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https://www.readbyqxmd.com/read/28401718/compliance-to-clinical-pathways-in-the-management-of-suspected-pulmonary-embolus-are-there-cost-implications
#1
Ata Rehman, Eric Yelf, Jacqueline Pearson, Wilf Yeo
This study investigated the cost implications of poor compliance to established guidelines for management of suspected pulmonary embolism (PE) in two NSW public hospitals. A retrospective audit showed that the prevalence of PE overall was 9.9% (4.3% in the low-risk groups) in 436 patients. An estimated total of $32 454 (14%) was spent on unnecessary tests.
April 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28375573/delayed-tsh-recovery-after-dose-adjustment-during-tsh-suppressive-levothyroxine-therapy-of-thyroid-cancer
#2
Hye In Kim, Tae Hyuk Kim, Hosu Kim, Young Nam Kim, Hye Won Jang, Jung-Han Kim, Kyu Yeon Hur, Jae Hoon Chung, Sun Wook Kim
BACKGROUND: Delayed thyroid-stimulating hormone (TSH) recovery during treatment of Graves' disease is caused by long-term excessive thyroid hormone, which results in down-regulation of pituitary thyrotropes. However, it is unknown whether delayed TSH recovery exists after levothyroxine (LT4) dose reduction in differentiated thyroid cancer (DTC) patients after long-term TSH suppression. METHODS: We retrospectively reviewed 97 DTC patients with LT4 dose reduction after long-term TSH suppression...
April 4, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28323957/risk-profile-of-the-ret-a883f-germline-mutation-an-international-collaborative-study
#3
Jes Sloth Mathiesen, Mouhammed Amir Habra, John Howard Duncan Bassett, Sirazum Mubin Choudhury, Sabapathy Prakash Balasubramanian, Trevor A Howlett, Bruce G Robinson, Anne-Paule Gimenez-Roqueplo, Frederic Castinetti, Peter Vestergaard, Karin Frank-Raue
Context: The A883F germline mutation of the REarranged during Transfection proto-oncogene causes multiple endocrine neoplasia 2B. In the revised American Thyroid Association (ATA) guidelines for the management of medullary thyroid carcinoma (MTC) the A883F mutation has been reclassified from the highest to high risk level, although no well-defined risk profile for this mutation exists. Objective: To create a risk profile for the A883F mutation for appropriate classification in the ATA risk levels...
March 17, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28285385/real-time-elastography-in-autonomously-functioning-thyroid-nodules-relationship-with-tsh-levels-scintigraphy-and-ultrasound-patterns
#4
Pierpaolo Trimboli, Gaetano Paone, Maria Chiara Zatelli, Luca Ceriani, Luca Giovanella
BACKGROUND: Real-time elastography has been proposed to increase the sensitivity of ultrasound and improve the detection of thyroid nodules at risk of malignancy. To date sparse data on real-time elastography assessment of autonomously functioning thyroid nodules exist. Here, we investigated the potential role of real-time elastography in autonomously functioning thyroid nodule assessment. Specifically, the correlation between serum hormones and real-time elastography score, as well as other clinical and ultrasound features, was analyzed...
March 11, 2017: Endocrine
https://www.readbyqxmd.com/read/28276947/assessment-of-depression-anxiety-quality-of-life-and-coping-in-long-standing-multiple-endocrine-neoplasia-type-2-patients
#5
Karine C Rodrigues, Rodrigo A Toledo, Flavia L Coutinho, Adriana B Nunes, Rui M B Maciel, Ana O Hoff, Marcos C Tavares, Sergio P A Toledo, Delmar M Lourenço
BACKGROUND: Data on psychological harm in multiple endocrine neoplasia type 2 (MEN2) are scarce. OBJECTIVES: The aim of this study was to assess anxiety, depression, quality of life, and coping in long-standing MEN2 patients. PATIENTS AND METHODS: Patients were 43 adults (age ≥18 years) with clinical and genetic diagnosis of MEN2 and long-term follow-up (10.6 ± 8.2 years; range 1-33 years). This was a cross-sectional study with qualitative and quantitative psychological assessment using semi-directed interviews and HADS, EORTC QLQ C30, and MINI-MAC scales...
