Search

The majority of benign thyroid nodules are asymptomatic, remain stable in size and do not require treatment. However, a minority of patients with growing nodules may have local symptoms or cosmetic concerns, and thus demand surgical therapy. The timely use of ultrasound-guided, minimally invasive thermal therapies has changed the natural history of benign, enlarging thyroid nodules (TNs). These procedures produce persistent shrinkage of TNs and an improvement of local symptoms. Among the various procedures, percutaneous ethanol injection represents the first-line treatment for thyroid cysts, while in solid cold nodules, laser and radiofrequency ablation (RFA) have proven to be very effective and safe techniques in producing significant volume reduction that remains stable over several years. In particular, RFA seems to be suited for the management of small and medium nodules, while larger nodules may require repeated RFA treatments, and could be difficult to treat if they extend into the chest. RFA is performed in outpatient clinics and has a lower risk of complications compared to surgery. However, to date, there is still no unanimous consensus on the percutaneous treatment of benign nodules using such minimally invasive thermal techniques. In this review, we critically revise the literature to identify patients who are more likely to benefit from RFA treatment as an alternative to surgery., (© 2017 John Wiley & Sons Ltd.)

Context: Ultrasound-guided radiofrequency ablation (RFA) of solid thyroid nodules (TNs) is a minimally invasive procedure that may induce a volume reduction of symptomatic solid benign TNs., Objective: The aim of the study was to evaluate the effectiveness and safety of RFA in debulking benign TNs., Design and Patients: Eighty-four consecutive patients with symptomatic and cytologically benign solid nodules were randomly assigned to either a single RFA session (group A; n = 42) or follow-up (group B; n = 42) at our center. Entry criteria were a solid thyroid nodule or predominantly solid (with a fluid component ≤ 30% of the volume), normal thyroid function, no autoimmunity, and no previous thyroid gland treatment. Three subgroups were formed according to the baseline volume of nodules: small (≤ 12 mL), medium (from 12 to 30 mL), or large (>30 mL)., Methods: In group A RFA was performed in a single session with the moving-shot technique. Volume and local symptom changes were evaluated 1 and 6 months after RFA., Results: In group A, the volume decreased from 24.5.5 ± 19.6 to 8.6 ± 9.5 6 months after RFA (P = .001). The greatest volume reduction was in small nodules. The pressure symptom score improved only in medium and large nodules (P < .001), whereas the cosmetic score improved in all treated patients (P < .001). The rate of thyroid volumetric reduction was not statistically different between solid and predominantly solid nodules. Only one patient experienced permanent right paramedian vocal cord palsy with inspiratory stridor without dysphonia. In group B, nodule volume remained unchanged, whereas the symptom score was worse at the 6-month evaluation (P = .01)., Conclusions: RFA is effective in reducing thyroid nodule volume. The best reduction rate was observed in small TNs. The thyroid volumetric reduction does not change according to the sonographic features. The mean treatment duration was longer in larger TNs.

The introduction of water, physiological, or iodine as contrast agents is shown to enhance minute image features in synchrotron-based X-ray diffraction radiographic and tomographic imaging. Anatomical features of rat kidney, such as papillary ducts, ureter, renal artery and renal vein are clearly distinguishable. Olfactory bulb, olfactory tact, and descending bundles of the rat brain are visible with improved contrast., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Ultrasonography-guided fine needle aspiration (FNA) and fine needle non-aspiration (FNNA) biopsy were performed consecutively on 104 patients (mean age 50 +/- 15 years) affected by multinodular and uninodular goiter. Both techniques were executed on the same patients in the same clinical session beginning with the first (FNA) on half of the patients (randomly selected) and vice versa. The cytological findings on cell samples were divided into four groups: colloidal (benign), follicular (suspicious), malignant, and inadequate. The overall cytologic findings obtained with the two techniques were as follows (FNA % vs FNNA %): inadequate, 16.3% vs 5.8%; colloidal, 69.2% vs 76.9%; follicular, 9.6% vs 10.5%; and malignant, 4.8% vs 6.7%. A statistically significant difference between FNA and FNNA cytology was found only on the number of inadequate results (p = 0.015). Interestingly, the frequency of inadequate specimens for FNNA showed a significantly different distribution depending on the sequence (first or second) in which the technique was executed. In conclusion, FNA and FNNA are useful and cost-effective techniques for the pre-operative assessment of patients with thyroid nodules. However, due probably to its minimally invasive procedure, FNNA produces specimens of better quality and reduces inadequate results. For these reasons FNNA should be preferable to FNA for the cytological evaluation of thyroid nodules.

Anti-endothelial cell antibodies (AECA) are a heterogeneous family of autoantibodies directed against antigens adhering to endothelial cells. These autoantibodies have a pathogenic role in disease characterized by endothelial damage. Aim of this study was to investigate the correlation between AECA and carotid artery stenosis at early stages of atherosclerosis process.

The aim of the study is to evaluate the pathogenetic factors which determine the association between obesity and hypertension. In particular we consider the role of adipose tissue. Activity of sympathetic nervous system, hyperinsulinemia, lower action of the atrial natriuretic peptide are important to understand the correlation between these pathologies.