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Carsote M, Stanciu M, Popa FL, Gheorghe AM, Ciuche A, Nistor C. Pediatric Neuroendocrine Neoplasia of the Parathyroid Glands: Delving into Primary Hyperparathyroidism. Biomedicines 2023; 11:2810. [PMID: 37893182 PMCID: PMC10603939 DOI: 10.3390/biomedicines11102810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/07/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Our objective was to overview the most recent data on primary hyperparathyroidism (PHP) in children and teenagers from a multidisciplinary perspective. Methods: narrative review based on full-length, English-language papers (from PubMed, between January 2020 and July 2023). Results: 48 papers (14 studies of ≥10 subjects/study, and 34 case reports/series of <10 patients/study). Study-sample-based analysis: except for one case-control study, all of the studies were retrospective, representing both multicenter (n = 5) and single-center (n = 7) studies, and cohort sizes varied from small (N = 10 to 19), to medium-sized (N = 23 to 36) and large (N = 63 to 83); in total, the reviewed studies covered 493 individuals with PHP. Case reports/series (n = 34, N = 41): the mean ages studied varied from 10.2 to 14 years in case reports, and the mean age was 17 years in case series. No clear female predominance was identified, unlike that observed in the adult population. Concerning the assessments, there were four major types of endpoints: imaging data collection, such as ultrasound, 99mTc Sestamibi, or dual-phase computed tomography (CT); gene testing/familial syndrome identification; preoperative findings; and exposure to surgical outcome/preoperative drugs, like cinacalcet, over a 2.2-year median (plus two case reports of denosumab used as an off-label calcium-lowering agent). Single-gland cases (representing 85% of sporadic cases and 19% of genetic PHP cases) showed 100% sensitivity for neck ultrasounds, with 98% concordance with 99mTc Sestamibi, as well as a 91% sensitivity for dual-phase CT, with 25% of the lesions being ectopic parathyroids (mostly mediastinal intra-thymic). Case reports included another 9/41 patients with ectopic parathyroid adenomas, 3/41 with parathyroid carcinomas, and 8/41 subjects with brown tumors. Genetic PHP (which has a prevalence of 5-26.9%) mostly involved MEN1, followed by CDC73, CASR, RET, and CDKN1B, as well as one case of VHL. Symptomatic PHP: 70-100% of all cases. Asymptomatic PHP: 60% of genetic PHP cases. Renal involvement: 10.5% of a cohort with genetic PHP, 71% of sporadic PHP cases; 50% (in a cohort with a mean age of 16.7), 29% (in a cohort with a mean age of 15.2); 0% (in infancy) to 50-62% (in teenagers). Bone anomalies: 83% of the children in one study and 62% of those in two other studies. Gastrointestinal issues: 40% of one cohort, but the data are heterogeneous. Cure rate through parathyroidectomy: 97-98%. Recurrent PHP: 2% of sporadic PHP cases and 38% of familial PHP cases. Hungry bone syndrome: maximum rate of 34-40%. Case reports identified another 7/41 subjects with the same post-parathyroidectomy condition; a potential connection with ectopic presentation or brown tumors is suggested, but there are limited data. Minimally invasive thoracoscopic approaches for ectopic tumors seemed safe. The current level of statistical evidence on pediatric PHP qualifies our study- and case-sample-based analysis (n = 48, N = 534) as one of the largest of its kind. Awareness of PHP is the key factor to benefit our young patients.
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Affiliation(s)
- Mara Carsote
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania;
| | - Mihaela Stanciu
- Department of Endocrinology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Victoriei Blvd., 550024 Sibiu, Romania
| | - Florina Ligia Popa
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Victoriei Blvd., 550024 Sibiu, Romania
| | - Ana-Maria Gheorghe
- C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania;
- Ph.D. Doctoral School, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adrian Ciuche
- Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.C.); (C.N.)
- Thoracic Surgery Department, Dr. Carol Davila Central Emergency University Military Hospital, 010825 Bucharest, Romania
| | - Claudiu Nistor
- Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.C.); (C.N.)
