1,720,968 research outputs found
Operation rate and cancer prevalence among thyroid nodules with FNAC report of suspicious for malignancy (TIR4) or malignant (TIR5) according to Italian classification system: a systematic review and meta-analysis
No full textBACKGROUND: In the Italian system for reporting thyroid cytology (ICCRTC), nodules suspicious for (TIR4) and consistent with (TIR5) malignancy are thought being 5% and 4–8% of all biopsies and having risk of malignancy of 60–80% and >95%, respectively. However, no evidence-based data exist about these figures. The present systematic review aimed at achieving solid estimates about TIR4 and TIR5 also considering potential influencing factors. METHODS: The review was conducted according to MOOSE. Databases of Google Scholar and Cochrane were searched. No language restriction was used. The last search was performed on February 26th 2022. Quality assessment was performed. Proportion meta-analyses were performed using random-effect model. Statistical analyses were performed using OpenMeta [Analyst]. RESULTS: The online search retrieved 271 articles and 16 were finally included for quantitative analysis. The risk of bias was generally low. The pooled cancer prevalence in TIR4 was 92.5% (95%CI 89.4–95.6%) with unexplained moderate heterogeneity. The pooled cancer rate among TIR5 was 99.7% (95%CI 99.3–100%) without heterogeneity. The resection rate in TIR4 and TIR5 showed heterogeneity, being the latter explained when using their prevalence among biopsies: the higher the prevalence, the higher the operation rate. The pooled risk difference between TIR5 and TIR4 was significant (OR 11.153). CONCLUSIONS: These figures can form the basis for the next updated version of ICCRTC. Any institution using ICCRTC should revise its series of TIR4/TIR5 to calculate the cancer rate, and, importantly, consider the modifiers of the risk of malignancy. A cross check among institutions is advised
Interest of researchers in ultrasound systems for risk stratification of thyroid nodules (TIRADS): a systematic review
No full textBackground A number of ultrasound risk stratification systems (RSSs) of thyroid nodule, often labeled as TIRADS (Thyroid Imaging Reporting and Data System), have been proposed. As a consequence, an increasing number of studies have been published on this topic. This systematic review was undertaken to answer specific questions in this field: how many articles and what type of studies have been published, which TIRADSs/RSSs have preferably been discussed, and what is the geographic distribution of the publications. Methods The study was conducted according to PRISMA. A specific search algorithm was used. Defined selection criteria were applied. Results 502 studies were finally included. The number of publications about TIRADSs/RSSs has increased over the time, being the Horvath TIRADS the most evaluated one. The first author of the article was from China in one fourth of cases. Conclusions The number of scientific articles focused on TIRADSs/RSSs is high and it has been importantly increased over the time
Non-invasive measurement of coronary flow reserve: uniqueness of radionuclide methods and alternative techniques
No full textOver the last several decades, radionuclide Myocardial Perfusion Imaging (MPI) has been a mainstay for the evaluation of coronary artery disease (CAD), based on the assumption that a detailed knowledge of stenosis localization and severity is not sufficient for clinical decision making. Furthermore, radionuclide MPI diagnostic accuracy has been implemented by the assessment of Coronary Flow Reserve (CFR) and Myocardial Blood Flow (MBF), as quantitative indexes of stenosis severity and surrogates of total ischaemic burden. Several considerations indicate that these measurement actually improve description of coronary physiology with respect to conventional qualitative image analysis. However, several alternative approaches have been optimized and increasingly proposed to achieve this task in the clinical setting. The aim of the present narrative review is to discuss strengths and weaknesses of the various cardiac modalities proposed to define CFR and MBF in the era of multi-modality imaging
Thyroid Nodules with Indeterminate FNAC According to the Italian Classification System: Prevalence, Rate of Operation, and Impact on Risk of Malignancy. An Updated Systematic Review and Meta-analysis
No full textA thyroid nodule classified as indeterminate on fine-needle aspiration cytology (FNAC), hereafter referred to as an indeterminate thyroid nodule (ITN), represents a clinical dilemma. The Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) divides ITNs into low- and high-risk categories (i.e., TIR3A and TIR3B, respectively) to better manage patients. This study aimed to achieve high-evidence estimates of the prevalence, rate of operation, and risk of malignancy of ITNs, including TIR3A and TIR3B ITNs. This systematic review was conducted according to MOOSE to retrieve all original studies citing ICCRTC. The last search was performed in February 2022. The risk of bias of the included studies was assessed. Separate proportion meta-analyses were performed with a random-effect model using OpenMeta[Analyst]. The online search processed 271 studies, and 33 were finally considered. First, the cancer prevalence among ITNs was 