A total of 54 patients underwent surgical exploration for primary hyperparathyroidism from 1980 to 1988. Beginning in November 1984 nearly all patients were evaluated with preoperative radionuclide and ultrasound imaging studies. Ultrasound correctly localized 76% of the adenomas removed at surgery, whereas the success rate with radionuclide imaging was 74%. Localization of hyperplastic glands was less successful with the use of either technique. Correct preoperative localization studies in cases of single adenoma reduced the operative time an average of 32 minutes when compared with those cases with no localization studies. Cost-effectiveness was studied based on current charges for operating room time, anesthesia, and the preoperative localization studies. An average cost savings of $124 per case was achieved when results of both localization studies were correct. These localization studies are quick, noninvasive, relatively inexpensive, and associated with no morbidity. Because it is possible to reduce operative time and overall costs, we recommend that radionuclide and ultrasound studies be routinely used in patients with primary hyperparathyroidism.
Economic integration in North AmericaER MORE THAN 70 YEARS NOW, the Couchiching Institute on Public Affairs has been bringing Canadians together with the purpose of asking some thought-provoking questions and encouraging lively, stimulating debates and action on a variety of key public policy issues. For example, it was at Couchiching, 56 years ago, where the idea of creating a North Atlantic Treaty Organization (NATO) was first floated publicly by Escott Reid, then a senior official with the Canadian Department of External Affairs. NATO was established a year and a half later, reflecting almost exactly the vision that Reid outlined in his speech at Couchiching. This year's conference theme, "Continentalism: What's in it for us?" is a topic that is thought-provoking and, some might say, provocative. Yet, before I venture any thoughts on the subject, let me make it clear that I am not here as an advocate for greater North American integration. This is very much a political decision for Canadians and their elected governments. It is a big decision, and all of us, as a democratic society, will have to determine what we really want. I am not a politician; I am an economist. So, what I intend to do is to lay down some parameters for an appropriate discussion of the issues relevant to greater economic integration in North America.First, I would like to review the benefits and costs of economic integration. By economic integration, I mean the free movement of goods
For over a decade, survey studies concerning drug use and college students have portrayed a significantly lower pattern of drug use by students attending Catholic controlled universities than other university types. In the spring of 1972 the author conducted a study of the undergraduates of a large Midwest Catholic University to assess various aspects of its drug scene. The involvement with drugs, especially marijuana, on this campus departed substantially from the usual Catholic control-low drug use nexus. The discussion presents a description of this departure and suggest that certain demographic and social characteristics of this Midwest Catholic University, when interacting, suffice to offset the religious control and religiosity influences that usually effect the low drug use--religious control nexus.
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