The Characteristic Clinical and Pathological Features of Incidental and Non-Incidental Papillary Microcarcinoma of the Thyroid

The incidence of papillary microcarcinoma (PMC) keeps raising due to fine needle aspiration (FNA) biopsies and the pathologic evaluation of thyroid specimens of cases operated for benign thyroid disorders. The files of 78 patients who underwent surgery between January 2006 and May 2013 in our department and were diagnosed with PMC were analyzed, retrospectively.Cases were grouped as incidental and non-incidental depending on the preoperative diagnosis. The diameter of the nodules in the preoperativeultrasonographic examination, pathological parameters such as tumor size, bilaterality, multifocality,and capsular invasion were found significantly high in non-incidental group(P<0.05). No significant difference was detected between the two groups’ age, sex, and vascular invasion.Preoperative radiologic examination by experienced radiologists and FNA performed for suspicious nodules may increase the rate of early and correct diagnosis. In our opinion, determining the most useful criteria for malignancy will help to detect incidental PMC in cases followed up for multinodular goiter

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (&lt;4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Is there a relation between plantar fasciitis and total cholesterol levels?

Background: The main objective of this study is to investigate the relationship between hypercholesterolemia and Plantar Fasciitis (PF). Methods: The study includes patients who presented to the orthopedics outpatient clinic with heel pain and were diagnosed with PF. The control group was composed of patients who came to the orthopedics outpatient clinic, with complaints other than heel pain. The two groups were compared in terms of epidemiological data, total cholesterol (TC) levels, and hypercholesterolemia prevalence. We also performed an in-group analysis of PF patients in terms of age, sex, body mass index, and duration of symptoms. Results: There were 238 patients (mean age, 46.7) in the PF group and 240 patients (mean age, 47.9) in the control group. There was a significant difference between the PF group and the control group in TC levels (207.6 +/- 47.5 versus 195.1 +/- 30.1, p = 0.001). Hypercholesterolemia (TC level > 240 mg/dL) was found in 22.7% (n = 54) of the patients in the PF group whereas in the control group this rate was 10.8% (n = 26) (p < 0.001). It was seen that the TC levels were significantly higher in patients over the age of 45 in the PF group (p = 0.038). We also found that TC levels were higher in PF patients with symptoms for longer than a year (p = 0.026). Conclusion: Significantly higher TC levels were found in PF patients in comparison with other orthopedic outpatients. Besides, being over the age of 45 and having a duration of symptoms longer than a year is associated with higher cholesterol levels for PF patients

Evaluation of the effect of internal rotation of the shoulder on the coracohumeral and acromial range with three-dimensional tomography

Amaç: Bu çalışmanın amacı korakohumeral aralık ve akromiyohumeral aralık miktarının omzun pasif iç rotasyonu ile gerçekten azalıp azalmadığını değerlendirmektiGereç ve Yöntem: Çalışmada Mayıs 2016 ile Ekim 2016 arasında poliklinikte rotator kılıf hasarı ön tanısı ile bilgisayarlı tomografi artrografi çekilen hastalar kullanıldı. Bilgisayarlı tomografi artrografi tetkiki omuz nötral ve iç rotasyonda olmak üzere iki kez yapıldı ve görüntülerin 3 boyutlu rekonstrüksiyonları oluşturuldu. Bu iki bilgisayarlı tomografi tetkikinin 3 boyutlu bilgisayarlı tomografi görüntülerinde korakohumeral aralık ve akromiyohumeral aralık ölçümleri yapıldı.Bulgular: Çalışmaya yaş ortalamaları 64.069.06 olan 17 hasta dahil edildi. Tam kat supraspinatus yırtığı olanlarla olmayanlar değerlendirildiğinde, korakohumeral aralık ve akromiyohumeral aralığın omzun nötral ve iç rotasyonundaki ölçümlerinin ortalamaları arasında istatistiksel olarak anlamlı fark görülmedi. Kadın ve erkekler arasında ölçüm ortalaması arasında istatistiksel fark yoktu.Sonuç: Omzun pasif iç rotasyonu ile korakohumeral aralık anlamlı derecede daralmaktadır. Üç boyutlu bilgisayarlı tomografi ile yapılan ölçümler korakoid anatomisi ve korakoidin çeşitli parametreleri ile ilgili bize daha güvenilir bilgi verebilirler.Purpose: The aim of this study was to assess whether the coracohumeral and acromiohumeral distances were really decreasing with the passive internal rotation of the shoulder.Materials and Methods: The patients who underwent computerized tomography arthrography with the prediagnosis of rotator cuff tear between May 2016 and October 2016 were enrolled in the study. The computerized tomography arthrography imagings were performed in two positions of the shoulder, the neutral position and the internal rotation of the arm, and then the 3 dimensional reconstructions of the images were constituted. The coracohumeral and acromiohumeral distance measurements were made on 3 dimensional reconstructions of these two computerized tomography examinations.Results: Seventeen patients with the mean age of 64.069.06 were involved in the study. The coracohumeral and acromiohumeral distance measurements in neutral and internally rotated arms were also statistically similar between patients with full-thickness rotator cuff tears and those without. Between the male and female patients, there was no statistically significant difference in any of measurements. Conclusion: The coraohumeral distance narrows significantly with the internal rotation of the arm. The measurements made on three dimensional computerized tomography may provide us more reliable data about the several parameters of the coracoid process

