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Povzetek: Minimally invasive parathyroidectomy is the treatment of choice in patients with primary hyperparathyroidism (PHP), but it needs a reliable preoperative localization method to detect hyperfunctioning parathyroid tissue. Higher sensitivity and lower radiation exposure was demonstrated for [18F]fluorocholine PET/CT (FCh-PET/CT) in comparison to [99mTc]sestamibi (MIBI) scintigraphy. However, data of its efficiency in resource use and patient outcomes is lacking. The aim of our study was to determine the resource efficiency and patient outcomes of FCh-PET/CT in comparison to conventional MIBI scintigraphy. Patients and methods A group of 234 patients who underwent surgery after MIBI scintigraphy was compared to a group of 163 patients who underwent surgery after FCh-PET/CT. The whole working process from the implementation of imaging to the completion of surgical treatment was analyzed. The economic burden was expressed in the time needed for the required procedures. Results The time needed to perform imaging was reduced by 83% after FCh-PET/CT in comparison to MIBI scintigraphy. The time needed to perform surgery was reduced by 41% when intraoperative parathyroid hormone monitoring was not used. There was no significant difference in the time of surgery between FCh-PET/CT and MIBI scintigraphy. Conclusions FCh-PET/CT reduces the time of imaging, the time of surgery and potentially reduces the number of reoperations for persistent disease.
Ključne besede: hyperparathyroidism, parathyroidectomy, cost-effectiveness
Objavljeno v DiRROS: 26.06.2026; Ogledov: 195; Prenosov: 78
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Ključne besede: melanom, kožni raki, onkološko zdravljenje
Objavljeno v DiRROS: 20.05.2026; Ogledov: 246; Prenosov: 180
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Povzetek: Background: Primary hyperparathyroidism (PHPT) is a relatively common disease with considerable heterogeneity. We aimed to assess the impact of age, gender, and body mass index (BMI) on the presentation of PHPT. Material and methods: We retrospectively analyzed the baseline biochemical status, symptoms, renal manifestations, and bone mineral density (BMD) of patients diagnosed with PHPT at the national tertiary endocrine referral clinic from January 2004 to December 2016. Results: We included 415 patients [333 women (41 premenopausal, 292 postmenopausal) and 82 men] with PHPT, aged 64 years on average [standard deviation (SD) 13, range 19–89 years], with an average BMI of 28.4 (SD 6.0, range 11.2–51.1 kg/m2). Older age was statistically significantly associated with milder biochemical presentation — lower total and corrected calcium (standardized regression coefficient β = –0.17, p < 0.001 and β = –0.12, p = 0.018). In comparison with premenopausal women, postmenopausal women [estimated odds ratio (OR) = 8.6, 95% confidence interval (CI): 3.9–20.8; p < 0.001] and men (OR = 5.9, 95% CI: 2.5–15.6; p < 0.001) were more likely to suffer from skeletal manifestations of PHPT. Renal manifestations were less likely among postmenopausal than premenopausal women (OR = 0.4, 95% CI: 0.2–0.8; p = 0.014). BMI was negatively associated with skeletal and renal manifestations (OR = 0.94 per unit change, p = 0.002) and symptomatic presentation (OR = 0.96 per unit change, p = 0.012). Conclusion: Older patients with PHPT presented with a biochemically less florid disease. Postmenopausal women and men with PHPT were more likely to suffer from skeletal manifestations of PHPT than premenopausal women. Patients with higher BMI had fewer skeletal and renal manifestations of PHPT and were less likely to be symptomatic.
Ključne besede: primary hyperparathyroidism, hypercalcemia, osteoporosis
Objavljeno v DiRROS: 23.02.2026; Ogledov: 491; Prenosov: 258
Celotno besedilo (527,26 KB)
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Ključne besede: melanom, kožni raki, kirurgija
Objavljeno v DiRROS: 09.06.2025; Ogledov: 1072; Prenosov: 505
Celotno besedilo (547,84 KB)
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Ključne besede: koža, rak (medicina), zaščitni ukrepi, dejavniki tveganja, klinična diagnostika, stadij, prognoza, histopatologija, kirurško zdravljenje, radioterapija, sistemsko zdravljenje, sledenje pacientov, prehranska podpora, paliativna oskrba, elektronske knjige
Objavljeno v DiRROS: 21.05.2025; Ogledov: 1012; Prenosov: 706
Celotno besedilo (289,31 KB)