The Relationship Between Imaging and Thyroid Cancer Diagnosis and Survival

BackgroundControversy exists over whether there has been a true increase in the occurrence of thyroid cancer or overdiagnosis secondary to imaging practices. Because cancer overdiagnosis is associated with detection of indolent disease, overdiagnosis can be associated with perceived improvement in survival.Materials and MethodsSurveillance, Epidemiology, and End Results- Medicare linked database was used to determine the relationship between type of imaging leading to thyroid cancer diagnosis and survival. Disease- specific and overall survival were evaluated in 11,945 patients aged - ¥66- years with differentiated thyroid cancer diagnosed between January 1, 2001, and September 30, 2015, who prior to their cancer diagnosis initially underwent thyroid ultrasound versus other imaging capturing the neck. Analyses were performed using the Kaplan- Meier method and Cox proportional hazards model with propensity score.ResultsPatients who underwent thyroid ultrasound as compared with other imaging had improved disease- specific and overall survival (p < .001, p < .001). However, those who underwent thyroid ultrasound were less likely to have comorbidities (p < .001) and more likely to be younger (p < .001), be female (p < .001), have localized cancer (p < .001), and have tumor size - ¤1 cm (p < .001). After using propensity score analysis and adjusting for tumor characteristics, type of initial imaging still correlated with better overall survival but no longer correlated with better disease- specific survival.ConclusionThere is improved disease- specific survival in patients diagnosed with thyroid cancer after thyroid ultrasound as compared with after other imaging. However, better disease- specific survival is related to these patients being younger and healthier and having lower- risk cancer, suggesting that thyroid ultrasound screening contributes to cancer overdiagnosis.Implications for PracticeThe findings from this study have implications for patients, physicians, and policy makers. Patients who have thyroid ultrasound as their initial imaging are fundamentally different from those who are diagnosed after other imaging. Because patients undergoing ultrasound are younger and healthier and are diagnosed with lower- risk thyroid cancer, they are less likely to die of their thyroid cancer. However, being diagnosed with thyroid cancer can lead to cancer- related worry and create risks for harm from treatments. Thus, efforts are needed to reduce inappropriate use of ultrasound, abide by the U.S. Preventive Services Task Force recommendations, and apply nodule risk stratification tools when appropriate.Because cancer overdiagnosis can be associated with both earlier detection and the detection of slower- growing tumors, overdiagnosis can lead to perceived improvement in survival. This article reports on the relationship between type of imaging and survival, using SEER- Medicare data to assess the initial imaging associated with cancer detection and disease- specific and overall survival.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162764/2/onco13329_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162764/1/onco13329.pd

Disparities in risk perception of thyroid cancer recurrence and death

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154276/1/cncr32670.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154276/2/cncr32670_am.pd

Effect of Recombinant Prophenin 2 on the Integrity and Viability of Trichomonas vaginalis

Trichomonas vaginalis is the causal agent of trichomoniasis, which is associated with preterm child delivery, low birth weight, and an increased risk of infection by human papilloma virus and human immunodeficiency virus following exposure. Several reports have established increasing numbers of trichomoniasis cases resistant to metronidazole, the agent used for treatment, and it is therefore important to identify new therapeutic alternatives. Previously, our group reported the effect of tritrpticin, a synthetic peptide derived from porcine prophenin, on T. vaginalis; however, the hemolytic activity of this small peptide complicates its possible use as a therapeutic agent. In this study, we report that the propeptide and the processed peptide of prophenin 2 (cleaved with hydroxylamine) affected the integrity and growth of T. vaginalis and that pro-prophenin 2 displays some resistance to proteolysis by T. vaginalis proteinases at 1 h. Its effect on T. vaginalis as well as its low hemolytic activity and short-time stability to parasite proteinases makes prophenin 2 an interesting candidate for synergistic or alternative treatment against T. vaginalis

Evidence‐based treatment for gynoid lipodystrophy: A review of the recent literature

Resumen La lipodistrofia ginoide (LDG) es una alteracion estructural, inflamatoria y bioquımica del tejido subcutaneo que causa modificaciones topograficas en la piel. Conocida comunmente como “celulitis”, la LDG afecta hasta a 90% de las mujeres, practicamente en todas las etapas de la vida, iniciando en la pubertad. Se trata de una condicion que afecta considerablemente la calidad de vida de quien la padece. Es motivo frecuente de consulta aunque las pacientes recurren a tratamientos empıricos, improvisados, sin bases ni evidencia cientıfica, los cuales desmotivan y producen frustracion no solo por su falta de resultados, sino por complicaciones derivadas de dichos tratamientos. Un grupo de expertos de diversas especialidades involucradas en el manejo de este problema presenta en este artıculo el resultado de una busqueda bibliografica sistematica y de la discusion consensuada de la evidencia obtenida de diversos tratamientos disponibles actualmente. El analisis se dividio en tratamientos topicos, tratamientos sistemicos, tratamientos no invasivos y tratamientos mınimamente invasivos

