Thyroid Weight Research Articles

A histopathological study of autopsied thyroid

Introduction: To find the prevalence and frequency of different thyroid lesions, especially papillary carcinoma in our population, we conducted a histopathological study of thyroid glands obtained from medicolegal autopsy in cases with no obvious history of thyroid disease in our region. Methods: The study population comprised deceased undergoing medicolegal autopsy in police morgue under the Forensic Medicine Department of our institution over a period of 18 months. Thyroid gland was dissected out at the time of autopsy. Gross and histopathological findings of each specimen were documented in details. The data were collected, compiled, and tabulated, and statistical analysis was done using IBM SPSS version 20 software and Microsoft Office Excel 2007. Results: The total number of samples was 240. The mean age of the study participants was 42.35 years. About 60.4% were male, and 39.6% were female. Mean weight of thyroid was 34.08 g. In 56 cases (23.3%), single or multiple nodules were observed on cut section of thyroid. Minimum and maximum size of the nodules was 0.40 and 1.30 cm, respectively, with mean size of 0.74 cm in diameter. On microscopic examination, 54.6% of the cases were seen to be normal in histological examination while 45.4% had one or other histopathological changes. Among the nonneoplastic lesions, the most common lesions seen were nodular colloid goiter (20%) and lymphocytic thyroiditis (7.5%). Papillary thyroid carcinoma was seen in 5 (2.1%) cases. Among the five cases of papillary carcinoma, three cases had papillary microcarcinoma (<1 cm). All cases of papillary carcinoma showed strong diffuse reactivity with cytokeratin-19 immunostain.

Radioiodine Treatment For Hyperthyroidism In A Patient With Pendred Syndrome

ABSTRACT Objective: To report a case of Pendred syndrome accompanied by hyperthyroidism that was treated with radioiodine. Pendred syndrome is an autosomal recessive disorder characterized by bilateral sensorineural hearing impairment, goiter, and impaired iodide organification. The majority of patients with Pendred syndrome are euthyroid or hypothyroid, and hyperthyroidism is rare. Thus far, there are no reported cases of Pendred syndrome with 131I-treated hyperthyroidism. Methods: A 39-year-old woman with congenital hearing impairment visited our clinic because of easy fatigability and body weight loss. Results: She had a diffuse goiter (estimated thyroid weight, 65 g) and subclinical thyrotoxicosis. 99mTechnetium pertechnetate scintigraphy revealed diffuse thyroidal uptake, but thyroid autoantibodies were absent. Since the therapeutic response to a single 131I dose was poor, the patient underwent a second 131I dose (13 mCi each) for hyperthyroidism. Seven years after the second 131I dose, she was euthy...

Recombinant human thyrotropin stimulation prior to 131I therapy in toxic multinodular goiter with low radioactive iodine uptake

AimStimulation with recombinant human thyrotropin (rhTSH) increases thyroid radioiodine uptake, and is an aid to 131I therapy in non-toxic multinodular goiter (MNG). However, there are not many studies using rhTSH prior to 131I in toxic multinodular goiter to improve hyperthyroidism and compressive symptoms. Materials and methodsA prospective study was conducted on patients with MNG and hyperthyroidism. Patients were recruited consecutively and divided into group I, stimulated with 0.3mg of rhTSH before radioiodine therapy, and a control group or group II, without stimulation. Thyroid function, radioiodine thyroid uptake, thyroid weight, and compressive symptoms were measured, and patients were followed-up for 9 months. ResultsGroup I consisted of 16 patients (14 women), with a mean age 69.7 years, and group II with 16 patients (12 women), with a mean age 70.7 years. After stimulation with 0.3mg rhTSH in group I, 131I uptake (RAIU) at 24h increased by 78.4%, and the estimated absorbed dose by 89.3%. In group II, the estimated absorbed dose was lower than group I after stimulation with rhTSH (29.8Gy vs. 56.4Gy; P=0.001).At 9 months of follow-up, hyperthyroidism was controlled in 87.5% of patients in group I, and 56.2% in group II (P=0.049). The mean reduction in thyroid weight was higher in group I than in group II (39.3% vs. 26.9%; P=0.017), with a tendency toward subjective improvement of compressive symptoms in group I, although non-significant. Only 2 patients described tachycardias after rhTSH administration, which were resolved with beta-blockers. ConclusionStimulation with 0.3mg of recombinant human thyrotropin prior to radioiodine therapy achieves a reduction in thyroid weight and functional improvement in patients with hyperthyroidism and multinodular goiter with low uptake, and with no need for hospital admission.

