scholarly journals Twenty Years of Experience with the Preoperative Diagnosis of Medullary Cancer in a Moderately Iodine-Deficient Region

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tamas Solymosi ◽  
Gyula Lukacs Toth ◽  
Dezso Nagy ◽  
Istvan Gal
Keyword(s):  
Frozen Section ◽  
False Negative ◽  
Nodular Goiter ◽  
Current Debate ◽  
Serum Calcitonin ◽  
Hemodialyzed Patient ◽  
Medullary Cancer ◽  
Low Prevalence ◽  
A Current ◽  
Calcitonin Screening

Background. There is a current debate in the medical literature about plasma calcitonin screening in patients with nodular goiter (NG). We decided on analyzing our 20-year experience with patients in an iodine-deficient region (ID).Patients and Methods. 22,857 consecutive patients with NG underwent ultrasonography and aspiration cytology (FNAC). If FNAC raised suspicion of medullary cancer (MTC), the serum calcitonin was measured.Results. 4,601 patients underwent surgery; there were 23 patients among them who had MTC (0.1% prevalence). Significantly more MTC cases were diagnosed cytologically in the second decade than in the first: 11/12 and 6/11, respectively. The frozen section was of help in 2 cases out of 3. Two patients suffered from a 3-year delay in proper therapy, and reoperation was necessary in 1 case. FNAC raised the suspicion of MTC in 20 cases that were later histologically verified and did not present MTC. The diagnostic accuracy of FNAC in diagnosing MTC was 99.2%. Two false-positive serum calcitonin tests (one of them in a hemodialyzed patient) and one false-negative serum calcitonin test occurred in 40 cases.Conclusion. Regarding the low prevalence of MTC in ID regions, calcitonin screening of all NG patients does not only appear superfluously but may have more disadvantages than advantages.

scholarly journals False-Negative Frozen Section of Sentinel Nodes in Early Breast Cancer Patients

2021 ◽  
Author(s):  
Zhu-Jun Loh ◽  
Kuo-Ting Lee ◽  
Ya-Ping Chen ◽  
Yao-Lung Kuo ◽  
Wei-Pang Chung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Frozen Section ◽  
False Negative ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Frozen Sections ◽  
Sentinel Nodes ◽  
Tumor Emboli

Abstract Background: Sentinel lymph node biopsy (SLNB) is the standard approach of the axillary region for early breast cancer patients with clinically negative nodes. The present study investigated patients with false-negative sentinel nodes of intraoperative frozen section (FNSNs) in real-world data.Methods: A case–control study with a 1:3 ratio was conducted. FNSN was diagnosed when sentinel nodes (SNs) are negative in frozen sections but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) sections. The control was defined as having no metastasis of SNs in both frozen and FFPE sections.Results: A total of 20 FNSN cases and 60 matched controls were enrolled from 333 SLNB patients between April 1, 2005, and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between FNSN and controls. The FNSN patients had larger tumor sizes in preoperative mammography (P = 0.033) and more lymphatic tumor emboli in core biopsy (P < 0.001). Four FNSN patients had metastasis in the non-relevant SNs. Another 16 FNSN patients had benign lymphoid hyperplasia of SNs in frozen sections and metastasis in the same SNs from the FFPE sections. Micrometastasis was detected in seven of 16 patients, and metastases in non-relevant SNs were recognized in two patients. All FNSN patients received a second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed recurrence of breast cancer. The disease-free survival, disease-specific survival, and overall survival in FNSN were not inferior to the controls.Conclusions: The patients with a larger tumor size and more lymphatic tumor emboli have a higher incidence of FNSN. However, outcomes of FNSN patients after completing ALND were noninferior to those without metastasis in SNs. ALND provides a correct diagnosis of patients with metastasis in non-sentinel axillary lymph nodes.

scholarly journals Clinicopathological study of thyroid swelling and its management

2020 ◽  
Vol 6 (4) ◽  
pp. 727
Author(s):  
Seema Patel ◽  
Varsha J. Gattani ◽  
Ashok Z. Nitnaware
Keyword(s):  
Papillary Carcinoma ◽  
Surgical Management ◽  
False Negative ◽  
Malignant Lesion ◽  
Nodular Goiter ◽  
Follicular Neoplasm ◽  
Histopathological Diagnosis ◽  
Predictive Values ◽  
Neoplastic Lesion ◽  
Thyroid Swelling

