Prevalence and predictors of thyroid cancer among thyroid nodules: a retrospective cohort study of 1,000 patients

Introduction Thyroid cancer is increasing in incidence globally due either to early detection (overestimation) or true increment. A recent debate concerns multinodular goitre (MNG) or toxic goitres which have classically been considered at a lower risk for cancer. Methods In this study, we enrolled retrospectively all patients with nodular goitre treated at our tertiary hospital and analysed their data with the aim of detecting the rate of cancer among different types of nodular goitre. We also studied predictors of incidental malignancy among thyroidectomies. Results A predilection for solitary thyroid nodules (STNs) was found in women of younger age, with STNs tending to be larger in comparison with MNG in the same age group. However, both types of nodules were at equal risk of harbouring malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) and Bethesda scores were the only dependent predictors of malignancy within thyroid nodules. Conclusion The authors recommend management of both STNs and MNG using the same algorithm.

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Epilepsy Patients in Bangladesh - The Experience of a Referral Hospital

Bangladesh Journal of Neuroscience ◽

10.3329/bjn.v31i2.57382 ◽

2015 ◽

Vol 31 (2) ◽

pp. 83-93

Author(s):

Abdus Salam ◽

Md Rafiqul Islam ◽

Hasan Zahidur Rahman ◽

Anis Ahmed ◽

Md Ruhul Quddus

Keyword(s):

Disease Burden ◽

Clinical Findings ◽

Referral Hospital ◽

Epilepsy Syndrome ◽

Age Group ◽

Community Based ◽

Private Practitioners ◽

Younger Age ◽

Different Types ◽

Generalized Epilepsy

Purpose: To analyze the socio-demographic and electro-clinical data of Epilepsy patients presenting in the ‘Epilepsy Clinic’ of a referral hospital. Method: Epilepsy patients came to this weekly clinic after referral from this hospital OPD, other hospitals and from private practitioners. All the patients were enrolled from November, 2012 to December, 2015. Then clinical diagnosis was established by the chief investigator. Routine EEG was done. MRI was advised in appropriate cases. Finally the clinical findings and investigation reports were correlated. Results: Among 331 patients, 63% were male and 37% were female. 86% patients were in the younger age group (0- 29years). 75% patients were suffering from various forms of LRE, 19% from Generalized Epilepsy Syndrome, 2.7% were unclassified and 2.7% had pseudo-seizure. Total 224 EEG could be done. Among them 118 (52.7%) had different types of abnormalities. Among total 158 MRI, 120 (76%) were abnormal. 6.3% patients could not go to school, 3.3% left study and 12.7% patients remain unemployed due to the disease burden. Conclusion: This is a hospital based study. In this study LRE comprises 75% of total patients which is relatively higher than other reports. Males were predominating and younger people were affected more with epilepsy. Due to this disease various social problems were occurring regarding study and employment. This result demands community based larger study in our country. Bangladesh Journal of Neuroscience 2015; Vol. 31 (2): 83-93

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Prospective sero surveillance among healthcare workers vaccinated with ChAdOx1 nCoV-19 Corona vaccine in a tertiary hospital of Kerala, India

10.1101/2021.06.29.21259686 ◽

2021 ◽

Author(s):

Swathi Krishna Njarekkattuvalappil ◽

Ramesh Bhaskaran ◽

Sree Raj Vijaya Raj ◽

Ponnu Jose ◽

Aboobacker Mohammed Rafi ◽

...

Keyword(s):

Healthcare Workers ◽

Care Setting ◽

Tertiary Care ◽

Tertiary Hospital ◽

Antibody Responses ◽

Age Group ◽

Younger Age ◽

Median Level ◽

Ig G ◽

Tertiary Care Setting

Background: India started Covid-19 vaccination from January 16, 2021 after the approval of two candidate vaccines namely Covishield TM and Covaxin TM .We report antibody responses among healthcare workers following two doses of CovishieldTM vaccination in a tertiary care setting. Methods: This prospective serosurveillance study was done among healthcare workers of JMMC&RI ,vaccinated during January to March 2021. Blood samples were drawn from 170 participants after their 1st dose and from 156 participants after their 2nd dose of COVID vaccine to measure the specific antibodies against the recombinant S1 subunit of the S protein of SARS CoV 2 Results: The median level of anti SARS CoV-2 Ig G antibody 28 days after the first dose vaccination is 3.64 S/C (IQR=5.91) and 11.6 S/C (IQR= 5.97) after 14 days of second dose vaccination. Protective levels of anti SARS CoV-2 Ig G antibodies is developed by 25 participants (14.7%) after 28 days of first dose of vaccination and by 109 participants (69.9%) after 14 days of second dose. 18-44 years age group (p=0.027) and absence of comorbidities (p=0.079) are associated with protective IgG levels. Conclusions: Rise in specific Ig G is observed after vaccination. Higher antibody response is observed with younger age group and absence of comorbidities, though statistically not significant. The influence of BMI is also not significant.

