Jindong Niu; Hongyan Chen; Juan Peng; Hui Yuan
Volume 25, Issue 10 , 2023
Abstract
Background: One major drawback of using ultrasound for diagnosing thyroid nodules is its limited ability to distinguish between benign and malignant nodules. In China, the common methods for risk stratification and guiding fine needle aspiration (FNA) in diagnosing thyroid nodules are the Chinese Thyroid ...
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Background: One major drawback of using ultrasound for diagnosing thyroid nodules is its limited ability to distinguish between benign and malignant nodules. In China, the common methods for risk stratification and guiding fine needle aspiration (FNA) in diagnosing thyroid nodules are the Chinese Thyroid Imaging Reports and Data Systems (C-TIRADS) and American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS).
Objectives: This review seeks to assess the effectiveness of C-TIRADS and ACR-TIRADS in accurately identifying the risk of malignancy in Chinese patients suspected of thyroid cancer.
Methods: A detailed search was conducted in PubMed, Google Scholar, Medline, Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure (CNKI) databases from January 2018 to December 2022. The analysis only considered original articles from China reporting the use of C-TIRADS and ACR-TIRADS confirmed by histology and FNA.
Results: This review analyzed 26 studies with a total of 23,064 thyroid nodules from 19,114 patients to compare the diagnostic performance of C-TIRADS and ACR-TIRADS in predicting malignancy risk in thyroid nodules. Although the malignancy rates in each risk category were similar between the two systems, the TIRADS showed better diagnostic performance than C-TIRADS in terms of pooled specificity (95.0 % vs. 66.8 % of C-TIRADS). However, the pooled analysis showed that C-TIRADS had a better pooled sensitivity (94.6 % vs. 76.5% of ACR-TIRADS). The diagnostic odds ratio was 1.37 (95 % CI: 0.75-2.51) for ACR-TIRADS and 0.89 (95 % CI: 0.36-2.16) for C-TIRADS.
Conclusion: Based on the results, both C-TIRADS and ACR-TIRADS are effective in predicting the risk of malignancy in thyroid nodules with similar overall diagnostic accuracy. The combination of both systems can be beneficial in enhancing accuracy in suspicious or uncertain cases. The long-term experience of the trained radiologists can readily help in concluding the diagnosis. As no single system or combination of systems can provide a 100% accurate prediction of the malignancy of thyroid nodules, the ultimate diagnosis relies on the concluding assessment of experienced radiologists and the medical team.
Sinan Karacabey; Erkman Sanr?
Volume 24, Issue 10 , 2022
Abstract
Background: Head trauma may cause an increase in intracranial pressure (ICP). The use of ocular ultrasound to measure optic nerve sheath diameter (ONSD) is a method to determine the ICP. The use of the rigid cervical collar in head trauma patients contribute to elevating ICP, and therefore, potentially ...
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Background: Head trauma may cause an increase in intracranial pressure (ICP). The use of ocular ultrasound to measure optic nerve sheath diameter (ONSD) is a method to determine the ICP. The use of the rigid cervical collar in head trauma patients contribute to elevating ICP, and therefore, potentially causing further deterioration in their condition.
Objectives: This study aimed to describe changes in ONSD after the placement of a c-collar and analyze these changes depending on the time in the c-collar.
Methods: This prospective study measured the ONSD of minor head trauma patients before and after the placement of a c-collar. Patients aged ³18 with blunt head trauma and Glasgow Coma Score ³13 were included in the study. Each eye was scanned twice. This was done before c-collar placement, at 5 and 20 min after placement. The mean values of both eyes were calculated and analyzed.
Results: This study investigated 50 patients. The mean baseline ONSD was obtained at 4.71mm±0.22 (4.54-4.77). Furthermore, T5 and T20 measurements were 5.19±0.41 (5.07-5.31) and 5.26±0.45 (5.14-5.39), respectively. The ONSD increased at T5 and T20. The changes from the baseline measurements were statistically significant (P=0.000, P=0.000). The difference between T5 and T20 groups was an increase in ONSD, and these differences were also statistically significant (0.07±0.19; P=0.008).
Conclusion: Our results revealed that minor head trauma patients using a c-collar may increase ONSD by timeline the clinical effects of which have to be determined with further studies. Enlargement in ONSD should be considered when interpreting ICP.
Poupak Rahimzadeh; Salome Sehat Kashani; Karim Hemmati; Farnad Imani; Akram Salimi; Seyed Hamid Reza Faiz
Volume 22, Issue 12 , 2020
Abstract
Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery.
Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient ...
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Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery.
Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient satisfaction, and muscle force preservation.
Materials and Methods: This single-blind clinical trial study investigated the patients who underwent elective knee arthroscopic ACL surgery randomly either by ultrasound-guided FNB or IPNB. Subsequently, the patients were evaluated 1, 3, 6, 12, and 24 h following NB for pain severity, patient satisfaction level, and muscle force.
Results: The pain score (both at rest and in flexion) was significantly lower in the first three h after the intervention in the FNB group. Moreover, the mean score of the patients satisfaction in the first hours was significantly higher in the FNB group after the procedure. Additionally, the IPNB group obtained a significantly faster mean time required for the first dose of opioid request. The mean dose of used opioids over 24 h was significantly lower in the FNB group. There was a significant difference between the groups in terms of the muscle strength score within 24 h; moreover, the FNB group obtained a significantly greater delay in muscle recovery.
Conclusion: The FNB is associated with greater pain relief and satisfaction in patients who underwent arthroscopic ACL reconstruction surgery, compared to the IFNB technique. However, a further delay in the recovery of quadriceps muscle force is evident in the FNB group.
Tahmineh Tavakoli; Toba Kazemi; Homa Mollaei; Fatemeh Salmani; Samira Saghafi; Ensiah Sadat Mousavi; Mahyar Mohamadifard; Gholamreza Sharifzadeh
Volume 20, Issue 6 , 2018, Pages 1-6
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most frequent liver diseases worldwide. There are several com- mon risk factors between NAFLD and coronary artery disease (CAD). Objectives: This study aims to evaluate the relationship between the prevalence of Non-alcoholic fatty liver ...
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Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most frequent liver diseases worldwide. There are several com- mon risk factors between NAFLD and coronary artery disease (CAD). Objectives: This study aims to evaluate the relationship between the prevalence of Non-alcoholic fatty liver disease (NAFLD) withseverity of Coronary Artery Disease (CAD) in patients undergoing coronary artery angiography. Methods: This study was a cross-sectional, descriptive-analysis research that included 514 patients who underwent angiography.The severity of CAD was assessed by the number of vessels involved (vessel score: vd). An ultrasound was performed for all the patients also, intensity of fatty liver involvement was graded from zero (absence of steatosis) to three (severe steatosis). Results: Ultrasonographic examination proven NAFLD in 59.1% of patients with different grades. Patients with NAFLD had signifi- cantly higher body mass index (P < 0.001), waist circumference (P = 0.03), and age (P < 0.001). In addition, there were significant differences between ALT and AST within the normal group and NAFLD patients (P < 0.001). Moreover, coronary angiographic data indicated that the presence of NAFLD significantly correlated with the CAD severity score as so: 64% of people with 2vd and 60.5% of people with three-vessle lisense had fatty liver that was statistically significant (df = 4; P = 0.014). Conclusions: This study showed a high prevalence of NAFLD in patients with documented CAD. It is extremely important since knowing risk factors, designing screening programs, and early treatment of fatty liver could lead to reducing the risk of cardiovas- cular diseases.