April 4, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28271054/association-of-diabetes-mellitus-and-structural-changes-in-the-central-nervous-system-in-children-and-adolescents-a-systematic-review
#6
REVIEW
Ata Pourabbasi, Mehdi Tehrani-Doost, Soqra Ebrahimi Qavam, Seyed Masoud Arzaghi, Bagher Larijani
BACKGROUND: The relationship between diabetes and academic performance have been of great interest to researchers during the year to date. Many studies have been conducted to discover this relationship during three recent decades. But, evaluation of the structural changes of brain in the context of diabetes is of paramount importance especially in children and adolescents. METHODS: This study is a systematic review conducted to investigate the structural changes in the central nervous system in children and adolescents living with diabetes...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28149805/radioguided-sentinel-lymph-node-biopsy-in-patients-with-papillary-thyroid-carcinoma
#7
Mattia Portinari, Paolo Carcoforo
BACKGROUND: The ATA guidelines do not recommend prophylactic central compartment neck dissection in patients with T1-T2 papillary thyroid carcinoma (PTC) with no clinical evidence of lymph node metastasis, however patients' staging is recommended. Lymph node metastasis may be present also in small PTC, but preoperative ultrasound identifies suspicious cervical lymphadenopathy in 20-30% of patients. The role of sentinel lymph node biopsy (SLNB) remain open to debate. It has been shown that the identification rate of SLN in PTC patients is improved using a radiotracer compared to a dye technique...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28135763/the-cyp2c19-2-and-cyp2c19-17-polymorphisms-play-a-vital-role-in-clopidogrel-responsiveness-after-percutaneous-coronary-intervention-a-pharmacogenomics-study
#8
Faruk Saydam, İrfan Değirmenci, Alparslan Birdane, Mahmut Özdemir, Taner Ulus, Cansu Özbayer, Ertuğrul Çolak, Necmi Ata, Hasan Veysi Güneş
Clopidogrel inhibits platelet activation and aggregation by blocking the P2Y12 receptor. Dual antiplatelet therapy with clopidogrel and aspirin is recommended treatment by current guidelines for patients undergoing percutaneous interventions. Recurrent ischaemic cardiac events after this treatment showed lack of clopidogrel responsiveness. We aimed to investigate the most noticeable variants in the genes involved in clopidogrel pharmacokinetics and pharmacodynamics. 347 Turkish patients who underwent percutaneous coronary interventions with stent implantation were included in our study...
January 30, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28127634/ultrasound-risk-stratification-for-malignancy-using-the-2015-american-thyroid-association-management-guidelines-for-children-with-thyroid-nodules-and-differentiated-thyroid-cancer
#9
Jennifer E Lim-Dunham, Iclal Erdem Toslak, Khalid Alsabban, Amany Aziz, Brendan Martin, Gokcan Okur, Katherine C Longo
BACKGROUND: The 2015 American Thyroid Association (ATA) Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer provides selection criteria for nodules prior to ultrasound-guided fine-needle aspiration biopsy. OBJECTIVE: To evaluate the diagnostic performance of pediatric thyroid nodule risk stratification for predicting malignancy when applying the ultrasound (US) criteria recommended. MATERIALS AND METHODS: US characteristics of 39 thyroid nodules in 33 pediatric patients who underwent US fine-needle aspiration biopsy were reviewed by two radiologists...
January 27, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28118554/thyroid-ultrasound-guided-fine-needle-aspiration-cytology-results-observed-increase-in-indeterminate-rate-over-the-past-decade
#10
Amy M Manning, Huaitao Yang, Mercedes Falciglia, Jonathan R Mark, David L Steward
Objectives To evaluate changes in distribution of reported thyroid nodule fine-needle aspiration (FNA) cytopathology results since implementation of the Bethesda classification and revised 2015 American Thyroid Association (ATA) guidelines for selecting nodules for biopsy. Study Design Retrospective review. Setting Tertiary academic medical center. Subjects and Methods Evaluation of ultrasound (US)-guided thyroid FNA by a single surgeon using 2015 ATA nodule selection criteria and Bethesda reporting on 211 thyroid nodules in a 1-year period (2015)...
