Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 513
Filter
1.
Rev. Assoc. Med. Bras. (1992) ; 68(7): 948-952, July 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394587

ABSTRACT

SUMMARY OBJECTIVE: To evaluate the efficacy of a training program in ultrasound-guided fine needle puncture using a cost-effective model. METHODS: We evaluated the training of 20 resident radiology physicians, based on a theoretical course and a practical simulation part with models that focused on the puncture technique of thyroid nodules. The total time to perform the procedure, the number of punctures on the model surface, and the application of a questionnaire were used to assess the performance and confidence of the resident physicians in performing the procedure. RESULTS: The training model used was easy to reproduce, inexpensive, versatile, and capable of simulating the echotexture of thyroid tissue. There was a significant reduction in the total time needed to perform the procedure with a mean of 173.7 s±91.28 s from R1 and 112.8 s±17.66 s from R2 before the course vs. 19.2 s±112.8 s and 14.3 s±9.36 s, respectively, after the course (p<0.0001); as well as the number of superficial punctures, with a mean of 2.2 punctures±0.92 from R1 and 1.5 punctures±0.32 from R2 before the course vs 1.1 punctures±0.71 and 1.0 puncture±0.0, respectively, after the course (p<0.0001). There was also a subjective improvement in the performance and confidence in performing this procedure. CONCLUSIONS: An inexpensive and easy-to-reproduce gelatin-based model enabled adequate training of resident physicians and proved capable of improving their skills and confidence in simulating the procedure, even with a short period of training.

2.
Acta neurol. colomb ; 38(2): 85-90, abr.-jun. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1383401

ABSTRACT

RESUMEN INTRODUCCIÓN: La encefalopatía asociada a enfermedad tiroidea autoinmune se caracteriza por un inicio insidioso de síntomas neuropsiquiátricos que incluyen alteración de la función cognoscitiva, cambios del comportamiento, crisis convulsivas y trastornos del movimiento. REPORTE DE CASO: Hombre de 69 años con antecedente de hipotiroidismo primario que consultó por dos semanas de alteración de la memoria, confusión y trastorno del lenguaje, asociados a hiperreflexia y temblor generalizado. Los estudios mostraron nivel de hormona tiroidea y títulos de anticuerpos antitiroideos elevados, líquido cefalorraquídeo con aumento de proteínas y anticuerpos antineuronales negativos, neuroimagen normal y electroencefalograma con alteraciónes inespecíficas. Posterior a descartar otras etiologías, se hizo el diagnóstico de encefalopatía asociada a enfermedad tiroidea autoinmune y se inició manejo con esteroides, con los que presentó una mejoría clínica significativa. DISCUSIÓN: La encefalopatía asociada a enfermedad tiroidea autoinmune es un trastorno complejo que requiere un diagnóstico oportuno y rápido. En todos los pacientes con síntomas neuropsiquiátricos agudos o subagudos, y sin causa clara, es pertinente solicitar un perfil de anticuerpos antitiroideos independiente de la función tiroidea basal.


ABSTRACT INTRODUCTION: Thyroid autoimmune disease-associated encephalopathy is characterized by an insidious onset of neuropsychiatric symptoms which may include impaired cognitive function, behavioral changes, seizures, and movement disorders. CASE REPORT: A 69-year-old man with a history of primary hypothyroidism who consulted for two weeks of memory impairment, confusion, and language disorder, associated with hyperreflexia and generalized tremor. Studies showed elevated thyroid hormone levels and antithyroid antibody titers, cerebrospinal fluid with increased protein and negative antineuronal antibodies, normal neuroimaging, and electroencephalogram with nonspecific abnormalities. After ruling out other etiologies, a diagnosis of encephalopathy associated with autoimmune thyroid disease was made and management with steroids was started, with which he presented significant clinical improvement. DISCUSSION: Encephalopathy associated with autoimmune thyroid disease is a complex disorder that requires timely and rapid diagnosis. In all patients with acute or subacute neuropsychiatric symptoms, and without a clear cause, it is pertinent to request an antithyroid antibody profile independent of baseline thyroid function

3.
Rev. Assoc. Med. Bras. (1992) ; 68(5): 680-684, May 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376198

ABSTRACT

SUMMARY Objective: The aim of this study was to evaluate the expression of endoglin and its correlation with histopathological and clinical findings in conjunctival nevi. Methods: The study included archival formalin-fixed, paraffin-embedded tissue sections of 44 patients with conjunctival nevi. Immunohistochemical staining for CD105 had been performed with monoclonal mouse antihuman CD105 antibodies. The intratumoral microvessel density for quantification of tumoral vascularization had been determined by this marker. Results: The expression of CD105 was positive in 30 (68.2%) cases. There was a statistically significant difference in the level of CD105 expression regarding the histological type of nevus (p=0.03) and intralesional cysts status (p=0.02). Spearman's rho (ρ −0.316) revealed a significant negative correlation between the expression of endoglin and the histological type of nevus (p=0.03) and between the expression of endoglin and the presence of intralesional cysts (ρ −0.380, p=0.01). Conclusion: This study suggests that endoglin could be a useful diagnostic and prognostic marker in differentiating between benign and malignant melanocytic ocular lesions.

