Improving the prediction of persistent and recurrent differentiated thyroid cancer using the American Thyroid Association 2015 risk stratification system

xlomafota13 shared this article with you from Inoreader Improving the prediction of persistent and recurrent differentiated thyroid cancer using the American Thyroid Association 2015 risk stratification system Via radioactive iodine Hormones (Athens). 2021 Aug 12. doi: 10.1007/s42000-021-00313-2. Online ahead of print. ABSTRACT PURPOSE: The 2015 American Thyroid Association risk stratification system (ATA RSS) is used in patients with differentiated thyroid carcinoma (DTC) to assess their risk of persistent/recurrent disease. Our aims were to validate the 2015 ATA RSS in a registry of DTC patients and to examine whether the addition of factors not included in it, such as pre-radioactive iodine therapy stimulat ed thyroglobulin (pre-RAI sTg), gender, and age could increase its predictive ability. METHODS: We studied 403 patients with DTC, treated at a tertiary center from 1990 to 2018 and subjected to total thyroidectomy. All patients had received RAI therapy, except those with low-risk papillary microcarcinoma. RESULTS: Of our patients, 81.9% were women and 91.1% had papillary thyroid carcinoma. After a median follow-up of 5.0 years, 53 cases of persistent and 21 cases of recurrent disease were recorded. The proportion of variance explained (PVE) regarding the outcome (presence or absence of recurrent/persistent disease) using the 2015 ATA RSS alone was 18.3% (persistence) and 16.9% (recurrence), increasing to 74.4% and 52.0%, respectively, when pre-RAI sTg was added to the logistic regression model. Gender and age were not associated with the disease outcome. In ROC analysis, pre-RAI sTg had a high predictive value for persistent (AUC 0.983, 95% CI 0.962-1.000) and recurrent disease (AUC 0.856, 95% CI 0.715-0.997). The optimal cut-offs and sensitivity, specificity, and positive and negative predictive value for pre-RAI sTg were the following: for persistence 12.75 ng/ml, 100%, 90.5%, 64%, and 100%, and for recurrence 8.05 ng/ml, 77.8%, 85.5%, 36.8%, and 97%. CONCLUSIONS: The 2015 ATA RSS displayed moderate performance in predicting recurrent/persistent disease in patients with DTC, which improved with the inclusion of pre-RAI sTg values; pre-RAI sTg was an independent predictor of the disease outcome, with high negative prognostic value. PMID:34383288 | DOI:10.1007/s42000-021-00313 -2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic and fluoroscopic-guided closure of the eustachian tube using a biliary cytology brush and liquid embolic agent for a persistent CSF leak after schwannoma resection

xlomafota13 shared this article with you from Inoreader Endoscopic and fluoroscopic-guided closure of the eustachian tube using a biliary cytology brush and liquid embolic agent for a persistent CSF leak after schwannoma resection Via leak of cerebrospinal fluid BMJ Case Rep. 2021 Aug 10;14(8):e241861. doi: 10.1136/bcr-2021-241861. ABSTRACT Vestibular schwannoma is a known cause of progressive sensorineural hearing loss. Treatment options include observation, radiation therapy and surgical resection. Cerebrospinal fluid (CSF) fistula is a known postsurgical complication that can lead to CSF otorrhoea, rhinorrhoea or CSF leakage from the surgical wound. We present a case report of a patient who underwent vestibular schwannoma resection and postoperatively developed CSF rhinorrhoea, which was refractory to multiple attempts at surgical repair. This was successfully treated under endoscopic and fluoroscopic guidance using a biliary cytology brush to disrupt the surface of the eustachian tube followed by injection of n-Butyl cyanoacrylate. PMID:34376411 | DOI:10.1136/bcr-2021-241861 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent Hurthle cell thyroid carcinoma does not preclude long-term survival: a case report and review of the literature

