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1.
Asia Pac J Clin Oncol ; 20(2): 285-291, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36791022

RESUMEN

AIMS: Multidisciplinary meetings (MDMs) play a crucial role in decision-making in breast cancer patient care. This study aimed to firstly assess the impact of breast cancer MDMs in decision-making for breast cancer patients and secondly to determine the concordance between MDM recommendations and implementation of clinical practice. METHODS: Patient cases to be presented at the weekly breast cancer MDMs were identified and prospectively enrolled. Management plans were predicted by the treating surgeon with the pre-MDM management plans then compared to MDM recommendations. Changes in decision-making were assessed in the following domains: further surgery, systemic therapy (endocrine, chemotherapy or targeted), radiotherapy, enrolment in a clinical trial, further investigations, and referral to other specialists or services. Patient records were subsequently reviewed at 3 months post-MDM to assess the rate of implementation of MDM recommendations and any reasons for discordance. RESULTS: Out of 50 cases, 66% (CI 53-79%; p < .005) experienced a change in management plan as a result of MDM discussion, with a total of 66 episodes of recorded change per decision-making domain affecting the following: further surgery (7.6%), endocrine therapy (4.5%), chemotherapy (19.7%), targeted therapy (4.5%), radiotherapy (18.2%), enrolment for a clinical trial (12.1%), additional investigations (22.7%), and further referrals (10.6%). MDM recommendations were implemented in 83.7% of cases. CONCLUSION: The breast cancer MDMs were found to substantially impact on the management plans for breast cancer patients, with 83.7% of MDM recommendations being implemented into clinical practice. This study reinforces the importance of MDMs in the management of these patients, as well as highlighting the need for further investigating and addressing the potential barriers to the implementation of MDM recommendations.


Asunto(s)
Neoplasias de la Mama , Oncología por Radiación , Humanos , Femenino , Neoplasias de la Mama/terapia , Grupo de Atención al Paciente , Derivación y Consulta , Atención a la Salud
2.
Psychooncology ; 31(2): 167-175, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34460129

RESUMEN

OBJECTIVE: Identifying modifiable factors affecting work ability among cancer survivors is important. The primary aim of the present study was to examine the effects of depression and related psychological factors on work ability among breast cancer survivors in Australia. METHODS: In this cross-sectional electronic and postal survey, Australian breast cancer survivors were investigated. Work status and conditions before and after cancer treatment were analysed. Work ability was measured using the Work Limitation Questionnaire©-Short Form (WLQ-SF) with its four domains (time management, physical tasks, mental-interpersonal tasks, and output tasks). Three psychological factors were investigated: depression, fear of cancer recurrence, and demoralisation. Sociodemographic and clinical data were also collected. Multivariate regression analysis was used to identify the associations of psychological factors with WLQ-SF. RESULTS: Among eligible survivors, 310 (50%) responded to the survey and were analysed. Nearly one third reported their work conditions had changed after cancer treatment. The depressed group reported limited work ability in 35%-44% of the four domains of WLQ-SF, while the non-depressed group reported limited work ability in only 8%-13%. At-work productivity loss was approximately fourfold higher in the depressed group than in the non-depressed group. In multivariate analysis, at-work productivity loss was associated with depression, demoralisation, and past history of anxiety. CONCLUSIONS: After breast cancer treatment, work conditions changed toward lower wages and working hours. Depression, demoralisation, and past history of anxiety were associated with lower work ability. Further evaluations of work rehabilitation in breast cancer survivors are warranted.


Asunto(s)
Neoplasias de la Mama , Supervivientes de Cáncer , Ansiedad/epidemiología , Australia , Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Supervivientes de Cáncer/psicología , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Recurrencia Local de Neoplasia , Calidad de Vida/psicología , Sobrevivientes/psicología , Evaluación de Capacidad de Trabajo
3.
Front Microbiol ; 12: 668240, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34248877

RESUMEN

We report on the effect of the end-Cretaceous impact event on the present-day deep microbial biosphere at the impact site. IODP-ICDP Expedition 364 drilled into the peak ring of the Chicxulub crater, México, allowing us to investigate the microbial communities within this structure. Increased cell biomass was found in the impact suevite, which was deposited within the first few hours of the Cenozoic, demonstrating that the impact produced a new lithological horizon that caused a long-term improvement in deep subsurface colonization potential. In the biologically impoverished granitic rocks, we observed increased cell abundances at impact-induced geological interfaces, that can be attributed to the nutritionally diverse substrates and/or elevated fluid flow. 16S rRNA gene amplicon sequencing revealed taxonomically distinct microbial communities in each crater lithology. These observations show that the impact caused geological deformation that continues to shape the deep subsurface biosphere at Chicxulub in the present day.