32.4%. Second, the cancer prevalence among TIR3As was 12.4%, with heterogeneity (I(2) 90%) explained by a linear correlation between sample size and cancer rate (p = 0.009). Third, the cancer prevalence among TIR3Bs was 44.4%, with heterogeneity (I(2) 75%) explained by the inverse correlation between sample size and cancer rate (p = 0.031). Fourth, the prevalence of ITNs, TIR3A, and TIR3B among FNACs was 29.6%, 12.6%, and 12.9%, respectively, with sample size and TIR3B prevalence being inversely correlated (p = 0.04). Fifth, the operation rates of ITNs, TIR3A, and TIR3B were 54.3%, 48.3%, and 75.2%, respectively, and the sample size and TIR3A operation rate were inversely correlated (p = 0.010). These data strongly support the division of ITNs into low- and high-risk subcategories. Importantly for clinical practice, the cancer rate among ITNs is significantly influenced by the study sample size. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12022-022-09729-x
Suboptimal accuracy of ultrasound and ultrasound‐based risk stratification systems in detecting medullary thyroid carcinoma should not be overlooked. Findings from a systematic review with meta‐analysis
No full textOBJECTIVE: Ultrasound (US) is the pivotal procedure during the diagnostic work‐up of thyroid nodule and several US‐based risk stratification systems (RSSs) have been recently developed. Since the performance of RSSs in detecting medullary thyroid carcinoma (MTC) has been rarely investigated, the present systematic review aimed to achieve high evidence about (1) how MTC is classified according to RSSs; (2) if RSSs correctly classify MTC at high risk/suspicion, and (3) if MTC is classified as suspicious at US when RSSs are not used. DESIGN: The review was performed according to MOOSE. The online search was performed by specific algorithm on January 2022. A random‐effects model was used for statistical analysis. RESULTS: Twenty‐five papers were initially included and their risk of bias was generally low. According to ATA system, 65% of MTCs was assessed at high suspicion and 25% at intermediate suspicion. Considering all RSSs, a 54.8% of MTCs was put in a high‐risk/suspicion category. Pooling data from studies without data of RSS the prevalence of ultrasonographically suspicious MTCs was 60%. CONCLUSIONS: As conclusion, MTC presentation according to RSSs is partially known and it is classified in a high‐risk/suspicion category of RSSs in just over a half of cases. This advises for further studies, ideally supported by international societies, to better define the US presentation of MTC
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Correlation between thoracic aorta 18F-natrium fluoride uptake and cardiovascular risk
No full textBackground and Aims: 18F Natrium Fluoride (NaF) has been proposed as a clinical tool to identify and quantify ongoing arterial calcification. Estimation of NaF uptake by vessel walls is feasible in the majority of large vessels; it is conversely more challenging within the coronary tree, given the small size of these vessels and the artifacts from cardiac movement. In CT-based studies, thoracic artery calcification has been linked to both coronary calcification and cardiovascular risk (CVR). Moreover, among thoracic segments, descending aorta has demonstrated the greatest correlation to CVR and to CV events. In this study, we evaluated NaF uptake in different segments of the thoracic aorta, its difference among CVR groups and its correlation with the absolute CVR value.
Patients and Methods: 78 patients (44 females, mean age 63, range 44-83) underwent whole body NaF PET/CT, to detect intraosseous localization of breast or prostate cancer. CVR risk score was assessed with a modified version of the Framingham model, accounting BMI in lieu of cholesterol levels; patients were divided in three CVR categories: low (LR), medium (MR) and high risk (HR), who had a likelihood of 10-years CV events of <10%, 10-20% and >20%, respectively. NaF uptake was measured by manually drawing volumes of interest (VOI) on the ascending aorta, on the aortic arch, on the descending aorta and on the myocardium; average SUV measured within these VOI was normalized for blood-pool SUV, assessed in the inferior vena cava, to obtain target-to-background ratio (TBR). Values from the three aortic segments were then averaged to obtain an index of the whole thoracic aorta.
Results: There was a significant difference in whole thoracic aorta ??? TBR between HR and LR (1.84±0.76 vs 1.07±0.3, p<0.001), but also between MR and HR-LR (1.4±0.4, p<0.02 and p<0.01, respectively). The most efficient CVR stratification was however observed in the descending aortic segment: significance of the TBR difference between HR vs LR, HR vs MR and MR vs LR was 0.0004, 0.008 and 0.01, respectively. Correlation between TBR and CVR was appreciable when the whole thoracic aorta was considered (R=0.67), but it peaked when correlating the descending thoracic segment (R=0.75), in comparison with the aortic arch and the ascending segment (R=0.55 and 0.53, respectively).
Conclusions: Fluoride uptake within the thoracic aorta wall effectively depicts patients' risk class and closely correlates with cardiovascular risk. Among segments, descending thoracic aorta is the most effective in CVR determination
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