a set of trauma management guidelines designed for use on the battlefield. The French Military Health Service also standardised a dedicated training programme, entitled "Sauvetage au Combat" (SC) ("forward combat casualty care"), with the characteristic of forward medicalisation on the battlefield, the medical team being projected as close as possible to the casualty at the point of injury. The aim of our article is to describe the process and the result of the SC training. MATERIALS AND METHODS Records from the French Military Health Service Academy - École du Val-de-Grâce administration, head of the SC teaching programme, defining its guidelines, and supporting its structure and its execution, were examined and analyzed, since the standardisation of the SC training programme in 2008. The total number of trainees was listed following the different courses (SC1, SC2, SC3). RESULTS At the end of 2013, every deployed combatant underwent SC1 courses (confidential data), 785 health-qualified combatants were graduated for SC2 courses and 672 Role 1 physician-nurse pairs for SC3 courses. CONCLUSION The SC concept and programmes were defined in France in 2007 and are now completely integrated into the predeployment training of all combatants but also of French Military Health Service providers. Finally, SC teaching programmes enhance the importance of teamwork in forward combat medicalisation settings.
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Dubost C, Pasquier P, Salvadori A, Mérat S, Benhamou D, Geeraerts T. Cerebrospinal fluid pressure after epidural blood patching. Int J Obstet Anesth 2014; 23:286. [PMID: 24934310 DOI: 10.1016/j.ijoa.2014.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/05/2014] [Indexed: 11/28/2022]
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Schaal JV, Pasquier P, Renner J, Dubost C, Mérat S. Ultrasounds for prehospital recognition of tension pneumothorax. Injury 2014; 45:1019. [PMID: 24332162 DOI: 10.1016/j.injury.2013.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 11/17/2013] [Indexed: 02/02/2023]
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Pasquier P, Malgras B, Savoie PH, Chrisment A, Dubost C, Mérat S. Application of negative-pressure wound therapy for the management of battlefield scrotum trauma. Injury 2013; 44:1250-1. [PMID: 23726143 DOI: 10.1016/j.injury.2013.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/11/2013] [Indexed: 02/02/2023]
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Dubourg J, Messerer M, Karakitsos D, Rajajee V, Antonsen E, Javouhey E, Cammarata A, Cotton M, Daniel RT, Denaro C, Douzinas E, Dubost C, Berhouma M, Kassai B, Rabilloud M, Gullo A, Hamlat A, Kouraklis G, Mannanici G, Marill K, Merceron S, Poularas J, Ristagno G, Noble V, Shah S, Kimberly H, Cammarata G, Moretti R, Geeraerts T. Individual patient data systematic review and meta-analysis of optic nerve sheath diameter ultrasonography for detecting raised intracranial pressure: protocol of the ONSD research group. Syst Rev 2013; 2:62. [PMID: 23919384 PMCID: PMC3751128 DOI: 10.1186/2046-4053-2-62] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 06/20/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The purpose of the optic nerve sheath diameter (ONSD) research group project is to establish an individual patient-level database from high quality studies of ONSD ultrasonography for the detection of raised intracranial pressure (ICP), and to perform a systematic review and an individual patient data meta-analysis (IPDMA), which will provide a cutoff value to help physicians making decisions and encourage further research. Previous meta-analyses were able to assess the diagnostic accuracy of ONSD ultrasonography in detecting raised ICP but failed to determine a precise cutoff value. Thus, the ONSD research group was founded to synthesize data from several recent studies on the subject and to provide evidence on the diagnostic accuracy of ONSD ultrasonography in detecting raised ICP. METHODS This IPDMA will be conducted in different phases. First, we will systematically search for eligible studies. To be eligible, studies must have compared ONSD ultrasonography to invasive intracranial devices, the current reference standard for diagnosing raised ICP. Subsequently, we will assess the quality of studies included based on the QUADAS-2 tool, and then collect and validate individual patient data. The objectives of the primary analyses will be to assess the diagnostic accuracy of ONSD ultrasonography and to determine a precise cutoff value for detecting raised ICP. Secondly, we will construct a logistic regression model to assess whether patient and study characteristics influence diagnostic accuracy. DISCUSSION We believe that this IPD MA will provide the most reliable basis for the assessment of diagnostic accuracy of ONSD ultrasonography for detecting raised ICP and to provide a cutoff value. We also hope that the creation of the ONSD research group will encourage further study. TRIAL REGISTRATION PROSPERO registration number: CRD42012003072.
