Prediction of hypocalcemia after total thyroidectomy using indocyanine green angiography of parathyroid glands: A simple quantitative scoring system.

Background: Hypocalcemia is one of the most common complications after total thyroidectomy. Recently, indocyanine green (ICG) angiography of the parathyroid glands (PGs) has been suggested as a reliable tool for predicting postoperative hypocalcemia. The aim of our study was to evaluate the performance of a simple quantitative score based on ICG angiography of the PGs (4-ICG score) for predicting postoperative hypocalcemia.

Family Screening in Familial Papillary Carcinoma: The Early Detection of Thyroid Disease.

Introduction: Blood relatives of patients with familial papillary thyroid carcinoma (FPTC) have a higher rate of thyroid disease. This study analyzed the utility of a screening protocol for thyroid disease on blood relatives of patients with FPTC.

Study Population: Members of families diagnosed with FPTC.

The Usefulness of International Cooperation in the Repair of Inguinal Hernias in Sub-Saharan Africa.

Introduction: The burden of disease and mortality associated with inguinal hernia in Africa, especially in sub-Saharan Africa, is very high. The purpose of this study is to show that International Cooperation work in the field of hernia repair is effective; it minimizes the delay in hernia repairs in the targeted population, and can prevent a large number of disability-adjusted life years (DALYs).

Materials And Methods: As a part of an International Cooperation program, a total of 990 black patients with inguinal hernias were studied, in whom hernioplasty was performed using polypropylene mesh.

Surgical treatment of endemic goiter in a nonhospital setting without general anesthesia in Africa.

Background: Endemic goiter remains a serious public health problem and 75 % of people affected live in underdeveloped countries where treatment is difficult for various reasons. The aim of this article is to report our experience in African countries with the management and surgical treatment of endemic goiter, performed in a nonhospital setting and without general anesthesia in the context of a collaborative development project by experienced endocrine surgeons.

Methods: Fifty-six black African patients with a goiter were studied.

Do hernia operations in african international cooperation programmes provide good quality?

Background: Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was to evaluate the quality of hernia repair processes carried out by the Surgical Solidarity Charity in Central African States.

[Histological and immunohistochemical profile of sporadic and familial medullary thyroid carcinoma].

Introduction: The histological and immunohistochemical profile of medullary thyroid carcinoma is ill-defined. The objective of this study was to determine the epidemiological, histological, and immunohistochemical characteristics of medullary carcinoma and to analyze whether differences exist between sporadic and familial carcinomas.

Patients And Methods: Fifty-five histologically confirmed tumors were studied.

[Toxic intrathoracic goiter. Clinical profile and surgical morbidity in an endocrine surgery unit].

Background: The development of postsurgical complications is exacerbated when several risk factors coincide in the same patient.

Objective: To analyze the results of surgery for toxic intrathoracic goiter in terms of (a) the need for sternotomy; (b) morbidity and mortality; and (c) remission of compressive symptoms.

Material And Methods: A review (1980-2002) was carried out of 43 cases of toxic intrathoracic multinodular goiter according to Eschapase's definition (3 cm below the sternal manubrium) occurring in patients without previous thyroid surgery who underwent total thyroidectomy.

Prognostic value of histological and immunohistochemical characteristics for predicting the recurrence of medullary thyroid carcinoma.

Introduction: In medullary thyroid carcinoma, there is currently no consensus about the prognostic value of histological and immunohistochemical parameters. This study was designed to analyze the value of various histological and immunohistochemical characteristics for predicting the recurrence of medullary carcinoma.

Methods: A total of 55 cases of medullary thyroid carcinoma have been reviewed.

The value of various definitions of intrathoracic goiter for predicting intra-operative and postoperative complications.

Background: Intrathoracic goiter (IG) is a pathologic and clinical entity defined by criteria that varies from one series to the next. The objective of this study was to determine the most useful definition of IG for predicting intra-operative and postoperative complications.

Methods: The study included 201 patients treated for multinodular goiter who met the following criteria: (1) they had no previous thyroid surgery; (2) they had undergone total thyroidectomy; and (3) they were diagnosed with IG according to 1 of the following definitions: (1) clinical; (2) Hsu's; (3) Kocher's; (4) Torre's; (5) Eschapase's; (6) Lahey's; (7) Lindskog's; (8) Crile's; (9) Katlic's; and (10) subcarinal.

[Spirometric evaluation of respiratory involvement in asymptomatic multinodular goiter with an intrathoracic component].

Respiratory tract obstruction is underestimated in asymptomatic intrathoracic goiter. Our aim was to evaluate the involvement of the upper airway of asymptomatic patients with intrathoracic multinodular goiter, assessing the effect on respiratory function by means of spirometry. We selected 21 patients with asymptomatic intrathoracic goiter on whom a thyroidectomy had been performed.

