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Stepwise Limited Axillary Lymph Node Dissection Based on Lymphatic Drainage from the Breast to Decrease Breast Cancer-Related Lymphedema: A Randomized Controlled Trial.

Ann Surg Oncol 2021 Jul 30. Epub 2021 Jul 30.

Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.

Background: Comprehensive axillary surgery is associated with an elevated rate of morbidity. This trial aimed to demonstrate the feasibility of axillary dissection of lymph nodes from the breast (bALND) for the purpose of limiting the extent of surgery.

Methods: Patients enrolled from two tertiary referral centers from September 2018 to September 2019 were randomly allocated to two groups: bALND and standard axillary lymph node dissection (sALND). Read More

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Slipped Capital Femoral Epiphysis in an Adult with Panhypopituitarism: A Case Report.

JBJS Case Connect 2021 Jul 30;11(3). Epub 2021 Jul 30.

Tallahassee Primary Care Associates, Tallahassee, Florida.

Case: Our patient was a 31-year-old woman with previously undiagnosed panhypopituitarism who presented with bilateral slipped capital femoral epiphysis (SCFE). Together with endocrinology, her treatment plan involved medical management of her panhypopituitarism and surgical correction with femoral neck osteotomy. Hormone deficiencies were corrected 6 weeks after replacement therapy began, and the patient was cleared for surgery. Read More

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Unilateral Nevoid Telangiectasia in a Healthy Man.

Case Rep Dermatol 2021 May-Aug;13(2):330-335. Epub 2021 Jun 23.

Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium.

We report the case of a healthy 26-year-old man presenting telangiectatic macules on the left thorax and arm since childhood. The main diagnostic hypothesis were unilateral nevoid telangiectasia (UNT), hereditary benign telangiectasia, atrial myxoma, segmental serpiginous angioma, circumscribed neviform angiokeratoma, and nevus vascularis mixtus. The diagnosis retained was UNT characterized by congenital or acquired telangiectasia distributed asymmetrically along the upper extremities, or the third or fourth cervical dermatomes. Read More

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Risk Factors for Contralateral Occult Carcinoma in Patients With Unilateral Papillary Thyroid Carcinoma: A Retrospective Study and Meta-Analysis.

Front Endocrinol (Lausanne) 2021 12;12:675643. Epub 2021 Jul 12.

Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, China.

Background: Bilateral lesions are common in papillary thyroid carcinoma (PTC). For patients with unilateral PTC, occult carcinoma that is not detected preoperatively, but pathologically after surgery, might remain in the contralateral lobe. In this situation, inadequate surgical extent could cause relapse and even lead to re-operation. Read More

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Should fluorodeoxyglucose positron emission tomography/computed tomography be the first-line imaging investigation for restaging the laryngeal carcinoma patients?

World J Nucl Med 2021 Apr-Jun;20(2):164-171. Epub 2021 Feb 12.

Department of Medical Oncology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.

Posttreatment detection of residual/recurrence disease in the head and neck cancers is not an easy task. Treatment induces changes create difficulties in diagnosis on conventional imaging (computed tomography [CT], magnetic resonance imaging) as well as macroscopic inspection (direct laryngoscopy). Hence, we evaluate the diagnostic performance of contract-enhanced F-18 fluorodeoxyglucose positron emission tomography (FDG PET)/CT in restaging of laryngeal carcinoma Postchemotherapy-surgery and/or radiation therapy. Read More

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February 2021

Association between Comorbidities and Preserved Ratio Impaired Spirometry: Using the Korean National Health and Nutrition Examination Survey IV-VI.

Respiration 2021 Jul 28:1-9. Epub 2021 Jul 28.

Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

Background: Preserved ratio impaired spirometry (PRISm) patients have more frequent respiratory symptoms and an increased risk of mortality. However, studies on comorbidities in these patients are lacking.

Objectives: We investigated the association between PRISm and comorbidities using the Korea National Health and Nutrition Examination Survey (KNHANES). Read More

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A Rare Cause of Autistic Regression in a Boy with Down Syndrome: Hashimoto Encephalopathy.

J Pediatr Neurosci 2021 Jan-Mar;16(1):65-68. Epub 2021 Jun 25.

Pediatric Neurology Clinic, Istanbul, Turkey.