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Dubost C, Arnaud FX, Geeraerts T. Cerebrospinal fluid hypovolemia. J Neurosurg 2013; 118:704-5. [PMID: 23289818 DOI: 10.3171/2012.11.jns121723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Dubost C, Motuel J, Geeraerts T. [Non-invasive evaluation of intracranial pressure: how and for whom?]. ACTA ACUST UNITED AC 2012; 31:e125-32. [PMID: 22683401 DOI: 10.1016/j.annfar.2012.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The invasive monitoring of intracranial pressure is useful in circumstances associated with high-risk of raised intracranial pressure. However the placement of intracranial probe is not always possible and non-invasive assessment of intracranial pressure may be useful, particularly in case of emergencies. Transcranial Doppler measurements allow the estimation of perfusion pressure with the pulsatility index. Recently, new ultrasonographic methods of cerebral monitoring have been developed: the diameter of the optic nerve sheath diameter, a surrogate marker of raised intracranial pressure and the estimation of median shift line deviation.
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Dubost C, Geeraerts T. Possible Pitfalls When Measuring the Optic Nerve Sheath with Sonography. J Surg Res 2012; 173:e43-4; author reply e44-5. [DOI: 10.1016/j.jss.2011.08.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 08/22/2011] [Accepted: 07/18/2011] [Indexed: 11/26/2022]
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Schaal JV, Dubost C, De Rudnicki S, Merat S, Auroy Y. Intratracheal instillation of epinephrine in life-threatening hemoptysis. Minerva Anestesiol 2011; 77:758. [PMID: 21709665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Dubost C, Le Gouez A, Zetlaoui PJ, Benhamou D, Mercier FJ, Geeraerts T. Increase in optic nerve sheath diameter induced by epidural blood patch: a preliminary report. Br J Anaesth 2011; 107:627-30. [PMID: 21693468 DOI: 10.1093/bja/aer186] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Post-dural puncture headache (PDPH) might be related to cerebrospinal fluid hypotension. Studies in brain-injured patients have shown a good relationship between optic nerve sheath diameter (ONSD) measured by ocular sonography and invasively measured intracranial pressure (ICP). The aim of this study was to evaluate changes in ONSD after lumbar epidural blood patch (EBP). METHODS Consecutive subjects receiving an EBP for PDPH were included. ONSD and pain measurements were performed before (T(0)), 10 min (M(10)), 2 h (H(2)), and 20 h (H(20)) after the EBP. RESULTS Ten subjects were included. ONSD [median (inter-quartile range)] increased with time after EBP, from 4.8 mm (4.5-5.1) at T(0) to 5.2 mm (4.9-5.7) at M(10) (P=0.005 vs T(0)), 5.5 mm (5.1-6.0) at H(2) (P=0.007 vs T(0)), and 5.8 mm (5.2-6.3) at H(20) (P=0.02 vs T(0)). EBP was clinically successful in nine of 10 subjects. In subjects in whom EBP was successful, ONSD significantly increased at M(10) and T(2) compared with T(0) (P=0.004 and 0.008, respectively) but did not reach statistical significance at H(20) (P=0.06). In the subject in whom EBP failed, a small increase in ONSD was observed over time. CONCLUSIONS In this preliminary report, EBP was followed by ONSD enlargement in subjects with successful EBP, but not in the subject with EBP failure. Since ONSD is a surrogate marker of ICP, this suggests that a sustained increase in ICP is associated with successful EBP.