4.
Sci Adv ; 7(9)2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33627429

RESUMEN

The Cretaceous-Paleogene (K-Pg) mass extinction is marked globally by elevated concentrations of iridium, emplaced by a hypervelocity impact event 66 million years ago. Here, we report new data from four independent laboratories that reveal a positive iridium anomaly within the peak-ring sequence of the Chicxulub impact structure, in drill core recovered by IODP-ICDP Expedition 364. The highest concentration of ultrafine meteoritic matter occurs in the post-impact sediments that cover the crater peak ring, just below the lowermost Danian pelagic limestone. Within years to decades after the impact event, this part of the Chicxulub impact basin returned to a relatively low-energy depositional environment, recording in unprecedented detail the recovery of life during the succeeding millennia. The iridium layer provides a key temporal horizon precisely linking Chicxulub to K-Pg boundary sections worldwide.

5.
Proc Natl Acad Sci U S A ; 117(41): 25327-25334, 2020 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-32989138

RESUMEN

An asteroid impact in the Yucatán Peninsula set off a sequence of events that led to the Cretaceous-Paleogene (K-Pg) mass extinction of 76% species, including the nonavian dinosaurs. The impact hit a carbonate platform and released sulfate aerosols and dust into Earth's upper atmosphere, which cooled and darkened the planet-a scenario known as an impact winter. Organic burn markers are observed in K-Pg boundary records globally, but their source is debated. If some were derived from sedimentary carbon, and not solely wildfires, it implies soot from the target rock also contributed to the impact winter. Characteristics of polycyclic aromatic hydrocarbons (PAHs) in the Chicxulub crater sediments and at two deep ocean sites indicate a fossil carbon source that experienced rapid heating, consistent with organic matter ejected during the formation of the crater. Furthermore, PAH size distributions proximal and distal to the crater indicate the ejected carbon was dispersed globally by atmospheric processes. Molecular and charcoal evidence indicates wildfires were also present but more delayed and protracted and likely played a less acute role in biotic extinctions than previously suggested. Based on stratigraphy near the crater, between 7.5 × 1014 and 2.5 × 1015 g of black carbon was released from the target and ejected into the atmosphere, where it circulated the globe within a few hours. This carbon, together with sulfate aerosols and dust, initiated an impact winter and global darkening that curtailed photosynthesis and is widely considered to have caused the K-Pg mass extinction.

6.
Proc Natl Acad Sci U S A ; 117(29): 17084-17093, 2020 07 21.
Artículo en Inglés | MEDLINE | ID: mdl-32601204

RESUMEN

The Cretaceous/Paleogene mass extinction, 66 Ma, included the demise of non-avian dinosaurs. Intense debate has focused on the relative roles of Deccan volcanism and the Chicxulub asteroid impact as kill mechanisms for this event. Here, we combine fossil-occurrence data with paleoclimate and habitat suitability models to evaluate dinosaur habitability in the wake of various asteroid impact and Deccan volcanism scenarios. Asteroid impact models generate a prolonged cold winter that suppresses potential global dinosaur habitats. Conversely, long-term forcing from Deccan volcanism (carbon dioxide [CO2]-induced warming) leads to increased habitat suitability. Short-term (aerosol cooling) volcanism still allows equatorial habitability. These results support the asteroid impact as the main driver of the non-avian dinosaur extinction. By contrast, induced warming from volcanism mitigated the most extreme effects of asteroid impact, potentially reducing the extinction severity.