Biochemical Parameters and Histopathological Findings in the Forced Molt Laying Hens

The aim of this study was to evaluate the effects of forced molting using biochemical parameters and histopathological findings in laying hens. 36 Hyline W36 strain laying hens, 90 weeks old were chosen for this research. Eight of these chickens were randomly selected and placed in a cage as the control group before the molting program began. All the others 28 chickens were used for the forced molting program. Eight laying hens were slaughtered at the end of the molting program named as molting group. The remaining 20 hens were fed for 37 days, weighted and slaughtered when they reached the maximum egg production (80%) as postmolting group. Then, blood was analyzed for malondialdehyde, glutathione, catalase, glucose, calcium, phosphorus, albumin, globulin, total protein, triiodothyronine, thyroxine and Vitamin C. The malondialdehyde and glutathione levels of the thyroid and liver tissues were also analyzed along with an examination of the histopathological changes of the liver, ovarium and thyroid glands; and live body, liver, ovarium, thyroid weights and thyroid lengths. In conclusion, it was found that forced molting produces stress and notable side effects in hens, like the oxidant and antioxidant status of the organs, tissue weights and sizes, hormon profiles, blood biochemical and histopathological parameter changes. The activities of thyroid malondialdehyde (p<0.05), liver glutathione (p<0.01), plasma catalase (p<0.001) were significantly decreased in molting group compared to control values, while liver malondialdehyde levels were significantly increased (p<0.001) and thyroid glutathione levels had nonsignificant effect. These levels in molting hens were the first study for veterinary science.

Analysis of iodine-131-induced early thyroid hormone variations in Graves' disease.

This prospective study aimed to assess iodine-131 (I)-induced early thyroid hormone variations in Graves' disease (GD) and determine the associated factors. One hundred and seventy-one GD patients treated with I were evaluated (47 men, 124 women). I was administered at 9.0±4.9 mCi on average. Serum free triiodothyronine and free thyroxin were measured within 24 h before treatment and 8 (3-14) days after treatment. Patients were divided into increase, no change, and decrease groups, respectively, on the basis of hormone variations after treatment. χ-Test, analysis of variance, and the Kruskal-Wallis test were used to compare groups in terms of sex, age, course of disease, thyroid stimulating hormone receptor antibodies, antithyroid drug (ATD) pretreatment time, time of ATD discontinuation before I treatment, 24 h thyroid I uptake, thyroid weight, I activity, and I activity/thyroid weight (μCi/g). The Spearman method was used for correlation analyses. Twenty-seven, 20, and 124 cases were assigned to increase, no change, and decrease groups, respectively. Significant differences were found among groups in the time of ATD discontinuation before I treatment [the median duration for methimazole was 11 (5-26), 16 (10-30), and 21 (1-30) days, P=0.000, the median duration for propylthiouracil was 12.5 (5-24), 22 (11-26), and 26 (21-30) days, P=0.000], thyroid weight (93.5±33.6, 90.3±48.8, and 74.1±26.0 g, P=0.003), and μCi/g (84.8±11.8, 100.4±24.9, and 121.1±44.0 μCi/g, P=0.000). Interestingly, μCi/g was negatively and positively correlated to the possibility of hormone increase and decrease, respectively. No significant differences were found in the other parameters assessed. At the early stage of I treatment for GD, few patients showed increased thyroid hormone levels. Key factors may include time of ATD discontinuation before I treatment and μCi/g. High μCi/g might decrease thyroid hormone levels in early treatment, making it safe.

