Thy3 cytology: what to do next?

INTRODUCTION

Cytological analysis of thyroid fine needle aspiration (FNA) is aided by the ‘Thy’ classification. However, there is often confusion surrounding the management of patients with a Thy3 classification. A subdivision of Thy3 has been created to help reduce this dilemma but its use within the UK appears to by infrequent. This paper analyses the management of patients with Thy3 cytology from FNA of a thyroid nodule in a UK case series and reviews the relevant literature. It also describes the results of a survey of selected UK ENT departments on the use of the Thy3 classification and its subdivisions.

PATIENTS AND METHODS

A retrospective analysis of a case series of patients was undertaken. In addition, a telephone survey of local/regional pathology departments was conducted to assess the utilisation of the Thy classification and to assess the awareness and usage of the Thy3 subdivisions.

RESULTS

A total of 39 Thy3 results (11 males, 28 females) were identified from 2007 to 2009. Of these, 24 patients went on to have surgery, 8 had a further FNA, 2 had a Tru-cut biopsy and 5 were lost to follow-up. Eleven (28.2%) patients were subsequently diagnosed with a thyroid malignancy. The survey identified that none of the departments had adopted the Thy3 subclassifications and only 40% were aware of them.

CONCLUSIONS

Thy3 results from thyroid FNA have a significant risk of malignancy but there remains confusion surrounding their management. This district general hospital has adopted and recommends the use of the Thy3 (i) and Thy3 (ii) subdivisions in order to assist decision-making and avoid delays in treatment or unnecessary surgery.     

C-reactive protein as an available biomarker determining mental component of health-related quality of life among individuals with spinal cord injury

Objectives: C-reactive protein (CRP) has been shown to correlate with health-related quality of life (HRQL) in some chronic medical conditions. However, these associations have not yet described in spinal cord injury (SCI). In this study, we tried to identify biomarkers associated with HRQL in SCI.

Design: Cross-sectional.

Setting: Tertiary rehabilitation center.

Participants: Referred patients to Brain and Spinal Cord Injury Research Center between November 2010 and April 2013.

Outcome Measure: Blood samples were taken to measure circulatory CRP, leptin, adiponectin, ferritin, parathyroid hormone, calcitonin, thyroid hormones, fasting plasma glucose and lipid profile. All the analyses were performed with adjustment for injury-related confounders (level of injury, injury completeness and time since injury) and demographic characteristics. HRQL was measured with Short Form health survey (SF-36).

Results: The initial inverse association between CRP and total score of SF-36 (P: 0.006, r?=??0.28) was lost after adjustment for confounders. However, the negative correlation between CRP and Mental Component Summary (MCS) remained significant (P: 0.0005, r?=??0.38). Leptin level was inversely correlated with Physical Component Summary (PCS) (P: 0.02, r?=??0.30).

Conclusion: Although CRP and leptin levels were not related with total scores of SF-36 questionnaire, CRP can be more useful in determining mental component of HRQL whereas leptin can be a determinant of physical component. The combined consideration of these two biomarkers may help to predict HRQL in individuals with SCI.     

Generality of genomic findings on blood pressure traits and its usefulness in precision medicine in diverse populations: A systematic review

Remarkable findings from genome-wide association studies (GWAS) on blood pressure (BP) traits have made new insights for developing precision medicine toward more effective screening measures. However, generality of GWAS findings in diverse populations is hampered by some technical limitations. There is no comprehensive study to evaluate source(s) of the non-generality of GWAS results on BP traits, so to fill the gap, this systematic review study was carried out. Using MeSH terms, 1545 records were detected through searching in five databases and 49 relevant full-text articles were included in our review. Overall, 749 unique variants were reported, of those, majority of variants have been detected in Europeans and were associated to systolic and diastolic BP traits. Frequency of genetic variants with same position was low in European and non-European populations (n = 38). However, more than 200 (>25%) single nucleotide polymorphisms were found on same loci or linkage disequilibrium blocks (r² ≥ 80%). Investigating for locus position and linkage disequilibrium of infrequent unique variants showed modest to high reproducibility of findings in Europeans that in some extent was generalizable in other populations. Beyond theoretical limitations, our study addressed other possible sources of non-generality of GWAS findings for BP traits in the same and different origins.     

Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis

Purpose

Bacterial vaginosis (BV) is a vaginal disorder which occurs either symptomatic or asymptomatic because of an imbalance between H₂O₂-producing Lactobacillus and Gardnerella vaginalis in the vagina. This systematic review and meta-analysis is the first to determine the prevalence of BV in pregnant and non-pregnant women in Iran.

Methods

We used national (SID, Irandoc, Iranmedex and Magiran) and international (PubMed, Scopus, Google Scholar and ISI web of knowledge) electronic databases to systematically search and collect available studies using related keywords (up to 1 December 2017). Inclusion and exclusion criteria were defined to select eligible studies.

Results

The overall prevalence of BV among Iranian women was 18.9% (95% CI 14–25). Gardnerella vaginalis was the most prevalent isolated bacteria. The prevalence of BV in non-pregnant women was 28% (95% CI 15.1–45.9) which was higher compared with pregnant women who had a prevalence of 16.5% (95% CI 12.5–21.6).

Conclusion

The present review revealed a high prevalence of BV in non-pregnant women. Given that BV is associated with a series of reproductive complications such as infertility, taking preventive measures such as awareness of patients as well as monitoring and controlling of syndrome are essential.