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1.
Article | IMSEAR | ID: sea-240422

ABSTRACT

Background: Thyroxine (T4) and triiodothyronine are the main thyroid hormones that play an essential role in cellular metabolism, growth, and tissue development, and subclinical hypothyroidism (SCH) is often defined by a thyroid-stimulating hormone (TSH) level above the upper limit of the reference range (usually around 4.0 or 4.5 mIU/L, usually TSH level in between 4 and 10 mIU/mL) along with a normal free T4 (fT4) level. Previous studies undertaken in various parts of the world have shown food intake can influence the TSH level at different percentages and these studies speculated that if we measure TSH level 2 h after breakfast (9:00 am) compared with the fasting blood samples that is generally collected in the morning (7:00 am), the TSH level is significantly reduced by about 30%, and this significant difference created reasonable doubt in the diagnosis of SCH. Aims and Objectives: The study aimed to evaluate the difference in serum TSH, fT4, leptin, cortisol, insulin, adiponectin, and glucagon-like peptide-1 (GLP-1) between fasting and post-prandial blood samples in known subclinical hypothyroid patients. Materials and Methods: This descriptive, cross-sectional, non-interventional study was done on 50 diagnosed subclinical hypothyroid patients after screening them through the inclusion–exclusion criteria. The estimations were done by chemiluminescence immunoassay or enzyme-linked immunosorbent assay method, statistical analysis was done using Statistical Packages for the Social Sciences. Results: After analysis of blood samples, it showed that the serum TSH decreased progressively after food intake for almost 2 h, the level of decrease is statistically significant (from 7.38 ± 1.22 mIU/mL to 5.9 ± 1.03 mIU/mL) (P < 0.001). Serum fT4 level remained almost unchanged after food intake. Conclusion: As per previous and our study a possible explanation of this post-prandial fall of TSH can be that food consumption causes an alteration in circulating glucose levels, insulin, leptin, gastric inhibitory polypeptide (cholecystokinin and GLP-1), and cortisol. Growth hormone (GH) and somatostatin levels also suppress TSH secretion from the pituitary. As both over- and under-treatment with eltroxin can be detrimental for subclinical hypothyroid children and pregnant women, so further studies with larger sample sizes and somatostatin and GH estimation should be done to authenticate the findings of this study.

2.
Arch. argent. pediatr ; 122(5): e202310288, oct. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1571223

ABSTRACT

Introducción. El yodo desempeña un rol fundamental en el metabolismo, el crecimiento y el desarrollo humano. Durante el embarazo y la infancia, la demanda de este micronutriente aumenta considerablemente. La tirotropinemia neonatal (TSHn) aumentada, definida como TSHn ≥5 mUI/l, es un marcador que señala la deficiencia de yodo en una población cuando su prevalencia supera el 3 %. Objetivo. Determinar la prevalencia de TSHn ≥ 5 en La Pampa durante el período 2021-2022, analizar su correlación con diferentes variables y compararla con datos de una cohorte histórica. Población y métodos. Estudio transversal, de diseño descriptivo-analítico, sobre una población de neonatos nacidos en las cinco zonas sanitarias de la provincia de La Pampa durante los años 2021 y 2022. Resultados. De los 5778 neonatos evaluados, el 9,6 % presentó niveles de TSHn ≥5 mUI/l. El 70,4 % de estas mediciones fueron realizadas después del tercer día de vida. No se observaron diferencias significativas en la frecuencia de niveles elevados de TSHn según el año de nacimiento, peso al nacer o días hasta la extracción. Se registró una mayor prevalencia en el sexo masculino (10,6 % versus 8,5 %; p = 0,007) y entre los neonatos nacidos a término (9,8 % versus 6,6 %; p = 0,02). La prevalencia de hipertirotropinemia fue superior a la observada en una cohorte de 2001-2002. Conclusiones. La prevalencia de hipertirotropinemia neonatal en La Pampa durante los años 2021 y 2022 fue del 9,6 %, lo que indica un estado de deficiencia leve de yodo en la provincia, superior al reportado hace dos décadas.


