The value of repeating fine-needle aspiration for thyroid nodules.

BACKGROUND: Fine-needle aspiration (FNA) is an invaluable technique used in the evaluation of thyroid nodules. OBJECTIVES: Evaluate the concordance of results for consecutive FNA readings. DESIGN: Retrospective, descriptive. SETTINGS: Two tertiary care centers. METHODS: Demographics were collected along with every FNA result and final pathology results for all patients (aged 9-90 years old) who underwent thyroid surgery from 2010 to 2017. The Bethesda system was used for cytology. Agreement levels were calculated and compared with final pathology. SAMPLE SIZE: Of 1237 initially included, 1134 had at least one FNA performed with results available for review. RESULTS: For the 1134 patients, demographic and clinical data were collection and a comparison was made between the three FNA results; the highest agreement was between FNA 2 and 3 (53.6%); however, the kappa value was consistently low for all comparisons, indicating a poor level of agreement overall. Also, the risk of malignancy was higher in this study than in the 2017 Bethesda system for reporting thyroid cytopathology in FNA cytology categories I and II. CONCLUSION: Repeating FNA biopsies yield different results every time; hence, there is a low level of agreement. The clinical decision should therefore include other important risk factors. Prospective studies could help shed more light on this topic. LIMITATIONS: Retrospective design. CONFLICT OF INTEREST: None.

Quality of life in living kidney donors: A single-center experience at the king abdulaziz medical city.

Chronic kidney disease (CKD) results in irreversible decline in renal function, which ultimately progresses to end-stage renal disease (ESRD). Transplantation is the treatment of choice for ESRD, and this is possible only if donor kidneys are available. Several doubts can appear in the minds of donors and among general public regarding the quality of life (QOL) after donation which can affect the willingness to donate. Therefore, we aimed to assess the QOL in living kidney donors in King Abdulaziz Medical City, Riyadh, Saudi Arabia using the kidney disease QOL instrument short form (KDQOL-SF). This was a cross-sectional survey of living kidney donors between 18 and 65 years of age who donated their kidneys between 2008 and 2014 and was conducted in the hepatobiliary and transplantation department of our hospital. The study measured 17 domains in KDQOL-SF. Each domain score is up to 100; the higher the score in each domain, the better the QOL. Data will be entered and analyzed using Statistical Package for the Social Sciences version 21.0. The descriptive statistics will be presented as frequency and percentage for the categorical variables (e.g., gender and income) and the mean ± SD for numerical variables (e.g., QOL score). The study included 60 donors who donated during the study period between 2008 and 2014. Males were 49 (82%) with the age (mean ± standard deviation) as 32 ± 6.5 years. The donors reported an "overall-mean-score" of 86.7 ± 14.6. Four domains had lower scores between 60 and 80: "sleep" (61.8 ± 13.8), "emotional-well-being" (71.6 ± 11.1), "quality-of-social-interaction," and "energy/fatigue." The other 13 domains had scores >80. The two highest domains: "role-physical" (97.9 ± 13.3) and "effect-of-kidney-disease" (97.4 ± 8). Comparing males and females scores, work status was higher in males with P = 0.03. Our findings suggest that donors have a good QOL which may result in more donations. It is important to improve the standard of care for donors to enable them to live their life to the fullest.