scholarly journals Thyroid morphology in lethal non-thyroidal illness: a post-mortem study

2001 ◽  
pp. 221-226 ◽  
Author(s):  
FE De Jongh ◽  
AC Jobsis ◽  
JW Elte
Keyword(s):  
Intensive Care ◽  
Thyroid Gland ◽  
Chronically Ill ◽  
Intensive Care Patients ◽  
Group A ◽  
Thyroid Morphology ◽  
Group B ◽  
Chronically Ill Patients ◽  
Thyroid Histology ◽  
Grade Iii

OBJECTIVE: Non-thyroidal illness (NTI) is associated with alterations in thyroid hormone metabolism. Whether morphological changes of the thyroid gland accompany NTI is unknown. The aim of the present study was to describe thyroid morphology in patients with lethal non-thyroidal disease. DESIGN: In an autopsy study 267 cases have been examined. METHODS: Clinical data were obtained from medical records. Subjects were patients with chronic disease (group A), intensive care patients (group B) or persons who had died suddenly without pre-existing illnesses (group C). Patients (n = 93) who did not fit into one of these categories and subjects with pre-existing thyroid disorders were excluded. Thyroid histology was assessed semi-quantitatively: grade I <25%, grade II 25--50% or grade III >75% occupation of the thyroid gland by follicles with a diameter <200 microm. RESULTS: Mean thyroid weight was 19.9 g in group A (n=75, age 19--96 (median 75) years, 48 males); 25.7 g in group B (n=64, age 24--93 (median 69) years, 43 males); and 26.0 g in group C (n=35, age 31--89 (median 69) years, 22 males) (P<0.0005, A vs B/C). Grade I thyroid histology was present in 6 out of 75 patients with chronic illness, in 3 out of 64 intensive care patients and in 33 out of 35 sudden-death subjects. Grade III thyroid histology occurred in 30 out of 75 chronically ill patients, in 17 out of 64 intensive care patients and in 0 out of 35 sudden-death subjects (P<0.0005, C vs A/B). CONCLUSIONS: NTI is associated with reduced thyroid follicular size that is accompanied by lower thyroid weight in chronically ill patients but not significantly in intensive care patients.

Histological Study of Human Thyroid Gland Relative Proportion of Parenchyma and Stroma in Thyroid Glands of Bangladeshi People

2013 ◽  
Vol 1 (2) ◽  
pp. 17-20
Author(s):  
Md Enayet Ullah ◽  
Hasna Hena ◽  
Rubina Qasim
Keyword(s):  
Thyroid Gland ◽  
Histological Study ◽  
Relative Proportion ◽  
Age Groups ◽  
Human Thyroid ◽  
Structural Units ◽  
Thyroid Glands ◽  
Group A ◽  
Group B ◽  
Connective Tissue Sheath

Deep cervical fascia forms a connective tissue sheath around the thyroid gland. Delicate trabeculae and septa penetrate the gland indistinctly dividing the gland into lobes and lobules which in turn composed of follicles.1,2,3 These follicles are structural units of thyroid gland which varies greatly in size and shape.4 The number of follicles varies in different age groups. The study was carried out to see the percentage of area occupied by follicles in the stained section of thyroid glands in different age groups. The collected samples were grouped as A (3.5 – 20yrs), B (21- 40yrs) & C (41 – 78yrs). Percentage of area occupied by follicles was (58.55±10.72) in group A, (63.79±12.35) in group B + (63.39±8.29) in group C.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13981 Update Dent. Coll. j. 2011: 1(2): 17-20

To Study the Deteriorating Effects of Lithium Carbonate on Thyroid Gland - A Study in Albino Rats

2021 ◽  
Vol 15 (12) ◽  
pp. 3292-3293
Author(s):  
Tazeen Kohari ◽  
Zaffar Iqbal Malik ◽  
Aftab Ahmad ◽  
Rana M. Asad Khan
Keyword(s):  
Thyroid Gland ◽  
Harmful Effect ◽  
Lithium Carbonate ◽  
Diet Group ◽  
Human Thyroid ◽  
Control Group ◽  
Albino Rats ◽  
Weight Changes ◽  
Group A ◽  
Group B

