Background: Amiodarone is a widely used antiarrythmic drug, which may produce secondary effects on the thyroid. In 14-18% of amiodarone-treated patients, there is overt thyroid dysfunction, usually in the form of amiodarone-induced thyrotoxicosis, which can be difficult to manage with standard medical treatment.
Case Presentation: Presented is the case of a 65-year-old man, under chronic treatment of atrial fibrillation with amiodarone, who was admitted to the Intensive Care Unit with acute cardio-respiratory failure and fever. He was recently hospitalized with respiratory distress, attributed to amiodarone-induced pulmonary fibrosis. Clinical and laboratory investigation revealed thyrotoxicosis due to amiodarone treatment. He was begun on thionamide, prednisone and beta-blockers. After a short term improvement of his clinical status the patient underwent percutaneous tracheotomy due to weaning failure from mechanical ventilation, which led to the development of recurrent thyrotoxicosis, unresponsive to medical treatment. Finally, the patient developed multiple organ failure and died, seven days later.
Conclusion: We suggest that percutaneous tracheotomy could precipitate a thyrotoxic crisis, particularly in non-euthyroid patients suffering from concurrent severe illness and should be performed only in parallel with emergency thyroid surgery, when indicated.
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http://dx.doi.org/10.1186/1752-1947-1-134 | DOI Listing |
Am J Transl Res
November 2024
Department of Respiratory and Critical Care, The First Affiliated Hospital, Zhejiang University School of Medicine Hangzhou 311100, Zhejiang, China.
Objective: To evaluate the clinical efficacy of early tracheotomy in neurologic critical care patients.
Methods: A retrospective analysis was conducted on 100 patients with severe craniocerebral injury (SCI) who underwent percutaneous tracheotomy at The First Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to February 2022. Of them, 52 cases (observation group) received the procedure within 24 hours of injury, while 48 patients (control group) received the procedure after 24 hours.
Nervenarzt
December 2024
Ambulanz für ALS und andere Motoneuronerkrankungen, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Background: Amyotrophic lateral sclerosis (ALS) is a disease that still has to be primarily treated symptomatically or palliatively. It is therefore all the more important, in addition to initiating treatment, such as percutaneous endoscopic gastrostomy (PEG), noninvasive ventilation therapy (NIVT) and invasive ventilation therapy via tracheotomy (IVT), to discuss the possible termination of these measures early on.
Question: What is the importance of advance directives for those affected and where are possible deficits in therapy planning for the end of life?
Material And Method: Between March 2017 and January 2019 patients with a clinically confirmed diagnosis of ALS at six treatment centers were asked to fill out a questionnaire.
J Clin Med
October 2024
Otolaryngology Head and Neck Unit, "Santo Spirito" Hospital, 65124 Pescara, Italy.
Transoral robotic surgery (TORS) is nowadays considered a valuable minimally invasive approach to treat oropharyngeal squamous cell carcinoma (OPSCC). The aim of this technique is to improve functional preservation and reduce morbidity with excellent oncologic outcomes compared to the traditional transoral approach and chemoradiotherapy (CRT). The purpose of this systematic review is to assess an exhaustive overview of functional outcomes of TORS for OPSCC by evaluating several parameters reported in the available literature, such as the prevalence and dependence of tracheotomy, feeding tubes (FTs) and percutaneous endoscopic gastrostomy (PEG), the length of hospitalization, swallowing scores, speech tests and quality of life (QoL) questionnaires.
View Article and Find Full Text PDFOral Oncol
December 2024
Department of Surgery, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology, Elsan Hospital, Poitiers, France; Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium. Electronic address:
Background: This systematic review investigated the surgical, functional, and oncological outcomes of transoral robotic supraglottic laryngectomy (TORS-SGL) for cT1-T3 laryngeal squamous cell carcinoma (LSCC).
Methods: Two investigators conducted an updated PubMed, Scopus, and Cochrane Library systematic review for studies investigating the surgical, functional, and oncological outcomes of TORS-SGL using the PRISMA statements. The bias analysis was conducted with the MINORS.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
June 2024
Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Chenzhou 423000, Hunan, China. Corresponding author: Li Guicheng, Email:
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