Dietary glycemic index and glycemic load predict longitudinal change in glycemic and cardio-metabolic biomarkers among old diabetic adults living in a resource-poor country.

This study aims to investigate longitudinal associations between the dietary glycemic index (GI) and glycemic load (GL) and changes in glycemic and cardio-metabolic outcomes. A 28-month retrospective cohort study included 110 Vietnamese diabetic patients, collecting their dietary GI and GL values along with blood biochemical data from baseline 24-h dietary recall and medical records. Latent class growth modelling identified three distinct HbA1c trajectories during the follow-up period, with 51% of patients achieving good glycemic control. The adjusted linear mixed-effect model showed that 1 unit increase in logarithms in dietary GL was associated with a 0.14% increase in the log-HbA1c. Among poorly controlled diabetic patients, baseline GL values were positively correlated with increases in HbA1c; GI showed effects on changes in fasting plasma glucose and the triglyceride-glucose (TyG) index. No significant association was observed in patients with good glycemic control.

Single-Port Access Endoscopic Thyroidectomy via Axillary Approach for the Benign Thyroid Tumor: New Aspects from Vietnam.

BACKGROUND: This study aims to describe our new experience with single-port totally endoscopic thyroidectomy via the axillary approach in patients with unilateral thyroid benign tumors. In parallel with that, we also discuss here the challenges and novelty highlights we have confronted and solved and the details of our operative technique. METHODS: Between August 2018 and May 2020, the study involved 54 patients who underwent a single-port single-incision endoscopic thyroidectomy via the axillary approach for benign thyroid tumor at the National Hospital of Endocrinology (Hanoi, Vietnam). Surgical patient indications were in working age, goiter classification of grade 1 or grade 2, the thyroid with mononuclear or multinucleated, lesion diameter of less than 4 cm, unilateral thyroid benign lesion and no previous history of neck surgery or irradiation. RESULTS: No mortality was observed. Morbidities included transient voice change in 8 patients, swallowing disorders in 2 patients, transient skin paresthesia in 2 patients and wound hematoma in 2 patients. Mean amount of postoperative drainage was 70.2 mL, mean duration of postoperative drainage was 2.7 days, and mean postoperative hospital day was 6.6 days. Mean total operation time was 66.0 minutes and mean blood loss was 13.3 mL. Regarding medium-term follow-up outcomes following surgery, we recorded the hypothyroidism in 3 patients (5.6%) and the hypocalcemia in 1 case (1.8%). Most patients felt normal neck movement and sensation (79.6%), 3 patients were painful (5.6%) and 8 those were numb (14.8%). We saw the soft incision scar in 35 patients (64.8%), convex scar in 14 patients (25.9%), and hard scar in 5 patients (9.3%). CONCLUSION: Single-port endoscopic thyroidectomy via axillary approach is a safe and feasible treatment option for removing benign thyroid tumor, delivering favorable surgical outcomes with ideal cosmetic effect and reduction in injury to the anterior neck tissue.

Feasibility and Safety of Endoscopic Thyroidectomy Via a Unilateral Axillobreast Approach for Unilateral Benign Thyroid Tumor in Vietnam.

The purpose of this research study was to assess the safety and surgical outcomes of endoscopic thyroidectomy applied via a unilateral axillobreast approach with CO2 insufflation to one-sided benign thyroid tumors in Vietnam. Only 1 patient of the 50 (2%) had a postoperative hematoma at the surgery site. Open surgical conversions did not occur. The duration of postoperative drainage was from 3 to 8 days, or 4.86±1.24 days on average. The length of stay in the hospital after surgery was 4 to 9 days, or 5.9±1.2 days on average. The postoperative pain in the first postoperative days was lower in intensity compared with open surgeries. The given method provided better results in terms of patient satisfaction with the cosmetic effect of the surgery compared with up-front surgery, minimally invasive video-assisted thyroidectomy, and endoscopic procedures via the breast approach, and 96% of patients were completely satisfied.