Background: The human thyroid gland is located in the front of neck. It consists of two lobes. The two lobes are joined with each other by isthmus. The mood stabilizer Lithium Caronate has deleterious effects on the thyroid gland. Aim: To observe and report the data of the harmful effect of Lithium on the weight changes of thyroid gland. Methods: Sixteen rats were selected for this experimental study. The rodents were divided into two groups. Group A comprised of eight animals which were given laboratory diet, Group B contained eight albinos who were given Tablet Lithium Carbonate in powder form at a dose of 60 mg/day for four weeks. After completion of the study time animals were sacrificed and thyroid gland weight were recorded and compared in both groups. Results: The results in both groups were recorded and compared .It was reported that Group B animals had a highly significantly decreased thyroid weight after four weeks Lithium ingestion than Group A control group. Conclusion: The results of our study concluded that Lithium Carbonate damages thyroid glandular tissue and causes its weight to decline. Key words: Thyroid gland, Isthmus, deteriorating

Neuromonitoring of the recurrent laryngeal nerve in thyroid gland surgery – results and experiences

2021 ◽  
Vol 70 (2) ◽  
pp. 89-96
Author(s):  
Jiří Hložek ◽  
Jan Rotnágl ◽  
Jaromír Astl
Keyword(s):  
Thyroid Gland ◽  
Recurrent Laryngeal Nerve ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Laryngeal Nerve ◽  
Operative Strategy ◽  
Predictive Values ◽  
Group A ◽  
Group B ◽  
Neural Monitoring

Paresis of the recurrent laryngeal nerve (RLN) is one of the serious complications of thyroid and parathyroid gland surgery. The intraoperative neural monitoring (IONM) enables to verify the functionality of RLN. The aim of this study is to compare the incidence of postoperative RLN palsy in patients who underwent surgery with and without the use of IONM RLN and to evaluate the positive and negative predictive values, sensitivity, specifi city and accuracy of the method. Methods: Retrospective analysis of thyroid gland surgeries performed within the period from 1. 7. 2016 to 1. 7. 2018. A total of 467 operations were performed (780 nerves exposed). One hundred and thirty procedures (215 nerves) were carried out without IONM (group A). In total, 337 procedures (565 nerves) were performed with IONM (group B). Results: In group A, unilateral postoperative RLN paresis occurred in 7 cases (3.26%); 6 of them were temporary (2.79%) and 1 was permanent (0.47%). In group B, unilateral postoperative RLN paresis occurred in 33 cases (5.84%); 32 of them were temporary (5.66%) and 1 was permanent (0.18%). The incidence of postoperative RLN paresis related to the use of IONM was not considered statistically signifi cant. (Chi-square test: P = 0.146; Fisher‘s exact test: P = 0.2015, P = 0.4715). The sensitivity, specifi city, positive predictive value, negative predictive value and accuracy were 78.79%, 99.25%, 86.67%, 98.69%, and 98.05%, respectively. There was no case of bilateral postoperative RLN paresis. Conclusion: There was no statistically significant diff erence in the incidence of postoperative RLN palsy in patients who underwent surgery with IONM compared to the group without IONM. The high negative predictive value, specifi city and accuracy indicate high reliability of the method. The IONM provides the surgeon with valuable information regarding the functional status of the nerve. This knowledge allows for changing the operative strategy during the procedure. Keywords: intraoperative neural monitoring – IONM – recurrent laryngeal nerve injury – recurrent laryngeal nerve – thyroid surgery

scholarly journals Subphenotypes in Patients with Septic Shock Receiving Vitamin C, Hydrocortisone, and Thiamine: A Retrospective Cohort Analysis

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2976 ◽  
Author(s):  
Won-Young Kim ◽  
Jae-Woo Jung ◽  
Jae Chol Choi ◽  
Jong Wook Shin ◽  
Jae Yeol Kim
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Vitamin C ◽  
Blood Cell ◽  
White Blood Cell ◽  
Blood Cell Count ◽  
Group A ◽  
Group B ◽  
Group D

This study aimed to identify septic phenotypes in patients receiving vitamin C, hydrocortisone, and thiamine using temperature and white blood cell count. Data were obtained from septic shock patients who were also treated using a vitamin C protocol in a medical intensive care unit. Patients were divided into groups according to the temperature measurements as well as white blood cell counts within 24 h before starting the vitamin C protocol. In the study, 127 patients included who met the inclusion criteria. In the cohort, four groups were identified: “Temperature ≥37.1 °C, white blood cell count ≥15.0 1000/mm3” (group A; n = 27), “≥37.1 °C, <15.0 1000/mm3” (group B; n = 30), “<37.1 °C, ≥15.0 1000/mm3” (group C; n = 35) and “<37.1 °C, <15.0 1000/mm3” (group D; n = 35). The intensive care unit mortality rates were 15% for group A, 33% for group B, 34% for group C, and 49% for group D (p = 0.051). The temporal improvement in organ dysfunction and vasopressor dose seemed more apparent in group A patients. Our results suggest that different subphenotypes exist among sepsis patients treated using a vitamin C protocol, and clinical outcomes might be better for patients with the hyperinflammatory subphenotype.