Asunto(s)
Dinosaurios , Extinción Biológica , Planetas Menores , Animales , Dióxido de Carbono , Clima , Fósiles , Historia Antigua , India , México , Modelos Biológicos , Paleontología , Erupciones Volcánicas
7.
Sci Adv ; 6(22): eaaz3053, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32523986

RESUMEN

The ~180-km-diameter Chicxulub peak-ring crater and ~240-km multiring basin, produced by the impact that terminated the Cretaceous, is the largest remaining intact impact basin on Earth. International Ocean Discovery Program (IODP) and International Continental Scientific Drilling Program (ICDP) Expedition 364 drilled to a depth of 1335 m below the sea floor into the peak ring, providing a unique opportunity to study the thermal and chemical modification of Earth's crust caused by the impact. The recovered core shows the crater hosted a spatially extensive hydrothermal system that chemically and mineralogically modified ~1.4 × 105 km3 of Earth's crust, a volume more than nine times that of the Yellowstone Caldera system. Initially, high temperatures of 300° to 400°C and an independent geomagnetic polarity clock indicate the hydrothermal system was long lived, in excess of 106 years.

8.
Proc Natl Acad Sci U S A ; 116(39): 19342-19351, 2019 09 24.
Artículo en Inglés | MEDLINE | ID: mdl-31501350

RESUMEN

Highly expanded Cretaceous-Paleogene (K-Pg) boundary section from the Chicxulub peak ring, recovered by International Ocean Discovery Program (IODP)-International Continental Scientific Drilling Program (ICDP) Expedition 364, provides an unprecedented window into the immediate aftermath of the impact. Site M0077 includes ∼130 m of impact melt rock and suevite deposited the first day of the Cenozoic covered by <1 m of micrite-rich carbonate deposited over subsequent weeks to years. We present an interpreted series of events based on analyses of these drill cores. Within minutes of the impact, centrally uplifted basement rock collapsed outward to form a peak ring capped in melt rock. Within tens of minutes, the peak ring was covered in ∼40 m of brecciated impact melt rock and coarse-grained suevite, including clasts possibly generated by melt-water interactions during ocean resurge. Within an hour, resurge crested the peak ring, depositing a 10-m-thick layer of suevite with increased particle roundness and sorting. Within hours, the full resurge deposit formed through settling and seiches, resulting in an 80-m-thick fining-upward, sorted suevite in the flooded crater. Within a day, the reflected rim-wave tsunami reached the crater, depositing a cross-bedded sand-to-fine gravel layer enriched in polycyclic aromatic hydrocarbons overlain by charcoal fragments. Generation of a deep crater open to the ocean allowed rapid flooding and sediment accumulation rates among the highest known in the geologic record. The high-resolution section provides insight into the impact environmental effects, including charcoal as evidence for impact-induced wildfires and a paucity of sulfur-rich evaporites from the target supporting rapid global cooling and darkness as extinction mechanisms.

9.
Nature ; 564(7736): E36, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30425342

RESUMEN

In this Article, the middle initial of author Kosei E. Yamaguchi (of the IODP-ICDP Expedition 364 Science Party) was missing and his affiliation is to Toho University (not Tohu University). These errors have been corrected online.

10.
Nature ; 562(7728): 511-518, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30356184

RESUMEN

Large meteorite impact structures on the terrestrial bodies of the Solar System contain pronounced topographic rings, which emerged from uplifted target (crustal) rocks within minutes of impact. To flow rapidly over large distances, these target rocks must have weakened drastically, but they subsequently regained sufficient strength to build and sustain topographic rings. The mechanisms of rock deformation that accomplish such extreme change in mechanical behaviour during cratering are largely unknown and have been debated for decades. Recent drilling of the approximately 200-km-diameter Chicxulub impact structure in Mexico has produced a record of brittle and viscous deformation within its peak-ring rocks. Here we show how catastrophic rock weakening upon impact is followed by an increase in rock strength that culminated in the formation of the peak ring during cratering. The observations point to quasi-continuous rock flow and hence acoustic fluidization as the dominant physical process controlling initial cratering, followed by increasingly localized faulting.

