scholarly journals Five-year follow-up and clinical outcome in euthyroid patients with thyroid nodules

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Katica Bajuk Studen ◽  
Simona Gaberscek ◽  
Edvard Pirnat ◽  
Katja Zaletel
Keyword(s):  
Cohort Study ◽  
Clinical Outcome ◽  
Thyroid Nodules ◽  
Thyroid Ultrasound ◽  
Single Centre ◽  
Need For Treatment ◽  
End Point ◽  
Single Centre Experience ◽  
History Of

Abstract Background Thyroid nodule diagnosis has become increasingly frequent. Defining optimum surveillance intervals for patients with unsuspicious thyroid nodules remains a challenge. This was a single centre cohort study in which patients diagnosed with unsuspicious thyroid nodules in whom no treatment was indicated were invited for re-evaluation 5 years after the diagnosis. The primary end point of the study was to estimate the change in nodule size with thyroid ultrasound (US) and the secondary end point was to assess the need for clinical management 5 years after the diagnosis. Patients and methods Baseline patient parameters and ultrasound characteristics of the nodules were retrospectively collected. At follow-up, thyroid ultrasound was performed. Results A hundred and eighteen (107 women / 11 men, aged 56.8 ± 13.4 years) patients were included in the study having 203 nodules at baseline, with mean largest nodule diameter 10.5 ± 7.4 mm. After 5 years, 58 (28.6%) nodules significantly increased in size, 27 (13.3%) decreased, and for 104 (51.2%) of nodules, no change in size was noted. Fourteen (6.9%) nodules disappeared. Additional 26 new nodules (mean largest diameter 7.7 ± 5.0 mm) in 16 patients were identified at follow-up. Regarding the clinical outcome, no new thyroid cancers were found. For 107 (90.7%) patients no further management was indicated. Five (4.2%) patients were referred to thyroidectomy because of the growth of the nodules. Two (1.7%) patients were treated for hyperthyroidism. Four (3.4%) patients did not complete the study. Conclusions We report a single centre experience of the natural history of unsuspicious thyroid nodules. Our results showed that 71.4% of such nodules remained stable in size, decreased or even disappeared and that the vast majority of the patients remained clinically stable with no need for treatment 5 years after the diagnosis.

Isolated pancreatic and peripancreatic nodal tuberculosis: A single-centre experience

2020 ◽  
pp. 004947552096294
Author(s):  
Sukanta Ray ◽  
Kshaunish Das ◽  
Ranajoy Ghosh
Keyword(s):  
Single Centre ◽  
Antitubercular Drugs ◽  
Pancreatic Tuberculosis ◽  
Number Of Patients ◽  
Single Centre Experience ◽  
History Of ◽  
High Index Of Suspicion ◽  
Modern Image ◽  
Extensive Surgery

Isolated pancreatic and peripancreatic nodal tuberculosis may mimic pancreatic malignancy and may result in unnecessary surgery. Being a treatable disease, it is desirable to diagnose this condition without a laparotomy. Pancreatic tuberculosis should be considered in the differential diagnosis of a peripancreatic mass if the patient is young, residing in endemic tuberculosis regions, or has had a history of tuberculosis. We report our experience with pancreatic tuberculosis. Over a period of 12 years, we have managed 16 such patients, of whom 10 were diagnosed preoperatively. In six, the diagnosis was only made after extensive surgery. All 16 patients received antitubercular drugs and were well at a median follow-up of 52 months. Although pancreatic tuberculosis can be diagnosed by modern image-guided biopsy in a fair number of patients, if a high index of suspicion is maintained, a laparotomy may still be unavoidable in a subset of patients.

scholarly journals Relationship between the Prevalence of Thyroid Nodules and Metabolic Syndrome in the Iodine-Adequate Area of Hangzhou, China: A Cross-Sectional and Cohort Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Junhua Yin ◽  
Changchun Wang ◽  
Qin Shao ◽  
Dihong Qu ◽  
Zhenya Song ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cohort Study ◽  
Thyroid Nodules ◽  
Cross Sectional Study ◽  
Thyroid Ultrasound ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elevated Triglyceride Level

Objective. The association between thyroid nodule (TN) prevalence and metabolic syndrome (MetS) has only rarely been examined in iodine-adequate areas and needs further clarification. We investigated correlations between MetS and TN prevalence in the iodine-adequate area of Hangzhou, China.Material and Method. A cross-sectional study that screened and recruited individuals for cohort research 3 years later. The 13522 subjects (8926 men, 4596 women) were screened in 2009 for all MetS components, thyroid ultrasound (US), and thyroid function. Cohort research recruited 1610 subjects who were screened in both 2009 and 2012, of whom 1061 underwent follow-up research.Results. The prevalence of TN was higher in the MetS (+) group than in the MetS (−) group (χ2= 69.63,P< 0.001) and higher in women than in men (χ2= 11.65,P= 0.001). Waist circumference (WC) was positively related to the prevalence of TN (OR = 1.022,P< 0.001). Individuals with greater WC in 2009 were more likely to suffer from TN in 2012 (RR = 1.434,P= 0.024). Elevated triglyceride level was a risk factor for developing new TN (RR = 1.001,P= 0.035).Conclusion. Both greater WC and elevated triglycerides are risk factors for new TN in this iodine-adequate area in China.