The enrichment of chicken meat with omega-3 fatty acids by dietary fish oil or its mixture with rapeseed or flaxseed—Effect of feeding duration: Dietary fish oil, flaxseed, and rapeseed and n-3 enriched broiler meat

The consumption of chicken meat has steadily increased in recent decades, thereby making meat enriched with long-chain polyunsaturated fatty acids (LC-PUFA) an important delivery route of this nutrient to humans. This study aimed to evaluate how feeding duration of a diet with fish oil and flaxseed or rapeseed can enhance broiler meat with n-3 fatty acids (FA). One hundred and twenty-three 15-day-old female broilers Ross 308 were housed individually and randomly allocated to four groups: control (15 birds), and three experimental groups (36 birds each) that were each divided into three subgroups of 12 birds. Four diets differing in fat composition were prepared. Lard was the source of supplementary fat in diet L; in the experimental diets, fat was derived from fish oil (FO, 10gkg−1 diet) and either lard (LFO), flaxseed (FFO), or rapeseed (RFO) in amounts appropriate to produce fat levels similar to those in the control diet. Diets were cold-pelleted and fed until slaughter at 36days of age. The control group was fed the L diet throughout the study, whereas birds in the experimental groups were fed the L diet until it was substituted by the experimental diets for one, two, or three weeks preceding slaughter. The performance of all groups did not differ from the control, but within the experimental groups, LFO birds had a higher body weight gain because of higher feed intake. RFO birds had a higher thyroid weight (P<0.02). The levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in breast and thigh meat lipids increased in groups fed the experimental diets as compared to the control. There were substantial increases in α-linolenic acid levels and a lower PUFAn-6/n-3 ratio in birds fed the FFO diet as compared to the RFO and LFO diets (P<0.001). Results indicated that one week of feeding the experimental diets was sufficient to enrich breast meat with LC-PUFA, whereas two weeks were needed to effectively enrich thigh meat with these FA. Thus, the meat of broilers fed diets with fish oil and either flaxseed or rapeseed over a period of two weeks before slaughter can be labeled as “high in omega-3 fatty acids.” A 100g portion of such breast or thigh meat would provide on average 33% and 15.5%, respectively, of the recommended daily intake of EPA and DHA for humans, and therefore make enriched chicken meat a superior source of LC-PUFA than lean fish meat.

A Comparative Relationship Between Thyroid Gland And Body Weight: A Study in Foetuses of Different Ages

Objective: To investigate the morphological structure and variation of thyroid gland in fetuses. Formalin fixed 40 aborted fetuses from 16weeks -36 weeks of gestational age were dissected to study the morphology of fetal thyroid glands. Crown -Rump length, and weight of the fetus along with fetal thyroid morphological and morphometric parameters were recorded. We observed the broader right lobes, broader left lobes of the thyroid glands, pyramidal lobe, levator glandulae thyroidae and isthmus agenesis which may consider under multiple morphological anomalies of the thyroid gland. The morphological parameters of the both broader right and left lobes of the thyroid glands of the fetuses were recorded. This study highlights various developmental anomalies of the thyroid gland, thereby forming a corner stone to safe and effective surgery. rd ring of trachea. There may be variations in its size and situation. (3) An anastomosis of superior thyroid artery is present along the upper border and inferior thyroid veins along lower border. The thyroid gland is covered by a thin fibrous sheath, the capsule of the thyroid. The anterior layer is continuous with pretracheal fascia and postero-laterally continous with the carotid sheath. The gland is covered anteriorly with infrahyoid muscles and laterally with the sternocleidomastoid muscle. On the posterior side, the gland is fixed to cricoids and tracheal ring cartilages and cricopharyngeus muscle by a thickening of the fascia to form the posterior suspensory ligament of thyroid gland also known as ligament of berry. Two parathyroid glands usually lies on each side between the two layers of the capsule, at the back of thyroid lobes.(4) Over the next few weeks, it migrates to the base of the neck, passing in front of the hyoid bone. During migration, the thyroid remains connected to the tongue by a narrow canal, the thyroglossal duct. At the end of the fifth week the thyroglossal duct degenerates and the detached thyroid continues on to its final position over the following two week. Persistence of pyramidal lobe, thyroglossal cysts, agenesis of the thyroid gland and aberrant thyroid are the major developmental anomalies of the thyroid gland (5). Accessory nodules or ectopic thyroid tissue of the thyroid are usually found at the embryonic origin of thyroid gland, at the foramen caecum, or on the lingual duct and thyroglossal tract within the tongue. (2,7) anomalies of the development of the thyroid gland distort the morphology of the gland may cause clinical functional disorders and various thyroid illnesses (6).

