Coagulopathies and inflammatory diseases: '…glimpse of a Snark'. Curr Opin Immunol. 2018 Sep 27;55:44-53 Authors: Del Carmen S, Hapak SM, Ghosh S, Rothlin CV Abstract Coagulopathies and inflammatory diseases, ostensibly, have distinct underlying molecular bases. Notwithstanding, both are host defense mechanisms to physical injury. In invertebrates, clotting can function directly in anti-pathogen defense. Molecules of the vertebrate clotting cascade have also been directly linked to the regulation of inflammation. We posit that thrombophilia may provide resistance against pathogens in vertebrates. The selective pressure of improved anti-pathogen defense may have retained mutations associated with a thrombophilic state in the human population and directly contributed t...
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Δευτέρα 1 Οκτωβρίου 2018
Coagulopathies and inflammatory diseases:'…glimpse of a Snark'.
Association of M470V polymorphism of CFTR gene with variability of clinical expression of asthma: Case-report study.
CONCLUSIONS: The present study is the first report on the distribution of the M470V polymorphism in asthmatic Tunisian patients. We noticed that the M470V variant could modulate the clinical phenotype of asthmatic patients. This preliminary study will establish the molecular basis of this disease in Tunisia. PMID: 30268379 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Evaluation of interleukin-12 receptor β1 and interferon gamma receptor 1 deficiency in patients with disseminated BCG infection.
CONCLUSION: It is recommended that to avoid BCG complications, screening be performed for MSMD before BCG inoculation in individuals with positive family history of primary immunodeficiency diseases and inhabitants of areas with high frequency of consanguinity. PMID: 30268380 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Current therapeutic paradigm in pediatric atopic dermatitis: Practical guidance from a national expert panel.
CONCLUSIONS: This set of practical recommendations represents a simple and fast snapshot on the pediatric use of common anti-AD therapeutics. PMID: 30268381 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Microflora of normal maxillary sinuses: does it justify perioperative antibiotic treatment in sinus augmentation procedures
Abstract
Objectives
To investigate bacterial flora of normal maxillary sinuses in order to facilitate perioperative antibiotic management in sinus augmentation procedures.
Materials and methods
Specimens of maxillary sinus mucosa were harvested during planned orthognatic surgery in 18 patients with no evidence of rhinosinusitis. The samples were processed according to hospital routine for aerobic and anaerobic cultures.
Results
Ten maxillary sinuses were found sterile. Twenty-six (72%) maxillary mucosa specimens were culture-positive. Aerobes were recovered in 21 sinus samples (58%), predominantly as polymicrobial flora (18 cultures, 50% of all specimens), S. aureus in 2 sinuses of the same patient (6% of the samples), and Bacillus sp. in 1 sinus (3%). Anaerobes were isolated in 20 of 26 culture-positive specimens (56% of all sinus samples). They were recovered alone in 5 samples. Fifteen anaerobic cultures were polymicrobial (42% of all samples). Propionibacterium acnes was isolated from another 5 sinuses (14%) of 3 patients.
Conclusions
Our data support the policy of perioperative antibiotic prophylaxis in sinus augmentation procedures where Schneiderian membrane is perforated.
Clinical relevance
Evaluating the need of a perioperative antibiotic therapy in sinus augmentation procedures.
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Evaluation of the genotoxic potential of different delivery methods of at-home bleaching gels: a single-blind, randomized clinical trial
Abstract
Objective
This single-blind, parallel, randomized clinical trial evaluated the genotoxic potential and effectiveness of 10% hydrogen peroxide (HP) in patients submitted to at-home bleaching.
Materials and methods
Sixty young volunteers with maxillary incisors equal to or darker than M1.5 were included in the study. Patients were submitted to bleaching for 14 days (30 min/day) with one of the three 10% HP treatments: the bleaching agent was delivered in a bleaching tray (White Class, FGM), whitening strips (White Strips, Oral-b), or in prefilled disposable trays (Opalescence Go, Ultradent). The color change was evaluated with the Vita Bleachedguide, and the micronucleus test of exfoliative oral mucosa was carried out, starting from a count of 1000 cells, at the baseline, immediately after and 30 days after the end of the treatment. The micronucleus data were evaluated with the Kruskal-Wallis and Wilcoxon tests and color change with the two-way ANOVA test and the Tukey test (α = 0.05).
Results
Significant whitening was observed for all groups after 14 days (p = 0.001) and was maintained after 30 days, with no difference between groups (p = 0.42). The micronucleus count did not indicate genotoxic potential in any of the groups studied (p = 0.32), irrespective of the time intervals (p = 0.62).
Conclusion
No genotoxic effects of 10% HP were observed in patients submitted to at-home bleaching systems (30 min/day for 14 days), even 30 days after the end of treatment.
Clinical significance
It is safe to use different systems to deliver 10% HP during at-home bleaching according to the manufacturers' recommendations, with no risk of genotoxic effects applied.
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Microflora of normal maxillary sinuses: does it justify perioperative antibiotic treatment in sinus augmentation procedures
Abstract
Objectives
To investigate bacterial flora of normal maxillary sinuses in order to facilitate perioperative antibiotic management in sinus augmentation procedures.
Materials and methods
Specimens of maxillary sinus mucosa were harvested during planned orthognatic surgery in 18 patients with no evidence of rhinosinusitis. The samples were processed according to hospital routine for aerobic and anaerobic cultures.
Results
Ten maxillary sinuses were found sterile. Twenty-six (72%) maxillary mucosa specimens were culture-positive. Aerobes were recovered in 21 sinus samples (58%), predominantly as polymicrobial flora (18 cultures, 50% of all specimens), S. aureus in 2 sinuses of the same patient (6% of the samples), and Bacillus sp. in 1 sinus (3%). Anaerobes were isolated in 20 of 26 culture-positive specimens (56% of all sinus samples). They were recovered alone in 5 samples. Fifteen anaerobic cultures were polymicrobial (42% of all samples). Propionibacterium acnes was isolated from another 5 sinuses (14%) of 3 patients.
Conclusions
Our data support the policy of perioperative antibiotic prophylaxis in sinus augmentation procedures where Schneiderian membrane is perforated.
Clinical relevance
Evaluating the need of a perioperative antibiotic therapy in sinus augmentation procedures.
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Evaluation of the genotoxic potential of different delivery methods of at-home bleaching gels: a single-blind, randomized clinical trial
Abstract
Objective
This single-blind, parallel, randomized clinical trial evaluated the genotoxic potential and effectiveness of 10% hydrogen peroxide (HP) in patients submitted to at-home bleaching.
Materials and methods
Sixty young volunteers with maxillary incisors equal to or darker than M1.5 were included in the study. Patients were submitted to bleaching for 14 days (30 min/day) with one of the three 10% HP treatments: the bleaching agent was delivered in a bleaching tray (White Class, FGM), whitening strips (White Strips, Oral-b), or in prefilled disposable trays (Opalescence Go, Ultradent). The color change was evaluated with the Vita Bleachedguide, and the micronucleus test of exfoliative oral mucosa was carried out, starting from a count of 1000 cells, at the baseline, immediately after and 30 days after the end of the treatment. The micronucleus data were evaluated with the Kruskal-Wallis and Wilcoxon tests and color change with the two-way ANOVA test and the Tukey test (α = 0.05).
Results
Significant whitening was observed for all groups after 14 days (p = 0.001) and was maintained after 30 days, with no difference between groups (p = 0.42). The micronucleus count did not indicate genotoxic potential in any of the groups studied (p = 0.32), irrespective of the time intervals (p = 0.62).
Conclusion
No genotoxic effects of 10% HP were observed in patients submitted to at-home bleaching systems (30 min/day for 14 days), even 30 days after the end of treatment.
Clinical significance
It is safe to use different systems to deliver 10% HP during at-home bleaching according to the manufacturers' recommendations, with no risk of genotoxic effects applied.
