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Wyszukujesz frazę "hypoparathyroidism" wg kryterium: Temat


Wyświetlanie 1-2 z 2
Tytuł:
Perioperative calcium and vitamin D supplementation in patients undergoing thyroidectomy – literature review
Autorzy:
Grzegory, Anna
Pomorski, Lech
Powiązania:
https://bibliotekanauki.pl/articles/1392434.pdf
Data publikacji:
2018
Wydawca:
Index Copernicus International
Tematy:
hypocalcemia
hypoparathyroidism
calcium
vitamin D
thyroidectomy
perioperative period
Opis:
Introduction: Postoperative hypocalcemia is a narrow but significant problem for patients undergoing thyroid and parathyroid surgery. It is the most common complication after thyroidectomy. It is associated with transient or permanent hypoparathyroidism. It could potentially be life-threatening for patients and increases the costs of hospitalization. The aim of the study was to evaluate the results of studies that routinely administrated calcium and/or vitamin D during the postoperative period. Materials and Methods: In this article, a literature review – 15 studies that used routine perioperative calcium (7 studies), vitamin D (2 studies) and calcium with vitamin D (11 studies) supplementation was performed. Supplementation effectiveness in prevention of postoperative hypocalcemia was compared to no prophylaxis in 10 studies. Five studies compared the effect of combined administration (calcium and vitamin D) to calcium alone. The number of papers dealing with this problem is not particularly high. Results: Supplementation significantly decreased the rate of laboratory and symptomatic hypocalcemia. It was also effective in reducing the severity of symptoms. The combination of calcium with vitamin D was the most effective strategy. No hypercalcemia or parathyroid hormone inhibition was observed in the supplemented groups. Routine supplementation was less expensive than performing laboratory tests in the course of treatment of hypocalcemia. Conclusions: The results of analyzed studies showed the clinical and economic advantage of routine perioperative prophylactic supplementation of vitamin D and/or calcium as compared to no prophylaxis. However, the majority of studies showed a significant range of variability in patients’ characteristics. Numerous studies did not evaluate the preoperative 25-hydroxycholecalciferol level – a risk factor for postoperative hypocalcemia. Discussion: The use of routine prophylactic supplementation of calcium and vitamin D in the perioperative period can be useful in everyday clinical practice. Further research is needed to draw clear guidelines regarding prophylactic calcium and vitamin D therapy for patients after thyroidectomy.
Źródło:
Polish Journal of Surgery; 2018, 90, 4; 46-50
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Early predictors of post – thyroidectomy hypoparathyroidism
Autorzy:
Sieniawski, Karol
Kaczka, Krzysztof
Paduszyńska, Katarzyna
Fendler, Wojciech
Tomasik, Bartłomiej
Pomorski, Lech
Powiązania:
https://bibliotekanauki.pl/articles/1393727.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
hypoparathyroidism
thyroid surgery
total thyroidectomy
intact PTH assay
hypocalcemia
Opis:
Thyroid surgery is the most commonly performed procedure in the field of endocrine surgery. Studies are still ongoing on the development of a single algorithm for diagnosis and care of patients at risk of postoperative hypoparathyroidism. The aim of the study was to determine the biochemical marker that would allow the most accurate diagnosis of patient groups at risk of developing hypoparathyroidism and to identify risk factors for this disorder. Material and methods. The prospective study included 142 consecutive patients undergoing total thyroidectomy for benign goiter from January 1st 2014 to December 31st 2015. Serum intact parathyroid hormone (iPTH), total calcium (Ca), phosphate (P), and magnesium (Mg) levels have been measured preoperatively and at 1, 6, 24, and 48 h postoperatively. Results. Clinical symptoms of hypoparathyroidism developed in 25 (17.6%) of 142 patients. The best diagnostic accuracy for hypoparathyroidism based on ROC curves was obtained for iPTH at 6h (AUC 0.942; 95% CI: 0.866-1.000, p<0.001) and its percentage change from baseline ΔiPTH at 6h (AUC 0.930; 95% CI: 0.858-1.000, p<0.001). In an multivariate analysis, the preoperative Ca level higher by 0.1 mmol/l, and iPTH level higher by 0.1 pmol/l were associated with a lower risk of hypoparathyroidism, by 68% (p=0.012) and 61% (p=0.007), respectively. A 1% decline in iPTH from baseline increased the risk of hypoparathyroidism by 15% (p<0.001). Conclusions. The most reliable markers indicating a high risk of postoperative hypoparathyroidism are the decline in ΔiPTH at 6h by > 65% or iPTH level at 6h <1.57 pmol /l. A postoperative decline in iPTH levels is an independent risk factor for the development of hypoparathyroidism. Preoperative higher concentrations of Ca and iPTH are protective factors for the development of this disorder.
Źródło:
Polish Journal of Surgery; 2016, 88, 6; 540-555
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-2 z 2

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