scholarly journals Postural drainage in intubated patients with acute lobar atelectasis - A pilot study

2000 ◽  
Vol 56 (3) ◽  
pp. 29-32 ◽  
Author(s):  
M. W. Krause ◽  
H. Van Aswegen ◽  
E. H. De Wet ◽  
G. Joubert
Keyword(s):  
Intensive Care ◽  
X Rays ◽  
Average Group ◽  
Postural Drainage ◽  
Group A ◽  
Chest X Ray ◽  
Group B ◽  
Comparison Of Effectiveness ◽  
Clinical Experiment

Objectives: The movement and mobilisation of an intubated patient in the intensive care unit is restricted by the presence of various drains and intravenous lines. Difficulty to position the patient in the correct postural drainage positions, often leads physiotherapists to using modified postural drainage positions to mobilise secretions. A comparison of effectiveness between the correct postural drainage positions and the modified postural drainage positions during the treatment of acute lobar atelectasis in the intubated patient was conducted. Subjects: Intubated men and women between the ages of 13 and 85 years in the intensive care units of Pelonomi and Universitas Hospitals in Bloemfontein diagnosed with acute lobar atelectasis of the lower lobes were considered for inclusion in this pilot study.Intervention: A controlled randomised clinical experiment was conducted. Group A received inhalation therapywhilst placed in a postural drainage position for 15 minutes. Thereafter percussion was done for five minutes followed by a sterile suction procedure. Group B received the same treatment but modified postural drainage positions were used. Both groups received treatment twice daily.Results: On average, group A required three treatments and nil follow-up chest X-rays before the collapse was resolved, as opposed to the average of 4.5 treatments and one follow-up chest X-ray required by group B before the same result was obtained. In group A the oxygenation compared to Group B was improved. The findings were not statistically significant.Conclusion: The use of postural drainage positions in intensive care suggests quicker resolution of acute lobar atelectasis and improves oxygenation.

scholarly journals Acute Cholecystitis in Very Elderly Patients: Disease Management, Outcomes, and Risk Factors for Complications

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Alfredo Escartín ◽  
Marta González ◽  
Elena Cuello ◽  
Ana Pinillos ◽  
Pablo Muriel ◽  
...  
Keyword(s):  
Disease Management ◽  
Elderly Patients ◽  
Acute Cholecystitis ◽  
Old Patients ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Very Old Patients ◽  
Grade Iii ◽  
Severe Grade

Background. The aim of this study was to evaluate the characteristics, management, and outcomes of acute cholecystitis in patients ≥80 years. Methods. This was a retrospective analysis of data from a prospective single-center patient registry. Results. The study population was composed of 348 patients, which were divided into two groups: those younger (Group A) and those older (Group B) than the median age (85.4 years). Although demographic and clinical characteristics of the two groups were similar, the disease management was clearly different, with older patients undergoing cholecystectomy less frequently (n=80 46.0% in Group A vs n=39 22.4% in Group B; p<0.001). The outcomes in both groups of age were similar, with 30-day mortality of 3.7%, morbidity of 17.2%, and readmissions of 4.2% and two-year AC recurrence in nonoperated patients of 22.5%. No differences were seen between operated and no operated patients. Severe (Grade III) AC was the only independent factor significantly associated with mortality (OR 86.05 (95% CI: 11–679); p<0.001). Conclusions. In elderly patients with AC, the choice of therapeutic options was not limited by the age per se, but rather by the disease severity (grade III AC) and/or poor physical status (ASA III-IV). In case of grade I-II AC, laparoscopic cholecystectomy can be safely performed and yield good results even in very old patients. Patients with grade III AC present high risk of morbidity and mortality, and the treatment should be individualized. ASA IV patients should avoid cholecystectomy, being antibiotic treatment and cholecystectomy the best option.

scholarly journals Effect of passive smoking on thyroid function in infants

1998 ◽  
pp. 379-382 ◽  
Author(s):  
A Gasparoni ◽  
M Autelli ◽  
MF Ravagni-Probizer ◽  
A Bartoli ◽  
M Regazzi-Bonora ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Passive Smoking ◽  
Serum Concentrations ◽  
Free T4 ◽  
Thyroxine Binding Globulin ◽  
Cord Serum ◽  
Group A ◽  
Group B ◽  
Design And Methods

