RESUMO
PURPOSE: Fine needle aspiration biopsy (FNAB) is currently the gold standard for diagnosis and treatment of thyroid nodules, but the growing need for anatomic pathology services in small communities is becoming a challenge. Telecytology (TC) is defined as the electronic transmission of cytological digital images, and allows for the collection of samples, primary diagnosis, and other applications without the physical presence of a pathologist. Our aim is to systematically report, summarize, and critically analyze the most up to date applications of TC to thyroid nodules FNAB evaluation. METHODS: We performed a systematic literature review by searching PubMed, Embase, and Cochrane Library databases. Only studies published in peer-reviewed scientific journals were included. Data were extracted using the PICO framework and critically analyzed. PRISMA guidelines were applied, and the risk of bias in the included studies was assessed using the ROBINS-I tools. The methodological quality was assessed following GRADE criteria. RESULTS: We included 13 observational studies, resulting in a total of 3856 evaluated FNAB specimens. The majority of studies (63.6%) showed an excellent concordance rate of diagnosis via TC and conventional cytology. TC can be used to perform preliminary assessment of samples with a concordance rate ranging from 74 and 100%, showing a significant reduction of the non-diagnostic rate. Image quality was referred to as perfect or nearly perfect in most cases, regardless of telecytology technique. CONCLUSION: Telecytology could be a valuable implementation for thyroid FNAB evaluation both for primary diagnosis and preliminary assessment of samples.
RESUMO
The aim of this study was to compare technological properties (gel hardness, foam drainage, and meringue crispness) of albumen of nonpacked table eggs (control) with those of eggs packed in high-barrier plastic pouches with 3 modified atmosphere packaging (MAP) conditions (air, 100% N(2), and 100% CO(2)) during 28 d of storage at 25°C. The values of gel hardness for the control sample showed an increasing trend, demonstrating the highest values throughout the experiment duration compared with the other samples. This behavior was probably attributable to the pH increase detected only for this sample during storage (from 8.82 ± 0.06 for fresh egg to 9.96 ± 0.06 at the end of the experiment). Air and N(2) samples showed constant and similar hardness values during storage. The hardness of coagulated albumen showed a strict correlation with raw albumen pH (r(2) = 0.929; P < 0.001). Other than reducing albumen pH during storage, MAP with CO(2) caused the formation of a soft and puffy coagulum with very low hardness, reaching the lowest value of 1.26 ± 0.38 N after 4 d of storage, that slowly increased to 2.11 ± 0.49 N at the end of the experiment. Foam stability decreased during storage for all samples, but CO(2) eggs showed a significantly (P < 0.05) higher foam stability than fresh eggs until 15 d, reaching values similar to those of the other samples only at the end of the storage time. Packing eggs in CO(2) promoted an improvement of meringue crispness. The application of this atmosphere could ameliorate the quality characteristics of albumen-based food products. Commercially, CO(2) MAP could provide an albumen-based ingredient tailored to maximize the characteristics needed in the final product (e.g., fresh shell eggs special for meringue preparation) that could give an added value to the product.
