Heath-related quality of life in thyroid cancer patients following radioiodine ablation

<p>Abstract</p> <p>Background</p> <p>There is limited information about the medium to long-term health-related quality of life (QOL) in thyroid cancer patients after initial therapy and the existing studies suffer from limitations. The aim of the study was to assess the determinants of medium-term QOL after the initial therapy.</p> <p>Methods</p> <p>Following a total thyroidectomy, 88 thyroid cancer patients received either rhTSH or hypothyroid-assisted radioiodine ablation (RRA) using 3.7 GBq (100 mCi) of radioiodine. QOL evaluation of the patients using the validated Functional Assessment of Chronic Illness & Therapy (FACIT) was performed at the time of inclusion (t0) and later at the 9-month post-RRA (t1).</p> <p>Results</p> <p>83 patients were eligible for the final evaluation. Medium-term FACIT scores were not statistically different between t0 and t1 patients. All but one domain of the QOL score was similar between t0 and t1. Using a multivariate analysis, only age and immediate postoperative QOL scores were found to be determinants of the overall medium term 9-month QOL scores. Analysis showed that 'high QOL levels' (baseline and 9-month) and 'no depression', 'low anxiety levels', were associated with '<45yrs', 'men', 'partner', and 'rhTSH stimulation'.</p> <p>Conclusions</p> <p>The use of radioiodine ablation does not seem to affect the medium term QOL scores of patients. Medium-term QOL is mainly determined by pre-ablation QOL. The assessment of baseline QOL might be interesting to evaluate in order to adapt the treatment protocols, the preventive strategies, and medical information to patients for potentially improving their outcomes.</p

Measurements on hydrophobic and hydrophilic surfaces using a porous gamma alumina nanoparticle aggregate mounted on Atomic Force Microscopy cantilevers

Atomic Force Microscopy (AFM) measurements are extensively used for a detailed understanding ofmolecular and surface forces. In this study, we present a technique for measuring such forces, using an AFM cantilever attached with a porous gamma alumina nanoparticle aggregate. The modified cantilever was used to measure the forces of interaction of the aggregate with hydrophilic and hydrophobic surfaces. A strong force of attraction was observed between the aggregate and hydrophilic surfaces when the aggregate was kept dry. However, the force of interaction on the aggregate in wet form (water filled in pores) was larger when the adjoining surface had hydrophobic characteristics. The results presented in this study show the versatility of the current technique and indicate its usefulness in directly characterizing hydrophilic/ hydrophobic properties of nano-scale surfaces and patterns

Risk factors for postoperative complications after adrenalectomy for phaeochromocytoma: multicentre cohort study

Background: To determine the incidence and risk factors for postoperative complications and prolonged hospital stay after adrenalectomy for phaeochromocytoma. Methods: Demographics, perioperative outcomes and complications were evaluated for consecutive patients who underwent adrenalectomy for phaeochromocytoma from 2012 to 2020 in nine high-volume UK centres. Odds ratios were calculated using multivariable models. The primary outcome was postoperative complications according to the Clavien–­­Dindo classification and secondary outcome was duration of hospital stay. Results: Data were available for 406 patients (female n = 221, 54.4 per cent). Two patients (0.5 per cent) had perioperative death, whilst 148 complications were recorded in 109 (26.8 per cent) patients. On adjusted analysis, the age-adjusted Charlson Co-morbidity Index ≥3 (OR 8.09, 95 per cent c.i. 2.31 to 29.63, P = 0.001), laparoscopic converted to open (OR 10.34, 95 per cent c.i. 3.24 to 36.23,

Paratiroidectom\ueda de acceso m\uednimo/m\uednimamente invasiva para hiperparatiroidismo primario

La paratiroidectom\ueda de acceso m\uednimo o m\uednimamente im asis a est\ue1 reemplazando a la exploraci\uf3n bilateral del cuello como el m\ue9todo quir\ufargico m\ue1s adecuado en hiperparatiroidismo primario (pHPT). Cuando se localiza un adenoma paratiroideo en el preoperatorio, idealmente la combinaci\uf3n de sestamibi con ultrasonograf\ueda. pueden lograrse resultados equivalentes a la exploraci\uf3n bilateral del cuello por medio de una incisi\uf3n menor de 2.5 cm. Las t\ue9cnicas de acceso m\uednimo ofrecen la ventaja de curaci\uf3n bajo anestesia local. con una incisi\uf3n m\ue1s peque\uf1a y sin necesidad de permanecer en el hospital durante la noche. La medici\uf3n transoperatoria de la hormona paratiroidea (PTH) puede ser un coadyuvante \ufatil para la confirmaci\uf3n de extirpaci\uf3n del adenoma paratiroideo. aunque en la actualidad parece agregar poco cuando es \uf3ptima la localizaci\uf3n preoperatoria. Se requerir\ue1n estudios con testigos y vigilancia a largo plazo para establecer el real valor de la cirug\ueda paratiroidea de acceso m\uednimo

