1,721,101 research outputs found
Clinical and subclinical autoimmune thyroid disorders insystemic sclerosis
No full textObjective: Several studies have reported the association of systemic sclerosis (SSc) with thyroidautoimmune disorders, but most of them have neither an appropriate control group nor include acomplete thyroid work-up.Design: The aim of our study was to evaluate the prevalence of thyroid disorders in a large number ofpatients with SSc using a complete clinical evaluation.Methods: Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroglobulinand antithyroid-peroxidase (AbTPO) autoantibodies, thyroid ultrasonography and blood flow and fineneedle aspirationwere performed in 202 SSc patients versus 404 gender- and age-matched controls fromthe general population, with similar iodine intake, to evaluate the prevalence of clinical and subclinicalthyroid disorders.Results: Odds ratio (OR) for female SSc versus controls was: for subclinical hypothyroidism, 3.2(95% CI)Z1.8–5.7); for clinical hypothyroidism, 14.5 (95% CIZ2.3–90.9); for AbTPO positivity,2.7 (95% CIZ1.8–4.1); for hypoechoic pattern, 3.2 (95% CIZ2.2–4.7); for thyroidautoimmunity, 3.7 (95% CIZ2.6–5.4); for thyroid volume !6 ml, 1.8 (95% CIZ1.2–2.7).OR for thyroid autoimmunity in male SSc versus controls was 10.8 (95% CIZ2.2–52.4). Meanvalues of TSH in female SSc, and of AbTPO in female and male SSc were higher (P!0.01) thanin controls. We observed three cases of Graves’ disease in female SSc versus zero in controls(PZ0.0140), and two cases of papillary thyroid cancer in SSc patients.Conclusions: Thyroid function, AbTPO and ultrasonography should be tested as part of theclinical profile in SSc patients. Females, subjects with positive AbTPO and hypoechoic and smallthyroid should have thyroid function follow-up and appropriate treatment in due course
Sorafenib and Thyroid Cancer
No full textSorafenib (Nexavar) is a multikinase inhibitor, which has demonstrated both anti-proliferative and anti-angiogenic properties in vitro and in vivo, inhibiting the activity of targets present in the tumor cell [c-RAF (proto-oncogene serine/threonine-protein kinase), BRAF, V600EBRAF, c-KIT, and FMS-like tyrosine kinase 3] and in tumor vessels (c-RAF, vascular endothelial growth factor receptor-2, vascular endothelial growth factor receptor-3, and platelet-derived growth factor receptor β). For several years, sorafenib has been approved for the treatment of hepatocellular carcinoma and advanced renal cell carcinoma. After previous studies showing that sorafenib was able to inhibit oncogenic RET mutants, V600EBRAF, and angiogenesis and growth of orthotopic anaplastic thyroid cancer xenografts in nude mice, some clinical trials demonstrated the effectiveness of sorafenib in advanced thyroid cancer. Currently, the evaluation of the clinical safety and efficacy of sorafenib for the treatment of advanced thyroid cancer is ongoing. This article reviews the anti-neoplastic effect of sorafenib in thyroid cancer. Several completed (or ongoing) studies have evaluated the long-term efficacy and tolerability of sorafenib in patients with papillary and medullary aggressive thyroid cancer. The results suggest that sorafenib is a promising therapeutic option in patients with advanced thyroid cancer that is not responsive to traditional therapeutic strategies. © 2013 Springer International Publishing Switzerland
VALIDAZIONE PRELIMINARE DI UN QUESTIONARIO SUL CARICO EXTRALAVORATIVO NELL’INTERFACCIA CASA-LAVORO IN OTTICA DI GENERE
No full textScopo del presente studio è quello di validare
uno strumento anamnestico parametrico a supporto
del Medico Competente nel rilevare difficoltà individuali del lavoratore legate al genere, con particolare attenzione agli aspetti di conciliazione che potrebbero avere ricadute su problemi di salute e sicurezza in ambito lavorativ
New Targeted Therapies for Anaplastic Thyroid Cancer
No full textAnaplastic thyroid cancer (ATC) is often incurable because it doesn't respond to radioiodine, radiotherapy or chemotherapy, and new therapeutic approaches are needed. Peroxisome proliferator-activated receptor-gamma (PPARg) gene and protein are present in ATC cells, and PPARg ligands inhibit cell proliferation, induce apoptosis, and also down regulate the invasive potential of ATC cells. Also, inhibitors of the Aurora serine/threonine kinases have antineoplastic effect on ATC cells in vitro and on ATC xenografts. Tyrosine kinases inhibitors are actually under evaluation for the treatment of ATC, for example imanitib or sorafenib. Other studies have focused on evaluating antiangiogenic agents for treatment of