Introduction. Iodine plays a key role in human metabolism, growth, and development. During pregnancy and childhood, the demand for this micronutrient increases notably. Increased neonatal thyroid stimulating hormone (nTSH) levels, defined as nTSH ≥ 5 mIUL, are a marker of iodine deficiency in a population if its prevalence is higher than 3%.Objective. To establish the prevalence of nTSH ≥ 5 in La Pampa in the 2021­2022 period, analyze its correlation with different variables, and compare it with data from a historical cohort.Population and methods. Cross-sectional, descriptive-analytical study in a population of newborn infants born in the 5 health regions of the province of La Pampa in 2021 and 2022. Results. Of  the  5778  assessed  newborn  infants,  9.6%  had  nTSH  levels  ≥  5  mIU/L. It was reported that 70.4% of these measurements were done after the third day of life. No significant differences were observed in the frequency of high nTSH levels by year of birth, birth weight, or days until samplecollection.A higher prevalence was observed among male infants (10.6% versus 8.5%; p = 0.007) and term infants (9.8% versus 6.6%; p = 0.02). The prevalence of high TSH levels was superior to that observed in the 2001­2002 cohort. Conclusions. The  prevalence of high nTSH levels in La Pampa during 2021 and 2022 was 9.6%, suggesting the presence of mild iodine deficiency in the population of this province, higher that what  had been reported 2 decades ago.


Subject(s)
Humans , Male , Female , Infant, Newborn , Thyrotropin/blood , Iodine/deficiency , Biomarkers/blood , Prevalence , Cross-Sectional Studies
3.
Article | IMSEAR | ID: sea-235031

ABSTRACT

Introduction: Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare tumor of the thyroid gland with a higher rate of incidence in females in their ?fth and sixth decades of life. The condition is associated with a very poor prognosis and has a ?ve-year overall survival (OS) rate of only 17.7%. It usually presents as a rapidly enlarging anterior neck mass. Other common symptoms include dyspnea, dysphagia, and voice changes. The diagnosis of PSCCT is usually challenging, and ruling out metastasis from other primary sites is mandatory for a proper diagnosis; hence, immunohistochemistry is of crucial importance. A 71-year-old woman presented with a rapidly progressive neck swelling,Case Report: with hoarseness and compressive symptoms. Physical examination revealed a multilobulated ?rm thyroid mass. Histopathological ?ndings con?rmed the diagnosis of SCC while radiological investigations ruled out the possibility of other primary tumors. PSCCT is a rareConclusion: disease that is usually diagnosed at an advanced stage and is associated with a poor prognosis. The main challenge in diagnosing PSCCT involves differentiating primary SCC arising in the thyroid from secondary SCC metastasis. The proper and accurate diagnosis of PSCCT can only be achieved through a combination of clinical, radiological and immunohistologic ?ndings.

4.
Article | IMSEAR | ID: sea-242132

ABSTRACT

Background: Hypertensive disorders affect approximately 10% of pregnancies, significantly impacting maternal and fetal health, particularly in low- and middle-income countries. Thyroid dysfunction during pregnancy is an underexplored factor that can exacerbate hypertensive conditions, contributing to poor outcomes. This study investigates the prevalence of thyroid dysfunction in pregnant women with hypertension and its impact on maternal and perinatal outcomes. Methods: A prospective observational study was conducted at NSCB Medical College, including 378 hypertensive pregnant women. Patients were categorized into euthyroid and thyroid dysfunction groups based on thyroid function tests. Data were analyzed using IBM SPSS 20 with p<0.05 considered significant. Results: In this study, 25.93% of hypertensive pregnancies had thyroid dysfunction, with 21.69% subclinical hypothyroidism and 3.17% overt hypothyroidism. Thyroid dysfunction was associated with more severe hypertension (p=0.009) and occurred more frequently in earlier gestational ages. The dysfunction group had significantly higher ICU admissions (64.6%) and maternal deaths (55.6%, p<0.05). Additionally, babies in the dysfunction group had worse perinatal outcomes, with more low birth weight and NICU admissions (57.1%). Conclusion: The study has concluded that thyroid dysfunction, particularly subclinical hypothyroidism, is prevalent among pregnant women with hypertensive disorders and is significantly associated with adverse maternal and perinatal outcomes.

