scholarly journals Role of Ultrasonography in Otolaryngology

2016 ◽  
Vol 24 (2) ◽  
pp. 80-87
Author(s):  
Rezaul Karim
Keyword(s):  
Thyroid Nodules ◽  
American Association ◽  
Clinical Endocrinology ◽  
Therapeutic Interventions ◽  
Standard Protocol ◽  
Imaging Tool ◽  
The Masses ◽  
Fair Degree

Ultrasonography (US) is frequently requested by the otolaryngologists in their day to day practice. Though US assessment is sensitive and in many situations, specific investigation for prognosis and management of patients, FNAC and Ultrasonography carries more predictive value. Ultrasonography is very useful for assessment of neck nodes and in combination with CT scan is an excellent imaging tool for follow up of head and neck cancers. Inflammatory neck nodes vary in characteristics from neoplastic nodes and US can classify them with fair degree of predictability. Thyroid nodules should strictly follow standard protocol of management, as most of the masses are benign and unnecessary diagnostic or therapeutic interventions are not required. Kim’s criteria and American Association for Clinical Endocrinology recommendations are sensitive and specific for offering systematic guidance for management of thyroid nodules. US have limited roles in the assessments of sialadenitis, Sialolithiasis and salivary tumors. US is an effective tool in guiding biopsies and aspirations for diagnostic and therapeutic purposes.

scholarly journals Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children

2018 ◽  
Vol 25 (4) ◽  
pp. 481-491
Author(s):  
Joseph M Shulan ◽  
Leonid Vydro ◽  
Arthur B Schneider ◽  
Dan V Mihailescu
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Subsequent Development ◽  
Thyroid Neoplasms ◽  
Childhood Cancer Survivors ◽  
Malignant Neoplasms ◽  
Increased Risk ◽  
Need To Evaluate

With increasing numbers of childhood cancer survivors who were treated with radiation, there is a need to evaluate potential biomarkers that could signal an increased risk of developing thyroid cancer. We aimed to examine the relationships between thyrotropin and thyroglobulin levels and the risk of developing thyroid nodules and cancer in a cohort of radiation-exposed children. 764 subjects who were irradiated in the neck area as children were examined and followed for up to 25 years. All subjects underwent a clinical examination, measurements of thyrotropin, thyroglobulin levels and thyroid imaging. At baseline, 216 subjects had thyroid nodules and 548 did not. Of those with nodules, 176 underwent surgery with 55 confirmed thyroid cancers. During the follow-up, 147 subjects developed thyroid nodules including 22 with thyroid cancer. Thyroglobulin levels were higher in subjects with prevalent thyroid nodules (26.1 ng/mL vs 9.37 ng/mL; P < 0.001) and in those who had an initial normal examination but later developed thyroid nodules (11.2 ng/mL vs 8.87 ng/mL; P = 0.017). There was no relationship between baseline thyrotropin levels and the prevalent presence or absence of thyroid nodules, whether a prevalent neoplasm was benign or malignant, subsequent development of thyroid nodules during follow-up or whether an incident nodule was benign or malignant. In conclusion, in radiation-exposed children, higher thyroglobulin levels indicated an increased risk of developing thyroid nodules but did not differentiate between benign and malignant neoplasms. There was no association between the baseline TSH level and the risk of developing thyroid nodules or cancer.

American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool

2021 ◽  
Vol 21 (11) ◽  
pp. 2104-2115
Author(s):  
Jeffrey R. Garber ◽  
Enrico Papini ◽  
Andrea Frasoldati ◽  
Mark A. Lupo ◽  
R. Mack Harrell ◽  
...  
Keyword(s):  
Decision Making ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Clinical Decision Making ◽  
American Association ◽  
Task Force ◽  
Clinical Endocrinology ◽  
Diagnostic Procedures ◽  
Classification Systems ◽  
Web Based

<P>Objective: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. <P> Methods: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. <P> Results: TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. <P> Conclusion: TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.</P>

scholarly journals Benign Aspirates on Follow-Up FNA May Be Enough in Patients with Initial Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ga Ram Kim ◽  
Jung Hyun Yoon ◽  
Eun-Kyung Kim ◽  
Hee Jung Moon ◽  
Jin Young Kwak
Keyword(s):  
Thyroid Nodules ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Risk Of Malignancy ◽  
Benign Nodules ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid ◽  
Undetermined Significance

Background.Management of thyroid nodules with benign aspirates following atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is not well established. We reviewed the risk of malignancy and the role of ultrasound (US) features among thyroid nodules with benign results following initial AUS/FLUS diagnoses.Methods.From December 2009 to February 2011, a total of 114 nodules in 114 patients diagnosed as benign on follow-up fine-needle aspiration (FNA) after AUS/FLUS results were included in our study. Eight among 114 nodules were confirmed pathologically and 106 were clinically observed by a follow-up FNA or US. Suspicious US features were defined as markedly hypoechogenicity, irregular or microlobulated margin, presence of microcalcifications, and taller than wide shape.Results.There were 110 (96.5%) benign nodules and 4 (3.5%) malignant nodules. Two (4.8%) among 42 nodules without suspicious US features and 2 (2.8%) out of 72 nodules with suspicious US features were confirmed as malignancy, but there were no significant associations between the malignancy rate and US features (P=0.625).Conclusion.Clinical follow-up instead of surgical excision or continuous repeat FNA may be enough for benign thyroid nodules after AUS/FLUS. The role of US features might be insignificant in the management of these nodules.

