scholarly journals Thyroid Microcarcinoma in Pediatric Population in Romania

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 422
Author(s):  
Andreea-Ioana Stefan ◽  
Andra Piciu ◽  
Maria Margareta Cosnarovici ◽  
Monica Dragomir ◽  
Romana Netea-Maier ◽  
...  
Keyword(s):  
Medullary Thyroid Cancer ◽  
Pediatric Population ◽  
Real Life ◽  
International Studies ◽  
Thyroid Microcarcinoma ◽  
Collaborative Studies ◽  
European Reference Networks ◽  
The Usa ◽  
Reference Networks ◽  
Current Guidelines

Thyroid microcarcinoma in pediatric population in Romania Non-medullary thyroid cancer (TC) is the most common endocrine malignancy, with an increasing incidence in the recent years, due to the increase of the thyroid microcarcinoma. Thyroid microcarcinoma (mTC) is defined, according to WHO criteria, as ≤1 cm dimension thyroid carcinoma, being a rare disease in children population. In adults, the current guidelines recommend a limited surgical approach. In children, however, there are no specific guidelines for mTC. Due to the scarcity of these tumors, mTC in children have largely been understudied, to our knowledge with only one previous publication reporting on the outcomes of a large historic series of patients with mTC from the USA. In Romania, the incidence of TC is rising, one of the reason may be the effect of Chernobyl nuclear accident in the past and the iodine deficiency. The purpose of this study was to describe the characteristics and outcome of children diagnosed with mTC in Romania diagnosed from 1 January 2000 to 31 December 2018. During the study period we identified 77 cases of differentiated TC (papillary and follicular) and of these 20 cases (19.4%) were mTC. The mTC represented roughly one fifth of our nationwide pediatric population diagnosed in the last 20 years, the majority of cases being recorded in adolescents aged between 15–18 years. Although patients with apparently more unfavorable local phenotype were identified, this was not reflected in the outcome of the patients in terms of remission of the disease and survival. Our study illustrates the heterogeneity of the real-life practice with respect to the pediatric mTC, and underscores the need for carefully designed multicenter international studies, including larger cohorts of patients in order to provide the data required for establishing evidence based uniform protocols. The European Reference Networks (ERN), such as the ERN for Rare Endocrine Diseases (Endo-ERN) provides an ideal platform to initiate such collaborative studies.

scholarly journals Choosing the best algorithm among five thyroid nodule ultrasound scores: from performance to cytology sparing—a single-center retrospective study in a large cohort

2021 ◽  
Author(s):  
Clotilde Sparano ◽  
Valentina Verdiani ◽  
Cinzia Pupilli ◽  
Giuliano Perigli ◽  
Benedetta Badii ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Real Life ◽  
Scoring Systems ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Common Disease ◽  
Single Center ◽  
Thyroid Microcarcinoma ◽  
Thyroid Malignancies

Abstract Objective Incidental diagnosis of thyroid nodules, and therefore of thyroid cancer, has definitely increased in recent years, but the mortality rate for thyroid malignancies remains very low. Within this landscape of overdiagnosis, several nodule ultrasound scores (NUS) have been proposed to reduce unnecessary diagnostic procedures. Our aim was to verify the suitability of five main NUS. Methods This single-center, retrospective, observational study analyzed a total number of 6474 valid cytologies. A full clinical and US description of the thyroid gland and nodules was performed. We retrospectively applied five available NUS: KTIRADS, ATA, AACE/ACE-AME, EUTIRADS, and ACRTIRADS. Thereafter, we calculated the sensitivity, specificity, PPV, and NPV, along with the number of possible fine-needle aspiration (FNA) sparing, according to each NUS algorithm and to clustering risk classes within three macro-groups (low, intermediate, and high risk). Results In a real-life setting of thyroid nodule management, available NUS scoring systems show good accuracy at ROC analysis (AUC up to 0.647) and higher NPV (up to 96%). The ability in FNA sparing ranges from 10 to 38% and reaches 44.2% of potential FNA economization in the low-risk macro-group. Considering our cohort, ACRTIRADS and AACE/ACE-AME scores provide the best compromise in terms of accuracy and spared cytology. Conclusions Despite several limitations, available NUS do appear to assist physicians in clinical practice. In the context of a common disease, such as thyroid nodules, higher accuracy and NPV are desirable NUS features. Further improvements in NUS sensitivity and specificity are attainable future goals to optimize nodule management. Key Points • Thyroid nodule ultrasound scores do assist clinicians in real practice. • Ultrasound scores reduce unnecessary diagnostic procedures, containing indolent thyroid microcarcinoma overdiagnosis. • The variable malignancy risk of the “indeterminate” category negatively influences score’s performance in real-life management of thyroid lesions.