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Thyroid Cancer in Patients 70 Years of Age or Older

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948709600411 ◽

1987 ◽

Vol 96 (4) ◽

pp. 403-410 ◽

Cited By ~ 9

Author(s):

Gady Har-El ◽

Jack Sidi ◽

Ernesto Kahan ◽

Karl Segal ◽

Aristide Abraham

Keyword(s):

Thyroid Cancer ◽

Thyroid Carcinoma ◽

Cancer Patients ◽

Death Rate ◽

Thyroid Nodules ◽

Clinical Stage ◽

Undifferentiated Carcinoma ◽

Older Age ◽

Age Group ◽

Advanced Clinical Stage

This report presents our experience with 50 thyroid cancer patients 70 years of age or older, out of 606 patients of all ages. Comparing this series to those describing thyroid cancer patients of all ages, we found that thyroid carcinoma in the 70 + age group presents at a more advanced clinical stage, behaves more aggressively, and has a higher death rate. These findings are attributed mainly to the higher incidence of undifferentiated carcinoma and the more aggressive course of the differentiated types of carcinoma in the older age group. If suspected thyroid nodules are managed by initial radical treatment, carcinoma can be diagnosed earlier and patients will survive longer.

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Are Bethesda III Thyroid Nodules More Aggressive than Bethesda IV Thyroid Nodules When Found to Be Malignant?

Cancers ◽

10.3390/cancers12092563 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2563

Author(s):

Sena Turkdogan ◽

Marc Pusztaszeri ◽

Veronique-Isabelle Forest ◽

Michael P. Hier ◽

Richard J. Payne

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Thyroid Nodules ◽

Molecular Genetic ◽

Hospital Setting ◽

Retrospective Chart Review ◽

Tertiary Hospital ◽

P Value ◽

Papillary Thyroid ◽

Genetic Test Results

The Bethesda classification system for thyroid fine needle aspirate (FNA) is used to predict the risk of malignancy and to guide the management of thyroid nodules. We postulated that thyroid malignancies characterized as Bethesda III on FNA have more aggressive features than those classified as Bethesda IV. A retrospective chart review was performed to identify those who underwent thyroid surgery at a single tertiary hospital setting between 2015 and 2020. Associations between Bethesda category, molecular genetic test results, and histopathologic findings were examined. Out of 628 surgeries that were performed, 199 (54.2%) Bethesda III nodules and 216 (82.8%) Bethesda IV nodules were malignant. Of those that were malignant, 37 (18.6%) and 22 (10.2%) Bethesda III and Bethesda IV nodules showed aggressive features, respectively (p value = 0.014). There was a proportionally increased number of aggressive features in extra-thyroidal extension, lymph nodes metastasis, and all aggressive subtypes of papillary thyroid cancer in the Bethesda III category. Although Bethesda IV nodules are much more likely to be malignant (p value = 0.002), our study suggests that Bethesda III nodules that are resected are more likely to have aggressive features than Bethesda IV nodules, with a statistically significant increase in the solid variant of papillary thyroid cancer and lymph node metastasis.

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Analysis of the Association between Female Medical History and Thyroid Cancer in Women: A Cross-Sectional Study Using KoGES HEXA Data

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158046 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8046

Author(s):

Young Ju Jin ◽

Suk Woo Lee ◽

Chang Myeon Song ◽

Bumjung Park ◽

Hyo Geun Choi

Keyword(s):