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A Primitive Form of Memory Exhibited by the Innate Immune System may Contribute to the Overall State of Immune Aging
The innate immune system evolved long before the adaptive immune system arose as a more sophisticated layer atop it. It is generally considered that only jawed vertebrates have an adaptive immune system, but there are interesting examples of stranger, adaptive-like innate immune systems in some of the more ancient jawless vertebrate lineages, such as lampreys. An overly simplistic view of the difference between innate and adaptive immunity is that the innate immune response is always the same, that for a given stimulus it will respond in the same way tomorrow as it does today. The adaptive immune system, on the other hand, maintains a memory. It will respond far more quickly and efficiently to any future incidence of a stimulus that it has encountered in the past. Nothing in biology...
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Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial
Thyroid, Ahead of Print.
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Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
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A Primitive Form of Memory Exhibited by the Innate Immune System may Contribute to the Overall State of Immune Aging
The innate immune system evolved long before the adaptive immune system arose as a more sophisticated layer atop it. It is generally considered that only jawed vertebrates have an adaptive immune system, but there are interesting examples of stranger, adaptive-like innate immune systems in some of the more ancient jawless vertebrate lineages, such as lampreys. An overly simplistic view of the difference between innate and adaptive immunity is that the innate immune response is always the same, that for a given stimulus it will respond in the same way tomorrow as it does today. The adaptive immune system, on the other hand, maintains a memory. It will respond far more quickly and efficiently to any future incidence of a stimulus that it has encountered in the past. Nothing in biology...
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Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P4vvYf
Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NW3V2T
Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OxKo8s
Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QiTcfw
Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OxKo8s
Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QiTcfw
Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OxKo8s
Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QiTcfw
Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial
Thyroid, Ahead of Print.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OxKo8s
Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
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AHRF Launches New Website, Refreshes Brand
AHRF Launches New Website, Refreshes Brand,
Energizing Mission to Overcome Hearing and Balance Disorders of the Inner Ear
Elmhurst, IL—The American Hearing Research Foundation (AHRF) announced today that it has launched a new website, recommitting itself to its mission and drawing attention to the importance of advancing scientific knowledge and public understanding of hearing and balance disorders of the inner ear. The launch includes a refreshed brand and logo, including entirely new website content.
For more than 60 years, AHRF has been making new discoveries possible. Each year, the Foundation funds five to ten research projects, with the seed grants averaging $20,000. The Foundation also educates the public about these life-altering conditions—including Meniere's disease, otosclerosis, tinnitus, hearing loss, and others—which are inextricably linked to people's quality of life and their ability to meet the challenges of day-to-day living.
According to AHRF's Executive Director, Joan Wincentsen, "The new website is an important initiative as AHRF continues to move forward with its mission. Our legacy of fueling hope and determination in the advancement of scientific knowledge to overcome hearing and balance disorders of the inner ear has been time tested over more than six decades. Certainly, the need to better understand and address these conditions has not gone away. Our commitment only deepens."
The new AHRF website includes information about the Foundation, which traces its roots back to the first-ever successful operation to restore hearing—on an individual with otosclerosis; on hearing and balance disorders of the inner ear; for researchers seeking funding; on recent grant recipients and their research; on past research awards; and on ways to donate to the cause, including specific giving for Meniere's disease and planned giving.
As part of its broader relaunch initiative, AHRF recently partnered with the Public Broadcasting System (PBS) to sponsor a 5-minute video, "Spotlight on Hearing and Balance," to educate the public on Meniere's disease, a difficult to diagnosis, debilitating condition that causes episodes of hearing loss, vertigo and often leads to anxiety and/or depression when not appropriately addressed or when symptoms become acute. PBS will air the video across its nationwide network, with a major airing push concentrated over the next three months.
"The thing about human ingenuity is that you don't know where that next great idea will come from—who the next big thinker will be," the new AHRF website reads. "Our ambition at the American Hearing Research Foundation is to make that next transformative discovery possible."
About AHRF
AHRF is a nonprofit organization that has been making new discoveries possible for more than 60 years by funding novel research to better understand and overcome hearing and balance disorders of the inner ear. Since 2010, the organization has funded 66 projects with more than $1.4 million in research grants. Donations for research funding can be made online.
Follow AHRF on Twitter. Like AHRF on Facebook. Sign up for newsletter updates on the AHRF homepage.
The post AHRF Launches New Website, Refreshes Brand appeared first on American Hearing Research Foundation.
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AHRF Launches New Website, Refreshes Brand
AHRF Launches New Website, Refreshes Brand,
Energizing Mission to Overcome Hearing and Balance Disorders of the Inner Ear
Elmhurst, IL—The American Hearing Research Foundation (AHRF) announced today that it has launched a new website, recommitting itself to its mission and drawing attention to the importance of advancing scientific knowledge and public understanding of hearing and balance disorders of the inner ear. The launch includes a refreshed brand and logo, including entirely new website content.
For more than 60 years, AHRF has been making new discoveries possible. Each year, the Foundation funds five to ten research projects, with the seed grants averaging $20,000. The Foundation also educates the public about these life-altering conditions—including Meniere's disease, otosclerosis, tinnitus, hearing loss, and others—which are inextricably linked to people's quality of life and their ability to meet the challenges of day-to-day living.
According to AHRF's Executive Director, Joan Wincentsen, "The new website is an important initiative as AHRF continues to move forward with its mission. Our legacy of fueling hope and determination in the advancement of scientific knowledge to overcome hearing and balance disorders of the inner ear has been time tested over more than six decades. Certainly, the need to better understand and address these conditions has not gone away. Our commitment only deepens."
The new AHRF website includes information about the Foundation, which traces its roots back to the first-ever successful operation to restore hearing—on an individual with otosclerosis; on hearing and balance disorders of the inner ear; for researchers seeking funding; on recent grant recipients and their research; on past research awards; and on ways to donate to the cause, including specific giving for Meniere's disease and planned giving.
As part of its broader relaunch initiative, AHRF recently partnered with the Public Broadcasting System (PBS) to sponsor a 5-minute video, "Spotlight on Hearing and Balance," to educate the public on Meniere's disease, a difficult to diagnosis, debilitating condition that causes episodes of hearing loss, vertigo and often leads to anxiety and/or depression when not appropriately addressed or when symptoms become acute. PBS will air the video across its nationwide network, with a major airing push concentrated over the next three months.
"The thing about human ingenuity is that you don't know where that next great idea will come from—who the next big thinker will be," the new AHRF website reads. "Our ambition at the American Hearing Research Foundation is to make that next transformative discovery possible."
About AHRF
AHRF is a nonprofit organization that has been making new discoveries possible for more than 60 years by funding novel research to better understand and overcome hearing and balance disorders of the inner ear. Since 2010, the organization has funded 66 projects with more than $1.4 million in research grants. Donations for research funding can be made online.
Follow AHRF on Twitter. Like AHRF on Facebook. Sign up for newsletter updates on the AHRF homepage.
The post AHRF Launches New Website, Refreshes Brand appeared first on American Hearing Research Foundation.
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Surgical treatments for a case of superior canal dehiscence syndrome associated with patulous Eustachian tube
The patulous Eustachian tube (PET) and superior semicircular canal dehiscence syndrome (SCDS) have similarity in their symptoms and similar effects caused by positional changes, causing difficulty in the differentiation between the two disorders. This report describes a case of both SCDS and PET that was eventually successfully treated.
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Simultaneous bilateral butterfly tympanoplasty using tragal cartilage from one ear
To evaluate the outcomes of simultaneous bilateral inlay butterfly cartilage tympanoplasties (BIBCT) using tragal cartilage from one ear in patients with bilateral chronic otitis media (BCOM).
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NYYC2A
Surgical treatments for a case of superior canal dehiscence syndrome associated with patulous Eustachian tube
The patulous Eustachian tube (PET) and superior semicircular canal dehiscence syndrome (SCDS) have similarity in their symptoms and similar effects caused by positional changes, causing difficulty in the differentiation between the two disorders. This report describes a case of both SCDS and PET that was eventually successfully treated.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QmCKe8
Simultaneous bilateral butterfly tympanoplasty using tragal cartilage from one ear
To evaluate the outcomes of simultaneous bilateral inlay butterfly cartilage tympanoplasties (BIBCT) using tragal cartilage from one ear in patients with bilateral chronic otitis media (BCOM).
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Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions.
