RESUMEN
BACKGROUND: Eight years after the Institute of Medicine recommended survivorship care plans (SCPs) for all cancer survivors, this study systematically reviewed the evidence for their use. METHODS: Studies evaluating outcomes after implementation of SCPs for cancer survivors were identified by searching databases (MEDLINE, EMBASE and Cochrane). Data were extracted and summarised. RESULTS: Ten prospective studies (2286 survivors) met inclusion criteria (5 randomised controlled trials (RCTs)). Study populations included survivors of breast, gynaecological, colorectal and childhood cancer. Several models of SCP were evaluated (paper based/on-line, oncologist/nurse/primary-care physician-delivered and different templates). No significant effect of SCPs was found on survivor distress, satisfaction with care, cancer-care coordination or oncological outcomes in RCTs. Breast cancer survivors with SCPs were better able to correctly identify the clinician responsible for their follow-up care. One study suggested a positive impact on reducing unmet needs. Levels of survivor satisfaction with, and self-reported understanding of, their SCP were very high. Feasibility was raised by health professionals as a significant barrier, as SCPs took 1-4 h of their time to develop. CONCLUSIONS: Emerging evidence shows very few measurable benefits of SCPs. Survivors reported high levels of satisfaction with SCPs. Resource issues were identified as a significant barrier to implementation.
Asunto(s)
Continuidad de la Atención al Paciente , Necesidades y Demandas de Servicios de Salud , Neoplasias/terapia , Planificación de Atención al Paciente , Sobrevivientes , Ensayos Clínicos como Asunto , Humanos , Metaanálisis como Asunto , Neoplasias/psicologíaRESUMEN
BACKGROUND: High breast density is an independent risk factor for breast cancer and decreases the sensitivity of mammography. This systematic review synthesizes the evidence on the impact of breast density (BD) information and/or notification on women's psychosocial outcomes among women from racial and ethnic minority groups. METHODS: A systematic search was performed in March 2023, and the articles were identified using CINHAL, Embase, Medline, and PsychInfo databases. The search strategy combined the terms "breast", "density", "notification" and synonyms. The authors specifically kept the search terms broad and did not include terms related to race and ethnicity. Full-text articles were reviewed for analysis by race, ethnicity and primary language of participants. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias. RESULTS: Of 1784 articles, 32 articles published from 2003 to 2023 were included. Thirty-one studies were conducted in the United States and one in Australia, with 28 quantitative and four qualitative methodologies. The overall results in terms of breast density awareness, knowledge, communication with healthcare professionals, screening intentions and supplemental screening practice were heterogenous across studies. Barriers to understanding BD notifications and intentions/access to supplemental screening among racial and ethnic minorities included socioeconomic factors, language, health literacy and medical mistrust. CONCLUSIONS: A one-size approach to inform women about their BD may further disadvantage racial and ethnic minority women. BD notification and accompanying information should be tailored and translated to ensure readability and understandability by all women.
Asunto(s)
Densidad de la Mama , Neoplasias de la Mama , Minorías Étnicas y Raciales , Mamografía , Humanos , Femenino , Neoplasias de la Mama/psicología , Neoplasias de la Mama/etnología , Minorías Étnicas y Raciales/psicología , Mamografía/psicología , Mamografía/estadística & datos numéricos , Detección Precoz del Cáncer/psicología , Detección Precoz del Cáncer/estadística & datos numéricos , Persona de Mediana Edad , Conocimientos, Actitudes y Práctica en Salud/etnología , Estados Unidos , Adulto , Australia , AncianoRESUMEN
BACKGROUND: Shame is a powerful negative emotion that has the potential to affect health. Due to the intimate nature of breast cancer treatment and its impact on body image, it is hypothesised that shame may be experienced during treatment. The aim of this study was to explore shame experiences related to clinical encounters for breast cancer treatment. METHODS: People with a lived experience of breast cancer were invited to anonymously share their stories of shame through an online survey. Using qualitative methodology, the stories were examined, and themes identified. PARTICIPANTS: Participants were members of the consumer organisation Breast Cancer Network Australia. RESULTS: Stories were contributed by 38 participants. Most (n = 28, 73.7 %) were >5 years post-diagnosis. Shame was experienced in a range of clinical settings (consulting rooms, wards, operating theatres, radiotherapy departments). They involved a different health professionals (oncologists, surgeons, nurses, radiation therapists, psychologists.) Five themes were identified: (1) Body shame (sub-themes: Naked/vulnerable and Weight), (2) Communication (subthemes: Lack of compassion/impersonal manner and Not listening), (3) Being blamed (subthemes: diagnosis and complications), (4) Feeling unworthy (subthemes: Burden to staff and Unworthy of care), (5) Judgement for treatment choices. CONCLUSIONS: Shame can be experienced in a range of situations, from scrutiny of the naked body to comments from health professionals. The impact of these experiences is profound, and the feelings of shame are carried for many years. These findings can inform strategies to support consumers and educate health professionals with the aim of reducing harm related to cancer treatment.
Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/terapia , Neoplasias de la Mama/psicología , Vergüenza , Emociones , Imagen Corporal/psicología , Encuestas y CuestionariosRESUMEN
This study assessed symptoms of anxiety, depression and fear of COVID-19 in members of the general community and healthcare workers (HCWs) attending for COVID testing. This cross-sectional study was conducted in a public hospital COVID-19 testing clinic (June-September 2020) using self-administered questionnaires (i.e. the Hospital Anxiety and Depression Scale (HADS) and the Fear of COVID-19 Scale). In all, 430 participants who met the criteria for COVID-19 testing with nasopharyngeal and throat swabs completed the questionnaires. The mean (±s.d.) age of participants was 37.6 ± 12.6 years. HCWs made up 35.1% of the sample. Overall, the mean (±s.d.) score for anxiety was 6.09 ± 4.41 and 'case' prevalence (any severity) was 151/430 (35.1%), higher than normative population scores. Higher anxiety was found in women (P = 0.001) and in clients who had previously been tested for coronavirus (P = 0.03). HCWs had lower anxiety scores than members of the general community (P = 0.001). For depression, the mean (±s.d.) score was 4.18 ± 3.60, with a 'case' prevalence (any severity) of 82/430 (19.1%), similar to normative population scores. Women reported a higher level of COVID-19 fear (P = 0.001), as did people with a lower education level (P = 0.001). A greater psychological impact of COVID-19 was observed in women, people undergoing repeat testing and participants reporting lower levels of educational attainment. HCWs had fewer symptoms of anxiety and depression than non-HCWs attending the same clinic for COVID-19 testing. This information can be used to plan mental health interventions in primary care and testing settings during this and future pandemics.
Asunto(s)
Prueba de COVID-19 , COVID-19 , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Australia/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Miedo , Femenino , Personal de Salud , Humanos , Persona de Mediana Edad , Pacientes Ambulatorios , SARS-CoV-2 , Adulto JovenRESUMEN
BACKGROUND: Breast reconstruction following mastectomy has proven benefits and is the standard of care in many high-income countries. This audit documented regional variation in immediate breast reconstruction rates across Australia. METHODS: The Breast Surgeons of Australia and New Zealand (BreastSurgANZ) Quality Audit database and geospatial software were used to model the distribution of breast reconstructions performed on women having mastectomy in Australia in 2013. Geospatial mapping identified the distribution of these procedures in relation to the Greater Capital City Statistical Areas (GCCSAs) of the five largest states. Data were analysed using χ2 tests of independence and an independent-samples t test. RESULTS: Of 3786 patients having a mastectomy, 692 underwent breast reconstruction of which 679 (98·1 per cent) were immediate reconstructions. Rates of reconstruction differed significantly between jurisdictions (χ2 = 164·90), and were significantly higher in GCCSAs (χ2 = 144·60) and private hospitals (χ2 = 50·72) (all P < 0·001). Immediate breast reconstruction was not reported for 43·8 per cent of hospitals where mastectomy was conducted by members of BreastSurgANZ, including 29·8 per cent of hospitals within GCCSAs. A wider age range of women appeared to have had immediate reconstructions at hospitals within GCCSAs, although the difference in mean age between regions was not significant. Immediate breast reconstruction was considerably less likely to be performed in women who lived in areas of lower to mid socioeconomic status. CONCLUSION: Variations in the rate of immediate breast reconstruction may not be purely resource-driven.
