A case of acute liver injury induced by methimazole

xlomafota13 shared this article with you from Inoreader A case of acute liver injury induced by methimazole Via Thyroid Res Pract Karthika Niveditha, Arun S Menon, Harish Kumar, Malini Eapen, Rajesh Gopalakrishna Thyroid Research and Practice 2021 18(1):34-36 Antithyroid drugs, methimazole, and propylthiouracil have been reported to cause hepatotoxicity. We report the case of a patient with methimazole induced liver injury who presented within a few weeks of commencement of the drug. She presented with a cholestatic picture and responded well to discontinuation of the drug and administration of steroids. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader Long-term hypocalcemia prediction post thyroidectomy Via Thyroid Res Pract Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna Thyroid Research and Practice 2021 18(1):14-18 Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader Long-term hypocalcemia prediction post thyroidectomy Via Thyroid Res Pract Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna Thyroid Research and Practice 2021 18(1):14-18 Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of metformin therapy on thyroid-stimulating hormone levels in women with polycystic ovarian syndrome

xlomafota13 shared this article with you from Inoreader Effect of metformin therapy on thyroid-stimulating hormone levels in women with polycystic ovarian syndrome Via Thyroid Res Pract Vinay Dhanpal, Mala Dharmalingam, Pramila Kalra Thyroid Research and Practice 2021 18(1):6-10 Introduction: Metformin has been shown to decrease thyroid-stimulating hormone (TSH) levels without effect on total T4 and total T3 levels, especially in patients with underlying thyroid dysfunction. The Aim of the Study: To evaluate the effect of metformin therapy on TSH levels in polycystic ovarian syndrome (PCOS) patients who were euthyroid with or without treatment. Design of the Study Nonrandomized prospective intervention trial. Materials and Methods: The study included all euthyroid PCOS patients of the reproductive age group diagnosed according to the modified Rotterdam criteria and the patients were divided into two groups. The first group was put on lifestyle modification alone (Group-I), whereas the second group was put on lifestyle modification and metformin therapy (Group-II). In both groups of patients, TSH, total T4, and total T3 levels were done at baseline and after 3 months of follow-up. Results: A total of 105 patients with PCOS were nonrandomly assigned to Group I (n = 53) and Group II (n = 52). The baseline parameters (age, body mass index, TSH, and Homeostatic Model Assessment for Insulin Resistance) were similar. Thirty-six patients in Group I and 39 in Group II were followed up for 3 months. The change in TSH levels in both groups was not significant at follow-up (Group I [2.56 ± 0.87 vs. 3.01 ± 1.54; P = 0.102] and Group II [2.90 ± 0.81 vs. 2.76 ± 1.26;P = 0.503]). In a subgroup analysis in patients who had thyroid dysfunction, there was a significant decrease in TSH levels in Group II (3.10 ± 0.54 vs. 2.57 ± 0.50;P = 0.031). Conclusion: Metformin significantly decreased TSH levels in women with PCOS with underlying thyroid dysfunction, while it did not show any effect on women without underlying thyroid dysfunction. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis

xlomafota13 shared this article with you from Inoreader Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis Via Thyroid Res Pract Pramila Kalra, KM Prasanna Kumar Thyroid Research and Practice 2021 18(1):1-5 Objectives: Subacute thyroiditis (SAT) is a temporary dysfunction of the thyroid gland and is commonly due to its viral infection. Permanent hypothyroidism after recovery from SAT has been reported in various studies. Methodology: This was a prospective study conducted in two tertiary care centers in South India to follow-up these cases for the development of permanent primary hypothyroidism at 1-year follow-up after recovery from SAT. Results: The total number of cases followed up was 146, including 103 females (70.5%) and 43 males (29.5%). Females' mean age was 33.03 ± 11.7 years, and males' mean age was 40.17 ± 11.84 years. Seven patients reported the second attack of thyroiditis. The mean thyroid-stimulating hormone (TSH) recorded at baseline was 0.042 ± 0.056 µIU/ml. Permanent hypothyroidism was seen in 19.86% of the cases at a 1-year follow-up and was found to be higher in patients with lower TSH at baseline. The females and males were affected at a younger age as compared to other studies. The incidence of permanent hypothyroidism was found to be higher as compared to some but lesser compared to a few others. The iodine supplementation could also be one of the postulates for this higher incidence of hypothyroidism. The severity of thyrotoxicosis was a significant determinant of the future development of hypothyroidism. Conclusions: The patients with SAT need to be followed up for the development of permanent hypothyroidism. The prevalence of hypothyroidism at 1 year was 19.86% after an attack of thyroiditis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adult False Vocal Cord Cavernous Lymphangioma Presenting with Hemoptysis: A Case Report

