ABSTRACT
BACKGROUND: Our aim was to evaluate the efficacy and security of ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) for the treatment of recurrent symptomatic thyroid cysts in two high-resolution consultations of thyroid nodule in the Valencian Community. PATIENTS AND METHODS: The study comprised thirty-three consecutive patients (51⯱â¯12 years, 76% women) with symptomatic benign thyroid cysts relapsed after drainage and benign cytology prior to treatment. Through ultrasound, maximum cyst diameter and volume were determined, and the content of the cyst was drained. We then instilled between 2 and 4â¯ml of ethanol (according to initial volume). We followed up with ultrasound at one, 3, 6 and 12 months and we calculated the total volume and the Volume Reduction Rate (VRR). We evaluated the perceived pain using a visual analog scale. RESULTS: The initial median cyst volume was 11.6â¯ml (8.5-16.5) A single session of US-PEIT was required in 22 patients (67%), two in 8 (24%) and three in 3 (9%). During PEIT, 49% of the patients experienced virtually no pain, 39% mild pain and 12% moderate pain. There were no complications. After 6 months of follow up the median VRR was 93% (84-98). All the patients achieved a volume reduction of more than 50%, 94% of more than 70% and 56% of more than 90%. Twenty-four patients completed a year of follow-up, achieving a VRR of 97% (93-98). CONCLUSIONS: In our experience US-PEIT has proven to be an effective, safe treatment of symptomatic thyroid cysts. For this reason it can be considered as the first line of treatment and included in the portfolio of services of a high-resolution consultation.
Subject(s)
Cysts/drug therapy , Ethanol/administration & dosage , Thyroid Neoplasms/drug therapy , Administration, Cutaneous , Adult , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Pain , SpainABSTRACT
BACKGROUND: We studied the presence of cardiovascular risk factors in patients with morbid obesity and analyzed the influence of weight loss achieved through diet on these factors. We also evaluated the influence of gender on the presence of cardiovascular risk factors and on its response to diet. PATIENTS AND METHODS: An anthropometric evaluation was performed in patients with morbid obesity (23 men and 36 women). The presence of cardiovascular risk factors was evaluated (fibrinogen, blood pressure, glucose metabolism determination by means of oral glucose tolerance test, complete lipid profile, sleep apnea syndrome), before and after following, on an alternative fashion, very-low calorie and low-calorie diets. The comparison was made with the t-test for paired samples. RESULTS: A very significant weight loss was achieved in our patients, particularly in men (decrease of 33.4 kg, 95% CI: 26.9 to 39.8). This was accompanied by a reduction in the presence of cardiovascular risk factors, particularly in men, in whom the body fat distribution improved significantly (decrease in waist: 24.8 cm, 95% CI 18.4 to 36.5), as well as the lipid profile including triglycerides, VLDLc, HDLc and B100 apoprotein. CONCLUSIONS: Patients with morbid obesity have a high prevalence of cardiovascular risk factors. A significant reduction of this prevalence can be achieved with diet during one year. This improvement is particularly significant in men.
Subject(s)
Cardiovascular Diseases/prevention & control , Obesity, Morbid/diet therapy , Adolescent , Adult , Aged , Cardiovascular Diseases/etiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Obesity, Morbid/complications , Prospective Studies , Risk Factors , Sex Factors , Weight LossABSTRACT
FUNDAMENTO: Analizar la presencia de factores de riesgo cardiovascular (FRCV) en pacientes con obesidad mórbida y la influencia de la reducción ponderal mediante intervención dietética sobre estos FRCV. Asimismo, valorar la influencia del sexo en la presencia de FRCV y en la respuesta a la intervención dietética. PACIENTES Y MÉTODO: A todos los pacientes con obesidad mórbida (23 varones y 36 mujeres) se les efectuó una valoración antropométrica y de los FRCV (fibrinógeno, presión arterial, estudio del metabolismo hidrocarbonado mediante la realización de sobrecarga oral de glucosa, perfil lipídico completo, presencia de síndrome de apneas del sueño), antes y después de una intervención dietética alternando dietas de muy bajo contenido calórico con dietas hipocalóricas convencionales. Se compararon los resultados antes y después de la intervención dietética mediante la prueba de la t de Student para muestras apareadas (tras comprobar que se cumplían las condiciones de aplicación). RESULTADOS: Se consiguió una reducción ponderal muy significativa, principalmente en varones (reducción de 33,4 kg; intervalo de confianza (IC) del 95 per cent, 26,9-39,8), que se acompañó de una reducción de los FRCV asociados, especialmente en el sexo masculino, en el que mejoró de forma significativa la distribución de grasa (reducción de cintura de 24,8 cm; IC del 95 per cent, 18,4-36,5) y el perfil lipídico: triglicéridos (IC del 95 per cent, 25,4-90), colesterol HDL y apoproteína B100.CONCLUSIONES: En pacientes con obesidad mórbida existe una elevada presencia de FRCV asociados. Con la reducción ponderal obtenida mediante intervención dietética durante un año hemos conseguido una reducción significativa de los mismos. Esta mejoría es especialmente importante en los varones (AU)
