Medicine
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Observational Study
Ultrasound risk evaluation of thyroid nodules that are "unspecified" in the 2015 American Thyroid Association management guidelines: A retrospective study.
This study sought to assess the malignant risks of "unspecified" thyroid nodules; that is, nodules that were not of a type described in the 2015 American Thyroid Association (ATA) guidelines. We retrospectively reviewed medical records and ultrasound (US) data for 1808 consecutive patients with 2614 thyroid nodules who underwent thyroidectomy between January 2015 and December 2015. Nodules with US features that did not satisfy the criteria for any risk category in the 2015 ATA guidelines were defined as "unspecified" nodules. ⋯ The percentages of nodules with ACR-TIRADS grades TR2, TR3, TR4, and TR5 were 5.7%, 2.9%, 70.0%, and 21.4%, respectively. Among the "unspecified" nodules, there were significantly more nodules in Kwak-TIRADS categories 4b and 4c in the malignant pathology group than in the benign pathology group (P <.01). Our results imply that "unspecified" thyroid nodules based on the ATA guidelines could partly be evaluated using the Kwak-TIRADS and that the ATA guidelines could incorporate more accurate malignant risk stratification.
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Case Reports
Case report: an intriguing sign in a patient with an inferior rectus muscle granular cell tumor.
Occurrence of granulosa cell tumors (GCTs) in the eye are rare and may be diagnosed by imaging examination and immune-histochemical studies. Two common signs of a rectus muscle tumor are the proptosis of the eye ball and the complaint of bi-ocular diploma. ⋯ Ophthalmologists should be aware that when a patient's visual acuity is normal when looking forward but severely low when gazing upward, it may be a sign of a GCT of the inferior rectus muscle.
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Clinical Trial Observational Study
Characterisation of gut, lung, and upper airways microbiota in patients with non-small cell lung carcinoma: Study protocol for case-control observational trial.
Several studies have confirmed the important role of the gut microbiota in the regulation of immune functions and its correlation with different diseases, including cancer. While brain-gut and liver-gut axes have already been demonstrated, the existence of a lung-gut axis has been suggested more recently, with the idea that changes in the gut microbiota could affect the lung microbiota, and vice versa. Likewise, the close connection between gut microbiota and cancer of proximal sites (intestines, kidneys, liver, etc.) is already well established. However, little is known whether there is a similar relation when looking at world's number one cause of death from cancer-lung cancer. ⋯ The study is a case-controlled observational trial. Forty NSCLC patients will be divided into 2 groups depending on their anamnesis: Pchir, patients eligible for surgery, or Pct-chir, patients eligible for neoadjuvant chemotherapy plus surgery. Composition of the UAs (saliva), gut (faeces), and lung microbiota (from broncho-alveolar lavage fluid (BALF) and 3 lung pieces: "healthy" tissue distal to tumour, peritumoural tissue and tumour itself) will be analysed in both groups. Immune properties will be evaluated on the local (evaluation of the tumour immune cell infiltrate, tumour classification and properties, immune cell phenotyping in BALF; human neutrophil protein (HNP) 1-3, β-defensin 2, and calprotectin in faeces) and systemic level (blood cytokine and immune cell profile). Short-chain fatty acids (SCFAs) (major products of bacterial fermentation with an effect on immune system) will be dosed in faecal samples. Other factors such as nutrition and smoking status will be recorded for each patient. We hypothesise that smoking status and tumour type/grade will be major factors influencing both microbiota and immune/inflammatory profile of all sampling sites. Furthermore, due to non-selectivity, the same effect is expected from chemotherapy.
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Observational Study
Efficacy and safety of ultrasound-guided cannulation via the right brachiocephalic vein in adult patients.
Central venous catheter (CVC) insertion is difficult to perform and is a high-risk operation; ultrasound (US)-guided cannulation helps increase the odds of success while reducing the associated complications. The internal jugular vein (IJV) and subclavian vein (SCV) are the most commonly sites in US-guided CVC insertion. In the present study, we evaluated the safety and efficacy of US-guided supraclavicular right brachiocephalic vein (BCV) cannulations in adult patients. ⋯ Insertion lasted an average of 10.68 ± 8.77 days. Supraclavicular, in-plane, US-guided cannulation of the right BCV is an effective and safe method for inserting central venous catheters in adult patients. It provides another option for catheter access to boost clinical performance in central venous catheterization.
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Fecal microbiota transplantation (FMT) has been used in a wide variety of diseases. In this article, we reported a 46-year-old female with diabetic neuropathy (DN) achieved remission by the treatment of FMT. ⋯ We proposed that FMT could be a promising treatment in patients with diabetes or diabetes-related complications like DN. FMT also appeared to be definitely safer and more tolerable than the pharmacologic treatment in patients with DN.