Complications related to thyroidectomy among patients with hyperthyroidism: Exploring the potential for ambulatory surgery

BACKGROUND

Total thyroidectomy for hyperthyroidism is typically followed by overnight admission to monitor for complications including thyrotoxicosis. Outpatient thyroid surgery is increasingly common, but its safety in patients with hyperthyroidism has not been well studied.

METHODS

This retrospective study reviewed 183 patients with hyperthyroidism who underwent total thyroidectomy from 2015 to 2022 at one urban, academic center. The main outcomes were rates of thyroid storm, surgical complications, and 30-day ED visits and readmissions.

RESULTS

Among 183 patients with hyperthyroidism (mean age, 45 ± 14.5 years; 82.5% female), there were no cases of thyroid storm and complications included recurrent laryngeal nerve (RLN) palsy (7.0%), symptomatic hypocalcemia (4.4%), and hematoma (1.6%). ED visits were present in 1.1% and no patients were readmitted.

CONCLUSION

Total thyroidectomy was not associated with thyroid storm and <6% of patients required inpatient management. Ambulatory total thyroidectomy for hyperthyroidism warrants further consideration through identification of predictive factors for postoperative complications.

[Research of the certified reference material of mecury in lyophilized bovine blood]

Objective: To develop a reference material for the analysis of mercury in freeze-dried bovine blood. Methods: The whole blood of the bovine was collected, mercury standard solution was added, After mixing, packaging and freeze-drying. Two concentration levels of reference materials were prepared. The homogeneity and stability were evaluated by t-test and F-test methods respectively. The uncertainty in preparation, long-term stability, short-term stability and fixed value were evaluated Evaluation and assignment of reference materials. The research products were fixed value and were analyzed by two methods and fixed value in 9 laboratories and the uncertainty during development was analyzed. Results: The reference material has good uniformity and can be kept stably for 12 months at -20 ℃; When transported at ≤35 ℃, the quantity value is stable within 7 days; After re dissolution, it can be stored at 4 ℃ for 5 days; The values are 9.4 respectively μg/L and 29.2 μg/L, and the uncertainty is ±1.1 respectively μg/L and ±2.3 μg/L (k=2) . Conclusion: The indexes of reference materials for mercury composition analysis in freeze-dried bovine blood meet the requirements of technical specifications and have certain application value.

[Determination of fluorine-ion in human urine by ion chromatography method]

Objective: To establish a method to determine fluorine ion in human urine by ion chromatography method. Methods: The samples were centrifuged, diluted and processed by C(18) solid-phase column, potassium hydroxide as mobile phase, gradient elution, separated by AS(15), and determined by anion conductivity detector. Results: The linear correlation coefficient of fluoride ion in the range of 0.02-10.00 mg/L was more than 0.999. The lowest detection limit of urinary fluoride was 0.06 mg/L (in 3 ml urine) . The recoveries of the method were 96.9%-99.5%, the inter batch precision range was 0.40%-2.89%. The intra batch precision was from 1.01 to 7.23%. Fluoride samples could be stored for 7 days at room temperature and 4 ℃, and be stored for 14 days at -20 ℃. Conclusion: Determination of fluoride in urine by ion chromatography, the method could meet the requirement in GBZ/T 210.5-2008.

[Analysis of inter-laboratory comparison results of arsenic in urine and explore the influence factors on detection]

Objective: Through inter-laboratory comparison to analysis and evaluation of the detection capacity of arsenic in the urine. Methods: Urine arsenic samples were prepared with normal human urine as matrix. The homogeneity of the samples was investigated and the results were statistically analyzed by single factor analysis of variance. 2 samples were issued to each participant laboratory. A robust statistical four-point distance method was used to calculate the results submitted by each participant laboratory and the test capability of the laboratory was assessed by the z-score method. By means of method experiments and records, the reasons of dissatisfaction and the influencing factors of the results were discussed. Results: The statistic of the homogeneity of urine arsenic samples was less than the critical value (P>0.05) , which showed that the arsenic in the sample was homogeneous. The satisfactory rate of comparison between 36 laboratories was 86.1%. The main reasons for dissatisfaction were the testing conditions and the quality control measures. The selection of sample pretreatment, acidity control and hydrogenation conditions was the main influencing factor for the determination of urinary arsenic by atomic fluorescence spectrometry. Conclusion: The level of urinary arsenic detection in the occupational health laboratories was generally better and a few laboratories need to be improved ability of detection. It was very important to control the test conditions reasonably and strengthen the quality control measures to improve the accuracy of urine arsenic detection.

[Optimization of ion selective electrode method in detection of urinary fluorine]

Objective: To optimize the ion selective electrode method of measuring urinary fluorine in WS/T 30-1996. Methods: The volume of 5 mol/L NaOH solution was fixed to confect the TISAB buffer solution. The samples were prepared by mixing 5 ml urine and equal volume of TISAB solution. Fluorine electrode and calomel electrode was used to test. When the potential value changed less than ±0.5 mV in one minute, it could be recorded. The standard curve method was selected as a quantitive method. Results: The linear range of this method was 0.07~50.0 mg/L, E=238.96-57.50lgC, r=0.999 8. The LOD and LOQ were 0.02 mg/L and 0.07 mg/L (with 5 ml urine) , respectively. The RSD of intra -and inter-batch precision were 0.80%~2.82% and 2.17%~2.86%, respectively. The recovery rate was 102%~107%. The urine sample could be preserved stably for 14 days at room temperature, and for 30 days at 4 ℃ and -20 ℃. Conclusion: In this method, the preparation process of TISAB buffer solution was simplified, and the linear range was expanded. It could meet the needs of occupational population detection.