ATC. These agents include: combretastatin A4 phosphate, aplidin, PTK787/ZK222584, and human VEGF monoclonal antibodies (bevacizumab, cetuximab). Small-molecule adenosine triphosphate (ATP) competitive inhibitors directed intracellularly at epidermal growth factor receptor (EGFR)'s tyrosine kinase, such as erlotinib, or gefitinib are also under evaluation. The development of drugs that have multiple therapeutic targets and the utilization of multiple cancer-targeting agents are both emerging strategies for ATC treatment. For example, a preclinical study evaluated the activity of a dual inhibitor of EGFR and vascular endothelial growth factor (VEGF), NVP-AEE788, alone and in combination with paclitaxel for the treatment of ATC. Even if new therapeutic approaches against ATC are under development, more research is needed to finally identify therapies able to control and to cure this disease. The possibility of testing the sensitivity of primary ATC cells from each subject to different drugs could increase the effectiveness of the treatment in the next future
A new class of tyrosine kinase inhibitors, “pyrazolo[3,4-d]pyrimidinic”compounds, has antitumoral activity in vitro and in vivo in papillary dedifferentiated thyroid cancer
No full textEmerging Therapeutic Approaches for the Most Aggressive Epithelial Thyroid Cancers.
Full text linkThe majority of epithelial thyroid carcinomas (TC) have a differentiated (DTC) histotype
and include the papillary (PTC) and the follicular (FTC) TC which, ensuing dedifferentiation,
generate the aggressive poorly differentiated (PDTC) and anaplastic (ATC)
TC. Although derived from the same cell type, each TC shows specific histological
features, biological behavior, and degree of differentiation because of different genetic
alterations. Total thyroidectomy, followed by adjuvant therapy with 131I, is the treatment
of choice for most patients affected by DTC. The prognosis of DTC patients is favorable,
with 10‐year survival rate of nearly 90%. However, one third of them face the
morbidity of disease recurrence and TC‐related deaths. The worst outcomes are
encountered in patients with PDTC and ATC. The latter, in particular, has a mean
survival time of few months from the diagnosis, which is not influenced by current
anticancer treatments. Following the progress made in the comprehension of the
underlying molecular mechanisms deregulated in TC progression, novel therapeutic
approaches have come to light. Here, we will attempt to review new targeted therapies,
which are currently being exploited in preclinical and clinical studies, with tyrosine
kinase inhibitors as well as with emerging inhibitors of mitotic kinases, in PDTC and
ATC
Lobectomy versus total thyroidectomy in children with post-Chernobyl thyroid cancer: a 15 year follow-up.
No full textIn 1994, 21 Belarus children presenting papillary thyroid cancer (PTC) diagnosed after the Chernobyl disaster, and already submitted to subtotal surgery, underwent thyroid re-operation and post-operative radioiodine (131(I)) therapy. All were re-evaluated after a 15-year follow-up, to evaluate the results of partial versus total thyroidectomy. Nineteen out of 21 children (mean age 9.2 years) had previously undergone a lobectomy. All cases underwent re-operation in 1994. Histology revealed a PTC in the residual lobe in three cases, three had lymph node metastases. After surgery, 20 patients underwent 131(I) therapy. The post-131(I) whole body scan was negative in seven cases, showed neck node metastases in five, lung metastases in three, multiple associated metastases in six. The follow-up was performed with rhTSH-stimulated serum thyroglobulin (Tg) evaluation and ultrasonography. Twenty patients showed Tg <1 ng/ml and negative ultrasonography; the patient who refused 131(I) therapy showed a thyroid remnant and a Tg of 32 ng/ml. Chi-square analysis showed significantly higher prevalences of residual cancer in the neck or lung, lymph node metastases, and re-operations (before completion) in patients who had undergone lobectomy than in those who had undergone completion thyroidectomy and 131(I) therapy. The surgical complications after lobectomy were similar to those after completion thyroidectomy. A less-than-total thyroidectomy should not be indicated in patients with radiation-induced PTC, due to the high risk of residual cancer in the thyroid left in situ. The results of this study favor total thyroidectomy as the initial treatment for thyroid cancer in children exposed to fallout radiation
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
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