ACTA ENDOCRINOLOGICA (BUC)

Background. Patients that recovered from COVID-19 may remain with symptoms which can persist for an uncertain period of time. Aim. The purpose of this study was to investigate the reasons why patients who passed the acute phase of COVID-19 presented themselves to the Emergency Department. Patients and Methods. We selected 87 patients admitted to the Emergency Department of the Bucharest University Emergency Hospital between 01.01.2021- 31.05.2021. Patients had pulmonary fibrosis (11.49%), pleural effusion (16.09%) or a history of hypertension (73.56%), type 2 diabetes (42.53%), stroke (24.14%), malignant diseases (10.34%). Results. Association between neutrophil levels and acute stroke and between fibrinogen levels and alveolar condensation were identified. The percentage of deaths was significantly higher in the subgroup of subjects that had maxim 11 days of hospitalization (p=0.004); we observed a trend of association between the age of more than 51 years old and admission in the Emergency Unit at less than a month after the SARS Cov2 infection, the positive result at the RT-PCR test or a lung damage of over 30% (p<0.05). Conclusion. A significant percentage of patients that were admitted to the Emergency Unit post COVID-19 had chronic pathologies and their characteristics were associated with neutrophilia, high fibrinogen levels or length of hospitalization.

Context. In the surgical treatment of primary hyperparathyroidism, intraoperative localization of the diseased glands is an essential issue. We aimed to evaluate the impact of the intraoperative frozen section during radio-guided focused parathyroidectomy and compare its efficiency with intraoperative gamma probe survey and measurement of intraoperative quick parathyroid hormone. Methods. All consecutive patients underwent radio-guided focused parathyroidectomy for primary hyperparathyroidism due to solitary parathyroid adenoma. The outcomes of parathyroidectomy were evaluated by serum levels of calcium and parathyroid hormone. The primary outcome was the surgical cure diagnosed by normal serum calcium levels in the sixth postoperative month. Results. A total of 55 patients with a mean age of 54.3±12.2 years were evaluated. The diagnostic accuracy of the preoperative localization tests was calculated as 92.7%. The intraoperative gamma probe survey impacted the operative plans of four patients (7.3%) by localizing the diseased gland in other positions. The accuracy of intraoperative quick parathyroid hormone and frozen section analysis was 100% for both. In all patients, serum calcium and PTH levels dropped to normal in the sixth postoperative month. There were no cases of the persistent or recurrent disease during the follow-up period. Conclusion. The results of the intraoperative gamma probe survey, intraoperative quick parathyroid hormone, and frozen section were concordant with the final pathology in all cases. In four patients (7.3%), intraoperative gamma probe survey impacted the operative plans. The intraoperative gamma probe survey may be used as the sole intraoperative method to locate the correct position of the solitary parathyroid adenoma.