Sarcopenic Obesity in Community-Dwelling Spanish Adults Older than 65 Years.

Sarcopenic obesity (SO) is diagnosed when sarcopenia and obesity coexist in patients. The objective of this study was to determine the prevalence of SO under different diagnostic criteria in community-dwelling Spanish adults aged over 65 years residing in Valencia (Spain). The research was conducted as an observational and cross-sectional study with a sample size of 202 subjects. To diagnose sarcopenia, we used the tests proposed by the European Working Group on Sarcopenia in Older People in 2019 (EWGSOP2): SARC-F, grip strength, sit-to-stand, gait speed, Appendicular Skeletal Muscle Mass (ASMM), and Short Physical Performance Battery (SPPB). For obesity diagnosis, we used body mass index (BMI), waist circumference (WC), total body fat percentage (%TBF), and tricipital skinfold (TS). The prevalence of SO was 16.5% in women and 29% in men, according to any of the diagnostic criteria used to determine obesity. A higher proportion of SO was observed as age increased in both groups, although no significant differences were found. Most values obtained in tests related to SO diagnosis were worse in the group affected by the disease; however, there were two exceptions related to the amount of ASMM. In total, 18.8% of the participants presented SO according to any diagnostic criteria related to obesity. Our results suggest significant differences in the number of SO cases depending on diagnostic criteria used to determine the participants' obesity. BMI, WC, and TBF% were shown as principal variables to be included in obesity diagnosis within the SO construct. These findings underscore the need to unify criteria to standardize the diagnosis of SO in the global population.

SarQoL Questionnaire in Community-Dwelling Older Adults under EWGSOP2 Sarcopenia Diagnosis Algorithm: A New Screening Method?

This article is an observational and cross-sectional study that related the result obtained in the questionnaire for the evaluation of quality of life related to muscle mass (SarQoL) and the prevalence of sarcopenic pathology measured under the EWGSOP2 algorithm. Participants were 202 community-dwelling older adults living in Valencia, Spain. The prevalence of sarcopenia in men was 28.9%, while in women it was 26.2%. In the case of the SarQoL questionnaire, the mean score obtained for men was 75.5 and 72.6 for women, showing significant differences in both sexes between the results obtained by the group with and without sarcopenia. After the exhaustive data analysis, a high discriminative capacity for sarcopenic disease was found in the SarQoL questionnaire total score and in domains 2 (locomotion), 4 (functionality) and 5 (activities of daily living). In accordance with the existing controversy regarding the use of SARC-F as a screening method for sarcopenia, the authors pointed out the capacity of domain 2 (locomotion) in isolation as a possible screening method for this disease, exposing a high risk of suffering sarcopenia when scores in this domain were below 60 points. Further research is needed to develop new lines of research as these showed in this work, as well as new and easily applicable screening methods for sarcopenia in clinical practice, that allow a rapid detection of this disease in the community.

Ingesta proteica en mujeres posmenopáusicas residentes en la comunidad y su relación con la sarcopenia / Protein intake in community-dwelling postmenopausal women and its relationship with sarcopenia

Objetivos: el envejecimiento general de la población se encuentra relacionado con el aumento de la prevalencia de la enfermedad sarcopénica, especialmente entre las mujeres mayores. Esta patología se encuentra estrechamente relacionada con la nutrición y, concretamente, con el consumo proteico en los adultos mayores. El objetivo de nuestro estudio fue evaluar la posible relación entre un bajo consumo de proteínas y una mayor prevalencia de la enfermedad sarcopénica, un peor patrón dietético y un menor rendimiento físico en mujeres posmenopáusicas residentes en la comunidad. Material y métodos: el estudio se realizó en un total de 164 mujeres mayores de 65 años, independientes, reclutadas en un centro social municipal de Valencia (Benimaclet). La presencia de sarcopenia fue evaluada utilizando el último algoritmo publicado por el EWGSOP2, y la ingesta de nutrientes a través de un registro dietético de tres días. El rendimiento físico fue evaluado a través del cuestionario iPaq-e, así como el test SPPB y el test de velocidad de la marcha de 4 metros. Resultados: la muestra total comprendió un total de 164 participantes con una edad media de ± 72 años. Un 26,2 % de la muestra presentaban una ingesta de proteínas inferior a la recomendada por la FAO/OMS. El 25,6 % de las mujeres presentaban algún estadio de sarcopenia y, en cuanto a la prevalencia de la obesidad sarcopénica, un 12,2 % de la muestra se encontró afectada por dicha enfermedad. Se encontraron relaciones significativas entre el consumo de proteína y la prevalencia de la sarcopenia (p = 0,021) y la obesidad sarcopénica (p = 0,043). Se encontraron diferencias significativas relacionadas entre la mayoría de macronutrientes y micronutrientes a estudio y el consumo proteico. No se encontró ninguna relación entre la ingesta proteica y el rendimiento físico. (AU)