Some remarks on endoscopic thyroidectomy with anterior breast wall and axillary approach: 2000 cases with nodules located in 1 lobe

Conventional thyroidectomy requires a transverse cervical incision and a cutting of myocutaneos flaps to gain access to the thyroid. This approach leaves an undesirable scar on the anterior surface of the neck especially for young patients. Endoscopic thyroidectomy is a new minimally invasive technique that permits thyroid excision results of conventional thyroidectomy. From May 2003 to January 2005, the authors have performed 200 cases of endoscopic thyroidectomy at Surgical Department of national Hospital of Endocrinology. The indication for operation included thyroid nodule multinodules located in 1 lobe. The average of nodule size is 2.6cm (1.0-5.6cm). To access the thyroid, the authors use 2 approach: breast approach (100 cases) and auxiliary approach (100 cases) - There are 122 cases of lobectomy (61%), 78 of subtotal lobectomy (39.0%). - The mean operative time was 98.6 minutes (40-180), the mean blood loss was 8.6ml(0-100). - There is no mortality, the life-threaten complication as well as the hypocalcimia and there is not the conversion to open surgery. There is only one patient of the transient hoarseness. Conclusion: Endoscopic lobectomy of thyroid is feasible and safe for single nodule or multinodules located in the same lobe. There may be 2 approaches: anterior breast wall and auxiliary approach.

Some observation on the paraclinical, clinical characteristics and the surgical treatment of 249 cases of thyroid cancer at the Central Hospital of Endocrinology

249 patients (28 males, 221 females) undergone surgical treatment for thyroid cancer at the Hospital of Endocrinology from the 7th January 2002 to the 30th June 2004. Thyroid cancer was more likely in male than in female. The clinical signs were not usually acute and likely passed by in the early stage of this disease. The fine needle aspiration was the paraclinical method which had the most value in order to diagnose thyroid cancer before surgery. Total thyroidectomy or total thyroidectomy associated with cervical node dissection were the most common procedure in durgical treatment for thyroid cancer. Papillary carcinoma and follicular carcinoma in 94%. Complications and sequel after operation for parathyroid and laryngeal nerve were low in 249 patients undergone surgical treatmnent

Preliminary results od 131 cases with endoscopic thoracic sympathectomy in treatment of palmar hyperhidrosis

From 14 June 2002 to 30 June 2004, at the surgery department of the Hospital of Endocrinology had performed the endoscopic thoracic sympathectomy on 131 patients (61 males, 70 females), in ranging of age from 11 year old to 50. Thoracoscopic sympathectomy can performed easily and effectivelly in semi-Fowler posittion, turning the opposite with a single-lumen endotracheal tube. The rate of dry hand was 98.8% of patient. There was no death, there was no patient with hematothorax. There were 2 cases with complication of one side pneumothorax by adhesion but having good results after one day of drainaging closed pleuroperitoneal. After operation 40 patients were re-examined had pneumothorax in chest and back

Preliminary outcome of operation for treating Basedow’s disease at National Hospital of Endocrinology

From 25 January 2002 to 11 May 2004, there were 200 patients operated at National Hospital of Endocrinology for treatment of Grave’s disease. Ratios of male/female were approximately 2/8. Most of them were in the range of age from 20 to 49 years old (81.0%). The operative indication included the euthyroid cases. The preoperative preparing by Lugol solution, prednisolon was necessary. The techniques of operation included: total thyroidectomy for 14 patients (7%), near total thyroidectomy with small amount of thyroid tissue left at the superior pole for 9 (4.5%), and with posterior wall remnant for 177 (88.5%). The total thyroidectomy was performed for patients who were accompanied with nodules, were allergic to synthesis anti-thyroid drugs, or severe ophthalmopathy. There were no mortality as well as thyroid storm and tarchycardia after operation. There were 3 cases had to be reoperated due to hemorrhage, 3 cases of transient hoarseness (1.5%), 19 cases of transient hypocalcaemia (9.5%).Only 64 patients came to hospital for reexamination at 3 months after operation. Among them, there were 58 euthyroid cases (90.7%) with FT4 in normal limit

Endoscopic thyroidectomy: discussions on the technique and results

From May 2003 to 30 June 2004, 173 patients including 163 females and 10 males suffering from thyroidectomy was performed safely, successfully. Surgeon must prosess good skill on open surgery as well as on endoscopic surgery. The indication of this method was a routine only in nodule goiter in one lobe, but in multinoduli goiter in two lobes and in basedow the operationc success was still limited, especially for basedow disease, it must be prepare well pior to operation. It can made the incision from the anterior wall of the chest or from armpit with more cosmetic benefits