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1.
Nature ; 578(7796): 489-490, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32099132
2.
Ophthalmic Surg Lasers Imaging Retina ; 50(11): 734-736, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31755973

RESUMO

Standard implementation of the M-CHARTS metamorphopsia tool presents patients with only vertical and horizontal lines, potentially overlooking distortions not occurring within those precise meridians. The authors propose rotating the M-CHARTS testing booklet about the central fixation point until maximal distortion is perceived, after which sequential M-CHARTS testing can take place along that same axis. In a symptomatic patient with residual parafoveal fluid cysts after release of vitreomacular traction, M-CHARTS testing yielded standard testing scores of 0 (false-negative); upon rotating the reference test line, a score of 0.3 was measured at the 30° meridian. The authors believe this modification of the original methodology is more sensitive and more accurately reflects the severity of a patient's distortions. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:734-736.].


Assuntos
Transtornos da Visão/diagnóstico , Testes Visuais/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Resultados Negativos
3.
BMC Infect Dis ; 19(1): 867, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638903

RESUMO

BACKGROUND: The therapeutic response of cervical tuberculous lymphadenitis (CTBL) may be delayed or paradoxical, with the frequent development of residual lymph nodes (LNs) during and after antituberculous treatment. We investigated the incidence of residual LNs and the clinical, radiological, microbiological, and pathologic responses of patients with CTBL after 6 months of antituberculous therapy. METHODS: The medical records of HIV-negative adult patients with CTBL diagnosed between July 2009 and December 2017 were analyzed. After 6 months of first-line antituberculous treatment, computed tomography (CT) scans were conducted to evaluate for residual LNs. Fine-needle aspiration biopsy (FNAB) was carried out if a patient presented with residual LNs > 10 mm in diameter with central necrosis, peripheral rim enhancement, or perinodal inflammation on CT scan. RESULTS: Residual LNs were detected in 35 of 157 patients who underwent follow-up CT scans and were more commonly observed in younger patients who completed the treatment (mean years ± standard deviation [SD]: 33 ± 13 vs. 44 ± 16, p < 0.001). The recurrence rate was approximately 5%, which was not significantly different in both groups. Among the 15 patients who underwent FNAB, 3 (30%) presented with granuloma, and 2 of 15 and 10 of 14 patients had positive AFB and TB PCR results, respectively. The TB culture results of 15 patients were negative. CONCLUSIONS: Residual LNs may still be observed after 6 months of antituberculous treatment. Although the radiologic and pathologic findings after treatment are still indicative of TB, not all residual LNs indicate recurrence or treatment failure. A six-month therapy may be sufficient for cervical tuberculous lymphadenitis.


Assuntos
Antituberculosos/uso terapêutico , HIV/imunologia , Linfonodos/patologia , Tuberculose dos Linfonodos/tratamento farmacológico , Adulto , Biópsia por Agulha Fina , Progressão da Doença , Feminino , Seguimentos , Granuloma/diagnóstico por imagem , Humanos , Inflamação/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Necrose/diagnóstico por imagem , Resultados Negativos , Estudos Prospectivos , Recidiva , Testes Sorológicos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose dos Linfonodos/diagnóstico
6.
Cochrane Database Syst Rev ; 6: CD011751, 2019 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-31173336