5.
J Cancer Res Ther ; 2024 Sep; 20(5): 1365-1369
Article | IMSEAR | ID: sea-238241

ABSTRACT

Background: Non?invasive follicular thyroid neoplasm with papillary?like nuclear features (NIFTP) is a newly added entity in the fourth edition of the WHO Classification of Tumors of Endocrine Organs (2017). It is regarded as a neoplasm with very low malignant potential, thus affecting further treatment of the patients. Aims: To study the recently diagnosed entity, NIFTP, as not many cases have been reported of the same. Materials and Methods: A retrospective analysis of all thyroid neoplasms received in the Department of Pathology of our institute over two years was done. Out of the 188 cases that we reported, 38 were of non?invasive follicular neoplasms. Results: Thirty?two patients were female, whereas six patients were male. Thirty?five patients presented with solitary thyroid nodule and the others had an ill?defined thyroid swelling. Thirty?four patients had normal thyroid profile while two patients each presented with hypothyroidism and hyperthyroidism. Conclusion: It is crucial to carefully study the histopathological features of solitary thyroid swellings and correlate with clinical and radiological findings. The recently added diagnostic category of NIFTP helps clinicians prevent over?treatment of a group of low?risk thyroid tumors.

6.
Rev. peru. med. exp. salud publica ; 41(3): 287-293, jul.-sep. 2024. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1576663

ABSTRACT

RESUMEN El propósito del estudio fue describir las características clínicas, anatomopatológicas, tratamiento y supervivencia de los pacientes con cáncer de tiroides diferenciado. Se realizó un estudio de cohorte retrospectiva con datos de 150 pacientes de un hospital peruano entre los años 2010 al 2020. Se describieron las características y supervivencia (método de Kaplan-Meier). La media de edad fue 48,3 años, 130 (86,7%) fueron mujeres y el tipo histológico más frecuente fue el papilar 94,6%. El 74,2% tenían estadio TNM I, 70,7% tiroidectomía total y 68,7% recibió yodo radiactivo. La supervivencia global a los 5 años fue 89,3%, siendo menor en aquellos con estadio TNM IV y mayor en los que usaron yodo radiactivo. En conclusión, en un hospital de Cusco, el cáncer diferenciado de tiroides fue más frecuente en mujeres y la supervivencia fue menor en comparación con reportes de otros países.


ABSTRACT This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries.


Subject(s)
Thyroidectomy , Thyroid Neoplasms , Survival Rate , Women , Mortality , Neoplasms
7.
Article | IMSEAR | ID: sea-236270

ABSTRACT

Double malignancy occurring in multiple organs is relatively rare yet possible. The second primary lesion is identified either simultaneously with the primary lesion (synchronous) or after a while (metachronous). We report a case of synchronous double malignancy in a patient who had two separate carcinomas, a non-seminomatous germ cell tumor (NSGCT) and a papillary carcinoma of thyroid. These types of synchronous double malignancies can be dealt as independent carcinomas. This existence of two carcinomas at anatomically dissimilar sites with distinct histopathologies, being a rare combination, led us to report the case.

8.
Article | IMSEAR | ID: sea-241862

ABSTRACT

Background: Fine-needle aspiration cytology (FNAC) has been widely accepted as a diagnostic safe method for preoperative assessment of salivary gland lesions. This diagnostic tool is inexpensive, easy to perform, relatively painless and it provides useful information to differentiate between benign and malignant salivary gland tumors that helps in the management and surgical planning. This study was undertaken to compare FNAC results with permanent histopathological ?ndings of salivary gland tumors in order to assess its diagnostic accuracy.

