scholarly journals Voice changes after thyroidectomy: an experience with 364 cases of thyroid surgery

2018 ◽  
Vol 5 (2) ◽  
pp. 626
Author(s):  
Arvind K. Prabhat ◽  
Niranjan Dash ◽  
J. M. Gadekar
Keyword(s):  
Total Thyroidectomy ◽  
Thyroid Surgery ◽  
Orotracheal Intubation ◽  
Age Group ◽  
Completion Thyroidectomy ◽  
Patient Age ◽  
Voice Changes ◽  
Patient Âgé ◽  
Laryngeal Nerve Injury ◽  
The Impact

Background: To study voice changes and to evaluate the impact of thyroidectomy and effects of factors such as patient age, sex, operation-type, surgeons-experience, laryngeal nerve injury and orotracheal intubation on voice of patients undergoing thyroidectomy.Methods: Author prospectively analyzed 364 cases of multinodular goiter (MNG) and neoplastic thyroid disorders, undergoing sub-total/total-thyroidectomy and completion-thyroidectomy in the department of surgery, during the study period of June 2016 to December 2016.Results: The study comprised of 364 patients, with 298 females and 66 males. Voice changes were seen in 216(59.34%) patients. Transient voice changes were seen in 212(98.15%) patients and permanent in 4(1.85%) patents. Out of 216 patents, age group ≥65 years were 128(59.25%) and age group <65 years were 88(40.75%) patients(p:0.012324). Out of 216 patients in which voice changes were seen,165(76.39%) patients were females and 51(23.61%) patients were males(p:0.001046). Voice changes were seen in 190(88%) patients in which sub-total/total-thyroidectomies were performed and in 26(12%) patients completion-thyroidectomies were performed. Voice changes were statistically significant in which completion-thyroidectomies were performed(p:0.002102). Voice changes were seen in 205(68.56%) cases and 11(16.92%) cases which were performed by post-graduate-trainee and experienced-surgeon respectively. Voice changes were seen in 122(67.77%) cases in which orotracheal intubation was performed and in 94(51.65%) cases cervical-epidural anaesthesia was given (p:0.00281). RLN palsy was seen in 2(0.60%) cases in which sub-total/total-thyroidectomy were performed and 2(6.25%) cases in which completion-thyroidectomy was performed (p:0.003426).Conclusions: Voice changes is common after thyroid surgery but usually transient and sometimes, permanent. So, patients must be informed about the risk of voice-impairment after thyroid surgery. Present study is novel as it investigates not only laryngeal neve injury but also highlights patient age, sex, types of operation, surgeons experience and laryngeal complications during orotracheal intubation.

scholarly journals The incidence and risk factors of hypocalcaemia after thyroid surgery

2018 ◽  
Vol 60 (1) ◽  
pp. 9-13
Author(s):  
Aws B. Abed ◽  
Mohannad K. Al Bermani ◽  
Waleed A. Salman
Keyword(s):  
Risk Factors ◽  
Total Thyroidectomy ◽  
Thyroid Surgery ◽  
Inferior Thyroid Artery ◽  
Pathology Report ◽  
Patient Age ◽  
Transient Event ◽  
Surgical Department ◽  
Patient Âgé ◽  
And Gender