RESUMO

BACKGROUND: Lung cancer is one of the most common causes of death from cancer worldwide. Smoking induces and aggravates many health problems, including vascular diseases, respiratory illnesses and cancers. Tobacco smoking constitutes the most important risk factor for lung cancer. Most people with lung cancer are still active smokers at diagnosis or frequently relapse after smoking cessation. Quitting smoking is the most effective way for smokers to reduce the risk of premature death and disability. People with lung cancer may benefit from stopping smoking. Whether smoking cessation interventions are effective for people with lung cancer and whether one method of quitting is more effective than any other has not been systematically reviewed. OBJECTIVES: To determine the effectiveness of smoking cessation programmes for people with lung cancer. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (accessed via PubMed) and Embase up to 22 December 2018. We also searched the American Society of Clinical Oncology (ASCO) Annual Meeting proceedings, the lung cancer sections of the proceedings of the ESMO Congress, the lung cancer sections of the proceedings of the European Conference of Clinical Oncology (ECCO) Congress, the World Conference on Lung Cancer proceedings, the Society for Research on Nicotine and Tobacco Annual Meeting from 2013, the Food and Drug Administration website, the European Medicine Agency for drug registration website, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal, ClinicalTrials.gov, and the metaRegister of Controlled Trials (mRCT) to 30 December 2018. We applied no restriction on language of publication. SELECTION CRITERIA: We planned to include any randomised controlled trial (RCT) of any psychosocial or pharmacological smoking cessation intervention or combinations of both, compared with no intervention, a different psychosocial or pharmacological (or both) intervention or placebo for pharmacological interventions in people with lung cancer. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the studies from the initial search for potential trials for inclusion. We planned to use standard methodological procedures expected by Cochrane. We found no trials that met the inclusion criteria. MAIN RESULTS: We identified no RCTs that met our inclusion criteria. Among the 1817 records retrieved using our search strategy, we retrieved 19 studies for further investigation. We excluded 15 trials: ten trials because we could not distinguish people with lung cancer from the other participants, or the participants were not people with lung cancer, four because they were not randomised, or RCTs. We excluded one trial because, though it was completed in 2004, no results are available. We assessed four ongoing trials for inclusion when data become available. AUTHORS' CONCLUSIONS: There were no RCTs that determined the effectiveness of any type of smoking cessation programme for people with lung cancer. There was insufficient evidence to determine whether smoking cessation interventions are effective for people with lung cancer and whether one programme is more effective than any other. People with lung cancer should be encouraged to quit smoking and offered smoking cessation interventions. However, due to the lack of RCTs, the efficacy of smoking cessation interventions for people with lung cancer cannot be evaluated and concluded. This systematic review identified a need for RCTs to explore these.


Assuntos
Neoplasias Pulmonares , Abandono do Hábito de Fumar , Humanos , Resultados Negativos , Fumar/efeitos adversos
7.
Clin Exp Nephrol ; 23(10): 1250-1256, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31250147

RESUMO

OBJECTIVES: Low fetuin-A levels in hemodialysis patients can be associated with development of vascular and valvular calcifications. The mechanisms underlying vascular and valvular calcifications are multifactorial. There are a few studies showing the relationship between low fetuin-A levels and valvular calcification after kidney transplantation. We aimed to evaluate the association between serum fetuin-A levels and valvular calcification in kidney transplant recipients. METHODS: The cardiac valvular calcification was assessed by echocardiography in 56 recipients. Patients were divided into two groups as those with (n = 11) and without (n = 45) aortic and/or mitral valve calcification. The extent of valvular calcification was visually assessed according to the standard visual score method: moderately (multiple larger spots) and heavily calcified (extensive thickening and calcification) of all cusps. Serum fetuin-A levels were measured. RESULTS: The demographic features of both groups were comparable. There was no significant difference between regular physical exercise (63.6% vs. 55.6%), obesity (18.2% vs. 17.8%), abdominal obesity (54.5% vs. 46.7%), smoking (0% vs. 13.3%), hypertension (63.6% vs. 68.9%), left ventricular hypertrophy (45.5% vs. 33.3%) and diabetes mellitus (9.1% vs. 20%) ratios in groups with or without valvular calcification, respectively (p > 0.05). Fetuin-A levels of both groups did not differ. Fetuin-A levels positively correlated with serum creatinine (r 0.326, p = 0.014), and negatively correlated with estimated glomerular filtration rate (r - 0.297, p = 0.026). CONCLUSIONS: We could not find a relationship between serum fetuin-A levels and valvular calcification in kidney recipients. In this population, further studies are needed to assess the role of serum fetuin-A in valvular calcification.