Authors: Elera-Fitzcarrald C, Fuentes A, González LA, Burgos P, Alarcón GS, Ugarte-Gil M Abstract INTRODUCTION: Patients with systemic lupus erythematosus (SLE) have a better survival than decades ago; nevertheless, they still experience a low health-related (HR) quality of life (QoL). Areas covered: After defining QoL and HRQoL we review the need to assess it, its elements, how to measure it, its predictors and its impact and potential interventions to improve it. Expert commentary: Physicians assessments of disease activity and damage do not capture the patients' perspective of their health, and these differences could lead to nonadherence to therapy. Based on that, a comprehensive evaluation of SLE should include the assessment of HRQoL or the sum of the physical, psychologica...
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GSE74375 Interleukin 2 distinctly activates human basophils in skin disorders
Contributors : Shuli Zhao ; Antonio Lentini ; Yelin Zhao ; Mikael Benson ; Hui WangSeries Type : Expression profiling by arrayOrganism : Homo sapiensBasophils are important effector cells in allergic inflammation, anti-parasitic immune response and skin disorders. A number of activators including interleukin 3 (IL-3) and IgE have been identified in the regulation of human basophils expressing mediators such as histamine and leukotriene C4 (LTC4) and cytokines, including IL-4 and IL-13. Human basophils express high levels of IL-2 receptors. However, the function of the IL-2 pathway in basophils remains unknown. Here, we identify that IL-2-stimulated human basophils in vitro express a variety of inflammatory cytokines and chemokines including IL-5, IL-13, GM-CSF and CCL-17. Of note, one o...
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Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions.
Authors: Elera-Fitzcarrald C, Fuentes A, González LA, Burgos P, Alarcón GS, Ugarte-Gil M Abstract INTRODUCTION: Patients with systemic lupus erythematosus (SLE) have a better survival than decades ago; nevertheless, they still experience a low health-related (HR) quality of life (QoL). Areas covered: After defining QoL and HRQoL we review the need to assess it, its elements, how to measure it, its predictors and its impact and potential interventions to improve it. Expert commentary: Physicians assessments of disease activity and damage do not capture the patients' perspective of their health, and these differences could lead to nonadherence to therapy. Based on that, a comprehensive evaluation of SLE should include the assessment of HRQoL or the sum of the physical, psychologica...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1yMY1
GSE74375 Interleukin 2 distinctly activates human basophils in skin disorders
Contributors : Shuli Zhao ; Antonio Lentini ; Yelin Zhao ; Mikael Benson ; Hui WangSeries Type : Expression profiling by arrayOrganism : Homo sapiensBasophils are important effector cells in allergic inflammation, anti-parasitic immune response and skin disorders. A number of activators including interleukin 3 (IL-3) and IgE have been identified in the regulation of human basophils expressing mediators such as histamine and leukotriene C4 (LTC4) and cytokines, including IL-4 and IL-13. Human basophils express high levels of IL-2 receptors. However, the function of the IL-2 pathway in basophils remains unknown. Here, we identify that IL-2-stimulated human basophils in vitro express a variety of inflammatory cytokines and chemokines including IL-5, IL-13, GM-CSF and CCL-17. Of note, one o...
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Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid nodules and goiters.
- Dr. Trevor Engell of the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women's Hospital and Harvard Medical School, in Boston, Massachusetts, will present a study called "Xpression Atlas Findings in the Genomic Sequencing Classifier (GSC) Clinical Validation Cohort."
The GSC used in this study classifies cytologically indeterminate thyroid nodules as either benign (B) or suspicious (S). The ability to detect genomic variants and fusions was recently expanded by the Xpression Atlas (XA), which identifies 761 nucleotide variants and 130 fusion gene pairs in 511 genes. In this study, researchers used XA to analyze the mutational spectrum of 190 nodules classified with standard histologic diagnoses (using microscopic studies of the tissues) as belonging to categories III and IV in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). The conclusion was that GSC is better than XA for ruling out cancers, while the two used together may provide additional insights into pathway activation and potential cancer treatment targets.
Another study involving XA will be presented by Dr. Allan C. Golding of the Memorial Center for Integrative Endocrine Surgery in Hollywood, Florida. Titled "Xpression Atlas Variants and Fusions Found Among 4,742 Thyroid Nodules," the study involved reanalyzing all clinical samples with complete XA profiles from July 2017 to April 3, 2018.
Overall, fusions were detected less frequently than variants across all BSRTC categories. This analysis supported excluding XA reporting among GSC-benign nodules. However, markedly different genomic insights were found between cohorts at increased risk of cancer, specifically, those in categories III through VI of the BSRTC. Together, the GSC and XA contribute substantial genomic content to advance preoperative risk stratification.
In a presentation by Dr. Christine Cherella of Boston Children's Hospital (BCH), attendees will learn how "Malignancy Rates of Thyroid Nodules Differ Between Children and Adults Within Indeterminate Cytopathological Categories." Thyroid nodules are more common in older individuals but are more likely to be malignant in younger ones. Although the BSRTC is widely used to interpret fine-needle aspiration (FNA) cytology, it is unclear whether BSRTC diagnostic categories suggest the same risk of malignancy in younger versus older patients.
Researchers evaluated all consecutive patients who underwent FNA of a thyroid nodule ≥1 cm in diameter, at the BCH and the Brigham and Women's Hospital between 1998 and 2016. They found that, in children and adults with clinically relevant thyroid nodules, malignancy rates differ within indeterminate BSRTC categories defined by similar morphologic features. This finding likely reflects true differences in nodule biology rather than variations in cytological classification.
Dr. Yu-kun Luo of the Ultrasound Department, General Hospital of Chinese PLA, Beijing, China, will present a study titled "Artificial Intelligence-Assisted Ultrasound Diagnosis for Thyroid Nodules." Due to uneven development of medical resources, diagnostic accuracy for thyroid nodules varies greatly. The aim of this study was to explore a novel AI-assisted ultrasound diagnostic system to improve the efficiency and accuracy of thyroid nodule diagnosis.
To test the accuracy of the new system, 500 pathologically confirmed thyroid nodules were selected, including 208 benign and 292 malignant ones. The images of all nodules, acquired from 10 different types of ultrasound equipment, were dynamically stored in the form of consecutively longitudinal and transverse sections. The AI-assisted diagnostic system recognized and analyzed the features of the images and offered recommendations for diagnosis. The diagnostic accuracy of the system was then compared with that of junior and senior physicians. Results showed the diagnostic accuracy of the AI system alone was higher than that of junior physicians (77.6% vs. 70.5%); however, accuracy could reach 92.4% when junior physicians were assisted by the new AI system—higher than the accuracy of senior physicians (85.6%) unassisted by the system. For nodules of different sizes, testing showed no significant difference in diagnostic accuracy among the three groups.
Another presentation will be given by Dr. Mingbo Zhang of the same department in Beijing's General Hospital. Dr. Mingbo will describe a "Randomized controlled clinical trial of ethanol-sensitized radiofrequency ablation (RFA) for benign solid thyroid nodules" that took place between June 2016 and February 2018. While solid thyroid nodules are good candidates for RFA surgery, they often require high power and energy, which increase the incidence of complications. This study used ethanol as a sensitizer before RFA to explore whether that could achieve a safer, faster, and more effective result.
Seventy-two patients with 84 nodules among them were enrolled in the study group and in a conventional RFA group, respectively, each with 42 nodules. The researchers concluded that ethanol can significantly improve the efficiency of RFA, reduce the time and energy of the ablation, and reduce the occurrence of complications.
In a presentation titled "Efficacy and Safety of Thermal Ablation of 200 Benign Thyroid Nodules: Comparison of Three Techniques (Radiofrequency, Laser, High Intensity Focused Ultrasound)," Dr. Adrien Ben Hamou of the Endocrinology Department at the University Hospital in Lille, France, will describe a bicentric retrospective study conducted between October 2013 and January 2018.
The aim was to compare the three ablation methods for treating benign thyroid nodules. Two hundred nodules were treated in 176 patients with benign histology or cytology, all of whom refused surgery. Clinical, biological, and ultrasound evaluation was performed before treatment. Researchers compared variations in volume and symptoms as well as side effects at 6 weeks and 12 months after treatment. Volume reduction between radiofrequency (RFA) and laser (LA) ablation was significantly different at 6 weeks but not at 12 months. After adjustments, no significant difference was observed at either 6 weeks or 12 months between RFA and high-intensity focused ultrasound (HIFU) or between LA and HIFU. Clinical symptoms were reduced in all three groups. Very few transient but potentially serious side effects were reported, the causes of which should be analyzed.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NUEuhX
Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns disorders of thyroid function.