Real-world clinical outcomes study of sequential novel antihormonal therapy (NAH) or radium-223 (Ra-223) treatment of metastatic castration-resistant prostate cancer (mCRPC) that progressed after first-line NAH.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 48-48
Author(s):  
Oliver A. Sartor ◽  
Daniel J. George ◽  
Bertrand Tombal ◽  
Celestia S. Higano ◽  
Cora N. Sternberg ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Real Life ◽  
Patient Characteristics ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Highly Active ◽  
Radium 223 ◽  
Alpha Emitter ◽  
Antihormonal Therapy ◽  
The Usa

48 Background: We assessed real-life clinical outcomes in patients with mCRPC treated in the USA who received sequential first-line (1L)/second-line (2L) NAH (abiraterone/enzalutamide or enzalutamide/abiraterone) or switched to a different mechanism of action (alpha-emitter Ra-223) after progression on 1L NAH. Methods: This was a retrospective study (PHENIX, NCT03896984) of the Flatiron electronic health record database in patients with mCRPC that progressed on 1L NAH and started 2L monotherapy with Ra-223 (n=120) or NAH (n=226) between Jan 2013 and Dec 2018. Patient characteristics, overall survival (OS) from 2L start, and symptomatic skeletal events (SSEs) were analyzed descriptively. Results: The two cohorts were generally similar at 2L start, including similar rates of bone-health agent (BHA) use, but the Ra-223 cohort had a higher incidence of bone-only metastases, shorter duration of 1L NAH, and higher rate of prior SSEs than the 2L NAH cohort (Table). Median treatment duration was 5.6 mo (median 4.5 doses) for Ra-223 and 4.7 mo for 2L NAH. Median OS from 2L start was 10.8 mo for Ra-223 and 11.2 mo for 2L NAH, with 49% and 39%, respectively, receiving subsequent therapy. Among those who received subsequent therapy, the proportion who received subsequent taxane was lower in the Ra-223 cohort (47%) than in the 2L NAH cohort (76%). SSEs were observed after 2L start in 32 patients (27%) on Ra-223 and 49 (22%) on 2L NAH. Conclusions: OS from start of 2L mCRPC treatment was similar for patients who received Ra-223 or alternative NAH in 2L. Slightly more patients received subsequent therapy in the Ra-223 cohort than in the 2L NAH cohort. Patients who received subsequent therapy were more likely to receive chemotherapy in the 2L NAH cohort, which is unsurprising as 2L NAH after 1L NAH is not highly active. Although the prior SSE rate before 2L start was higher in the Ra-223 cohort than in the 2L NAH cohort, and the two cohorts had similar rates of BHA use at 2L start, the rate of SSEs after 2L start was similar in both cohorts. Clinical trial information: NCT03896984. [Table: see text]

A 16-year real-life study on the prevalence of mycoses in a pediatric population

2021 ◽  
Vol 156 (4) ◽  
Author(s):  
Mariatresa NOCERINO ◽  
Eleonora CINELLI ◽  
Matteo MEGNA ◽  
Gabriella FABBROCINI ◽  
Lucia GALLO
Keyword(s):  
Pediatric Population ◽  
Real Life ◽  
Life Study ◽  
Real Life Study

scholarly journals The use of real life contexts in the CTA: Some unintended consequences

Pythagoras ◽  
2009 ◽  
Vol 0 (69) ◽  
Author(s):  
Sarah Bansilal
Keyword(s):  
South Africa ◽  
Real Life ◽  
Unintended Consequences ◽  
Assessment Programme ◽  
Assessment Tasks ◽  
The Usa ◽  
The Common ◽  
The Uk ◽  
Assessment Activities

The Common Tasks for Assessment (CTA) was a new assessment programme that was introduced in 2002 in South Africa for all Grade 9 learners. The purpose of this paper is to articulate some concerns around the use of contextualised assessment activities in the CTA. The study reported here was carried out in 2003. Data for the study was generated from lesson observations and interviews with the participant teachers and groups of learners. It is argued that although the intentions behind the design of the CTA are well meaning and noble, there are in fact some learners who may be unintentionally disadvantaged by the design of the CTA which uses an extended context as a source for all the assessment tasks. In this paper two unintended consequences of using ‘real life’ contexts are identified and the implications of these are discussed, by linking the observations to research carried out in the UK and the USA.