Background: Hypocalcaemia is a well-recognized complication of thyroid surgery. It is the most often transient event that occurs after extensive thyroid resection that may require calcium and/or vitamin D supplements to alleviate or prevent the symptoms.Objective: of this study is to determine the incidence of hypocalcaemia after thyroid surgery and find out the risk factors involved regarding the patient age, gender, and muscular build, clinical diagnosis, the extent of surgery, ligation of the inferior thyroid artery, pathology report and the experience of the surgeon.Patients and methods: This prospective study was carried out on 100 patients who underwent thyroid surgery for various thyroid diseases at the surgical department of Baghdad teaching hospital in the period between November 2009 to November 2013.Serial serum calcium measurements were recorded as well as details of the operation, patient age and gender, ligation of the inferior thyroid artery or not, pathological report and experience of the operator. Hypocalcaemia was considered transient if it was resolved within 6 months and permanent if it persisted after 6 months and the patient was maintained on supplementation therapy of calcium and vitamin D.Results: We found that the incidence of post-thyroidectomy hypocalcaemia was 30 % and in the majority of the cases (24%) was transient, while it was permanent in only (6%) of cases and had occurred mainly after total thyroidectomy and in cases with ligation of the inferior thyroid artery.Conclusions: We concluded that post thyroidectomy hypocalcaemia is a relatively common complication, but it is transient in the majority of the patients. Its incidence is related to the extent of the surgery and can be reduced by the use of the correct surgical procedures.Keywords: hypocalcaemia, post thyroidectomy, total thyroidectomy, subtotal thyroidectomy قياس معدل انخفاض الكالسيوم في الدم بعد عمليات استئصال الغدة الدرقية وبحث العوامل المؤدية الى ذلك  اوس بشير عبد  العبد   مهند كامل البيرماني  وليد عبد الحسين سلمان    الخلاصة: الخلفية : تعتبر انخفاض نسبة الكالسيوم من المضاعفات الشائغة بعد عمليات استئصال الغدة الدرقية .وفي معظم الاجيان يكون ذلك الانخفاض مؤقتا وليس دائميا .وتعتمد نسبة حدوثه على الحجم المستئصل من الغدة الدرقية وطبيعة الحالة المرضية للغدة وفيما اذا تم عقد الشريان السفلي المغذي للغدة الدرقية ام لا . الغرض: ان الغاية من البحث هو تحديد نسبة انخفاض الكالسيوم في بعد اجراء عمليات استاصال الغدة الدرقية وبحث العوامل المؤدية الى ذلك كعمر وجنس المريض وبنيته العضلية ,اضافة الى التشخيص السريري والنسيجي للغدة الدرقية ونوع العملية وفيما اذا قد تم عقد الشريان السفلي المغذي لها ام لا وخبرة الجراح. المرضى والطريقة : دراسة مقارنة مستقبلية في مستشفى بغداد التعليمي ابتداءا من الاول من تشرين الثاني   2009   ولغاية الاول من تشرين الثاني 2013 ,هذة الدراسة شملت 100 مريض من الذين اجريت لهم عمليات استئصال الغدة الدرقية الكامل وشبه الكامل والجزئي. وقد تم تسجيل ودراسة المعلومات المتعلقة بعمر وجنس المريض وبنيته العضلية اضافة الى التشخيص السريري والنسيجي للغدة الدرقية ونوع العملية وفيما اذا قد تم عقد الشريان السفلي المغذي لها اولا وخبرة الجراح تم قياس مستوى الكالسيوم في الدم في اليوم الاول والثاني والثالث بعد اجراء العملية وتم اعتبار مستوى نسبة الكالسيوم (8 ملي غرام / ديسي لتر) كالحد الطبيعي الادنى المقبول. اعتبرت حالة انخفاض الكالسيوم مؤقتة اذا ما استمرت النسبة منخفضة او استمرت الاعراض لاقل من 6 اشهر, ودائمية في حالة استمرارها لاكثر من ذلك مع حاجة المريض لجرعات مستمرة من الكالسيوم وفيتامين د عن طريق الفم. النتائج: لقد وجد ان معدل نسبة حدوث انخفاض الكالسيوم في الدم بعد عمليات استئصال الغدة الدرقية هي 30%وقد كانت مؤقتة في معضم الحالات(24%), ودائمية فقط في 6% وخاصة في حالات الاستئصال الكامل للغدة الدرقية وفي حالات عقد الشريان السفلي المغذي لها. الاستنتاج : ان انخفاض نسبة الكالسيوم في الدم بعد عمليات استئصال الغدة الدرقية هي ظاهرة شائعة الحدوث وخصوصا بعد عمليات الاستئصال الكلي للغدة الدرقية , ولكنها مؤقتة في معظم الحالات .وان نسبة حدوثها مرتبطة بمقدار الحجم المستئصل من الغدة الدرقية وفيما لو تم عقد الشريان السفلي المغذي لها ام لا , وانه بالامكان التقليل من نسبة حدوثها وذلك باتباع الطرق الجراحية الصحيحة .  مفتاح الكلمات : انخفاض مستوى الكالسيوم في الدم,عملية استاصال الغدة الدرقية الكلي ,استاصال الغدة الدرقية الجزئي .