- Dr. Maia Banige will give a presentation titled "Prediction of fetal and neonatal dysthyroidism," showing how imperfect development and function of the thyroid in fetuses (FD) and newborns (ND) can be predicted from perinatal variables. Dr. Banige is from the Department of Pediatrics-Neonatology and Pediatric Emergency of the French-British Hospital Institute, Levallois-Perret, Ile-de-France.
She and her colleagues conducted a retrospective, multicenter study using data from the medical records of all patients monitored for pregnancy from 2007 to 2014 in 10 obstetric centers of the Assistance Publique des Hôpitaux de Paris. Women with Graves' disease who were positive for thyrotropin receptor antibodies (TRAb) at least once during pregnancy were included. Among 280,000 births, 2,288 medical records of women with thyroid dysfunction were selected and screened, and 417 women with Graves' disease who were positive for TRAb during pregnancy (0.15%) were finally included in the study.
Analysis revealed that the TRAb level in the mother and child was the strongest independent predictor of thyroid dysfunction. The risk of FD and ND increases with maternal hormonal imbalance and is also greater in the patients receiving antithyroid drugs (ATDs) during pregnancy. In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician with special attention for thyroid dysfunction.
A presentation titled "Pre-conception thyroid stimulating hormone level and risk of preterm birth in over 4.3 million rural Chinese women aged 20-49 years: a population-based cohort study" will be given by Dr. Ying Yang of the National Research Institute for Health and Family Planning and the National Human Genetic Resources Center. Dr. Ying and his colleagues studied the association between the pre-conception thyroid stimulating hormone (TSH) levels of women planning for pregnancy and the risk of preterm births (PTB).
Researchers conducted a historical cohort study of 4,320,584 rural reproductive-age women who had participated in free National Free Pre-pregnancy Checkups (NFPC) in 2013-2016 in China. Data on preconception TSH, history of pregnancy and diseases, and other variables were obtained from the physical examination record in NFPC. Successful conception and pregnancy outcomes were documented during the follow-up period, June 2013 to December 2017. PTB is defined as any birth within 28 to 37 weeks of gestational age. Participants who failed to become pregnant within 6 months, suffered from fetal death or stillbirth, or had multiple gestations during the period of study were excluded from the analysis. The data documented 283,854 PTB events (6.57%).
The study identified a V-shaped relationship between maternal pre-conception TSH levels and PTB risk. Either decreasing or increasing pre-conception TSH levels can significantly increase the risk of preterm birth.
Dr. George Kahaly of the Department of Medicine at Johannes Gutenberg University Medical Center in Mainz, Germany, and colleagues have undertaken a three-phase clinical trial of the drug teprotumumab. Results from the first phase—a 24-week randomized, double-masked, placebo-controlled treatment trial of the drug, which is an insulin-like growth-factor-1 receptor inhibitory antibody—were reported in the New England Journal of Medicine (NEJM 2017; 376:1748). Compared with a placebo (69% versus 20%), teprotumumab reduced protopsis (protrusion of the eyeballs) significantly beginning at week 6 and continuing over the 24 weeks of the trial. This second-phase report is an assessment of clinical status at weeks 28 and 72.
At week 28 (4 weeks after the treatment period), proptosis response was 73.8% in the teprotumumab group versus 13.3% in controls. At week 72 (48 weeks after treatment), 53% of week 24 teprotumumab proptosis responders maintained ≧ 2 mm improvement relative to baseline. Compared to baseline and placebo, clinical activity also decreased at week 28 and was relatively unchanged in the teprotumumab group at week 72. These results indicate no acute rebound of disease following the 24-week treatment.
Dr. Kahaly's group conclude that teprotumumab may represent a disease-modifying therapy in TAO by reducing proptosis and clinical activity, with sustained effects seen in most patients 48 weeks after treatment. In phase 3 of the trial, the research group will investigate whether patients would benefit from longer treatment or retreatment with teprotumumab.
Dr. Mats Holmberg of Institute of Medicine, Sahlgrenska Academy, and the Karolinska University Hospital, ANOVA, both in Stockholm, Sweden, will present a study titled "Structural brain changes in Graves' hyperthyroidism may be of autoimmune origin." During the hyperthyroid state of Graves' disease (GD), the volumes of medial temporal lobe (MTL) structures, e.g., the hippocampi, are reduced. This has been attributed to high thyroid hormone levels, but Dr. Holmberg and his colleagues hypothesized that the structural changes and mental symptoms may be due to autoimmunity per se. The aim of their study was to determine the relationship between nonthyroid autoimmunity and MTL volumes during hyperthyroidism in GD.
Dr. Holmberg's project is a longitudinal, observational, prospective case-controlled study in which 65 premenopausal women were evaluated within 2 weeks after a diagnosis of GD and again after 15 months of antithyroid treatment. Thyroid-stimulating hormone receptor antibodies, thyroid-stimulating immunoglobulins, and several additional antibodies were measured in the hyperthyroid state. MTL structures were scanned to determine hippocampal and amygdala volumes. This presentation reports preliminary data on the nonthyroid antibodies at baseline. Data on the thyroid antibodies will be reported separately.
The data so far support the hypothesis that autoimmunity that is not directly connected to the thyroid may be involved in the impairment of brain function in GD, introducing a new concept that needs further study.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y42u7t
Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid nodules and goiters.
- Dr. Trevor Engell of the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women's Hospital and Harvard Medical School, in Boston, Massachusetts, will present a study called "Xpression Atlas Findings in the Genomic Sequencing Classifier (GSC) Clinical Validation Cohort."
The GSC used in this study classifies cytologically indeterminate thyroid nodules as either benign (B) or suspicious (S). The ability to detect genomic variants and fusions was recently expanded by the Xpression Atlas (XA), which identifies 761 nucleotide variants and 130 fusion gene pairs in 511 genes. In this study, researchers used XA to analyze the mutational spectrum of 190 nodules classified with standard histologic diagnoses (using microscopic studies of the tissues) as belonging to categories III and IV in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). The conclusion was that GSC is better than XA for ruling out cancers, while the two used together may provide additional insights into pathway activation and potential cancer treatment targets.
Another study involving XA will be presented by Dr. Allan C. Golding of the Memorial Center for Integrative Endocrine Surgery in Hollywood, Florida. Titled "Xpression Atlas Variants and Fusions Found Among 4,742 Thyroid Nodules," the study involved reanalyzing all clinical samples with complete XA profiles from July 2017 to April 3, 2018.
Overall, fusions were detected less frequently than variants across all BSRTC categories. This analysis supported excluding XA reporting among GSC-benign nodules. However, markedly different genomic insights were found between cohorts at increased risk of cancer, specifically, those in categories III through VI of the BSRTC. Together, the GSC and XA contribute substantial genomic content to advance preoperative risk stratification.
In a presentation by Dr. Christine Cherella of Boston Children's Hospital (BCH), attendees will learn how "Malignancy Rates of Thyroid Nodules Differ Between Children and Adults Within Indeterminate Cytopathological Categories." Thyroid nodules are more common in older individuals but are more likely to be malignant in younger ones. Although the BSRTC is widely used to interpret fine-needle aspiration (FNA) cytology, it is unclear whether BSRTC diagnostic categories suggest the same risk of malignancy in younger versus older patients.
Researchers evaluated all consecutive patients who underwent FNA of a thyroid nodule ≥1 cm in diameter, at the BCH and the Brigham and Women's Hospital between 1998 and 2016. They found that, in children and adults with clinically relevant thyroid nodules, malignancy rates differ within indeterminate BSRTC categories defined by similar morphologic features. This finding likely reflects true differences in nodule biology rather than variations in cytological classification.
