Znaczenie badania krwi pobranej z żył tarczowych górnych i dolnych w rozpoznawaniu raka tarczycy

Introduction: We aimed to determine whether levels of thyroglobulin measured in blood from the inferior-superior thyroid veins and the peripheral antecubital vein could predict the presence of thyroid carcinoma in patients undergoing surgery for thyroid diseases. Material and methods: Sixty-one patients were prospectively enrolled in the study. Levels of thyroglobulin were analysed. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of these markers were investigated. Results: Twenty-six out of 61 patients (42.6%) with malignancy were diagnosed. The levels of thyroglobulin in the inferior-superior thyroid veins were higher than those in the peripheral antecubital vein (p = 0.001). The levels of thyroglobulin in the blood taken from the antecubital vein and the inferior-superior thyroid veins did not differ between benign and malignant thyroid disorders. For thyroglobulin, sensitivity was 33.3%, specificity 60.6%, PPV 27.8%, and NPV 66.7% respectively. Conclusion: Thyroglobulin levels in the antecubital vein compared to the inferior-superior thyroid veins were not significant either in benign or malignant disorders.Wstęp: Celem badania było ustalenie, czy oznaczenie stężeń tyreoglobuliny we krwi pobranej z żył tarczowych górnych i dolnych oraz z żyły przedłokciowej ma wartość prognostyczną w wykrywaniu nowotworów tarczycy u chorych poddawanych zabiegom chirurgicznym z powodu chorób tarczycy. Materiał i metody: Do tego prospektywnego badania włączono 61 chorych. Analizowano wartości stężeń tyreoglobuliny. Badano czułość, swoistość oraz wartość prognostyczną dodatnią (PPV) i ujemną (NPV) tych wskaźników. Wyniki: U 26 spośród 61 chorych (42,6%) rozpoznano chorobę nowotworową. Stężenia tyreoglobuliny w żyłach tarczowych dolnych i górnych były wyższe niż stężenia mierzone we krwi pobranej z żyły przedłokciowej (p = 0,001). Stężenia tyreoglobuliny w próbkach krwi pobranych z żyły przedłokciowej i żył tarczowych nie różniły się istotnie między osobami z łagodnymi i złośliwymi guzami tarczycy. Oznaczenie tyreoglobuliny cechowało się czułością wynoszącą 33,3%, swoistością równą 60,6%, PPV — 27,8% i NPV — 66,7%. Wnioski: Porównanie stężeń tyreoglobuliny w żyle przedłokciowej i w żyłach tarczowych górnych i dolnych nie miało istotnego znaczenia diagnostycznego w wykrywaniu zarówno zmian łagodnych, jak i złośliwych

Are the characteristics of thyroid cancer different in young patients?

WOS: 000338835600016PubMed: 24353138Background: Thyroid carcinoma in pediatric patients continues to be a rare albeit significant condition because local recurrence or distant metastases may be revealed during its diagnosis, or even years after completion of treatment. Methods: This study was prepared by retrospective analysis of patient files to focus on the clinical presentation of thyroid carcinoma in pediatric patients, and proposes to investigate the clinical parameters that differ from, or that correspond to, those in adult patients. Subjects: A total of 108 patients, of whom 22 were children and adolescents and 86 were adults, and who were operated on for differentiated thyroid carcinoma during the period 2001-2009, were included in the study. Results: The rate of large thyroid, multinodular goiter, or tumor >1 cm was significantly higher in the adult group than in the pediatric group. Our analysis also revealed that that the frequency of lymph node metastasis was significantly higher in the pediatric group than in the adult group. Moreover, the frequencies of total lymph node and positive lymph node presentations were significantly higher in the pediatric group than in the adult group. Conclusion: Although thyroid carcinoma has a good prognosis in young patients, one must stress that late diagnosis and ineffective treatment are the main criteria for poor prognosis and, most important, that it is advisable to keep the management of thyroid carcinoma on a path that differs from the management of adult thyroid carcinomas, in nearly all aspects from presentation to treatment

