/pdf/guidelines-for-laparoscopic-tapp-and-endoscopic-tep-1zayojn9it.pdf

Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia [International Endohernia Society (IEHS)]

Objective: No consensus exists on the association between papillary thyroid carcinoma (PTC) and Hashimoto’s thyroiditis (HT). To resolve this controversy, this study aimed to evaluate the relationship between the two conditions using a meta-analysis. Methods: We searched relevant published studies using citation databases including PubMed, Embase, and ISI Web of Science. The effect sizes of clinicopathologic parameters were calculated by odds ratio (OR), weighted mean difference, or hazard ratio (HR). The effect sizes were combined using a randomeffects model. Results: Thirty-eight eligible studies including 10 648 PTC cases were selected. Histologically proven HT was identified in 2471 (23.2%) PTCs. HT was more frequently observed in PTCs than in benign thyroid diseases and other carcinomas (ORZ2.8 and 2.4; P!0.001). PTCs with coexisting HT were significantly related to female patients (ORZ2.7; P!0.001), multifocal involvement (ORZ1.5; PZ0.010), no extrathyroidal extension (ORZ1.3; PZ0.002), and no lymph node metastasis (ORZ1.3; PZ0.041). Moreover, PTCs with HT were significantly associated with long recurrence-free survival (HRZ0.6; PZ0.001). Conclusions: Our meta-analysis showed that PTC is significantly associated with pathologically confirmed HT. PTC patients with HT have favorable clinicopathologic characteristics compared with PTCs without HT. However, patients with HT need to be carefully monitored for the development of PTC.

https://eje.bioscientifica.com/downloadpdf/journals/eje/168/3/343.pdf

The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis: a meta-analysis

Context: The link between Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC) has long been a topic of controversy. There are conflicting reports; some suggest that these two are positively correlated, whereas other studies report no relationship. Evidence Acquisition: We performed a systematic literature review of original studies that investigated the correlation between HT and PTC. The two main search engines used to identify articles were OVID Medline and PubMed. The included studies were categorized into a fine-needle aspiration biopsy (FNAB) group and an archival thyroidectomy specimen group. Evidence Synthesis: There is no clear evidence to support the correlation between HT and PTC. Population-based FNAB studies report no linkage, whereas many of the studies of thyroidectomy specimens report a positive relationship. The average prevalence rate of PTC in patients with HT was 1.20% in 8 FNA studies of 18 023 specimens and 27.56% in 8 archival thyroidectomy studies of 9 884 specimens. The...

/pdf/hashimoto-s-thyroiditis-and-papillary-thyroid-carcinoma-is-355ky0m7ki.pdf

Hashimoto's Thyroiditis and Papillary Thyroid Carcinoma: Is There a Correlation?

We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3-0.9%) 12 months and 1.8% (95%CI 1.1-2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1-0.3%) 12 months and 0.6% (95%CI 0.5-0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3-82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure.

/pdf/common-surgical-procedures-in-pilonidal-sinus-disease-a-meta-3gr03m0tkn.pdf

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence.

Context: Thyroglobulin autoantibodies (TgAb) are primarily measured in serum in conjunction with thyroglobulin (Tg)—the primary tumor marker used to monitor patients with differentiated thyroid cancers (DTC). Every specimen needs TgAb testing to authenticate that the Tg measurement is not compromised by TgAb interference. When present, TgAb concentrations per se can be monitored as a surrogate tumor marker. Objectives: The aims of the study were: 1) to review published reports concerning whether there are associations between DTC, thyroid autoimmunity (Hashimoto's thyroiditis), and the presence of TgAb; and 2) to evaluate the methodological factors that influence TgAb interference with serum Tg testing. Data Sources: PubMed was used to identify studies published over the last 55 yr that focused on DTC relationships with thyroid autoimmunity and the presence of thyroid autoantibodies. Results: Many studies have reported significant associations between papillary thyroid cancer and Hashimoto's thyroiditis t...

