1,721,429 research outputs found

    Current methodologies for molecular screening of thyroid nodules

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    Several molecular tests have been developed for thyroid cytology with the main purpose to define the nature of indeterminate nodules in presurgical phase thus overcoming the limitations of cytological analysis. Molecular tests currently available for thyroid nodules are based on a variety of methodologies and display peculiar strengths and limitations: in this review of the literature they are summarized and critically discussed. The use of molecular diagnostics for thyroid cytology is increasingly widespread and accepted, however large, prospective validation studies are still needed to ultimately demonstrate the clinical efficacy of a wide incorporation of molecular tests into clinical practice

    BRAF mutation status in papillary thyroid carcinoma: Significance for surgical strategy

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    Background: BRAF mutation is probably the only molecular marker acting as a risk factor that is available before surgery: for this reason, soon after it became quite widespread, it seemed an important tool as a guide towards an individualized surgical therapy in papillary thyroid carcinoma. Purpose: Capsule invasion, multifocality, and lymph node involvement are the most important parameters influencing the choice of surgical strategy in front of small papillary cancers and, in more detail, of micro papillary carcinomas. The relationship between these parameters and the BRAF mutation are closely examined through the more recent literature. Capsular invasion seems to show the strongest correlation with the mutation and this has important correlations, thus suggesting that a more aggressive local surgery might be advisable, whereas the correlation between the mutation and lymph node involvement would be weaker, at least according to the most recent studies. Conclusions: The personalization of surgical therapy, today, seems easier to achieve thanks to molecular testing. In particular, an important result could be in the short term reduction in the number of completion thyroidectomies following simple lobectomies. Also, post operative radioactivated iodine therapies should be more carefully evaluated and tailored according to BRAF status. A possible flow chart for the decision of the therapeutic approach is proposed in accordance to the results of the literature. © 2013 Springer-Verlag

    Dalla gioiosa anarchia alla standardizzazione secondo l'ANVUR : i dottorati di ricerca di area medica dell'Università di Pisa 2005-2014 : analisi, valutazione, proposte operative

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    Trenta anni esatti separano la cosiddetta legge 382 dalla legge 240, la “Gelmini”, del 2010. In questo intervallo il terzo livello della formazione, il Dottorato di Ricerca, ha visto le sue caratteristiche mutare più volte nel tempo fino ad approdare in tempi assai recenti all’accreditamento dei Corsi relativi da parte dell’Agenzia Nazionale di Valutazione della Università e della Ricerca (ANVUR). Nel ripercorrere le varie fasi attraversate dal Dottorato, gli Autori individuano le criticità, talora anche gli aspetti contraddittori delle normative, per analizzare infine in dettaglio le caratteristiche dei Dottorati di area medica di un singolo Ateneo, nelle sue specificità. Pur mettendo in debita luce i pregi di una seria valutazione da parte degli organi competenti, non possono sfuggire a questa disamina alcune inadempienze soprattutto a livello di finanziamento dei Dottorati di Ricerca che rischiano di limitare non poco lo sviluppo di questo importante settore della formazione senza cui non si può pensare che l’istruzione superiore possa dirsi completa, così come non è possibile concepire una ricerca avanzata se non sostenuta da un adeguato strumento di selezione e reclutamento dei ricercatori quale è in tutto il mondo avanzato il Dottorato di Ricerca

    Noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP): a new entity

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    Since its first official definition in 2016, the new histo-pathological entity of noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) has attracted much interest among “thyroidologists” worldwide. This is a subset of encapsulated and noninvasive follicular variant papillary thyroid cancer, whose introduction had the intent of de-escalating treatment given its very low malignant potential, approaching to that of follicular adenomas. Many researchers focused on the possibility of preoperatively identifying NIFTP, and investigated their cyto-morphological and molecular characteristics; other ones explored histological and clinical-pathological NIFTP features. Although the majority of published studies confirmed that NIFTP are indolent lesions, some papers did question their low-risk nature. In this brief review, the main aspects of histology, cytology and molecular pathology of NIFTP are discussed based on the current literature
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