A case-control study of mastitis: nasal carriage of Staphylococcus aureus

BACKGROUND: Mastitis is a common problem for breastfeeding women. Researchers have called for an investigation into the possible role of maternal nasal carriage of S. aureus in the causation of mastitis in breastfeeding women. METHODS: The aim of the study was to investigate the role of maternal S. aureus nasal carriage in mastitis. Other factors such as infant nasal S. aureus carriage, nipple damage, maternal fatigue and oversupply of milk were also investigated. A case-control design was used. Women with mastitis (cases, n = 100) were recruited from two maternity hospitals in Melbourne, Australia (emergency departments, breastfeeding clinics and postnatal wards). Breastfeeding women without mastitis (controls, n = 99) were recruited from maternal and child health (community) centres and the rooms of a private obstetrician. Women completed a questionnaire and nasal specimens were collected from mother and baby and placed in charcoal transport medium. Women also collected a small sample of milk in a sterile jar. RESULTS: There was no difference between nasal carriage of S. aureus in breastfeeding women with mastitis (42/98, 43%) and control women (45/98, 46%). However, significantly more infants of mothers with mastitis were nasal carriers of S. aureus (72/88, 82%) than controls (52/93, 56%). The association was strong (adjusted OR 3.23, 95%CI 1.30, 8.27) after adjustment for the following confounding factors: income, private health insurance, difficulty with breastfeeding, nipple damage and tight bra. There was also a strong association between nipple damage and mastitis (adjusted OR 9.34, 95%CI 2.99, 29.20). CONCLUSION: We found no association between maternal nasal carriage of S. aureus and mastitis, but nasal carriage in the infant was associated with breast infections. As in other studies of mastitis, we found a strong association between nipple damage and mastitis. Prevention of nipple damage is likely to reduce the incidence of infectious mastitis. Mothers need good advice about optimal attachment of the baby to the breast and access to skilled help in the early postpartum days and weeks

Effects of zilpaterol hydrochloride and zinc methionine on growth performance and carcass characteristics of beef bulls

Sixty beef bulls with a body weight (BW) of 314.79 16.2 kg were used to evaluate the effects of zilpaterol hydrochloride (ZH) and zinc methionine (ZM) on growth performance and carcass characteristics. The experimental design was a randomized complete block, with a factorial 22 arrangement of treatments (ZH: 0 and 0.15 mg kg 1 BW; ZM: 0 and 80 mg kg 1 dry matter). The ZH increased (PB0.05) the final BW, average daily gain, feed conversion, carcass yield and longissimus dorsi area. Bulls fed ZH plus ZM had less (PB0.01) backfat thickness and intramuscular fat (IMF) compared with those fed ZH or ZM alone. The ZH increased (PB0.02) the meat crude protein content and cooking loss. It is therefore concluded that ZH increases growth performance, carcass yield, longissimus dorsi area, and meat crude protein. The interaction of ZM and ZH did not present additional advantages. The reason for the reduction in backfat thickness and IMF by ZH plus ZM is unclear, and implies that our knowledge of b-agonistic adrenergic substances and their interactions with minerals is incomplete

Molecular diagnosis of Chagas' disease and use of an animal model to study parasite tropism

Chagas' disease, which is an important health problem in humans, is caused by the protozoan Trypanosoma cruzi. The cellular and molecular mechanisms, involved in the selective tropism of T. cruzi to different organs remain largely unknown. In this study we designed a PCR-based molecular diagnosis method in order to study the tropism and growth kinetics of T. cruzi in a murine model infected with parasites isolated from an endemic area of Mexico. The growth kinetics and parasite tropism of T. cruzi were also evaluated in the blood and other tissues. We observed that T. cruzi isolates from the Western Mexico showed a major tropism to mouse heart and skeletal muscles in this murine model

Tiempo de ciclado y carga viral en pacientes infectados por SARS-CoV-2 en Sonora, México

Antecedentes: La infección por SARS-CoV-2 se confirma con la prueba de reacción en cadena de la polimerasa. Su positividad se determina mediante el tiempo de ciclado (Ct, cycle threshold), el cual es inversamente proporcional a la carga viral. Objetivo: Describir las características clínicas y epidemiológicas de pacientes infectados por SARS-CoV-2 de acuerdo con su carga viral estimada mediante Ct. Material y métodos: Estudio transversal que incluyó 21 110 casos confirmados, los cuales fueron estratificados conforme a su carga viral: baja (Ct > 30), media (Ct 25-30) y alta (Ct < 25). Resultado: 53 % de los casos tuvo una carga viral alta, la hospitalización fue más frecuente en sujetos con carga viral media y las defunciones fueron más prevalentes en aquellos con carga viral alta. La mediana del Ct fue más baja durante los primeros cinco días y aumentó linealmente con los días de evolución clínica. Hubo una mayor prevalencia de defunciones, hospitalizaciones y apoyo ventilatorio en sujetos con infección confirmada por SARS-CoV-2 que presentaron carga viral media y alta. Conclusiones: El valor de Ct, correlacionado con otras características del paciente, puede orientar el pronóstico, así como al diseño de intervenciones que limiten la diseminación poblacional del virus

2,4-D mobility in clay soils: Impact of macrofauna abundance on soil porosity

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