Laying performance, digestibility and plasma hormones in laying hens exposed to chronic heat stress as affected by betaine, vitamin C, and/or vitamin E supplementation.

Heat stress had a negative effect on laying hens’ performance, thus this research was to study the influences of betaine (Bet, 1000 mg/kg betaine), vitamin C (VC, 200 mg/kg ascorbic acid), and vitamin E (VE, 150 mg/kg α-Tocopherol acetate) and their possible combinations on egg production, digestibility of nutrients, plasma hormones and reproductive organs of dual-purpose hens exposed to chronic heat stress. Two hundred and eighty eight hens and thirty-six cocks from 32 to 48 weeks of age were divided into nine treatment groups of four replicates, each containing eight hens and one cock. One group was kept under thermo-natural condition and the eight others were kept under chronic heat stress (CHS). One of these eight was used as a negative control, while the others were supplemented with VC, VE and/or betaine and their possible combinations. Body weights, laying rate, feed intake, and feed conversion ratio in hens reared under CHS rooster without any supplementation during 32 to 48 weeks of impairment (P = 0.0052) were recorded. Hens reared under heat stress and fed a diet supplemented with either Bet, VC, VE or combination of the supplements increased production traits. However, hens supplemented with VC showed the greatest production traits. Plasma glucose, estradiol-17 (E2), progesterone (P4), tri-iodothyronine (T3) and thyroxine (T4) decreased in hens reared under CHS and fed a diet with no supplementation compared to the other treatments (P = 0.001). Liver weights, spleen weights, thyroid gland weights, ovary weights, oviduct weights and oviduct lengths were lowest in hens reared under CHS and fed a diet with no supplementation (P = 0.0480). In conclusion, dual purpose hens reared under CHS and supplemented with VC at 200 mg/kg diet and Bet at 1000 mg/kg enhanced the laying performance and combated CHS.

Identifying reference chemicals for thyroid bioactivity screening

Reference chemicals were selected based on thyroid bioactivity in ‘Tier 1’ screening assays used by the U.S. EPA’s Endocrine Disruptor Screening Program. Active reference chemicals had significant effects on thyroid-responsive endpoints in the amphibian metamorphosis assay, and the male and female pubertal rat assays. In the absence of thyroid weight or histopathological effects, additional published studies providing mechanistic data on thyroid activity were required for active chemicals. Inactive reference chemicals had no significant effects on thyroid-responsive endpoints in Tier 1 assays, or in amphibian or rodent studies from several online databases. The 34 reference chemicals (29 active and five inactive) will be useful for performance-based validation of alternative, high throughput screening assays for thyroid bioactivity.