Thyroid Cancer ◽

Medical History ◽

Oral Contraceptives ◽

Older Age ◽

Age Group ◽

Bilateral Oophorectomy ◽

Cross Sectional ◽

Number Of Children ◽

Younger Age ◽

Adjusted Model

The purpose of this study was to evaluate the association between female medical history and thyroid cancer. Methods: Data from the Korean Genome and Epidemiology Study were collected from 2004 to 2016. Among a total of 1303 participants with thyroid cancer and 106,602 control (non-thyroid cancer) participants, the odds ratios (ORs) with 95% confidence intervals (CIs) of hysterectomy, oophorectomy, use of oral contraceptives, and number of children were evaluated. Results: The adjusted OR of hysterectomy for thyroid cancer was 1.73 (95% CI = 1.48–2.01, p < 0.001) in the minimally adjusted model. The adjusted ORs for thyroid cancer were 1.89 (95% CI = 1.06–3.37, p = 0.031), 0.89 (95% CI = 0.83–0.94, p < 0.001), and 0.85 (95% CI = 0.73–0.99, p = 0.040) for bilateral oophorectomy, number of children, and use of oral contraceptives, respectively, in the fully adjusted model. In the subgroup analysis, the adjusted ORs of bilateral oophorectomy were significant in the younger age (OR = 3.62, 95% CI = 1.45–9.03, p = 0.006), while the number of children was significant in the older age (OR = 0.86, 95% CI = 0.80–0.93, p < 0.001). Conclusions: The ORs of hysterectomy and bilateral oophorectomy were significantly higher in the thyroid cancer group in the younger age group. The adjusted ORs of the number of children were significantly low in the older age group.

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Prevalence and risk factors for thyroid cancer in patients with multinodular goitre

BJS Open ◽

10.1093/bjsopen/zraa014 ◽

2020 ◽

Vol 5 (2) ◽

Author(s):

K Apostolou ◽

V Zivaljevic ◽

K Tausanovic ◽

G Zoric ◽

G Chelidonis ◽

...

Keyword(s):

Risk Factors ◽

Thyroid Cancer ◽

High Volume ◽

University Hospital ◽

Endocrine Surgery ◽

Multinodular Goitre ◽

Thyroid Status ◽

Younger Age ◽

Multivariable Regression ◽

Independent Risk Factors

Abstract Background Rates of thyroid cancer in patients with multinodular goitre (MNG) vary widely, from 3 per cent in older studies to 35 per cent in more recent studies. The purpose of the present study was to evaluate the prevalence of thyroid cancer in patients operated on for MNG, and to determine risk factors for incidental thyroid malignancy. Methods A prospectively developed database of all patients who underwent thyroidectomy for a benign MNG at the high-volume endocrine surgery unit of a tertiary referral university hospital was interrogated. Results A total of 3233 patients were analysed, separated into three groups according to their functional thyroid status (hypothyroid, hyperthyroid or euthyroid). There were 2788 women (86.2 per cent); the mean patient age was 56.4 years and mean preoperative disease duration was 106.2 months. Incidental thyroid cancer was identified in 1026 patients (31.7 per cent), of which 917 (89.4 per cent) were papillary cancers. Multivariable regression analysis identified functional thyroid status, younger age, male sex, smaller adenoma size, smaller thyroid glands, Hashimoto’s thyroiditis and chronic non-specific thyroiditis as independent risk factors for thyroid cancer. Conclusion MNG was associated with a considerable rate of incidental thyroid cancer, which has been underestimated. A variety of factors should be taken into account when considering the malignant potential of a presumed benign MNG.

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Utility of pre-operative serum thyroid stimulating hormone in predicting thyroid malignancy

International Surgery Journal ◽

10.18203/2349-2902.isj20173421 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2796

Author(s):

Arun K. ◽

Santhosh Nayak K. ◽

Suhas Gowda

Keyword(s):

Thyroid Cancer ◽

Thyroid Nodules ◽

Thyroid Stimulating Hormone ◽

Multinodular Goitre ◽

Advanced Stages ◽

Test Of Significance ◽

Thyroid Malignancies ◽

Serum Tsh ◽

Tsh Levels ◽

Stimulating Hormone

Background: Thyroid cancer is the most common endocrine malignancy and its incidence continues to rise. Thyroid carcinoma in most cases presents clinically as a solitary nodule or as a dominant nodule within a multinodular thyroid gland. There are a number of well-established of predictors of malignancy in thyroid nodules. More recently studies have suggested that higher concentration of TSH, even within the normal range are associated with subsequent diagnosis of thyroid cancer in patients with thyroid nodules and even higher serum TSH levels have been found associated with advanced stages of thyroid cancer. The objective of this study was to determine the serum thyroid stimulating hormone (TSH) concentration before surgery in different thyroid malignancies and to compare serum TSH concentration after surgery in thyroid malignancyMethods: A hospital based observational study was conducted in a tertiary care hospital for a period of 2 year. 120 patients presenting with thyroid nodule without an overt thyroid dysfunction during the study period were included in the study. Chi-square was used as test of significance. Independent t test was the test of significance for quantitative data between two groups.Results: Mean serum TSH was higher in thyroid malignancies and significant difference was observed between solitary and multinodular goitre. Mean serum TSH concentrations was significantly high in papillary carcinoma and advanced stages of carcinoma. Mean serum TSH was high in stage III and stage IV (5.17±1.36 mIU/l) compared to stage I and II (4.03±1.87 mIU/l).Conclusions: The study concludes that TSH levels were high in thyroid malignancies arising from multinodular goitre, majority of thyroid malignancies had high levels of serum TSH concentrations and TSH was high with advanced stage of thyroid cancer