Background: Hashimoto encephalopathy (HE) is a rare condition associated with autoimmune thyroid disease. We aimed to report the youngest patient with Down syndrome and HE with an unusual presentation.

Case Report: Six years and six months old boy with Down syndrome admitted due to loss of speech. Read More

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Diagnostic performance rates of the ACR-TIRADS and EU-TIRADS based on histopathological evidence.

Diagn Interv Radiol 2021 Jul;27(4):511-518

Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey.

Purpose: In this study, we aimed to assess the effectiveness of malignancy stratification algorithms of the American College of Radiology (ACR) and European Thyroid Association (ETA) in the delineation of thyroid nodules using a database of nodules that were unequivocally diagnosed by means of histopathological examination and meticulously matched with the imaged nodules.

Methods: A total of 165 patients having 251 thyroid nodules with histopathologically proven definitive diagnoses during a 5-year period were included in this study. All patients had preoperatively undergone ultrasonography (US) examination, and US characteristics of the thyroid nodules were retrospectively analyzed and assigned in compliance with the thyroid imaging reporting and data system categories recommended by the ACR (ACR-TIRADS) and ETA (EU-TIRADS). Read More

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Primary Extra-Osseous Ewing Sarcoma of the Thyroid: A Case Report and Review of the Literature.

Head Neck Pathol 2021 Jul 26. Epub 2021 Jul 26.

Department of Clinical Pathology, Geneva University Hospital, Geneva, Switzerland.

Extra-osseous Ewing sarcoma (ES) is a rare and aggressive malignant tumor found in a variety of organs. Primary ES of the thyroid is exceedingly rare and few cases have been documented to date. We describe the case of a 54-year old woman with a history of breast carcinoma in whom a unique hypermetabolic left thyroid nodule was identified during a follow-up PET-CT scan. Read More

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Bartter syndrome and hypothyroidism masquerading cystinosis in a 3-year-old girl: rare manifestation of a rare disease.

BMJ Case Rep 2021 Jul 26;14(7). Epub 2021 Jul 26.

Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

Cystinosis is a multisystem disorder with varied presentations secondary to deposition of cystine crystals in different organ systems. Children with cystinosis typically present with renal tubular acidosis and failure to thrive. We report a 3-year-old girl, born to a third-degree consanguineous couple, who presented with failure to thrive and polyuria. Read More

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Case 292: Lyme Neuroborreliosis.

Radiology 2021 Aug;300(2):484-488

From the Departments of Ophthalmology (V.P.D., K.A.A.D., B.K.C.) and Radiology (K.L.R.), Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles St, Boston, MA 02114; and Department of Neurology, Neuro-Ophthalmology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (B.K.C.).

History A 24-year-old right-handed woman presented to a neuro-ophthalmology clinic in Massachusetts in the summer with acute binocular diplopia when looking down and to the left, which started about 1 month earlier. Her medical history was notable for Raynaud syndrome, recurrent streptococcal pharyngitis, and an allergy to amoxicillin. Three days prior to developing diplopia, she presented to an outside emergency department due to fever, chills, and back pain. Read More

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Late Onset of an Overlooked Follicular Thyroid Carcinoma Presenting as a Chest Wall Tumor 10 Years Following Thyroidectomy.

AACE Clin Case Rep 2021 Jul-Aug;7(4):268-272. Epub 2021 Mar 5.

Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul, Turkey.

Objective: Metastatic chest wall tumors resulting from thyroid carcinomas are not unusual; however, the late onset of metastasis of a follicular thyroid carcinoma (FTC) is extremely rare. We aim to present a report of a case with chest wall metastasis of an FTC 10 years following thyroidectomy.

Methods: Among the studies performed were chest wall tumor imaging, serum thyroid stimulating hormone determination, and histopathology of the chest wall tumor and thyroid tissue examination. Read More

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Surgical Remission of Diabetes in a Patient With Mutation of Proto-Oncogene.

AACE Clin Case Rep 2021 Jul-Aug;7(4):256-260. Epub 2021 Feb 5.

Division of Endocrinology, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru.

