Effectiveness and safety of the radiofrequency ablation of single hyperfunctioning parathyroid lesions suggestive of adenomas in primary hyperparathyroidism.

INTRODUCTION: Radiofrequency ablation (RFA) has emerged as a minimally invasive approach to single parathyroid adenoma in primary hyperparathyroidism; however, there is limited evidence on its effectiveness. OBJECTIVE: To evaluate the effectiveness and safety of RFA to treat hyper-functioning parathyroid lesions suggestive of adenomas. MATERIAL AND METHODS: A prospective study was conducted in consecutive patients with primary hyperparathyroidism treated with RFA for single parathyroid lesions in our reference center between November 2017 and June 2021. Pre-treatment (baseline) and follow-up analytical data were gathered on total protein-adjusted calcium, parathyroid hormone [PTH], phosphorus, and 24-h urine calcium. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 15.0 was used for statistical analysis. RESULTS: Four of thirty-three enrolled patients were lost to the follow-up. The final sample comprised 29 patients (22 females) with mean age of 60.93 ± 13.28 years followed up for a mean of 16.29 ± 7.23 months. Complete response was observed in 48.27%, partial response in 37.93%, and hyperparathyroidism persistence in 13.79%. Serum calcium and PTH levels were significantly lower at 1 and 2 years of post-treatment than at baseline. Adverse effects were mild, with two cases of dysphonia (self-limited in one patient) and no cases of hypocalcaemia or hypoparathyroidism. CONCLUSION: RFA may be a safe and effective technique to treat hyper-functioning parathyroid lesions in selected patients.

Radiofrequency ablation for thyroid and parathyroid disease.

Radiofrequency ablation is a well-known, safe, and effective method for treating benign thyroid nodules and recurring thyroid cancer as well as parathyroid adenomas that has yielded promising results in recent years. Since the Korean Society of Thyroid Radiology introduced the devices and the basic techniques for radiofrequency ablation in 2012, radiofrequency ablation has been approved all over the world and both the devices and techniques have improved. This review aims to instruct interventional radiologists who are doing or intend to start doing radiofrequency ablation of thyroid and parathyroid lesions, as well as thyroid and parathyroid specialists who provide pre- and post-operative care, in the training, execution, and quality control for radiofrequency ablation of thyroid nodules and parathyroid adenomas to optimize the efficacy and safety of the treatment.

Ablación por radiofrecuencia en la enfermedad tiroidea y paratiroidea / Radiofrequency ablation for thyroid and parathyroid disease

La ablación por radiofrecuencia (ARF) es un método bien conocido, seguro y eficaz para tratar los nódulos tiroideos benignos, los cánceres tiroideos recurrentes, así como los adenomas de paratiroides, con resultados prometedores en los últimos años. Los dispositivos empleados y las técnicas básicas para la ARF fueron introducidos por la Sociedad Coreana de Radiología de Tiroides (KSThR) en 2012, si bien la ARF se ha aprobado en todo el mundo, con avances posteriores tanto en dispositivos como en técnica.El objetivo de esta revisión es instruir a los radiólogos intervencionistas que pretendan realizar, o que ya estén realizando, intervenciones de ARF, así como especialistas en tiroides y paratiroides que brinden atención pre y postoperatoria, acerca de la capacitación, la ejecución y el control de calidad de la ARF de los nódulos tiroideos y adenomas paratiroideos, para optimizar la eficacia del tratamiento y la seguridad del paciente.(AU)

Radiofrequency ablation is a well-known, safe, and effective method for treating benign thyroid nodules and recurring thyroid cancer as well as parathyroid adenomas that has yielded promising results in recent years. Since the Korean Society of Thyroid Radiology introduced the devices and the basic techniques for radiofrequency ablation in 2012, radiofrequency ablation has been approved all over the world and both the devices and techniques have improved.This review aims to instruct interventional radiologists who are doing or intend to start doing radiofrequency ablation of thyroid and parathyroid lesions, as well as thyroid and parathyroid specialists who provide pre- and post-operative care, in the training, execution, and quality control for radiofrequency ablation of thyroid nodules and parathyroid adenomas to optimize the efficacy and safety of the treatment.(AU)

Vessel resistance to blood flow in the nailfold in patients with psoriasis: a prospective case-control echo Doppler-based study.

BACKGROUND: Psoriasis is a disease in which endothelial cells seem to play an important pathogenic role. No report published to date has examined nail vascularity in patients with psoriasis. OBJECTIVES: To evaluate the vascularity in the nails of patients with psoriasis treated with classic and biologic therapies for comparison with disease-free controls, and to evaluate whether there are differences in nail vascularity among patients with and without nail involvement. METHODS: We performed a prospective study with two cohorts comprising 23 patients with moderate-to-severe psoriasis and 23 controls without psoriasis. We measured the nailfold vessel resistance index (NVRI) in each subgroup. RESULTS: We found significant differences in the NVRI between patients and controls (P<0·001). Among patients with psoriasis, those with nail involvement showed a higher mean±SD NVRI (0·58±0·10) than those without (0·52±0·45). CONCLUSIONS: Psoriasis decreases the blood flow in nails, suggesting that this skin disease confers an independent risk for microvascular changes. This outcome may be associated with greater risk of nail-related signs.

Priapismo de bajo flujo convertido en priapismo de alto flujo por fístula arterio-lacunar secundaria a la técnica de Winter / Low-flow priapism developing to high-flow priapism by arterial-lacunar fistula secondary to the winter procedure

El priapismo es una afección patológica que consiste en una erección peneana persistente más allá de la estimulación sexual. Presentamos el caso de un paciente de 80 años, diagnosticado inicialmente, por la historia clínica, valores gasométricos de los cuerpos cavernosos y ultrasonografía doppler color peneana, de priapismo de bajo flujo que durante la realización de la técnica de Winter se produce iatrogénicamente la laceración bilateral de las arterias dorsales, originando una fístula arteriolacunar y en consecuencia un priapismo de alto flujo. Se realizó arteriografía selectiva de la pudenda, al no ser la eco-doppler color concluyente, que puso de manifiesto dicha fístula y permitió la embolización supraselectiva con microcoils...

Priapism is a pathology consisting of prolonged penile erection unrelated to sexual stimulation. We present an 80-year-old patient with relevant clinical history; corpora cavernosa blood gas analysis and penile Doppler ultrasound examination confirmed low-flow priapism. The Winter procedure was performed, which provoked iatrogenic laceration of the dorsal artery, leading to an arterio-lacunar fistula and high-flow priapism. A second Doppler ultrasound was inconclusive, and so a selective angiography was performed to observe the pudendal artery, following which selective embolization with microcoils was carried out...

Aproximación diagnóstica de la osteomielitis aguda en la infancia. Estudio por imagen / Diagnostic aproach of acute osteomyelitis in infants. Imaging modalities

La infección ósea en el niño representa un retodiagnóstico y terapéutico para el pediatra, radiólogo,cirujano y patólogo. Su diagnóstico precoz permiteun tratamiento temprano lo cual evita la apariciónde complicaciones devastadoras y secuelaspermanentes. Revisamos los métodos de diagnósticopor imagen con los que contamos en la actualidadhaciendo hincapié en la radiología convencionalpor su disponibilidad y alcance para los pediatras

Osteomyelitis in children represents a diagnosticand therapeutic challenge to the pediatrician, the radiologist,the surgeon and the pathologist. Earlydiagnosis allows prompt treatment which can preventthe devasting complications and permanent sequelaeoutcome. In the present article we review themodern imaging techniques for the diagnosis of osteomyelitisinsisting on the importance of conventionalradiology for its availability for pediatricians