4.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389832

ABSTRACT

Resumen El tiroides ectópico es una alteración congénita infrecuente que presenta una prevalencia entre 1/100.000-1/300.000. En el 90% de los casos se encuentra en la línea media cervical, siendo los casos de tiroides ectópico cervical lateral muy infrecuentes. Presentamos el caso de una paciente de 44 años que consultó por presentar una tumoración submandibular izquierda de más de seis meses de evolución. Las pruebas de imagen (ecografía, tomografía computarizada y gammagrafía) sugirieron un bocio ectópico multinodular; la punción aspiración con aguja fina (PAAF) informó de tejido tiroideo sin atipias (Bethesda II) y el estudio sanguíneo de hormonas tiroideas fue normal, orientando finalmente el caso como un bocio multinodular ectópico submandibular eutiroideo. Ante la ausencia de síntomas y signos sugerentes de malignidad, en conjunto con una PAAF con características de benignidad, se decidió realizar seguimiento. En el momento que presentó clínica por efecto masa se decidió realizar la exéresis de la lesión, que confirmó el diagnóstico de bocio multinodular ectópico. Los casos descritos en la literatura de bocio multinodular ectópico submandibular como único tejido tiroideo funcionante son excepcionales. El tiroides ectópico se debe considerar en el diagnóstico diferencial de una masa submandibular. Aunque actualmente no existe un consenso en relación con el manejo de dicha patología, el crecimiento de la masa puede contribuir a la decisión de una exéresis completa del tiroides ectópico, aun tratándose del único tejido tiroideo funcionante.


Abstract Ectopic thyroid is an uncommon congenital disorder with a prevalence between 1/100,000-1/300,000. In 90% of cases, it is placed in cervical midline, being the cases of lateral cervical ectopic thyroid very infrequent. We present the case of a 44-year-old female patient who had a left submandibular mass during more than six months. Imaging tests (ultrasound, computed tomography and scintigraphy) suggested a multinodular ectopic goiter; fine needle aspiration (FNA) reported thyroid tissue without atypia (Bethesda II) and the thyroid hormone blood tests were normal, finally orienting the case as a euthyroid submandibular ectopic multinodular goiter. In the absence of symptoms and signs suggestive of malignancy, together with an FNA with benign characteristics, it was decided to follow up. When the patient presented clinical symptoms due to mass effect, it was decided to perform excision of the lesion, which confirmed the diagnosis of ectopic multinodular goiter. There are very few cases described in the literature of submandibular ectopic multinodular goiter as the only functioning thyroid tissue. Ectopic thyroid should be considered in the differential diagnosis of a submandibular mass. Although there is currently no consensus on the management of this pathology, the growth of the mass may contribute to the decision of a complete excision of the ectopic thyroid, even if it is the only functioning thyroid tissue.

5.
Radiol. bras ; 55(1): 47-53, Jan.-Feb. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360663

ABSTRACT

Abstract High-resolution ultrasound is the imaging method of choice for the evaluation of thyroid nodules. The method has recently come to be used widely and often, which has increased the rate of thyroid nodule detection. In 2017, the American College of Radiology (ACR) established a risk-stratification system designated the Thyroid Imaging Reporting and Data System (TI-RADS) to be a practical guide for widespread use, with a single lexicon and standardization of ultrasound reports of thyroid nodules. The objective of this study was to present a practical approach, using examples to illustrate the criteria evaluated by the 2017 ACR TI-RADS, in order to help minimize uncertainties regarding its application by sonographers.


RESUMO A ultrassonografia de alta resolução é a modalidade de escolha para avaliação de imagem dos nódulos tireoidianos, e sua recente aplicação ampla e difusa tornou a detecção de nódulos tireoidianos mais frequentes. O American College of Radiology (ACR) estabeleceu um sistema de estratificação de risco denominado Thyroid Imaging, Reporting and Data System (TI-RADS) para ser um guia prático para utilização ampla com um léxico único e padronização de relatórios ultrassonográficos de nódulos tireoidianos. O objetivo deste trabalho é fazer uma abordagem prática com base em exames para ilustrar e exemplificar os critérios avaliados pelo TI-RADS-ACR 2017, a fim de ajudar a reduzir os pontos de dúvidas de sua aplicação pelos profissionais ultrassonografistas.

6.
Einstein (Säo Paulo) ; 20: eAO6747, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1375324

ABSTRACT

ABSTRACT Objective To determine whether the size of thyroid nodules in ACR-TIRADS ultrasound categories 3 and 4 is correlated with the Bethesda cytopathology classification. Methods Thyroid nodules (566) subclassified as ACR-TIRADS 3 or 4 were divided into three size categories according to American Thyroid Association guidelines. The frequency of different Bethesda categories in each size range within ACR-TIRADS 3 and 4 classifications was analyzed. Results Most nodules in both ACR-TIRADS classifications fell in the Bethesda 2 category, regardless of size (90.8% and 68.6%, ACR-TIRADS 3 and 4 respectively). The prevalence of Bethesda 6 nodules in the ACR-TIRADS 4 group was 14 times higher than in the ACR-TIRADS 3 group. There were no significant differences between nodule size and fine needle aspiration biopsy classification in any of the ACR-TIRADS categories. Conclusion Size does not appear to be an important criterion for indication of fine needle aspiration biopsy in thyroid nodules with a high suspicion of malignancy on ultrasound examination.