OBJECTIVE: To evaluate the effect of passive smoking on thyroid function in infants. DESIGN AND METHODS: Cord serum tri-iodiothyronine (T3), free T3 (fT3), thyroxine (T4), free T4 (fT4), TSH, thyroxine binding globulin (TBG), thyroglobulin (TG) and cord plasma thiocyanate were measured at birth, and serum TG and thiocyanate after 1 year of life, in 18 infants born from parents who did not smoke (group A), in 18 infants with a father who smoked (group B) and in 18 infants with parents both being smokers (group C). RESULTS: No significant differences were observed in cord serum concentrations of T3, fT3, T4, fT4, TSH and TBG among the three groups. Median (range) TG concentrations (ng/ml) were 30.2 (5.0-102.0), 56.3 (20.5-208.0) and 76.0 (26.0-199.0) at birth (P=0.009 for groups A and B compared; P=0.0002 for groups A and C compared), and 14.9 (5.4-32.0), 19.5 (10.0-57.5) and 20.0 (14.0-40.7) at 1 year (P=0.017 for groups A and C compared), in the three groups respectively, and thiocyanate concentrations (mmol/l) were 3.3 (0.0-51.4), 12.9 (0.0-122.2) and 27.8 (3.3-184.5) at birth (P=0.015 for groups A and C compared), and 3.1 (0.0-32.7), 6.0 (0.0-47.3) and 20.3 (0.0-230.8) at 1 year (P=0.01 for groups A and C compared) in the three groups respectively. CONCLUSIONS: TG and thiocyanate concentrations at birth and at 1 year of age in infants of smoking parents are greater than in infants with non-smoking parents. These results indicate that the change in thyroid function as evaluated by serum TG concentrations observed at birth can persist at least for 1 year if the exposure to passive smoking from both parents is continued. Increased TG concentrations may be due to a direct effect of thiocyanate on the thyroid gland.

scholarly journals 669 COVID-19-related acute pericarditis. A retrospective observational study

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Vito Maurizio Parato ◽  
Maria Chiara Galieni ◽  
Stefano Marcelli ◽  
Salvatore La Carruba
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pericardial Effusion ◽  
Observational Study ◽  
Cardiovascular Complications ◽  
Retrospective Observational Study ◽  
Published Data ◽  
Acute Pericarditis ◽  
Group A ◽  
Group B

Abstract Aims Acute pericarditis is considered one of the cardiovascular complications of COVID-19. The published data suggest that the diagnosis of acute pericarditis in patients with COVID-19 infection may be more frequent than usually diagnosed and as a consequence, undertreated. The proposed investigation is a retrospective observational study in which 170 patients, admitted to an Intensive Care Unit because of a COVID-19 diagnosis, were analysed. All patients underwent cardiological evaluation including a bedside echocardiogram. The aim of the study was to evaluate the prevalence and clinical implications of acute pericarditis diagnosed through the presence of pericardial effusion. Methods and results The proposed investigation is a retrospective observational study enrolling patients admitted to Intensive Care Unit of Madonna del Soccorso Hospital (San Benedetto del Tronto, Italy) because of a SARS-CoV-2 induced severe acute respiratory syndrome. No. 170 patients, admitted from 1 April 2020 to 30 April 2021, were enrolled. All patients presented a variable picture of bilateral interstitial pneumonia characterized by ground glass opacifications at HR-Chest CT. Some patients underwent oro-tracheal intubation and invasive ventilation. All patients underwent cardiological consultation including a transthoracic bedside echocardiogram, using ultrasound E9-GE machine (Boston, MA, USA). Demographic, laboratory and clinical data were collected for all enrolled patients (Table 1). The diagnosis of acute pericarditis was defined by: (i) different degree of pericardial effusion; (ii) C-reactive proteine elevation. All patients were divided in two groups: (1) pericarditis group (a); (2) pericarditis-free group (b). Of 170 enrolled patient, 51 were females (30%) and 119 were males (70%). Median age for all patients was 67.6 ± 13.3 [females: 70.5 (±16.2); males: 66.4 (±11.7)]. Of 170, n. 60 patients had a diagnosis of acute pericarditis (32.2%). Group A (patient with acute pericarditis) consisted of 60 patients, age 69.2 (±12.6), 39 (65%) male [age 69.3 (±10.6)], 21 (35%) female [age 69.1 (±16.0)]. Of 60, only 6 had a pericardial effusion &gt;10 mm (10%); the remaining group A-patients (90%) had a mild pericardial effusion (&lt;10 mm). No patient had tamponade picture. Group B (pericarditis-free patients) included 110 patients, age 66.7 (±13.7), 80 (72.7%) males [age 65.0 (±12.1)], 30 (27.3%) females [age 71.4 (±16.6)]. Group A-patients (with pericarditis) had more days of intubation and a prolonged global hospital stay compared with group B (pericarditis-free). Other demographic, clinical and laboratory parameters were similar between the two groups. Conclusions Pericarditis is a frequent cardiovascular complication of COVID-19 (32.2% in our study). It may have clinical and prognostic implications.

scholarly journals Comparison of Dexmedetomidine versus Midazolam in weaning from mechanical ventilation and length of stay in ICU.