xlomafota13 shared this article with you from Inoreader Recurrent Hurthle cell thyroid carcinoma does not preclude long-term survival: a case report and review of the literature Via radioactive iodine J Med Case Rep. 2021 Aug 11;15(1):399. doi: 10.1186/s13256-021-02987-z. ABSTRACT BACKGROUND: Follicular thyroid carcinoma is the second most common malignancy of the thyroid gland. In 2016, the so-called Hurthle cell thyroid carcinoma, formerly known as the oxyphilic variant of the follicular thyroid carcinoma, was reclassified by the World Health Organization as a separate pathological entity, which accounts for approximately 3% of all thyroid cancers. Although Hurthle cell thyroi d carcinomas are known for their more aggressive tumor biology, metastases are observed in a minority of cases, and long-term survival can be expected. However, disseminated disease is often associated with poor outcome. CASE PRESENTATION: In the presented case, a 63-year-old Caucasian female was incidentally diagnosed with Hurthle cell thyroid carcinoma after undergoing hemithyroidectomy for a nodular goiter. Following completion thyroidectomy, two courses of radioactive iodine therapy were administered. After 4 years of uneventful follow-up, the patient gradually developed metastases in five different organs, with the majority representing unusual sites, such as heart, kidney, and pancreas over a course of 14 years. The lesions were either treated with radioactive iodine therapy or removed surgically, depending on iodine avidity. CONCLUSION: Follicular and Hurthle cell thyroid carcinoma are known to potentially spread hematogenously to typical sites, such as lung or bo nes, however; unusual metastatic sites as presented in our case can also be observed. A search of the literature revealed only scattered reports on patients with multiple metastases in unusual locations. Furthermore, the observed long-term survival of our patient is contradictory to the existing data. As demonstrated, recurrent disease may appear years after the initial diagnosis, emphasizing the importance of consistent aftercare. Radioactive iodine therapy, extracorporeal radiation therapy, and surgical metastasectomy are central therapeutic components. In summary, our case exemplifies that thorough aftercare and aggressive treatment enables long-term survival even in recurrent Hurthle cell thyroid carcinoma displaying unusual multisite metastases. PMID:34376229 | DOI:10.1186/s13256-021-02987-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiology perspective on anatomy teaching in Australia and New Zealand

xlomafota13 shared this article with you from Inoreader Radiology perspective on anatomy teaching in Australia and New Zealand Via radiol anat Surg Radiol Anat. 2021 Aug 10. doi: 10.1007/s00276-021-02811-9. Online ahead of print. ABSTRACT INTRODUCTION: Anatomy pedagogy and radiologists involvement in teaching undergraduate anatomy varies widely. We surveyed radiologists practising in Australia and New Zealand to establish their opinions on their own experience of undergraduate anatomy and their view on the role of radiology in anatomy teaching. We also sought their views on the role of radiologists in anatomy teach ing. METHODS: A short survey was designed on the Survey Monkey platform using the website surveymonkey.com. The survey was distributed to members of the Royal Australian and New Zealand College of Radiologists (RANCZR) as a link attached to a monthly e-newsletter with a short paragraph outlining its aim. RESULTS: Sixty-seven responses were eligible for analysis. 33% (22/67) were dissatisfied with their own anatomy training and 55% (38/67) felt that current graduates had an inadequate level of anatomy. 55% (38/67) indicated that radiology had not been a major part of their own undergraduate anatomy training. 58% (39/67) of respondents felt that non-radiology medical and para-medical professionals were not suitably qualified to teach radiologic anatomy. 75% (42/67) were of the opinion that radiology with 3-D support platforms may replace cadaveric dissection in the future, yet most were not familiar with 3-D platforms in current usage. PMID:34378106 | DOI:10.1007/s00276-021-02811-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity

xlomafota13 shared this article with you from Inoreader Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity Via radiol anat Surg Radiol Anat. 2021 Aug 11. doi: 10.1007/s00276-021-02813-7. Online ahead of print. ABSTRACT PURPOSE: This study aimed to detect the idyllic locations for botulinum neurotoxin injection by analyzing the intramuscular neural distributions of the sartorius muscles. METHODS: An altered Sihler's staining was conducted on sartorius muscles (15 specimens). The nerve entry points and intramuscular arborization areas were measured as a percentage of the total distance from the most prominent point of the anterior superior iliac spine (0%) to the medial femoral epicondyle (100%). RESULTS: Intramuscular neural distribution were densely detected at 20-40% and 60-80% for the sartorius muscles. The result suggests that the treatment of sartorius muscle spasticity requires botulinum neurotoxin injections in particular locations. CONCLUSIONS: These locations, corresponding to the locations of maximum arborization, are suggested as the most suggestive points for botulinum neurotoxin injection. PMID:34378107 | DOI:10.1007/s00276-021-02813-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngopharyngeal symptoms are insufficient to diagnose laryngopharyngeal reflux

xlomafota13 shared this article with you from Inoreader Laryngopharyngeal symptoms are insufficient to diagnose laryngopharyngeal reflux Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Aug 11. doi: 10.1007/s00405-021-07034-7. Online ahead of print. NO ABSTRACT PMID:34378056 | DOI:10.1007/s00405-021-07034-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impressive finding in a case of pharyngeal foreign body sensation

xlomafota13 shared this article with you from Inoreader Impressive finding in a case of pharyngeal foreign body sensation Via hno HNO. 2021 Aug 10. doi: 10.1007/s00106-021-01093-2. Online ahead of print. NO ABSTRACT PMID:34378057 | DOI:10.100 7/s00106-021-01093-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.