April 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28114862/american-thyroid-association-guidelines-on-the-management-of-thyroid-nodules-and-differentiated-thyroid-cancer-task-force-review-and-recommendation-on-the-proposed-renaming-of-encapsulated-follicular-variant-papillary-thyroid-carcinoma-without-invasion-to-noninvasive
#11
Bryan R Haugen, Anna M Sawka, Erik K Alexander, Keith C Bible, Patrizio Caturegli, Gerard M Doherty, Susan J Mandel, John C Morris, Aziza Nassar, Furio Pacini, Martin Schlumberger, Kathryn Schuff, Steven I Sherman, Hilary Somerset, Julie Ann Sosa, David L Steward, Leonard Wartofsky, Michelle D Williams
American Thyroid Association (ATA) leadership asked the ATA Thyroid Nodules and Differentiated Thyroid Cancer Guidelines Task Force to review, comment on, and make recommendations related to the suggested new classification of encapsulated follicular variant papillary thyroid carcinoma (eFVPTC) without capsular or vascular invasion to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). The task force consists of members from the 2015 guidelines task force with the recusal of three members who were authors on the paper under review...
April 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28092116/changes-in-thyroid-cancer-incidence-post-2009-american-thyroid-association-guidelines
#12
Lucy L Shi, Carol DeSantis, Ahmedin Jemal, Amy Y Chen
BACKGROUND: The thyroid cancer incidence rate has tripled in the United States since the 1980s, especially among women and small-sized tumors. This trend has been attributed to increased detection due to the availability of ultrasound and fine-needle aspiration technology. In 2009, the American Thyroid Association (ATA) released revisions to their guidelines for well-differentiated thyroid cancers. OBJECTIVE: To examine trends in thyroid cancer incidence rates by tumor size and gender following the 2009 ATA guideline revisions...
January 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28081173/effect-of-rifampin-on-thyroid-function-test-in-patients-on-levothyroxine-medication
#13
Hye In Kim, Tae Hyuk Kim, Hosu Kim, Young Nam Kim, Hye Won Jang, Jae Hoon Chung, Seong Mi Moon, Byung Woo Jhun, Hyun Lee, Won-Jung Koh, Sun Wook Kim
BACKGROUND: Levothyroxine (LT4) and rifampin (RIF) are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose. METHODS: We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association (ATA)/American Association of Clinical Endocrinologists (AACE) guidelines were identified, and risk factors of increased LT4 dose were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28056690/2017-guidelines-of-the-american-thyroid-association-for-the-diagnosis-and-management-of-thyroid-disease-during-pregnancy-and-the-postpartum
#14
Erik K Alexander, Elizabeth N Pearce, Gregory A Brent, Rosalind S Brown, Herbert Chen, Chrysoula Dosiou, William A Grobman, Peter Laurberg, John H Lazarus, Susan J Mandel, Robin P Peeters, Scott Sullivan
BACKGROUND: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception, and the postpartum period...
March 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28024119/accuracy-of-international-ultrasound-risk-stratification-systems-in-thyroid-lesions-cytologically-classified-as-indeterminate
#15
Pierpaolo Trimboli, Franco Fulciniti, Valentina Zilioli, Luca Ceriani, Luca Giovanella
BACKGROUND: Eminent international societies have published their thyroid ultrasound risk stratification system (US-RSS) to give a friendly tool for thyroidologists. In particular, American Thyroid Association (ATA), American Association Clinical Endocrinologists/American College of Endocrinologists and Associazione Medici Endocrinologi (AACE/ACE/AME), British Thyroid Association (BTA), and Thyroid Imaging Reporting and Data System (TIRADS) are often adopted for clinical practice. The reliability of these US-RSS has not been evaluated in discriminating cancers from benignancy in nodules with indeterminate FNA...
February 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/27896825/is-it-time-to-reconsider-lobectomy-in-low-risk-paediatric-thyroid-cancer
#16
Wouter P Kluijfhout, Jesse D Pasternak, Danielle van der Kaay, Menno R Vriens, Evan J Propst, Jonathan D Wasserman
OBJECTIVE: Current guidelines recommend total thyroidectomy for nearly all children with well-differentiated thyroid cancer (WDTC). These guidelines, however, derive from older data accrued prior to current high-resolution imaging. We speculate that there is a subpopulation of children who may be adequately treated with lobectomy. DESIGN: Retrospective analysis of prospectively maintained database. PATIENTS: Seventy-three children with WDTC treated between 2004 and 2015...