7.
Med. lab ; 26(1): 15-33, 2022. Tabs, ilus, Grafs
Article in Spanish | LILACS | ID: biblio-1370944

ABSTRACT

Durante el embarazo se generan múltiples cambios fisiológicos a nivel hormonal para llevar a cabo de manera satisfactoria la gestación. Uno de los ejes hormonales con cambios más importantes que repercuten de manera directa en el desarrollo fetal y bienestar materno es el tiroideo, el cual presenta modificaciones para lograr suplir las necesidades de hormona tiroidea tanto materna como fetal, principalmente en las primeras etapas del embarazo. Entre estas, se describen cambios en la cantidad de proteínas transportadoras de hormonas, aumento en el estímulo y producción de hormonas tiroideas, incremento del aclaramiento renal de yodo y alteración en la actividad de las desyodinasas. Estos mecanismos ofrecen suficiente hormona tiroidea al feto, el cual es dependiente del aporte materno. Un desajuste en cualquiera de estos mecanismos, puede conducir al desarrollo de hipotiroidismo con múltiples complicaciones, como la pérdida del embarazo e hipertensión gestacional, entre otras. Una tamización oportuna y un tratamiento temprano pueden evitar estos desenlaces adversos. De ahí la necesidad fundamental de conocer y comprender el comportamiento del eje tiroideo en la gestación


During pregnancy, multiple physiological changes are generated at the hormonal level to successfully carry out pregnancy. One of the hormonal axes with the most important changes that have a direct impact on fetal development and maternal well-being is the thyroid axis, which presents multiple modifications to reach the needs of thyroid hormone for both the mother and the fetus, primarily in the early stages of pregnancy. Changes in the amount of hormone transport proteins, increased stimulation and production of thyroid hormones, increased renal clearance of iodine, and alteration in deiodinase activity are included within these modifications. These mechanisms offer enough thyroid hormone to the fetus, which is dependent on the maternal supply. An imbalance in any of these can lead to the development of hypothyroidism with multiple complications, such as pregnancy loss and gestational hypertension, among others. Timely screening and early treatment can avoid these adverse outcomes, hence the importance of knowing and understanding the regulation of the thyroid axis in pregnancy


Subject(s)
Humans , Thyroid Gland , Physiology , Pregnancy , Hypothyroidism
8.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 108-117, 28 dec. 2021.
Article in Portuguese | LILACS | ID: biblio-1352339

ABSTRACT

As neoplasias endócrinas múltiplas (NEM) são síndromes genéticas autossômicas dominantes implicadas no desenvolvimento de neoplasias benignas ou malignas, envolvendo ao menos duas glândulas endócrinas. Entre seus subtipos, está a NEM2A, que consiste em carcinoma medular de tireoide (CMT), feocromocitoma e hiperparatireoidismo. Este texto apresente o relato de caso de um paciente de 40 anos, previamente hígido, que passou a apresentar episódios de cefaleia associada a sudorese profusa, vômitos e taquicardia. Evoluiu com distensão abdominal intensa após alimentação por via oral, perda ponderal, desnutrição, astenia, obstipação, humor deprimido e picos pressóricos. Exames laboratoriais evidenciaram alterações dos hormônios tireoidianos, PTH e hormônios da adrenal. Foi levantada a suspeita clínica de NEM2A, posteriormente corroborada pelos diagnósticos anatomopatológicos de feocromocitoma e CMT, associados à presença de hiperparatireoidismo. Foi possível concluir que, a despeito de sua baixa prevalência na população geral, a NEM é uma síndrome clínica de grande relevância, tendo em vista os impactos para os pacientes e famílias acometidas. Dessa forma, é necessário que os profissionais de saúde tenham conhecimento acerca da síndrome e que o Sistema Único de Saúde (SUS) esteja apto a assistir aos pacientes portadores de NEM, possibilitando diagnóstico precoce e tratamento adequado.


Multiple endocrine neoplasias (MEN) are dominant autosomal genetic syndromes involved in the development of benign or malignant tumors in at least two endocrine glands. MEN2A is one of its subtypes, which consists of medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism. This study reports the case of a healthy 40-year-old male patient presenting with episodes of headache associated with profuse sweating, vomiting, and tachycardia. The patient evolved with severe abdominal distension after oral feeding, weight loss, malnutrition, asthenia, constipation, depressed mood, and pressure peaks. Laboratory tests showed abnormalities in thyroid, parathyroid (PTH), and adrenal hormones ­ thus raising the hypothesis of MEN2A, which was later corroborated by the histological diagnosis of pheochromocytoma and MTC, associated with hyperparathyroidism. The results indicate that, despite its low prevalence in the general population, MEN has a great impact on affected patients and families, thus being a relevant clinical syndrome. For enabling early diagnosis and adequate treatment, health professionals must be familiarized with such a condition, and the Brazilian Unified Health System (SUS) must be able to assist affected patients.


