ABSTRACT
BACKGROUND: Most surgeons have rapidly accepted the use of minimally invasive surgical approaches for the treatment of primary hyperparathyroidism. The role of the endoscope in neck surgery is still being discussed due to its technical difficulty and complex patient selection criteria. MATERIALS AND METHODS: A prospective study was conducted between April 2010 and April 2013. It included patients diagnosed with sporadic primary hyperparathyroidism (sPHPT) by locating a single adenoma using ultrasound and sestamibi scintigraphy imaging. All patients agreed to be included in the study. Experienced endocrine surgeons that had been trained in endocrine minimally invasive surgery performed the procedure. The same surgical technique was used in all of the cases. The demographic and clinical variables were evaluated. A descriptive analysis was performed on the data measuring mean, standard deviation, and range. RESULTS: A total of 28 endoscopic lateral parathyroidectomies were performed. All patients were diagnosed with sporadic hyperparathyroidism sPHPT. The mean age was 68 years (59-89). No intraoperative complications were registered. Postoperative morbidity was comparable to that reported in the classical approach. A favourable outcome was observed in 27 of the 28 patients (96%) after a mean follow-up time of 22 (9 - 53) months. CONCLUSIONS: An endoscopic approach for hyperparathyroidism sPHPT is feasible and reproducible, and it obtains comparable results to the classical open surgery. Several factors make this technique suitable for highly specialised hospitals with a high patient volume and specialised endocrine surgery units.
Subject(s)
Adenoma/surgery , Endoscopy/methods , Hyperparathyroidism, Primary/surgery , Parathyroid Neoplasms/surgery , Parathyroidectomy/methods , Adenoma/complications , Aged , Aged, 80 and over , Conversion to Open Surgery , Female , Humans , Hypercalcemia/etiology , Hyperparathyroidism, Primary/etiology , Male , Middle Aged , Parathyroid Neoplasms/complications , Postoperative Complications/etiology , Prospective Studies , Recurrent Laryngeal Nerve Injuries/etiology , Treatment OutcomeABSTRACT
Objetivos. Aproximar el riesgo cardiovascular de los pacientes adultos atendidos en la Clínica Médica Cayetano Heredia (CMCH), de acuerdo al perfil lipídico y las características demográficas. Materiales y métodos. Se realizó un estudio descriptivo-retrospectivo, en base a los registros del laboratorio de la CMCH, durante el periodo comprendido entre 2004 y 2006. Se seleccionaron los datos del perfil lipídico completo (colesterol total, triglicéridos, HDL-C, LDL-C). Los datos obtenidos fueron almacenados en una base de datos. La clasificación y el análisis de los datos obtenidos tuvo como referencia principal el reporte Adult Treatment Panel iii (ATP iii). Resultados. Se encontró una población adulta total de 1 300 pacientes: 279 en adulto i (de 20 a 40 años) y 1 021 en adulto ii (de 41 a 64 años). Los triglicéridos ≥ 150 mg/dL en mujeres fueron 18,5% y 37,2% y en varones, 43% y 48,9%, en adultos i y ii, respectivamente. El HDL-C < 50 mg/dL en mujeres se encontró en 73,1% y 71,1% en adultos i y ii, respectivamente; HDL-C < 40 mg/dL en varones se encontró en 57,7% y 61,5% en adultos i y ii, respectivamente. La asociación HDL-C disminuido y triglicéridos ≥ 150 mg/dL en mujeres se encontró en 16,2% y 31,3% y en varones, 28,9% y 32,9%, en adultos i y ii, respectivamente. La tríada de HDL-C disminuido, triglicéridos ≥150 mg/dL y LDL-C ≥130 mg/dL en mujeres se halló en 8,5% y 23,8% y en varones, en 19,5% y 21,5%, en adultos i y ii, respectivamente. El no-HDL-C > 130 mg/dL en mujeres fue 58,5% y 78,1% y en varones, 71,1% y 80,8%, en adultos i y ii, respectivamente. La asociación triglicéridos ≥ 200 mg/dL y no-HDL-C > 130 mg/dL en mujeres fue 7,7% y 17,1% y en varones, 20,1% y 28,4%, en adultos i y ii, respectivamente. Conclusiones. A la población adulta atendida en la CMCH, le corresponde un riesgo cardiovascular incrementado según los niveles séricos hallados de HDL-C, triglicéridos, LDL-C y no HDL-C.