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Dubost C, Vest P, Pelletier C, Mégarbane B, Rousseau JM. [Milnacipram intoxication during multi-intoxication: interest of toxicologic screening]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2010; 29:169. [PMID: 20074893 DOI: 10.1016/j.annfar.2009.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 12/03/2009] [Indexed: 05/28/2023]
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Libert N, Schérier S, Dubost C, Franck L, Rouquette I, Tortosa JC, Rousseau JM. Prise en charge anesthésique d’un accouchement chez une patiente atteinte d’un déficit en inhibiteur de C1 estérase. ACTA ACUST UNITED AC 2009; 28:375-80. [DOI: 10.1016/j.annfar.2009.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 02/25/2009] [Indexed: 10/20/2022]
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Geeraerts T, Dubost C. Theme: Neurology - Optic nerve sheath diameter measurement as a risk marker for significant intracranial hypertension. Biomark Med 2009; 3:129-37. [DOI: 10.2217/bmm.09.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Raised intracranial pressure (ICP) is a frequent condition in many medical and surgical situations and is often difficult to detect. Noninvasive estimates of raised ICP are of interest to allow rapid detection of significant intracranial hypertension. In the anterior part of the optic nerve, the sheath is distensible and can inflate in the case of raised pressure in the cerebrospinal fluid. Measurement of optic nerve sheath diameter using ocular sonography or MRI has been shown to correctly estimate the risk of raised ICP in various settings, including traumatic brain injury. Ocular sonography is simple, rapid, noninvasive and can be performed at the patient’s bedside, but it requires training and experience. The cut-off value for ICP greater than 20 mmHg is 5.8 mm, with a 90% probability of correct diagnosis. When raised ICP is suspected, but invasive ICP monitoring cannot be used or is not clearly recommended, this estimation of the risk of raised ICP may be of great clinical value, aiding in the detection of patients at risk of raised ICP.
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Batjom E, Franck L, Dubost C, Rouquette-Vincenti I. [When an antibiotic becomes toxic]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2009; 28:105-106. [PMID: 19101108 DOI: 10.1016/j.annfar.2008.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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D’allaines F, Lenègre J, Dubost C, Scébat L, Mathivat M. L’anastomose veineuse azygo-pulmonaire dans le traitement du rétrécissement mitral œdémateux. Cardiology 2008. [DOI: 10.1159/000164914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Dragin N, Smani M, Arnaud-Dabernat S, Dubost C, Moranvillier I, Costet P, Daniel JY, Peuchant E. Acute oxidative stress is associated with cell proliferation in the mouse liver. FEBS Lett 2006; 580:3845-52. [PMID: 16797015 DOI: 10.1016/j.febslet.2006.06.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2006] [Accepted: 06/01/2006] [Indexed: 12/18/2022]
Abstract
Oxidative stress is known to produce tissue injury and to activate various signaling pathways. To investigate the molecular events linked to acute oxidative stress in mouse liver, we injected a toxic dose of paraquat. Liver necrosis was first observed, followed by histological marks of cell proliferation. Concomitantly, activation of the MAP kinase pathway and increased levels of the anti-apoptotic protein Bcl-XL were observed. Gene expression profiles revealed that the differentially expressed genes were potentially involved in cell proliferation. These data suggest that paraquat-induced acute oxidative stress triggers the activation of regeneration-related events in the liver.
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Dubost C. Need for surgical wound dressing. Br J Surg 2005. [DOI: 10.1002/bjs.1800760740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dubost C, Chaubin F. [Aortic aneurysms. Technique--indications--results. 1958]. ANNALES DE CHIRURGIE 1998; 51:531-6. [PMID: 9432953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Dubost C, Blondeau P, Lenfant C, Passelecq J, Guéry J, Weiss M, de Balsac H. [Twenty four open heart interventions under extracorporeal circulation. 1957]. ANNALES DE CHIRURGIE 1998; 51:505-23. [PMID: 9432950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Sarfati E, Billotey C, Halimi B, Fritsch S, Cattan P, Dubost C. Early localization and reoperation for persistent primary hyperparathyroidism. Br J Surg 1997; 84:98-100. [PMID: 9043469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Reoperation for persistent primary hyperparathyroidism is often performed after a delay of 4-6 months. Success can be expected in over 90 per cent of cases but exploration is technically difficult and there is the possibility of creating permanent hypoparathyroidism and vocal cord paralysis. This is a study of early localization and reoperation. METHODS In a consecutive series of 273 patients who had surgery for primary hyperparathyroidism, three remained hypercalcaemic and in three the abnormal parathyroid was not found at initial exploration. They underwent early (6-48 h) single-tracer 99mTc Sestamibi scintigraphy with factor analysis of dynamic structures (FADS) and single photon emission computed tomography (SPECT) followed by reoperation within 24-72 h. RESULTS Scintigraphy with FADS and SPECT was helpful in all six patients, who were cured by reoperation with no morbidity or symptomatic hypocalcaemia. CONCLUSION Reoperation for persistent primary hyperparathyroidism is possible and may be easier within days of an initially unsuccessful procedure. With the intact 1-84 parathyroid hormone measurement, the diagnosis is accurate. Single-tracer 99mTc Sestamibi scintigraphy with FADS and SPECT is non-invasive, easily and rapidly performed, and was accurate in these six patients.