Las neoplasias endocrinas múltiples (NEM) son síndromes genéticos autosómicos dominantes involucrados en el desarrollo de neoplasias benignas o malignas, que afectan al menos dos glándulas endocrinas. Entre sus subtipos se encuentra NEM2A, que consiste en carcinoma medular de tiroides (CMT), feocromocitoma e hiperparatiroidismo. Este es un reporte de caso de un paciente de 40 años de edad, previamente sano, que comenzó a presentar episodios de cefalea asociada a sudoración profusa, vómitos y taquicardia. Evolucionó con distensión abdominal severa después de alimentarse, pérdida de peso, desnutrición, astenia, estreñimiento, estado de ánimo deprimido y picos de presión. Las pruebas de laboratorio mostraron alteraciones en las hormonas tiroideas, PTH y hormonas suprarrenales. Se planteó la hipótesis de MEN2A, posteriormente corroborada por el diagnóstico anatomopatológico de feocromocitoma y CMT, asociado a hiperparatiroidismo. Se pudo concluir que, a pesar de su baja prevalencia en la población general, el NEM es un síndrome clínico de gran relevancia, dado el impacto que tiene en los pacientes y familiares afectados. Por tanto, es necesario que los profesionales sanitarios tengan conocimiento sobre el síndrome y que el Sistema Único de Salud (SUS) sea capaz de asistir a los pacientes con NEM, posibilitándoles diagnóstico precoz y tratamiento adecuado.


Subject(s)
Humans , Pheochromocytoma , Multiple Endocrine Neoplasia , Thyroid Neoplasms , Carcinoma, Medullary , Endocrine Glands , Hyperparathyroidism
9.
Rev. colomb. cir ; 36(4): 682-695, 20210000. tab, graf
Article in English | LILACS | ID: biblio-1365770

ABSTRACT

Abstract Coexistence between thyroid cancer and hyperthyroidism is rare, and most of the nodular lesions from which a malignant tumor is documented in this group of patients correspond to cold nodules. Justified by the increasing number of reports in the literature about malignant tumors diagnosed from hot nodules, a systematic review was carried out to determine possible factors associated with the diagnosis of thyroid cancer from hot nodules in patients with hyperthyroidism. The results suggest that the clinical diagnosis of toxic nodular goiter, nodular lesions of diameter > 10 mm and a histological type compatible with a follicular carcinoma, are factors that on their own increase the risk of making the diagnosis of cancer from a hot nodule.


Resumen La coexistencia entre cáncer de tiroides e hipertiroidismo es infrecuente, y la mayoría de las lesiones nodulares a partir de las cuales se documenta un tumor maligno en este grupo de pacientes corresponden a nódulos fríos. Justificado en el creciente número de reportes en la literatura acerca de tumores malignos diagnosticados a partir de nódulos calientes, se realizó una revisión sistemática que tuvo como objetivo determinar los posibles factores asociados con el diagnóstico de cáncer de tiroides a partir de nódulos calientes en pacientes con hipertiroidismo. Los resultados sugieren que el diagnóstico clínico de bocio nodular tóxico, lesiones nodulares de diámetro mayor de 10 mm y tipo histológico compatible con carcinoma folicular, son factores que aumentan por sí solos el riesgo de realizar el diagnóstico de cáncer a partir de un nódulo caliente.


Subject(s)
Thyroid Gland , Thyroid Neoplasms , Thyroid Nodule , Adenocarcinoma, Follicular , Systematic Review , Hyperthyroidism
10.
Rev. colomb. cir ; 36(4): 682-695, 20210000. fig, tab
Article in Spanish | LILACS | ID: biblio-1291253

ABSTRACT

La coexistencia entre cáncer de tiroides e hipertiroidismo es infrecuente, y la mayoría de las lesiones nodulares a partir de las cuales se documenta un tumor maligno en este grupo de pacientes corresponden a nódulos fríos. Justificado en el creciente número de reportes en la literatura acerca de tumores malignos diagnosticados a partir de nódulos calientes, se realizó una revisión sistemática que tuvo como objetivo determinar los posibles factores asociados con el diagnóstico de cáncer de tiroides a partir de nódulos calientes en pacientes con hipertiroidismo. Los resultados sugieren que el diagnóstico clínico de bocio nodular tóxico, lesiones nodulares de diámetro mayor de 10 mm y tipo histológico compatible con carcinoma folicular, son factores que aumentan por sí solos el riesgo de realizar el diagnóstico de cáncer a partir de un nódulo caliente


Coexistence between thyroid cancer and hyperthyroidism is rare, and most of the nodular lesions from which a malignant tumor is documented in this group of patients correspond to cold nodules. Justified by the increasing number of reports in the literature about malignant tumors diagnosed from hot nodules, a systematic review was carried out to determine possible factors associated with the diagnosis of thyroid cancer from hot nodules in pa-tients with hyperthyroidism. The results suggest that the clinical diagnosis of toxic nodular goiter, nodular lesions of diameter > 10 mm and a histological type compatible with a follicular carcinoma, are factors that on their own increase the risk of making the diagnosis of cancer from a hot nodule