9.
J Cancer Res Ther ; 2024 Aug; 20(4): 1241-1250
Article | IMSEAR | ID: sea-238223

ABSTRACT

Aims: Papillary thyroid cancer (PTC) is a serious threat to human health worldwide, while metastasis in the early phase limits therapeutic success and leads to poor survival outcomes. The CXC chemokine receptor type 4 (CXCR4) plays an important role in many cellular movements such as transcriptional modulation, cell skeleton rearrangement, and cell migration, and the change in CXCR4 levels are crucial in various diseases including cancer. In this study, we explored the role of CXCR4 in the migration and invasion of PTC and investigated the potential mechanisms underlying its effects. Subjects and Methods: We analyzed the expression levels of CXCR4 in PTC tissues and cell lines. Would healing migration, Transwell invasion assay in vitro, and tail?vein lung metastasis assay In vivo were performed to evaluated the migration and invasion abilities of PTC cells with stable CXCR4 knockdown or overexpression. Signal transducers and activators of transcription (STAT3) signaling pathway?related protein expressions were examined by Western blotting assays. Results: The results showed that CXCR4 was highly expressed in PTC cell lines and PTC tissues. CXCR4 knockdown in PTC cells dampened the migration, invasion, and epithelial–mesenchymal transition (EMT), whereas CXCR4 overexpression enhanced these properties. In vivo, we also found that CXCR4 promoted the metastasis of PTC. Mechanistic studies showed that CXCR4 played these vital roles through the STAT3 signaling pathway. Furthermore, PTC patients with high CXCR4 or p?STAT3 expression correlated with aggressive clinical characteristics such as extrathyroidal extension (ETE), and lymph node metastasis (LNM). Conclusions: We provided evidence that CXCR4 might activate the STAT3 signaling pathway and further promote PTC development. Thus, CXCR4 might be a novel therapeutic target for PTC.

10.
Med. clín. soc ; 8(2)ago. 2024.
Article in English | LILACS-Express | LILACS | ID: biblio-1575210

ABSTRACT

Introduction: Thyroid cancer, considered one of the most frequent malignant tumors of the endocrine system, accounts for 80%-90% of cases. The most common histological type observed in most studies is papillary cancer. Objective: To determine the frequency of thyroid cancer in patients undergoing total thyroidectomy at the Otorhinolaryngology Department of the Hospital de Clínicas between the period 2018-2022. Methodology: This retrospective study included 260 patients treated during the study period. Data were obtained from the patients' medical records, and sociodemographic and clinical variables related to thyroid cancer were analyzed. Data were analyzed with the SPSS v25 program, using descriptive statistics. Results: The frequency of thyroid cancer was 48.1%. The mean age of the cancer patients was 42.10±13.10 years. A higher frequency was observed in females 34.2%, n=89) and among those aged 25-44 years 20.0%, n=52). The most frequent were papillary (36.9%), follicular (2.7%), medullary (1.5%), and anaplastic (1.2%) types. Discussion: The frequency of thyroid cancer is high; it is more common in women and as age increases.


Introducción: El cáncer de tiroides, considerado uno de los tumores malignos más frecuentes del sistema endocrino, representa entre el 80% y el 90% de los casos. El tipo histológico más común observado en la mayoría de los estudios es el cáncer papilar. Objetivo: Determinar la frecuencia de cáncer de tiroides en pacientes sometidos a tiroidectomía total en la Cátedra y Servicio de Otorrinolaringología del Hospital de Clínicas durante el período 2018-2022. Metodología: se realizó un estudio retrospectivo con un total de 260 pacientes atendidos en el período de estudio. Los datos fueron tomados de las historias clínicas de los pacientes, en el cual se analizan variables sociodemográficas y clínicas relacionadas con el cáncer de tiroides. Los datos se analizaron con el programa SPSS v25, mediante estadística descriptiva. Resultados: La frecuencia del cáncer de tiroides fue del 48.1%. El promedio de edad de los pacientes con cáncer fue de 42.10±13.10 años. se observó una mayor frecuencia en las personas del sexo femenino 34.2% (n=89) y entre quienes tuvieron de 25-44 años 20.0% (n=52). El más frecuente fue el tipo papilar 36.9%, el folicular 2.7%, el medular 1.5% y el anaplásico 1.2%. Discusión: la frecuencia de cáncer de tiroides es alta, es más frecuente en las mujeres y a medida que aumenta la edad.