Objectives: the general aging of the population is related to the increase in the prevalence of sarcopenic disease; especially among older women, this pathology is closely related to nutrition and specifically to protein consumption in older adults. The aim of our study was to evaluate the possible relationship between a low protein intake and a higher prevalence of sarcopenic disease, a worse dietary pattern, and lower physical performance in postmenopausal women living in the community. Material and methods: the study was carried out in a total of 164 independent women over 65 years of age, recruited from a municipal social center in Valencia (Benimaclet). The presence of sarcopenic pathology was evaluated using the latest algorithm published by EWGSOP2, and the intake of nutrients through a three-day dietary record. Physical performance was evaluated through the iPaq-e questionnaire, as well as the SPPB test and the 4-meter gait speed test. Results: the total sample comprised 164 women with a mean age of ± 72 years; 26.2 % of the sample had a protein intake lower than recommended by the FAO/WHO; 25.6 % of the women presented some stage of sarcopenia; regarding the prevalence of sarcopenic obesity, 12.2 % of the sample was affected by this disease. Significant relationships were found between protein consumption and the prevalence of sarcopenia (p = 0.021) and sarcopenic obesity (p = 0.043). Significant related differences were found between the majority of macronutrients and micronutrients under study and protein consumption. No relationship was found between protein intake and physical performance. (AU)

[Protein intake in community-dwelling postmenopausal women and its relationship with sarcopenia]. / Ingesta proteica en mujeres posmenopáusicas residentes en la comunidad y su relación con la sarcopenia.

INTRODUCTION: Objectives: the general aging of the population is related to the increase in the prevalence of sarcopenic disease; especially among older women, this pathology is closely related to nutrition and specifically to protein consumption in older adults. The aim of our study was to evaluate the possible relationship between a low protein intake and a higher prevalence of sarcopenic disease, a worse dietary pattern, and lower physical performance in postmenopausal women living in the community. Material and methods: the study was carried out in a total of 164 independent women over 65 years of age, recruited from a municipal social center in Valencia (Benimaclet). The presence of sarcopenic pathology was evaluated using the latest algorithm published by EWGSOP2, and the intake of nutrients through a three-day dietary record. Physical performance was evaluated through the iPaq-e questionnaire, as well as the SPPB test and the 4-meter gait speed test. Results: the total sample comprised 164 women with a mean age of ± 72 years; 26.2 % of the sample had a protein intake lower than recommended by the FAO/WHO; 25.6 % of the women presented some stage of sarcopenia; regarding the prevalence of sarcopenic obesity, 12.2 % of the sample was affected by this disease. Significant relationships were found between protein consumption and the prevalence of sarcopenia (p = 0.021) and sarcopenic obesity (p = 0.043). Significant related differences were found between the majority of macronutrients and micronutrients under study and protein consumption. No relationship was found between protein intake and physical performance. Conclusions: protein consumption in most of the women studied (73.8 %) was higher than the daily recommendations established by the FAO/WHO. There was a significant relationship between the prevalence of sarcopenia and sarcopenic obesity, and low protein intake. Higher protein intake was associated with a higher energy intake pattern. No relationship was found between protein intake and physical performance of the participants.

