Diagnostic Performance Comparison of Liquid-Based Preparation Methods in Thyroid FNAs.

Introduction: Fine needle aspiration (FNA) is recognized worldwide as the primary diagnostic method for evaluating thyroid nodules. Samples collected by FNA can be spread directly onto slides, prepared for cell blocks, or processed as liquid-based cytology. Advocates of the traditional smear technique emphasize that background material such as colloid, cell sequencing characteristics in cell clusters, and cellularity is important in cytological diagnosis. They state that these properties are not observed in liquid-based liquids. Liquid-based cytology techniques aim to provide standardized slides of homogeneous cellular smears with well-preserved cell morphology, producing more precise visualization, shorter interpretation time, and more reproducible results. This study aimed to investigate and compare the diagnostic performance of liquid-based thyroid FNA samples prepared with SurePath and Cytospin over the last 6 years. Methods: Patients who underwent ultrasound-guided FNA between January 2015 and December 2021 were included in the study. Cytology reports, pathology reports, and demographic information of the patients were collected from the Hospital Information Management System. The programs "SPSS for Windows 21" and "MedCalc Diagnostic Test Evaluation Calculator" were used for data analysis. Chi-square tests were used in crosstab analysis. The Kolmogorov-Smirnov two-sample test, two proportions test, and the confidence interval tests were used to analyze the variables of the methods. P < .05 was considered statistically significant. Results: The study population comprised 4,855 patients, 83.8% female and 16.2% male. There were no statistical differences in age and gender distribution in the population of both methods. Nondiagnostic outcome rates were 11.2% for SurePath and 12.8% for Cytospin. Sensitivity, specificity, and accuracy values for SurePath and Cytospin methods were determined as 58.57%, 98.28%, and 91.12% and 79.07%, 96.88%, and 94.03%, respectively. Conclusion: In our study, although the qualitative analytical results were slightly in favor of the cytospin method, we think both ways can be used safely, especially in hospitals where the clinics performing sampling activities are variable and many, as well as in pathology laboratories where the workload is intense.

The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes.

BACKGROUND: Our aim was to detect the role of radiological abdominal fat parameters by tomography and stone density by plain X-ray on extracorporeal Shock Wave Lithotripsy (SWL) stone-free rate. METHODS: The patients who had undergone SWL for a single opaque renal stone < 2 cm in diameter and proximal ureteric stone < 1 cm in diameter were collected retrospectively. The characteristics of patients and stones were recorded. The stone attitude, HU, abdominal fat parameters, paraperirenal fat area, perirenal infiltration and severity of hydronephrosis with pre-treatment Non- Contrast Computed Tomography (NCCT) and stone density with radiography were evaluated by a radiologist. Four weeks after the last SWL; all patients were evaluated by plain X-ray and categorized as Stone Free (SF) and Residual Fragment (RF) group. RESULTS: 51 patients with renal stones and 88 patients with proximal ureteral stones were included in the study. 24 (47%) and 63 (71%) patients were classified as SFfor renal and ureteral stones respectively. Only stone size was an independent predictor for stone-free rates after SWL for renal and proximal ureteral stones on multivariate analysis. The Receiver Operating Characteristic (ROC) curves for renal calculi revealed that creatinine level, stone size, stone attitude, Houns-Field Unit (HU) and Skin-to-Stone Distance (SSD) were the predictive factors for the SWL outcome (p< 0.05). The ROC curve for ureteral calculi demonstrated that HU, stone size and attitude were the predictive factors (p< 0.05). CONCLUSION: All abdominal fat parameters and the stone density were not related to SWL failure. A large follow-up with more patients is essential to confirm the role of radiological parameters on the outcome of SWL.

Comparison of the effects of mandibular protruding devices on obstructive sleep apnoea patients and healthy volunteers.

