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Purpose: To investigate the association between papillary thyroid cancer (PTC) and Hashimoto's thyroiditis (HT). Design: This study is a retrospective study that conducted during 7 consecutive years with a median 119.5 months follow-up. Subjects and Method: Patients who underwent thyroidectomy in Dokuz Eylül University Hospital during 7 consecutive years were included. Patients' demographics, biochemical, radiological, and pathological results were retrospectively assessed. Results: Four hundred sixty nine patients were evaluated. Among 469 patients who underwent thyroidectomy, 132 (28.1%) were malignant, while 182 patients were diagnosed with HT (38.8%). PTC was ranked first at 92.4% (n: 122). The prevalence of HT was 54.9% in patients with PTC and 33.1% in patients without PTC diagnosis (p<0.001). Younger age and the presence of HT were independently associated with PTC. The presence of HT was associated with increased risk of development of PTC (OR: 2.2, %95 CI: 1.4-3.5, p<0.001) but not with TNM stage or recurrence. Lymph node metastasis at presentation was the strongest predictor of recurrence (OR: 13.9, CI: 3.5-54.6, p<0.001). Conclusions: HT was an independent risk factor for development of PTC. According to our findings, HT patients (particularly with nodular HT) should be observed carefully and thyroid fine needle aspiration biopsy (TFNAB) should be encouraged if necessary.
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Aims and Background: Shoulder pathologies are frequently linked to sleep disturbances. The aim of this study is to investigate the effect on sleep disorders in patients with arthroscopic rotator cuff repair. Materials and Methods: Thirty-three patients who underwent arthroscopic rotator cuff repair due to a full-thickness rotator cuff tear were prospectively analyzed. The Pittsburgh Sleep Quality Index (PSQI), the American Shoulder and Elbow Surgeons Shoulder Score (ASES), visual analog scale (VAS), and Constant and Murley shoulder scores before surgery and at 6 months postoperatively. Preoperative clinical and radiological parameters of the patients were also evaluated. Results: The study analyzed 33 patients with a median age of 59.79 ± 9.0 years. There was a significant difference preoperatively versus postoperatively in terms of all PSQI global scores and subdivisions (P < 0.001). A statistically significant improvement was determined by the simple shoulder test, the Constant and Murley shoulder scores, and VAS (P < 0.001). Conclusion: Sleep disturbance is common in patients with symptomatic rotator cuff tear, and sleep disturbance can resolve after arthroscopic rotator cuff repair.
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Lesiones del Manguito de los Rotadores , Trastornos del Sueño-Vigilia , Anciano , Artroscopía , Humanos , Persona de Mediana Edad , Rango del Movimiento Articular , Manguito de los Rotadores/patología , Manguito de los Rotadores/cirugía , Lesiones del Manguito de los Rotadores/complicaciones , Lesiones del Manguito de los Rotadores/cirugía , Sueño , Trastornos del Sueño-Vigilia/etiología , Resultado del TratamientoRESUMEN
AIM: The aim of this study was to correlate findings of perfusion magnetic resonance imaging (MRI) and perfusion scintigraphy in cases where there was a suspicion of abnormal pulmonary vasculature, and to evaluate the usefulness of MRI in the detection of perfusion deficits of the lung. METHODS: In all, 17 patients with suspected abnormality of the pulmonary vasculature underwent dynamic contrast-enhanced MRI. T1-weighted 3D fast-field echo pulse sequences were obtained (TR/TE 3.3/1.58 ms; flip angle 30 degrees; slice thickness 12 to 15 mm). The dynamic study was acquired in the coronal plane following administration of 0.1 mmol/kg gadopentetate dimeglumine. A total of 8 to 10 sections repeated 20 to 25 times at intervals of 1s were performed. Perfusion lung scintigraphy was carried out a maximum of 48 h before the MR examination in all cases. Two radiologists, who were blinded to the clinical data and results of other imaging methods, reviewed all coronal sections. MR perfusion images were independently assessed in terms of segmental or lobar perfusion defects in the 85 lobes of the 17 individuals, and the findings were compared with the results of scintigraphy. RESULTS: Of the 17 patients, 8 were found to have pulmonary emboli, 2 chronic obstructive pulmonary disease with emphysema, 2 bullous emphysema, 2 Takayasu arteritis and 1 had a hypoplastic pulmonary artery. Pulmonary perfusion was completely normal in 2 cases. In 35 lobes, perfusion defects were detected using both methods, in 4 with MR alone and in 9 only with scintigraphy. There was good agreement between MRI and scintigraphy findings (kappa=0.695). CONCLUSION: Pulmonary perfusion MRI is a new alternative to scintigraphy in the evaluation of pulmonary perfusion for various lung disorders. In addition, this technique allows measurement and quantification of pulmonary perfusion abnormalities.
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Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Enfermedades Pulmonares/fisiopatología , Pulmón/fisiopatología , Angiografía por Resonancia Magnética , Adulto , Anciano , Medios de Contraste/administración & dosificación , Estudios de Factibilidad , Gadolinio DTPA/administración & dosificación , Humanos , Pulmón/irrigación sanguínea , Pulmón/diagnóstico por imagen , Enfermedades Pulmonares/diagnóstico por imagen , Persona de Mediana Edad , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Embolia Pulmonar/diagnóstico , Enfisema Pulmonar/diagnóstico , Enfisema Pulmonar/fisiopatología , Radiografía , Cintigrafía , Sensibilidad y Especificidad , Arteritis de Takayasu/diagnóstico , Arteritis de Takayasu/fisiopatología , Agregado de Albúmina Marcado con Tecnecio Tc 99mRESUMEN
The aim of this study was to investigate the effects of sildenafil on ocular hemodynamics by color Doppler ultrasonography (CDU). In all, 38 patients with erectile dysfunction diagnosed by International Index of Erectile Function (IIEF) and Sexual Health Inventory of Men (SHIM) scores were included into the study. After taking 100 mg of oral sildenafil citrate, all patients underwent CDU examination of central retinal artery at 60 and 75 min and CDU examination of cavernosal artery at 20, 60 and 75 min. All of the side effects during and after the test were also recorded. The mean cavernous artery peak systolic flow velocity increased significantly after sildenafil. However, no significant change was determined in central retinal artery flow parameters including peak systolic flow velocity, end-diastolic flow velocity, resistive index, pulsatility index, volume and diameter. Five patients experienced ocular side effects. No significant change was observed in retinal artery CDU measurements of patients having ocular side effects. Sildenafil has no effect on ocular hemodynamics on the basis of CDU. Ocular side effects may be the result of other changes in retinal photoreceptors rather than the ocular circulation.
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Disfunción Eréctil/tratamiento farmacológico , Ojo/irrigación sanguínea , Ojo/diagnóstico por imagen , Piperazinas/efectos adversos , Ultrasonografía Doppler en Color , Vasodilatadores/efectos adversos , Adulto , Anciano , Diástole/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Flujo Pulsátil/efectos de los fármacos , Purinas , Arteria Retiniana/efectos de los fármacos , Arteria Retiniana/fisiología , Citrato de Sildenafil , Sulfonas , Sístole/efectos de los fármacos , Resistencia Vascular/efectos de los fármacosRESUMEN
We report a case of interruption of the inferior vena cava with azygos/hemiazygos continuation and additional variations of the renal veins, an uncommon developmental anomaly. Magnetic resonance angiography and computed tomography, in association with clinical awareness, can be used to diagnose this entity.