INTRODUCCIÓN: Objetivos: el envejecimiento general de la población se encuentra relacionado con el aumento de la prevalencia de la enfermedad sarcopénica, especialmente entre las mujeres mayores. Esta patología se encuentra estrechamente relacionada con la nutrición y, concretamente, con el consumo proteico en los adultos mayores. El objetivo de nuestro estudio fue evaluar la posible relación entre un bajo consumo de proteínas y una mayor prevalencia de la enfermedad sarcopénica, un peor patrón dietético y un menor rendimiento físico en mujeres posmenopáusicas residentes en la comunidad. Material y métodos: el estudio se realizó en un total de 164 mujeres mayores de 65 años, independientes, reclutadas en un centro social municipal de Valencia (Benimaclet). La presencia de sarcopenia fue evaluada utilizando el último algoritmo publicado por el EWGSOP2, y la ingesta de nutrientes a través de un registro dietético de tres días. El rendimiento físico fue evaluado a través del cuestionario iPaq-e, así como el test SPPB y el test de velocidad de la marcha de 4 metros. Resultados: la muestra total comprendió un total de 164 participantes con una edad media de ± 72 años. Un 26,2 % de la muestra presentaban una ingesta de proteínas inferior a la recomendada por la FAO/OMS. El 25,6 % de las mujeres presentaban algún estadio de sarcopenia y, en cuanto a la prevalencia de la obesidad sarcopénica, un 12,2 % de la muestra se encontró afectada por dicha enfermedad. Se encontraron relaciones significativas entre el consumo de proteína y la prevalencia de la sarcopenia (p = 0,021) y la obesidad sarcopénica (p = 0,043). Se encontraron diferencias significativas relacionadas entre la mayoría de macronutrientes y micronutrientes a estudio y el consumo proteico. No se encontró ninguna relación entre la ingesta proteica y el rendimiento físico. Conclusiones: el consumo de proteínas en la mayoría de las mujeres estudiadas (73,8 %) fue superior a las recomendaciones diarias establecidas por la FAO/OMS. Existió una relación significativa entre la prevalencia de la sarcopenia y de la obesidad sarcopénica y un consumo bajo de proteínas. Un mayor consumo de proteínas se asoció con un patrón de ingesta energética superior. No se encontró relación alguna entre la ingesta proteica y el rendimiento físico de las participantes.

Accidentes infantiles. Valoración del grado de supervisión de los padres a sus hijos por parte de los pediatras de Atención Primaria / Unintentional injuries in children: assessment of parental supervision of children by Primary Care paediatricians

INTRODUCCIÓN: los accidentes infantiles son una de las mayores causas de morbimortalidad en la edad pediátrica, y pueden ser prevenibles si se conoce y se actúa sobre los factores de riesgo que los propician. El grado de supervisión parental es un factor que puede influir, entre otros, en la aparición de estos. El objetivo de este estudio ha sido la comparación entre el grado de supervisión parental atribuido de forma subjetiva por los profesionales sanitarios, y el medido de forma objetiva mediante la utilización de un cuestionario validado para este fin. La finalidad es valorar la necesidad de utilizar cuestionarios para actuar de forma más eficiente frente a los factores de riesgo. MATERIAL Y MÉTODOS: estudio observacional, trasversal y analítico, para comparar la concordancia entre el grado de supervisión parental estimado por los pediatras de Atención Primaria y el medido de forma objetiva mediante el Parental Supervision Attributes Profile Questionnaire (PSAPQ), adaptado y validado a lengua española. RESULTADOS: se ha demostrado que no existe concordancia entre el grado de supervisión parental expresado de forma subjetiva por parte de los profesionales sanitarios y el medido de forma objetiva mediante la utilización del cuestionario PSAPQ. CONCLUSIONES: es necesaria la utilización de metodología validada para la medición de forma objetiva de los diversos factores de riesgo de accidentes infantiles, entre ellos el grado de supervisión, para de esta forma evitar sesgos de percepción y actuar de la forma más eficiente posible