The impact of patient age and procedure type on postoperative opioid use following ambulatory pediatric urologic procedures

2021 ◽  
Author(s):  
Michael F. Basin ◽  
Zoë G. Baker ◽  
Melissa Trabold ◽  
Terry Zhu ◽  
Lorraine I. Kelley-Quon ◽  
...  
Keyword(s):  
Opioid Use ◽  
Patient Age ◽  
Patient Âgé ◽  
The Impact ◽  
Procedure Type

scholarly journals Early CT features of COVID-19 pneumonia, association with patients’ age and duration of presenting complaint

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Reem M. EL Kady ◽  
Hosam A. Hassan ◽  
Tareef S. Daqqaq ◽  
Rania Makboul ◽  
Hanan Mosleh Ibrahim
Keyword(s):  
Pleural Effusion ◽  
Ground Glass Opacity ◽  
Ct Imaging ◽  
Older Age ◽  
Ground Glass ◽  
Imaging Features ◽  
Age Group ◽  
Patient Age ◽  
Atypical Features ◽  
Patient Âgé

Abstract Background Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients’ age. Results The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group (≥ 50 years old) and increased duration of presenting complaint (≥ 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age. Conclusion The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.

scholarly journals THE UTILITY OF PGT VS NON-PGT FROZEN EMBRYO TRANSFER BY PATIENT AGE GROUP

2020 ◽  
Vol 114 (3) ◽  
pp. e416-e417
Author(s):  
Christopher Hibray ◽  
Nicole George ◽  
Lynn B. Davis ◽  
Gerard Letterie ◽  
G. David Ball
Keyword(s):  
Embryo Transfer ◽  
Frozen Embryo Transfer ◽  
Age Group ◽  
Patient Age ◽  
Patient Âgé

Chondrocyte Viability After Intra-articular Calcaneal Fractures in Humans

2007 ◽  
Vol 28 (6) ◽  
pp. 665-668 ◽  
Author(s):  
Scott T. Ball ◽  
Kyle Jadin ◽  
R. Todd Allen ◽  
Alexandra K. Schwartz ◽  
Robert L. Sah ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Calcaneal Fractures ◽  
Patient Age ◽  
Chondrocyte Viability ◽  
Articular Fractures ◽  
Patient Âgé ◽  
Post Traumatic ◽  
The Impact ◽  
Traumatic Arthritis ◽  
Time From Injury

Background: Chondral damage from the impact of injury may contribute to the high incidence of post-traumatic arthritis after calcaneal fractures, but this has yet to be proven. We sought to study the effect of intra-articular calcaneal fractures on chondrocyte viability and to correlate these effects with injury severity, time from injury to surgery, and patient age and co-morbidities. Methods: Irreducible osteochondral fragments from 12 patients undergoing operative treatment for intra-articular calcaneal fractures were analyzed. Control cartilage was obtained from four tissue donors who died of unrelated causes. The cartilage was assessed for chondrocyte viability through the full thickness of tissue using a Live/Dead assay followed by laser scanning confocal microscopy. Patient demographics including injury classification and severity, time from injury to surgery, and patient age were recorded. Results: Chondrocyte viability from fracture patients averaged 72.8% ± 12.9% (range 53% to 95%), which was significantly lower than the 94.8% ± 1.5% viability observed in the control specimens ( p = 0.005). Chondrocyte viability declined with higher energy injuries ( p = 0.13), time from injury to surgery ( p = 0.07), and increasing patient age ( p = 0.07). However, none of these factors reached a level of statistical significance. Conclusions: A significant decline in chondrocyte viability occurs after intra-articular fractures of the calcaneus. This may contribute to the development of post-traumatic arthritis.

scholarly journals SAT-168 Adrenal Incidentalomas: Impact of Patient Age on Referral Rates for Endocrine Evaluation

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anthony Fryer ◽  
Sarah Hancock ◽  
Cherian George ◽  
Basil George Issa ◽  
Simon Lea ◽  
...  
Keyword(s):  
Age Groups ◽  
Adrenal Incidentaloma ◽  
Older Age ◽  
Age Group ◽  
Adrenal Incidentalomas ◽  
Patient Age ◽  
Radiology Reports ◽  
Patient Âgé ◽  
Mri Scans ◽  
Ct And Mri