Pheochromocytoma in MEN 2A syndrome. Study of 54 patients.

Background: Pheochromocytoma occurs in nearly 50% of MEN 2A (multiple endocrine neoplasia, type 2A) cases. Many issues related to this tumor are still the subject of debate: the diagnostic management in patients who have had positive genetic study results (RET mutation), variations related to mutation, the best surgical option, and the real relapse rate during long-term follow-up. The aim of this study is to present our experience with this unusual disease, looking for answers to some of these questions.

Results of surgical treatment in multinodular goiter with an intrathoracic component.

Purpose: (1) To determine the clinical profile of intrathoracic multinodular goiter (IMG); (2) to evaluate the results of surgery, and (3) to analyze the incidence of malignancy and its evolution.

Methods: Two hundred and forty-seven operated cases of IMG were reviewed. These cases of IMG had all been diagnosed according to Eschapse's definition (>3cm below the sternal manubrium).

Spontaneous retroperitoneal hemorrhage from adrenal artery aneurysm.

Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture.

[Multivariate study of risk factors for developing complications after multinodular goiter surgery].

Introduction: Multinodular goiter (MG) accounts for a large volume of procedures performed in endocrine surgery departments. However, risk factors for postoperative complications have not been systematically investigated. The aim of the present study was to evaluate surgical outcomes in terms of morbidity and mortality through multivariate statistical analysis with a view to determining risk factors in MG surgery.

Definitive treatment for persistent hypoparathyroidism in a kidney transplant patient: parathyroid allotransplantation.

Post-surgical hypocalcemia is usually a transitory complication in thyroid and parathyroid surgery that can be resolved quickly, although it becomes a delicate matter when the problem persists. Parathyroid transplantation is the choice of treatment; however, the associated immunosuppression can cause side effects. The following case study shows the transplantation of parathyroid tissue from a patient with secondary hyperparathyroidism to another kidney transplant patient with severe hypocalcemia that was medically intractable.

Results of surgery for toxic multinodular goiter.

Purpose: We analyzed the clinical and histological features of patients operated on for toxic multinodular goiter (TMG) to determine the clinical profile and evaluate the surgical results.

Methods: We reviewed 672 patients who underwent surgery for multinodular goiter (MG), 112 (17%) of whom had hyperthyroidism, and analyzed the epidemiological, clinical, and surgical variables.

Results: The patients with TMG tended to be older than those with nontoxic MG, with a greater evolution time of the goiter and a higher rate of positive antithyroid antibodies.

Pericardial tamponade as initial presentation of papillary thyroid carcinoma.

We herein describe a 19-year-old woman who presented with pericardial effusion that resulted in heart tamponade. The clinicopathological study revealed papillary carcinoma of the thyroid metastasized to the heart. Although malignant pericardial effusion is a known complication of thyroid cancer, it is rarely the first manifestation and shows a relatively favourable prognosis despite widespread metastases if adequate treatment is given.

Risk factors for malignancy in multinodular goitres.

Background: Multinodular goitre (MNG) is quite often associated with thyroid carcinoma, but the risk factors for malignancy are not well known. The aim is to analyse patients with thyroid carcinoma associated with MNG to determine the clinical risk factors for malignancy.

Method: From a series of 672 MNGs we analysed a subgroup of 59 patients presenting with an associated thyroid carcinoma.

[Relation between clinical presentation and prognosis of patients with papillary thyroid microcarcinoma].

Background And Objective: We aimed to analyze patients with papillary thyroid microcarcinoma (PTM) in order to establish the prognosis according to the differences observed between those diagnosed before surgery and those diagnosed postoperatively.

Patients And Method: Retrospective study of 83 PTM patients who were distributed in 2 groups. Clinical, histological and follow-up data were compared.

Presurgical assessment of the tumor burden of familial medullary thyroid carcinoma by calcitonin testing.

Background: Early diagnosis of familial medullary thyroid carcinoma (MTC) is currently done by genetic analysis. These techniques have replaced calcitonin stimulation testing, which was previously used for this purpose. Some studies suggest a relationship between MTC spread and calcitonin levels.

Prophylactic thyroidectomy in MEN 2A syndrome: experience in a single center.

Background: Genetic study of the RET proto-oncogene has modified the management, treatment, and prognosis of medullary thyroid carcinoma (MTC), multiple endocrine neoplasia 2A (MEN 2A), for patients with less advanced tumor stages. Classically, the diagnosis was based on an increase in basal and poststimulus peak calcitonin (bCT and pCT). Prophylactic thyroidectomy, based on results of genetic testing, may reduce recurrences in MTC.