11.
Nature ; 558(7709): 288-291, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29849143

RESUMEN

The Cretaceous/Palaeogene mass extinction eradicated 76% of species on Earth1,2. It was caused by the impact of an asteroid3,4 on the Yucatán carbonate platform in the southern Gulf of Mexico 66 million years ago 5 , forming the Chicxulub impact crater6,7. After the mass extinction, the recovery of the global marine ecosystem-measured as primary productivity-was geographically heterogeneous 8 ; export production in the Gulf of Mexico and North Atlantic-western Tethys was slower than in most other regions8-11, taking 300 thousand years (kyr) to return to levels similar to those of the Late Cretaceous period. Delayed recovery of marine productivity closer to the crater implies an impact-related environmental control, such as toxic metal poisoning 12 , on recovery times. If no such geographic pattern exists, the best explanation for the observed heterogeneity is a combination of ecological factors-trophic interactions 13 , species incumbency and competitive exclusion by opportunists 14 -and 'chance'8,15,16. The question of whether the post-impact recovery of marine productivity was delayed closer to the crater has a bearing on the predictability of future patterns of recovery in anthropogenically perturbed ecosystems. If there is a relationship between the distance from the impact and the recovery of marine productivity, we would expect recovery rates to be slowest in the crater itself. Here we present a record of foraminifera, calcareous nannoplankton, trace fossils and elemental abundance data from within the Chicxulub crater, dated to approximately the first 200 kyr of the Palaeocene. We show that life reappeared in the basin just years after the impact and a high-productivity ecosystem was established within 30 kyr, which indicates that proximity to the impact did not delay recovery and that there was therefore no impact-related environmental control on recovery. Ecological processes probably controlled the recovery of productivity after the Cretaceous/Palaeogene mass extinction and are therefore likely to be important for the response of the ocean ecosystem to other rapid extinction events.


Asunto(s)
Biodiversidad , Extinción Biológica , Vida , Calcio/metabolismo , Foraminíferos/aislamiento & purificación , Fósiles , Golfo de México , Historia Antigua , Magnesio/metabolismo , Oxígeno/metabolismo , Plancton/aislamiento & purificación , Tamaño de la Muestra , Especificidad de la Especie , Factores de Tiempo
12.
BMJ Case Rep ; 20182018 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-29306859

RESUMEN

Shewanella algae is a rare pathogen related to water exposure in temperate climates. It is commonly associated with skin and soft tissue infections, peritonitis and bacteraemia. We report the first-ever case of S. algae infective endocarditis in a patient with previous splenectomy and explore the difficulties in treatment as well as highlight the importance of this organism as an emerging pathogen.


Asunto(s)
Endocarditis Bacteriana/microbiología , Infecciones por Bacterias Gramnegativas/microbiología , Complicaciones Posoperatorias/microbiología , Shewanella , Anciano , Antibacterianos/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Resultado Fatal , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Humanos , Masculino , Complicaciones Posoperatorias/tratamiento farmacológico , Esplenectomía/efectos adversos
13.
Science ; 354(6314): 878-882, 2016 11 18.
Artículo en Inglés | MEDLINE | ID: mdl-27856906

RESUMEN

Large impacts provide a mechanism for resurfacing planets through mixing near-surface rocks with deeper material. Central peaks are formed from the dynamic uplift of rocks during crater formation. As crater size increases, central peaks transition to peak rings. Without samples, debate surrounds the mechanics of peak-ring formation and their depth of origin. Chicxulub is the only known impact structure on Earth with an unequivocal peak ring, but it is buried and only accessible through drilling. Expedition 364 sampled the Chicxulub peak ring, which we found was formed from uplifted, fractured, shocked, felsic basement rocks. The peak-ring rocks are cross-cut by dikes and shear zones and have an unusually low density and seismic velocity. Large impacts therefore generate vertical fluxes and increase porosity in planetary crust.