scholarly journals ISMAR-study presentation: in-hospital epidemiology and clinical management of respiratory and cardiac comorbidities in cardiac and respiratory disease units

2014 ◽  
Vol 9 ◽  
Author(s):  
Roberto Tramarin ◽  
Mario Polverino ◽  
Maurizio Volterrani ◽  
Bruna Girardi ◽  
Claudio Chimini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Management ◽  
Real Life ◽  
Length Of Hospital Stay ◽  
Relevant Information ◽  
Hospital Epidemiology ◽  
Discharge Data ◽  
Definition Of ◽  
Current Guidelines

Background: Cardiovascular and respiratory diseases are leading causes of morbidity and their co-occurrence has important implications in mortality and other outcomes. Even the most recent guidelines do not reliably address clinical, prognostic, and therapeutic concerns due to the overlap of respiratory and cardiac diseases. Study objectives and design: In order to evaluate in the reality of clinical practice the epidemiology and the reciprocal impact of cardio-pulmonary comorbidity on the clinical management, diagnostic workup and treatment, 1,500 cardiac and 1,500 respiratory inpatients, admitted in acute and rehabilitation units, will be enrolled in a multicenter, nationwide, prospective observational study. For this purpose, each center will enroll at least 50 consecutive patients. At discharge, data analysis will be aimed at the definition of cardiac and pulmonary inpatient comorbidity prevalence, demographic characteristics, length of hospital stay, and risk factors, taking into account also procedures, pharmacological and non-pharmacological treatment, and follow up in patients with cardio-respiratory comorbidity. Conclusions: The purely observational design of the study aims to give new relevant information on the assessment and management of overlapping patients in real life clinical practice, and new insight for improvement and implementation of current guidelines on the management of individual diseases.

scholarly journals IMPROVING TEACHING PRACTICUM: SUGGESTIONS FROM THE ANALYSIS OF FOREIGN LANGUAGE TEACHER EDUCATION CURRICULA

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Ha Le Kim Anh
Keyword(s):  
Teacher Education ◽  
Foreign Language ◽  
Teacher Education Program ◽  
Real Life ◽  
International Studies ◽  
Language Teacher Education ◽  
Language Teacher ◽  
Teaching Practicum ◽  
Pedagogical Competence ◽  
National University

Teaching practicum is an important component of a foreign language teacher education program, which helps future teachers to learn and develop pedagogical competence in a real-life context. Within the scope of this article, we focus on analyzing the foreign language teacher education curricula of 9 universities in Vietnam, and offer our recommendations for improving foreign language teacher education in general and English teaching practicum in particular at the University of Languages and International Studies, Vietnam National University, Hanoi.

scholarly journals Orphanet – Information, Education and Expert Centres for Rare Diseases / Orphanet – informovanosť, vzdelávanie a špecializované centrá starostlivosti o pacientov so ZCH

2013 ◽  
Vol 60 (Supplementum-VIII) ◽  
pp. 10-15
Author(s):  
L. Kovács ◽  
E. Hegyi ◽  
G. Nagyová
Keyword(s):  
Rare Diseases ◽  
National Level ◽  
Quality Criteria ◽  
Basic Data ◽  
Current Status ◽  
Paper Briefly ◽  
European Reference Networks ◽  
Reference Networks ◽  
Centres Of Expertise

The paper briefly describes the role of Orphanet as an informational and educational source for rare diseases. Most attention is given to the Centres of Expertise and European Reference Networks. The authors suggest an easy procedure how to get the basic data about the readiness of the clinics to be recognised for Centres of Expertise at the national level. EUCERD recommendations on quality criteria for centres of expertise are introduced. The coordinators of the potential Centres of Expertise should be contacted and asked to fill in the questionnaire designed to check whether the centre matches the EUCERD recommendations or not. In order for the process to be transparent, the selection criteria of expert resources are listed on national website (www.orphanet.sk). The analysis of the questionnaires has to be carried out at the national level, to map the basic data about the current status. One questionnaire per department or clinic shall be filled in order to allow the evaluation. Clinics will be divided in two groups the ones which achieved the threshold and could be recognised as Centres of Expertise at the National level and the ones which need to be further monitored to reach the threshold.

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