Trends in thyroid cancer incidence in Sweden, 1958-1981, by histopathologic type

Time trends in the incidence of malignant neoplasms of the thyroid were examined for Sweden for the period 1958-81, 5,838 cases being studied. Autopsy-diagnosed cases were excluded. Mean annual changes in the age-standardized rates over this period were 1.9% and 1.2% for women and men, respectively, for all thyroid carcinomas combined; 4.9% and 2.1% for papillary carcinoma; 0.9% and 2.1% for follicular carcinoma; and -1.0% and -2.1% for anaplastic carcinoma. Age, period and cohort models were fitted. There was a progressive increase in papillary cancer incidence for cohorts born since 1919. This increase cannot be satisfactorily explained as an artefact of trends in classification, and probably reflects a real increase in incidence. A less marked increase was seen for follicular cancer, and there was a decline for cohorts born since 1939. While the risk of papillary and anaplastic carcinoma was lower in iodine-deficient areas, follicular cancer risk was twice as high in these areas, for men only. There was a steady decline of anaplastic cancer in both sexes after 1965, largely attributable to a decline in cohorts born since 1924.     

Interpretation of T-wave inversion in physiological and pathological conditions: Current state and future perspectives

The presence of T-wave inversion (TWI) at 12-lead electrocardiogram (ECG) in competitive athletes is one of the major diagnostic challenges for sports physicians and consulting cardiologists. Indeed, while the presence of TWI may be associated with some benign conditions and it may be occasionally seen in healthy athletes presenting signs of cardiac remodeling, it may also represent an early sign of an underlying, concealed structural heart disease or life-threatening arrhythmogenic cardiomyopathies, which may be responsible for exercise-related sudden cardiac death (SCD). The interpretation of TWI in athletes is complex and the inherent implications for the clinical practice represent a conundrum for physicians. Accordingly, the detection of TWI should be viewed as a potential red flag on the ECG of young and apparently healthy athletes and warrants further investigations because it may represent the initial expression of cardiomyopathies that may not be evident until many years later and that may ultimately be associated with adverse outcomes. The aim of this review is, therefore, to report an update of the literature on TWI in athletes, with a specific focus on the interpretation and management.     

Correlations of HOMA2-IR and HbA1c with Algorithms Derived from Bioimpedance and Spectrophotometric Devices

Background

Homeostasis model assessment of insulin resistance (HOMA2-IR) and HbA1c, markers of metabolic syndrome and glycemic control, were compared with Electro Sensor (ES) Complex software algorithms. ES complex software integrates data from Electro Sensor Oxi (ESO; spectrophotometry) and Electro Sensor-Body Composition (ES-BC; bioimpedance).

Methods

One hundred forty-eight Brazilian obese candidates for bariatric surgery underwent complete physical examinations, laboratory tests (fasting plasma glucose, fasting plasma insulin, and HbA1c) and ES complex assessments. HOMA2-IR was calculated from fasting plasma glucose and fasting plasma insulin using free software provided by The University of Oxford Diabetes Trial Unit. ES complex?Cinsulin resistance (ESC-IR) and ES complex?Cblood glucose control (ESC-BCG) were calculated from ESO and ES-BC data using ES complex software. Correlations between HOMA2-IR and ESC-IR and between ESC-BGC and HbA1c were determined.

Results

ESC-BGC was correlated with HbA1c (r?=?0.85). ESC-BCG values >3 were predictive of HbA1c?>?6.5?% (???=?0.94; unweighted ???=?0.9383). ESC-IR was correlated with HOMA2-IR (r?=?0.84). Patients with ESC-IR score >2.5 or >3 were more likely to have metabolic syndrome or insulin resistance, respectively, compared with HOMA2-IR value >1.4 and >1.8, respectively. ESC-IR performance was evaluated by receiver operating characteristic curves. The areas under the curve for metabolic syndrome and insulin resistance were 0.9413 and 0.9022, respectively.

Conclusion

The results of this study in Brazilian subjects with obesity suggest that ES complex algorithms will be useful in large-scale screening studies to predict insulin resistance, metabolic syndrome, and HbA1c >6.5?%. Additional studies are needed to confirm these correlations in non-obese subjects and in other ethnic groups.     

Sudden paraplegia in a case of apparently isolated frontal embryonal tumour with abundant neuropil and true rosettes

The exceptional case of a 19-month-old boy with an apparently isolated frontal lesion and a huge holocord neoplastic involvement, presenting with a subtly indolent preoperative course and a particularly tumultuous evolution, is reported. The diagnosis of embryonal tumour with abundant neuropil and true rosettes was posed.     

Complications of delayed cranial repair after decompressive craniectomy in children less than 1 year old

Background  

Decompressive craniectomy is an effective treatment option in case of refractory intracranial hypertension after severe head injury. The incidence of complications following cranial repair after decompressive craniectomy for traumatic brain injury is not negligible, particularly in infants and young toddlers. However, only a few dedicated papers can be found in the literature.     

Endoscopic septostomy through a standard precoronal ventricular access: feasibility and effectiveness

Background  

Although endoscopic septostomy is widely adopted in the treatment of unilateral or specific types of hydrocephalus, there is no consensus on surgical indications, technical aspects and postoperative outcome. In particular, the choice of the ventricular access has been recently debated. We investigated the results of endoscopic septostomy performed through a standard precoronal ventricular access using a rigid endoscope.