scholarly journals Thyroid Nodules in the Follow-Up of Irradiated Individuals: Comparison of Thyroid Ultrasound with Scanning and Palpation1

1997 ◽  
Vol 82 (12) ◽  
pp. 4020-4027 ◽  
Author(s):  
Arthur B. Schneider ◽  
Carlos Bekerman ◽  
Joel Leland ◽  
Jeffrey Rosengarten ◽  
Hyewon Hyun ◽  
...  
Keyword(s):  
Physical Examination ◽  
Thyroid Nodules ◽  
False Negative ◽  
Thyroid Ultrasound ◽  
Thyroid Ultrasonography ◽  
Serum Thyroglobulin ◽  
Neck Irradiation ◽  
A Prospective Study

In 1974 we began a prospective study of a cohort of 4296 individuals exposed to therapeutic head and neck irradiation during childhood for benign conditions. To define the role of thyroid ultrasonography in following irradiated individuals, we studied a subgroup of 54 individuals. They all had been screened between 1974–1976 and had normal thyroid scans and no palpable nodules at that time. Thyroid ultrasonography, thyroid scanning, physical examination, and serum thyroglobulin measurements were performed. One or more discrete ultrasound-detected nodules were present in 47 of 54 (87%) subjects. There were a total of 157 nodules, 40 of which were 1.0 cm or larger in largest dimension. These 40 nodules occurred in 28 (52%) of the subjects. Thirty (75%) of these 1.0-cm or larger nodules matched discrete areas of diminished uptake on corresponding thyroid scans. The 10 that did not match (false negative scans for ≥1.0-cm nodules) were the only nodules of this size in 7 subjects. Of 11 nodules 1.5 cm or larger, only 5 were palpable. Serum thyroglobulin correlated to the number (P = 0.04; r2 = 0.10), but not the volume of the thyroid nodules (P = 0.07; r2 = 0.08). We conclude that thyroid nodules are continuing to occur and are exceedingly common in this irradiated cohort of individuals. The results confirm that thyroid ultrasonography is more sensitive than physical examination and scanning. However, thyroid ultrasound is so sensitive and nodules so prevalent that great caution is needed in interpreting the results.

scholarly journals Neuro-radiology: a new gold standard investigation for management of central nervous system tuberculosis

2016 ◽  
Vol 4 (1) ◽  
pp. 14
Author(s):  
Vinod Gautam
Keyword(s):  
Drug Sensitivity ◽  
Therapeutic Interventions ◽  
Drug Resistant ◽  
Biochemical Tests ◽  
Sensitivity Testing ◽  
Radiological Investigation ◽  
Ct Guided ◽  
Ct Guided Biopsy

<p>Treatment of CNS TB is challenging due to lack of specific biochemical tests and inability to get the pathological sample from deeply located eloquent areas of CNS without causing any neurological deficit. Moreover, it is unnecessary to operate for biopsy in a patient who has presented with a very small granulomatious lesion in brain or spinal cord. In such as situations neuro-radiology helps in managing CNS TB and it may be the only source of establishing diagnosis and evaluating treatment response.</p><p>Role of radiological investigation has expanded from the initial diagnosis to the therapeutic interventions. In some Muli-drug- resistant (MDR) CNS TB cases, Stereotaxy or USG or CT guided biopsy helps in obtaining pathological sample and drug sensitivity testing. A regular clinical and neuro-radiological follow-up is mandatory during the entire course of anti tuberculous therapy to take prompt decisions to change ATT and to reduce morbidity and mortality associated with CNS TB.</p>

scholarly journals CORRELATION BETWEEN ULTRASOUND-BASED ACR TI-RADS AND BETHESDA SYSTEM FOR REPORTING THYROID-CYTOPATHOLOGY: A PROSPECTIVE STUDY AT TERTIARY CARE CENTER IN EASTERN INDIA

2020 ◽  
pp. 1-4
Author(s):  
Kapse Pratik Siddheshwar ◽  
Beena Devi Agarwal ◽  
S. S. G. Mohapatra ◽  
Niranjan Sahu ◽  
Apoorva Dixit
Keyword(s):  
Prospective Study ◽  
Thyroid Nodules ◽  
Care Center ◽  
Tertiary Care ◽  
Imaging Tool ◽  
Risk Of Malignancy ◽  
Initial Imaging ◽  
A Prospective Study ◽  
Risk Of Cancer