Natural history of helicobacter pylori infection from infancy to adulthood: A 21-year follow-up cohort study

2001 ◽  
Vol 120 (5) ◽  
pp. A128-A128 ◽  
Author(s):  
H MALATY ◽  
D GRAHAM ◽  
A ELKASABANY ◽  
S REDDY ◽  
S SRINIVASAN ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cohort Study ◽  
Natural History ◽  
Helicobacter Pylori Infection ◽  
History Of

The natural history of benign thyroid nodules: 10 years follow-up

2020 ◽  
Author(s):  
Valeria Ramundo ◽  
Giorgio Grani ◽  
Rocco Bruno ◽  
Giuseppe Costante ◽  
Domenico Meringolo ◽  
...  
Keyword(s):  
Natural History ◽  
Thyroid Nodules ◽  
History Of ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

scholarly journals Long-term remission of acromegaly after somatostatin analogues withdrawal: a single-centre experience

2021 ◽  
Author(s):  
E. Sala ◽  
G. Carosi ◽  
G. Del Sindaco ◽  
R. Mungari ◽  
A. Cremaschi ◽  
...  
Keyword(s):  
Median Time ◽  
Pituitary Surgery ◽  
Somatostatin Analogues ◽  
Exclusion Criterion ◽  
Single Centre ◽  
Disease Evolution ◽  
Single Centre Experience ◽  
Pituitary Irradiation

Abstract Purpose A long-lasting remission of acromegaly after somatostatin analogues (SAs) withdrawal has been described in some series. Our aim was to update the disease evolution after SAs withdrawal in a cohort of acromegalic patients. Methods We retrospectively evaluated 21 acromegalic patients previously included in a multicentre study (Ronchi et al. 2008), updating data at the last follow-up. We added further 8 patients selected for SAs withdrawal between 2008–2018. Pituitary irradiation represented an exclusion criterion. The withdrawal was suggested after at least 9 months of clinical and hormonal disease control. Clinical and biochemical data prior and after SAs withdrawal were analysed. Results In the whole cohort (29 patients) mean age was 50 ± 14.9 years and 72.4% were females. In 69% pituitary surgery was previously performed. Overall, the median time of treatment before SAs withdrawal was 53 months (IQR = 24–84). At the last follow up in 2019, 23/29 patients (79.3%) had a disease relapse after a median time of 6 months (interquartile range or IQR = 3–12) from the drug suspension, while 6/29 (20.7%) were still on remission after 120 months (IQR = 66–150). IGF-1 levels were significantly lower before withdrawal in patients with persistent remission compared to relapsing ones (IGF-1 SDS: -1.5 ± 0.6 vs -0.11 ± 1, p = 0.01). We did not observe any other difference between patients with and without relapse, including SAs formulation, dosage and treatment duration. Conclusion A successful withdrawal of SAs is possible in a subset of well-controlled acromegalic patients and it challenges the concept that medical therapy is a lifelong requirement.

Abstract 646: Epicardial Ablation Of Ventricular Tachycardia - A Single Centre Experience

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Boris Schmidt ◽  
KR Julian Chun ◽  
Buelent Koektuerk ◽  
Feifan Ouyang ◽  
Karl-Heinz Kuck
Keyword(s):  
Ventricular Tachycardia ◽  
Success Rate ◽  
Single Centre ◽  
Epicardial Ablation ◽  
Single Centre Experience ◽  
Radiofrequency Current ◽  
Acute Success ◽  
Procedural Success ◽  
Lv Aneurysm

Background: Radiofrequency current ablation (RFA) of ventricular tachycardia (VT) focuses on endocardial (endo) substrates. However, if endo RFA fails, an epi approach is a potential treatment option. We report a single centre experience of epi VT ablation. Patients and Methods: Between 06/2005 and 02/2008 42 pts (14 female, mean age 49 ± 18 years) underwent electroanatomical endo and epi mapping and ablation for intractable VT, syncope or VT storm with multiple ICD discharges. Pts with normal heart (n=7), ischemic cardiomyopathy (ICM; n=8), NICM (n=11), ARVD (n=8), LV-aneurysm (n=7) or sarcoidosis (n=1) were studied. Mean LV ejection fraction was 45±12%. 20/42 had had at least 1 previous ablation attempt for VT (range 1– 4 ablations). Acute success was defined as non-inducibility of the previously inducible VT. Chronic success was defined as recurrence of any VT. Results: Acute procedural success rate was 79% (30/38). In 4 pts VTs were not inducible during EPS. In 28/42 pts endo mapping revealed no pathologic potentials. In 23/38 pts and 7/38 the succesful RFC ablation site was epi and endo, respectively. In 9/38 pts endo ablation failed and VT could only be ablated from epi. Further 7/38 pts needed both endo and epi ablation. In In 4/8 failed ablations epi RFC ablation was impossible due to failed access to target site (adhesions; n=2), close vicinity of a coronary artery (n=1) or the phrenic nerve (n=1). Procedure duration was 263±97 min. Unfortunately, 1 pt died due to perforation of RV and 1 pt had severe hepatic bleeding after epi puncture. One pt died in cardiogenic shock 1 d after the procedure. In 2 pts a sterile pericarditis occurred which resolved without any further intervention. After a median follow-up of 293 days (1–929 days) 53% of pts were alive and free from any VT. Conclusion: In pts with failed endo RFC ablation for VT due to different etiologies epi RFC ablation was acutely successful in 61% of pts with a moderate chronic success rate. However, major complications occured in approximately 5% of pts. Epi mapping should be considered if endo pathologic potentials are absent or if endo ablation failed.

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