Assuntos
Calcinose/sangue , Doenças das Valvas Cardíacas/sangue , Transplante de Rim , alfa-2-Glicoproteína-HS/análise , Adulto , Calcinose/diagnóstico por imagem , Cálcio/sangue , Creatinina/sangue , Ecocardiografia , Feminino , Taxa de Filtração Glomerular , Doenças das Valvas Cardíacas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Resultados Negativos , Fatores de Risco
8.
Rev. iberoam. micol ; 36(2): 61-65, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185477

RESUMO

Background: The gold standard for the sporotrichosis diagnosis is culture; however, serologic approaches have been recently implemented to aid in the sporotrichosis diagnosis. Nevertheless, the clinical consequences of the introduction of serologic tests are poorly addressed. Aims: To correlate the results of culture and serology of patients with suspected sporotrichosis. Methods: A retrospective study of 198 patients with suspected sporotrichosis was conducted. Information about culture isolation of Sporothrix from clinical samples and antibody detection by an enzyme-linked immunosorbent assay (ELISA) were obtained from the medical records of the patients. Results: Positive culture and antibody detection was observed in the samples of 84 patients (42.4%). Forty-one samples (20.7%) showed negative results with both techniques and divergent results were obtained in the samples of 73 patients (36.9%). False negative results in the ELISA were observed with 23 patients (31.5%), 78.3% of them with less than 30 days of infection (p = 0.0045). Among the initial false positive ELISA in the sera of 50 patients, four samples in culture yielded the growth of Sporothrix, and 27 improved with itraconazole. At the end of follow-up, a diagnosis of proven or probable sporotrichosis was established in 139 patients, and possible sporotrichosis in 11 patients. The treatment of the patients with probable sporotrichosis with antifungal drugs resulted in clinical cure for these individuals. Conclusions: These two techniques are complementary in the diagnosis of sporotrichosis, making diagnosis and clinical decision more precise


Antecedentes: El método de referencia en el diagnóstico de la esporotricosis es el cultivo, aunque las técnicas serológicas pueden complementar el diagnóstico. Sin embargo, la interpretación de las pruebas serológicas en la práctica clínica y en el diagnóstico de la enfermedad necesitan un abordaje más eficiente. Objetivos: Correlacionar los resultados del cultivo y la serología en pacientes con posibles síntomas de esporotricosis. Métodos: Se realizó un estudio retrospectivo de 198 pacientes con posibles síntomas de esporotricosis. Para establecer el diagnóstico se tuvieron en cuenta el aislamiento de Sporothrix a partir de las muestras clínicas y la detección de anticuerpos anti-Sporothrix realizados por un análisis de inmunoabsorción enzimática (ELISA), datos todos ellos registrados en las respectivas historias clínicas. Resultados: Los cultivos y la detección de anticuerpos fueron positivos en 84 pacientes (42,4%). Las muestras de 41 pacientes (20,7%) resultaron negativas con ambas técnicas y en 73 pacientes (36,9%) los resultados fueron divergentes. Se obtuvieron resultados falsos negativos en el ELISA en 23 pacientes (31,5%), el 78,3% de ellos con menos de 30días de infección (p = 0,0045). De los 50 pacientes con un resultado falso positivo en el ELISA, en 4 de ellos se obtuvo cultivo positivo de Sporothrix y 27 mejoraron con itraconazol. Al finalizar el estudio se estableció un diagnóstico de esporotricosis, que fue probada o probable en 139 pacientes y posible en 11 pacientes. El tratamiento de pacientes con esporotricosis probable con fármacos antifúngicos produjo la cura clínica de estos individuos. Conclusiones: Estos dos métodos son complementarios en el diagnóstico de la esporotricosis y ayudan a la toma de las decisiones clínicas más acertadas


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Micologia/métodos , Testes Sorológicos/estatística & dados numéricos , Esporotricose , Esporotricose/diagnóstico , Anticorpos Antifúngicos/análise , Antifúngicos/uso terapêutico , Estudos Transversais , Ensaio de Imunoadsorção Enzimática/estatística & dados numéricos , Reações Falso-Positivas , Itraconazol/uso terapêutico , Resultados Negativos/estatística & dados numéricos , Estudos Retrospectivos , Esporotricose/imunologia , Esporotricose/tratamento farmacológico
9.
Am J Otolaryngol ; 40(4): 536-541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31036419