Subject(s)
Humans , Thyroid Neoplasms , Hyperthyroidism , Thyroid Gland , Thyroid Nodule , Adenocarcinoma, Follicular , Systematic Review
11.
Article in English | WPRIM | ID: wpr-880695

ABSTRACT

Extraskeletal Ewing sarcoma is a rare event, and extraskeletal Ewing sarcoma of the thyroid gland is even rarer. It has non-specific clinical manifestation and difficulty in early diagnosis. The diagnosis mainly depends on histology and immunohistochemistry. It possesses the features of high malignancy, high rate of local recurrence, and distant metastasis. Currently, the aggressive multimodal treatment contains surgery, chemotherapy, and radiotherapy. This study presented a case of extraskeletal Ewing sarcoma arising in the thyroid gland of a 30-year-old woman, who presented with supraclavicular mass and sense of dysphagia obstruction in Department of Otolaryngology, Head and Neck Surgery, Second Xiangya Hospital, Central South University in 2018. Imaging studies demonstrated a cystic-solid mass in inferior of the left leaf of thyroid gland and in the posterior of the trachea and esophagus. The patient underwent localized tumor resection. The pathological diagnosis revealed that it was a small round cell tumor, and the immunohistochemistry results were considered to be extraskeletal Ewing sarcoma. Subsequently, the patient was given chemotherapy and local radiation therapy. There was no evidence of tumor recurrence or metastasis.


Subject(s)
Adult , Combined Modality Therapy , Female , Humans , Immunohistochemistry , Neoplasm Recurrence, Local , Sarcoma, Ewing/therapy , Thyroid Gland
12.
Article in Chinese | WPRIM | ID: wpr-907825

ABSTRACT

Ectopic thyroid gland refers to the presence of thyroid tissue outside the normal position of the neck, which is relatively rare in clinical practice, and ectopic and cancer change is rare. This article focuses on a patient with "supraclavicular mass" as the first symptom admitted to the Thyroid Surgery Department of Binzhou People’s Hospital, After the operation, the pathology confirmed ectopic thyroid cancer with lymph node metastasis, and the imaging showed lung metastasis. This article summarizes the case data.

13.
Autops. Case Rep ; 11: e2021318, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285425

ABSTRACT

Epidermal inclusion cyst (EIC) of the thyroid is extremely rare in the clinical practice. A handful of cases have been documented in the past in the world literature. A giant EIC of the thyroid is hitherto unreported. This lesion may arise from the squamous metaplasia of the thyroid follicular cells. Though non-neoplastic, giant forms can cause compression of the vital structures of the neck. In the present case, we have described a giant epidermal inclusion cyst successfully managed with surgical management.


Subject(s)
Humans , Female , Middle Aged , Thyroid Gland/abnormalities , Epidermal Cyst/surgery , Rare Diseases , Metaplasia
14.
An. bras. dermatol ; 95(6): 721-723, Nov.-Dec. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142123

ABSTRACT

Abstract Thyroid hormone has effects on the skin. Patients with hypothyroidism have changes such as dry, scaly and rough skin. Increase carotene in the dermis becomes a yellowish tone to the skin of the patient with hypothyroidism. There is an increase in capillary cycle (anagen phase) and nail growth and a reduction in eccrine gland secretion. It is a case of primary hypothyroidism with nail manifestations associated with dermatologic disorders and successful treatment with levothyroxine. Receptors for thyroid hormone have already been found in keratinocytes, fibroblasts, hair follicles and sebaceous glands. Genes responsive to thyroid hormones and elements of the hypothalamic-pituitary-thyroid axis were identified on the skin. This report highlights the importance of cutaneous manifestations as markers of thyroid disease.


Subject(s)
Humans , Hypothyroidism/drug therapy , Skin , Thyroid Hormones , Thyroxine , Hair Follicle
15.
Rev. Assoc. Med. Bras. (1992) ; 66(11): 1573-1576, Nov. 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1143630

ABSTRACT

SUMMARY INTRODUCTION: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy. METHODS: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI≥ 25 (group B). Demographics, operative time, and complications were retrospectively reviewed. RESULTS: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055). CONCLUSION: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.


RESUMO INTRODUÇÃO: A obesidade é um crescente problema de saúde pública associado a muitas doenças comórbidas. O objetivo deste estudo foi avaliar a relação entre o índice de massa corporal e as complicações da tireoidectomia. MÉTODOS: Os pacientes submetidos a tireoidectomia total entre janeiro de 2015 e dezembro de 2018 foram incluidos. Os pacientes foram divididos em dois como IMC <25 (grupo A) e IMC . 25 (grupo B). Demografia, tempo operatorio e complicacoes revisadas retrospectivamente. RESULTADOS: O estudo incluiu 145 pacientes (66 no grupo A e 79 no grupo B). Não houve diferença significativa entre os dois grupos em termos de idade (p = 0,033) e sexo (p = 0,055). Nenhuma infecção do sítio cirúrgico e complicações hemorrágicas foram observadas em nenhum paciente. O tempo operatório médio foi de 148,4 minutos (90-235) no grupo A e 153,4 minutos (85-285) no grupo B (p = 0,399). Hipocalcemia transitória foi observada em 25 (37,9%) pacientes do grupo A e 23 (29,1%) do grupo B (p = 0,291). Hipocalcemia permanente não foi observada em nenhum paciente do grupo A e em 2 pacientes do grupo B (2,5%) (p = 0,501). Paralisia nervosa recorrente transitória foi observada em 1 (1,5%) paciente no grupo A e em 3 (3,8%) pacientes no grupo B (p = 0,626). Nenhum dos pacientes apresentou paralisia nervosa recorrente permanente. O autotransplante de paratireóide foi realizado em 1 paciente (1,5%) no grupo A e em 7 (8,9%) pacientes no grupo B (p = 0,055). CONCLUSÃO:: Acreditamos que não há relação entre um IMC alto e as complicações da tireoidectomia e a cirurgia pode ser realizada com segurança também neste grupo de pacientes.


