ABSTRACT
Resumen: Objetivo. Evaluar retrospectivamente la capacidad diagnóstica de la elastografía cuantitativa para determinar la posibilidad de malignidad o benignidad de los nódulos tiroideos benignos y malignos, y determinar su utilidad para así decidir qué nódulos deberán ser sometidos a punción aspirativa con aguja fina (PAAF). Pacientes y métodos. Se analizaron 203 nódulos tiroideos de 195 pacientes remitidos por el Servicio de Endocrinología para estudio citológico durante el año 2018. A todos ellos se les realizó ecografía convencional, elastografía cuantitativa y PAAF. Se realizó un análisis estadístico mediante regresión logística, que pone en relación la probabilidad de que un nódulo sea sospecho de malignidad y el valor de la elasticidad medido en kilopascales (kPa) y el ratio elastográfico. Resultados. Existe una relación significativa y positiva entre el resultado citológico de Bethesda V/VI y los kPas/ratio elastográfico. Se recomienda realizar PAAF a aquellos nódulos con valores superiores a 25kPa y/o ratio elastográfico superior a 1,5. Conclusión. La elastografía cuantitativa es una herramienta útil que, junto a otros parámetros ecográficos, ayudaría a predecir o sospechar la malignidad de un nódulo tiroideo y a una mejor selección para la PAAF.
Abstract: Objective. To retrospectively assess the diagnostic capacity of quantitative elastography to determine the odds between benign and malignant thyroid nodules, and determine its usefulness in deciding which nodules should be subjected to fine needle aspiration puncture (FNA). Patients and methods. 203 thyroid nodules from 195 patients referred by the Endocrinology Service for cytological study during the year 2018 were analyzed. All of them underwent conventional ultrasound, quantitative elastography and FNA. A statistical analysis was performed using logistic regression that relates the probability that a nodule is suspected of malignancy and the elasticity value measured inkilopascals (kPa) and the elastographic ratio. Results. There is a significant and positive relationship between the cytological result of Bethesda V / VI and the kPas / elastographic ratio. FNA is recommended for those nodules with values greater than 25kPa and / or elastographic ratio greater than 1.5. Conclusion. Quantitative elastography is a useful tool that, together with other ultrasound parameters, would help to predict the malignancy of a thyroid nodule and to better select for FNA.
ABSTRACT
AIM: To examine foot posture changes during the three trimesters of pregnancy and to determine whether there is a relationship between these changes and the pain experienced in this period. METHODS: The study sample consisted of 62 pregnant women who attended the Gynaecology Service at Hospital âSanta María del Puerto (Cádiz, Spain), between January 2013 and May 2014. In their first visit, the following sociodemographic and anthropometric data were recorded: age, weight, height and foot size. In addition, information was obtained regarding pain in the lower back, knees, ankles and feet. In this first visit, too, the Foot Posture Index (FPI) was assessed, and three subsequent controls were performed during the first, second and third months of pregnancy (termed Stages 1, 2 and 3, respectively). RESULTS: In Stage 1, the average foot size (i.e., shoe size) was 38.3 (SD 1.5). This size did not change between Stages 1, 2 and 3. However, body weight and BMI did present statistically significant changes during this period (p<0.0001). The FPI varied during pregnancy but no relation was observed between these changes and the onset of pain. CONCLUSIONS: During pregnancy, pronation increases but this does not appear to influence the onset of pain in the lower limbs.
Subject(s)
Back Pain/physiopathology , Foot/anatomy & histology , Musculoskeletal Pain/physiopathology , Postural Balance/physiology , Posture/physiology , Pregnancy Complications/physiopathology , Adult , Anthropometry , Back Pain/etiology , Cohort Studies , Female , Humans , Longitudinal Studies , Male , Musculoskeletal Pain/etiology , Pregnancy , Pregnancy Complications/etiology , Pregnancy Trimesters , Pressure , SpainABSTRACT
La miositis proliferativa es una lesión muy infrecuente y benigna, la presencia de metaplasia ósea es aún más rara. Su rápido crecimiento y el patrón de infiltración difusa propicia la confusión con un tumor maligno. Se trata de un paciente varón de 68 años con antecedente de sarcoma fibromixoide de bajo grado que presentó aumento de volumen en hombro izquierdo. Se observa en el músculo deltoides una lesión blanquecina, mal delimitada que mide 2 × 1 cm. Se identifica una proliferación de células fusiformes, células pseudoganglionares y osteoide calcificado. La inmunohistoquímica muestra positividad para vimentina, β-catenina (citoplasmático), Ki 67 (6%) y positividad focal para miosina músculo liso y actina muscular en las células fusiformes, negatividad para MYO-D1, miogenina, CD-34, desmina, caldesmón. El diagnóstico es miositis proliferativa con focos de metaplasia ósea (AU)
Proliferative myositis is a rare, benign lesion and the presence of osseous metaplasia is even more infrequent. Its rapid growth and diffuse infiltration pattern may cause it to be confused with a malignant tumour. We present a case of proliferative myositis in a 68 year old male with a history of low grade fibromyxiod sarcoma who presented with swelling in the anterior left shoulder. An ill-defined, 2 × 1 cm whitish lesion was found in the deltoid muscle. A proliferation of spindle cells, pseudoganglion cells and calcified osteoid was observed. Immunohistochemistry showed positivity for vimentin, β-catenin (cytoplasmic), Ki 67 (6%) and focal positivity for actin and myosin smooth muscle in spindle cells, negativity for MYO-D1, myogenin, CD34, desmin, caldesmon. A diagnosis of proliferative myositis with foci of osseous metaplasia was made (AU)