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Background: The role of telemedicine in the transition to primary care for type 2 diabetes mellitus (T2DM) is yet unknown. We aimed to evaluate this issue in well-controlled T2DM patients discharged from a tertiary clinic., Methods: This is a CONSORT-compliant 12-month randomized clinical trial (RCT). T2DM patients with glycated hemoglobin (HbA1c) < 8%, being discharged to primary care from a tertiary clinic, were recruited. The intervention group periodically received nurse phone calls focusing on education. The control group received primary care as usual. The main outcome was glycemic control (HbA1c) at 12 months., Results: 147 patients were randomized (73 in intervention vs. 74 in control groups) with no differences in baseline data. After one year, we found no differences between groups in HbA1c (7.46% ± 1.37 in intervention vs. 7.54% ± 1.6 in control group; P = 0.76). HbA1c slightly increased from baseline in both groups (0.46% in intervention vs. 0.64% in control group) at 12 months, without differences between them (P = 0.69)., Conclusions: A telemedicine intervention based on phone calls plus primary care shows a similar effect to primary care alone on T2DM patients' HbA1c after tertiary clinic discharge. Patients remained with a reasonable HbA1c during the trial, suggesting that the transition to primary care was safe., Trial Registration: Clinical Trials, NCT02768480. Registered on April 29, 2016., Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Ethical approval and consent to participate: The Institutional Review Board evaluated and approved this study: Hospital de Clínicas de Porto Alegre (IRB: 150503). A trained research interviewer obtained written informed consent before randomization and after explaining the research procedures., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Cervical lymph nodes (LN) represent the most common site of recurrence in differentiated thyroid cancer (DTC), frequently requiring repeated interventions that contribute to increase morbidity to a usually indolent disease. Data on active surveillance (AS) of nodal metastasis are limited. Therefore, we performed a systematic review and meta-analysis to evaluate AS in nodal metastasis of DTC patients., Methods: MEDLINE, EMBASE, and Cochrane databases were searched up to July 2023 for studies including DTC patients with metastatic LN who were followed up with AS. The primary outcome was disease progression, according to the study's definition. Additional outcomes were LN enlargement ≥3 mm, occurrence of new cervical metastasis, and conversion from AS to surgical treatment., Results: The search identified 375 studies and seven were included, comprising 486 patients with metastatic nodal DTC. Most were female (69.5%) and had papillary thyroid cancer (99.8%). The mean AS follow-up ranged from 28-86 months. Following each study's definition of progression, the pooled incidence was 28% [95% confidence interval (CI), 20-37%]. The pooled incidence of LN growth ≥ 3 mm was 21% [95% CI, 17-25%] and the emergence of new LN sites was 19% [95% CI, 14-25%]. Combining growth of 3 mm and the emergence of new LN criteria, we found an incidence of 26% [95% CI, 20-33%]. The incidence of neck dissection during AS was 18% [95% CI, 12-26%]., Conclusions: AS seems to be a suitable strategy for selected DTC patients with small nodal disease, avoiding or postponing surgical reintervention., Prospero Registration: CRD42023438293., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)