Dr. Yu-kun Luo of the Ultrasound Department, General Hospital of Chinese PLA, Beijing, China, will present a study titled "Artificial Intelligence-Assisted Ultrasound Diagnosis for Thyroid Nodules." Due to uneven development of medical resources, diagnostic accuracy for thyroid nodules varies greatly. The aim of this study was to explore a novel AI-assisted ultrasound diagnostic system to improve the efficiency and accuracy of thyroid nodule diagnosis.
To test the accuracy of the new system, 500 pathologically confirmed thyroid nodules were selected, including 208 benign and 292 malignant ones. The images of all nodules, acquired from 10 different types of ultrasound equipment, were dynamically stored in the form of consecutively longitudinal and transverse sections. The AI-assisted diagnostic system recognized and analyzed the features of the images and offered recommendations for diagnosis. The diagnostic accuracy of the system was then compared with that of junior and senior physicians. Results showed the diagnostic accuracy of the AI system alone was higher than that of junior physicians (77.6% vs. 70.5%); however, accuracy could reach 92.4% when junior physicians were assisted by the new AI system—higher than the accuracy of senior physicians (85.6%) unassisted by the system. For nodules of different sizes, testing showed no significant difference in diagnostic accuracy among the three groups.
Another presentation will be given by Dr. Mingbo Zhang of the same department in Beijing's General Hospital. Dr. Mingbo will describe a "Randomized controlled clinical trial of ethanol-sensitized radiofrequency ablation (RFA) for benign solid thyroid nodules" that took place between June 2016 and February 2018. While solid thyroid nodules are good candidates for RFA surgery, they often require high power and energy, which increase the incidence of complications. This study used ethanol as a sensitizer before RFA to explore whether that could achieve a safer, faster, and more effective result.
Seventy-two patients with 84 nodules among them were enrolled in the study group and in a conventional RFA group, respectively, each with 42 nodules. The researchers concluded that ethanol can significantly improve the efficiency of RFA, reduce the time and energy of the ablation, and reduce the occurrence of complications.
In a presentation titled "Efficacy and Safety of Thermal Ablation of 200 Benign Thyroid Nodules: Comparison of Three Techniques (Radiofrequency, Laser, High Intensity Focused Ultrasound)," Dr. Adrien Ben Hamou of the Endocrinology Department at the University Hospital in Lille, France, will describe a bicentric retrospective study conducted between October 2013 and January 2018.
The aim was to compare the three ablation methods for treating benign thyroid nodules. Two hundred nodules were treated in 176 patients with benign histology or cytology, all of whom refused surgery. Clinical, biological, and ultrasound evaluation was performed before treatment. Researchers compared variations in volume and symptoms as well as side effects at 6 weeks and 12 months after treatment. Volume reduction between radiofrequency (RFA) and laser (LA) ablation was significantly different at 6 weeks but not at 12 months. After adjustments, no significant difference was observed at either 6 weeks or 12 months between RFA and high-intensity focused ultrasound (HIFU) or between LA and HIFU. Clinical symptoms were reduced in all three groups. Very few transient but potentially serious side effects were reported, the causes of which should be analyzed.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NUEuhX
Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns disorders of thyroid function.
- Dr. Maia Banige will give a presentation titled "Prediction of fetal and neonatal dysthyroidism," showing how imperfect development and function of the thyroid in fetuses (FD) and newborns (ND) can be predicted from perinatal variables. Dr. Banige is from the Department of Pediatrics-Neonatology and Pediatric Emergency of the French-British Hospital Institute, Levallois-Perret, Ile-de-France.
She and her colleagues conducted a retrospective, multicenter study using data from the medical records of all patients monitored for pregnancy from 2007 to 2014 in 10 obstetric centers of the Assistance Publique des Hôpitaux de Paris. Women with Graves' disease who were positive for thyrotropin receptor antibodies (TRAb) at least once during pregnancy were included. Among 280,000 births, 2,288 medical records of women with thyroid dysfunction were selected and screened, and 417 women with Graves' disease who were positive for TRAb during pregnancy (0.15%) were finally included in the study.
Analysis revealed that the TRAb level in the mother and child was the strongest independent predictor of thyroid dysfunction. The risk of FD and ND increases with maternal hormonal imbalance and is also greater in the patients receiving antithyroid drugs (ATDs) during pregnancy. In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician with special attention for thyroid dysfunction.
A presentation titled "Pre-conception thyroid stimulating hormone level and risk of preterm birth in over 4.3 million rural Chinese women aged 20-49 years: a population-based cohort study" will be given by Dr. Ying Yang of the National Research Institute for Health and Family Planning and the National Human Genetic Resources Center. Dr. Ying and his colleagues studied the association between the pre-conception thyroid stimulating hormone (TSH) levels of women planning for pregnancy and the risk of preterm births (PTB).
Researchers conducted a historical cohort study of 4,320,584 rural reproductive-age women who had participated in free National Free Pre-pregnancy Checkups (NFPC) in 2013-2016 in China. Data on preconception TSH, history of pregnancy and diseases, and other variables were obtained from the physical examination record in NFPC. Successful conception and pregnancy outcomes were documented during the follow-up period, June 2013 to December 2017. PTB is defined as any birth within 28 to 37 weeks of gestational age. Participants who failed to become pregnant within 6 months, suffered from fetal death or stillbirth, or had multiple gestations during the period of study were excluded from the analysis. The data documented 283,854 PTB events (6.57%).
The study identified a V-shaped relationship between maternal pre-conception TSH levels and PTB risk. Either decreasing or increasing pre-conception TSH levels can significantly increase the risk of preterm birth.
Dr. George Kahaly of the Department of Medicine at Johannes Gutenberg University Medical Center in Mainz, Germany, and colleagues have undertaken a three-phase clinical trial of the drug teprotumumab. Results from the first phase—a 24-week randomized, double-masked, placebo-controlled treatment trial of the drug, which is an insulin-like growth-factor-1 receptor inhibitory antibody—were reported in the New England Journal of Medicine (NEJM 2017; 376:1748). Compared with a placebo (69% versus 20%), teprotumumab reduced protopsis (protrusion of the eyeballs) significantly beginning at week 6 and continuing over the 24 weeks of the trial. This second-phase report is an assessment of clinical status at weeks 28 and 72.
At week 28 (4 weeks after the treatment period), proptosis response was 73.8% in the teprotumumab group versus 13.3% in controls. At week 72 (48 weeks after treatment), 53% of week 24 teprotumumab proptosis responders maintained ≧ 2 mm improvement relative to baseline. Compared to baseline and placebo, clinical activity also decreased at week 28 and was relatively unchanged in the teprotumumab group at week 72. These results indicate no acute rebound of disease following the 24-week treatment.
Dr. Kahaly's group conclude that teprotumumab may represent a disease-modifying therapy in TAO by reducing proptosis and clinical activity, with sustained effects seen in most patients 48 weeks after treatment. In phase 3 of the trial, the research group will investigate whether patients would benefit from longer treatment or retreatment with teprotumumab.
Dr. Mats Holmberg of Institute of Medicine, Sahlgrenska Academy, and the Karolinska University Hospital, ANOVA, both in Stockholm, Sweden, will present a study titled "Structural brain changes in Graves' hyperthyroidism may be of autoimmune origin." During the hyperthyroid state of Graves' disease (GD), the volumes of medial temporal lobe (MTL) structures, e.g., the hippocampi, are reduced. This has been attributed to high thyroid hormone levels, but Dr. Holmberg and his colleagues hypothesized that the structural changes and mental symptoms may be due to autoimmunity per se. The aim of their study was to determine the relationship between nonthyroid autoimmunity and MTL volumes during hyperthyroidism in GD.
Dr. Holmberg's project is a longitudinal, observational, prospective case-controlled study in which 65 premenopausal women were evaluated within 2 weeks after a diagnosis of GD and again after 15 months of antithyroid treatment. Thyroid-stimulating hormone receptor antibodies, thyroid-stimulating immunoglobulins, and several additional antibodies were measured in the hyperthyroid state. MTL structures were scanned to determine hippocampal and amygdala volumes. This presentation reports preliminary data on the nonthyroid antibodies at baseline. Data on the thyroid antibodies will be reported separately.