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Correlation between sonological and clinical profile of mesenteric lymphadenitis among children in a tertiary care hospital of central Kerala

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20211416 ◽

2021 ◽

Author(s):

Vinod Joseph ◽

Danny Jose Titus ◽

Aby Dany Varghese ◽

Jijo Joseph John ◽

Girija Mohan ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Care Hospital ◽

Age Group ◽

Sectional Study ◽

Cross Sectional ◽

Mesenteric Lymphadenitis ◽

Younger Age

Background: For abdominal pain in children, imaging is routinely applied to make a possible diagnosis both in the outpatient and in the emergency department. Though the diagnosis of mesenteric lymphadenitis is made often these days, the significance of the size and number is still ambiguous and most studies consider mesenteric lymphadenitis is defined as three or more lymph nodes that are each 5 mm or greater in the short axis.Methods: Cross-sectional study was conducted in a tertiary hospital in central Kerala and the study tool included a detailed structured questionnaire.Results: Our study included 115 children with pain in the abdomen. 69 were found to have mesenteric lymphadenitis. Younger age group, fever as a symptom and acute infective gastroenteritis are statistically significantly associated with mesenteric lymphadenitis.Conclusions: In our study, acute infective gastroenteritis was the most common cause to be associated with mesenteric lymphadenitis which was. The incidence of mesenteric lymphadenitis was found to be more in children below 5 years.

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Thyroid Swellings Undergoing Thyroidectomy in a Tertiary Hospital of Nepal: A Retrospective Study of Distribution and Prevalence of Malignancy

Nepal Journal of Health Sciences ◽

10.3126/njhs.v1i2.42373 ◽

2021 ◽

Vol 1 (2) ◽

pp. 27-33

Author(s):

Mudit Gupta ◽

Rajeev Kumar Mahaseth ◽

Sajish Khadgi ◽

Asmita Shrestha ◽

Neeti Bhat ◽

...

Keyword(s):

Retrospective Study ◽

Thyroid Nodule ◽

Papillary Carcinoma ◽

Thyroid Nodules ◽

Benign Lesion ◽

Needle Aspiration ◽

Tertiary Hospital ◽

Common Finding ◽

Age Group ◽

Histopathological Evaluation

Introduction: Thyroid nodules brought to a hospital are checked for cancer. A post-operative histological examination is a gold standard for diagnosing thyroid lesions. Treatment is aided by a prior understanding of the disease’s underlying pattern. Objective: A retrospective study was done to determine the prevalence and distribution of malignancy in suspicious thyroid nodules. Methods: The study was conducted at Ganesh Man Singh Memorial Academy of ENT- Head and Neck studies from August 2017 to March 2020. All the subjects (n=183) presenting with a thyroid nodule and who had post-operative histopathological evaluation available were recruited in the study. The proportion and percentage of findings of Fine Needle Aspiration Cytology (FNAC) and histopathological evaluation were done. The distribution of histopathological observation was also analyzed in terms of age group and gender. Results: The mean age of study participants was 40.23 ± 13.77 years (n=183). The predominance of women was notable. In about 98 (53.55%) of the patients who underwent thyroidectomy, a benign lesion was found, but the most common finding was papillary carcinoma (40.98%). In the age group below 50 years, papillary carcinoma was most common. Among people older than 50, colloid goiter was more common. Follicular and medullary carcinomas were only observed in female participants. Gender did not appear to be associated with malignancy (p=0.99). Follicular adenomas were noted to have the youngest mean age. Conclusions: We observed a high prevalence of malignancy, particularly papillary carcinoma in clinically suspected thyroid nodules of a tertiary hospital in Nepal. Keywords: Colloid Goiter; malignancy; papillary carcinoma; thyroid cancer; thyroid nodule.

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