Approximation of the cardiovascular risk as related to the lipid profile in an adult population attended at the Cayetano Heredia Medical Clinic (CHMC) in the period 2004-2006. Objectives. To approximate the global cardiovascular risk of adult patients treated at the CHMC as related to their lipid profile and demographic characteristics. Materials and Methods. A descriptive retrospective study was conducted. The clinical laboratory registry was searched for the first lipid profile results (total cholesterol, triglycerides, HDL-C and LDL-C) that were registered between April 2004 and January 2006. The data obtained were stored in a database. The classification and analysis of the data obtained were reported in terms of the Adult Treatment Panel iii (ATP iii). Results. We identified 1 300 adult patients; 279 of whom were adult i (20 to 40 years) and 1 021 were adult ii (from 41 to 64 years). Triglycerides ≥ 150 mg/dL in females were found in 18,5% and 37,2% in adult i and ii, respectively; in men they were found in 43% and 48,9%, respectively. HDL-C < 50 mg/dL in females were found in 73.1% and 71,1% in adults i and ii, respectively; HDL-C < 40 mg/dL in men were found in 57,7% and 61,5% in adults i and ii, respectively. The association of low HDL-C and triglycerides ≥ 150 mg/dL in women was found in 16.2% and 31,3% in adults i and ii, respectively; in men it was found in 28,9% and 32,9% % in adults i and ii, respectively. The association of low HDL-C, triglycerides ≥150 mg/dL and LDL-C ≥ 130 mg/dL, in women was found in 8,5% and 23,8% in adults i and ii, respectively; and in men was found in 19,5% and 21,5%, respectively. The non-HDL-C > 130 mg/dL in women was in 58,4% and 78,1% in adults i and ii, respectively; and in men it was found in 71,1% and 80,7%, respectively. The association of triglycerides ≥ 200 mg/dL and non-HDL-C > 130 mg/dL in women was found in 7,7% and 17.1% in adults i and ii, respectively; in men was found in 20,1% and 28,4%, respectively...
Subject(s)
Humans , Male , Adult , Female , Cardiovascular Diseases , Lipids , Epidemiology, Descriptive , Retrospective StudiesABSTRACT
Objetivos: Aproximar el riesgo cardiovascular de los pacientes adultos atendidos en la Clínica Médica Cayetano Heredia, de acuerdo al perfil lipídico y características demográficas. Materiales y métodos: Se realizó un estudio descriptivo - retrospectivo, en base a los registros del laboratorio de la Clínica Médica Cayetano Heredia, durante el periodo comprendido entre el 2004 y el 2006. Se seleccionaron los datos del perfil lipídico completo (Colesterol total, Triglicéridos, HDL-C, LDL-C); los datos obtenidos fueron almacenados en una base de datos. La clasificación y análisis de los datos obtenidos tuvo como referencia principal el reporte Adult Treatment Panel III (ATP III). Resultados: Se encontró una población adulta total de 1300 pacientes: 279 en Adulto I (de 20 a 40 años) y 1021 en Adulto II (de 41 a 64 años). Los triglicéridos mayor o igual que 150 mg/dL en mujeres fueron 18.5 por ciento y 37.2 por ciento en Adulto I y II, respectivamente; y en varones 43 por ciento y 48.9 por ciento, respectivamente. HDLûC menor que 50 mg/dL en mujeres se encontró en 73.1 por ciento y 71.1 por ciento en Adulto I y II, respectivamente; HDL-C menor que 40 mg/dL en varones se encontró en 57.7 por ciento y 61.5 por ciento en Adulto I y II, respectivamente. La asociación HDL-C disminuido y triglicéridos mayor o igual que 150 mg/dL en mujeres se encontró en 16.2 por ciento y 31.3 por ciento en Adulto I y II, respectivamente; y en varones 28.9 por ciento y 32.9 por ciento, respectivamente. La triada de HDL-C disminuido, triglicéridos mayor o igual que 150 mg/dL y LDL-C mayor o igual que 130 mg/dL en mujeres se halló en 8.5 por ciento y 23.8 por ciento en Adulto I y II, respectivamente; y en varones en 19.5 por ciento y 21.5 por ciento, respectivamente. El no-HDL-C mayor que 130 mg/dL en mujeres fue 58.5 por ciento y 78.1 por ciento en Adulto I y II, respectivamente; y en varones 71.1 por ciento y 80.8 por ciento, respectivamente.
Objectives: To approximate the global cardiovascular risk of adult patients treated at the Cayetano Heredia Medical Clinic as related to their lipid profile and demographic characteristics. Materials and Methods: A descriptive retrospective study was conducted. The clinical laboratory registry was searched for the first lipid profile results (total cholesterol, triglycerides, HDL-C and LDL-C) that were registered between April 2004 and January 2006. The data obtained were stored in a database. The classification and analysis of the data obtained were reported in terms of the Adult Treatment Panel III (ATP III). Results: We identified 1300 adult patients; 279 of whom were adult I (20 to 40 years) and 1021 were adult II (from 41 to 64 years). Triglycerides more or equal than 150 mg/dL in females were found in 18.5 per cent and 37.2 per cent in adult I and II, respectively; in men they were found in 43 per cent and 48.9 per cent, respectively. HDL-C less than 50 mg/dL in females were found in 73.1 per cent and 71.1 per cent in adults I and II, respectively; HDL-C less than 40 mg/dL in men were found in 57.7 per cent and 61.5 per cent in adults I and II, respectively. The association of low HDL-C and triglycerides more or equal than 150 mg/dL in women was found in 16.2 per cent and 31.3 per cent in adults I and II, respectively; in men it was found in 28.9 per cent and 32.9 per cent in adults I and II, respectively. The association of low HDL-C, triglycerides more or equal than 150 mg/dL and LDL-C more or equal than 130 mg/dL, in women was found in 8.5 per cent and 23.8 per cent in adults I and II, respectively; and in men was found in 19.5 per cent and 21.5 per cent, respectively. The non-HDL-C less than 130 mg/dL in women was in 58.4 per cent and 78.1 per cent in adults I and II, respectively; and in men it was found in 71.1 per cent and 80.7 per cent, respectively.