November 29, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27870977/longitudinal-treatment-patterns-with-adp-receptor-inhibitors-after-myocardial-infarction-insights-from-the-canadian-observational-antiplatelet-study
#17
Akshay Bagai, Tracy Y Wang, Shaun G Goodman, Harold N Fisher, Robert C Welsh, Jean-Pierre Dery, Xiang Zhang, Yajun E Zhu, Asim N Cheema, Payam Dehghani, Saleem A Kassam, John Ducas, Neil Brass, Hahn Hoe Kim, Anthony Fung, Erick Schampaert, Ata Ur Rehman Quraishi, Shamir R Mehta
BACKGROUND: After myocardial infarction (MI) treated with percutaneous coronary intervention (PCI), guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and an ADP receptor inhibitor (ADPri) for at least 1year. However, whether real-world Canadian practice patterns reflect this recommendation is unknown. METHODS: We studied 2175 MI patients treated with PCI and discharged from 26 Canadian hospitals between 12/2011 and 05/2013 in the Canadian Observational Antiplatelet sTudy (COAPT)...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27835925/response-to-therapy-status-is-an-excellent-predictor-of-pregnancy-associated-structural-disease-progression-in-patients-previously-treated-for-differentiated-thyroid-cancer
#18
Luba Rakhlin, Stephanie Fish, R Michael Tuttle
BACKGROUND: Pregnancy may be associated with an increased risk of recurrence/progression of differentiated thyroid cancer (DTC). However, it is unclear if the impact of pregnancy would differ based on pre-pregnancy response to therapy status. The objective of this study was to investigate the risk of recurrence/progression of DTC, applying the response to therapy assessments to pre-pregnancy status as recommended by the 2015 American Thyroid Association thyroid cancer guidelines. METHODS: This was a retrospective review of 235 women followed at Memorial Sloan Kettering Cancer Center for DTC who had a term pregnancy after initial treatment for DTC between 1997 and 2015...
March 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27804016/ultrasonography-scoring-systems-can-rule-out-malignancy-in-cytologically-indeterminate-thyroid-nodules
#19
Giorgio Grani, Livia Lamartina, Valeria Ascoli, Daniela Bosco, Francesco Nardi, Ferdinando D'Ambrosio, Antonello Rubini, Laura Giacomelli, Marco Biffoni, Sebastiano Filetti, Cosimo Durante, Vito Cantisani
PURPOSE: To assess the accuracy and reproducibility of ultrasonography classification systems in characterizing cytologically indeterminate thyroid nodules. METHODS: We retrospectively identified 49 nodules that had been surgically resected owing to features classified as indeterminate according to 2010 Italian Consensus on Thyroid Cytology criteria. Three experienced sonographers independently reviewed original sonographic images of each nodule and classified it using the 2015 American Thyroid Association (ATA) guidelines and the Thyroid Imaging Reporting and Data System (TI-RADS) classification proposed by Korean radiologists; later, images were reviewed jointly to obtain consensus classifications of each nodule...
October 31, 2016: Endocrine
https://www.readbyqxmd.com/read/27758032/temporal-analysis-of-thyroid-cancer-management-in-a-melbourne-tertiary-centre
#20
James C Lee, Paula Chang, Simon Grodski, Meei Yeung, William Johnson, Jonathan Serpell
BACKGROUND: The American Thyroid Association (ATA) management guidelines for thyroid cancer were revised in 2009. The aim of this study was to determine if management of thyroid cancer in our institution has changed in accordance with the introduction of the revised ATA guidelines (ATA(2009) ), and to compare the characteristics and management of thyroid cancer in a Melbourne endocrine surgery unit over a 7-year period. METHODS: All patients treated by the Monash University Endocrine Surgery Unit for thyroid cancer between 2007 and 2013 were divided into two groups - the pre-ATA(2009) group (2007-2010) and the post-ATA(2009) group (2011-2013)...
October 18, 2016: ANZ Journal of Surgery
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