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A Spillane

Publications and source records attributed to A Spillane.

3 recordsLinked to original sources

A pilot study to evaluate the impact of involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan.

Multidisciplinary care is the accepted best model of management of breast cancer patients. Current evidence suggests that multidisciplinary care has the potential to reduce mortality, improve quality of life, and reduce health care costs. We investigated the impact of patient involvement in the multidisciplinary meeting. A pilot study was conducted to assess the feasibility and acceptability of directly involving patients diagnosed with breast cancer in multidisciplinary clinic discussions and treatment planning. 30 consecutive breast cancer patients presenting for surgery were invited to attend our weekly multidisciplinary breast meeting at the time of receiving their results of surgery. Patients completed questionnaires before and after the meeting, and participated in a tape-recorded interview with the breast care nurse after the meeting. Members of the multi-disciplinary team also completed a short survey at the end of the study. The intervention was highly valued by most of the participating patients; and acceptable to and welcomed by most health professionals in the multidisciplinary team. Change in anxiety scores was not affected by participation. Patient attendance at the breast multidisciplinary meeting was shown to be potentially acceptable to both patients and health professionals, without unduly raising patient anxiety. A national survey exploring attitudes towards patient involvement in the multidisciplinary team meeting is currently in progress.

Adult↗

Serum ionized calcium and parathyroid hormone in renal stone disease.

Serum ionized calcium was shown to be significantly elevated in a group of twenty-eight subjects with idiopathic hypercalciuria in whom the mean total serum calcium concentration was within normal limits. Measurement of parathyroid hormone levels confirmed that elevated values are suppressible by infusion of calcium. Ten subjects with simultaneous elevation of serum ionized calcium and parathormone levels above 3 S.D. of normal were referred for neck exploration, and a parathyroid adenoma was found and removed in nine. Significant decreases to normal values of serum ionized calcium and parathormone levels of urine and calcium excretion were documented some weeks following operation. The results conflict with both the alimentary calcium hyperabsorption theory and the renal calcium leak theory of the aetiology of idiopathic hypercalciuria, and support the possibility that idiopathic hypercalciuria in many cases represents an early or mild form of 'normocalcaemic' primary hyperparathyroidism.

Adenoma↗