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Allison C Sylvetsky, Rebecca J Brown, Jenny E Blau, Mary Walter, Kristina I Rother
BACKGROUND: Non-nutritive sweeteners (NNS), especially in form of diet soda, have been linked to metabolic derangements (e.g. obesity and diabetes) in epidemiologic studies. We aimed to test acute metabolic effects of NNS in isolation (water or seltzer) and in diet sodas. METHODS: We conducted a four-period, cross-over study at the National Institutes of Health Clinical Center (Bethesda, Maryland). Thirty healthy adults consumed 355 mL water with 0 mg, 68 mg, 170 mg, and 250 mg sucralose, and 31 individuals consumed 355 mL caffeine-free Diet Rite Cola™, Diet Mountain Dew™ (18 mg sucralose, 18 mg acesulfame-potassium, 57 mg aspartame), and seltzer water with NNS (68 mg sucralose and 41 mg acesulfame-potassium, equivalent to Diet Rite Cola™) in randomized order, prior to oral glucose tolerance tests...
2016: Nutrition & Metabolism
Do Hoon Koo, KwangSeop Song, Hyungju Kwon, Dong Sik Bae, Ji-Hoon Kim, Hye Sook Min, Kyu Eun Lee, Yeo-Kyu Youn
Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A-E on the basis of maximal diameter on ultrasound (≤0...
2016: International Journal of Endocrinology
Marc Pusztaszeri, Esther Diana Rossi, Manon Auger, Zubair Baloch, Justin Bishop, Massimo Bongiovanni, Ashish Chandra, Beatrix Cochand-Priollet, Guido Fadda, Mitsuyoshi Hirokawa, SoonWon Hong, Kennichi Kakudo, Jeffrey F Krane, Ritu Nayar, Sareh Parangi, Fernando Schmitt, William C Faquin
The Bethesda System for Reporting Thyroid Cytology (TBSRTC) was proposed in 2007 at the National Cancer Institute Thyroid Fine Needle Aspiration State of the Art and Science Conference held in Bethesda, Maryland. The aim was to address the inconsistent and sometimes confusing reporting terminologies used for thyroid FNA throughout the world. The TBSRTC consists of 6 diagnostic categories, each associated with an implied risk of malignancy that translates directly into a clinical management algorithm. Since the publication of the TBSRTC cytology Atlas in January 2010, considerable experience has been gained regarding its application in cytology practice, clinical impact, and limitations...
October 21, 2016: Acta Cytologica
Soo Yeon Hahn, Jung Hee Shin, Hyun Kyung Lim, So Lyung Jung, Young Lyun Oh, In Ho Choi, Chan Kwon Jung
BACKGROUND: A recent concept was proposed that the non-invasive encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) reclassified as "non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is benign. Our aim was to identify the differences between NIFTP and non-NIFTP preoperatively. METHODS: This retrospective study included a total of 208 patients with 208 FVPTCs that were surgically confirmed at 3 university hospitals from 2008 through 2014...
October 19, 2016: Clinical Endocrinology
J-S Pyo, J H Sohn, G Kang
PURPOSE: The aim of this study was to elucidate the cytological characteristics and the diagnostic usefulness of intraoperative cytology (IOC) for papillary thyroid carcinoma (PTC). In addition, using decision tree analysis, effective features for accurate cytological diagnosis were sought. METHODS: We investigated cellularity, cytological features and diagnosis based on the Bethesda System for Reporting Thyroid Cytopathology in IOC of 240 conventional PTCs. The cytological features were evaluated in terms of nuclear score with nuclear features, and additional figures such as presence of swirling sheets, psammoma bodies, and multinucleated giant cells...