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Sarfati E, Billotey C, Halimi B, Fritsch S, Cattan P, Dubost C. Early localization and reoperation for persistent primary hyperparathyroidism. Br J Surg 1997. [DOI: 10.1046/j.1365-2168.1997.02413.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sarfati E, Billotey C, Halimi B, Fritsch S, Cattan P, Dubost C. Early localization and reoperation for persistent primary hyperparathyroidism. Br J Surg 1997. [DOI: 10.1002/bjs.1800840137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Sarfati E, Dubost C. Posterior mediastinal parathyroid adenoma and hyperparathyroid crisis. Surgery 1994; 115:661-2. [PMID: 8031378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Gagné ER, Ureña P, Leite-Silva S, Zingraff J, Chevalier A, Sarfati E, Dubost C, Drüeke TB. Short- and long-term efficacy of total parathyroidectomy with immediate autografting compared with subtotal parathyroidectomy in hemodialysis patients. J Am Soc Nephrol 1992; 3:1008-17. [PMID: 1450363 DOI: 10.1681/asn.v341008] [Citation(s) in RCA: 117] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A retrospective study was performed in chronic hemodialysis patients comparing total parathyroidectomy (PTX) followed by immediate autografting (IA) (total PTX+IA) with subtotal parathyroidectomy (subtotal PTX). One hundred six patients with severe, uncontrolled hyperparathyroidism were referred to this center and underwent surgery during the period from 1980 to 1990. Long-term follow-up after PTX was available in 49 of them: 28 patients had total PTX+IA and 21 had subtotal PTX. The two surgical methods were evaluated with respect to preoperative severity of hyperparathyroidism, immediate postoperative results, and long-term parathyroid status, as evaluated by an RIA measuring intact immunoreactive parathyroid hormone (intact iPTH; normal values, 15 to 65 pg/mL). The initial degree of hyperparathyroidism was comparable in the two groups. An excellent short-term control of hyperparathyroidism was achieved in the great majority (95%) of patients with either surgical procedure. However, long-term normalization of parathyroid gland activity was achieved in only one third of patients whereas 33% had elevated intact iPTH levels (> 130 pg/mL; i.e., higher than twice the upper range of normal) and 32% had low intact iPTH levels (< 15 pg/mL), consistent with permanent hypoparathyroidism. No difference was found in the immediate failure rates: 0 of 28 cases after total PTX+IA compared with 2 of 21 cases after subtotal PTX. Similarly, long-term intact iPTH levels were comparable: 400 +/- 105 versus 212 +/- 82 pg/mL (mean +/- SE; P = not significant). Interestingly, long-term serum intact iPTH levels were higher in patients with nodular (N = 18) than with diffusely (N = 26) hyperplastic glands: 556 +/- 146 versus 126 +/- 52 pg/mL (P < 0.001) and recurrence of hyperparathyroidism was more frequent with nodular hyperplasia (11 of 18) than with diffuse hyperplasia (4 of 26) (P < 0.02). In conclusion, although excellent short-term results were obtained with both procedures, satisfactory long-term control of parathyroid gland function was achieved in only one third of the patients, the other two third remaining either hypoparathyroid or developing recurrent hyperparathyroidism. Last, the histological subtype of parathyroid glands was partially predictive of the recurrence of hyperparathyroidism.
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