RESUMO
Obesity is a risk factor for differentiated thyroid cancer (DTC), but the association with DTC aggressiveness is controversial. To evaluate the association between preoperative body mass index (BMI)/other metabolic parameters and DTC aggressiveness in our surgical cohort, we retrospectively evaluated patients following thyroid surgery who were diagnosed with DTC between December 2013 and January 2021. Baseline characteristics, histopathological features, treatment modalities, and follow-up data were studied. We conducted logistic regression to analyze the association between BMI/other metabolic parameters and adverse DTC features. The final study cohort included 211 patients (79.6% women; mean age± standard deviation 48.7 ± 15.9 years): 66 (31.3%) with normal weight, 81 (38.4%) with overweight, and 64 (30.3%) with obesity. The median follow-up was 51 months (range 7-93). Complete versus partial thyroidectomy was more common among patients living with overweight or obesity than in normal weight patients (79.7% versus 61.7%, p = 0.017, respectively). Logistic regression demonstrated that higher BMI was associated with mildly increased risk for lymph nodes metastases (odds ratio [OR] 1.077, 95% CI: 1.013-1.145), and higher triglycerides/high-density lipoprotein-cholesterol (TG/HDL-C) ratio was associated with aggressive histological variants of DTC (OR 1.269, 95% CI 1.001-1.61). To conclude, specific adverse clinical and histopathological DTC features were indeed associated with higher BMI and higher TG/HDL-C ratio.
RESUMO
INTRODUCTION: Voice therapy (VT), a cornerstone in dysphonia treatment, relies on patient adherence for efficacy. Despite its positive outcomes, adherence rates remain consistently low. This study investigates the impact of cultural background on adherence to VT. METHODS: This is a retrospective cohort study that included all adult patients referred to our institution's Speech and Hearing unit, in 2018 for VT related to dysphonia. The study group included a distinct adult minority group (Bedouin Arabs) which was compared to a control group. Adherence rates, demographic factors, and therapy outcomes were analyzed. RESULTS: A total of 137 adult patients with dysphonia (20 in the study group and 117 in the control group) were included. There were no significant differences in adherence rates between the study and control groups (75% vs 74.3%, P = 1), with an overall nonadherence rate of 74.4%. The median leg of time for VT was 239days, and the median number of visits was 3.0. Logistic regression analysis, adjusting for age and visits, indicated lower odds of dysphonia improvement in the study group (odds ratios [OR]: 0.12, P = 0.05). However, visits showed a significant positive impact on improvement (OR: 2.58, P < 0.001). CONCLUSION: While cultural background does not impact adherence rate, it is associated with different attendance patterns and lower voice outcomes following VT. Future efforts should concentrate on investigating aspects of adherence such as home exercises, accessibility of treatment, and the frequency of follow-up sessions to facilitate customized interventions for specific populations.