PURPOSE: To evaluate upper airway diameter differences before and after placement of custom made mandible protruding devices (MPD) in OSAS group and to compare with control group using computerized tomography. METHODS: The OSAS group was composed of 15 patients aged from 25 to 45 years with mild-moderate OSAS and the control group included 15 healthy volunteers, aged from 25 years to 44 years. On coronal and sagittal reformated CT images, anteroposterior (AP) and lateral (LAT) diameters at three levels (passing through soft palate [level 1], 5 mm above uvula [level 2] and 1 cm above the tip of epiglottis [level 3]) were measured before and after MPD placement in both groups. RESULTS: LAT diameters at level 1, level 2 and AP diameter at level 2 in OSAS group were significantly lower than in control group before MPD placement. Only LAT diameters at level 2 in OSAS group were significantly lower than in control group after MPD placement. When we compared upper airway diameters before and after placement of the MPD within each group, statistically significant increase in diameters at all levels were observed. CONCLUSION: MPD is a cheap, easily usable device providing increase in upper airway diameters.

Is there a relationship between cribriform plate dimensions and septal deviation angle?

The aim of this retrospective study was to investigate the relationship between cribriform plate (CP) dimensions and septal deviation degree. Coronal paranasal CT scans of 99 patients were reviewed. We measured depth and width of cribriform plate on both sides and compared with septal deviation side and septal deviation degree. Deviation angles were 6.85 ± 1.47° for right deviations; and 7.11 ± 1.63° for the left deviations. The mean depth of CP was 5.08 ± 1.57 mm at the right side and 5.06 ± 1.59 mm at the left side; and the mean width of CP was found 4.71 ± 1.36 mm at the right side and 4.56 ± 1.51 mm at the left side. When CP dimensions were evaluated according to the septal deviation side, mean width of CP was 4.69 ± 1.36 mm at ipsilateral side (deviated side); and 4.58 ± 1.51 mm at the contralateral side. The mean depth of CP was 4.9 ± 1.56 mm at the ipsilateral side (deviated side); and 5.22 ± 1.58 mm at the contralateral side. The CP depth at the contralateral side was significantly higher than that of the ipsilateral side (deviated side). In right SD, ipsilateral and contralateral CP depth increased. As deviation angle increased, ipsilateral and contralateral CP width, right and left CP width increased. Ipsilateral and contralateral CP width; and additionally ipsilateral and contralateral CP depth increased together. In other words, right and left CP width; and CP depth increased simultaneously. It is well known that the higher incidence of intracranial penetration is on the side where the position of the ethmoid roof (ER) is lower. The presence of septal deviation, the possibility of the deeper CP at the contralateral side should be taken into consideration to avoid iatrogenic injury.

The metabolic syndrome is associated with complicated gallstone disease.

BACKGROUND: Gallstone disease (GD) is a common condition worldwide. Several studies demonstrated that the presence of gallstones is strongly associated with cardiovascular disease. The metabolic syndrome is a highly prevalent cardiovascular condition. OBJECTIVE: To examine the relationship between complicated GD (CGD) and the metabolic syndrome or its components. METHODS: Two hundred seventeen patients with gallstones were examined. All patients underwent biliary ultrasonography after a complete medical history and laboratory examination. Data collection for the diagnosis of metabolic syndrome included measurements of waist circumference, blood pressure and lipids, and biochemical tests. RESULTS: Of the 217 patients examined, 115 patients (53%) had CGD and 102 patients (47%) had uncomplicated GD (UCGD). There was a significant difference between the number of patients with large gallstones in the CGD and UCGD groups (n=14 [12%] versus n=2 [2%], respectively; P=0.004). Metabolic syndrome, diabetes mellitus and large waist circumference were more prevalent in the CGD group than in the UCGD group. Homeostatic model assessment of insulin resistance scores were higher in the CGD group than in UCGD group (2.51 [95% CI 0.57 to 23.90] versus 2.20 [95% CI 0.09 to 8.87], respectively; P=0.032). Logistic regression analysis revealed that the presence of metabolic syndrome (OR 1.434; 95% CI 1.222 to 1.846, P=0.014), diabetes mellitus (OR 1.493; 95% CI 1.255 to 1.953; P=0.035) and large gallstones (OR 1.153; 95% CI 1.033 to 1.714; P=0.017) were independent predictors of CGD. CONCLUSION: Results of the present study demonstrated that metabolic syndrome, diabetes and gallstone size were associated with CGD. Further prospective studies are needed to understand the clinical importance of this association.