Nutritional value of yellow-seeded winter rapeseed cakes for growing pigs

Objective of the study was to compare the composition and nutritional value of a winter brown- (BRC) and three yellow-seeded (YRC) cold-pressed rapeseed cakes as the components of pigs’ diets, and to assess their effects on colonic bacterial fermentation and the relative weight of organs. In experiment 1, the standardised ileal digestibility (SID) of protein and amino acids (AA) of cakes was determined in 12 male cannulated pigs. Each diet was fed to six pigs during three seven-day periods. Ileal digesta was collected during the last three days of the period. In experiment 2, five groups each containing six female pigs with initial body weights (BW) of 20 kg were fed on diets containing BRC, YRC, or soyabean oil meal (SBM) as the main protein source. The apparent total tract digestibility (ATTD) of nutrients and growth performance were measured untill 60 kg BW was reached, and short chain fatty acids (SCFA) concentrations in the colon, as well as the weight of the liver, kidney, heart, and thyroid, were recorded. The main differences between BRC and YRC were found in higher content of fat and protein, lower amounts of fibre and glucosinolates (Gls), and higher ATTD of fibre in YRC. Protein and AA SID, ATTD of nutrients, total SCFA colonic concentration, and growth performance did not significantly differ. The chemical composition of the three YRC was not uniform, the greatest differences were found among the amounts of Gls. The relative weights of the thyroid and heart were greater in pigs fed BRC than in YRC and SBM diets. Thyroid weight was positively correlated with dietary progoitrin, alkenyl Gls, and total Gls, whereas heart weight was positively correlated with progoitrin and alkenyl Gls. It was concluded that winter yellow-seeded rapeseed is a better raw material for cold-pressing than brown-seeded due to having lower Gls and fibre content.

Noise Induces Hypothyroidism and Gonadal Dysfunction Via Stimulation of Pineal–Adrenal Axis in Chicks

Noise is a world-wide problem that causes nervous, endocrine and cardiovascular disorders, and eventually health hazards in humans and animals. Objective of the current work is to investigate endocrine interaction in noise stress, which subsequently affects other endocrine functions including gonads in a poultry bird like chicks. Gravimetric, ultrastructural and hormonal status of the endocrine organs were examined to ascertain the effects of noise stress. Acute noise at 60 dB had no effect, but at 80 and 100 dB each for 3 h, increased pineal and serum serotonin, and adrenal and serum corticosterone, epinephrine and norepinephrine concentrations, without any change in thyroid or gonadal hormones. Chronic noise exposure at 60, 80 and 100 dB each for 6 h, daily for 7 days, drastically disturbed normal behavior, and quantum of food consumption and water intake. Chronic exposure also significantly decreased body weight including thyroid, ovary and testis weight, and increased adrenal weight. Noise stress caused ultrastructural changes leading to stimulations of pinealocytes (with abundance of rough endoplasmic reticulum and mitochondria), adrenocortical cells (enlarged nuclei and abundance of smooth endoplasmic reticulum) and adrenomedullary cells (enlarged nuclei with presence of chromaffin granules) were observed in noise stress. Additionally, pineal and serum serotonin, N-acetyl serotonin and melatonin, and adrenal and serum corticosterone, epinephrine and norepinephrine levels were significantly elevated following chronic noise exposure. Contrarily, thyroid activity was suppressed with atrophied thyroid follicles followed by declined levels of serum T3 and T4 with elevation of TSH level. Simultaneously, serum 17β-estradiol (E2) and testosterone (T) concentrations were also significantly declined in all the doses of chronic noise. These changes were dose dependent of noise exposure. The findings suggest that (a) adrenal and pineal glands respond primarily to noise and secondarily act on other endocrine organs including gonads in chicks, (b) adrenal directly and/or indirectly causes thyroid and gonadal dysfunctions via pineal following noise exposure in chicks.