11.
Medicina (B.Aires) ; Medicina (B.Aires);84(4): 741-745, ago. 2024. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1575269

ABSTRACT

Abstract Metastases to the thyroid gland from nonthyroidal malignant tumors are rare but significant. They are often asymptomatic, indicating advanced-stage primary tumors and poor prognosis. Although infrequently, breast cancer (BC) can metastasize to the thyroid gland. We present the case of a 56-year-old woman with a history of BC who pre sented with a nodular goiter. Physical examination and im aging revealed a thyroid nodule and cervical lymph nodes with suspicious features. Fine-needle aspiration biopsy (FNAB) confirmed the presence of atypical epithelial cells in the thyroid nodule and lymph nodes. Further evaluation, including positron emission tomography, histological biop sy, and immunohistochemistry, supported the diagnosis of metastatic BC to the thyroid gland. Due to the local extent of the disease, total thyroidectomy was not feasible. The treatment with ribociclib and letrozole was initiated, but unfortunately, the patient had an unfavorable progression with the development of metastasis in the nervous system. Metastatic carcinoma to the thyroid gland is rare but has increased due to improved diagnostic techniques. BC can metastasize to the thyroid. Diagnosis involves imaging, FNAB, and immunohistochemistry. Treatment options include surgery, radiotherapy, and chemotherapy, but the prognosis is generally poor.


Resumen Las metástasis en la glándula tiroides a partir de tu mores malignos no tiroideos son raras pero significativas. A menudo son asintomáticas, lo que indica tumores primarios en etapas avanzadas y un mal pronóstico. Aunque infrecuentemente, el cáncer de mama puede metastatizar en la glándula tiroides. Presentamos el caso de una mujer de 56 años con antecedente de cáncer de mama que consultó por bocio nodular. El examen físico y las imágenes revelaron un nódulo tiroideo y ganglios linfáticos cervicales con características sospechosas. La punción aspiración con aguja fina confirmó la presencia de células epiteliales atípicas en el nódulo tiroideo y los ganglios linfáticos. Una evaluación adicional, que incluyó tomografía por emisión de positrones, biopsia histológica e inmunohistoquímica, respaldó el diagnóstico de cáncer de mama metastásico en la glándula tiroides. Debido a la extensión local de la enfermedad, no fue factible realizar una tiroidectomía total. Se inició el tratamiento con ri bociclib y letrozol, pero desafortunadamente la paciente tuvo una progresión desfavorable con el desarrollo de metástasis en el sistema nervioso. El carcinoma metas tásico en la glándula tiroides es raro, pero ha aumentado debido a las técnicas de diagnóstico mejoradas. El cáncer de mama puede metastatizar en la tiroides. El diagnóstico implica imágenes, punción aspiración con aguja fina e in munohistoquímica. Las opciones de tratamiento incluyen cirugía, radioterapia y quimioterapia, pero el pronóstico generalmente es desfavorable.

12.
Article | IMSEAR | ID: sea-234251

ABSTRACT

Cancer remains a challenging disease for our profession despite the medical and technological advances achieved in recent years. This challenge increases when we encounter multiple primary tumors that significantly modify the prognosis of our patients.

13.
Article | IMSEAR | ID: sea-234217

ABSTRACT

Background: Thyroidectomy is a common surgical procedure for various thyroid disorders, but it often leads to complications such as hypocalcemia. Understanding the prevalence and predictors of hypocalcemia post-total thyroidectomy is crucial for improving patient outcomes. Methods: This prospective cross-sectional study was conducted at a tertiary care hospital with 100 patients undergoing thyroid surgery, including total thyroidectomy, completion thyroidectomy, and thyroidectomy with neck dissection. We analyzed the incidence of transient and permanent hypocalcemia, examining correlations with surgery type, demographic variables, and postoperative day of onset. Data were collected through patient records and postoperative follow-ups. Results: The study revealed that 30% of patients experienced hypocalcemia postoperatively. Hypocalcemia was most prevalent among patients undergoing thyroidectomy with neck dissection (58.33%), compared to those undergoing total thyroidectomy (18.18%) and completion thyroidectomy (40.00%). The majority of hypocalcemia cases (66.67%) occurred on the second postoperative day. Most hypocalcemia instances were transient (86.67%), with a smaller fraction being permanent (13.33%). Conclusions: Hypocalcemia remains a significant complication following thyroid surgery, particularly in surgeries involving neck dissection. Early identification and management of at-risk patients could mitigate the severity of this complication. Our findings underscore the importance of vigilant monitoring and tailored postoperative care to minimize the impact of hypocalcemia on patient recovery and quality of life.

