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The clinicopathological impact of chronic lymphocytic thyroiditis on patients with papillary thyroid carcinoma patients is still controversial. This study aimed to evaluate the clinicopathologic differences and risk factors for central lymph node metastasis based on the presence of coexistent chronic lymphocytic thyroiditis in patients with low- to intermediate-risk papillary thyroid carcinoma. The medical records of 1,022 patients with low- to intermediate-risk papillary thyroid carcinoma who underwent lobectomy and central neck dissection between June 2020 and March 2022 were reviewed. Differences in clinicopathological factors were analyzed in patients with papillary thyroid carcinoma with or without chronic lymphocytic thyroiditis. Furthermore, risk factors for central lymph node metastasis in patients with low- to intermediate-risk papillary thyroid carcinoma with or without chronic lymphocytic thyroiditis were evaluated. Among the 1,022 patients with low to intermediate-risk papillary thyroid carcinoma, 102 (10.0%) had coexisting chronic lymphocytic thyroiditis. Female sex (odds ratio = 3.536, P =.001, 95% confidence interval 1.781–8.069), a multifocal tumor (odds ratio = 2.162, P =.001, 95% confidence interval 1.358–3.395), and angiolymphatic invasion (odds ratio = 0.365, P <.001, 95% confidence interval 0.203–0.625) were independent factors associated with patients who had coexisting chronic lymphocytic thyroiditis compared to those without chronic lymphocytic thyroiditis. There were 358 (35%) patients who had central lymph node metastasis. Multivariate analysis showed that younger age (odds ratio = 0.667, P =.013, 95% confidence interval 0.482–0.555), male sex (odds ratio = 0.549, P <.001, 95% confidence interval 0.402–0.751), tumor size >1 cm (odds ratio = 1.454, P =.022, 95% confidence interval 1.053–2.003), extrathyroidal extension (odds ratio = 1.874, P <.001, 95% confidence interval 1.414–2.486), and angiolymphatic invasion (odds ratio = 3.094, P <.001, 95% confidence interval 2.339–4.101) were risk factors for central lymph node metastasis. Angiolymphatic invasion (odds ratio = 11.184, P <.001, 95% confidence interval 3.277–46.199) was identified as the sole independent risk factor for central lymph node metastasis in patients with papillary thyroid carcinoma with coexisting chronic lymphocytic thyroiditis. Our data suggest that patients with low to intermediate-risk papillary thyroid carcinoma with coexistent chronic lymphocytic thyroiditis exhibit different clinical features than patients with papillary thyroid carcinoma without chronic lymphocytic thyroiditis. Additionally, the presence of chronic lymphocytic thyroiditis may be considered a potential factor against central lymph node metastasis. [ABSTRACT FROM AUTHOR]

The clinical utility of the pulmonary artery catheter (PAC) for the management of cardiogenic shock (CS) remains controversial. We performed a systematic review and meta-analysis exploring the association between PAC use and mortality among patients with CS. Published studies of patients with CS treated with or without PAC hemodynamic guidance were retrieved from MEDLINE and PubMed databases from January 1, 2000, to December 31, 2021. The primary outcome was mortality, which was defined as a combination of in-hospital mortality and 30-day mortality. Secondary outcomes assessed 30-day and in-hospital mortality separately. To assess the quality of nonrandomized studies, the Newcastle-Ottawa Scale (NOS), a well-established scoring system was used. We analyzed outcomes for each study using NOS with a threshold value of >6, indicating high quality. We also performed analyses based on the countries of the studies conducted. Six studies with a total of 930,530 patients with CS were analyzed. Of these, 85,769 patients were in the PAC-treated group, and 844,761 patients did not receive a PAC. PAC use was associated with a significantly lower risk of mortality (PAC: 4.6 % to 41.5 % vs control: 18.8 % to 51.0 %) (OR 0.63, 95 % CI: 0.41–0.97, I2 = 0.96). Subgroup analyses demonstrated no difference in the risk of mortality between NOS ≥ 6 studies and NOS < 6 studies (p -interaction = 0.57), 30-day and in-hospital mortality (p -interaction = 0.83), or the country of origin of studies (p -interaction = 0.08). The use of PAC in patients with CS may be associated with decreased mortality. These data support the need for a randomized controlled trial testing the utility of PAC use in CS. • Pulmonary artery catheter (PAC) in cardiogenic shock (CS) may decrease mortality. • Subgroup analyses showed no difference between 30-day and in-hospital mortality. • This is the first meta-analysis that assessed the impact of PAC in CS. [ABSTRACT FROM AUTHOR]

A new diagnostic criterion of metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed. However, only few studies have shown that MAFLD predicts cardiovascular disease (CVD) mortality better than non-alcoholic fatty liver disease (NAFLD). Therefore, a cohort study was conducted to assess this relationship. Health examination data from health care centers in South Korea were assessed after excluding participants with missing covariates and cancer history (n = 701,664). Liver ultrasonography reports, laboratory and anthropometric data were extracted. Diagnoses of NAFLD and MAFLD were performed according to standard definitions. Participants were categorized based on the presence of NAFLD and MAFLD. In addition, participants were classified into five categories: no fatty liver disease (no FLD), NAFLD-only, MAFLD-only, both FLDs, and alcoholic FLD (AFLD) and non-MAFLD. Multivariable regression modeling was performed. The median follow-up duration was 8.77 years, and 52.56% of participants were men. After stratifying the cohort into no-MAFLD and MAFLD groups, MAFLD was associated with increased CVD mortality (adjusted HR 1.14, 95% CI 1.02–1.28). When participants were divided into no-NAFLD and NAFLD groups, there was a non-significant trend towards an increase in CVD mortality in NAFLD group (adjusted HR 1.07, 95% CI 0.95–1.21). When participants were divided into five categories, MAFLD-only group showed increased CVD mortality (adjusted HR 1.35, 95% CI 1.07–1.70) while NAFLD-only group showed no significant association with CVD mortality (adjusted HR 0.67, 95% CI 0.38–1.19). In conclusion, MAFLD is associated with increased CVD mortality in a relatively young Korean population. • The evidence regarding the association between MAFLD and CVD mortality is limited. • MAFLD is associated with increased CVD mortality in a young Korean population. • However, the presence of NAFLD was not associated with CVD mortality. • Our results suggest MAFLD would be a stronger predictor of CVD mortality than NAFLD. [ABSTRACT FROM AUTHOR]

Although existing research has reported the impacts of COVID-19 on child abuse and neglect (CAN), little attention was paid to the relationship between spatial patterns in the trends of COVID-19 cases and their effects on the prevalence of CAN cases. This study examined the associations between trends of confirmed cases of COVID-19 and child removal due to physical abuse and neglect at the county level in the U.S while taking the social vulnerability into account. This study utilized three secondary data sets nationally collected. Spatial-temporal cluster analysis was used to classify and assign trends in confirmed cases of COVID-19 into their distinctive clusters. These spatial-temporal clusters were then used as independent variables in the negative binomial regression (NBR) models. Average cases of physical abuse and neglect increased as the growth rates of confirmed cases of COVID-19 were accelerated except for the counties assigned to the cluster characterized by moderately low increase and very high increases. NBR found social vulnerability measures have no effects on child removal due to physical abuse and neglect after controlling spatial-temporal clusters of the confirmed cases of COVID-19. Our study indicates that concentration of disaster has certain effects on child maltreatment. This suggests that child welfare pay special attention to the areas that undergo steep increases in confirmed cases under public health crises. [ABSTRACT FROM AUTHOR]