Inadvertent parathyroidectomy: incidence, risk factors, and outcomes

BackgroundParathyroid glands are ≤5 mm, often subcapsular or intrathyroidal, and obscured by lymph nodes, making preservation a challenge. The purpose of this study was to determine the incidence of inadvertent parathyroidectomy (IP) and whether it contributes to hypoparathyroidism after thyroidectomy. Materials and methodsA retrospective review of all thyroidectomies by a single surgeon from January 2010 to August 2014 was completed to determine the rate of IP and permanent hypoparathyroidism. Medical records were assessed for demographics, extent of thyroidectomy, central compartment neck dissection, thyroid gland weight, parathyroid autotransplantation, reoperation, pathology, postoperative calcium levels, and number of parathyroid glands removed. ResultsA total of 386 patients underwent thyroidectomy. Mean age was 52 y, and 327 (85%) patients were women. There were 25 (7%) patients who underwent reoperation, 40 (10%) who underwent central compartment neck dissection, and 128 (33%) who underwent parathyroid autotransplantation. IP occurred in 78 (20%) patients. Permanent hypoparathyroidism occurred in 7 (2.7%) of 258 patients after total or completion thyroidectomy, four (6.7%) with IP compared with three (1.5%) without IP (P = 0.033). Logistic regression analysis revealed that female gender (odds ratio = 2.768, P = 0.040), central compartment neck dissection (odds ratio = 9.584, P = 0.001), and thyroid gland weight (odds ratio = 0.994, P = 0.022) were independent factors associated with IP. ConclusionsIP, which occurred in 20% of patients undergoing thyroidectomy, is a potentially remediable factor associated with a higher rate of hypoparathyroidism. Central compartment neck dissection is an independent risk factor for IP.

Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery.

Inadvertent (or incidental) parathyroidectomy can occur during thyroidectomy. However, the factors associated with inadvertent parathyroidectomy remain unclear. This study aimed to report the rate of inadvertent parathyroidectomy during thyroidectomy and associated risk factors. Variables including fine needle aspiration cytology findings, age, sex, thyroid weight, concurrent neck dissection, extent of thyroidectomy, and the presence of cancer and parathyroid tissue within the specimen were recorded for 266 patients. The incidence of post-operative hypocalcaemia was also recorded. Univariate and multivariate analysis were performed to identify factors associated with inadvertent parathyroidectomy. The inadvertent parathyroidectomy rate was 16 per cent. Univariate analysis revealed that cancer and concurrent neck dissection predicted inadvertent parathyroidectomy. On multivariate analysis, only concurrent neck dissection remained an independent predictor of inadvertent parathyroidectomy: it was associated with a fourfold increase in inadvertent parathyroidectomy. The inadvertent parathyroidectomy rate was 16 per cent and concurrent neck dissection was identified as an independent predictor of inadvertent parathyroidectomy.

Harmonic versus LigaSure hemostasis technique in thyroid surgery: A meta-analysis.

Harmonic scalpel and LigaSure vessel sealing systems have been suggested as options for saving surgical time and reducing postoperative complications. The aim of the present meta-analysis was to compare surgical time, postoperative complications and other parameters between them in for the open thyroidectomy procedure. Studies were retrieved from MEDLINE, Cochrane Library, EMBASE and ISI Web of Science until December 2015. All the randomized controlled trials (RCTs) comparing Harmonic scalpel and LigaSure during open thyroidectomy were selected. Following data extraction, statistical analyses were performed. Among the 24 studies that were evaluated for eligibility, 7 RCTs with 981 patients were included. The Harmonic scalpel significantly reduced surgical time compared with LigaSure techniques (8.79 min; 95% confidence interval, -15.91 to -1.67; P=0.02). However, no significant difference was observed for the intraoperative blood loss, postoperative blood loss, duration of hospital stay, thyroid weight and serum calcium level postoperatively in either group. The present meta-analysis indicated superiority of Harmonic Scalpel only in terms of surgical time compared with LigaSure hemostasis techniques in open thyroid surgery.

Thyroid hormone disruption and cognitive impairment in rats exposed to PBDE during postnatal development.

Polybrominated diphenyl ether flame-retardants (PBDEs) are thyroid-disrupting environmental chemicals. We investigated the effects of postnatal exposure to DE-71 (a mixture of tetra- and penta-brominated congeners), n-propylthiouracil (PTU) and thyroxine (T4) replacement on open-field (OF) and radial maze (RAM) tests. Wistar rats (5 males/5 females per litter, 32 litters) were treated orally (PND 5-22) with PTU (4mg/kg bw/d), DE-71 (30mg/kg bw/d), with and without co-administration of T4 (15μg/kg bw/d, sc). PTU depressed T4 serum levels and body weight gain and enlarged thyroid gland. Although decreasing T4 levels, DE-71 did not change thyroid and body weights. PTU-treated rats showed hyperactivity (PND 42 and 70), and working and reference memory learning deficits (RAM, PND 100). Although not altering motor activity and working memory, DE-71 caused a reference memory deficit (females only). T4 co-administration averted hypothyroxinemia and long-term cognitive deficits caused by PTU and DE-71.