Accuracy of stress measurement by Laue microdiffraction (Laue-DIC method): the influence of image noise, calibration errors and spot number

Laue microdiffraction, available at several synchrotron radiation facilities, is well suited for measuring the intragranular stress field in deformed materials thanks to the achievable submicrometer beam size. The traditional method for extracting elastic strain (and hence stress) and lattice orientation from a microdiffraction image relies on fitting each Laue spot with an analytical function to estimate the peak position on the detector screen. The method is thus limited to spots exhibiting ellipsoidal shapes, thereby impeding the study of specimens plastically deformed. To overcome this difficulty, the so-called Laue-DIC method introduces digital image correlation (DIC) for the evaluation of the relative positions of spots, which can thus be of any shape. This paper is dedicated to evaluating the accuracy of this Laue-DIC method. First, a simple image noise model is established and verified on the data acquired at beamline BM32 of the European Synchrotron Radiation Facility. Then, the effect of image noise on errors on spot displacement measured by DIC is evaluated by Monte Carlo simulation. Finally, the combined effect of the image noise, calibration errors and the number of Laue spots used for data treatment is investigated. Results in terms of the uncertainty of stress measurement are provided, and various error regimes are identified.

Pathways of energy flow through the light-harvesting antenna of the photosynthetic purple bacterium rhodobacter sphaeroides

Using low intensity picosecond absorption spectroscopy with independently tunable excitation and probing infrared pulses, we have studied the pathways of energy transport through the light-harvesting antenna pigments of the photosynthetic purple bacterium Rhodobacter sphaeroides. From the observed excited-state rise time of the red-most pigment B896 as a function of excitation wavelength it is concluded that the B850 pigment of LH2 is spectrally heterogeneous. For excitations originating in the B850 pigment this results in a fast channel (9 ps) that is mainly excited in the peak of the B850 absorption band, and a slow channel (35 ps) that is predominantly excited at approximately 840 nm. Upon excitation of B800, more than 90% of the excitations follow the fast path. From the observed kinetics it is concluded that the majority of the LH2 --> LH1 energy transfer takes place within at most a few picoseconds. The rate-limiting step in the whole energy transfer sequence appears to be the B896 --> reaction center transfer. The origin of the B850 heterogeneity and the slow 35-ps component is at the moment unclear. Possibly it represents a highly extended form of LH2 in which transfer to LH1 takes a relatively long time, due to a large number of transfer steps.

A new and simple method for concentration of enteric viruses from water

A new type of electropositive filter media particle was tested to adsorb bacteriophage f2 and enteric viruses from tap water. 3 x nutrient broth (pH 7.2) was used to elute the adsorbed viruses, and the eluate was reconcentrated by polyethylene glycol (Mw 6000) precipitation with a final concentration of 10% (wt./vol.). The adsorption of bacteriophage was reliable and efficient, and not affected by the pH value, temperature, turbidity and organic materials in water. This method gave a recovery of Polio 1 virus 96.0% for small-volume tap water; 88.7% for large-volume water; and gave a comparable recovery of HAV, Coxsackie B3 and Echo 7 from tap water. The concentration method need not acidify virus-containing water, add exogenous multivalent cation salts, or require expensive equipment.

Dynamics of energy transfer and trapping in the light-harvesting antenna of Rhodopseudomonas viridis

By low intensity picosecond absorption spectroscopy it is shown that the exciton lifetime in the light-harvesting antenna of Rhodopseudomonas (Rps.) viridis membranes with photochemically active reaction centers at room temperature is 60 +/- 10 ps. This lifetime reflects the overall trapping rate of the excitation energy by the reaction center. With photochemically inactive reaction centers, in the presence of P+, the exciton lifetime increases to 150 +/- 15 ps. Prereducing the secondary electron acceptor QA does not prevent primary charge separation, but slows it down from 60 to 90 +/- 10 ps. Picosecond kinetics measured at 77 K with inactive reaction centers indicates that the light-harvesting antenna is spectrally homogeneous. Picosecond absorption anisotropy measurements show that energy transfer between identical Bchlb molecules occurs on the subpicosecond time scale. Using these experimental results as input to a random-walk model, results in strict requirements for the antenna-RC coupling. The model analysis prescribes fast trapping (approximately 1 ps) and an approximately 0.5 escape probability from the reaction center, which requires a more tightly coupled RC and antenna, as compared with the Bchla-containing bacteria Rhodospirillum (R.) rubrum and Rhodobacter (Rb.) sphaeroides.

Coumarin 120 laser pulses close to the Fourier transform limit from a simplified resonant cavity

Using a simplified resonant cavity consisted of an optical parallel glass plate and a diffraction grating at near grazing incidence and the appropriate laser parameters, coumarin 120 laser pulses close to the Fourier transform limit have been obtained. These laser pulses have a spectral linewidth of 600 +/- 40 MHz and a pulse width of 1.5 +/- 0.2 ns. The laser wavelength tuning range is from 4280 to 4600 A.