The coupling of blue emitting carbon dots with Eu3+/Tb3+ co-doped luminescent glasses for utilization in white light emitting diodes

Lanthanide-doped luminescent glasses have attracted tremendous attention in modern optoelectronic applications, especially for solid-state white light-emitting diodes (WLEDs). Eu3+/Tb3+ co-doped luminescent glasses are well-known to emit intense yellowish-orange light resulting from the energy transfer from green-emitting sensitizer Tb3+ ions to red-emitting activator Eu3+ ions. Obtaining highly efficient blue light from lanthanide ions remains a challenge due to their weak down-converted emission. In this work, we attempt to use the unique characteristics of blue-emitting carbon dots (BCDs), i.e., a broad emission spectrum, ease of synthesis, and high stability, to compensate for this blue light deficiency problem. Correspondingly, a new strategy is proposed by coupling BCDs with Eu3+/Tb3+ co-doped glasses for their potential utilization in WLEDs. Hence, Eu3+/Tb3+ co-doped glasses are prepared in different thicknesses, i.e., 0.8, 1, and 1.5 mm, via the conventional melt-quenching method and subsequently spin-coated with BCDs to achieve adjustable photoluminescence quantum yield (PLQY) values. Ultimately, a proof-of-concept WLED is prepared using a 0.8 mm thick BCD-coated Eu3+/Tb3+ co-doped luminescent glass exhibiting outstanding luminescence performance with a CRI value of 92, a CCT of 4683 K, color coordinates of (x = 0.3299, y = 0.3421), a satisfying PLQY value of 55.58%, and a corresponding LER value of 316 lm W−1 under the excitation of a 375 nm UV LED. BCD-coated Eu3+/Tb3+ co-doped luminescent glasses show excellent stability against photobleaching, temperature variations, and humidity. The findings of this work indicate that the coupling of BCDs with Eu3+/Tb3+ co-doped luminescent glasses holds great potential as a substitute for traditional solid-state lighting sources

Bright white light emission from blue emitting carbon dot-coated Dy3+-doped luminescent glasses

Dy3+-doped luminescent glasses have received great attention due to their ability to emit white light at a suitable yellow-to-blue intensity ratio. However, achieving bright white light using single Dy3+-doped glasses remains a challenge due to the hypersensitivity of the emission band at 575 nm — usually resulting in intense yellow emission. In this work, we present a novel approach for compensating for the blue emission deficiency of Dy3+ to produce resin-free white light-emitting diodes (WLEDs) by synthesizing two series of Dy3+-doped glasses from tellurite and silicate systems on which blue-emitting carbon dots (BCDs) are spin-coated. The structural, chemical, optical, and luminescence properties of tellurite and silicate glasses are compared and discussed in detail. White light emissions are obtained upon 365-nm excitation for BCD-coated Dy3+-doped tellurite and silicate glasses with color coordinates of (x = 0.31, y = 0.33) and (x = 0.31, y = 0.34) and correlated color temperatures (CCT) of 5518 K and 5316 K, respectively. BCDs coating increases photoluminescence quantum yield (PLQY) values from 3.10 % to 5.62 % and from 20.81 % to 31.49 % for tellurite and silicate glasses, respectively. Ultimately, the findings in this work show the potential of BCD-coated luminescent glasses with excellent luminescent properties to be considered in solid-state lighting applications

Headache in idiopathic/genetic epilepsy: Cluster analysis in a large cohort

Objective The link between headache and epilepsy is more prominent in patients with idiopathic/genetic epilepsy (I/GE). We aimed to investigate the prevalence of headache and to cluster patients with regard to their headache and epilepsy features. Methods Patients aged 6-40 years, with a definite diagnosis of I/GE, were consecutively enrolled. The patients were interviewed using standardized epilepsy and headache questionnaires, and their headache characteristics were investigated by experts in headache. Demographic and clinical variables were analyzed, and patients were clustered according to their epilepsy and headache characteristics using an unsupervised K-means algorithm. Results Among 809 patients, 508 (62.8%) reported having any type of headache; 87.4% had interictal headache, and 41.2% had migraine. Cluster analysis revealed two distinct groups for both adults and children/adolescents. In adults, subjects having a family history of headache, >= 5 headache attacks, duration of headache >= 24 months, headaches lasting >= 1 h, and visual analog scale scores > 5 were grouped in one cluster, and subjects with juvenile myoclonic epilepsy (JME), myoclonic seizures, and generalized tonic-clonic seizures (GTCS) were clustered in this group (Cluster 1). Self-limited epilepsy with centrotemporal spikes and epilepsy with GTCS alone were clustered in Cluster 2 with the opposite characteristics. For children/adolescents, the same features as in adult Cluster 1 were clustered in a separate group, except for the presence of JME syndrome and GTCS alone as a seizure type. Focal seizures were clustered in another group with the opposite characteristics. In the entire group, the model revealed an additional cluster, including patients with the syndrome of GTCS alone (50.51%), with >= 5 attacks, headache lasting >4 h, and throbbing headache; 65.66% of patients had a family history of headache in this third cluster (n = 99). Significance Patients with I/GE can be clustered into distinct groups according to headache features along with seizures. Our findings may help in management and planning for future studies