Search

Context The coexistence of differentiated thyroid cancer ( DTC) and thyroid autoimmune disease could represent a better or worse prognosis. This study investigated the prognostic importance of preoperative anti-thyroglobulin antibody (TgAb) in DTC patients. Design and patients This retrospective hospital-cohort study enrolled 1171 consecutive DTC patients with preoperative TgAb data, who underwent total thyroidectomy between January 2006 and December 2011. Clinical parameters studied included demographics, primary tumour characteristics, radioiodine therapy, thyroid function tests, preoperative thyroglobulin (Tg) and TgAb levels, and cancer persistence/recurrence. Results A total of 254 (21.7%) patients were preoperatively TgAb positive. The percentage positive for thyroid peroxidase ( TPO) antibody and lymphocytic thyroiditis was significantly higher in the TgAb-positive group. The TgAb-positive group had a significantly higher rate of lymphatic invasion and lymph node metastasis both overall and in patients without TPOAb and lymphocytic thyroiditis (non- HT group). The mean number of total and central lymph nodes dissected and rate of lateral lymph node dissection were significantly higher in the TgAb-positive group, both overall and in non- HT patients. In regression analysis, preoperative TgAb was an independent risk factor for lateral lymph node metastasis. Over 50.2±14.5 months of follow-up, disease persistence/recurrence was not significantly different between patients with and without TgAb, both overall and in non- HT patients. Preoperative TgAb showed no significant correlation with final disease status. Conclusion Positive preoperative serum TgAb is associated with worse primary tumour characteristics but rarely showed poor prognosis, probably due to more aggressive treatment of these subjects. [ABSTRACT FROM AUTHOR]

Aims/Introduction Sleep disturbances caused by painful diabetic neuropathy ( PDN) might have substantial impacts on the multifaceted aspects of PDN, including quality of life. There are no convincing data on the validation or reliability of sleep problem measurements in patients with PDN in Korea. This large population-based cross-sectional study examined psychometric properties of the Medical Outcomes Study ( MOS) Sleep Scale in patients with PDN in Korea. Materials and Methods Measurements of patient-reported outcomes ( Brief Pain Inventory-short form, MOS Sleep Scale and Euro Qo L Health [ EQ-5D]) were documented. PDN was diagnosed if the average daily pain intensity was ≥4 based on the visual analog scale or if patients were taking medication for their current pain. Results There were 577 patients with PDN (41.6% with diabetic peripheral neuropathy). The internal consistency of reliability for the MOS Sleep Scale was 0.80 as measured by Cronbach's alpha. The extent to which multiple items in a dimension were intercorrelated and formed a dimension measuring the same underlying concept ( Pearson's correlation coefficient) ranged from 0.24 to 0.71 (all P < 0.001). Each item of the MOS Sleep Scale was significantly correlated with the average pain score and the pain interference score ( Pearson's correlation coefficients ranged from 0.20 to 0.28 and from 0.29 to 0.40, respectively; all P < 0.001). The correlations between the EQ-5 D index and the MOS Sleep Scale ranged from −0.27 to −0.31 (all P < 0.001). Conclusions The MOS Sleep Scale showed good reliability in the evaluation of PDN in Korean type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

Objective Patients with type 2 diabetes mellitus are at greater risk of bone fractures than nondiabetics. However, the risk factors for fractures in patients with diabetes have not been fully evaluated. This study was designed to evaluate the relative frequency of fractures at different sites and the diabetes-associated factors that affect nontraumatic bone fracture in patients with type 2 diabetes. Patients and design This retrospective case-control study recruited 144 patients with type 2 diabetes, who presented with nontraumatic fractures between March 2004 and March 2009 and 150 age-, gender-, body mass index (BMI)- and duration of diabetes-matched control subjects. Nontraumatic fractures were confirmed using patients' medical records and radiological findings. All subjects were examined for their diabetes status and associated factors for fracture, including bone mineral density (BMD). Results Of 150 reported bone fractures, the hip was the most frequent fracture site (32·7%), followed by the upper extremity (19·3%). Nontraumatic fractures were associated with diabetic retinopathy, diabetic peripheral neuropathy, stroke history, previous fracture and insulin treatment ( P < 0·05). In multivariate analyses, independently associated factors for bone fracture were diabetic peripheral neuropathy [odds ratio (OR) = 37·3, 95% confidence interval (CI) = 1·46-652·57] and previous fracture (OR = 9·54, 95% CI = 1·18-77·37; P < 0·05). Conclusions The hip was the most frequent site of nontraumatic fracture, and diabetic peripheral neuropathy was significantly associated with an increased risk of nontraumatic fractures in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]