Subject(s)
Humans , Male , Female , Thyroidectomy/adverse effects , Postoperative Complications/etiology , Postoperative Complications/epidemiology , Body Mass Index , Retrospective Studies , Operative Time , Hypocalcemia/etiology
16.
Rev. bras. ginecol. obstet ; 42(11): 752-758, Nov. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144179

ABSTRACT

Abstract Objective: To identify whether the effects of thyroid disease during pregnancy and lactation affect the nutritional composition of human milk. Methods: Systematic review of the scientific literature using the Medical Literature Analysis and Retrieval System Online/MedLine databases to evaluate the association of thyroid diseases during pregnancy and lactation with the nutritional composition of human milk. There was no delimitation by period or by language, and the searches were completed in March 2019. The following descriptors were applied: human milk AND thyroid AND composition, using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol for data search, selection, and extraction. The flowchart proposed for bibliographic search resulted in 12 articles and, of these, four were selected. Results: The articles elected for this review were published between 1976 and 2018. Two studies found significant differences in the nutritional composition of mothers' milk with hypothyroidism or overweight compared with the milk of those without hypothyroidism. Studies have shown that the presence of the disease led to changes in the nutritional composition of human milk, especially a higher concentration of human milk fat. Conclusion: It is extremely important that these women have continuous nutritional follow-up to minimize the impact of these morbidities on the nutritional composition of human milk.


Resumo Objetivo: Identificar se os efeitos da doença da tireoide durante a gestação e lactação afetam a composição nutricional do leite humano. Métodos: Revisão sistemática da literatura científica por meio das bases de dados Medical Literature Analysis and Retrieval System Online/MedLine a fim de avaliar a associação das doenças da tireoide na gestação e na lactação com a composição nutricional do leite humano. Não houve delimitação por período nem por idioma, e as buscas foram finalizadas em março de 2019. Foram aplicados os seguintes descritores: human milk AND thyroid AND composition, utilizando protocolo preferred reporting items for systematic reviews and meta-analyses (PRISMA) para a busca, seleção e extração de dados. De acordo com o fluxograma proposto, a busca bibliográfica resultou em 12 artigos e, destes, quatro foram selecionados. Resultados: Os artigos elegidos para a presente revisão foram publicados entre 1976 e 2018. Dois estudos verificaram diferenças significativas na composição nutricional do leite de mães com hipotireoidismo ou excesso de peso em comparação ao grupo controle sem hipotireoidismo. Os estudos demonstraram que a presença da doença levava a modificações na composição nutricional do leite humano, principalmente em relação à maior concentração da gordura. Conclusão: É de extrema importância que essas mulheres tenham acompanhamento nutricional contínuo a fim de minimizar o impacto dessas morbidades sobre a composição nutricional do leite humano.


Subject(s)
Humans , Female , Pregnancy , Puerperal Disorders , Thyroid Diseases , Lactation , Milk, Human/chemistry
17.
Rev. cuba. invest. bioméd ; 39(3): e640, jul.-set. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1138936

ABSTRACT

Introducción: La microscopía holográfica digital ha permitido a la microscopía óptica hacer uso de herramientas numéricas y computacionales; y esto, a su vez, ha favorecido múltiples avances en el estudio de las células y los tejidos en diferentes campos de la medicina y otras ciencias afines. Objetivo: Describir las características histológicas y morfométricas de los folículos tiroideos humanos con la microscopía holográfica digital. Métodos: Se realizó, desde el punto de vista histomorfométrico, un estudio descriptivo y transversal de folículos tiroideos humanos utilizando una instalación de microscopía holográfica digital. Se empleó la técnica de inclusión en parafina y tinción de hematoxilina-eosina para el procesamiento de las muestras. Se realizaron de 10 a 12 capturas de hologramas por muestra y el método de doble propagación para la reconstrucción de los hologramas. Se calculó el área, el perímetro, el diámetro mayor y menor de los folículos y cavidades foliculares y se realizaron reconstrucciones de imágenes holográficas en tres dimensiones. Se determinó como medida de tendencia central la media aritmética y como medida de dispersión la desviación típica o estándar. Resultados: Parámetros foliculares: área (5140,31 ± 1126,71 µm2); perímetro (2961,54 ± 71,2 µm); diámetro mayor:(921,17 ± 24,34 µm); diámetro menor: (746,67 ± 18,08 µm); altura del epitelio (7,92 ± 0,96). Cavidades foliculares: área (3686,18 ±1023,52 µm2); diámetro mayor: (698,86 ± 19,55 µm) y diámetro menor: (581,15 ± 13,82 µm). Conclusiones: Existen parámetros foliculares, determinados mediante la microscopía holográfica digital, no reportados por la literatura consultada, que resultan de interés en el estudio histológico de los folículos tiroideos humanos(AU)