INTRODUCTION: unintentional injuries are one of the leading causes of morbidity and mortality in the paediatric population and can be prevented if the risk factors that make them more likely are identified and addressed. The degree of parental supervision is one of the factors that may affect the occurrence of unintentional injuries. The aim of our study was to compare the degree of parental supervision estimated subjectively by health care professionals and the degree measured objectively using a questionnaire validated for this purpose. The ultimate objective was to determine the need to use questionnaires to act more efficiently to address risk factors. MATERIAL AND METHODS: we conducted an observational, cross-sectional and analytic study to assess the agreement between the degree of parental supervision perceived by paediatricians and the degree measured using the Parental Supervision Attributes Profile Questionnaire (PSAPQ), which has been adapted and validated for use in Spanish translation. RESULTS: we found no correlation between the agreement between the degree of parental supervision perceived by paediatricians and the degree measured using the PSAPQ. CONCLUSIONS: validated methods need to be used to objectively measure the risk factors involved in unintentional injuries in children, including the degree of parental supervision, in order to avoid perception biases and address these factors as efficiently as possible

Salivary Testosterone and Cortisol as Biomarkers for the Diagnosis of Sarcopenia and Sarcopenic Obesity in Community-Dwelling Older Adults.

Nowadays, the appearance of sarcopenia (S) or sarcopenic obesity (SO) is related to aging. According to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP), the feasibility of using salivary cortisol and testosterone levels was analyzed as diagnostic biomarkers of S or SO. One hundred and ninety non-institutionalized people aged ≥65 years were studied, independent of the activities of daily living (ADLs) (Barthel > 60), and sociodemographic variables were determined together with criteria for the diagnosis of S and SO including grip force, lower body strength, appendicular skeletal muscle mass, physical performance, total body fat percentage, body mass index (BMI), waist circumference, and triceps skinfold, together with the levels of salivary cortisol and testosterone. Our results reflected that women presented a higher prevalence of S and SO (21.2% and 30.2%, respectively). A significant difference was observed between salivary testosterone levels and the age of the participants with differences by sex. Testosterone values in men with S and SO were significantly lower (p = 0.043 and p = 0.048, respectively), which suggests a potential use of the biomarker for diagnostic purposes. No significant differences were shown with cortisol values.

Prevalence of Sarcopenia in Community-Dwelling Older Adults in Valencia, Spain.

This study is an observational and cross-sectional study on the prevalence of sarcopenic disease in 202 autonomous older adults; 18.8 and 81.2% were men and women, respectively, living in their own homes in Valencia, Spain. Sarcopenia was diagnosed using the criteria and cutting points for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), using the tests: SARC-F, grip strength, sit-to-stand, gait speed, appendicular skeletal muscle mass and short physical performance battery. According to the EWGSOP2 criteria, probable sarcopenia was present in 21.1% and 18.3% of men and women, respectively, and the sum of confirmed and severe sarcopenia was 7.9% and 7.3% in men and in women, respectively. A relationship was shown between the prevalence of the disease and the age of the participants, but no significant differences were found between the sum of confirmed and severe sarcopenia between the sexes, nor a relationship between the amount of muscle mass and the strength of grip. The SARC-F questionnaire diagnosed 40% of the sarcopenia cases present in the study. More thorough research is needed to continue using the EWGSOP2 criteria in different populations to establish a correct prevalence of sarcopenic disease in different populations of the world.

Predictive model for risk of cesarean section in pregnant women after induction of labor.

PURPOSE: To develop a predictive model for risk of cesarean section in pregnant women after induction of labor. METHODS: A retrospective cohort study was conducted of 861 induced labors during 2009, 2010, and 2011 at Hospital "La Mancha-Centro" in Alcázar de San Juan, Spain. Multivariate analysis was used with binary logistic regression and areas under the ROC curves to determine predictive ability. Two predictive models were created: model A predicts the outcome at the time the woman is admitted to the hospital (before the decision to of the method of induction); and model B predicts the outcome at the time the woman is definitely admitted to the labor room. RESULTS: The predictive factors in the final model were: maternal height, body mass index, nulliparity, Bishop score, gestational age, macrosomia, gender of fetus, and the gynecologist's overall cesarean section rate. The predictive ability of model A was 0.77 [95% confidence interval (CI) 0.73-0.80] and model B was 0.79 (95% CI 0.76-0.83). The predictive ability for pregnant women with previous cesarean section with model A was 0.79 (95% CI 0.64-0.94) and with model B was 0.80 (95% CI 0.64-0.96). For a probability of estimated cesarean section ≥80%, the models A and B presented a positive likelihood ratio (+LR) for cesarean section of 22 and 20, respectively. Also, for a likelihood of estimated cesarean section ≤10%, the models A and B presented a +LR for vaginal delivery of 13 and 6, respectively. CONCLUSION: These predictive models have a good discriminative ability, both overall and for all subgroups studied. This tool can be useful in clinical practice, especially for pregnant women with previous cesarean section and diabetes.

