[Evaluación funcional de deglución-aspiración en pacientes sometidos a laringectomía subtotal supracricoidea con cricohioidoepiglotopexia]

Introduction

Cardiovascular disease is the main cause of mortality worldwide. In women, its incidence increases at the sixth decade of life, coinciding with postmenopause. Whether this effect is due to menopause-related hormonal changes is not known.

Objective

To evaluate the differences in cardiovascular risk in pre- and postmenopausal women by means of the Globorisk risk scale, the triglyceride/high-density lipoproteinsHDL cholesterol (Tg/HDL-C) ratio and metabolic syndrome (MS) criteria.

Method

Cross-sectional study that included 408 women from 40 to 60 years of age; anthropometric measurements and biochemical determinations were performed. The participants were classified as premenopausal and postmenopausal. Cardiovascular risk was assessed using the MS criteria, the Globorisk risk calculator and the Tg/HDL-C ratio.

Results

Postmenopausal women showed a significant increase in waist circumference, total cholesterol and triglycerides Tg in comparison with premenopausal women. Significant associations were found between hormonal state and Globorisk-measured cardiovascular risk (OR = 2.50; 95 % CI = 1.67-3.74) and the Tgtriglyceride/HDL-C ratio (OR = 1.66; 95 % CI = 1.09-2.52).

Conclusion

Cardiovascular risk factors have a higher prevalence in postmenopause. The Globorisk scale and Tg/HDL-C ratio identify cardiovascular risk in postmenopausal women.

[Parathyroid glands radio-guided surgery]

INTRODUCTION

Several advances have been made in the management of hyperparathyroidism. The preoperative sestamibi scan appears to have revolutionized the entire approach to parathyroid surgery including minimally invasive parathyroidectomy. Gamma probe is a useful tool that complements a well performed localization of parathyroid adenomas.

METHODS

We conducted a retrospective analysis of the patients submitted to radio-guided parathyroidectomy between January and December 2003 at a Oncology tertiary hospital in Mexico City, for evaluate the results and shows the feasibility of this approach.

RESULTS

Six patients was included, all of them referred to the hospital with the diagnosis of bone tumors or with bone disease suggest malignancy. Median serum level of preoperative calcium was 13.18 mg/dl. In all cases the transoperative localization of the affected gland was possible using gamma probe and according with Tc 99m sestamibi scintigraphy imaging. None perioperative deaths reported and there were no recurrent laryngeal nerve injuries neither recurrent hypercalcemia. Median serum level of postoperative calcium was 9.39 mg/dl. There were at histopathological analysis five adenomas and one hyperplasia.

CONCLUSIONS

Radio-guided parathyroidectomy is a useful approach for transopertaive localization of the affected gland, we obtained a 100% success rate, according with the histopathologic analysis and the normal postoperative serum calcium level.