Thyroid lobectomy is an effective option for unilateral benign nodular disease.

The use of thyroid lobectomy in the treatment of unilateral, benign nodules is limited by the potential of nodular recurrence in the remaining lobe. This study aimed to assess the rate and clinical impact of nodular recurrence in the contralateral lobe after thyroid lobectomy and to identify predictive factors of recurrence. Single-centre retrospective study. Records of patients that underwent lobectomy for unilateral thyroid nodules between 1991 and 2010 were reviewed and 270 patients were included. Exclusion criteria were: presence of contralateral nodule(s) ≥5mm on preoperative ultrasound, diagnosis of cancer necessitating completion thyroidectomy or pseudonodules. Recurrence was defined as the occurrence of nodule(s) ≥5mm in the remaining lobe on at least one postoperative ultrasound. A set of clinical, imaging, histological and biochemical parameters was tested as predictors of recurrence using logistic regression. After a median follow-up of 78months (range, 12-277months), the global recurrence rate was 42% and recurrence of nodules of a size ≥1cm occurred in 19%. Reoperation rate was 1·1%. 90% of patients were treated postoperatively by levothyroxine. Median time to nodular recurrence was 4years. Preoperative contralateral lobe volume and resected thyroid weight were identified as significant predictors of recurrence (P=0·045 and P=0·03 respectively). Thyroid lobectomy is an effective therapeutic strategy for unilateral, benign nodules, resulting in a low rate of clinically relevant nodular relapse in a mildly iodine-deficient area. Patients with uninodular disease and a contralateral lobe of normal size are particularly good candidates for lobectomy.

Incidence and Risk Factors for Post-thyroidectomy Hypocalcemia

Objectives. This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia. Methodology. This was a retrospective study of 242 patients who underwent total or completion thyroidectomy from 2011-2014 at the St. Luke’s Medical Center, Quezon City, Philippines. The overall and type-specific incidences of hypocalcemia were determined. Patient and surgery-related factors were assessed and hypocalcemic events described. Results. Overall incidence of hypocalcemia is 11.98% distributed into symptomatic (10.74%) and asymptomatic (1.24%). The following patient-related factors were not found to be significantly associated with hypocalcemia: age, gender, thyroid disease and thyroid gland weight. Among surgery-related factors, the presence of concomitant complications of thyroidectomy (hoarseness and/or hematoma) and inadvertent parathyroidectomy were significantly associated with hypocalcemia both in the univariate [p=0.046; OR 2.369 (95%CI: 0.995-5.643) and p=0.027; OR 2.426 (95%CI: 1.084-5.432), respectively] and multivariate analyses [p=0.025; OR 2.842 (95%CI: 1.142-7.069) and p=0.013; OR 2.941 (95%CI: 1.252-6.907), respectively]. Other surgery-related factors were not found to be significantly associated with hypocalcemia: extent of thyroidectomy [total vs completion]; neck dissection; surgery duration (hours); and surgeon [consultant vs. trainee]. Among those with symptomatic hypocalcemia, manifestations occurred 29.85±23.07 hours post-operatively and these were: Chvostek’s (80.8%), acral paresthesia (76.9%), perioral numbness (46.1%), carpopedal spasm (15.3%), Trousseau’s (7.7%) and cramps (3.8%). Those who presented with manifestations of hypocalcemia but with normal serum iCa post-operatively comprised 33.9% of the study population and the majority presented with Chvostek’s sign (52%) and acral paresthesia (50%). Conclusion. In this study, hoarseness and/or hematoma and inadvertent parathyroidectomy are risk factors for post-thyroidectomy hypocalcemia. Closer monitoring of these patients for hypocalcemia may be necessary.

