Nodule size as predictive factor of efficacy of radiofrequency ablation in treating autonomously functioning thyroid nodules.

CONTEXT: No defined pre-treatment factors are able to predict the response to radiofrequency ablation (RFA) of an autonomously functioning thyroid nodule (AFTN). OBJECTIVE: Primary endpoint was to evaluate the success rate of RFA to restore euthyroidism in a cohort of adult patients with small solitary AFTN compared with medium-sized nodules. Secondary endpoints included nodule volume reduction and rate of conversion from hot nodules to cold using scintiscan. METHODS: This was a 24-month prospective monocentric open parallel-group trial. Twenty-nine patients with AFTN were divided into two groups based on thyroid volume: 15 patients with small nodules (<12 mL) in group A and 14 patients with medium nodules (>12 mL) in group B. All patients underwent a single session of RFA and were clinically, biochemically, and morphologically evaluated at baseline and at 1, 6, 12 and 24 months after treatment. RESULTS: After RFA, there was greater nodule volume reduction in group A compared with group B (p < 0.001 for each follow-up point). In group A, there was a greater increase in TSH levels than in group B at 6 (p = 0.01), 12 (p = 0.005), and 24 months (p < 0.001). At 24 months, the rate of responders was greater in group A than in group B (86 vs. 45%; p < 0.001). In group A, 86% of nodules converted from hot to cold compared with 18% in group B (p < 0.001). CONCLUSIONS: A single session of RFA was effective in restoring euthyroidism in patients with small AFTNs. Nodule volume seems to be a significant predictive factor of the efficacy of RFA in treating AFTN.

[Health education in the prevention of ischemic heart disease in school children: feasibility study]. / L'educazione sanitaria nella prevenzione della cardiopatia ischemica in età scolare: uno studio di fattibilità.

A feasibility study of health education was undertaken among the pupils of a primary school in order to: 1) investigate the level of participation of children and teachers to the program; 2) test the efficacy of the program itself; 3) determine whether the children can modify family's behavioral patterns of the family components. Seventy-two children, belonging to different socio-economic classes, were studied. Children were given a questionnaire at the beginning and the end of the programme course, which was held by previously trained teachers. The participation of children and teachers to the program was very satisfactory. On the contrary very low involvement of the parents was achieved. This experience emphasizes the difficulties that arise when interventions to modify adult people's life style are attempted. On the contrary, a standardized education program, to last a whole school year, could be a feasible useful and costless type of intervention not only for the primary prevention of coronary artery disease, but for any program of extensive health care.

[Psychosis and creativity. Reflections on an autistic painter: Sylvain Fusco]. / Psychose et créativité. Réflexions à propos d'un peintre autiste: Sylvain Fusco.

Through the life and the creative activities of an autistic schizoid, the authors describe the relationship and the fundamental differences existing between the genuine artist and the psychotic subject, and consequently, the distinction between the concepts of art and creativeness.