RESUMO
OBJECTIVES: This systematic review and meta-analysis aimed to determine the true risk of bleeding and nondiagnostic (ND) specimens associated with fine-needle aspiration cytology (FNAC) for neck lesions in patients taking antithrombotic/anticoagulation (AT/AC) medications. METHODS: Using the Population Intervention Comparison and Outcome modeling, we searched PubMed and Google Scholar databases to identify studies published between January 2000 and March 2023 reporting the safety and sample adequacy of FNAC for neck lesions in patients taking AT/AC medications. The pooled incidences of bleeding and ND specimens and pooled risk ratio (RR) with 95% confidence intervals (CIs) obtained using a fixed-effects model were compared for patients continuing AT/AC (AT/AC group) and patients not receiving AT/AC therapy (no-AT/AC group). RESULTS: We included six original articles involving a total of 3014 patients. The pooled incidence of bleeding was 0.9% (95% CI, 0.344-2.026) and 0.7% (95% CI, 0.390-1.146) in the AT/AC and no-AT/AC groups, respectively. The pooled RR under the fixed-effects model was 1.39 (95% CI, 0.56-3.44) with no evidence of between-study heterogeneity (I2 = 0.0%; p = 0.92). The pooled incidence of ND specimens was 7.6% (95% CI, 5.617-10.073) and 7.6% (95% CI, 6.511-8.752) in the AT/AC and no-AT/AC groups, respectively. The pooled RR under the fixed-effects model was 1.33 (95% CI, 0.98-1.81) with moderate between-study heterogeneity (I2 = 60.0%; p = 0.06). CONCLUSIONS: The AT/AC medication is not associated with increased risk of bleeding or ND specimens in FNAC for neck lesions. Therefore, interruption of the AT/AC medication is not recommended before FNAC even in patients taking AT/AC medications. CLINICAL RELEVANCE STATEMENT: This study is the first meta-analysis evaluating risk of bleeding and nondiagnostic specimens associated with fine-needle cytology for neck lesions in patients taking antithrombotic/anticoagulation (AT/AC) medications. This suggests withholding AT/AC medications is not mandatory for safe and diagnostic FNACs. KEY POINTS: ⢠True risk of fine-needle aspiration cytology (FNAC) for neck lesions in patients taking antithrombotic/anticoagulation (AT/AC) medications is still controversial. ⢠This meta-analysis demonstrated that maintaining AT/AC medication was not associated with increased risk in terms of both bleeding and nondiagnostic samples. ⢠Interruption of the AT/AC medication is not needed for safe and diagnostic FNAC for neck lesions even in patients taking AT/AC medications.
RESUMO
Graphene oxide quantum dots (GOQDs) are promising candidates for biomedical applications since they have lower toxicity and higher biocompatibility than traditional semiconductor quantum dots. However, oxygen functional groups such as epoxy and hydroxyl groups usually induce nonradiative relaxation, which leads to GOQDs exhibiting nonemissive properties. For the enhancement of the emission efficiency of GOQDs, the number of nonradiative relaxation sites should be reduced. This paper reports the synthesis of highly luminescent reduced GOQDs prepared by liquid-phase photoreduction (LPP-rGOQDs). First, GOQDs was fabricated from single-walled carbon nanotubes through chlorate-based oxidation and separation after acoustic cavitation. Subsequently, LPP-rGOQDs were obtained by liquid-phase photoreduction of the GOQD suspension under intense pulsed light irradiation. Liquid-phase photoreduction selectively reduced epoxy groups present on the basal plane of GOQDs, and hydrogenated the basal plane without removal of carbonyl and carboxyl groups at the edges of the GOQDs. Such selective removal of oxidative functional groups was used to control the reduction degree of GOQDs, closely related to their optical properties. The optimized LPP-rGOQDs were bright blue in color and showed quantum yields up to about 19.7%, which was 10 times the quantum yield of GOQDs. Furthermore, the LPP-rGOQDs were utilized to image a human embryonic kidney (HEK293A), and a low cytotoxicity level and satisfactory cell imaging performance were observed.