Risk factors for recurrent papillary thyroid carcinoma

OBJECTIVE: To identify risk factors associated with disease recurrence among Filipinos with papillary thyroid carcinoma (PTC).METHODS:Design: Retrospective Cohort StudySetting: Tertiary National University HospitalParticipants: 76 patients diagnosed with papillary thyroid carcinoma, classified as low and low-to-intermediate risk (2015 ATA classification) that underwent total thyroidectomy with or without neck dissection from 2010-2014 and were followed up from 10 months to 5 years. Log rank and Cox regression analyses were used to determine significant risk factors for recurrence.RESULTS: 29 (38.15%) had recurrence. On univariate analysis, age, tumor size, multifocality, extrathyroidal extension, presence of lateral neck nodes and RAI therapy were statistically associated with recurrence. However, on multivariate analysis, no clinicopathologic factor was statistically associated with recurrence.CONCLUSION: Age of >45 years, female sex, tumor size of >2 cm, multifocality, presence of microscopic extrathyroidal extension and lymph node metastasis might contribute to the recurrence of papillary thyroid cancer while post-operative radioactive ablation may have some protective effect. However, this study suggests that other factors must be included in the model to better understand the relationship between these factors and recurrence.

Prevalence and reasons for non-follow-up of newborns with "refer" results on initial hearing screening

OBJECTIVE: To determine the prevalence rate of follow-up among infants who had a "refer" result on initial newborn hearing screening and to identify reasons for default by parents or guardians.METHODS:Design: Cross-Sectional StudySetting: Tertiary National University HospitalParticipants: 79 parents or guardians whose newborns obtained a "refer" result on initial hearing screening were interviewed over the phone.RESULTS: Among those babies who had a "refer" result on initial hearing screening, 51% followed up for repeat testing. The most common reasons for non-follow up by parents or guardians include being busy, distance from the hospital and baby's health condition.CONCLUSIONS: The follow-up rate in this study is higher compared to previous figures (27%), but is still below target. The reasons for non-follow-up obtained suggest problems may exist on all levels of the healthcare system. Appropriate solutions to address these problems should be explored.