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Related Concept Videos

Skeleton and Calcium Homeostasis01:21

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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Synthesis and Functions of Calcitonin00:51

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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Hormones and Bone Tissue01:17

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
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The Parathyroid Glands00:59

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Related Experiment Video

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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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Modification, validation and implementation of a protocol for post-thyroidectomy hypocalcaemia.

T Stedman1, P Chew1, P Truran1

  • 1Sheffield Teaching Hospitals NHS Foundation Trust , UK.

Annals of the Royal College of Surgeons of England
|November 29, 2017
PubMed
Summary
This summary is machine-generated.

Implementing a revised protocol for post-thyroidectomy hypocalcaemia management, using Day 1 parathyroid hormone (PTH) and calcium levels, effectively reduces readmissions and overtreatment, facilitating early patient discharge.

Keywords:
CalciumHypercalcaemiaHypocalcaemiaParathyroidProtocolThyroidectomy

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Area of Science:

  • Endocrinology
  • Surgical Management
  • Patient Outcomes

Background:

  • Post-thyroidectomy hypocalcaemia poses risks of readmission and overtreatment.
  • Optimal management protocols are crucial for patient safety and efficient healthcare delivery.

Purpose of the Study:

  • To implement, evaluate, and revise a protocol for managing post-thyroidectomy hypocalcaemia.
  • To reduce hypocalcaemia, readmissions, and treatment-related hypercalcaemia.
  • To facilitate early patient discharge after thyroid surgery.

Main Methods:

  • Introduction of Day 1 parathyroid hormone (PTH) and calcium measurements.
  • Review of a three-year patient cohort to amend the protocol.
  • Validation of revised protocols over seven months, assessing compliance and outcomes.
  • Implementation of further revisions based on collected data.

Main Results:

  • Temporary and long-term hypocalcaemia rates were 29.1% and 3.2%, respectively.
  • Day 1 calcium measurements altered management in only 1.4% of cases.
  • Protocol adherence reached 90%, with minimal post-discharge hyper/hypocalcaemia episodes.

Conclusions:

  • A unit protocol for post-thyroidectomy hypocalcaemia, refined by literature and local data, is effective.
  • Day 1 PTH and calcium levels guide treatment, follow-up, and early discharge.
  • The protocol minimizes risks of undertreatment and overtreatment, indicating permanent hypocalcaemia accurately.