October 19, 2016: Journal of Endocrinological Investigation
Alborz Jooya, Joe Saliba, Audrey Blackburn, Michael Tamilia, Michael P Hier, Alex Mlynarek, Véronique-Isabelle Forest, Louise Rochon, Anca Florea, Hangjun Wang, Richard J Payne
BACKGROUND: Management decisions are not straightforward when the Ultrasound Guided Fine Needle Aspiration (USFNA) demonstrates a Bethesda score of either category III or IV, and a diagnostic hemi-thyroidectomy or a repeat USFNA (r-USFNA) could be performed. The aim of this study is to assess the effectiveness of r-USFNA in the management of indeterminate thyroid nodules by evaluating the likelihood of obtaining a definite diagnosis. METHODS: We reviewed the medical records of all patients with thyroid nodules between 2011 and 2015 at the Jewish General Hospital (Montreal, Canada)...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Kwang Hwi Lee, Dong Wook Kim, Jin Wook Baek, Yoo Jin Lee, Hye Jung Choo, Young Jun Cho, Sun Joo Lee, Young Mi Park, Soo Jin Jung, Hye Jin Baek
BACKGROUND: To date, appropriate management for Bethesda IV thyroid nodules is controversial, and no specific features of follicular neoplasm and nodular hyperplasia on ultrasonography, computed tomography (CT), or other imaging modalities have been reported. This study aimed to compare CT features of follicular neoplasm and nodular hyperplasia and to determine the specific CT features that could be used to distinguish follicular neoplasm from nodular hyperplasia. METHODS: In 122 patients who underwent preoperative CT of the neck and thyroid surgery, 59 follicular neoplasms and 65 nodular hyperplasias were included...
October 3, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Jason T Hamamoto, Timothy Leroux, Jorge Chahla, Sanjeev Bhatia, John D Higgins, Anthony A Romeo, Adam B Yanke, Nikhil N Verma
The preoperative assessment of anterior glenoid bone loss is a critical step in surgical planning for patients with recurrent anterior glenohumeral instability. The structural integrity of the glenoid has been identified as one of the most important factors influencing the success of operative repair. The currently accepted gold standard for glenoid structural assessment among most orthopaedic surgeons is the use of 3-dimensional reconstructed computed tomography images with the humeral head digitally subtracted, yielding an en face sagittal oblique view of the glenoid...
August 2016: Arthroscopy Techniques
Lester D R Thompson, Hannah B Herrera, Sean K Lau
Carcinomas arising from thyroglossal duct remnant cysts (TGDCs) are rare, without well-defined management and staging criteria. All TGDCs (n = 685) diagnosed between 2005 and 2015 were retrospectively reviewed, with 22 carcinomas identified (3.2 % incidence). Twenty-two patients (17 females, 5 males), aged 12-64 years (mean 39.9 years; median 39 years) were identified. An anterior, superior midline neck mass was the presenting symptom in all patients. A cancer diagnosis [all papillary thyroid carcinoma (PTC)] was made after the Sistrunk procedure (SP), with a Bethesda Category V or VI classification preoperatively by fine needle aspiration in 5 of 12 cases tested...
October 4, 2016: Head and Neck Pathology
Dariusz Janczak, Wiktor Pawlowski, Tadeusz Dorobisz, Dawid Janczak, Karolina Dorobisz, Michal Leśniak, Agnieszka Ziomek, Mariusz Chabowski
BACKGROUND: Thyroid cancer (TC) comprises 1% of all carcinomas and is the most common malignancy of the endocrine system. The disease is more common in women, with its peak morbidity observed in 40-50-year-old patients. The main risk factors include radiation, iodine deficiency, hereditary background, and genetic mutations. Among all diagnosed thyroid nodules, 5%-30% will evolve into cancer. The gold-standard procedure in the preoperative evaluation of a nodular goiter, apart from ultrasonography, is fine needle aspiration (FNA) biopsy...
2016: OncoTargets and Therapy
Ellen J Eckes, Debbie Gutierrez, Ann Peterson, Melissa Hubbard, Kevin Barrett, Ann Marie Matlock
Nurses manage patients with common infectious diseases by following institutional guidelines based on expert advice, evidence in the literature, and a wealth of experience. Today nurses are challenged to provide care to patients with multidrug-resistant organisms and virulent infectious diseases such as Ebola virus disease. Management of some patients with virulent infectious diseases occurs in the context of minimal experience with the pathogen, course of infection, diagnostics, nursing care, and treatment...
October 2016: Critical Care Nurse
Sujay Kakarmath, Howard T Heller, Caroline A Alexander, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta, Neal I Lindeman, Mary C Frates, Carol B Benson, Atul A Gawande, Nancy L Cho, Matthew Nehs, Francis D Moore, Ellen Marqusee, Mathew I Kim, P Reed Larsen, Norra Kwong, Trevor E Angell, Erik K Alexander
CONTEXT: Mutations in the BRAF and RAS oncogenes are responsible for most well-differentiated thyroid cancer. Yet, our clinical understanding of how BRAF-positive and RAS-positive thyroid cancers differ is incomplete. OBJECTIVE: We correlated clinical, radiographic, and pathologic findings from patients with thyroid cancer harboring a BRAF or RAS mutation. DESIGN: Prospective cohort study Setting: Academic, tertiary care hospital Patients: 101 consecutive patients with well-differentiated thyroid cancer Main Outcome Measure: We compared the clinical, sonographic, and pathologic characteristics of patients with BRAF-positive cancer to those with RAS-positive cancer...