BACKGROUND: Ultrasound(USG) is the initial imaging tool for the assessment of thyroid lesions, due to its easy availability and no radiation risk.USG based TIRADS uses particular lexicons for reporting a focal thyroid nodule,based on which risk of malignancy is calculated and finally a TIRADS category is assigned.The lexicons used are helpful for effective communication between the practitioners. OBJECTIVE:To determine the efficacy of ACR based TIRADS in predicting suspicious thyroid nodules and categorizing the patients in need of further evaluation with FNAC or follow up. MATERIALS AND METHODS: This prospective study was done over a period of 1 year (January 2019–January 2020)and include 50 patients. Patients having thyroid nodules in B-mode ultrasound were included in the study. The nodules were then grouped into their respective categories based on ACR TI-RADS and further management was decided. Pathological correlation using Bethesda classification and cancer risk of each TIRADS category was determined in the follow-up period simultaneously. RESULTS:All the 6 nodules classified under the TIRADS 5 category were found to be malignant while none of the TIRADS 2 nodules out of 29 were malignant i.e.Bethesda IV or higher.The risk of malignancy for ACR TI-RADS categories 1,2,3,4 and 5 was 0, 14.3, 62.5 and 100%, respectively.The risk of cancer in our study is almost comparable to other prominent studies. CONCLUSION:ACR based TIRADS classification is reliable in predicting thyroid malignancy.

scholarly journals Self-resolving focal non-ossifying myositis: a poorly known clinical and imaging entity diagnosed with MRI

2015 ◽  
Vol 4 (12) ◽  
pp. 205846011560615
Author(s):  
Vasiliki Perlepe ◽  
Benjamin Dallaudière ◽  
Patrick Omoumi ◽  
Lora Hristova ◽  
Afshin Rezzazadeh ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Myositis Ossificans ◽  
Long Term Follow Up ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Us Findings ◽  
The Masses

Background Focal myositis is a rare benign inflammatory pseudotumor, presenting as a painful nodular mass within a muscle, and characterized by spontaneous resolution within weeks. Purpose To assess the clinical and imaging findings of focal nodular myositis simulating a neoplasm at clinical examination, with no history of trauma. Material and Methods This study describes the locations and appearance at ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) of this condition in a series of five patients. Results MRI and US displayed a solid intramuscular “tumor” and suggested a continuum between the proximal and distal muscle fibers that appeared thickened within the nodular lesion, a sign that has been reported in myositis ossificans. MRI showed edema in adjacent muscles and soft tissues, as well as intense enhancement of the mass. Intense vascular flows were seen at Doppler analysis. CT did not reveal the appearance of peripheral ossifications, ruling out the diagnosis of myositis ossificans. In some patients, the diagnosis of sarcoma had been suggested as possible by the radiologist. Imaging follow-up with MRI showed complete resolution of the masses over several weeks, thus avoiding a biopsy; no recurrence was observed at long-term follow-up (more than 24 months). Conclusion This paper highlights MRI and US findings in focal non-ossifying myositis, and emphasizes the role of MRI in suggesting this diagnosis, leading to the careful follow-up of the lesion until its resolution, and ruling out more aggressive lesions.

scholarly journals Role of Laparoscopy in Diagnosis and Treatment of Endometriosis Associated with Infertility: A Prospective Analysis

2021 ◽  
Vol 73 (11) ◽  
pp. 772-776
Author(s):  
Ankita Ratan ◽  
Sujata Pradhan ◽  
Pradip Kumar Panigrahi ◽  
Manisha Sahu ◽  
Pratyasha Peepal ◽  
...  
Keyword(s):  
Early Stage ◽  
Therapeutic Interventions ◽  
Diagnosis And Treatment ◽  
Disease Stage ◽  
Female Age ◽  
Surgical Interventions ◽  
Spontaneous Conception ◽  
American Fertility Society

Objective: Endometriosis is often considered as an enigma due to its varied clinical presentation and challenges in diagnosis. The objective of this study is to evaluate the role of laparoscopy in diagnosis and treatment of endometriosis associated with infertility.Materials and Methods: Infertile females diagnosed to have endometriosis during or before undergoing laparoscopic surgery from August 2018 to February 2020 were followed up for spontaneous conception for 6 months following laparoscopy. Revised American Fertility Society (r-AFS) scoring system was used to score endometriosis and stage the disease (stage I-IV). Surgical interventions were done on individual cases basis following ESHRE guidelines.Results: Fifty infertile females diagnosed with endometriosis during or before laparoscopy were recruited for the study. Mean age of patients was 28.58 (±4.21) years. Thirty-four (68%) patients had primary infertility and 16 (32%) has secondary infertility. Mean duration infertility was 3.33 (±1.43). Only 37 patients (74%) had evidence of endometriosis in pre-operative ultrasonography. During the follow up period of first 6 months after surgery 34 (68%) patients conceived spontaneously. Lower mean endometriosis score (p=0.00) and early stage of endometriosis (p=0.00) were associated with higher chances of conception. But, female age, duration and type infertility, USG findings, and type of surgical interventions did not affect pregnancy rate.Conclusion: Laparoscopy helps in diagnosis of endometriosis. Laparoscopic therapeutic interventions for endometriosis increase the probability of spontaneous conception in infertile females. Lower surgical score and early stages of endometriosis are associated with higher chance of conception.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

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