14.
Int J Gynaecol Obstet ; 123(1): 50-3, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23856674

RESUMEN

OBJECTIVE: To determine whether differences exist in the rates of obstetric intervention between women with type 1 diabetes and those with type 2 diabetes, and whether there has been any change in cesarean rates over time, paralleling that seen in the general obstetric population. METHODS: Data were examined from a prospectively collected series on the outcomes of 1030 deliveries (382 by women with type 1 diabetes, 648 by women with type 2 diabetes) from 1988 to 2008. RESULTS: There was a secular trend to increasing maternal age (type 1, P < 0.003; type 2, P < 0.03). Intervention rates (induction of labor or elective cesarean) did not differ between type 1 (88%) and type 2 (85%) diabetes. The overall cesarean rate was 52%-55% with no secular trend. Poorer glycemic control in early pregnancy and primiparity were associated with primary cesarean in both groups. In women with type 1 diabetes, greater maternal obesity and retinopathy were also associated with primary cesarean. CONCLUSION: Intervention rates are high in pregnancies among women with type 1 diabetes and those with type 2 diabetes but they have not changed significantly. Secular trends toward increasing maternal age and obesity suggest that intervention rates are unlikely to decrease in the near future.


Asunto(s)
Cesárea/estadística & datos numéricos , Diabetes Mellitus Tipo 1/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Embarazo en Diabéticas/fisiopatología , Adulto , Factores de Edad , Cesárea/tendencias , Parto Obstétrico/estadística & datos numéricos , Parto Obstétrico/tendencias , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Retinopatía Diabética/epidemiología , Femenino , Humanos , Obesidad/complicaciones , Obesidad/epidemiología , Embarazo , Resultado del Embarazo , Estudios Prospectivos , Adulto Joven
15.
Science ; 327(5970): 1214-8, 2010 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-20203042

RESUMEN

The Cretaceous-Paleogene boundary approximately 65.5 million years ago marks one of the three largest mass extinctions in the past 500 million years. The extinction event coincided with a large asteroid impact at Chicxulub, Mexico, and occurred within the time of Deccan flood basalt volcanism in India. Here, we synthesize records of the global stratigraphy across this boundary to assess the proposed causes of the mass extinction. Notably, a single ejecta-rich deposit compositionally linked to the Chicxulub impact is globally distributed at the Cretaceous-Paleogene boundary. The temporal match between the ejecta layer and the onset of the extinctions and the agreement of ecological patterns in the fossil record with modeled environmental perturbations (for example, darkness and cooling) lead us to conclude that the Chicxulub impact triggered the mass extinction.


Asunto(s)
Extinción Biológica , Fósiles , Planetas Menores , Animales , Sedimentos Geológicos , México
16.
Science ; 321(5893): 1158; author reply 1158, 2008 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-18755958

RESUMEN

Paquay et al. (Reports, 11 April 2008, p. 214) reported that osmium isotope ratios in marine sediments can be used to determine the size of a chondritic impactor. Their assumptions on the fate of an impacting projectile may need to be reassessed, however, because only a small, unpredictable fraction of the impactor ends up dissolved in seawater.

17.
ANZ J Surg ; 73(7): 477-9, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12864819

RESUMEN

BACKGROUND: Resolution of cystic thyroid lesions after aspiration occurs in 8-45% of cases, the remainder require treatment for residual tumour or recurrent cysts. The aim of this study was to identify patient characteristics that predict cyst recurrence to enable these patients to undergo early surgery. METHODS: A retrospective analysis of 123 patients with benign thyroid cysts that were suitable for conservative management was undertaken. Demographic, clinical, ultrasound and fine needle aspiration cytology data were collated for patients who underwent surgery or were managed conservatively. Univariate and multivariate analyses were performed to identify factors predictive of cyst recurrence. RESULTS: Of the 123 patients, 43 underwent surgery consequent on cyst recurrence or persistent symptoms after aspiration, and 80 were treated by aspiration alone. There were 17 males and 106 females, of mean age 45.5 years. The mean cyst size was 27 mm. Those undergoing surgery had a significantly greater mean cyst size (P = 0.001). The only factor predicting cyst recurrence on univariate analysis was absence of follicular cells on initial aspiration (P = 0.005). Multivariate analysis confirmed absence of follicular cells as an independent characteristic predicting recurrence, the odds ratios for recurrence was 3.18 (95%CI 1.39-7.29). CONCLUSION: The present study suggests consideration of early surgery for patients with thyroid cysts with absence of follicular cells on initial cytology.


