Assessment of Computer Regulation Thermography (CRT) as a Complemetrary Diagnostic tool for Breast Cancer Patient.

BACKGROUND: Breast cancer is the most common type of cancer in women demanding accurate diagnosis to take remedial measures to treat. OBJECTIVE: Comparing the diagnostic capability of the computer regulation thermography (CRT), as a novel and safe diagnostic procedure, with common methods including sonography, mammography and clinical examinations for diagnosing breast cancer in suspicious patients against pathology as the gold standard. MATERIAL AND METHODS: In this prospective clinical trial study, out of 97 referred patients, 44 meeting the inclusion criteria were selected. The selected patients were subjected to mammography, sonography, CRT and clinical examinations. Then, the patients showing suspicious symptoms of breast cancer underwent pathological examinations. RESULTS: CRT indicated a higher specificity compared to mammography and sonography (78.9% vs. 71.4% and 47.0%, respectively). However, CRT sensitivity was lower than those of mammography, sonography and clinical examination (52% vs. 70.6%, 82.4% and 84.0%). Furthermore, CRT accuracy was lower than mammography, sonography and clinical examination (63.6% vs. 70.9%, 64.7% and 88.6%). While CRT positive prediction value (PPV) was higher than those of mammography and sonography, it was lower than that of clinical examination (76.5% vs. 75%, 60.9% and 95.5%). The negative prediction value (NPV) of CRT was less than all other modalities (55.5% vs. 66.7%, 72.7% and 81.8% for the clinical examination, mammography and sonography, respectively). CONCLUSION: Although CRT with a lower sensitivity and higher specificity, cannot be recommended to be used as a definitive diagnostic tool for breast cancer patients, it can be used as a complementary method with other methods to increase the diagnostic accuracy of suspicious patients.

Transient threshold shift after gunshot noise exposure.

BACKGROUND: Many people, such as soldiers, are routinely exposed to gunshot noise during target practice. It is suspected that this high-intensity noise may affect audition through repeated Transient Threshold Shifts (TTS); it can also mechanically alter auditory components such as waves. This study investigates the scope of gunshot noise from the AK-47 rifle (Kalashnikov) and the impact on the shooters' audition. METHODS: Forty soldiers (80 ears) were recruited in this study. They were all young and being exposed to gunshot noise for the first time. Gunshot characteristics were measured before exposure. The soldiers underwent auditory evaluation with Pure Tone Audiometry (PTA) and Oto-Acoustic Emission (OAE) once before exposure and immediately (less than one hour) after exposure. RESULTS: The AK-47 gunshot noise pressure level varied between L(AIm) = 73.7 dBA to L(AIm) = 111.4 dBA. Fourteen participants had subclinical hearing impairment in their pre-exposure evaluation; this number increased to 16 after the exposure. Six months post-exposure and later, the number of cases with impairment had fallen to eight (improvement in 50%). Both pre- and post-exposure OAE results were within normal values, while PTA results indicated a significant threshold alteration only at 6 kHz. CONCLUSION: The results of this study confirm that exposure to gunshot noise with no ear protection can represent a significant hazard for auditory function, especially at higher frequencies.

The role of pre-operative infection in the recurrence of thyroglossal duct cyst.

OBJECTIVES: To evaluate the role of pre-operative infection in thyroglossal duct cyst recurrence and post-operative complications of Sistrunk procedure. METHODOLOGY: Medical records of 55 patients undergoing thyroglossal duct cyst excision from 1998 to 2005 were reviewed. The following data was collected: age at operation, gender, surgical technique, presence and length of infection prior to operation, time interval between resolution of infection and operation, recurrence, management of recurrence, and complications. RESULTS: Forty-two patients (76.3%) had no recurrence following Sistrunk procedure, while 13 patients (23.7%) underwent one or more additional procedures due to recurrence. Our results indicate that 61.5% (8 of 13) of those with a failed Sistrunk had pre-operative thyroglossal cyst infection that lasted more than 6 months. In 92.3% of patients with recurrence, the interval between resolution of infection and time of operation was less than one month. CONCLUSION: Effective treatment of thyroglossal duct cyst infection, at least one month pre-operatively, is warranted to reduce post-operative recurrence rate.