RESUMO

PURPOSE: As imaging technology improves and more thyroid nodules and malignancies are identified, it is important to recognize factors associated with malignancy and poor prognosis. Vitamin D has proven useful as a prognostic tool for other cancers and may be similarly useful in thyroid cancer. This study explores the relationship of Vitamin D to papillary thyroid carcinoma stage while accounting for socioeconomic covariates. MATERIALS AND METHODS: The medical records of all patients who underwent thyroidectomy at one institution between 2000 and 2015 were reviewed. Subjects with non-papillary thyroid cancer pathology, prior malignancy, and without Vitamin D levels were excluded. The remaining 334 patient records were examined for cancer stage, Vitamin D levels, Vitamin D deficiency listed in history, and demographic and comorbid factors. RESULTS: Vitamin D laboratory values showed no significant relationship to cancer stage (p = 0.871), but patients with Vitamin D deficiency documented in the medical record were more likely to have advanced disease (28.6% versus 14.7%; p = 0.028). The patients with documented Vitamin D deficiency also had lower 25-hydroxyvitamin D nadirs (21.5 ng/mL versus 26.5 ng/mL, p = 0.008) and were more likely to be on Vitamin D supplementation (92.6% versus 41.8%, p < 0.001). CONCLUSIONS: The results suggest that Vitamin D deficiency may have value as a negative prognostic indicator in papillary thyroid cancer and that pre-operative laboratory evaluation may be less useful. This is important because Vitamin D deficiency is modifiable. While different racial subgroups had different rates of Vitamin D deficiency, neither race nor socioeconomic status showed correlation with cancer stage.


Assuntos
Resultados Negativos , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Deficiência de Vitamina D , Adulto , Idoso , Biomarcadores Tumorais/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Fatores Socioeconômicos , Câncer Papilífero da Tireoide/etiologia , Neoplasias da Glândula Tireoide/etiologia , Vitamina D/sangue , Deficiência de Vitamina D/complicações
10.
Rev Iberoam Micol ; 36(2): 61-65, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31078386

RESUMO

BACKGROUND: The gold standard for the sporotrichosis diagnosis is culture; however, serologic approaches have been recently implemented to aid in the sporotrichosis diagnosis. Nevertheless, the clinical consequences of the introduction of serologic tests are poorly addressed. AIMS: To correlate the results of culture and serology of patients with suspected sporotrichosis. METHODS: A retrospective study of 198 patients with suspected sporotrichosis was conducted. Information about culture isolation of Sporothrix from clinical samples and antibody detection by an enzyme-linked immunosorbent assay (ELISA) were obtained from the medical records of the patients. RESULTS: Positive culture and antibody detection was observed in the samples of 84 patients (42.4%). Forty-one samples (20.7%) showed negative results with both techniques and divergent results were obtained in the samples of 73 patients (36.9%). False negative results in the ELISA were observed with 23 patients (31.5%), 78.3% of them with less than 30 days of infection (p=0.0045). Among the initial false positive ELISA in the sera of 50 patients, four samples in culture yielded the growth of Sporothrix, and 27 improved with itraconazole. At the end of follow-up, a diagnosis of proven or probable sporotrichosis was established in 139 patients, and possible sporotrichosis in 11 patients. The treatment of the patients with probable sporotrichosis with antifungal drugs resulted in clinical cure for these individuals. CONCLUSIONS: These two techniques are complementary in the diagnosis of sporotrichosis, making diagnosis and clinical decision more precise.


Assuntos
Micologia/métodos , Testes Sorológicos , Sporothrix/isolamento & purificação , Esporotricose/diagnóstico , Adolescente , Adulto , Idoso , Anticorpos Antifúngicos/análise , Antifúngicos/uso terapêutico , Criança , Pré-Escolar , Estudos Transversais , Ensaio de Imunoadsorção Enzimática/estatística & dados numéricos , Reações Falso-Positivas , Feminino , Humanos , Itraconazol/uso terapêutico , Masculino , Pessoa de Meia-Idade , Resultados Negativos/estatística & dados numéricos , Estudos Retrospectivos , Testes Sorológicos/estatística & dados numéricos , Sporothrix/imunologia , Esporotricose/tratamento farmacológico , Adulto Jovem
11.
Zhonghua Yi Xue Za Zhi ; 99(19): 1499-1501, 2019 May 21.
Artigo em Chinês | MEDLINE | ID: mdl-31137142