The data so far support the hypothesis that autoimmunity that is not directly connected to the thyroid may be involved in the impairment of brain function in GD, introducing a new concept that needs further study.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y42u7t
Direct percutaneous puncture digital-subtraction-angiography-based classification and treatment selection for soft-tissue arteriovenous malformations of maxillofacial region: a retrospective study
Treatment of arteriovenous malformations (AVMs) should be individualized based on the imaging findings. A total of 117 AVM cases were categorized into three types based on the angio-architectural characteristics: Type I (n=14, no draining vein or diameter of the draining vein <2mm); Type II (n=64, draining vein diameter 2–6mm); and Type III (n=39, draining vein diameter >6mm). Subjects were randomly allocated to one of two treatment groups: Group A (n=59) received multipoint percutaneous ethanol injection (MPEI), while Group B (n=58) received super-selective angiograms followed by embolization with gelfoam (EFAG) plus MPEI.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zKxs6O
Ultrasound-guided versus blind temporomandibular joint injections: a pilot cadaveric evaluation
Temporomandibular disorders are painful conditions that require precise injection therapy in selected patients. This pilot cadaveric study was undertaken to compare the accuracy of temporomandibular joint (TMJ) injection between the anatomical landmark-based (blind) technique and an ultrasound-guided technique. TMJ injections using the blind technique or the ultrasound-guided technique were performed in 10 non-embalmed cadavers. After dissection, the accuracy of the TMJ injections was found to be significantly greater for the ultrasound-guided injections than for the blind technique (blind 55% vs.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NgvLBo
Clinical efficacy of sublingual immunotherapy is associated with restoration of steady-state serum lipocalin 2 after SLIT: a pilot study
So far, only a few biomarkers in allergen immunotherapy exist that are associated with a clinical benefit. We thus investigated in a pilot study whether innate molecules such as the molecule lipocalin-2 (LCN2)...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y9uuqi
Direct percutaneous puncture digital-subtraction-angiography-based classification and treatment selection for soft-tissue arteriovenous malformations of maxillofacial region: a retrospective study
Treatment of arteriovenous malformations (AVMs) should be individualized based on the imaging findings. A total of 117 AVM cases were categorized into three types based on the angio-architectural characteristics: Type I (n=14, no draining vein or diameter of the draining vein <2mm); Type II (n=64, draining vein diameter 2–6mm); and Type III (n=39, draining vein diameter >6mm). Subjects were randomly allocated to one of two treatment groups: Group A (n=59) received multipoint percutaneous ethanol injection (MPEI), while Group B (n=58) received super-selective angiograms followed by embolization with gelfoam (EFAG) plus MPEI.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zKxs6O
Ultrasound-guided versus blind temporomandibular joint injections: a pilot cadaveric evaluation
Temporomandibular disorders are painful conditions that require precise injection therapy in selected patients. This pilot cadaveric study was undertaken to compare the accuracy of temporomandibular joint (TMJ) injection between the anatomical landmark-based (blind) technique and an ultrasound-guided technique. TMJ injections using the blind technique or the ultrasound-guided technique were performed in 10 non-embalmed cadavers. After dissection, the accuracy of the TMJ injections was found to be significantly greater for the ultrasound-guided injections than for the blind technique (blind 55% vs.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NgvLBo
Clinical efficacy of sublingual immunotherapy is associated with restoration of steady-state serum lipocalin 2 after SLIT: a pilot study
So far, only a few biomarkers in allergen immunotherapy exist that are associated with a clinical benefit. We thus investigated in a pilot study whether innate molecules such as the molecule lipocalin-2 (LCN2)...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y9uuqi
Patient Safety in Audiology
There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2RjPELt
Patient Safety in Audiology
There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2RjPELt
Feasibility of multi-parametric PET and MRI for prediction of tumour recurrence in patients with glioblastoma
Abstract
Background
Recurrence in glioblastoma patients often occur close to the original tumour and indicates that the current treatment is inadequate for local tumour control. In this study, we explored the feasibility of using multi-modality imaging at the time of radiotherapy planning. Specifically, we aimed to identify parameters from pre-treatment PET and MRI with potential to predict tumour recurrence.
Materials and methods
Sixteen patients were prospectively recruited and treated according to established guidelines. Multi-parametric imaging with 18F-FET PET/CT and 18F-FDG PET/MR including diffusion and dynamic contrast enhanced perfusion MRI were performed before radiotherapy. Correlations between imaging parameters were calculated. Imaging was related to the voxel-wise outcome at the time of tumour recurrence. Within the radiotherapy target, median differences of imaging parameters in recurring and non-recurring voxels were calculated for contrast-enhancing lesion (CEL), non-enhancing lesion (NEL), and normal appearing grey and white matter. Logistic regression models were created to predict the patient-specific probability of recurrence. The most important parameters were identified using standardized model coefficients.
Results
Significant median differences between recurring and non-recurring voxels were observed for FDG, FET, fractional anisotropy, mean diffusivity, mean transit time, extra-vascular, extra-cellular blood volume and permeability derived from scans prior to chemo-radiotherapy. Tissue-specific patterns of voxel-wise correlations were observed. The most pronounced correlations were observed for 18F-FDG- and 18F-FET-uptake in CEL and NEL. Voxel-wise modelling of recurrence probability resulted in area under the receiver operating characteristic curve of 0.77 from scans prior to therapy. Overall, FET proved to be the most important parameter for recurrence prediction.
Conclusion
Multi-parametric imaging before radiotherapy is feasible and significant differences in imaging parameters between recurring and non-recurring voxels were observed. Combining parameters in a logistic regression model enabled patient-specific maps of recurrence probability, where 18F-FET proved to be most important. This strategy could enable risk-adapted radiotherapy planning.
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NaF uptake in unstable plaque: what does fluoride uptake mean?
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New Cancer Treatments Just Won Two Scientists a Nobel Prize. Here ’s How They Work
It wasn't the Nobel Committee that reached James Allison first on Monday to inform him that he had won the coveted annual prize in Physiology or Medicine. It was his son who broke the news with a 5:30 am phone call. Minutes later, a Swedish reporter reached him before the committee could. "I was like, 'Oh my God, it happened,'" Allison says to TIME. "I'm just in shock, I guess." Allison, chair of immunology at the University of Texas MD Anderson Cancer Center, was awarded the Nobel for his discovery in 1994 in mice that led to an entirely new class of anti-cancer drugs called checkpoint inhibitors. They're designed to unleash the power of the immune system and have saved tens of thousands of lives—including that of President Jimmy...
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y7578D
Feasibility of multi-parametric PET and MRI for prediction of tumour recurrence in patients with glioblastoma
Abstract
Background
Recurrence in glioblastoma patients often occur close to the original tumour and indicates that the current treatment is inadequate for local tumour control. In this study, we explored the feasibility of using multi-modality imaging at the time of radiotherapy planning. Specifically, we aimed to identify parameters from pre-treatment PET and MRI with potential to predict tumour recurrence.
Materials and methods
Sixteen patients were prospectively recruited and treated according to established guidelines. Multi-parametric imaging with 18F-FET PET/CT and 18F-FDG PET/MR including diffusion and dynamic contrast enhanced perfusion MRI were performed before radiotherapy. Correlations between imaging parameters were calculated. Imaging was related to the voxel-wise outcome at the time of tumour recurrence. Within the radiotherapy target, median differences of imaging parameters in recurring and non-recurring voxels were calculated for contrast-enhancing lesion (CEL), non-enhancing lesion (NEL), and normal appearing grey and white matter. Logistic regression models were created to predict the patient-specific probability of recurrence. The most important parameters were identified using standardized model coefficients.
Results
Significant median differences between recurring and non-recurring voxels were observed for FDG, FET, fractional anisotropy, mean diffusivity, mean transit time, extra-vascular, extra-cellular blood volume and permeability derived from scans prior to chemo-radiotherapy. Tissue-specific patterns of voxel-wise correlations were observed. The most pronounced correlations were observed for 18F-FDG- and 18F-FET-uptake in CEL and NEL. Voxel-wise modelling of recurrence probability resulted in area under the receiver operating characteristic curve of 0.77 from scans prior to therapy. Overall, FET proved to be the most important parameter for recurrence prediction.
