Research on the primary thyroid lymphoma (PTL) diagnosis is limited, with only a few large sample size studies, reported from Asian countries. The aim of the present study was to clarify the current ...prevalence and challenges in PTL diagnosis, and recommended ancillary studies for PTL in non-Western countries. PTL (n = 153) cases were retrieved from 10 institutions in non-Western countries and analyzed. Ultrasound examination (UE) and fine needle aspiration cytology (FNAC) were used as main preoperative diagnostic tools in all participating institutions. Flow cytometry (FCM) was performed in the 5 institutions (50%). Lobectomy was the most common histological procedure to confirm the PTL diagnosis. All institutions routinely performed immuno-histochemical analysis. PTL was 0.54% of malignant thyroid tumor cases, with mucosa-associated lymphoid tissue lymphoma (MALTL) and diffuse large B-cell lymphoma (DLBCL) being 54.9% and 38.6%, respectively. Kuma Hospital, where the frequency of MALTL was highest (83.7%), routinely performed FCM using the materials obtained by FNAC. UE and FNAC sensitivities were 62.5% and 57.8%, respectively. In both UE and FNAC, sensitivity of MALTL was lower than of DLBCL. The study elucidated that the prevalence of PTL in non-Western countries was lower than previously reported. We propose that FCM should be more actively used to improve the preoperative diagnosis of MALTL. Our data predicted that the MALTL proportion will increase with improved diagnostic tools, while observation of PTL-suspected nodules without histological examination remains a viable option.
Polymorphisms in long non-coding RNA and microRNA genes may play a significant role in the susceptibility and progression of papillary thyroid carcinoma (PTC). The current study investigates the ...polymorphisms HOTAIR rs920778, MIR155HG rs1893650, TERC rs10936599, miR-155 rs767649, miR-196a2 rs11614913 and miR-146a rs2910164 in 102 PTC patients and 106 age- and sex-matched controls of the Caucasian Serbian population, using real-time PCR. We observed differences in genotype distributions of the HOTAIR rs920778 (
= 0.016) and MIR155HG rs1893650 (
= 0.0002) polymorphisms between PTC patients and controls. HOTAIR rs920778 was associated with increased PTC susceptibility (adjusted OR = 1.497,
= 0.021), with the TT variant genotype increasing the risk compared to the CC genotype (OR = 2.466,
= 0.012) and C allele carriers (CC + CT) (OR = 1.585,
= 0.006). The HOTAIR rs920778 TT genotype was associated with lymph node metastasis (
= 0.022), tumor recurrence (
= 0.016), and progression-free survival (
= 0.010) compared to C allele carriers. Multivariate Cox regression revealed that ATA risk (HR = 14.210,
= 0.000004) and HOTAIR rs920778 (HR = 2.811,
= 0.010) emerged as independent prognostic factors in PTC. A novel polymorphism, MIR155HG rs1893650, was negatively correlated with susceptibility to PTC, with TC heterozygotes exerting a protective effect (OR = 0.268,
= 0.0001). These results suggest that the polymorphisms HOTAIR rs920778 and MIR155HG rs1893650 could be potential prognostic and risk biomarkers in papillary thyroid carcinomas.
Objective
To propose a new reference line in diagnosing a high-riding patella (patella alta) on routine digital lateral radiographs of the knee.
Materials and methods
On 64 routine digital lateral ...radiographs of adult knees with no bone pathology or surgery and over the range of knee flexion between 1.6° and 79.1° (34.4°± 16.6°), the long axis of the superimposed egg-shaped femoral condyles was drawn and moved upward to pass through the point where the posterior contours of the femoral diaphysis and the femoral condyles meet—the posterior reference point—to become a new reference line. Any part of the patella crossing the new reference line indicated a high-riding patella. The new reference line was compared with the four most common patellar height ratios (Insall–Salvati, Grelsamer–Meadows or the modified Insall–Salvati, Caton Deschamps, and Blackburne–Peel) for the drawing time, accuracy, and reproducibility (intra- and interobserver agreement).
Results
The new reference line required approximately one-third to one-half of the drawing time compared to the most common patellar height ratios, with equal accuracy and complete reproducibility. On the contrary, the reproducibility of the most common patellar height ratios ranged from poor to moderate, with the best results for the Insall–Salvati ratio.
Conclusions
The new reference line proved to be a very simple, accurate, and reproducible tool in diagnosing a high-riding patella. We believe that our preliminary results are an encouraging impetus to more complex research.
Introduction: Research objectives of present study were to examine sex and age-related specifics of diabetic retinopathy according to the therapy approach and duration of diabetes mellitus. The study ...also aimed to determine the association between the presence of diabetic retinopathy and diabetes duration as a prognostic factor of retinopathy progression in such patients.
Materials and Methods: The study was designed as a retrospective study and included 289 patients with diabetic retinopathy, who were treated at the Department of Ophthalmology of the General Hospital “Dr. Josip Benčević” in Slavonski Brod during the period from 2019 to 2020.