Risk Factors for Perioperative Anxiety in Laparoscopic Surgery

WOS: 000348437400027PubMed: 25392610Background and Objectives: Our aim is to investigate the anxiety status of the patient before elective cholecystectomy and to analyze the relation between the level of anxiety for a given operation type (laparoscopic and open cholecystectomy) and the corresponding demographic and social data. Methods: A total of 333 patients undergoing cholecystectomy due to cholelithiasis were included in the study; 218 patients (66.1%) received laparoscopic cholecystectomy and 115 patients (33.9%) were treated with open cholecystectomy. The Beck Anxiety Inventory was given to all patients to be completed. We evaluated levels of anxiety in 3 groups as follows: 0 to 15, low to mild anxiety; 16 to 25, moderate anxiety; 26 to 63, severe anxiety. The following patient information remained confidential and was recorded: age and sex, associated disease, civil status, educational status, having open/laparoscopic cholecystectomy, previous knowledge of the operation, job status, economic status, health insurance, and having a child in need of care. Results: The following criteria were determined: the most determinant factors in differentiating between the score groups were having a low level of education, being of the female sex, being single, and having laparoscopic operation; the factors of being a homemaker and over the age of 25 years were determined to have significant effects. Conclusions: When analyzing the results that may appear during the intraoperative and postoperative period, understanding preoperative anxiety, analyzing the risk factors in depth, and taking the necessary precautions are all considerations that need to be the primary objectives of operators who are involved with laparoscopic, endoscopic, and robotic surgery

Anostomose Covered by Mesh: Can We Prevent Leakage with New Instrumantation Methods?

79th Annual Scientific Meeting of the American-College-of-Gastroenterology -- OCT 17-22, 2014 -- Philadelphia, PAWOS: 000344383100650…Amer Coll Gastroentero

Effects of melatonin and dexpanthenol on antioxidant parameters when combined with estrogen treatment in ovariectomized rats

Tiwari, Prafulla/0000-0001-7913-5386WOS: 000326100600017PubMed: 23471492The purpose of the study was to assess whether it is possible to reduce the oxidative damage using antioxidant agents combined with hormone replacement therapy after menopause. In this prospective experimental study, 50 mature female Wistar albino rats weighing 270-310 g were used. Rats were divided into the following six groups: (1) Ovx group (n = 7): the animals underwent bilateral ovariectomy. No drug was administered following bilateral ovariectomy. (2) Ovx + E (2) group (n = 7): bilateral ovariectomy + 17 beta-estradiol (100 mu g/kg/day); (3) Ovx + E (2) + MT5 group (n = 7): bilateral ovariectomy + 17 beta-estradiol (100 mu g/kg/day) + melatonin (5 mg/kg/day); (4) Ovx + E (2) + MT20 group (n = 7): bilateral ovariectomy + 17 beta-estradiol (100 mu g/kg/day) + melatonin (20 mg/kg/day); (5) Ovx + E (2) + Dxp250 group (n = 7): bilateral ovariectomy + 17 beta-estradiol (100 mu g/kg/day) + dexpanthenol (250 mg/kg/day); (6) Ovx + E (2) + Dxp500 group (n = 7): bilateral ovariectomy + 17 beta-estradiol (100 mu g/kg/day) + dexpanthenol (500 mg/kg/day), and the activity of these antioxidative enzymes and oxidative stress products were measured. Enzymatic activity levels of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase(GSH-Px), and glutathione reductase and levels of free radicals (malondialdehyde (MDA) and nitric oxide) were both analyzed. We observed an increase in the level of GSH activity, but no significant differences in levels of CAT, SOD, and GSH-Px enzymatic activity and in levels of free radical MDA following 17 beta-estradiol or additional antioxidant treatment (melatonin or dexpanthenol). Despite the present study indicating that the addition of melatonin and dexpanthenol into the hormone replacement therapy regimen may contribute to the antioxidant effect of estrogen, the existence of limited data in this field indicates that further studies are warranted

Effects of glucagon-like peptide-2 on bacterial translocation in rat models of colitis

Background/aims: The aim of this trial was to study the role of glucagon-like peptide-2 in reducing bacterial translocation by virtue of its anti-inflammatory effects and ability to decrease intestinal permeability in rat models of inflammatory bowel diseases. On the basis of our results and those of other recent studies, we suggest a new treatment modality for colitis. To our knowledge, this is the first study of the effectiveness of glucagon-like peptide-2 on bacterial translocation, in treating an. experimental colitis model. Methods: Rats were randomized into 3 groups of 7 rats each-the control group, colitis group, and treatment group. On the 75 day after induction of colitis, the levels of tissue myeloperoxidase, serum tumor necrosis factor-alpha, and plasma endotoxin were measured. Tissue samples were obtained from the liver, spleen, and mesenteric lymph nodes for evaluating bacterial translocation. Results: Bacterial translocation in samples of the liver, spleen, mesenteric lymph nodes, and portal and systemic blood obtained from the treatment group was lower than that in samples obtained from the colitis group (p<0.05). The levels of tissue myeloperoxidase, serum tumor necrosis factor-alpha, and plasma endotoxin in the treatment group were significantly lower than those in the colitis group (p<0.05). Conclusions: In experimental colitis models, which were induced using trinitrobenzene sulfonic acid in ethanol, glucagon-like peptide-2 treatment reduced inflammation and bacterial translocation from the intestinal mucosa. Our results indicate that glucagon-like peptide-2 is a potential agent for treating colitis; however, extensive trials are needed to confirm our results