- Thoracic Surgery Department, Dr. Carol Davila Central Emergency University Military Hospital, 010825 Bucharest, Romania
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Zhu J, Wang Y, Yang C, Feng Z, Huang Y, Liu P, Chen F, Deng Z. circ-PSD3 promoted proliferation and invasion of papillary thyroid cancer cells via regulating the miR-7-5p/METTL7B axis. J Recept Signal Transduct Res 2021; 42:251-260. [PMID: 33858297 DOI: 10.1080/10799893.2021.1910706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Papillary thyroid cancer (PTC) is a common tumor malignancy of the endocrine system worldwide. Recently, circular RNAs (circRNAs) have been reported to participate in diverse pathological processes, especially in tumorigenesis. However, the functional role and mechanism of circRNA pleckstrin and Sec7 domain containing 3 (circ-PSD3) in PTC are still unclear. In this study, qRT-PCR results showed that circ-PSD3 was significantly upregulated in PTC tissues and cell lines. Meanwhile, circ-PSD3 overexpression was positively associated with larger tumor size, TNM stage, and lymph node metastasis. Knockdown of circ-PSD3 suppressed the proliferation and invasion of PTC cells. Besides, circ-PSD3 interacted with miR-7-5p to reduce its expression, and methyltransferase like 7B (METTL7B) was verified as a target gene of miR-7-5p. Functionally, inhibition of circ-PSD3 impeded PTC cell proliferation and invasion via targeting miR-7-5p to downregulate METTL7B expression. Taken together, silencing of circ-PSD3 hampered the proliferation and invasion of PTC cells via upregulating the inhibitory effect of miR-7-5p on METTL7B expression. Therefore, circ-PSD3 could be a potential diagnostic biomarker or molecular treatment target for PTC.
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Affiliation(s)
- Jialun Zhu
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Yongbin Wang
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Chuanzhou Yang
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Zhiping Feng
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Yanni Huang
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Pengjie Liu
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Fukun Chen
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
| | - Zhiyong Deng
- Department of Nuclear Medicine, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, People's Republic of China
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Lan X, Gao H, Wang F, Feng J, Bai J, Zhao P, Cao L, Gui S, Gong L, Zhang Y. Whole-exome sequencing identifies variants in invasive pituitary adenomas. Oncol Lett 2016; 12:2319-2328. [PMID: 27698795 PMCID: PMC5038494 DOI: 10.3892/ol.2016.5029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 03/18/2016] [Indexed: 12/24/2022] Open
Abstract
Pituitary adenomas exhibit a wide range of behaviors. The prediction of invasion or malignant behavior in pituitary adenomas remains challenging. The objective of the present study was to identify the genetic abnormalities associated with invasion in sporadic pituitary adenomas. In the present study, the exomes of six invasive pituitary adenomas (IPA) and six non-invasive pituitary adenomas (nIPA) were sequenced by whole-exome sequencing. Variants were confirmed by dideoxynucleotide sequencing, and candidate driver genes were assessed in an additional 28 pituitary adenomas. A total of 15 identified variants were mainly associated with angiogenesis, metabolism, cell cycle phase, cellular component organization, cytoskeleton and biogenesis immune at a cellular level, including 13 variants that occurred as single nucleotide variants and 2 that comprised of insertions. The messenger RNA (mRNA) levels of diffuse panbronchiolitis critical region 1 (DPCR1), KIAA0226, myxovirus (influenza virus) resistance, proline-rich protein BstNI subfamily 3, PR domain containing 2, with ZNF domain, RIZ1 (PRDM2), PR domain containing 8 (PRDM8), SPANX family member N2 (SPANXN2), TRIO and F-actin binding protein and zinc finger protein 717 in IPA specimens were 50% decreased compared with nIPA specimens. In particular, DPCR1, PRDM2, PRDM8 and SPANXN2 mRNA levels in IPA specimens were approximately four-fold lower compared with nIPA specimens (P=0.003, 0.007, 0.009 and 0.004, respectively). By contrast, the mRNA levels of dentin sialophospho protein, EGF like domain, multiple 7 (EGFL7), low density lipoprotein receptor-related protein 1B and dynein, axonemal, assembly factor 1 (LRRC50) were increased in IPA compared with nIPA specimens (P=0.041, 0.037, 0.022 and 0.013, respectively). Furthermore, decreased PRDM2 expression was associated with tumor recurrence. The findings of the present study indicate that DPCR1, EGFL7, the PRDM family and LRRC50 in pituitary adenomas are modifiers of tumorigenesis, and most likely contribute to the development of oncocytic change and to the invasive tumor phenotype.