[Endogenous endophthalmitis: case report and brief review of a serious ocular disease]. / Endoftalmitis endógenas: revisión de una serie de casos y revaloración de una entidad ocular grave.

INTRODUCTION: Endogenous endophthalmitis (EE) is a prevalent but serious disease. Our aim was to describe cases of EE, with emphasis in the risk factors and the improvement of the prognosis. METHODS: A review of EE cases was done between 1996-2011 in a secondary care hospital in Spain. The reported variables were: comorbidities, isolated microorganisms, susceptibility to antimicrobial treatment and visual prognosis. RESULTS: 9 cases of EE were analyzed. All had some underlying disease, diabetes mellitus being the most frequent. Seven of the nine cases had a history of eye injury. Extraocular source of infection was identified in 7 cases, with predominantly gastrointestinal disease. Most microorganisms were isolated from blood cultures. The visual prognosis was unfavorable in five patients and was associated with virulent microorganisms and delayed treatment. CONCLUSIONS: EE is a rare disease that involve immunocompromised patients with ophthalmic disease. To improve prognosis, appropriate diagnosis and early treatment is require. Therefore, we recommend funduscopy examination in patients with sepsis, risk factors and prior history of ocular disease.

Endoftalmitis endógenas: revisión de una serie de casos y revaloración de una entidad ocular grave / Endogenous endophthalmitis: case report and brief review of a serious ocular disease

Endogenous endophthalmitis (EE) is a prevalent but serious disease. Our aim was to describe cases of EE, with emphasis in the risk factors and the improvement of the prognosis. Methods: A review of EE cases was done between 1996-2011 in a secondary care hospital in Spain. The reported variables were: comorbidities, isolated microorganisms, susceptibility to antimicrobial treatment and visual prognosis. Results: 9 cases of EE were analyzed. All had some underlying disease, diabetes mellitus being the most frequent. Seven of the nine cases had a history of eye injury. Extraocular source of infection was identified in 7 cases, with predominantly gastrointestinal disease. Most microorganisms were isolated from blood cultures. The visual prognosis was unfavorable in five patients and was associated with virulent microorganisms and delayed treatment. Conclusions: EE is a rare disease that involve immunocompromised patients with ophthalmic disease. To improve prognosis, appropriate diagnosis and early treatment is require. Therefore, we recommend funduscopy examination in patients with sepsis, risk factors and prior history of ocular disease.

La endoftalmitis endógena (EE) es una patología poco prevalente aunque grave. Nuestro objetivo es describir los casos de EE diagnosticados en un hospital secundario español, con particular atención a los factores de riesgo y la posible mejora del pronóstico. Material y Métodos: Revisamos las historias clínicas de los pacientes diagnosticados de EE entre 1996-2011. Las variables recogidas fueron: co-morbilidades, microorganismo/s aislados y su susceptibilidad a los antimicrobianos, tratamiento administrado y pronóstico visual. Resultados: Se estudiaron nueve casos de EE. Todos presentaban alguna enfermedad de base, siendo diabetes mellitus la más frecuente. Siete de los nueve casos presentaron antecedentes de lesión ocular. La probable fuente extraocular se identificó en siete casos, predominando el foco gastrointestinal. La mayoría de microorganismos se aisló de hemocultivos. El pronóstico visual fue desfavorable en cinco pacientes, asociándose a microorganismos virulentos y al retraso terapéutico. Conclusiones: La EE es una enfermedad inusual que afecta a pacientes con inmunidad disminuida y antecedentes oftalmológicos. Para mejorar el pronóstico se requiere un diagnóstico acertado y un tratamiento precoz, todo un reto para médicos clínicos y microbiólogos. Por ello, recomendamos realizar un fondo de ojo a los pacientes con sepsis, factores de riesgo de EE y antecedentes de patología ocular.

