Background: Fine-needle aspiration cytology (FNAC) has become a well-established modality in the diagnosis, staging and follow-up of thyroid nodules. FNAC outcomes are routinely classified using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), facilitating appropriate clinical management. Bethesda categories III and IV encompass varying risks of malignancy. This retrospective study established a possible association between these cytological categories and malignancy rates in patients treated at a single institution. Methods: Over a 6-year period, 11,627 FNAC procedures were performed on thyroid nodules. Of these, 814 (59.63%) patients were submitted to thyroidectomy. The nodules of 108 patients were classified as Bethesda category III and 47 patients as Bethesda category IV. Patient data were reviewed to establish a correlation between the FNAC results and the final histopathological analyses. Results: The rates of malignancy among patients who underwent surgery were 25% for category III and 27.6% for category IV, with no significant differences between categories (p = 0.67). The pathological parameters of malignant nodules, namely tumour type, size, encapsulation, invasion into the thyroid capsule, extrathyroidal extension and lymphovascular invasion did not significantly differ between the groups (p > 0.05). Conclusions: This paper provides a more precise correlation of malignancy rates with thyroid nodules classified as Bethesda categories III and IV, as our findings are comparable to the literature, giving malignancy rates ranging from 10 to 30% for category III and 25-40% for category IV. Use of the BSRTC is heterogeneous across institutions, and there is some degree of subjectivity in the distinction between categories III and IV; therefore, it is crucial to estimate the rates of malignancy at each institution. Molecular assays are of increasing importance in determining the need for surgical intervention for thyroid lesions. Gene expression assays using FNAC material may demonstrate a high predictive value for cytologically indeterminate thyroid nodules diagnosed as Bethesda classes III and IV.
Nomophobia refers to an intense anxiety and stress caused by being out of contact with mobile phones (MPs). It is known that excessive engagement with MPs decreases adolescents' psychological well-being, social and academic functioning. The aim of this study was to investigate the associations of nomophobia with alexithymia which is characterized by difficulties in describing and expressing emotions and using empathy, and with the metacognition characteristics which have the function of controlling the cognitions in an adolescent population. The study was conducted on 1817 participants (n = 972, 54% female, n = 835, 46% male). The Nomophobia Questionnaire (NMP-Q), The Twenty-Item Toronto Alexithymia Scale (TAS-20) and The Metacognition Questionnaire for Children and Adolescents (MCQ-C) were administered to participants. A question form for socio-demographic data was also administered to participants and their families. Cathegorical variables were analyzed by chi-square test, and numerical variables were analyzed by independent sample t test. The relationships between the scales' scores were analyzed by the Pearson-product moments correlation test. The predictive effects of alexithymia, metacognition problems and gender were assessed by multiple linear regression analysis. Nomophobia, alexithymia and metacognition problem levels were significantly higher in females than males. There was a significant correlation between NMP-Q and TAS-20 scores and MCQ-C scores. TAS-20, MCQ-C scores and gender significantly predicted the nomophobia when NMP-Q score was a dependent variable. Therapeutic interventions for improving social skills like emphatic thinking and/or increasing emotional expression may be beneficial in the treatment of adolescents with alexithymic traits which experience nomophobia. Moreover, interventions that enhance metacognitive skills which can control negative thoughts triggered by the possibility of losing contact with MPs may increase treatment success.
Despite the fast development of technology in the world, diabetic foot wounds cause deaths and massive economical losses. Diabetes comes first among the reasons of non traumatic foot amputations. To reduce the healing time of these fast progressing wounds, effective wound dressings are in high demand. In our study, sheep small intestinal submucosa (SIS) based biocompatible sponges were prepared after SIS decellularization and their wound healing potential was investigated on full thickness skin defects in a diabetic rat model. The decellularized SIS membranes had no cytotoxic effects on human fibroblasts and supported capillary formation by HUVECs in a fibroblast-HUVEC co-culture. Glutaraldehyde crosslinked sponges of three different compositions were prepared to test in a diabetic rat model: gelatin (GS), gelatin: hyaluronic acid (GS:HA) and gelatin: hyaluronic acid: SIS (GS:HA:SIS). The GS:HA:SIS sponges underwent a 24.8 ± 5.4% weight loss in a 7-day in vitro erosion test. All sponges had a similar Young’s modulus under compression but GS:HA:SIS had the highest (5.00 ± 0.04 kPa). Statistical analyses of histopathological results of a 12-day in vivo experiment revealed no significant difference among the control, GS, GS:HA, and GS:HA:SIS transplanted groups in terms of granulation tissue thickness, collagen deposition, capillary vessel formation, and foreign body reaction (P > 0.05). On the other hand, in the GS:HA:SIS transplanted group 80% of the animals had a complete epidermal regeneration and this was significantly different than the control group (30%, P < 0.05). Preclinical studies revealed that the ECM of sheep small intestinal submucosa can be used as an effective biomaterial in diabetic wound healing.
Purpose To evaluate the effectiveness of treatment with topical and intralesional steroids for idiopathic granulomatous mastitis (IGM) and to compare with surgical methods. Methods Data was retrospectively collected from records. Intralesional steroid injection and topical steroid administration, hereafter referred to as local steroid treatment (LST) were applied in Group 1. Surgery (local excision, wide excision and mastectomy) was performed in Group 2. In Group 1 changes in lesion sizes were recorded and factors complicating treatment were identi ed. The Numeric Pain Rating Scale was used to determine subjective pain. LST and surgery were compared with regard to: pain before and after the treatment; complication rate; recurrence rate; and treatment cost.Results There were 38 and 48 patients in Group 1 and Group 2, respectively. In the LST group 72 lesions were present and 70 of 72 (97%) responded completely to treatment. Pre-treatment median maximum diameter was 23.50 (15.25-35.25) mm, which regressed to 16 (12-25) mm after the rst session. While the pre-treatment pain scores of Group 1 and Group 2 were similar (p=0.756), there was a signi cant difference in the post-treatment pain scores (p<0.001). No recurrence occurred in any patients in Group 1, while recurrence developed in 15 (31.2%) patients in Group 2 (p<0.001).Conclusion LST is a treatment for IGM that is cheap, with high e ciency, negligible recurrence, and has good esthetic outcome. Our results suggest that LST should be the rst-line treatment option for all IGM patients, including complicated cases.
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