2020 ◽  
Vol 27 (11) ◽  
pp. 2309-2313
Author(s):  
Afia Arshed Dodhy
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Significant Relationship ◽  
Controlled Trial ◽  
Cost Study ◽  
Extubation Time ◽  
Group A ◽  
Surgical Icu ◽  
Group B

Objectives: To compare the role of dexmedetomidine versus midazolam as sedative in facilitating early mechanical ventilation weaning thereby decreasing ICU cost. Study Design: Randomized Controlled trial. Setting: Surgical ICU of Lahore General Hospital, Lahore. Period: December 2018 to July 2019. Material & Methods: Total of 60 adult postoperative patients (30 in each group) who required mechanical ventilation in the surgical ICU for minimum 24 hours postoperatively after major pelvi-abdominal operations were included. Patients of group “A” and “B” received midazolam infusion 20-100 mcg/kg/hr & dexmedetomidine infusion 0.2-0.7 μg/kg/hr respectively while being mechanically ventilated. The degree of sedation was measured by using the Richmond agitation sedation score (RASS) every 6 hourly. Extubation time (i.e. time from termination of drug to extubation) was recorded. The time of ICU length of stay was also recorded Results: Mean age of patients was 41.97 ±10.21 and 42.57±10.93 years in group-A and B, respectively. In group-A 18 patients (60%) and in group-B 16 patients (53.0%) were male while 12 patients (40%) in group-A and 14 patients (47.0%) were females. A significant decrease in extubation time was observed in Group-B when compared with the Group-A (p=0.046) along with odds ratio 0.938 while no significant relationship could be proved between length of stay at ICU between two groups. Stratification with regard to age, gender height, weight and type of surgery was carried out. Conclusion: Dexmedetomidine is more favourable than midazolam for sedation in intensive care patients by facilitating early exubation and decreasing the duration of invasive ventilation while no significant relationship could be proved in two groups between length of stay in intensive care unit.

scholarly journals Elastic intramedullary nailing combined with methylprednisolone acetate injection for treatment of unicameral bone cysts in children: a retrospective study

2020 ◽  
pp. 1-8
Author(s):  
JianWu Zhou ◽  
ShangKun Ning ◽  
Yuxi Su ◽  
Chuankang Liu
Keyword(s):  
Blood Loss ◽  
Intramedullary Nailing ◽  
Methylprednisolone Acetate ◽  
Bone Cysts ◽  
Hospitalization Time ◽  
Group A ◽  
Grade Ii ◽  
Group B ◽  
Elastic Intramedullary Nailing ◽  
Grade Iii

Purpose The aetiology of unicameral bone cysts (UBCs) is unclear. This study aims to evaluate the feasibility of elastic intramedullary nailing (EIN) combined with injections of methylprednisolone acetate (MPA) for the treatment of UBCs in children. Methods We retrospectively analyzed 53 children with UBCs in our hospital between January 2010 and April 2016. A total of 24 patients (Group A) were treated by EIN and MPA, whilst 29 patients (Group B) were treated by curettage, bone grafts and EIN fixation. The radiographs of the UBCs were evaluated following the Capanna criteria. All patients were followed-up on the third, sixth, 12th, 24th and 36th months. Fixation time, hospitalization time and complications were evaluated. Results In Group A, the mean number of MPA injections was 1.8 (1 to 3). Based on radiographic evaluation, eight patients were healed (Capanna grade I), 14 were healed with residual cysts (Capanna grade II), one showed recurrence (Capanna grade III) and one showed no response to the treatment (Capanna grade IV). In Group B, 11 patients were evaluated as Capanna grade I, 12 as Capanna grade II, three as Capanna grade III and three as Capanna grade IV. There was significant difference in the early postoperative function activity (p < 0.001), hospitalization time (p = 0.028), blood loss during surgery (p < 0.001) and surgery time (p < 0.001). Conclusion The combination of EIN and MPA for the treatment of UBCs in children is feasible, has little operative trauma, short surgery time, short hospitalization time, less blood loss and a low risk of incision infection. Level of evidence: III

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