[Handling of thyroid diseases: usefulness and limitations of rapid and fine-needle percutaneous biopsy]. / Manejo de la patología tiroidea: utilidad y limitaciones de la biopsia percutánea con aguja fina y de la biopsia rápida.

Fine needle aspiration biopsy of the thyroid (FNAB) has become an accepted procedure for evaluation of the thyroid nodule, with 899 performed at the Lahey Clinic from 1981 to 1990. We examined them by medical record, pathology, and cytology review, with follow-up by chart or personal communication. Three-hundred-forty-five came to surgery, of which 188 (34%) were malignant; the specificity of the aspirate was 97%, sensitivity 92%, with false negative of 8% and false positive of 3%. By comparison, the frozen section had a false negative rate of 1% and false positive rate of 5%. In combination with frozen section, the fine needle aspirate result improved the accuracy of the intraoperative estimate of malignancy (p = 0.03). When the aspiration was benign but the lesion was clinically suspicious, a cancer was found at surgery in 13% of cases. Of the patients observed for a minimum of 5 years, 1.3% developed a carcinoma. Both cases had a non diagnostic FNAB None of the patients with a clinical and cytological benign lesion developed cancer. The complication rate of FNAB was 1.3% FNAB is a helpful and low risk diagnostic procedure but it needs to be done and read appropriately and its result used within the clinical context. Each medical team needs to monitor their results (continued quality control).

Evaluation of syntax in three-year-old Spanish-speaking Puerto Rican children.

The performance of 30 normal and 30 language-deviant three-year-ols Spanish-speaking Puerto Rican children was compared on two measures of linguistic proficiency. They are mean length of utterance, following a scoring procedure adapted for Spanish speakers by the primary investigator, and Lees' Developmental Sentence Scoring procedure adapted for Spanish by Toronto. Results indicated that both methods of language assessment were sensitive to age and language status differences within the three-year age range. Accordingly, they can be usefully employed in research investigations to equate subjects on a linguistic basis, and in the clinical evaluation of small differences in the language maturity of preschool Spanish-speaking Puerto Rican children.