xlomafota13 shared this article with you from Inoreader Adult False Vocal Cord Cavernous Lymphangioma Presenting with Hemoptysis: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Nov 20:1455613211047131. doi: 10.1177/01455613211047131. Online ahead of print. ABSTRACT Lymphangiomas are rare benign tumors of the lymphatic system, most often found at birth and before the age of 2 years. The head and neck region are the most frequent locations for lymphangioma. Involvement of the adult larynx in isolation is rare, and only a few cases have been reported so far. We report the case of a patient with a left false vocal cord reddish t umor presenting with hemoptysis and voice cracking. The surgical excision of mass was performed by direct laryngoscopy-assisted CO2 laser. The histopathological report revealed the diagnosis as cavernous lymphangioma. After a follow-up of 1 year, the patient is free of recurrence with all laryngeal functions being normal. PMID:34802262 | DOI:10.1177/01455613211047131 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of vein grafts in reconstructive head and neck microsurgery

xlomafota13 shared this article with you from Inoreader The role of vein grafts in reconstructive head and neck microsurgery Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 26:S1808-8694(21)00175-0. doi: 10.1016/j.bjorl.2021.09.004. Online ahead of print. ABSTRACT OBJECTIVE: Free tissue transfer is widely used for head and neck reconstruction. In certain circumstances, vein grafting is required to elongate free flap pedicles to connect them to appropriate recipient vessels. Because of controversy regarding the use of interposition vein grafts in free tissue reconstruction, this paper reports vein graft indications, techniques, safety, and outcomes for head and neck microvascular surgery. METHODS: Twenty-six patients (23 men and 3 women) who underwent interposition vein grafting concurrent with free tissue transfer were included in this study. The most common reason for head and neck reconstruction with vein graft was tumor recurrence, followed by flap salvage. The interposition vein grafts were applied in two manners as temporary arteriovenous (A-V) loop and conduit to extend the length of the free flap for venous drainage. RESULTS: The most common reconstructions were anterolateral thigh flaps (15 cases), followed by vastus lateralis myocutaneous (3 cases) and radial forearm (2 cases) flaps. The common recipient vessels were superior thyroid artery, superficial temporal artery and external jugular vein. The free flap loss rate was 7.7% with vein grafts and 4.9 without vein grafts (p = 0.380). The free flap complication rate was 50.0% and 16.8% in patients with and without vein grafts, respectively (p < 0.001). Radiation therapy, chemotherapy, prior neck dissection, and prior free flap transfer were more common in the vein graft group (all p < 0.001). The hospital stay was significantly longer for the vein graft group than for the non-vein graft group (29.5 vs. 19.0 days; p = 0.001). CONCLUSION: Overall free flap survival rates of 92.3% and 95.1% in the vein and non-vein graft groups, respectively - indicating the reliability of the vein grafts in challenging head and neck reconstructions, particularly in salvage cases and patients with multiple reconstructions. LEVEL OF EVIDENCE: Level 3. PMID:34802968 | DOI:10.1016/j.bjorl.2021.09.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rectal Cancer: Organ preservation and neoadjuvant treatment escalation

xlomafota13 shared this article with you from Inoreader Rectal Cancer: Organ preservation and neoadjuvant treatment escalation Via Association française pour l'étude du cancer Bull Cancer. 2021 Nov 18:S0007-4551(21)00391-X. doi: 10.1016/j.bulcan.2021.09.007. Online ahead of print. ABSTRACT Standard treatment consisting of chemoradiotherapy followed by radical surgery with total mesorectal excision, results in good oncologic local control but high morbidity and poor functional results. Since chemoradiotherapy results in 15% pathological complete response, even reaching up to 30% in case of association with neoadjuvant chemotherapy, radical surgery has been recently debated for good responders. Therefore, a de-escalation strategy, by omitting radical surgery in good responders, has recently been developed with two different options: a watch and wait strategy, requiring an accurate clinical and radiological definition of complete response and a local excision strategy including patients with sub-complete response. Ongoing trials focus on response optimization by chemotherapy intensification or radiotherapy dose escalation. However, many questions are still to be answered regarding definition of complete response, follow-up strategy, morbidity of salvage surgery in case of recurrence as well as long-term oncological and functionnal results. PMID:34802716 | DOI:10.1016/j.bulcan.2021.09.007 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict

xlomafota13 shared this article with you from Inoreader The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 23:S1748-6815(21)00516-7. doi: 10.1016/j.bjps.2021.09.076. Online ahead of print. ABSTRACT While scaphoid excision combined with Four Corner Arthrodesis (FCA) or Proximal Row Carpectomy (PRC) is a commonly-used salvage procedures to treat type two and type three Scapholunate Advanced Collapse (SLAC) and Scaphoid Nonunion Advanced Collapse (SNAC)-induced degenerative arthritis, controversy remains over which treatment intervention provides superior outcomes. We searched for articles comparing a range of motion, grip strength, complications requiring reoperation, conversion to wrist arthrodesis, pain, and disability of shoulder and arm scores between FCA and PRC-treated patients. The risk of bias was assessed using the National Institutes of Health (NIH) quality assessment tool. We performed a meta-analysis using Random-Effects Models. Fifteen articles (10 retrospective, 2 cross-sectional, 1 prospe ctive, and 2 randomized trials) were included. There was no significant difference between PRC and FCA in any of the different outcome measures. The risk of bias was found consistently high across all studies. Despite the lack of high-quality evidence, based on existing literature, we recommend PRC as the preferred choice of treatment because of the simplicity of the surgical procedure, lack of hardware-related complications, and comparable long-term outcomes. Level of evidence: III - Therapeutic. PMID:34802951 | DOI:10.1016/j.bjps.2021.09.076 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

To explore the curative effect of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage primary hepatocellular carcinoma

xlomafota13 shared this article with you from Inoreader To explore the curative effect of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage primary hepatocellular carcinoma Via radioactive iodine J Interv Med. 2021 Feb 27;4(2):82-86. doi: 10.1016/j.jimed.2021.02.009. eCollection 2021 May. ABSTRACT OBJECTIVES: To explore the clinical efficacy and survival of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage Ⅳ primary hepatocellular carcinoma. METHODS: A retrospective study of 62 patients with primary hepatocellular carcinoma in our hospital from January 2017 to December 2018 [60 males, 2 females, age (52.76 ​± ​10.82) years old], All p atients were implanted with Iodine-125 radioactive seeds under CT guidance, followed up regularly after operation to observe the clinical efficacy, including comparison of changes in cancer size before and after treatment, tumor marker AFP, and improvement in complications such as abdominal pain and ascites. Follow-up 3-36 months to assess patient survival. RESULTS: Among the 62 patients, 3 months after Iodine-125 radioactive seed implantation, 5 cases (8.1%) had complete remission of cancer, 33 cases (53.2%) had partial remission, 12 cases (19.4%) had stable lesions, and 12 cases (19.4%) had disease progression. The effective rate was 61.3%. The tumor volume (31.44 ​± ​14.51cm3) was significantly smaller than before (50.96 ​± ​30.13cm3) (t ​= ​5.303, p ​< ​0.05). The tumor marker AFP (69.28 ​± ​50.99) ug/L of 3 months after implantation was significantly lower than that before treatment (90.63 ​± ​68.58) ug/L (t ​= ​3.702, P ​< ​0.05) . The average survival time of Iodine-125 seed implantation for stageⅣhepatocellular carcinoma is 11.47 ​± ​0.85 months, and the median survival time is 9 months. The survival time of the group with better pathological differentiation (gradeⅠ+Ⅱ) was significantly better than that of the group with poor differentiation (grade Ⅲ+Ⅳ) (x2 ​= ​6.869 p ​< ​0.05). Among the 38 patients with different degrees of abdominal pain, 22 patients improved better than before; 15 of 28 patients with different degrees of ascites were better than before. All patients had no serious complications related to treatment. CONCLUSIONS: Iodine-125 radioactive seed implantation therapy can safely and effectively treat hepatocellular carcinoma, and relieve the clinical symptoms of abdominal pain and ascites. PMID:34805953 | PMC:PMC8562200 | DOI:10.1016/j.jimed.2021.02.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Do patients with chronic rhinosinusitis exhibit elevated rates of Covid‐19 infection?

xlomafota13 shared this article with you from Inoreader Do patients with chronic rhinosinusitis exhibit elevated rates of Covid‐19 infection? Via The Laryngoscope Abstract Patients with chronic rhinosinusitis (CRS) may have concerns regarding their potential for an increased likelihood of contracting Covid-19, given baseline inflammatory disease and utilization of topical or oral immunosuppressive therapies for disease treatment. In the present study, we utilize matched cohort sampling of over 12,000 CRS patients and 12,000 controls seen between June of 2020 and January of 2021, examining rates of Covid-19 testing and positivity during that time period. We found no difference in Covid-19 contraction between CRS patients and matched non-CRS patients, despite an almost two-fold significant increase in testing among those with CRS. This suggests that CRS patients are likely not inherently more vulnerable to Covid-19 infection at a rate above that of the general population. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.