Publications by authors named "Katarina M Tausanovic"

3 Publications

  • Page 1 of 1

Predictive value of calcium test for preoperative diagnosis of medullary thyroid carcinoma in patients with moderately elevated basal calcitonin.

Endocr Pract 2021 Jun 30. Epub 2021 Jun 30.

Center for Endocrine surgery, University Clinical Center of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia, Doktora Subotica 8, 11000 Belgrade, Serbia.

Introduction: Medullary thyroid carcinoma (MTC) can be very aggressive, and the early diagnosis is based on the routine measurement of serum calcitonin (CT) and on the RET genetic testing for hereditary forms. Basal serum CT concentrations (bCT) are helpful in the early detection of MTC, while it is still unclear whether they can be used also for the differential diagnosis between MTC and C cell hyperplasia (CCH). Since false-positive results can be gained with the basal measurement of calcitonin, a provocative test to evaluate stimulated calcitonin (sCT) is often needed.

Aim: The objective of this study was to investigate the utility of calcium gluconate test for CT in distinguishing MTC from CCH, a precancerous condition in hereditary forms of MTCs, but with unclear significance in sporadic MTCs.

Method: A total of 74 patients underwent the calcium loading test before thyroidectomy, and basal and stimulated calcitonin levels were compared with histological results by receiver operating characteristic (ROC) plot analyses.

Results: A peak of calcitonin after stimulation with calcium gluconate of 388.4 pg/ml was able to significantly distinguish patients with MTC from patients with CCH and patients without C cell pathology, with 81.8% sensitivity and 36.5% specificity. Basal calcitonin of 16.1 pg/ml was able to distinguish these two group of patients with 90% sensitivity.

Conclusion: High dose calcium test is potent procedure that can be applied for differential diagnosis of MTC and CCH. Reference ranges for calcium sCT levels and CT thresholds in different group of patients have been identified.
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June 2021

Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism.

Med Princ Pract 2017 10;26(4):381-386. Epub 2017 Apr 10.

Objective: To investigate the incidence and identify risk factors for the occurrence of intraoperative hypertension (IOH) during surgery for primary hyperparathyroidism (pHPT).

Subjects And Methods: The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. IOH was defined as an increase in systolic blood pressure ≥20% compared to baseline values which lasted for 15 min. The investigated influence were demographic characteristics, surgical risk score related to physical status (based on the American Society of Anesthesiologists [ASA] classification), comorbidities, type and duration of surgery, and duration of anesthesia on IOH occurrence. The investigated factors were obtained from the patients' medical history, anesthesia charts, and the daily practice database. Logistic regression analysis was done to determine the predictors of IOH.

Results: Of the 269 patients, 153 (56.9%) had IOH. Based on the univariate analysis, age, body mass index, ASA status, duration of anesthesia, and preoperative hypertension were risk factors for the occurrence of IOH. Multivariate analysis showed that independent predictors of IOH were a history of hypertension (OR = 2.080, 95% CI: 1.102-3.925, p = 0.024) and age (OR = 0.569, 95% CI: 0.360-0.901, p = 0.016).

Conclusion: In this study, a high percentage (56%) of the patients developed IOH during surgery for pHPT, which indicates that special attention should be paid to these patients, especially to the high-risk groups: older patients and those with a history of hypertension. Further, this study showed that advanced age and hypertension as a coexisting disease prior to parathyroid surgery were independent risk factors for the occurrence of IOH.
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June 2018

Improvement of quality of life in patients with benign goiter after surgical treatment.

Langenbecks Arch Surg 2014 Aug 8;399(6):755-64. Epub 2014 Jul 8.

Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, Belgrade, 11000, Serbia,

Purpose: A quality of life (QoL) assessment is considered an important outcome measure in the treatment of benign thyroid diseases. The aims of this study were to analyze the impact of different surgical treatments on QoL in patients with benign thyroid diseases and to evaluate factors correlating with the QoL outcomes.

Methods: A prospective longitudinal study was conducted. One hundred thirty-two patients met the inclusion/exclusion criteria and completed the disease-specific questionnaire, thyroid patient-reported outcome (ThyPRO), before surgery and after 6 months. Preoperative and postoperative QoL outcomes were compared and correlating factors were analyzed.

Results: Indication for surgery was euthyroid goiter, toxic goiter, and suspicious malignant thyroid disease in 58.3, 29.5, and 12.1 % of the patients, respectively. None of the patients had overtly toxic goiter. There were 65.2 % of the patients who underwent total thyroidectomy, while 34.8 % underwent hemithyroidectomy. The total postoperative complication rate was 5.3 %. QoL improved significantly after surgical treatment, independent of the extent of performed surgery. The most affected domain, pre- and postoperative, was for tiredness. QoL improvement was significant for women in all domains, while for men, it was significant in only three domains (goiter symptoms, emotional susceptibility, and cosmetic complaints) and in overall QoL. Younger patients had significantly better cognitive functioning and daily life, while elderly patients had significantly less cosmetic complaints. The factors that significantly correlated with improvement of QoL in different domains were lower education level, duration of disease, and microcarcinoma at final histology.

Conclusion: QoL in patients with benign thyroid diseases improves significantly after operative treatment, independent of the extent of the operation.
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August 2014