<p class="abstract"><strong>Background:</strong> There is high prevalence of thyroid lesions in India. In this study, an attempt is made to find out the clinical spectrum of thyroid swellings in central India, diagnostic accuracy of fine needle aspiration cytology (FNAC), appropriate surgical management and to compare it with postoperative histopathological diagnosis so as to determine its role in surgical management.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 100 subjects presenting to ENT OPD of GMC, Nagpur during the period from September 2017 to August 2019 with thyroid swelling who were fit to undergo surgery and willing to participate in the study were selected. After detailed evaluation and routine investigations, thyroid function test (TFT), FNAC, ultrasonography (USG) neck, all the subjects underwent required thyroidectomy. The postoperative histopathological examination (HPE) report was correlated with cytological report.  </p><p class="abstract"><strong>Results:</strong> In 100 subjects, majority of subjects were from 4th decade (32%) with female: male ratio=6.14:1. FNAC findings were colloid goiter (61%), nodular goiter (19%), follicular neoplasm (10%), and papillary carcinoma (9%). On HPE, colloid goitre (57%) was most common non-neoplastic lesion and papillary carcinoma (65.21 %) was most common malignant lesion. Hemithyroidectomy (70%) was most common procedure done. Transient hypocalcemia (5%), recurrent laryngeal nerve (RLN) paresis (2%) were the postoperative complications encountered. Sensitivity, specificity, accuracy, positive and negative predictive values of FNAC to diagnose malignancy were 55.6%, 100%, 91%, 100% and 90% respectively.</p><p class="abstract"><strong>Conclusions:</strong> FNAC is an easy, rapid, reliable, cost-effective, minimally invasive and readily repeatable technique for diagnosis of thyroid swellings. The common false negative diagnosis is seen in follicular pattern cases, cystic papillary thyroid carcinoma (PTC) and papillary microcarcinoma.  </p>

scholarly journals SPEAKING – WRITING MODE: STRATEGIES IN TRANSFORMING SPOKEN AND WRITTEN LANGUAGE

2013 ◽  
Vol 7 (1) ◽  
pp. 58
Author(s):  
Siska Amelia Maldin
Keyword(s):  
Spoken Language ◽  
Written Language ◽  
Current Debate ◽  
Written Production ◽  
Good Writing ◽  
A Current

There is a tendency of cases in transforming spoken and written language. A current debate was proposed about the role. This debate derives from current phenomenon which shows evidence which is related with learner mastery in the particular skills. Some learners are able to produce spoken form of language fluently, however, when it comes to writing, it is seen that they find difficulties and get disturbance to put down ideas and elaborate the ideas into a good writing.  Hence, two questions arise. First, to what extent is the nature of spoken and written language? Second, what are strategies to help learners in transforming their spoken language to the written production? Therefore, this article is proposed to explain the nature of spoken and written language and present any strategies to help learners in transforming their spoken language into the written forms.

scholarly journals Evaluation of a step-by-step approach to frozen section diagnosis in ovarian masses

2021 ◽  
Vol 12 (12) ◽  
pp. 133-139
Author(s):  
Ashumi Gupta ◽  
Neelam Jain
Keyword(s):  
Sensitivity And Specificity ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Tertiary Care ◽  
False Negative ◽  
Significant Proportion ◽  
False Negative Rate ◽  
Accurate Diagnosis ◽  
Care Hospital ◽  
Ovarian Masses

Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females. It is often detected late due to non-specific clinical presentation. Radiology and tumor markers may indicate an ovarian mass. However, exact diagnosis requires pathological evaluation, which may not be possible before surgery. Intraoperative frozen section (FS) is, therefore, an important modality for the diagnosis of ovarian masses. Aims and Objectives: This study was conducted to study step-by-step approach along with diagnostic utility and accuracy of intraoperative FS in diagnosis of ovarian masses. Materials and Methods: Retrospective comparative analysis was done to determine the diagnostic accuracy of FS as compared to routine histopathology in the pathology department of a tertiary care hospital. Diagnostic categorization was done into benign, borderline, and malignant. Overall accuracy, sensitivity, and specificity of FS technique were calculated. Results: Out of 51 cases, FS analysis yielded accurate diagnosis in 94.1% of ovarian masses. Intraoperative FS had a sensitivity of 94.7%, specificity of 96.9%, 3.1% false-positive rate, and 5.3% false-negative rate in malignant tumors. In benign lesions, FS had 91.7% sensitivity and 100% specificity. FS had 75% sensitivity and 96.4% specificity in cases of borderline tumors. Conclusion: FS is a fairly accurate technique for intraoperative evaluation of ovarian masses. It can help in deciding the extent of surgery. It distinguishes benign and malignant tumors in most cases with high sensitivity and specificity. A methodical approach is useful in determining accurate diagnosis on FS diagnosis.