/pdf/clinical-utility-of-thyroglobulin-antibody-tgab-measurements-jh8ec85h71.pdf

Clinical Utility of Thyroglobulin Antibody (TgAb) Measurements for Patients with Differentiated Thyroid Cancers (DTC)

PURPOSE: The surgical treatment of sacrococcygeal pilonidal disease varies widely. This study reports outcomes of cleft lift procedure combined with pit excision performed both in primary and recurrent pilonidal disease. METHODS: A total of 76 consecutive patients with primary or recurrent pilonidal disease who received cleft lift procedure or combined (cleft lift with pit excision) procedure in our clinic between March 2005 and May 2007 were investigated prospectively. Rate of postoperative complications and disease recurrence were the primary outcomes. RESULTS: Mean follow-up was 16.4 months (SD 7.0, range 5-34). The most common early postoperative complications were minor wound dehiscence (11 patients, 14.5 percent), followed by infection (10 patients, 13.2 percent), and wound break (4 patients, 5.3 percent). One recurrence (1.3 percent) was observed during the follow-up. CONCLUSIONS: The results of the current study supported that cleft lift procedure fulfills the requirements of an ideal operation for pilonidal disease. The cleft list procedure was a relatively simple procedure that was easy to learn, to teach, and perform under either spinal or local anesthesia. The procedure can be performed as a "day-surgery" procedure with low postoperative morbidity, acceptable time to return to work, and low recurrence rate.

Cleft lift procedure for sacrococcygeal pilonidal disease.

Purpose
Lichtenstein repair has been the gold standard in inguinal hernia surgery. The aim of this study was to investigate the role of mesh fixation in terms of postsurgical chronic pain and recurrence.

A prospective comparative study of the efficacy of conventional Lichtenstein versus self-adhesive mesh repair for inguinal hernia.

OBJECTIVE To evaluate routine oral calcium and vitamin D administration for preventing symptoms of hypocalcemia after total thyroidectomy. SUBJECTS AND METHODS A total of 487 consecutive patients were prospectively randomized into two groups in terms of routine oral calcium and vitamin D supplementation: In the control group (244 patients) the treatment was not routinely started after surgery, whereas the treated group (243 patients) received routine supplementation that started on postoperative day 1. RESULTS Patients of treated group had only minor hypocalcemia symptoms, whereas 7 patients of control group experienced carpopedal spasm as a major symptom (p<0.001). None of the patients in the treated group required intravenous calcium administration. Average hospital stay of the treated group patients was significantly shorter than that of control group (p<0.001). CONCLUSIONS Routine postoperative calcium and vitamin D supplementation therapy may be useful for the prevention of symptomatic hypocalcemia after total thyroidectomy and may allow for a safe and early discharge from the hospital.

Potential benefit of oral calcium/vitamin D administration for prevention of symptomatic hypocalcemia after total thyroidectomy.

Background
Pneumoperitoneum causes intracranial pressure elevation and blood stasis at lower extremities. This study investigates cerebral oxygen saturation changes during laparoscopy and the effects of intermittent sequential compression (ISC) of the lower extremities in patients during elective laparoscopic cholecystectomy.

Intermittent pneumatic sequential compression of the lower extremities restores the cerebral oxygen saturation during laparoscopic cholecystectomy

Idiopathic granulomatous mastitis (IGM) is a benign and rare chronic inflammatory disease of the breast with unknown etiology. While there is no consensus regarding its post-diagnosis management, there are different treatment alternatives. In this study, it was aimed to question the effectiveness of follow-up strategy without administering any treatment. One hundred eighteen female patients diagnosed with IGM were retrospectively evaluated. Patients with histopathologically confirmed IGM were included in the study. Medical treatment was given only to patients who did not accept the follow-up option without treatment. The protocol used in steroid therapy was 16 mg prednisolone twice daily for 2 weeks, and then the dose was gradually reduced, and the treatment was stopped after 2 months. Patients were followed up with a physical examination every 3 months. The effectiveness of the systemic corticosteroid treatment and the follow-up approach without any treatment was compared. The recurrence rates and pre-treatment and post-treatment methods of the patients were examined. While 30.5% of the patients recovered with corticosteroid treatment, 42.4% recovered under observation without any treatment. The mean recovery period of the patients in these two groups was calculated as 3.9 months and 5.6 months, respectively. However, no statistically significant difference was found in terms of recovery period (p = 0.064). The recurrence rate was 11.9%. For IGM, the “watch and wait” approach is an effective option. A chance should be given to the self-limiting nature of the disease with the addition of drainage when necessary.

Granulomatous mastitis, watch and wait is a good option.

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