Introduction: Digital holographic microscopy has made it possible to incorporate the use of numerical and computer tools into optical microscopy. This in turn has led to great progress in the study of cells and tissues in several fields of medicine and related sciences. Objective: Describe the histological and morphometric characteristics of human thyroid follicles using digital holographic microscopy. Methods: A descriptive cross-sectional histomorphometric study was conducted of human thyroid follicles using a digital holographic microscopy facility. Sample processing was based on inclusion technique by paraffin and hematoxylin-eosin staining. Ten to twelve holographic captures were made per sample, and the double propagation method was used for holographic reconstruction. Estimation was carried out of the area, perimeter, and greatest and smallest diameter of follicles and follicular cavities, and tri-dimensional reconstructions were made of holographic images. Arithmetic mean was determined as the measure of central tendency, and typical or standard deviation as the measure of dispersion. Results: Follicular parameters: area (5 140.31 ± 1 126.71 µm2); perimeter (2 961.54 ± 71.2 µm); greatest diameter (921.17 ± 24.34 µm); smallest diameter (746.67 ± 18.08 µm); epithelial height (7.92 ± 0.96). Follicular cavities: area (3 686.18 ± 1 023.52 µm2); greatest diameter (698.86 ± 19.55 µm); smallest diameter (581.15 ± 13.82 µm). Conclusions: A number of follicular parameters determined by digital holographic microscopy have not been reported by the literature consulted, and they are of interest to the histological study of human thyroid follicles(AU)


Subject(s)
Humans , Computers , Holography/methods , Hematoxylin/therapeutic use , Thyroid Gland/physiology , Eosine Yellowish-(YS)
18.
Rev. Finlay ; 10(3): 222-230, jul.-set. 2020. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1143813

ABSTRACT

RESUMEN Fundamento la disfunción tiroidea se encuentra con frecuencia entre los pacientes con diabetes mellitus tipo 2, esa proporción aumenta y es el hipotiroidismo la disfunción más frecuente. Objetivo determinar el comportamiento de la disfunción tiroidea en pacientes con diabetes mellitus tipo 2 en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Método: se realizó un estudio de corte transversal, entre el 1 de enero y el 31 de diciembre de 2018, en el Servicio Ambulatorio de personas con diabetes mellitus del Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Se estudiaron un total de 210 pacientes. Las variables analizadas fueron: edad, sexo, antecedentes patológicos personales, antecedentes patológicos familiares, tiempo de diagnóstico, presencia de disfunción tiroidea y tipo de disfuncióntiroidea. Se calculó el intervalo de confianza del 95 %. Para efectuar las comparaciones entre las frecuencias, se utilizó el test de Fisher. Resultados el 32,4% de los pacientes estudiados presentaron disfunción tiroidea, de ellos un 23,3 % fueron del sexo femenino en las cuales predominó el hipotiroidismo subclínico lo que representó el 42,6 %. El grupo de edad entre 40 y 49 años fue el más representativo en el 9,1% de los pacientes. La presencia de antecedentes patológicos familiares de diabetes mellitus tipo 2 y de disfunción tiroidea fue del 30 y el 19,5% respectivamente. Conclusión: la prevalencia de disfunción tiroidea es similar a la encontrada en algunos estudios previos, siendo más representativa en la quinta década de la vida, es más frecuente en el sexo femenino y el hipotiroidismo subclínico fue el que más predominó.


ABSTRACT Background: thyroid dysfunction is frequently found among patients with type 2 diabetes mellitus, this proportion increases, being hypothyroidism the most frequent. Objective: to determine the behavior of thyroid dysfunction in patients with type 2 diabetes mellitus at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos. Method: a cross-sectional study was carried out between January the 1st and December the 31st, 2018, in the Outpatient Service of people with diabetes mellitus in the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos. A total of 210 patients were studied. The variables analyzed were: age, sex, personal pathological history, family pathological history, time of diagnosis, presence of thyroid dysfunction and type of thyroid dysfunction. The 95 % confidence interval was calculated. The Fisher's test was used to compare between frequencies. Results: the 32.4 % of the patients studied had thyroid dysfunction, from which 23.3 % were female, in which subclinical hypothyroidism predominated, representing the 42.6 %. The age group between 40 and 49 years was the most representative with the 9.1% of the patients. The presence of a family pathological history of type 2 diabetes mellitus and thyroid dysfunction was the 30 % and the 19.5 %, respectively. Conclusion: the prevalence of thyroid dysfunction is similar to that found in some previous studies, being more representative in the 5th decade of life, it is more frequent in the female sex and the subclinical hypothyroidism was the most predominant.