RESUMO

Objective: To analyze the indication and the outcome of trans-sphenoidal surgery (TSS) in Cushing's disease (CD) with negative high dose dexamethasone suppression tests (HDDST) results. Methods: Eighteen cases of ACTH-dependent Cushing's syndrome (CS) with negative HDDST results in the Department of Neurosurgery in Shanghai Ruijin Hospital from January 2015 to December 2017 were retrospectively reviewed. All patients underwent TSS. There were 5 males and 13 females, with an average age of (41±14) years. Results: All patients underwent bilateral inferior petrosal sinus sampling (BIPSS) before the surgery and got evidence of pituitary origin of ACTH secretion. They were thus indicated for TSS. Immediate post-operative remission was achieved in ratio 17/18. There were no recurrences within a flow-up of 1 to 3 years. Pituitary ACTH secreting adenomas were pathologically confirmed in 15 cases, including the one who did not achieve post-operative remission. Thus, all 18 patients with negative HDDST results can finally be confirmed as CD. Conclusions: HDDST alone is not sufficient to eliminate CD. For patients with ACTH-dependent CS with negative HDDST results, BIPSS should be further performed. The fact of post-operative remission and the pathological confirm of ACTH secreting pituitary adenoma may add final evidence to the diagnosis of CD.


Assuntos
Síndrome de Cushing , Neoplasias Hipofisárias , Hormônio Adrenocorticotrópico , Adulto , China , Dexametasona , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultados Negativos , Amostragem do Seio Petroso , Estudos Retrospectivos
13.
BMC Public Health ; 19(1): 411, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30991987

RESUMO

BACKGROUND: In Scotland a new, easier to complete bowel screening test, the Faecal Immunochemical Test (FIT), has been introduced. This test gives more accurate information about an individual's risk of having colorectal cancer (CRC), based on their age and gender, and could lead to fewer missed cancers compared to the current screening test. However, there is no evidence of the effect on colonoscopy uptake of providing individuals with personalised risk information following a positive FIT test. The objectives of the study are: 1) To develop novel methods of presenting personalised risk information in an easy-to-understand format using infographics with involvement of members of the public 2) To assess the impact of different presentations of risk information on informed choice and intention to take up an offer of colonoscopy after FIT 3) To assess participants' responses to receiving personal risk information (knowledge, attitudes to screening/risk, emotional responses including anxiety). METHODS: Adults (age range 50-74) registered on the Scottish Bowel Screening database will be invited by letter to take part. Consenting participants will be randomised to one of three groups to receive hypothetical information about their risk of cancer, based on age, gender and faecal haemoglobin concentration: 1) personalised risk information in numeric form (e.g. 1 in 100) with use of infographics, 2) personalised information described as 'highest', 'moderate' or 'lowest' risk with use of infographics, and 3) as a 'positive' test result, as is current practice. Groups will be compared on informed choice, intention to have a colonoscopy, and satisfaction with their decision. Follow-up semi-structured qualitative interviews will be conducted, by telephone, with a small number of consenting participants (n = 10 per group) to explore the acceptability/readability and any potential negative impact of the risk information, participants' understanding of risk factors, attitudes to the different scenarios, and reasons for reported intentions. DISCUSSION: Proving personalised risk information and allowing patient choice could lead to improved detection of CRC and increase patient satisfaction by facilitating informed choice over when/whether to undergo further invasive screening. However, we need to determine whether/how informed choice can be achieved and assess the potential impact on the colonoscopy service. TRIAL REGISTRATION: The trial is registered on www.isrctn.com on 08/12/2017. Registration no: ISRCTN14254582.