14.
Article | IMSEAR | ID: sea-228665

ABSTRACT

Chronic urticaria is a common disorder of unknown origin, which is often associated with normal routine laboratory values and no evidence of systemic disease. Cutaneous vasculitis is one of the rare presentation of chronic urticaria. We reported a 13-year-old female child, who presented to us with tender urticarial wheals all over the body, who on further evaluation was found to have positive anti-thyroid peroxidase antibodies and was diagnosed to have urticarial vasculitis.

15.
Article | IMSEAR | ID: sea-228638

ABSTRACT

Background: Thalassemia, a prevalent genetic disorder, necessitates recurrent blood transfusions for life, precipitating iron overload and premature death. In ?-thalassemia major (BTM), hypothyroidism prevalence fluctuates (6-30%) globally, influenced by diverse chelation regimens. The objective of this study is to evaluate the thyroid hormone levels in pediatric patients diagnosed with transfusion-dependent thalassemia (TDT).Methods: A hospital-based cross-sectional study was conducted at the paediatrics department of Sir Salimullah medical college Mitford hospital, Dhaka, focusing on TDT patients aged 4 to 18 years. Exclusions comprised known cases of hypothyroidism, children receiving hormonal therapy, those with a family history of hypothyroidism, and individuals with fewer than 10 blood transfusions. Serum separation involved centrifugation at 3000 rpm for 5 minutes, with subsequent aliquoting into two screw-capped dry clean vials: 1 ml each for FT4/TSH and serum ferritin estimation. Data were analyzed using SPSS version 24.0.Results: Eighty-seven transfusion dependent thalassemia children aged between 4 to 18 years were chosen in this study. The hypothyroidism was seen in 7 (8%) patients. Of these, 4 (4.6%) participants were compensated hypothyroid and 3 (3.4%) participants were uncompensated hypothyroid. Most of the participants were hypothyroidism with Hb E-? thalassemia. The mean serum ferritin level was 2578.49�85.06 ng/ml. Positive correlation of TSH with duration of disease (in years), total number of blood transfusion times and serum ferritin were statistically significant (p<0.05).Conclusions: The present study demonstrates that 8% of the children with TDT have hypothyroidism. Hypothyroidism is more frequent among Hb E ?-thalassemic children as compared to ?-thalassemic children.

16.
Article | IMSEAR | ID: sea-241025

ABSTRACT

Background: Carcinoma of the thyroid gland is an uncommon cancer, 0.6% and 1.6% of all cases of malignant neoplasms in men and women respectively. But is the most common malignancy in the endocrine system. This study aimed to analyze the pattern of differentiated thyroid carcinoma and its management plan. Material & Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology, Rajshahi Medical College Hospital, Rajshahi, and Department of Otolaryngology Bangabandhu Sheikh Mujib Medical University (BSMMU), from July 2011 to Jun 2012. A total of 40 patients were selected as study subjects by simple random sampling technique. A descriptive analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows. Results: The highest number of cases were found in the 3rd and 5th decade of life in papillary and follicular carcinoma respectively. The male-to-female ratio was 1:2.5 in papillary, and 1:5 in follicular carcinoma, with a majority (55.0%) from rural areas. Most of the cases (35, 87.5%) suffered from papillary carcinoma, followed by (5,12.5%) follicular carcinoma. The commonest symptom for seeking medical admission was swelling in the neck (Lymph node swelling included), which was present in 39(97.5%) cases. Symptoms of distant metastasis and dyspnoea were present in 3(7.5%) and 1(2.5%) case respectively. Through FNAC 38 (95.0%) cases were diagnosed or suspected preoperatively. Conclusions: The majority of the patients present in the 3rd and 5th decade of life in papillary and follicular carcinoma respectively, with a female preponderance. Moreover, papillary carcinoma is more common than follicular carcinoma, which commonly presents with unilateral tumors. Concerning the symptoms, swelling of the neck (including lymph node swelling) is the most common feature. It can be emphasized that nodal metastasis needs total thyroidectomy, and neck dissection with radio-iodine ablation. Distant metastasis needs total thyroidectomy, surgical resection of the metastatic mass, radio-iodine ablation (if the radioiodine scan is positive), and/or radiotherapy with thyroxine.