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Affiliation(s)
- Xiaolei Lan
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China; Department of Neurosurgery, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong 266071, P.R. China
| | - Hua Gao
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Fei Wang
- Department of Neurosurgery, Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui 230032, P.R. China
| | - Jie Feng
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Jiwei Bai
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Peng Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 200050, P.R. China
| | - Lei Cao
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Songbai Gui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 200050, P.R. China
| | - Lei Gong
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Yazhuo Zhang
- Key Laboratory of Central Nervous System Injury Research, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
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Wijnen M, van den Heuvel-Eibrink MM, Medici M, Peeters RP, van der Lely AJ, Neggers SJCMM. Risk factors for subsequent endocrine-related cancer in childhood cancer survivors. Endocr Relat Cancer 2016; 23:R299-321. [PMID: 27229933 DOI: 10.1530/erc-16-0113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 05/26/2016] [Indexed: 12/12/2022]
Abstract
Long-term adverse health conditions, including secondary malignant neoplasms, are common in childhood cancer survivors. Although mortality attributable to secondary malignancies declined over the past decades, the risk for developing a solid secondary malignant neoplasm did not. Endocrine-related malignancies are among the most common secondary malignant neoplasms observed in childhood cancer survivors. In this systematic review, we describe risk factors for secondary malignant neoplasms of the breast and thyroid, since these are the most common secondary endocrine-related malignancies in childhood cancer survivors. Radiotherapy is the most important risk factor for secondary breast and thyroid cancer in childhood cancer survivors. Breast cancer risk is especially increased in survivors of Hodgkin lymphoma who received moderate- to high-dosed mantle field irradiation. Recent studies also demonstrated an increased risk after lower-dose irradiation in other radiation fields for other childhood cancer subtypes. Premature ovarian insufficiency may protect against radiation-induced breast cancer. Although evidence is weak, estrogen-progestin replacement therapy does not seem to be associated with an increased breast cancer risk in premature ovarian-insufficient childhood cancer survivors. Radiotherapy involving the thyroid gland increases the risk for secondary differentiated thyroid carcinoma, as well as benign thyroid nodules. Currently available studies on secondary malignant neoplasms in childhood cancer survivors are limited by short follow-up durations and assessed before treatment regimens. In addition, studies on risk-modifying effects of environmental and lifestyle factors are lacking. Risk-modifying effects of premature ovarian insufficiency and estrogen-progestin replacement therapy on radiation-induced breast cancer require further study.
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Affiliation(s)
- M Wijnen
- Department of Pediatric Oncology/HematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M M van den Heuvel-Eibrink
- Department of Pediatric Oncology/HematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands Princess Maxima Center for Pediatric OncologyUtrecht, the Netherlands
| | - M Medici
- Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands Rotterdam Thyroid CenterErasmus University Medical Center, Rotterdam, the Netherlands
| | - R P Peeters
- Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands Rotterdam Thyroid CenterErasmus University Medical Center, Rotterdam, the Netherlands
| | - A J van der Lely
- Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - S J C M M Neggers
- Department of Pediatric Oncology/HematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands Department of MedicineSection Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Barczyński M, Bränström R, Dionigi G, Mihai R. Sporadic multiple parathyroid gland disease--a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg 2015; 400:887-905. [PMID: 26542689 PMCID: PMC4747992 DOI: 10.1007/s00423-015-1348-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/05/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sporadic multiglandular disease (MGD) has been reported in literature in 8-33 % of patients with primary hyperparathyroidism (pHPT). This paper aimed to review controversies in the pathogenesis and management of sporadic MGD. METHODS A literature search and review was made to evaluate the level of evidence concerning diagnosis and management of sporadic MGD according to criteria proposed by Sackett, with recommendation grading by Heinrich et al. and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results were discussed at the 6th Workshop of the European Society of Endocrine Surgeons entitled 'Hyperparathyroidism due to multiple gland disease: An evidence-based perspective'. RESULTS Literature reports no prospective randomised studies; thus, a relatively low level of evidence was achieved. Appropriate surgical therapy of sporadic MGD should consist of a bilateral approach in most patients. Unilateral neck exploration guided by preoperative imaging should be reserved for selected patients, performed by an experienced endocrine surgeon and monitored by intraoperative parathormone assay (levels of evidence III-V, grade C recommendation). There is conflicting or equally weighted levels IV-V evidence supporting that cure rates can be similar or worse for sporadic MGD than for single adenomas (no recommendation). Best outcomes can be expected if surgery is performed by an experienced parathyroid surgeon working in a high-volume centre (grade C recommendation). Levels IV-V evidence supports that recurrent/persistence pHPT occurs more frequently in patients with double adenomas hence in situations where a double adenoma has been identified, the surgeon should have a high index of suspicion during surgery and postoperatively for the possibility of a four-gland disease (grade C recommendation). CONCLUSIONS Identifying preoperatively patients at risk for MGD remains challenging, intraoperative decisions are important for achieving acceptable cure rates and long-term follow-up is mandatory in such patients.