September 30, 2016: Journal of Clinical Endocrinology and Metabolism
Elliot A Krauss, Megan Mahon, Jean M Fede, Lanjing Zhang
CONTEXT: -Fine-needle aspiration (FNA) biopsies have been an important component in the preoperative evaluation of thyroid nodules. Until the introduction of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) in 2008, individual institutions had developed their own diagnostic categories. The BSRTC proposed 6 categories in an attempt to standardize reporting of thyroid FNA. OBJECTIVE: -To present a 15-year experience of thyroid FNA at one institution, including data before and after introduction of the BSRTC...
October 2016: Archives of Pathology & Laboratory Medicine
Nicholas J Olson, Donna Robert, Amin A Hedayat, Xiaoying Liu, Deborah L Ornstein
Factor V inhibitors are rare and have varied clinical presentations. We report on a 76-year-old female admitted to the hospital for pneumonia and treated with multiple antibiotics. Her baseline prothrombin time was 15.6 s and the activated partial thromboplastin time was 35 s. On admission day 10, she developed arm weakness and brain imaging showed a subdural hematoma. The prothrombin time was now 59.1 s with an activated partial thromboplastin time of more than 160 s and a normal thrombin time. A mixing study did not correct the clotting times and coagulation factor assays showed a nonspecific inhibition pattern...
September 24, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
B Evranos, S B Polat, H Baser, D Ozdemir, A Kilicarslan, A Yalcin, R Ersoy, B Cakir
BACKGROUND: A fine needle aspiration biopsy (FNAB) is the most valuable diagnostic procedure for pre-operative discrimination of benign and malignant nodules. The Bethesda System for Reporting Thyroid Cytopathology provides standardised reporting and cytomorphological criteria in aspiration smears. The aim of the present study was to determine malignancy rates in nodules with different cytology results and evaluate the diagnostic value of Bethesda for variants of papillary thyroid carcinoma (PTC)...
September 25, 2016: Cytopathology: Official Journal of the British Society for Clinical Cytology
Travis M Cotton, Jing Xin, John Sandyhya, Roy Lirov, Barbara S Miller, Mark S Cohen, Paul G Gauger, David T Hughes
BACKGROUND: The utility of frozen section (FS) for indeterminate thyroid nodules is controversial. In 2009, the Bethesda System for Reporting Thyroid Cytopathology was established to further subcategorize indeterminate fine-needle aspiration results (follicular lesions, FL) into Bethesda category 3 (BC3) and Bethesda category 4 (BC4). We hypothesize that FS will have less utility in the evaluation of BC3 lesions when compared to BC4. MATERIALS AND METHODS: A total of 479 patients who underwent thyroid lobectomy from January 2008 to July 2014 were retrospectively reviewed...
October 2016: Journal of Surgical Research
Leda Klouda, Wayne J Franklin, Anita Saraf, Dhaval R Parekh, David D Schwartz
OBJECTIVE: Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity...
September 21, 2016: Congenital Heart Disease
Michael Losos, Scott Scrape, Sarita Joshi, Aaron Shmookler, Jian Chen
Acquired hemophilia A (AHA) is a rare autoimmune disorder that leads to factor VIII (FVIII) deficiency via autoantibody formation. Standard treatment options include FVIII bypassing factors and immunosuppression. However, the role of therapeutic plasma exchange (TPE) is not clear in the treatment of AHA. We present a case of idiopathic AHA in a 66 year old female with severe bleeding and a FVIII inhibitor of 17.6 Bethesda units (BU). She failed to respond to standard treatment including maximum dose of recombinant FVIIa (rFVIIa), rituximab, and other immunosuppressive agents...
September 20, 2016: Journal of Clinical Apheresis
Katherine Witte Saylor
On October 30, 2015, the National Institutes of Health (NIH) convened a workshop "Multiple Approaches to Understanding and Preventing Elder Abuse" in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop...
September 16, 2016: Journal of Elder Abuse & Neglect
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