Assuntos
Protocolos Clínicos , Colonoscopia/métodos , Neoplasias Colorretais/diagnóstico , Tomada de Decisões , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/organização & administração , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultados Negativos , Sangue Oculto , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Escócia
14.
Behav Cogn Psychother ; 47(5): 559-572, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30871650

RESUMO

BACKGROUND: Psychological treatments provide many benefits for patients with psychiatric disorders, but research also suggests that negative effects might occur from the interventions involved. The Negative Effects Questionnaire (NEQ) has previously been developed as a way of determining the occurrence and characteristics of such incidents, consisting of 32 items and six factors. However, the NEQ has yet to be examined using modern test theory, which could help to improve the understanding of how well the instrument works psychometrically. AIMS: The current study investigated the reliability and validity of the NEQ from both a person and item perspective, establishing goodness-of-fit, item bias, and scale precision. METHOD: The NEQ was distributed to 564 patients in five clinical trials at post-treatment. Data were analysed using Rasch analysis, i.e. a modern test theory application. RESULTS: (1) the NEQ exhibits fairness in testing across sociodemographics, (2) shows comparable validity for a final and condensed scale of 20 instead of 32 items, (3) uses a rating scale that advances monotonically in steps of 0 to 4, and (4) is suitable for monitoring negative effects on an item-level. CONCLUSIONS: The NEQ is proposed as a useful instrument for investigating negative effects in psychological treatments, and its newer shorter format could facilitate its use in clinical and research settings. However, further research is needed to explore the relationship between negative effects and treatment outcome, as well as to test it in more diverse patient populations.


Assuntos
Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Psicologia/métodos , Psicometria/métodos , Inquéritos e Questionários/normas , Adulto , Feminino , Humanos , Masculino , Resultados Negativos , Reprodutibilidade dos Testes , Falha de Tratamento
15.
Endocr Pathol ; 30(2): 134-137, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30825100

RESUMO

Molecular tests and mutational panels such as Afirma Gene Expression Classifier (GEC) and ThyroSeq, respectively, have been used to help risk stratify cytologically indeterminate thyroid nodules with the aim to reduce unnecessary surgeries. We studied the effect of molecular testing on the rate of surgical resection in these nodules. Thyroid nodules with indeterminate (Bethesda III/IV) cytology that underwent molecular testing (GEC or ThyroSeq) at our institution between June 2012 and August 2016 were retrospectively reviewed. We collected demographics, cytology diagnoses, molecular test results, and whether surgical resection was performed. Two hundred eighty-three nodules met inclusion criteria: 202 nodules tested with GEC and 81 tested with ThyroSeq. In the cohort of GEC-tested nodules, 99/202 (49%) yielded "suspicious" and 103/202 (51%) yielded "benign" results, with an overall resection rate of 70/99 (71%) in "suspicious" versus 13/103 (13%) in "benign" nodules. In the cohort of ThyroSeq-tested nodules, 13/81 (16%) of nodules yielded a "high-risk mutation" and 68/81 (84%) of nodules yielded "no high-risk mutation," with overall resection rates of 11/13 (85%) and 30/68 (44%), respectively. Rates of resection were higher for Bethesda IV than for III nodules, regardless of molecular results. For both GEC and ThyroSeq, molecular test results seemed to correlate with the rate of resection at our institution. Rates of resection for cytologically indeterminate nodules that were "benign" or "no high-risk mutation" appeared to differ from those that were "suspicious" or "high-risk mutation" on molecular panel testing by GEC and ThyroSeq, respectively. Our findings support that molecular test results are impacting management.


Assuntos
Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/cirurgia , Biópsia por Agulha Fina , Estudos de Coortes , Humanos , Mutação/genética , Resultados Negativos , Patologia Molecular/métodos , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento
16.
Psychon Bull Rev ; 26(2): 693-698, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30903584

RESUMO

Duffy, Huttenlocher, Hedges, and Crawford (2010, Psychonomic Bulletin & Review, 17[2], 224-230) examined whether the well-established central tendency bias in people's reproductions of stimuli reflects bias toward the mean of an entire presented distribution or bias toward only recently seen stimuli. They reported evidence that responses were biased toward the long-run mean and found no evidence that they were biased toward the most recent stimuli. Duffy and Smith (2018) reexamine the data using a different analytical strategy and argue that estimates are biased by recent stimuli rather than toward the long-run mean. I argue that this reanalysis misses a true effect of the running mean and that the data are (mostly) consistent with the claims in the original work. I suggest that these results, and many other null results presented by Duffy and Smith, do not have major theoretical significance for the category adjustment model and similar Bayesian models. (Code and data available: https://osf.io/tkqvn .).