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Affiliation(s)
- Marcin Barczyński
- Department of Endocrine Surgery, Third Chair of General Surgery, Jagiellonian University Medical College, 37 Prądnicka Street, 31-202, Kraków, Poland.
| | - Robert Bränström
- Endocrine and Sarcoma Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Gianlorenzo Dionigi
- First Division of Surgery, Research Center for Endocrine Surgery, University of Insubria School of Medicine, Varese, Italy
| | - Radu Mihai
- Department of Endocrine Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
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Risk Assessment, Prevention, and Early Detection: Challenges for the Advanced Practice Nurse. Semin Oncol Nurs 2015; 31:306-26. [DOI: 10.1016/j.soncn.2015.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Shoag J, Eisner BH. Relationship between C-reactive protein and kidney stone prevalence. J Urol 2013; 191:372-5. [PMID: 24071479 DOI: 10.1016/j.juro.2013.09.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE We evaluated the relationship between serum C-reactive protein and the lifetime kidney stone prevalence. MATERIALS AND METHODS We performed a cross-sectional study of participants from the Continuous National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 and 2008 to 2009. Data were available on 11,033 participants. RESULTS On univariate analysis we noted a strong correlation between C-reactive protein quintile and kidney stone history. After adjusting for known confounders multivariate logistic regression revealed a significant relationship between C-reactive protein and the lifetime prevalence of kidney stones in younger individuals (age 20 to 39 years, p for trend = 0.002). In individuals 20 to 39 years old the lifetime prevalence of kidney stones increased with increasing C-reactive protein quintile (p = 0.002 for trend), specifically, those in the third quintile (OR 3.86, 95% CI 1.07-13.88, p = 0.04) and the fifth quintile (OR 3.85, 95% CI 1.46-10.17, p = 0.009). The fourth quintile of C-reactive protein approached statistical significance (OR 2.56, 95% CI 0.96-6.81, p = 0.059). The relationship between C-reactive protein and kidney stone history was not significant in the older age groups (40 to 59 and 60 years or greater). CONCLUSIONS There exists a significant relationship between serum C-reactive protein and self-reported kidney stones in younger individuals. This may shed light on potential mechanisms of stone formation in this age group and help gain a better understanding of stone risk mediators. Further studies are needed to understand the mechanisms underlying these epidemiological findings.
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Affiliation(s)
- Jonathan Shoag
- Departments of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, and Massachusetts General Hospital, Harvard Medical School (BHE), Boston, Massachusetts
| | - Brian H Eisner
- Departments of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, and Massachusetts General Hospital, Harvard Medical School (BHE), Boston, Massachusetts.
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Manchester CS. Multiple Endocrine Neoplasia. AACN Adv Crit Care 2013. [DOI: 10.4037/nci.0b013e31829b7eff] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Multiple endocrine neoplasia (MEN) is an array of tumors found in various endocrine glands throughout the human body. A wide spectrum of clinical manifestations accompanies this syndrome. The complexities of the glandular function and subtle development of symptoms can cause the diagnosis to be missed, and individuals with MEN can be an enigma to the care team. Appropriate differential diagnosis and assessment are critical for these individuals to receive optimal care. An interprofessional team of health care providers, including an endocrinologist and an advanced practice endocrine nurse, must work in concert to orchestrate a plan of care across the continuum. Those specialized nurses who encounter individuals with MEN in a critical care setting are positioned to support the patient, the family, and the care team through this maze of multiple endocrinopathies and tumors.
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Affiliation(s)
- Carol S. Manchester
- Carol S. Manchester is Diabetes Clinical Nurse Specialist, University of Minnesota Medical Center, Fairview, and University of Minnesota Amplatz Children’s Hospital, 420 Delaware St SE, MMC 732, Minneapolis, MN 55455
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