The Interaction of Oxidative Stress Response with Cytokines in the Thyrotoxic Rat: Is There a Link?

Oxidative stress is regarded as a pathogenic factor in hyperthyroidism. Our purpose was to determine the relationship between the oxidative stress and the inflammatory cytokines and to investigate how melatonin affects oxidative damage and cytokine response in thyrotoxic rats. Twenty-one rats were divided into three groups. Group A served as negative controls. Group B had untreated thyrotoxicosis, and Group C received melatonin. Serum malondialdehyde (MDA), glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GPx), and nitric oxide derivates (NO•x), and plasma IL-6, IL-10, and TNF-alpha were measured. MDA, GSH, NO•x, IL-10, and TNF-alpha levels increased after L-thyroxine induction. An inhibition of triiodothyronine and thyroxine was detected, as a result of melatonin administration. MDA, GSH, and NO•x levels were also affected by melatonin. Lowest TNF-alpha levels were observed in Group C. This study demonstrates that oxidative stress is related to cytokine response in the thyrotoxic rat. Melatonin treatment suppresses the hyperthyroidism-induced oxidative damage as well as TNF-alpha response

65 YEARS OF THE DOUBLE HELIX Genetics informs precision practice in the diagnosis and management of pheochromocytoma

Although the authors of the present review have contributed to genetic discoveries in the field of pheochromocytoma research, we can legitimately ask whether these advances have led to improvements in the diagnosis and management of patients with pheochromocytoma. The answer to this question is an emphatic Yes! In the field of molecular genetics, the well-established axiom that familial (genetic) pheochromocytoma represents 10% of all cases has been overturned, with >35% of cases now attributable to germline disease-causing mutations. Furthermore, genetic pheochromocytoma can now be grouped into five different clinical presentation types in the context of the ten known susceptibility genes for pheochromocytoma-associated syndromes. We now have the tools to diagnose patients with genetic pheochromocytoma, identify germline mutation carriers and to offer gene-informed medical management including enhanced surveillance and prevention. Clinically, we now treat an entire family of tumors of the paraganglia, with the exact phenotype varying by specific gene. In terms of detection and classification, simultaneous advances in biochemical detection and imaging localization have taken place, and the histopathology of the paraganglioma tumor family has been revised by immunohistochemical-genetic classification by gene-specific antibody immunohistochemistry. Treatment options have also been substantially enriched by the application of minimally invasive and adrenal-sparing surgery. Finally and most importantly, it is now widely recognized that patients with genetic pheochromocytoma/paraganglioma syndromes should be treated in specialized centers dedicated to the diagnosis, treatment and surveillance of this rare neoplasm.Peer reviewe

Less than total thyroidectomy for goiter: when and how?

WOS: 000423441300007PubMed ID: 29322022Benign goiter is the most common endocrine disease that requires surgery, especially in endemic areas suffering from iodine-deficiency. Recent European and American guidelines recommended total thyroidectomy for the surgical treatment of multinodular goiter. Total thyroidectomy has now become the technique of choice and is widely considered the most reliable approach in preventing recurrence. Nevertheless, total thyroidectomy carries a substantial risk in terms of hypoparathyroidism and the morbidity associated with injury to the inferior laryngeal nerve. In this context, partial/less-than-total thyroidectomy is being considered once again as a viable alternative. This review will discuss the extent of thyroid surgery for benign disease and the impact of the surgical protocol on the patient-and surgeon-specific risk factors for specific complication rates

İntraoperatif nöromonitörizasyon uygulaması sonrası, sinyal kaybı yaşanmayan tiroid ve paratiroid hastalarında postoperatif laringeal muayene ihmal edilebilir mi?

Objective: We aimed to evaluate the necessity and the worthiness of postoperative vocal cord examination in cases with no loss of signal during intraoperative nerve monitoring (IONM) in thyroid and parathyroid surgery.Material and Methods: We retrospectively evaluated cases that had no loss of signal during intraoperative nerve monitoring in cases who underwent thyroid and parathyroid surgery in our endocrine surgery unit, between January 2014 – January 2017.Results: A total of 171 patients were analyzed who had no loss of signal during IONM. It was observed that 94 of the patients (55%) had at least one previous surgery and 77 (45%) underwent their first operation. Ninetyone patients were monitored with continuous-IONM and 80 with intermittent-IONM. All patients’ preoperative and postoperative laryngeal examinations were identical and no postoperative vocal cord problems were observed.Conclusion: The signal from the vagus nerve is sufficiently sensitive to show the postoperative vocal cord functions after resection in patients having no loss of signal during IONM. We support the idea that postoperative vocal cord examination may be neglected in these patientsAmaç: Tiroid ve paratiroid bezlerinin cerrahisinde, intraoperatif nöromonitörizayon (İONM) uygulaması sırasında sinyal kaybı yaşanmayan olgularda postoperatif vokal kord bakısının gerekliliğini ve standardizasyondaki yerini irdelemeyi amaçladık.Gereç ve Yöntemler: Kliniğimizin endokrin cerrahisi bölümünde, Ocak 2014-Ocak 2017 tarihleri arasında, İONM uygulanmış ve sinyal kaybı yaşanmamış tiroidektomi ve paratiroidektomi hastaları geriye dönük olarak incelendi. Bulgular: İONM eşliğinde sinyal kaybı saptanmayan 171 hasta ele alındı. Hastaların 94'ünün (%55) en az bir kere ameliyat geçirdiği, 77'sinin (%45) ise ilk ameliyatı olduğu gözlendi. Hastalardan 91'ine sürekli, 80 hastaya ise aralıklı İONM uygulandı. Tüm hastaların ameliyat öncesi larinks muayeneleri ile ameliyat sonrası larinks muayenelerinin aynı olduğu, ameliyat sonrası dönemde hiç bir hastada vokal kord sorunu olmadığı gözlendi. Sonuç: İONM uygulanan ve sinyal kaybı olmayan olgularda rezeksiyon sonrası nervus vagustan alınan sinyal postoperatif vokal kord fonksiyonlarını göstermede yeterince duyarlıdır. Bu hastalara postoperatif vokal kord bakısının ihmal edilebileceği kanısındayı

Can postoperative laryngeal examination be neglected in thyroid and parathyroid patients with no loss of signal after intraoperative neuromonitoring?

WOS: 000461107900005Objective: We aimed to evaluate the necessity and the worthiness of postoperative vocal cord examination in cases with no loss of signal during intraoperative nerve monitoring (IONM) in thyroid and parathyroid surgery. Material and Methods: We retrospectively evaluated cases that had no loss of signal during intraoperative nerve monitoring in cases who underwent thyroid and parathyroid surgery in our endocrine surgery unit, between January 2014 - January 2017. Results: A total of 171 patients were analyzed who had no loss of signal during IONM. It was observed that 94 of the patients (55%) had at least one previous surgery and 77 (45%) underwent their first operation. Ninety-one patients were monitored with continuous-IONM and 80 with intermittent-IONM. All patients' preoperative and postoperative laryngeal examinations were identical and no postoperative vocal cord problems were observed. Conclusion: The signal from the vagus nerve is sufficiently sensitive to show the postoperative vocal cord functions after resection in patients having no loss of signal during IONM. We support the idea that postoperative vocal cord examination may be neglected in these patients