Prenatal and genetic diagnostics and trisomia 21: a current debate of ethical and psychosocial implications with reference to Greece

2019 ◽  
pp. 369-380
Author(s):  
Gerasimos Kolaitis ◽  
Stelios Christogiorgos ◽  
Vassiliki Vassilopoulou ◽  
Eugenia Soumaki ◽  
John Tsiantis
Keyword(s):  
Genetic Diagnostics ◽  
Current Debate ◽  
Psychosocial Implications ◽  
A Current

scholarly journals Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years

2005 ◽  
Vol 8 (8) ◽  
pp. 1275-1285 ◽  
Author(s):  
Jodi Dunmeyer Stookey ◽  
Carl F Pieper ◽  
Harvey Jay Cohen
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
The Elderly ◽  
Community Dwelling ◽  
Plasma Sodium ◽  
Current Debate ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Low Prevalence ◽  
Community Dwelling Older Adults

AbstractObjectiveThe fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.DesignCross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.ResultsDepending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.ConclusionsThe true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.

Entrepreneurial Orientation in Family Firms: Looking at a European Outermost Region

2017 ◽  
Vol 25 (04) ◽  
pp. 441-460 ◽  
Author(s):  
Duarte Pimentel ◽  
João Pedro Couto ◽  
Marc Scholten
Keyword(s):  
Family Business ◽  
Entrepreneurial Orientation ◽  
Family Firms ◽  
Three Dimensions ◽  
Current Debate ◽  
Family Participation ◽  
Autonomous Region ◽  
Business Context ◽  
The Family ◽  
A Current

This study addresses a current debate in the family business literature involving the extent to which the family business context hinders or promotes entrepreneurial behavior. The empirical evidence is provided by 155 small-sized firms, 82 family-controlled and 73 nonfamily-controlled, operating in an outermost region, the Autonomous Region of the Azores. This study analyzes the differences between family and nonfamily firms in regard to entrepreneurial orientation and how it is influenced by family participation. Results show that there are differences in entrepreneurship orientation and in two of its three dimensions, while revealing that family participation is negatively associated with entrepreneurial orientation and its three dimensions.

Comparison of contact endoscopy and frozen section histopathology in the intra-operative diagnosis of laryngeal pathology

2007 ◽  
Vol 122 (8) ◽  
pp. 836-839 ◽  
Author(s):  
D Cikojević ◽  
I Glunčić ◽  
V Pešutić-Pisac
Keyword(s):  
Precancerous Lesions ◽  
Frozen Section ◽  
False Negative ◽  
Paraffin Section ◽  
Negative Results ◽  
Laryngeal Mucosa ◽  
Laryngeal Disease ◽  
Malignant Lesions ◽  
Microscopic Diagnosis

AbstractAndrea et al. were the first to use contact endoscopy in the diagnosis of laryngeal disease, in 1995. This method enables in vivo microscopy of laryngeal mucosa.In the present study, comparison of contact endoscopy with frozen section histopathology was performed in 142 patients with various diseases of the larynx. Paraffin section histopathology diagnosed 70 benign lesions, 23 precancerous lesions and 49 malignant lesions. Frozen section histopathology showed a sensitivity of 89.8 per cent, a specificity of 98.9 per cent and an accuracy of 95.7 per cent (χ2 = 1.5; p = 0.18). Frozen histopathology diagnosed 45 malignant lesions, including one false positive and five false negative results. Contact endoscopy yielded a sensitivity of 79.59 per cent, a specificity of 100 per cent and an accuracy of 92.95 per cent (χ2 = 8.1; p = 0.002). All malignant lesions diagnosed by contact endoscopy were confirmed by histopathology; contact endoscopy failed to recognise malignant lesions in 10 patients.Contact endoscopy is preferable to frozen section histopathology as it is noninvasive, provides information on microscopic diagnosis and laryngeal lesion margins, and enables visualisation of the laryngeal mucosa microvasculature. The use of contact endoscopy along with frozen section histopathology improves diagnostic accuracy and allows for operative (or other) therapy to continue according to the results obtained.

Sign in / Sign up

Export Citation Format

Share Document