19.
Rev. bras. anal. clin ; 52(3): 238-242, 20200930. tab, graf
Article in Portuguese | LILACS | ID: biblio-1255090

ABSTRACT

Objetivo: Caracterizar o perfil dos hormônios tireoidianos de mulheres com idade maior ou igual a 50 anos atendidas no Laboratório Municipal de Referência Regional de Serrinha (LMRRS) no ano de 2017. Métodos: Os resultados de T3, T4 livre e TSH foram coletados retrospectivamente através do sistema informatizado utilizado pelo laboratório para construção de uma base de dados, e analisados de acordo com valores de referência recomendados pela Sociedade Brasileira de Endocrinologia. Resultados: Foi encontrada uma prevalência moderada de disfunções tireoidianas, sendo 58,62% de casos de hipotireoidismo e 41,38% de hipertireoidismo. Houve também aumento dos níveis de TSH e T4 livre entre os 50 e 70 anos, sem alterações nos níveis de T3 total. Conclusão: Os resultados assemelham-se a estudos anteriores, envolvendo outras populações, com predomínio do hipotireoidismo subclínico entre mulheres na mesma faixa etária. No entanto, a tendência crescente dos níveis de T4 livre não reflete os achados prévios que associam o avanço da idade e redução da produção de estrogênios com a diminuição da função tireoidiana.


Objective: To characterize the thyroid hormone profile of women aged 50 years and older attended at the Laboratório Municipal de Referência Regional de Serrinha (LMRRS) in the year 2017. Methods: The results of T3, free T4 and TSH were retrospectively collected from the computerized system of laboratory for building a database, and analyzed according to the reference values recommended by the Brazilian Society of Endocrinology. Results: A moderate prevalence of thyroid dysfunction was found, with 58.62% of cases of hypothyroidism and 41.38% of hyperthyroidism. There was also an increase of TSH and free T4 levels between 50 and 70 years with no changes in total T3 levels. Conclusion: The results are similar to previous studies involving other populations, with a prevalence of subclinical hypothyroidism in women in the same age group. However, the increasing trend of free T4 levels does not reflect the previous findings that associate the advancement of age and reduction of estrogen production with the decrease of thyroid function.


Subject(s)
Humans , Female , Middle Aged , Aged , Aged, 80 and over , Thyroid Gland , Thyroid Hormones , Menopause , Hyperthyroidism , Hypothyroidism
20.
Arch. méd. Camaguey ; 24(4): e7366, jul.-ago. 2020. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1131148

ABSTRACT

RESUMEN Fundamento: la tiroides es donde con más frecuencia se originan enfermedades tumorales de naturaleza endocrina maligna. A este antecedente se suman las múltiples variantes histológicas que posee la enfermedad, que en ocasiones son motivo de importantes dudas diagnósticas. Por esta razón, se desarrollan estudios en los que cada vez más se añaden procedimientos morfométricos. Se reconoce que el éxito de un tratamiento individualizado depende de un diagnóstico preciso, donde la morfometría, al descartar la subjetividad en el diagnóstico se convierte en una herramienta de mucho valor. Objetivo: caracterización morfométrica del carcinoma papilar de tiroides diagnosticado por biopsias escisionales. Métodos: se realizó un estudio morfométrico de serie de casos en 12 pacientes con este diagnóstico histopatológico, atendidos en el Hospital Provincial Universitario Vladimir Ilich Lenin. Se seleccionaron 340 campos y se midieron 10 465 núcleos celulares, lo que constituyó la muestra. Se caracterizaron indicadores morfométricos nucleares del carcinoma papilar de tiroides como el área, el volumen y el factor de forma. Resultados: el área y volumen nuclear mostraron valores aumentados comparados con los valores de enfermedades nodulares benignas de otros estudios. El valor del factor de forma nuclear se acercó a uno por lo que los núcleos tienden a ser redondos y se pudo observar que a mayores valores del área nuclear mayores valores del factor de forma nuclear. Conclusiones: se caracterizaron indicadores morfométricos del carcinoma papilar de tiroides en los casos estudiados como el área, el volumen y el factor de forma que contribuyen a su diagnóstico histopatológico.


ABSTRACT Background: thyroid is where malignant endocrine tumor diseases originate more frequently. This entity possesses multiple histological variants added to this antecedent, which are usually the cause of important diagnostic doubts. For this reason, studies in which more and more morphometric procedures are added have been developed. The success of an individualized treatment depends on an accurate diagnosis, in which morphometry is recognized by ruling out subjectivity in diagnosis, becomes a valuable tool. Objective: morphometric characterization of papillary thyroid carcinoma diagnosed by excisional biopsies. Morphometric. Methods: a morphometric study of a series of cases was carried out with 12 patients with this histopathological diagnosis, attended at the Vladimir Ilich Lenin University Provincial Hospital. 340 fields were selected and 10 465 cell nuclei were measured, which was our sample. Nuclear morphometric indicators were characterized, such as area, volume and shape factor. Results: nuclear area and volume showed increased values compared to benign nodular disease values from other studies. The value of the nuclear form factor approached one, so the nuclei tend to be round and it was observed that the higher the values of the nuclear area, the higher the values of the nuclear form factor. Conclusions: morphometric indicators of papillary thyroid carcinoma were characterized in the studied cases that may contribute to histopathological diagnosis.

SELECTION OF CITATIONS
SEARCH DETAIL