Assuntos
Resultados Negativos , Teorema de Bayes , Viés , Coleta de Dados
17.
Neurology ; 92(18): 827-828, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-30926682
18.
Br J Neurosurg ; 33(2): 119-124, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30784332

RESUMO

Purpose of the article: To determine whether intraoperative ventilation with pure oxygen during the last stage of surgery reduces the occurrence and volume of postoperative pneumocephalus when compared to conventional air/oxygen mixture in patients undergoing craniotomy. MATERIAL AND METHODS: prospective randomized single-blinded study to compare the rate of occurrence and volume of postoperative pneumocephalus in patients undergoing craniotomy receiving intraoperative ventilation with pure oxygen (Group B) versus a conventional air/oxygen 1:1 mixture (Group A) during the last stage of surgery. This trial was registered in ClinicalTrials.gov #NCT02722928, protocol number 2015H0032. RESULTS: One hundred patients were randomized into group 'A' and group 'B'. Seventy patients were included in the final analysis with 39 patients allocated in group 'A' and 31 patients in group 'B'. Median and IQR were used for postoperative penumocephalus volume. Group A: 9.65 [3.61-23.20]; Group B: 7.06 [2.70-20.1]. Our study showed no prophylactic effect on postoperative pneumocephalus volume when using mechanical ventilation with higher oxygen concentrations than the standard FiO2 during the last stage of surgery in patients undergoing craniotomy (p = .47). No statistical difference was found in SICU LOS between groups (median 1,380 min [group A] versus 1,524 min [group B]; p = .18). CONCLUSION: The use of intraoperative mechanical ventilation with pure oxygen was not associated with a prophylactic effect on the occurrence and extent of postoperative pneumocephalus in our patient setting. Published literature describing the extent of postoperative pneumocephalus is limited or highly variable among institutions.


Assuntos
Craniotomia , Oxigenoterapia/métodos , Pneumocefalia/epidemiologia , Pneumocefalia/etiologia , Complicações Pós-Operatórias/epidemiologia , Respiração Artificial/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultados Negativos , Procedimentos Neurocirúrgicos/métodos , Pneumocefalia/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Método Simples-Cego
20.
Endocr Pathol ; 30(2): 113-117, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30694510

RESUMO

C cell hyperplasia is considered a precursor lesion for hereditary forms of medullary thyroid carcinoma. It has therefore been suggested as a morphological marker to distinguish hereditary from sporadic medullary thyroid carcinoma and to triage genetic testing in resource poor settings. However, numerous definitions for C cell hyperplasia have been suggested, and there is surprisingly little data regarding the number of C cells present in thyroid glands removed for conditions other than medullary carcinoma. We therefore sought to investigate the specificity of different criteria for C cell hyperplasia. We examined the number of C cells and solid cell nests (ultimobranchial body remnants) present in 118 completion thyroidectomy specimens from patients without medullary carcinoma and with no risk factors for MEN2. Morphological review was performed on all H&E-stained slides, and immunohistochemistry for calcitonin was performed on one block from each case. Solid cell nests were found in 4 (3.3%) of thyroids. Increased numbers of C cells sufficient to fulfil criteria for C cell hyperplasia were found in 5 (4.2%) to 36 (30.5%) cases depending on the criteria used. We conclude that large numbers of C cells are commonly found in thyroids not associated with medullary carcinoma. Therefore, regardless of which criteria are used, the presence of C cell hyperplasia is not a specific marker for hereditary medullary thyroid carcinoma.


Assuntos
Carcinoma Medular/congênito , Carcinoma Neuroendócrino/patologia , Neoplasia Endócrina Múltipla Tipo 2a/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Carcinoma Medular/patologia , Carcinoma Medular/cirurgia , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Hiperplasia/patologia , Hiperplasia/cirurgia , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasia Endócrina Múltipla Tipo 2a/cirurgia , Resultados Negativos , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Adulto Jovem
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