17.
Article | IMSEAR | ID: sea-240875

ABSTRACT

Minimally invasive surgery is increasingly employed in the treatment of thyroid diseases. Several minimal access approaches to the thyroid gland have been described. Minimally invasive surgery is rapidly expanding its role in almost all the surgical sub-specialties. There is also a growing demand for minimally invasive approaches, as nowadays, patients are more concerned about cosmesis in addition to their original surgery. Although its role in thyroid surgery has already been proven earlier, it is not yet accepted as a routine approach amongst many thyroid surgeons. The commonly performed surgeries have been endoscopic lobectomies. We have done one such procedure in our institution with a successful outcome.

18.
Article | IMSEAR | ID: sea-240357

ABSTRACT

Background: Individuals with type 2 diabetes mellitus and pre-diabetes have an increased risk of coronary artery disease. Thyroid dysfunction may amplify existing cardiovascular disease risk in hyperglycemic subjects. Studying the association between thyroid profile abnormalities in the pre-diabetes population is of considerable clinical importance. Aims and Objectives: The aims and objectives of the study are to study thyroid profile in pre-diabetes and control. Materials and Methods: Group-I: Patients with pre-diabetes are considered cases. (patients with fasting plasma glucose [FPG] – 100–125 mg/dL and/or post-prandial blood glucose 140–199 mg/dL and/or hemoglobin A1c [HbA1c] – 5.7–6.4% as per “American Diabetes Association 2017”). Group-II: Patients with normal FPG, post-prandial blood glucose, and HbA1C are considered controls. Results: Among pre-diabetes, 12% have hypothyroidism as compared to 5% among non-diabetic (P < 0.001). Conclusion: There is a significant increase in the prevalence of hypothyroidism among the pre- diabetes population. Hence, they should be screened early for these parameters and early management may reduce future cardiovascular morbidity and mortality.

19.
Article | IMSEAR | ID: sea-239302

ABSTRACT

Background: Hypothyroidism, an endocrine disorder caused by thyroid dysfunction found to be more prevalent globally in females than in males. Young females are more prone to subclinical hypothyroidism (SCH). The study aimed to estimate the different types of hypothyroidism based on the clinical profile of thyroid hormone and to detect various comorbidities in correlation with age in women. In female patients with hypothyroidism, there is a significant association between age groups and the type of hypothyroidism (subclinical, clinical, overt), with younger age groups showing a higher prevalence of SCH. Additionally, comorbidities, such as polycystic ovarian disorder (PCOD), are more prevalent in hypothyroidism patients, particularly in those with SCH. Materials and Methods: A prospective cross-sectional study executed in a tertiary care hospital for one year with an inclusion of female hypothyroid patients above 18 years of age. An informed written consent form was received from each patient with clarification of the protocol. Results: A total of 44.6% women were in the 18–28 years of age group (young females) and 42.8% of women with SCH. PCOD (38.2%) was a predominant comorbid condition among hypothyroidism women. In the age group of 18–28 years, there were significantly more patients 114 (81.4%) with SCH (p < 0.01) than those with clinical 22 (18.4%) and overt hypothyroidism 10 (14.7%). The hypothyroidism of women with PCOD 95 (67.8%) was significantly (p < 0.01) more in subclinical than clinical 28 (23.5%) and overt hypothyroidism 2 (2.9%). Conclusion: Thyroid dysfunction is uncertain in females, bulges to complications of maternal and fetal outcomes, and is associated with other comorbidities, leading to an increase in the mortality rate. Hypothyroidism is a growing burden for other comorbidities. Pharmaceutical care by healthcare professionals is to be adopted with prompt diagnostic and screening techniques.