Conclusion
Multi-parametric imaging before radiotherapy is feasible and significant differences in imaging parameters between recurring and non-recurring voxels were observed. Combining parameters in a logistic regression model enabled patient-specific maps of recurrence probability, where 18F-FET proved to be most important. This strategy could enable risk-adapted radiotherapy planning.
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NaF uptake in unstable plaque: what does fluoride uptake mean?
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New Cancer Treatments Just Won Two Scientists a Nobel Prize. Here ’s How They Work
It wasn't the Nobel Committee that reached James Allison first on Monday to inform him that he had won the coveted annual prize in Physiology or Medicine. It was his son who broke the news with a 5:30 am phone call. Minutes later, a Swedish reporter reached him before the committee could. "I was like, 'Oh my God, it happened,'" Allison says to TIME. "I'm just in shock, I guess." Allison, chair of immunology at the University of Texas MD Anderson Cancer Center, was awarded the Nobel for his discovery in 1994 in mice that led to an entirely new class of anti-cancer drugs called checkpoint inhibitors. They're designed to unleash the power of the immune system and have saved tens of thousands of lives—including that of President Jimmy...
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Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation
Abstract
Objective
This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist.
Material and methods
Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics.
Results
OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = − 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage.
Conclusion
OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis.
Clinical relevance
Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.
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Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation
Abstract
Objective
This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist.
Material and methods
Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics.
Results
OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = − 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage.
Conclusion
OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis.
Clinical relevance
Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.
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Map2Excel updated for MindManager 2019
Click the link below to download Map2Excel for MindManager 2019:
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Map2Excel updated for MindManager 2019
Click the link below to download Map2Excel for MindManager 2019:
As this download is not signed, you need to click "more information", "download anyway".
Related posts:
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Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma
Abstract
Purpose
Burkitt's lymphoma (BL) is an aggressive lymphoma subtype with high 18F-FDG avidity at 18F-FDG-PET/CT, but no validated criteria for PET/CT in treatment evaluation or prediction of outcome in BL are available. The aim of our study was to investigate whether the metabolic baseline PET/CT parameters can predict treatment response and prognosis in BL.
Materials and methods
We retrospectively enrolled 65 patients who underwent baseline 18F-FDG-PET/CT, interim and end of treatment PET/CT. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value body weight (SUVbw), the maximum standardized uptake value lean body mass (SUVlbm), the maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), total metabolic tumor volume (tMTV) and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan–Meier method.
Results
At a median follow-up of 40 months, the median PFS and OS were 34 and 39 months. MTV and TLG were significantly higher in patients with partial response compared to complete response group at end of treatment, while no significant differences were found at interim. Other metabolic PET/CT parameters were not related to treatment response. MTV and TLG were demonstrated to be independent prognostic factors for both PFS and OS; instead SUVbw, SUVlbm, SUVbsa, L-L SUV R and L-BP SUV R were not related to outcome survival.
Conclusions
Metabolic tumour features (MTV and TLG) were significantly correlated with response to treatment and long-term outcome.
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New Cancer Treatments Just Won Two Scientists a Nobel Prize. Here ’s How They Work
It wasn't the Nobel Committee that reached James Allison first on Monday to inform him that he had won the coveted annual prize in Physiology or Medicine. It was his son who broke the news with a 5:30 am phone call. Minutes later, a Swedish reporter reached him before the committee could. "I was like, 'Oh my God, it happened,'" Allison says to TIME. "I'm just in shock, I guess." Allison, chair of immunology at the University of Texas MD Anderson Cancer Center, was awarded the Nobel for his discovery in 1994 in mice that led to an entirely new class of anti-cancer drugs called checkpoint inhibitors. They're designed to unleash the power of the immune system and have saved tens of thousands of lives—including that of President Jimmy...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y7578D
Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma
Abstract
Purpose
Burkitt's lymphoma (BL) is an aggressive lymphoma subtype with high 18F-FDG avidity at 18F-FDG-PET/CT, but no validated criteria for PET/CT in treatment evaluation or prediction of outcome in BL are available. The aim of our study was to investigate whether the metabolic baseline PET/CT parameters can predict treatment response and prognosis in BL.
Materials and methods
We retrospectively enrolled 65 patients who underwent baseline 18F-FDG-PET/CT, interim and end of treatment PET/CT. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value body weight (SUVbw), the maximum standardized uptake value lean body mass (SUVlbm), the maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), total metabolic tumor volume (tMTV) and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan–Meier method.
Results
At a median follow-up of 40 months, the median PFS and OS were 34 and 39 months. MTV and TLG were significantly higher in patients with partial response compared to complete response group at end of treatment, while no significant differences were found at interim. Other metabolic PET/CT parameters were not related to treatment response. MTV and TLG were demonstrated to be independent prognostic factors for both PFS and OS; instead SUVbw, SUVlbm, SUVbsa, L-L SUV R and L-BP SUV R were not related to outcome survival.
Conclusions
Metabolic tumour features (MTV and TLG) were significantly correlated with response to treatment and long-term outcome.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zJMOZl
New Cancer Treatments Just Won Two Scientists a Nobel Prize. Here ’s How They Work
It wasn't the Nobel Committee that reached James Allison first on Monday to inform him that he had won the coveted annual prize in Physiology or Medicine. It was his son who broke the news with a 5:30 am phone call. Minutes later, a Swedish reporter reached him before the committee could. "I was like, 'Oh my God, it happened,'" Allison says to TIME. "I'm just in shock, I guess." Allison, chair of immunology at the University of Texas MD Anderson Cancer Center, was awarded the Nobel for his discovery in 1994 in mice that led to an entirely new class of anti-cancer drugs called checkpoint inhibitors. They're designed to unleash the power of the immune system and have saved tens of thousands of lives—including that of President Jimmy...
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2y7578D
Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid nodules and goiters.
- Dr. Trevor Engell of the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women's Hospital and Harvard Medical School, in Boston, Massachusetts, will present a study called "Xpression Atlas Findings in the Genomic Sequencing Classifier (GSC) Clinical Validation Cohort."
The GSC used in this study classifies cytologically indeterminate thyroid nodules as either benign (B) or suspicious (S). The ability to detect genomic variants and fusions was recently expanded by the Xpression Atlas (XA), which identifies 761 nucleotide variants and 130 fusion gene pairs in 511 genes. In this study, researchers used XA to analyze the mutational spectrum of 190 nodules classified with standard histologic diagnoses (using microscopic studies of the tissues) as belonging to categories III and IV in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). The conclusion was that GSC is better than XA for ruling out cancers, while the two used together may provide additional insights into pathway activation and potential cancer treatment targets.
Another study involving XA will be presented by Dr. Allan C. Golding of the Memorial Center for Integrative Endocrine Surgery in Hollywood, Florida. Titled "Xpression Atlas Variants and Fusions Found Among 4,742 Thyroid Nodules," the study involved reanalyzing all clinical samples with complete XA profiles from July 2017 to April 3, 2018.
Overall, fusions were detected less frequently than variants across all BSRTC categories. This analysis supported excluding XA reporting among GSC-benign nodules. However, markedly different genomic insights were found between cohorts at increased risk of cancer, specifically, those in categories III through VI of the BSRTC. Together, the GSC and XA contribute substantial genomic content to advance preoperative risk stratification.
In a presentation by Dr. Christine Cherella of Boston Children's Hospital (BCH), attendees will learn how "Malignancy Rates of Thyroid Nodules Differ Between Children and Adults Within Indeterminate Cytopathological Categories." Thyroid nodules are more common in older individuals but are more likely to be malignant in younger ones. Although the BSRTC is widely used to interpret fine-needle aspiration (FNA) cytology, it is unclear whether BSRTC diagnostic categories suggest the same risk of malignancy in younger versus older patients.
Researchers evaluated all consecutive patients who underwent FNA of a thyroid nodule ≥1 cm in diameter, at the BCH and the Brigham and Women's Hospital between 1998 and 2016. They found that, in children and adults with clinically relevant thyroid nodules, malignancy rates differ within indeterminate BSRTC categories defined by similar morphologic features. This finding likely reflects true differences in nodule biology rather than variations in cytological classification.