Hereditary hyperparathyroidism\u2014a consensus report of the European Society of Endocrine Surgeons (ESES)

Background Hereditary hyperparathyroidism has been reported to occur in 5-10 % of cases of primary hyperparathyroidism in the context of multiple endocrine neoplasia (MEN) types 1, 2A and 4; hyperparathyroidism-jaw tumour (HPT-JT); familial isolated hyperparathyroidism (FIHPT); familial hypocalciuric hypercalcaemia (FHH); neonatal severe hyperparathyroidism (NSHPT) and autosomal dominant moderate hyperparathyroidism (ADMH). This paper aims to review the controversies in the main genetic, clinical and pathological features and surgical management of hereditary hyperparathyroidism. Methods A peer review literature analysis on hereditary hyperparathyroidism was carried out and analyzed in an evidence-based perspective. Results were discussed at the 2015 Workshop of the European Society of Endocrine Surgeons devoted to hyperparathyroidism due to multiple gland disease. Results Literature reports scarcity of prospective randomized studies; thus, a low level of evidence may be achieved. Conclusions Hereditary hyperparathyroidism typically presents at an earlier age than the sporadic variants. Gene penetrance and expressivity varies. Parathyroid multiple gland involvement is common, but in some variants, it may occur metachronously often with long disease-free intervals, simulating a single-gland involvement. Bilateral neck exploration with subtotal parathyroidectomy or total parathyroidectomy + autotransplantation should be performed, especially in MEN 1, in order to decrease the persistent and recurrent hyperparathyroidism rates; in some variants (MEN 2A, HPT-JT), limited parathyroidectomy can achieve long-term normocalcemia. In FHH, surgery is contraindicated; in NSHPT, urgent total parathyroidectomy is required. In FIHPT, MEN 4 and ADMH, a tailored case-specific approach is recommended

Breast cancer metastases to the thyroid gland – an uncommon sentinel for diffuse metastatic disease: a case report and review of the literature

Abstract Background Metastases to the thyroid are rare. The most common primary cancer to metastasize to the thyroid is renal cell carcinoma, followed by malignancies of the gastrointestinal tract, lungs, and skin, with breast cancer metastases to the thyroid being rare. Overall, the outcomes in malignancies that have metastasized to the thyroid are poor. There are no prospective studies addressing the role of surgery in metastatic disease of the thyroid. Isolated thyroidectomy has been proposed as a local disease control option to palliate and prevent the potential morbidity of tumor extension related to the airway. Here, we present a case of a patient with breast cancer metastases to the thyroid gland and discuss the role of thyroidectomy in the context of the current literature. Case presentation A 62-year-old Afro-Caribbean woman was diagnosed as having bilateral breast carcinoma in 2004, for which she underwent bilateral mastectomy. The pathology revealed multifocal disease on the right, T2N0(0/20)M0 grade 1 and 2 invasive ductal carcinoma, and on the left side, T3N1(2/18)M0 grade 1 invasive ductal carcinoma. Surgery was followed by adjuvant chemotherapy and regional radiotherapy. The disease was under control on hormonal therapy until 2016, when she developed cervical lymphadenopathy. The fine-needle aspiration cytology of the thyroid was reported as papillary thyroid cancer; and the fine-needle biopsy of the left lateral nodal disease was more suggestive of breast malignancy. She underwent a total thyroidectomy and a clearance of the central compartment lymph nodes and a biopsy of the lateral nodal disease. The histopathological analysis was consistent with metastatic breast cancer in the thyroid and lymph nodes with no evidence of a primary thyroid malignancy. Conclusions A past history of a malignancy elsewhere should raise the index of suspicion of metastatic disease in patients presenting with thyroid lumps with or without cervical lymphadenopathy. Detection of metastases to the thyroid generally indicates poor prognosis, obviating the need of surgery in an already compromised patient. An empirical thyroidectomy should be considered in select patients for local disease control