PMID- 20231234
OWN - NLM
STAT- MEDLINE
DCOM- 20100812
LR  - 20100430
IS  - 1460-2393 (Electronic)
IS  - 1460-2393 (Linking)
VI  - 103
IP  - 5
DP  - 2010 May
TI  - Improvement in the care of multiple endocrine neoplasia type 1 through a regional 
      multidisciplinary clinic.
PG  - 337-45
LID - 10.1093/qjmed/hcq020 [doi]
AB  - BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is associated with 
      significant morbidity and mortality. Timely detection of MEN1 kindred, together 
      with treatment of associated tumours, results in an improved outcome. We describe 
      how the development of a dedicated multidisciplinary MEN clinic has improved the 
      diagnosis and treatment of MEN1-associated endocrinopathies. DESIGN AND PATIENTS: 
      A dedicated MEN clinic was developed at Aintree University Hospital, Liverpool in 
      2002 for patients living in Merseyside, Cheshire and North Wales. The 
      multidisciplinary approach adopted, aimed to improve communication and continuity 
      of care. Patients see all clinicians involved in their care (Consultant 
      Endocrinologist, Paediatrician, Clinical Geneticist and Endocrine Surgeon) 
      simultaneously, allowing for a unified, clear approach and a reduction in 
      unnecessary attendances. The clinicians adopt a proactive approach to tracing the 
      relatives of patients, with the aim of identifying kindred with previously 
      asymptomatic disease. RESULTS: In 2002, 16 patients from 5 families were 
      diagnosed clinically with MEN1. Twenty MEN1-associated endocrinopathies had been 
      diagnosed and 21 surgical procedures had been performed. By the end of 2008, 45 
      patients from 15 families had been identified, with 83 endocrinopathies diagnosed 
      and 50 surgical procedures performed. Ninety-four known relatives are awaiting 
      screening for MEN1. CONCLUSION: The successful identification of patients with 
      MEN1 has resulted in an exponential increase in the number of patients attending 
      the clinic. As relatives undergo screening, the diagnosis of MEN is likely to 
      increase. The ever increasing numbers of patients requiring screening, 
      surveillance and treatment has implications in the planning of future service 
      provision.
FAU - White, H D
AU  - White HD
AD  - Gladstone Centre, North Wales NHS Trust, Croesnewydd Road, Wrexham LL13 7TD. 
      helen.white2@wales.nhs.uk
FAU - Blair, J
AU  - Blair J
FAU - Pinkney, J
AU  - Pinkney J
FAU - Cuthbertson, D J
AU  - Cuthbertson DJ
FAU - Day, R
AU  - Day R
FAU - Weber, A
AU  - Weber A
FAU - MacFarlane, I A
AU  - MacFarlane IA
LA  - eng
PT  - Journal Article
DEP - 20100315
PL  - England
TA  - QJM
JT  - QJM : monthly journal of the Association of Physicians
JID - 9438285
SB  - IM
MH  - Cancer Care Facilities/*organization & administration
MH  - Communication
MH  - DNA Mutational Analysis
MH  - Family Health
MH  - Female
MH  - Frameshift Mutation
MH  - Genetic Counseling
MH  - Genetic Testing/organization & administration
MH  - Humans
MH  - Interdisciplinary Communication
MH  - Male
MH  - Mass Screening/*organization & administration
MH  - *Multiple Endocrine Neoplasia Type 1/diagnosis/genetics/surgery
MH  - Mutation, Missense
MH  - *Patient Care Team
MH  - Professional-Patient Relations
EDAT- 2010/03/17 06:00
MHDA- 2010/08/13 06:00
CRDT- 2010/03/17 06:00
PHST- 2010/03/17 06:00 [entrez]
PHST- 2010/03/17 06:00 [pubmed]
PHST- 2010/08/13 06:00 [medline]
AID - hcq020 [pii]
AID - 10.1093/qjmed/hcq020 [doi]
PST - ppublish
SO  - QJM. 2010 May;103(5):337-45. doi: 10.1093/qjmed/hcq020. Epub 2010 Mar 15.