Mostrando entradas con la etiqueta Hyperthyroidism. Mostrar todas las entradas
Mostrando entradas con la etiqueta Hyperthyroidism. Mostrar todas las entradas

viernes, 21 de julio de 2017

Anestesia e hipertiroidismo / Anesthesia and hyperthyroidism

Julio 20, 2017. No. 2755






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La tiroidectomía total como método de elección en el tratamiento de la enfermedad de Graves - análisis de 1432 pacientes.
Total thyroidectomy as a method of choice in the treatment of Graves' disease - analysis of 1432 patients.
BMC Surg. 2015 Apr 9;15:39. doi: 10.1186/s12893-015-0023-3.
Abstract
BACKGROUND: Graves' disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment. The aim of our paper was to analyze the results of surgical treatment, the frequency of microcarcinoma and carcinoma, as well as to compare surgical complications in relation to the various types of operations performed for Graves' disease. METHODS: We analysed 1432 patients (221 male and 1211 female) who underwent surgery for Graves' disease at the Centre for Endocrine Surgery in Belgrade during 15 years (1996-2010). Average age was 34.8 years. Frequency of surgical complications within the groups was analyzed with nonparametric Fisher's test. RESULTS: Total thyroidectomy (TT) was performed in 974 (68%) patients, and Dunhill operation (D) in 221 (15.4). Carcinoma of thyroid gland was found in 146 patients (10.2%), of which 129 (9%) were a microcarcinoma. Complication rates were higher in the TT group, where there were 31 (3.2%) patients with permanent hypoparathyroidism, 9 (0.9%) patients with unilateral recurrent nerve paralysis and 10 (1.0%) patients with postoperative bleeding. Combined complications, such as permanent hypoparathyroidism with bleeding were more common in the D group where there were 2 patients (0,9%), while unilateral recurrent nerve paralysis with bleeding was more common in the TT group where there were 3 cases (0,3%). CONCLUSIONS: Frequency of complications were not significantly statistically different in relation to the type of surgical procedure. Total thyroidectomy represents a safe and efficient method for treating patients with Graves' disease, and it is not followed by a greater frequency of complications in relation to less extensive procedures.
 Anestesia y cirugía tiroidea: los interminables desafíos.
Anesthesia and thyroid surgery: The never ending challenges.
Indian J Endocrinol Metab. 2013 Mar;17(2):228-34. doi: 10.4103/2230-8210.109671.
Abstract
Thyroidectomy is the most common endocrine surgical procedure being carried out throughout the world. Besides, many patients who have deranged thyroid physiology, namely hyperthyroidism and hypothyroidism, have to undergo various elective and emergency surgical procedures at some stage of their life. The attending anesthesiologist has to face numerous daunting tasks while administering anesthesia to such patients. The challenging scenarios can be encountered at any stage, be it preoperative, intra-op or postoperative period. Preoperatively, deranged thyroid physiology warrants optimal preparation, while anticipated difficult airway due to enlarged thyroid gland further adds to the anesthetic challenges. Cardiac complications are equally challenging as also the presence of various co-morbidities which make the task of anesthesiologist extremely difficult. Thyroid storm can occur during intra-op and post-op period in inadequately prepared surgical patients. Postoperatively, numerous complications can develop that include hemorrhage, laryngeal edema, nerve palsies, tracheomalacia, hypocalcemic tetany, pneumothorax, etc., The present review aims at an in-depth analysis of potential risk factors and challenges during administration of anesthesia and possible complications in patients with thyroid disease.
KEYWORDS: Airway management; carbimazole; propanolol; thyroid; thyroidectomy; thyroxin; tracheomalacia
Anestesia para timectomia en un paciente con miastenia gravis e hipertiroidismo no controlado
Anesthetic management of patient with myasthenia gravis and uncontrolled hyperthyroidism for thymectomy.
Ann Card Anaesth. 2010 Jan-Apr;13(1):49-52. doi: 10.4103/0971-9784.58835.Abstract
The relationship between myasthenia gravis (MG) and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently or after the appearance of MG. The effect of treatment of hyperthyroidism on the control of MG is variable. There may be resolution or conversely, deterioration of the symptoms also. We present a patient who was diagnosed to be hyperthyroid two and half years before the appearance of myasthenic symptoms. Pharmacotherapy for three months neither improved the myasthenic symptoms nor the thyroid function tests. Thymectomy resulted in control of MG as well as hyperthyroidism. In conclusion, effective control of hyperthyroidism in the presence of MG may be difficult. The authors opine that careful peri-operative management of thymectomy is possible in a hyperthyroid state.
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XIV Congreso Virtual Mexicano de Anestesiología 2017
Octubre 1-Diciembre 31, 2017
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Anestesiología y Medicina del Dolor

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martes, 18 de julio de 2017

Hipertiroidismo / Hyperthyroidism

Julio 18, 2017. No. 2753






Hipertiroidismo
Hyperthyroidism.
Lancet. 2016 Aug 27;388(10047):906-18. doi: 10.1016/S0140-6736(16)00278-6. Epub 2016 Mar 30.
Abstract
Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves' disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. Treatment options for Graves' disease include antithyroid drugs, radioactive iodine therapy, and surgery, whereas antithyroid drugs are not generally used long term in toxic nodular goitre, because of the high relapse rate of thyrotoxicosis after discontinuation. β blockers are used in symptomatic thyrotoxicosis, and might be the only treatment needed for thyrotoxicosis not caused by excessive production and release of the thyroid hormones. Thyroid storm and hyperthyroidism in pregnancy and during the post-partum period are special circumstances that need careful assessment and treatment.

Enfermedad de Graves-Basedow. Fisiopatología y tratamiento
Manejo perioperatorio del paciente para cirugía de tiroides
Dr. Salvador Velásquez-Bravo
Rev Mex Anestesiología Vol. 30. Supl. 1, Abril-Junio 2007 pp S185-S192
Los pacientes con alteraciones tiroideas pueden ser sometidos a procedimientos diagnósticos o terapéuticos para los cuales requieran apoyo anestésico y que no tengan que ver directamente con la tiroides; con base en esto, hay que conocer los eventos que se pueden presentar durante estos procedimientos y cómo resolverlos adecuadamente. Cuando la cirugía es del tiroides, requiere del esfuerzo del médico tratante y de todo el equipo que lo apoya en el diagnóstico y tratamiento del paciente. Cuando un paciente llega al quirófano, ha recorrido un camino que a veces es largo y desgastante. La cirugía en ocasiones no es el remedio definitivo, sino el inicio de un tratamiento con suplementos hormonales de por vida. Para los anestesiólogos es importante conocer el diagnóstico, el estado físico que tiene el paciente (que incluye la valoración del estado hormonal), el estado de la vía aérea y las probables complicaciones que pudieran presentarse durante el perioperatorio para establecer el mejor plan de manejo

XIV Congreso Virtual Mexicano de Anestesiología 2017
Octubre 1-Diciembre 31, 2017
Información / Information
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905