[Mental illness, personality traits and quality of life in epilepsy: control study of patients with juvenile myoclonic epilepsy and other epilepsies]. / Enfermedad mental, rasgos de personalidad y calidad de vida en epilepsia: estudio control de pacientes con epilepsia mioclonica juvenil y otras epilepsias.

INTRODUCTION: The association of epilepsy with mental illness is described for years. Current is trying to relate certain epilepsies, such as juvenile myoclonic epilepsy (JME) with certain personality traits marked by emotional instability. SUBJECTS AND METHODS: We study a group of patients with JME and his mental state, with emphasis on the personality traits, presence of clinical anxiety or depression and quality of life, with other epilepsy patients versus a control group. RESULTS: Patients with epilepsy have more marked personality traits and symptoms of anxiety and depression, making a more negative assessment of their quality of life than the control group. Patients with others epilepsy have a higher other personality disorder and a poorer perception of their quality of life than patients with JME. CONCLUSIONS: Differences are obtained among patients with epilepsy and control groups in all the variables analyzed (personality, anxiety, depression and quality of life). JME patients have better scores on personality and quality of life than those in the other group of epilepsies.

TITLE: Enfermedad mental, rasgos de personalidad y calidad de vida en epilepsia: estudio control de pacientes con epilepsia mioclonica juvenil y otras epilepsias.Introduccion. La asociacion de epilepsia con enfermedad mental esta descrita desde hace años. En la actualidad, se intenta relacionar ciertas epilepsias, como la epilepsia mioclonica juvenil (EMJ), con determinados rasgos de personalidad marcados por la inestabilidad afectiva. Sujetos y metodos. Se estudia un grupo de pacientes con EMJ y su estado mental, con especial interes sobre los rasgos de personalidad, la presencia de clinica de ansiedad o depresion, y la calidad de vida, junto con otros pacientes diagnosticados de otras epilepsias, asi como frente a un grupo control. Resultados. Los pacientes con epilepsia presentan rasgos de personalidad mas marcados, asi como sintomas de ansiedad y depresion, y realizan una valoracion mas negativa de su calidad de vida respecto al grupo control. Los pacientes con otras epilepsias presentan una mayor alteracion de la personalidad y una peor percepcion de su calidad de vida que los pacientes con EMJ. Conclusiones. Se obtienen diferencias entre los pacientes con epilepsia y el grupo control en todas las variables analizadas (personalidad, ansiedad, depresion y calidad de vida). Los pacientes con EMJ presentan mejores puntuaciones en personalidad y calidad de vida que los pertenecientes al grupo de otras epilepsias.

Rendimiento diagnóstico de los hallazgos ecográficos de los nódulos tiroideos en la detección de lesiones malignas / Diagnostic efficiency of sonographic findings of thyroid nodules in the detection of malignancy