RESUMEN
In Australia, and many health care provider systems, primary care physicians are the first to see women with breast symptoms and are responsible for making decisions on whether to investigate and when to refer to specialist teams. We present an audit of new patient referrals from primary care triaged to a 'low-risk' (low likelihood of cancer) clinic on the basis of benign findings. The most common reason for referral was 'breast lump' (38%) followed by 'image-detected' abnormality (26%.) We have identified that (outside of population screening services) many women are being referred from primary care to specialist clinics for management of screen-detected lesions considered benign on imaging. Further research is needed to identify the reasons for such referrals and to develop appropriate educational strategies and clinical policy, both for the primary care and the specialist breast practitioner.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Medicina Familiar y Comunitaria/normas , Auditoría Médica , Pautas de la Práctica en Medicina , Atención Primaria de Salud/normas , Derivación y Consulta/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Niño , Femenino , Control de Acceso , Humanos , Registros Médicos , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Radiografía , Estudios Retrospectivos , Medición de RiesgoRESUMEN
PURPOSE: Older age is associated with lower rates of breast reconstruction (BR) for women requiring mastectomy. The purpose was to assess the available evidence on uptake, outcome and quality of life (QoL) after BR in older women. METHODS: A systematic literature review was performed via Medline, Embase and Cochrane databases using the search terms breast reconstruction, breast cancer, and mastectomy. Eligible studies reported rates of BR, rates of different reconstructive techniques, complication rates, and/or patient reported outcome measures (PROMs) of BR in women aged 60 years or older undergoing mastectomy for ductal carcinoma in situ or invasive carcinoma. RESULTS: A total of 42 eligible studies were included, with 32 of these reporting BR rates, 10 reporting rates of different reconstructive techniques, 10 reporting rates of complications, and four reporting PROMs. The studies reported 24,746 cases of BR in 407,570 mastectomy patients aged 60 years or older from 1987 to 2012. Implant based BR was more common than autologous techniques. Mostly, complication rates were not higher in older women, and QoL outcomes were similar to younger women. CONCLUSIONS: This review confirms that BR rates are lower in older women despite recent studies demonstrating its efficacy. The perception among some surgeons and women requiring mastectomy that the potential risks of BR in older women outweigh the benefits needs to be revisited. Education of consumers and surgeons along with public advocacy for offering BR to all clinically eligible women are the most promising means of changing practice.
Asunto(s)
Neoplasias de la Mama/cirugía , Mamoplastia/métodos , Anciano , Femenino , Humanos , Mastectomía , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Complicaciones Posoperatorias , Calidad de VidaRESUMEN
The association between mortality at the ages of 0-4 and 5-14 years in the county boroughs of England and Wales for 1971, using Kendall's correlation technique, and a variety of socioeconomic indicators, was computed. Kendall's partial correlation technique was used to determine whether any association remained when the effect of social class and unemployment was kept constant. At ages 0-4 years there was a significant and positive association between mortality and low socioeconomic position, high density housing, inadequate housing amenities, and the unemployment rate (P less than 0.001). A significant association with the housing variables remained when the effect of socioeconomic status and unemployment was kept constant. Between the ages 5-14 years there was a statistically significant association (P less than 0.001) between mortality and housing density which was eliminated when the effect of social class was held constant. There was no association between unemployment and mortality in this age group.
Asunto(s)
Vivienda , Mortalidad Infantil , Mortalidad , Desempleo , Adolescente , Niño , Preescolar , Inglaterra , Humanos , Lactante , Recién Nacido , GalesRESUMEN
The Resource Allocation Working Party concluded that standardised mortality ratios are the best available indicators of geographical variations in morbidity. In this paper we give the results of a statistical analysis of the relationship between mortality and two indicators of morbidity, obtained from the 1971 census, for three age groups. The level of aggregation in the data is comparable with that at district or area level. Strong linear relationships are obtained, suggesting that it is reasonable to use mortality data in the RAWP formulae in applications at area of district level. However, this method of resource allocation should not be used in isolation from planning. A possible solution which reduces conflict between the two approaches is to incorporate mortality data in the planning indicators used to establish relative need and, in addition, to take due account of established patterns of service and local circumstances.
