No abstract

Psoriasis is a skin disorder that frequently begins in the pediatric and young adult population but imposes physical and psychosocial burdens over a lifetime. The objective of this retrospective cohort study was to evaluate the effect of age at diagnosis on the lifetime outcomes of psoriasis patients. Individuals with psoriasis (N = 114) completed a questionnaire regarding disabilities, relationships, education, finances, and medical outcomes. Responses were compared among quartiles of age at diagnosis and regression analyses were performed. Those diagnosed at a younger age were more likely to have a greater lifetime Dermatology Life Quality Index (LT DLQI) (p < 0.001), have felt depressed (p = 0.003), believe that psoriasis had caused their depression (p < 0.001), experience lifetime sleep problems (p = 0.004), use recreational drugs (p < 0.001), hide their psoriasis over their lifetime (p < 0.001), and experience more severe lifetime discrimination in social settings (p = 0.002). Early onset psoriasis is associated with depression, social discrimination, and greater LT DLQI.

The diagnostic imaging key facilitates RCC subtype characterization and can be used as a decision support tool.

Purpose: This study aims to evaluate the quality of diagnostic thyroid ultrasound reports and determine the impact of consistent adherence to 2015 American Thyroid Association (ATA) and 2017 American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) on reducing unnecessary referrals for thyroid nodule biopsy. Materials and Methods: Reports from 291 referrals for thyroid nodule biopsy were included for retrospective report evaluation (males: 42; mean age: 56) according to 2015 ATA and ACR TI-RADS lexicon. Cytology results were collected for each patient. Two radiologists blinded to cytology results independently, retrospectively reviewed imaging of the referrals, and rescored them according to 2015 ATA and 2017 ACR TI-RADS risk stratification systems. Statistical analysis was completed using chi-square analysis and calculation of κ statistic for interobserver variability. Results: No report completely addressed all features associated with malignancy. Over half of the reports did not include descriptors on echogenicity, shape, margin, or echogenic foci. In all, 9.3% of biopsies showed malignant histology. Rescoring of referrals demonstrated decrease in biopsy referrals by 55% as per 2017 ACR TI-RADS and 14% as per 2015 ATA ( P < .0001). There was no impact on detection of malignancy with adherence to ATA or ACR criteria and less interobserver variability with application of 2017 ACR TI-RADS compared to 2015 ATA. Conclusion: Thyroid ultrasound report quality was found variable with respect to nodule description. Reports recommended biopsy based on nodule size with no detailed description of other imaging features. Adherence to risk stratification system would have resulted in significant reduction in the number of unnecessary biopsy referrals.