Browsing by Author "Tošković, Anka (56609235500)"

Introduction/Objective Alcohol abuse influence on developing thyroid cancer is controversial. While some studies consider it a protective factor, others deny any impact on thyroid cancer. The objective of the paper was to establish a possible link between alcohol abuse and certain types of thyroid cancers. Methods The retrospective study included 502 patients with thyroid cancer and a control group of 600 patients with benign forms of thyroid diseases (e.g. nodular, multinodular, and toxic nodular goiter). Thyroid cancer patients were divided into four groups: I – papillary, II – medullary, III – anaplastic, and IV – follicular carcinoma, and grouped by sex, age (< 30 years; > 30 years) and alcohol abuse, as defined by the World Health Organization. Results Thyroid cancer patients were predominantly male of younger age. This distribution difference was statistically significant in groups I and II (p < 0.001). Of total 10 (0.9%) patients with chronic alcohol abuse, eight (1.6%) had thyroid cancer, while two (0.3%) belonged to the control group (p < 0.001). In thyroid cancer patients, chronic alcohol abuse was absent from groups III and IV. Distribution in groups I and II was six (1.6%) and two (2%), respectively (p < 0.001). Conclusion Alcohol abuse deserves to be considered as a risk factor for papillary and medullary forms of thyroid cancer, while it does not stay the same for anaplastic and follicular thyroid cancers. © 2021, Serbia Medical Society. All rights reserved.

Difficult tracheal intubation (DI) is more common in thyroid than in other surgical branches due to thyromegaly. Proper preoperative airway evaluation is necessary in order to reduce the potential numerous complications. The study examined the incidence of DI in thyroid surgery and the influence of tracheal dislocation and other risk factors on DI. A prospective study was conducted on 2379 patients who underwent thyroidectomy at the Center for Endocrine Surgery, Clinical Center of Serbia, from 2007 to 2012. Patients were divided into groups with (n=162) and without DI (n=2217). Besides tracheal dislocation, another 13 risk factors contained in 13 screening tests and three additional factors of gender, age and diagnosis were defined. The incidence of DI in our study was 6.81%. The presence of tracheal dislocation was statistically significant, but not an independent predictor of DI. The diagnosis, large circumference and small neck length, previous DI, recessive mandible, tooth characteristics and oral anomalies were the most significant and independent predictors of DI. Neck circumference and small neck length had highest sensitivity. Previous DI had highest specificity. Thyromegaly, if causing tracheal dislocation and/or stenosis, represents a significant DI predictor, not individually, but in combination with other factors.

Introduction/Objective Intraoperative variations in blood pressure and/or cardiac dysrhythmias (IOVBP/CD) represent one of the most common causes of morbidity and mortality in surgical patients. The aim of the study was to determine the incidence and risk factors for IOVBP/CD in thyroid surgery patients with comorbidities. Methods The study included 1,252 euthyroid patients with ASA 2 and ASA 3 status (American Society of Anesthesiologists – physical status classification) who underwent thyroid surgery. The following risk factors were examined: sex, age, body mass index (BMI), ASA status, admission diagnoses, type of operation, duration of surgery, time under general anesthesia, difficult intubation of trachea, and coexisting diseases – hypertension, cardiomyopathy, cardiac arrhythmias, angina pectoris, diabetes mellitus, kidney disease. The following intraoperative events were recorded: hypertension, severe hypertension, hypotension, and cardiac arrhythmias. We used Pearson χ2 square test, univariate, and multivariate logistic regression for statistical analysis. Results The majority of patients were female (86.3%). In 903 (72.1%) patients IOVBP/CD were detected. The most common problem was intraoperative hypertension (61.4%). Eight risk factors for IOVBP/CD were registered by univariate analysis: advanced age, ASA 3 status, BMI > 25 kg/m², duration of surgery, time under general anesthesia, hypertension, and cardiomyopathy as a coexisting disease. The multivariate regression model identified three independent predictors for IOVBP/CD: age, hypertension, and cardiomyopathy. Conclusion IOVBP/CD are common in thyroid surgery. The most common is intraoperative hypertension. Older age, hypertension, and cardiomyopathy as a coexisting disease are independent risk factors for IOVBP/CD. © 2018, Serbia Medical Society. All rights reserved.