Asunto(s)
Morbilidad , Mortalidad , Adolescente , Adulto , Anciano , Inglaterra , Métodos Epidemiológicos , Humanos , Persona de Mediana Edad , DesempleoRESUMEN
PURPOSE: There is enormous range in the reported rates of breast reconstruction. This study explored reasons for this variation by reviewing the published literature to examine rates of reconstruction, factors associated with uptake, and possible barriers. METHODS: A systematic review of the literature was performed. Eligible studies reported rates of breast reconstruction and variables associated with uptake in women undergoing mastectomy for early invasive or in situ breast malignancy. RESULTS: Twenty-eight eligible studies were included, reporting 159,305 cases of breast reconstruction in 940,678 women. In these studies 16·9% of women underwent immediate or delayed reconstruction (range 4·9-81·2%, median 23·3%). Variables associated with reconstruction were: patient/tumour factors (early stage, no adjuvant therapy, young age, white race, private insurance, higher education/income), surgeon/hospital factors and psychological/other factors (including patient choice). CONCLUSION: Rates of breast reconstruction were highly variable. Reconstruction appeared to be offered to a minority of women; around half took up the offer. The main reasons reported for no reconstruction included patient-related and adjuvant therapy-related factors. Clinicians' beliefs about reconstruction may be an important factor. Rates of reconstruction could be increased with early discussion of the options when mastectomy is chosen or required.
Asunto(s)
Neoplasias de la Mama/cirugía , Mamoplastia/estadística & datos numéricos , Mastectomía Radical Modificada , Factores de Edad , Australia/epidemiología , Neoplasias de la Mama/patología , Carcinoma in Situ/cirugía , Carcinoma Ductal de Mama/cirugía , Toma de Decisiones , Escolaridad , Europa (Continente)/epidemiología , Femenino , Humanos , Renta , Japón/epidemiología , Estadificación de Neoplasias , Estudios Prospectivos , Estudios Retrospectivos , Sudáfrica/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiologíaAsunto(s)
Neoplasias de la Mama/diagnóstico , Dermatofibrosarcoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Adulto , Antígenos CD34/metabolismo , Biopsia , Mama/metabolismo , Mama/patología , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Dermatofibrosarcoma/metabolismo , Dermatofibrosarcoma/patología , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología , Ultrasonografía MamariaRESUMEN
While guidelines recommend against routine use of staging imaging to detect asymptomatic distant metastases (DM) in newly diagnosed breast cancer (BC), modern imaging technologies may have improved detection capability and may have a role in some cases. We performed a systematic review of studies (1995-2011) evaluating the prevalence of DM and the accuracy of staging imaging for detection of asymptomatic DM. Twenty-two studies reporting on 14,824 BC subjects (median age 53 years) undergoing staging imaging were eligible. Median prevalence of DM was 7.0% (range 1.2-48.8%); prevalence increased with increasing BC stage. Conventional imaging studies had lower DM prevalence than studies of PET(PET/CT). Imaging median sensitivity/specificity respectively were: combined conventional imaging 78.0%/91.4%; bone scintigraphy 98.0%/93.5%; chest X-ray 100%/97.9%; liver ultrasound 100%/96.7%; CT chest/abdomen 100%/93.1%; FDG-PET 100.0%/96.5%; FDG-PET/CT 100%/98.1%. Low prevalence of DM was seen in Stage I-II BC with much higher prevalence in more advanced disease. Accuracy of PET modalities was very high however the high proportion of detected asymptomatic DM partly reflects selection bias.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Diagnóstico por Imagen/métodos , Metástasis de la Neoplasia/diagnóstico , Femenino , Humanos , Metástasis de la Neoplasia/patología , Estadificación de NeoplasiasRESUMEN
BACKGROUND: While sentinel lymph node biopsy (SLNB) is established in the management of small unifocal breast cancer its role in management of multifocal (MF), multicentric (MC) and larger tumors is still evolving. METHODS: Medline was searched; studies meeting pre-determined criteria were included. Data were extracted and entered into evidence tables. RESULTS: Twenty six studies met inclusion criteria and reported data on accuracy; no randomized trials were identified. For MF cancers (n = 314 cases), success rate for identification of an SLN was 86-94%, SLN positivity rate 42-59%, false negative rate (FNR) 0-33% and overall accuracy 78-100%. For MC (n = 294 cases): success rate 92-100%, SLN positivity rate 25-61%, FNR 4-8% and accuracy 96-100%. For 'multiple breast cancer' (studies combining MF/MC cases; n = 996 cases): success rate 92-100%, SLN positivity rate 12-63%, FNR 0-25%, and accuracy 82-100%. For larger tumors (n = 1912 cases): success rate 86-100%, SLN positivity rate 49-77%, FNR 3-18% and accuracy 85-98%. For MC/MF and larger cancers overall non-SLN positivity rates were up to 82%; axillary recurrence rates were low but seldom reported. CONCLUSION: There are no randomized trials evaluating the safety of SLNB in MF/MC and larger breast cancers. Based on limited evidence, success rate and FNR appear to be similar to those for small unifocal cancers, however node positivity rates are higher and rates of non-SLN positivity are very high. Awareness of these issues is essential when recommending SLNB based axillary management for these higher-risk tumors.
Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Ganglios Linfáticos/patología , Ganglios Linfáticos/cirugía , Biopsia del Ganglio Linfático Centinela , Axila , Femenino , Humanos , Escisión del Ganglio Linfático , Metástasis Linfática , Estadificación de Neoplasias , Sensibilidad y EspecificidadRESUMEN
AIMS: Minimal access breast surgery (MABS) is a procedure that completes breast conservation surgery (BCS) and sentinel node biopsy (SNB) through a single incision. It allows access to axillary sentinel nodes via the breast incision and also provides access to the internal mammary nodes (IMN) as well as other nodal sites when needed. The aims of this study are to describe the MABS approach and to evaluate its safety and efficacy in cases undergoing BCS and SNB (axillary or IMN) for treatment of breast cancer. METHODS: The surgical technique for MABS is described. One hundred and three consecutive clinically lymph node negative patients undergoing BCS and SNB (axillary or IMN) were considered for MABS. Cases were classified according to the location of sentinel nodes dissected (axillary, internal mammary or other), the location of the tumour and whether MABS was used. The success of MABS was calculated based on the number of cases where BCS and SNB were completed through a single breast incision. Number of lymph nodes (LN) retrieved, rate of LN positivity, aesthetics and complications were documented. RESULTS: Eighty-six percent of cases of BCS with axillary-only SNB were completed with MABS. For cases of BCS with axillary and IMN SNB, MABS was successful for BCS and IMN SNB in 97% of cases and for BCS and SNB from both nodal regions in 63%. There was only one case, a woman with breast prostheses, who required three separate incisions. When axillary-only SNB cases were completed with MABS, an average of 2.9 axillary LN per case with a 29% axillary LN positivity rate was seen. When axillary and IMN SNB were completed with MABS for both regions, an average of 3.0 axillary LN per case were retrieved with an axillary LN positivity rate of 65%. When separate axillary and breast incisions were made, 2.7 LN per case were removed with an axillary LN positivity rate of 30%. Aesthetics were excellent and there were no complications associated with reaching the nodes through the breast incision. CONCLUSION: MABS is a feasible option for the majority of women undergoing BCS and SNB and it does not compromise the success of SNB.
Asunto(s)
Neoplasias de la Mama/cirugía , Mastectomía Segmentaria , Biopsia del Ganglio Linfático Centinela , Adulto , Anciano , Anciano de 80 o más Años , Axila/cirugía , Neoplasias de la Mama/patología , Estética , Estudios de Factibilidad , Femenino , Humanos , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/cirugía , Metástasis Linfática , Persona de Mediana Edad , Biopsia del Ganglio Linfático Centinela/métodos , Resultado del Tratamiento , Adulto JovenRESUMEN
The Canadian Cancer Society's public education program is based on the premise that early detection of cancer, followed by immediate treatment, saves lives. To promote this program the Society has developed the Seven Steps to Health which include "Have a Pap test" and "Do a monthly breast self-examination." To evaluate the effect of these two 'steps' on the female population of Canada, a public opinion poll was conducted which included a national random sample of women representative of age, educational and socio-economic levels and occupation. The poll showed that 76 percent of Canadian women have had at least one Pap test and 63 percent do breast self-examination regularly or occasionally. Significant relationships were revealed between social factors and participation in these health measures and reasons are elicited for non-participation.