Differences in Thyroidectomy Outcomes Based on Surgical Method: A Comparison of LigaSure Precise, Harmonic Focus, and Traditional Methods

New surgical devices have been developed to improve haemostatic control and vascular closure in thyroid surgery. Here, we compare the efficacy and clinical outcomes of 3 surgical methods, Harmonic Focus, LigaSure Precise, and the traditional suture-ligation method, in patients undergoing total thyroidectomies. This retrospective study compared total thyroidectomies performed between July 2008 and August 2012. Thyroidectomies were performed in 243 patients using Harmonic Focus (n = 81), LigaSure Precise (n = 81), and traditional suture-ligation (n = 81). No significant differences were observed among groups in terms of patient demographics, thyroid weight, pathological diagnoses, pre- and postoperative calcium levels, postoperative complications, length of hospitalization, and clinical outcomes. The Harmonic Focus approach showed an ∼15% shortening in operating time relative to the suture-ligation group; no statistically significant differences were detected between the LigaSure and traditional suture-ligation groups. All 3 methods were found to be both safe and effective. Operating time was significantly shorter in the Harmonic Focus group; no differences in terms of postoperative complications were observed among groups.

Studies on Goitrogenic/ Antithyroidal Potentiality of Thiocyanate, Catechin and After Concomitant Exposure of Thiocyanate-Catechin

In adequate iodine intake including and a number of environmental agents can affect thyroid gland functions in man and animals. Thiocyanate and catechin that arise for the consumption of cyanogenic and flavonoids containing foods respectively, affect thyroid hormone synthesis but the data comparing the goitrogenic/ antithyroid potentiality of thiocyanate and catechin when act individually or synergistically on thyroid function found scanty. Experimental animals were divided into groups and orally administered either thiocyanate or catechin or both in combination for 30 days followed by analysis of thyroid gland weight, histology, thyroid peroxidase, sodium potassium ATPase, 5’-deiodinase- I activities, thyroid hormone profiles, urinary iodine and urinary thiocyanate of each group of animals. Enlarged thyroid showing hypertrophic and hyperplastic changes, decreased thyroid peroxidase, sodium potassium ATPase, 5’-deiodinase- I activities activities and thyroid hormone profiles were observed in the treated groups. Overall results reveal that goitrogenic/ antithyroid potentiality found highest after concomitant exposure of thiocyanate and catechin followed by thiocyanate and least after catechin.

Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy

This study evaluated the efficiency of transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the early postoperative screening of vocal cord palsy (VCP) after total thyroidectomy, performed for benign and non-extensive malignant disease. A prospective study was performed on patients who underwent total thyroidectomy between October 2013 and January 2015 at the Nantes University Hospital (France). Patients underwent DFL on postoperative day 1 performed by an otolaryngologist, followed by TLUS performed by a radiologist on postoperative day 1 or 2. One hundred and three (103) patients were included in this study, 17.5% were male and 82.5% were female, with a mean age of 51 ± 12 years. Nine patients (9.5%) were diagnosed with postoperative VCP using DFL of these cases 2 were not completely resolved at 3 months postoperatively. Three cases of VCP (33%) were diagnosed using TLUS. TLUS had a sensitivity of 33% and a negative predictive value (NPV) of 95% for the diagnosis of postoperative VCP. Vocal cords (VC) were unassessable in 27.2% of patients. Unassessable VC were significantly associated with male gender (p = 0.0001), age (p = 0.0001), weight (p = 0.002), operating time (p = 0.032), postoperative drainage (p = 0.001), and thyroid weight (p = 0.001). Independent risk factors in the multivariate analysis were male gender (p = 0.0001) and age (p = 0.0001). In the group of women under 50-year old, TLUS had a sensitivity of 50% and a NPV of 97.4%. TLUS sensitivity is insufficient in early postoperative screening of VCP after thyroid surgery. Ultrasonographic VCP diagnosis should be confirmed with DFL.