Asunto(s)
Quistes/patología , Nódulo Tiroideo/patología , Biopsia con Aguja Fina , Estudios de Casos y Controles , Quistes/cirugía , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Glándula Tiroides/patología , Nódulo Tiroideo/cirugía
18.
ANZ J Surg ; 73(7): 480-3, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12864820

RESUMEN

BACKGROUND: Thyroid nodules are common and the principal method of diagnosis is fine-needle aspiration cytology (FNAC). METHODS: To determine the value of FNAC in the diagnosis of thyroid nodules, thyroid cytology of 253 patients with definitive histology after surgery was analyzed from 1992 to 2002. FNAC was correlated with histology and the sensitivity, specificity and likelihood ratios were calculated. The method of FNAC and number of non-diagnostic aspirates were noted. The frequency of thyroid cancer was investigated in male and females who presented with a solitary thyroid nodule. RESULTS: The overall sensitivity of FNAC detecting thyroid neoplasia was 55.0%, specificity 73.7% and accuracy 67.2%. Likelihood ratios indicate that a 'malignant' or 'suspicious for malignancy' cytology dramatically increase the pretest probability of thyroid neoplasia. There were no false positive 'malignant' FNAC. Ultrasound guided FNAC had a significantly lower non-diagnostic rate compared to freehand FNAC (P < 0.02). Of 22 males, 22.7% who proceeded to surgery for their solitary nodule had thyroid carcinoma compared with 11.9% of 167 females (P = 0.02). CONCLUSIONS: FNAC was essential to management in this series of patients. 'Malignant' or 'suspicious for malignancy' cytology are absolute indicators for thyroidectomy. FNAC should be undertaken with ultrasound guidance and if possible with a pathologist in attendance to assess sample adequacy. We recommend a high index of suspicion of thyroid cancer in the male patient who presents with a solitary nodule. If solitary nodules are to be observed, repeat FNAC should be undertaken because of the high false negative rate.


Asunto(s)
Glándula Tiroides/patología , Nódulo Tiroideo/patología , Biopsia con Aguja Fina , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Nódulo Tiroideo/cirugía
19.
ANZ J Surg ; 72(8): 570-2, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12190731

RESUMEN

BACKGROUND: Frozen section in thyroid surgery is used to make an intraoperative pathological diagnosis of malignancy in a thyroid nodule at the time of hemithyroidectomy. A positive diagnosis allows completion of thyroidectomy, thus avoiding reoperation. However, the use of fine needle aspiration cytology in making a preoperative diagnosis of cancer has resulted in the lack of a defined role for frozen section. We examined the role of frozen section as an adjunct to fine needle aspiration cytology in determining which cytological subset will benefit from frozen section. METHODS: All patients who underwent thyroidectomy between 1992 and 2000 by a single endocrine surgeon were reviewed. RESULTS: Two hundred and nine frozen sections were performed, of which 144 underwent preoperative fine needle aspiration cytology. Frozen sections reported 135 benign nodules, 59 follicular neoplasms, five specimens with suspicious histology and 10 cancers. Ten out of 20 thyroid cancers were correctly identified by frozen section (sensitivity: 50%; specificity: 100%), eight cancers were reported on frozen section as indeterminate and two benign. Of 144 fine needle aspiration cytological procedures, frozen section on seven suspicious aspirates identified two cancers, and frozen section on 70 follicular aspirates identified four cancers, allowing intraoperative conversions to total thyroidectomy. Frozen section on seven malignant aspirates confirmed four cancers but resulted in reoperation for three because of the indeterminate frozen section reports. There were no cancers found on 135 benign aspirates. CONCLUSIONS: Frozen section on benign aspirates is unhelpful in the management of thyroid nodules. It need not be performed for cytologically proven malignant thyroid nodules. Selective use of frozen section complements fine needle aspiration cytology findings of suspicious or follicular lesions, especially in the subset with papillary cancer, allowing one-stage total thyroidectomy.


Asunto(s)
Secciones por Congelación , Cuidados Intraoperatorios , Nódulo Tiroideo/patología , Nódulo Tiroideo/cirugía , Tiroidectomía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos
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