RESUMEN
All general practitioners on the list of a single executive council were contacted and 91% were interviewed. They were asked about the type of family planning service currently provided and their willingness to extend the service. Only 3% said that they were not providing any service at the time of interview, but only 4% stated that they provided a complete range of techniques to all patients; almost two thirds of practitioners only provided advice and the "pill". Lack of training in family planning techniques emerged as the most important factor in determining the type of service provided. At the time of interview 64% of doctors stated that they would like further training, and 35% of all doctors asked for a full course of clinical training. Many general practitioners (81%) were willing to extend their family planning services but 65% wanted financial reimbursement and 50% needed additional administrative support as prerequisites.
Asunto(s)
Servicios de Planificación Familiar , Medicina Familiar y Comunitaria , Atención Integral de Salud , Dispositivos Anticonceptivos , Anticonceptivos Orales , Emigración e Inmigración , Financiación Personal , Relaciones Médico-Paciente , Religión y Medicina , Reino UnidoRESUMEN
A method of survey for the long-term assessment of extradural analgesia in labour is described. The difficulties and problems of collecting the data are discussed.
Asunto(s)
Anestesia Epidural , Anestesia Obstétrica , Desarrollo Infantil , Femenino , Humanos , Lactante , Recién Nacido , Relaciones Madre-Hijo , Proyectos Piloto , Embarazo , Encuestas y CuestionariosRESUMEN
Angiotensin IV (Val-Tyr-Ile-His-Pro-Phe) has been reported to interact with specific high-affinity receptors to increase memory retrieval, enhance dopamine-induced stereotypy behavior, and induce c-fos expression in several brain nuclei. We have isolated a decapeptide (Leu-Val-Val-Tyr-Pro-Trp-Thr-Gln-Arg-Phe) from sheep brain that binds with high affinity to the angiotensin IV receptor. The peptide was isolated using 125I-angiotensin IV binding to bovine adrenal membranes to assay receptor binding activity. This peptide is identical to the amino acid sequence 30-39 of sheep betaA- and betaB-globins and has previously been named LVV-hemorphin-7. Pharmacological studies demonstrated that LVV-hemorphin-7 and angiotensin IV were equipotent in competing for 125I-angiotensin IV binding to sheep cerebellar membranes and displayed full cross-displacement. Using in vitro receptor autoradiography, 125I-LVV-hemorphin-7 binding to sheep brain sections was identical to 125I-angiotensin IV binding in its pattern of distribution and binding specificity. This study reveals the presence of a globin fragment in the sheep brain that exhibits a high affinity for, and displays an identical receptor distribution with, the angiotensin IV receptor. This globin fragment, LVV-hemorphin-7, may therefore represent an endogenous ligand for the angiotensin IV receptor in the CNS.
Asunto(s)
Corteza Cerebral/metabolismo , Hemoglobinas/metabolismo , Fragmentos de Péptidos/metabolismo , Receptores de Angiotensina/metabolismo , Glándulas Suprarrenales/química , Angiotensina II/análogos & derivados , Angiotensina II/metabolismo , Animales , Autorradiografía , Unión Competitiva/fisiología , Bovinos , Cerebelo/química , Cerebelo/metabolismo , Corteza Cerebral/química , Cromatografía Líquida de Alta Presión , Hemoglobinas/aislamiento & purificación , Radioisótopos de Yodo , Ligandos , Fragmentos de Péptidos/aislamiento & purificación , Sistema Renina-Angiotensina/fisiología , OvinosRESUMEN
Enlarged parathyroid glands were percutaneously aspirated under computed tomographic (CT) control in 7 patients, and levels of parathyroid hormone (PTH) and human thyroglobulin (HTg) were measured. All 7 patients had high levels of PTH in at least 1 specimen. It is concluded that the measurement of high concentrations of PTH in the aspirate from a cervical or mediastinal mass, with CT documentation of needle position, provides absolute localization of parathyroid masses.