Objective: Micropapillary thyroid carcinoma (micro-PTC) has a good prognosis but a number of cases will present with aggressive behavior. This study aims to determine the clinical outcomes with surgical management and histopathologic characteristics of Filipino patients with micro-PTC at University of Santo Tomas Hospital. Methodology: 139 patients were diagnosed with micro-PTC from the year 2004-2011. Seventy five patients had complete data and were included in this retrospective study. Chi square test with Yates correction, T-test for tumor diameter, statistical means and percentages were used in data analysis. Results: A total of 1,689 thyroid surgeries were done between 2004 and 2011. There were 1,054 patients (62.4%) diagnosed with benign thyroid tumor(s) and 635 patients (37.6%) with well-differentiated thyroid carcinoma. Of these, 139 (22%) patients have micro-PTC. The prevalence rate of micro-PTC was 22%, with a female predominance (86.6%). The patients’ ages ranged from 24-80 years old with a mean age of 47 years. Comparison of groups showed that having either incidental or non-incidental micro-PTC is independent of the clinical variables of the patient. Two (2.6%) patients initially presented with cranial and supraclavicular metastasis. This study had a low recurrence rate (5.3%) and a mortality rate of 1.3%. Conclusion Male gender is the only significant variable for lymph node and distant metastasis. The patient’s age, family history of cancer, number of foci, size and histological type of tumor have no prognostic value.
Thyroidectomy

OBJECTIVES

Pre-impaired glucose tolerance (pre-IGT) is a prediabetes stage characterized by normoglycemia and compensatory hyperinsulinemia due to insulin resistance. Hyperinsulinemia increases cardiovascular disease (CVD) risk, especially, endothelial dysfunction (ED). However, there is paucity of studies on ED with hyperinsulinemia alone, particularly in individuals with pre-IGT. This study aimed to determine the presence of ED using brachial artery flow-mediated dilatation (FMD) among adult participants with pre-IGT and its correlation with insulin levels and other related clinical parameters.

METHODOLOGY

This is a cross-sectional analytical study. We screened adult patients with risk factors for developing diabetes (first-degree relative with type 2 diabetes mellitus, obesity, history of gestational diabetes and polycystic ovary syndrome). Brachial artery FMD was performed among participants with pre-IGT and findings were correlated with CVD risk factors using Pearson’s correlation and linear regression.

RESULTS

Of the 23 pre-IGT patients, 5 (21.74%) had decreased FMD values with significant associations with serum insulin and HbA1c. It was further observed that for every 1-unit increase in second-hour serum insulin and in HbA1c, there was a decrease in FMD values by 0.38% and 0.50%, respectively. Serum insulin was elevated, while other biochemical parameters were normal. Moreover, participants with low FMD were older, with higher BMI and had higher HBA1c, total cholesterol and low-density lipoprotein (LDL) cholesterol.

CONCLUSION

As early as the pre-IGT stage, endothelial dysfunction using the FMD test is already present, with red flags on other CVD risk factors already developing.

Human ; Insulin Resistance (ir) ; Hyperinsulinism ; Hyperinsulinemia ; Diabetes Mellitus, Type 2 ; Cardiovascular Diseases