Thyroid autotransplantation after total thyroidectomy in multi-nodular goiter—a case series analysis

Abstract Aims Although the relationship between attention-deficit/hyperactivity disorder (ADHD) and transport accidents has been shown, there is limited information on the relationship between medication and dose–response effects and transport accident risk. This study aims to determine whether young people with ADHD, including adolescents, are more prone to transport accidents than those without, and the extent to which methylphenidate (MPH) prescription in these patients reduces the risk. Methods We identified 114 486 patients diagnosed with ADHD from Taiwan's National Health Insurance Research Database from 1997 to 2013. Using a Cox regression model, we compared the risk of transport accidents between ADHD and non-ADHD groups and estimated the effect of MPH on accidents. Furthermore, we applied a self-control case-series analysis to compare the risk of accidents during the medication periods with the same patients' non-medication periods. Results Male ADHD patients had a higher risk of transport accidents than non-ADHD individuals (adjusted hazard ratio [aHR] = 1.24, [95% confidence interval (CI) 1.10–1.39]), especially for those comorbid with epilepsy, oppositional defiant disorder/conduct disorder (ODD/CD), and intellectual disabilities (ID). Female ADHD patients showed no relationship, except for comorbid with autism spectrum disorder (ASD) or ID. We found a reduced risk of transport accidents in patients with ADHD with MPH medication than those without MPH, with a plausible dose–response relationship (aHR of 0.23 to 0.07). A similar pattern was found in self-controlled case-series analysis. Conclusions Male patients with ADHD, especially those comorbid with epilepsy, ODD/CD, or ID, were at high risk of transport accidents. Female patients, when comorbid with ASD or ID, also exhibited a higher risk of accidents. MPH treatment lowered the accident risk with a dose–response relationship.

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Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis

Clinics ◽

10.6061/clinics/2015(01)05 ◽

2015 ◽

Vol 70 (1) ◽

pp. 24-29 ◽

Cited By ~ 12

Author(s):

J You ◽

Y Yue ◽

F Xing ◽

W Xia ◽

S Lai ◽

...

Keyword(s):

Fish Consumption ◽

Case Series ◽

Retrospective Case ◽

Southeast China ◽

Series Analysis ◽

Retrospective Case Series

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Factors Associated With Intraoperative Conversion to Total Thyroidectomy in Benign Goiters

Pan African Journal of Life Sciences ◽

10.36108/pajols/9102/20(0180) ◽

2019 ◽

Vol 2 (1) ◽

pp. 105-109

Author(s):

Samuel Olatoke ◽

Olayide Agodirin ◽

Ganiyu Rahman ◽

Benjamin Bolaji ◽

Habeeb Olufemi

Keyword(s):

Total Thyroidectomy ◽

Nodular Goiter ◽

Degenerative Changes ◽

P Value ◽

Receiver Operator Curve ◽

Factors Associated ◽

Patient Demographics ◽

Partial Thyroidectomy ◽

Intraoperative Conversion ◽

Operator Curve

Background: Decision to undertake total thyroidectomy when gross inspection of the gland raises suspicion of widespread degenerative changes is often intraoperative. Knowing the factors associated with intraoperative conversion to total thyroidectomy may assist preoperative counselling. This study describes the probability of conversion to total thyroidectomy and factors associated with con-version among patients hitherto planned for partial thyroidectomy. Methods: We reviewed 191 records and extracted data on patient demographics, the pre-operative radiograph findings, the weight of excised gland and the operation performed. Descriptive and inferential statistics were performed. Receiver operator curve was used to assess for cut-off point. P-value was set at 0.05. Results: A total of 191 records was reviewed consisting of 181 females (94.8% 95% CI 90.6-97.5) and 10 males (5.2%, 95%CI 2.5-9.4). Only nodular goiters required conversion to total thyroidectomy. The over-all probability of total thyroidectomy was 11%(95% CI 7.0-16.3). The probability of total thyroidectomy in female was 10.5%(95% CI 6.4-16.9) while in male was 20%(95% CI2.5-55.6). The probability of total thyroidectomy in a female with nodular goiter was 8.1%(95% CI 4.8-13.5), compared to 28.6%(95% CI 3.7-71) in males. The risk of total thyroidectomy was associated with the weight of the excised gland. Conclusion: Only nodular goiters required intraoperative conversion to total thyroidecto-my and the probability of conversion was higher in males.

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Differences in Surgical Outcome in Near Total Thyroidectomy for Benign Nodular Goiter: A Comparison of LigaSure Vessel Sealer versus Conventional Clamp Knot Tie Technique

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i30b31641 ◽

2021 ◽

pp. 65-69

Author(s):

Shiraz Shaikh ◽

Champa Sushel ◽

Ahsan Ali Laghari ◽

Qamber Ali Laghari ◽

Zameer Hussain Laghari ◽

...

Keyword(s):

Hospital Stay ◽

Total Thyroidectomy ◽

Calcium Level ◽

Operative Time ◽

Nodular Goiter ◽

Cross Sectional Study ◽

Cross Sectional ◽

Post Operative Pain ◽

Significant Difference ◽

One Year

Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage. Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique. Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001). Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.

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Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1217 ◽

2017 ◽

Vol 9 (3) ◽

pp. 79-87 ◽

Cited By ~ 1

Author(s):

Marilla Dickfos ◽

Robert Franz

Keyword(s):

Total Thyroidectomy ◽

Surgical Management ◽

Medical Therapy ◽

Clinical Status ◽

Case Series ◽

Primary Treatment ◽

Surgical Removal ◽

Efficient Treatment ◽

Select Group ◽

Small Subgroup

ABSTRACT Introduction Amiodarone can be a life-saving medication; however, it can also cause amiodarone-induced thyrotoxicosis (AIT). Though rare, AIT is a complex and life-threatening side effect, which can cause significant cardiac dysfunction and lead to cardiac failure. Primary treatment is with thionamides, perchlorates, and steroids. However, a small subgroup does not respond and their cardiovascular function continues to deteriorate. This select group is referred for a semi-elective total thyroidectomy. Without surgical removal of their thyroid gland, these patients will continue to deteriorate, with a 30 to 50% mortality rate for those not operated on. Aim The aim of this case series was to assess for any indicators as to when these patients should be referred for total thyroidectomies and the efficacy of this method of treatment. Materials and methods A case series of patients with AIT treated with a total thyroidectomy from 1998 to 2015 was used to assess the efficacy of and indicators for surgery. Results Total thyroidectomy results in efficient and significant improvement in the patient's biochemistry and symptoms. The patient's symptoms and options for medical therapy have an influence on the duration of the trial of medical therapy. Conclusion Surgery is an effective and efficient treatment for AIT. However, there does not appear to be a specific indicator for when this treatment should be instigated. A case-by-case approach should be adopted when treating these complicated patients. Clinical significance Clinicians should see surgery as an effective and efficient treatment for AIT. The timing of surgery should be assessed on a case-by-case basis considering the patient's clinical status and therapeutic options and not as a last resort. How to cite this article Dickfos M, Franz R. Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis. World J Endoc Surg 2017;9(3):79-87.

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