Baena-Nieto, G. (Gloria)

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    Permanent postoperative hypoparathyroidism: an analysis of prevalence and predictive factors for adequacy of control in a cohort of 260 patients
    (AME Publishing Company, 2020) Fernandez-Garcia, J.C. (José C.); Baena-Nieto, G. (Gloria); Bandrés, O. (Orosia); Zafón, C. (Carles); Anda, E. (Emma); Sánchez-Ragnarsson, C. (Cecilia); Megía, A. (Ana); Romero-Lluch, A.R. (Ana Reyes); Sambo, M. (Marcel); Picallo, M. (María); Donnay, S. (Sergio); Iglesias, P. (Pedro); Manjón, L. (Laura); Lecumberri, B. (Beatriz); Sahún-de-la-Vega, M. (Manel); Fernández, P.S. (Piedad Santiago); Pérez-Corral, B. (Begoña); Sanz, E. (Eva); Navarro, E. (Elena); Díez, J.J. (Juan J.); Paja, M. (Miguel); Blanco-Carrera, C. (Concepción); Galofre, J.C. (Juan Carlos); Sastre, J. (Julia); Álvarez-Escolá, C. (Cristina); Oleaga, A. (A.)
    Background: Recent guidelines for the treatment of hypoparathyroidism emphasize the need for long-term disease control, avoiding symptoms and hypocalcaemia. Our aim has been to analyze the prevalence of poor disease control in a national cohort of patients with hypoparathyroidism, as well as to evaluate predictive variables of inadequate disease control. Methods: From a nation-wide observational study including a cohort of 1792 patients undergoing total thyroidectomy, we selected 260 subjects [207 women and 53 men, aged (mean ± SD) 47.2±14.8 years] diagnosed with permanent hypoparathyroidism. In every patient demographic data and details on surgical procedure, histopathology, calcium (Ca) metabolism, and therapy with Ca and calcitriol were retrospectively collected. A patient was considered not adequately controlled (NAC) if presented symptoms of hypocalcemia or biochemical data showing low serum Ca levels or high urinary Ca excretion. Results: Two hundred and twenty-one (85.0%) patients were adequately controlled (AC) and 39 (15.0%) were NAC. Comparison between AC and NAC patients did not show any significant difference in demographic, surgical, and pathological features. Rate of hospitalization during follow-up was significantly higher among NAC patients in comparison with AC patients (35.9% vs. 10.9%, P<0.001). Dose of oral Ca and calcitriol were also significantly higher in NAC subjects. In a subgroup of 129 patients with serum parathyroid hormone (PTH) levels available, we found that NAC patients exhibited significantly lower postoperative PTH concentrations than AC patients [median (interquartile range) 3 (1.9-7.8) vs. 6.9 (3.0-11) pg/mL; P=0.009]. Conclusions: In a nation-wide cohort of 260 subjects with definitive hypoparathyroidism, 15% of them had poor disease control. These patients required higher doses of oral Ca and calcitriol, had higher rate of hospitalization during follow-up and showed lower PTH concentrations in the postoperative period.
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    Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics
    (MDPI, 2019) Fernandez-Garcia, J.C. (José C.); Molina-Vega, M. (María); Baena-Nieto, G. (Gloria); Romero-Lluch, A.R. (Ana Reyes); Riestra, M. (María); Alcázar, V. (Victoria); Rodríguez-Pérez, C.A. (Carlos Antonio); Álvarez-Mancha, A.I. (Ana Isabel); Galofre, J.C. (Juan Carlos)
    Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single appointment. We aimed to evaluate the clinical outcomes at HR-TNCs. Design and Methods: A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain. We evaluated fine-needle aspiration (FNA) indications and the association between clinical and ultrasound characteristics with cytological and histopathological outcomes. Results: A total of 2809 thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications, significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid component were independently associated with increased odds of malignancy. Thyroid nodules <20 mm and ≥20–<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively in comparison with those ≥40 mm. Conclusion: In this large multicenter study, we found that the presence of a solid component and irregular margins are factors independently related to malignancy in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy, this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with a low rate of nondiagnostic FNA.