RESUMEN
BACKGROUND: Thyroid nodule fine needle aspiration (FNA) biopsies are associated with a low false-negative rate. There is limited data regarding the predictive value of American College of Radiology Thyroid Imaging Reporting and Data System for false-negative FNA. METHODS: This single-center retrospective study evaluated 119 patients who underwent thyroidectomy. The association of TR category, along with other clinical variables, with false-negative FNA was evaluated. RESULTS: The overall false-negative rate of FNA was 10.8% (n = 9). False-negative FNAs were associated with younger age (mean 42 years vs 50.6 years, P = .04), larger nodule size (mean 4.4 cm vs 3.2 cm, P = .03), and a lower TR category (median 3 v 4, P = .01). DISCUSSION: Lower TR category, younger age, and larger nodule size were associated with false-negative FNA of thyroid nodules. These findings should be taken into context when counseling patients with thyroid nodules who have a benign FNA.
Asunto(s)
Valor Predictivo de las Pruebas , Neoplasias de la Tiroides , Nódulo Tiroideo , Tiroidectomía , Humanos , Biopsia con Aguja Fina , Estudios Retrospectivos , Persona de Mediana Edad , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Adulto , Femenino , Masculino , Reacciones Falso Negativas , Nódulo Tiroideo/patología , Nódulo Tiroideo/diagnóstico por imagen , Nódulo Tiroideo/cirugía , Anciano , Sistemas de Información RadiológicaRESUMEN
BACKGROUND: There is currently no clear consensus recommendation for the use of short-interval follow-up mammography after a benign-concordant breast biopsy (BCBB), and practice patterns vary widely. The objectives of this study were to evaluate whether a short-interval follow-up mammogram provided clinical utility after stereotactic BCBB and to examine the costs associated with this surveillance strategy. METHODS: A retrospective review of women who underwent a stereotactic breast biopsy yielding benign-concordant results between January 2005 and October 2014 was performed to evaluate findings on subsequent imaging, to calculate compliance with recommended short-interval imaging, and to examine whether subsequent imaging revealed an abnormality at the site of the initial stereotactic BCBB. A cost analysis was performed utilizing Medicare reimbursement rates to calculate projected and actual costs of short-interval follow-up imaging after stereotactic BCBB. RESULTS: Of the 470 stereotactic BCBB performed, a short-interval mammogram was completed in 207 (44.0%), 9 (4.3%) of which had suspicious mammographic findings at the initial biopsy site, and 6 subsequently underwent biopsy, with none resulting in malignant or high-risk pathology. The cost of short-interval mammographic follow-up (nâ¯=â¯207) was calculated at $28,541.16. CONCLUSIONS: This study provides evidence that 6-month follow-up mammography has low clinical utility and unnecessarily increases costs after stereotactic BCBB. A safe and more cost-effective strategy may be resumption of routine mammography at 12 months post-biopsy.
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Neoplasias de la Mama/patología , Detección Precoz del Cáncer/estadística & datos numéricos , Biopsia Guiada por Imagen/estadística & datos numéricos , Mamografía/estadística & datos numéricos , Adulto , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/economía , Neoplasias de la Mama/cirugía , Detección Precoz del Cáncer/economía , Femenino , Estudios de Seguimiento , Humanos , Biopsia Guiada por Imagen/economía , Mamografía/economía , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios RetrospectivosAsunto(s)
Aneurisma Falso , Aorta Torácica , Procedimientos Endovasculares/efectos adversos , Hemoptisis , Injerto Vascular/efectos adversos , Aneurisma Falso/diagnóstico , Aneurisma Falso/etiología , Aneurisma Falso/fisiopatología , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/patología , Aneurisma de la Aorta Torácica/cirugía , Broncoscopía/métodos , Angiografía por Tomografía Computarizada/métodos , Diagnóstico Diferencial , Procedimientos Endovasculares/métodos , Femenino , Hemoptisis/diagnóstico , Hemoptisis/etiología , Humanos , Persona de Mediana Edad , Manejo de Atención al Paciente/métodos , Injerto Vascular/métodosRESUMEN
Foregut duplication cysts are extremely rare congenital malformations. Herein we report a case of 73 year old male with a left upper quadrant abdominal lesion identified on CT scan.
Asunto(s)
Quistes/diagnóstico por imagen , Epitelio/diagnóstico por imagen , Estómago/diagnóstico por imagen , Anciano , Humanos , Masculino , Manejo de Especímenes , Estómago/anomalías , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Patients with end-stage renal disease are at increased risk for sudden cardiac death, although the utility of implantable cardioverter-defibrillators (ICDs) in these patients is unknown. OBJECTIVES: The purpose of this study was to evaluate whether end-stage renal disease is an independent risk factor for appropriate ICD therapy for ventricular tachycardia (VT) or ventricular fibrillation (VF) and to compare the long-term survival of ICD recipients with and without end-stage renal disease. METHODS: A retrospective cohort study was performed on ICD recipients at a single center. The primary endpoint was first appropriate ICD therapy for VT/VF. The secondary endpoint was survival. RESULTS: The study included 585 patients, 19 (3.2%) of whom had end-stage renal disease prior to device implantation. Average follow-up time was 2.2 +/- 2.4 years, during which time 156 patients (26.7%) received appropriate ICD therapy. End-stage renal disease was strongly associated with appropriate ICD therapy (hazard ratio 2.30, 95% confidence interval 1.17-4.54) and remained a significant predictor following adjustment for implant indication, ejection fraction, diabetes, hypertension, and beta-blocker use. Survival was significantly shorter in the end-stage renal disease patients, with a median survival time of 3.2 +/- 0.6 (SEM) years in the dialysis cohort and 7.4 +/- 0.5 (SEM) years in those without end-stage renal disease (log rank P = .009). The majority of deaths in the end-stage renal disease cohort were due to non-device-related infection. CONCLUSION: In this cohort, end-stage renal disease was the single greatest predictor of ICD therapies for VT/VF. The survival rate was significantly shorter than that of ICD recipients without end-stage renal disease, suggesting that comorbidities in end-stage renal disease patients meeting current implant indications may reduce the survival benefit of ICD placement in this population.