Objetivo Evaluar el rendimiento diagnóstico de los hallazgos ecográficos (tamaño nodular, existencia de microcalcificaciones y ecogenicidad) en relación con el resultado de las citologías tiroideas obtenidas por punción aspiración con aguja fina. Metodología Fueron analizados los resultados de las citologías y las características ecográficas de 341 nódulos tiroideos. Resultados El 25,5% de las citologías fueron insuficientes, el 65,1% benignas y el 7,9% sospechosas y malignas. El porcentaje de muestras insuficientes fue claramente mayor en los nódulos menores de 15mm, pero también fue mayor el de citologías malignas entre este grupo de menor tamaño (11,1 frente al 2,8%; p=0,04). Entre los menores de 10mm, el porcentaje de muestras insuficientes se elevó hasta el 66,7% y no se detectó ninguna maligna. Destacó la ausencia de citologías sospechosas o malignas en los nódulos hiperecoicos y los anecoicos. La hipoecogenicidad fue, por el contrario, el rasgo de ecogenicidad que se asoció más frecuentemente con malignidad. Aunque la ecogenicidad en su conjunto no se asoció significativamente con la malignidad (p=0,313). La mayoría (6 de 10) de los casos con microcalcificaciones tuvo diagnóstico de malignidad frente a 4 de los 239 casos (1,7%) sin calcificaciones (p<0,001). En un modelo multivariante de regresión logística, la única variable que retuvo la significación estadística en su relación con la malignidad de la citología fue la presencia de microcalcificaciones. Conclusiones La citología tiroidea es un método eficaz para evaluar los nódulos tiroideos mayores de 10mm. La presencia de microcalcificaciones intranodulares se asocia significativamente con malignidad, mientras que la hiperecogenicidad y la anecogenicidad lo hacen con benignidad (AU)

Objetive To evaluate the diagnostic efficiency of sonographic findings (nodule size, the presence of microcalcifications and echogenicity) compared with the results of fine-needle aspiration biopsy (FNAB) of thyroid nodules. Methods The results of cytology and the ultrasound characteristics of 341 thyroid nodules were analyzed. Results A total of 25.5% of the FNAB were inadequate, 65.1% were benign and 7.9% were suspicious or malignant. The percentage of inadequate samples was clearly larger in nodules smaller that 15 mm but that of malignant cytologies was also larger in this group of nodules (11.1 versus 2.8%: p=0.04). The percentage of inadequate samples among nodules smaller than 10 mm was 66.7% and no malignancies were detected. A notable finding was the absence of suspicious or malignant FNAB in hyperechogenic and anechogenic nodules. In contrast, the echogenic feature most frequently associated with malignancy was hypoechogenicity, although echogenicity, as a whole, was not significantly associated with malignancy (p=0.313). Most cases with microcalcifications (6 of 10) were malignant compared with four of the 239 nodules (1.7%) without calcifications (p<0.001). Multivariate logistic regression revealed that the only variable maintaining a significant association with malignancy was the presence of microcalcifications. Conclusions Thyroid cytology is an efficient method to evaluate thyroid nodules larger than 10mm. The presence of nodule microcalcifications is significantly associated with malignancy, while hyperechogenicity and anechogenicity are associated with benign nodules (AU)

[Diagnostic efficiency of sonographic findings of thyroid nodules in the detection of malignancy]. / Rendimiento diagnóstico de los hallazgos ecográficos de los nódulos tiroideos en la detección de lesiones malignas.

OBJECTIVE: To evaluate the diagnostic efficiency of sonographic findings (nodule size, the presence of microcalcifications and echogenicity) compared with the results of fine-needle aspiration biopsy (FNAB) of thyroid nodules. METHODS: The results of cytology and the ultrasound characteristics of 341 thyroid nodules were analyzed. RESULTS: A total of 25.5% of the FNAB were inadequate, 65.1% were benign and 7.9% were suspicious or malignant. The percentage of inadequate samples was clearly larger in nodules smaller that 15 mm but that of malignant cytologies was also larger in this group of nodules (11.1 versus 2.8%: p=0.04). The percentage of inadequate samples among nodules smaller than 10 mm was 66.7% and no malignancies were detected. A notable finding was the absence of suspicious or malignant FNAB in hyperechogenic and anechogenic nodules. In contrast, the echogenic feature most frequently associated with malignancy was hypoechogenicity, although echogenicity, as a whole, was not significantly associated with malignancy (p=0.313). Most cases with microcalcifications (6 of 10) were malignant compared with four of the 239 nodules (1.7%) without calcifications (p<0.001). Multivariate logistic regression revealed that the only variable maintaining a significant association with malignancy was the presence of microcalcifications. CONCLUSIONS: Thyroid cytology is an efficient method to evaluate thyroid nodules larger than 10 mm. The presence of nodule microcalcifications is significantly associated with malignancy, while hyperechogenicity and anechogenicity are associated with benign nodules.