Dr. Yu-kun Luo of the Ultrasound Department, General Hospital of Chinese PLA, Beijing, China, will present a study titled "Artificial Intelligence-Assisted Ultrasound Diagnosis for Thyroid Nodules." Due to uneven development of medical resources, diagnostic accuracy for thyroid nodules varies greatly. The aim of this study was to explore a novel AI-assisted ultrasound diagnostic system to improve the efficiency and accuracy of thyroid nodule diagnosis.
To test the accuracy of the new system, 500 pathologically confirmed thyroid nodules were selected, including 208 benign and 292 malignant ones. The images of all nodules, acquired from 10 different types of ultrasound equipment, were dynamically stored in the form of consecutively longitudinal and transverse sections. The AI-assisted diagnostic system recognized and analyzed the features of the images and offered recommendations for diagnosis. The diagnostic accuracy of the system was then compared with that of junior and senior physicians. Results showed the diagnostic accuracy of the AI system alone was higher than that of junior physicians (77.6% vs. 70.5%); however, accuracy could reach 92.4% when junior physicians were assisted by the new AI system—higher than the accuracy of senior physicians (85.6%) unassisted by the system. For nodules of different sizes, testing showed no significant difference in diagnostic accuracy among the three groups.
Another presentation will be given by Dr. Mingbo Zhang of the same department in Beijing's General Hospital. Dr. Mingbo will describe a "Randomized controlled clinical trial of ethanol-sensitized radiofrequency ablation (RFA) for benign solid thyroid nodules" that took place between June 2016 and February 2018. While solid thyroid nodules are good candidates for RFA surgery, they often require high power and energy, which increase the incidence of complications. This study used ethanol as a sensitizer before RFA to explore whether that could achieve a safer, faster, and more effective result.
Seventy-two patients with 84 nodules among them were enrolled in the study group and in a conventional RFA group, respectively, each with 42 nodules. The researchers concluded that ethanol can significantly improve the efficiency of RFA, reduce the time and energy of the ablation, and reduce the occurrence of complications.
In a presentation titled "Efficacy and Safety of Thermal Ablation of 200 Benign Thyroid Nodules: Comparison of Three Techniques (Radiofrequency, Laser, High Intensity Focused Ultrasound)," Dr. Adrien Ben Hamou of the Endocrinology Department at the University Hospital in Lille, France, will describe a bicentric retrospective study conducted between October 2013 and January 2018.
The aim was to compare the three ablation methods for treating benign thyroid nodules. Two hundred nodules were treated in 176 patients with benign histology or cytology, all of whom refused surgery. Clinical, biological, and ultrasound evaluation was performed before treatment. Researchers compared variations in volume and symptoms as well as side effects at 6 weeks and 12 months after treatment. Volume reduction between radiofrequency (RFA) and laser (LA) ablation was significantly different at 6 weeks but not at 12 months. After adjustments, no significant difference was observed at either 6 weeks or 12 months between RFA and high-intensity focused ultrasound (HIFU) or between LA and HIFU. Clinical symptoms were reduced in all three groups. Very few transient but potentially serious side effects were reported, the causes of which should be analyzed.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
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Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns disorders of thyroid function.
- Dr. Maia Banige will give a presentation titled "Prediction of fetal and neonatal dysthyroidism," showing how imperfect development and function of the thyroid in fetuses (FD) and newborns (ND) can be predicted from perinatal variables. Dr. Banige is from the Department of Pediatrics-Neonatology and Pediatric Emergency of the French-British Hospital Institute, Levallois-Perret, Ile-de-France.
She and her colleagues conducted a retrospective, multicenter study using data from the medical records of all patients monitored for pregnancy from 2007 to 2014 in 10 obstetric centers of the Assistance Publique des Hôpitaux de Paris. Women with Graves' disease who were positive for thyrotropin receptor antibodies (TRAb) at least once during pregnancy were included. Among 280,000 births, 2,288 medical records of women with thyroid dysfunction were selected and screened, and 417 women with Graves' disease who were positive for TRAb during pregnancy (0.15%) were finally included in the study.
Analysis revealed that the TRAb level in the mother and child was the strongest independent predictor of thyroid dysfunction. The risk of FD and ND increases with maternal hormonal imbalance and is also greater in the patients receiving antithyroid drugs (ATDs) during pregnancy. In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician with special attention for thyroid dysfunction.
A presentation titled "Pre-conception thyroid stimulating hormone level and risk of preterm birth in over 4.3 million rural Chinese women aged 20-49 years: a population-based cohort study" will be given by Dr. Ying Yang of the National Research Institute for Health and Family Planning and the National Human Genetic Resources Center. Dr. Ying and his colleagues studied the association between the pre-conception thyroid stimulating hormone (TSH) levels of women planning for pregnancy and the risk of preterm births (PTB).
Researchers conducted a historical cohort study of 4,320,584 rural reproductive-age women who had participated in free National Free Pre-pregnancy Checkups (NFPC) in 2013-2016 in China. Data on preconception TSH, history of pregnancy and diseases, and other variables were obtained from the physical examination record in NFPC. Successful conception and pregnancy outcomes were documented during the follow-up period, June 2013 to December 2017. PTB is defined as any birth within 28 to 37 weeks of gestational age. Participants who failed to become pregnant within 6 months, suffered from fetal death or stillbirth, or had multiple gestations during the period of study were excluded from the analysis. The data documented 283,854 PTB events (6.57%).
The study identified a V-shaped relationship between maternal pre-conception TSH levels and PTB risk. Either decreasing or increasing pre-conception TSH levels can significantly increase the risk of preterm birth.
Dr. George Kahaly of the Department of Medicine at Johannes Gutenberg University Medical Center in Mainz, Germany, and colleagues have undertaken a three-phase clinical trial of the drug teprotumumab. Results from the first phase—a 24-week randomized, double-masked, placebo-controlled treatment trial of the drug, which is an insulin-like growth-factor-1 receptor inhibitory antibody—were reported in the New England Journal of Medicine (NEJM 2017; 376:1748). Compared with a placebo (69% versus 20%), teprotumumab reduced protopsis (protrusion of the eyeballs) significantly beginning at week 6 and continuing over the 24 weeks of the trial. This second-phase report is an assessment of clinical status at weeks 28 and 72.
At week 28 (4 weeks after the treatment period), proptosis response was 73.8% in the teprotumumab group versus 13.3% in controls. At week 72 (48 weeks after treatment), 53% of week 24 teprotumumab proptosis responders maintained ≧ 2 mm improvement relative to baseline. Compared to baseline and placebo, clinical activity also decreased at week 28 and was relatively unchanged in the teprotumumab group at week 72. These results indicate no acute rebound of disease following the 24-week treatment.
Dr. Kahaly's group conclude that teprotumumab may represent a disease-modifying therapy in TAO by reducing proptosis and clinical activity, with sustained effects seen in most patients 48 weeks after treatment. In phase 3 of the trial, the research group will investigate whether patients would benefit from longer treatment or retreatment with teprotumumab.
Dr. Mats Holmberg of Institute of Medicine, Sahlgrenska Academy, and the Karolinska University Hospital, ANOVA, both in Stockholm, Sweden, will present a study titled "Structural brain changes in Graves' hyperthyroidism may be of autoimmune origin." During the hyperthyroid state of Graves' disease (GD), the volumes of medial temporal lobe (MTL) structures, e.g., the hippocampi, are reduced. This has been attributed to high thyroid hormone levels, but Dr. Holmberg and his colleagues hypothesized that the structural changes and mental symptoms may be due to autoimmunity per se. The aim of their study was to determine the relationship between nonthyroid autoimmunity and MTL volumes during hyperthyroidism in GD.
Dr. Holmberg's project is a longitudinal, observational, prospective case-controlled study in which 65 premenopausal women were evaluated within 2 weeks after a diagnosis of GD and again after 15 months of antithyroid treatment. Thyroid-stimulating hormone receptor antibodies, thyroid-stimulating immunoglobulins, and several additional antibodies were measured in the hyperthyroid state. MTL structures were scanned to determine hippocampal and amygdala volumes. This presentation reports preliminary data on the nonthyroid antibodies at baseline. Data on the thyroid antibodies will be reported separately.
The data so far support the hypothesis that autoimmunity that is not directly connected to the thyroid may be involved in the impairment of brain function in GD, introducing a new concept that needs further study.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
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