Results: 176 patients were treated with oral antidiabetic drugs (OAD), while 113 patients were insulin-dependent. The median age of patients treated with OAD was 77 years. Diabetic retinopathy was present in 35 (19.9%) patients, of whom 33 (18.8%) had non-proliferative diabetic retinopathy, while 2 patients (1.1%) had proliferative diabetic retinopathy. The median age of the insulin-dependent patients was 79 years. Diabetic retinopathy was present in 54 patients (47.8%), non-proliferative diabetic retinopathy was diagnosed in 51 patients (45.1%), while proliferative diabetic retinopathy was diagnosed in only 3 (2.7%) patients. There was a significant difference between the presence of diabetic retinopathy and diabetes duration (P<0.001), as well as between the therapy approach and diabetes duration (⍺<0.001).
Conclusion: Various hypotheses have been proposed to explain the worsening of diabetic retinopathy, and we assume that the therapy approach, duration of diabetes and HbA1c have a significant role in retinopathy progression. Hereby, we emphasize that, although there have been significant advances, there is still a pressing need for a better understanding of a new therapeutic modality, new tools for identifying high-risk patients and continued monitoring in order to intervene effectively before vision loss occurs. Further research is needed to identify and implement the best practices to increase diabetic eye screening rates in the long term.
•A decreased value of the Böhler’s angle (<20°) indicates calcaneal fracture.•The Böhler’s angle is not related to age, sex, and laterality.•Its interrater reliability is almost perfect.
To examine ...the relationship of the Böhler’s angle with age, sex, and laterality, and to analyze the interrater agreement.
After 248 digital lateral radiographs of the foot were submitted to exclusion criteria, three raters independently measured the Böhler’s angle on the remaining 130 X-rays in PACS. The variables were analyzed with correlation coefficients, and one-way ANOVA. The repeated measures of ANOVA were computed across age groups (30–39, 40–49, 50–59, and 60–69 years). The interrater agreement was calculated using intraclass correlation coefficient (ICC).
The mean value of the Böhler’s angle was 34±5° (21–46°). It was not related to age (in general p=0.057, and across groups p from 0.107 to 0.122), sex (p=0.344; p=0.342), and laterality (p=0.618; p=0.617). The interrater reliability was almost perfect (ICC=0.94).
The Böhler’s angle was not related to age, sex, and laterality, whereas the interrater agreement was almost perfect.
Background/Aim. Thyroid nodules represent a common problem in medicine. Ultrasound examination of the thyroid glands is a common method for the initial diagnosis of thyroid neoplasia enabling the ...selection of nodules that should undergo fine needle aspiration biopsy (FNAB). It is a noninvasive method that has a great potential in discovering suspicious lesions, enabling timely actions for further diagnostics and potential treatment. However, it is still not clear enough how the quantitative data collected from Ultrasound elastography correlate with those obtained by other diagnostic tools used for detecting thyroid nodules. The aim of this study was to estimate the importance of ultrasound elastography in diagnostics of differentiated thyroid carcinomas but also to estimate the importance of other diagnostic procedures as well. Methods. The research was performed on patients initially referred to the Clinic of Endocrinology in Military Medical Academy, Belgrade to evaluate the status of thyroid nodules. The da-ta from ultrasound elastography was then correlated with those from other diagnostic procedures including clinical examination, echosonography, cytological and histopathological analyses. Results. Statistically significant difference between the group of patients with follicular adenoma and the group of patients with differentiated thyroid carcinoma was detected for consistency, nodules immovability, thyroglobulin (Tg) levels, presence of calcifications in the nodules and the elastographic score. Fixed nodules and those with firmer consistency were significantly more common in the group of patients with malignant lesions, in which Tg levels were higher. The elastography score 3-4 showed a high predictive value for the detection of thyroid carcinoma, unlike the elasticity score. Conclusion. Ultrasound elastography represents a new non-invasive method that has a very significant, high predictive value for the detection of thyroid carcinoma, especially in correlation with other diagnostic procedures.
The ileal neobladder should be a lowpressure reservoir with acceptable volume and relatively small resorptive surface. A larger inner surface of the ileal pouch is associated with the high resorption ...of urine metabolites through intestinal mucosa and systemic metabolic disturbances, while a too small pouch results in a higher frequency of voiding and incontinency. The aim of this study was to investigate it is possible to create a neobladder from a shorter ileal segment compared to standard surgical techniques, and reduce metabolic complications.
This prospective study included 77 male patients, scheduled for radical cystectomy and orthotopic neobladder derivation. The patients were divided into two groups: the standard pouch (SP) group of 37 patients scheduled for standard orthotopic neobladder, using a 50−70 cm long terminal ileum segment; the “Belgrade pouch” (BP) group of 40 patients scheduled for original, orthotopic urinary reservoir, using a 25−35 cm long terminal ileum segment. We measured neobladder capacity, acidosis, base excess and bicarbonate concentration in the postoperative month 3rd, 6th, 12th and 15th.
At the end of the study, the patients from the SP group had much higher neobladder capacity than the natural bladder − 750 mL (range 514−2,050 mL); in contrast, the patients from the BP group had average capacity of 438 mL (range 205−653 mL) (p < 0.001). At the end of the study, there were more patients with acidosis (37.8% : 2.5%), base excess (35.1% : 7.5%) and low bicarbonate level (40.5% : 20.0%) in the SP group, than in the BP group, respectively (p < 0.001).
“Belgrade pouch”, make from 25−35 cm long terminal ileum segment may obtain adequate capacity and lower rate of metabolic disturbances than standard, high capacity orthotopic neobladders.
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