20.
Horiz. med. (Impresa) ; 24(3): e2593, jul.-set. 2024. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1582394

ABSTRACT

RESUMEN Objetivo: Comparar las tiroidectomías endoscópicas transorales por abordaje vestibular (TOETVA) con la tiroidectomía abierta convencional realizadas en el Hospital Central del Estado de Chihuahua. Materiales y métodos: Se realizó un estudio retrospectivo a 10 pacientes, a quienes se les sometió a tiroidectomías totales o parciales mediante la técnica endoscópica y por cirugía abierta convencional, durante el periodo comprendido entre marzo del 2018 y marzo del 2019. Se incluyeron datos demográficos (edad e índice de masa corporal [IMC]), indicación quirúrgica (tamaño de tumoración según ultrasonido), antecedentes quirúrgicos y comorbilidades, tiempo quirúrgico (calculado en horas para cada procedimiento), número de procedimientos que requirieron conversión, tiempo de estancia hospitalaria, resultado histopatológico de las biopsias transoperatoria y definitiva y complicaciones posoperatorias inmediatas y tardías específicas de ambos procedimientos. Para la aplicación de la técnica, se coloca a la paciente en posición supina y se le administra anestesia general, se posiciona el cuello en hiperextensión; posteriormente, se desinfecta la cavidad oral con hipoclorito y se procede a realizar una incisión de 1,5 a 2,0 cm de manera horizontal al final de frenillo; finalmente, se diseca, a través del espacio avascular, hasta el polo tiroideo superior. Resultados: Las pacientes fueron mujeres con una edad media de 46 años; 50 % de ellas se sometieron a cirugía abierta y el otro 50 %, a cirugía endoscópica. El tiempo quirúrgico del abordaje transoral fue de 1,2 h y del abierto, 1,5. Se registró una complicación posquirúrgica en el grupo de cirugía abierta, representada por un estado de hipocalcemia por lesión de la glándula paratiroides, mientras que en el grupo de cirugía endoscópica dos de los procedimientos tuvieron que convertirse a cirugías abiertas debido a que ambas pacientes presentaron hemorragia durante el evento. Conclusiones: El procedimiento TOETVA se asocia con menor frecuencia de dolor posoperatorio, es seguro y su ventaja consiste en que no deja cicatriz visible. No obstante, se recomienda que el estudio sea replicado en un tamaño de muestra más grande para que quede clara la ventaja de este procedimiento.


ABSTRACT Objective: To make a comparison between the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and the conventional open approach of thyroidectomies performed at the Hospital Central del Estado de Chihuahua. Materials and methods: A retrospective study was carried out on 10 patients who underwent total or partial thyroidectomies using either an endoscopic technique or conventional open surgery between March 2018 and March 2019. The study included patient demographics (age and body mass index [BMI]), indications for surgery (tumor size by ultrasound), surgical history and comorbidities, surgical time (in hours for both open and endoscopic procedures), number of conversions required, length of hospital stay, histopathological results from intraoperative and definitive biopsies, and immediate and late postoperative complications specific to both procedures. During the TOETVA, the patients were positioned supine under general anesthesia, with the neck in hyperextension. The oral cavity was disinfected with hypochlorite and a horizontal incision of 1.5 to 2.0 cm was made at the frenulum, followed by dissection through the avascular space to the superior thyroid pole. Results: The patients were female, with a mean age of 46 years; 50 % of them underwent open surgery, while the other 50 % underwent endoscopic surgery. The surgical time of the transoral approach averaged 1.2 hours, compared to 1.5 hours for the open approach. A postsurgical complication in the open surgery group included hypocalcemia due parathyroid gland injury. In the endoscopic surgery group, two procedures required conversion to open surgery because both patients experienced intraoperative hemorrhage. Conclusions: The TOETVA procedure is associated with lower frequency of postoperative pain, is safe and has the advantage of not leaving a visible scar. However, further studies with larger samples are recommended to clearly establish the advantages of this procedure.

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