Abstract It is estimated that the prevalence of adrenal incidentaloma increases with age: ~3% of those aged 50 years, rising to 10% in those &gt;70 years (1). Given the aging population together with increased utilisation of cross-sectional imaging in the UK (eg CT urogram, MR angiogram), we explored the proportion of patients with adrenal incidentaloma by age based on current imaging trends. Furthermore, there is no information currently available on the relationship between age and pattern of endocrine referrals. We extracted data for all CT and MRI scans from Jan 2018-Oct 2019 and used key phrases in radiology reports (eg adrenal adenoma/lesion/mass/nodule/incidentaloma, incidental adrenal, indeterminate adrenal) to identify potential lesions. We also extracted data on patient age and referral patterns as identified by a logged referral or an attendance (new or follow-up) to endocrine clinic 3 months post index scan, stratified by 10 year age groups. Where possible, we excluded false hits (eg no adrenal lesion). Preliminary data showed that, of the 2604 potential lesions identified by CT and MRI scans, 78.7% were on patients aged over 60 years. The numbers of identified lesions gradually increased with age to a peak in the 71-80 year age group after which these declined. Whilst patients younger that 60 years had fewer potential lesions identified, they were more likely to be referred to endocrine services (73 out of 55 patients; 13.2%) than those in the older age group (168 out of 2049; 8.2%; p&lt;0.001). Indeed there was a statistically significant trend towards decreasing referral with age group (Chi-squared test for trend; p&lt;0.001). In conclusion, patients over 60 years have a higher number of potential adrenal incidentalomas. However, this group is less likely to be referred for endocrine evaluation. This is particularly concerning given the large number of scans requested and the higher prevalence of incidentalomas in this age group. This study represents preparatory work on innovations to enhance case detection, particularly in the older age groups (2). 1. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline. Eur J Endocrinol. 2016;175:G1-G34 2. Hanna FWF, Issa BG, Lea SC, George C, Golash A, Firn M, Ogunmekan S, Maddock E, Sim J, Xydopoulos G, Fordham R, Fryer AA. Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness. BMJ Open Quality. 2019;In press.

scholarly journals Distribution of SARS-CoV-2 PCR Cycle Threshold Values Provide Practical Insight Into Overall and Target-Specific Sensitivity Among Symptomatic Patients

2020 ◽  
Vol 154 (4) ◽  
pp. 479-485 ◽  
Author(s):  
Blake W Buchan ◽  
Jessica S Hoff ◽  
Cameron G Gmehlin ◽  
Adriana Perez ◽  
Matthew L Faron ◽  
...  
Keyword(s):  
Viral Load ◽  
Limit Of Detection ◽  
False Negative ◽  
Age Group ◽  
Rt Pcr ◽  
Patient Age ◽  
Cycle Threshold ◽  
Negative Results ◽  
Patient Âgé ◽  
False Negative Results

Abstract Objectives We examined the distribution of reverse transcription polymerase chain reaction (RT-PCR) cycle threshold (CT) values obtained from symptomatic patients being evaluated for coronavirus disease 2019 (COVID-19) to determine the proportion of specimens containing a viral load near the assay limit of detection (LoD) to gain practical insight to the risk of false-negative results. We also examined the relationship between CT value and patient age to determine any age-dependent difference in viral load or test sensitivity. Methods We collected CT values obtained from the cobas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay corresponding to 1,213 combined nasopharyngeal-oropharyngeal specimens obtained from symptomatic individuals that were reported as positive or presumptive positive for SARS-CoV-2. CT values were stratified by SARS-CoV target and patient age group. Results In total, 93.3% to 98.4% of specimens demonstrated CT values greater than 3× the assay LoD, at which point false-negative results would not be expected. The mean of CT values between age groups was statistically equivalent with the exception of patients in age group 80 to 89 years, which demonstrated slightly lower CTs. Conclusions Based on the distribution of observed CT values, including the small proportion of specimens with values near the assay LoD, there is a low risk of false-negative RT-PCR results in combined nasopharyngeal-oropharyngeal specimens obtained from symptomatic individuals.

Prehospital Emergency Medical Services Departure Interval: Does Patient Age Matter?

2016 ◽  
Vol 31 (6) ◽  
pp. 608-613 ◽  
Author(s):  
Bruno Schnegg ◽  
Mathieu Pasquier ◽  
Pierre-Nicolas Carron ◽  
Bertrand Yersin ◽  
Fabrice Dami
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Time Of Day ◽  
Medical Services ◽  
Time Interval ◽  
Patient Age ◽  
Emergency Medical ◽  
Patient Âgé ◽  
Prehospital Emergency ◽  
The Impact

AbstractIntroductionThe concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood.ProblemIn a process of improvement of response time, the impact of the patient’s age on ambulance departure intervals was investigated.MethodThis was a 3-year observational study. Departure intervals of ambulances, according to age of patients, were analyzed and a multivariate analysis, according to time of day and suspected medical problem, was performed.ResultsA total of 44,113 missions were included, 2,417 (5.5%) in the pediatric group. Mean departure delay for the adult group was 152.9 seconds, whereas it was 149.3 seconds for the pediatric group (P =.018).ConclusionA statistically significant departure interval difference between missions for children and adults was found. The difference, however, probably was not significant from a clinical point of view (four seconds).SchneggB, PasquierM, CarronPN, YersinB, DamiF. Prehospital Emergency Medical Services departure interval: does patient age matter?Prehosp Disaster Med. 2016;31(6):608–613.

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