Objective: In pheochromocytomas, accelerated catecholamine production can cause secondary diabetes. The gene responsible for multiple endocrine neoplasia type 2 (MEN2)-related pheochromocytomas is the proto-oncogene. The objective of this report is to describe a unique case of surgical remission of misdiagnosed type 2 diabetes mellitus (T2DM) in a woman with bilateral pheochromocytoma and proto-oncogene mutation. Read More

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February 2021

Metastatic Malignant Struma Ovarii and Graves' Disease: A Rare Occurrence.

AACE Clin Case Rep 2021 Jul-Aug;7(4):243-246. Epub 2021 Jan 6.

Tan Tock Seng Hospital, Department of Endocrinology, Novena, Singapore.

Objective: Malignant struma ovarii (SO) is a rare condition. Although there have been a few reported cases of malignant SO with coexisting Graves' disease (GD), the exact incidence of metastasis in these cases is not known. We report a rare case of metastatic malignant SO coexisting with GD. Read More

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January 2021

The value of 1.5T MRI in the evaluation of vocal fold mobility in patients with goiter.

Eur J Radiol Open 2021 14;8:100368. Epub 2021 Jul 14.

Zakład Diagnostyki i Terapii Radiologicznej i Izotopowej, Uniwersytet Medyczny w Łodzi, Poland.

The laryngoscopic examination remains the gold standard in the perioperative evaluation of the mobility of the vocal folds in patients with goiter. During the COVID-19 pandemic, many medical procedures, including laryngoscopy are optimized in terms of epidemiological safety. Therefore, it seems deeply justified to implement methods like i. Read More

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Higher Prevalence of Non-thyroidal-Illness Syndrome in Elderly Male Patients With Active Infection.

Front Med (Lausanne) 2021 8;8:682116. Epub 2021 Jul 8.

Department of Gastroenterology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China.

It is currently unclear whether the infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period. A case retrospective study. Read More

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Autopsy findings in a patient with primary systemic AL (kappa light chain) amyloidosis.

Autops Case Rep 2021 6;11:e2021273. Epub 2021 May 6.

Universidade de São Paulo (USP), Hospital das Clínicas, Divisão de Anatomia Patológica, São Paulo, SP, Brasil.

First described by Rokitansky in 1842, and further characterized by Virchow in 1854, amyloidosis is a disorder caused by amyloid deposition, a fibrillary insoluble protein. The clinical spectrum of amyloidosis is broad, as the amyloid deposition may virtually occur in all tissues. Herein, we report the case of a 66-year-old man with a long-lasting emaciating disease, diagnosed, at autopsy, with primary systemic amyloidosis. Read More

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Analysis of misses in imaging of head and neck pathology by attending neuroradiologists at a single tertiary academic medical centre.

Clin Radiol 2021 Jul 22. Epub 2021 Jul 22.

Department of Radiology, Section of Neuroradiology, University of California - Davis Medical Center, Sacramento, CA 95817, USA.

Aim: To analyse errors in head and neck (H&N) pathology made by attending neuroradiologists at a single tertiary-care centre.

Materials And Methods: A neuroradiology quality assurance (QA) database of radiological errors was searched for attending physician errors in H&N pathology from 2014-2020. Data were limited to computed tomography (CT) and magnetic resonance imaging (MRI) reports. Read More

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[Comparison of the diagnostic value of high frequency ultrasound and ultrasound-guided fine needle aspiration biopsy in papillary thyroid microcarcinoma].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Aug;35(8):718-723

Department of Head and Neck Thyroid Surgery,Affiliated Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou,450008,China.

To explore the application value of high frequency ultrasound and ultrasound-guided fine needle aspiration biopsy(US-FNAB) in the diagnosis of papillary thyroid microcarcinoma(PTMC), and to compare the characteristics and value of the two methods, so as to find a more convenient and non-invasive diagnostic method of PTMC, reduce unnecessary puncture and operation. The data of 190 postoperative pathologically confirmed PTMC patients admitted to Henan Province Cancer Hospital and Henan Provincial Hospital from January to June 2020 were retrospectively analyzed, with a total of 305 nodules, including 198 PTMC nodules and 107 benign thyroid nodules(BTN). According to the postoperative pathological results, they were divided into groups, and the relationship between the ultrasound appearance of the nodules and whether the cervical lymph nodes could be explored and PTMC was analyzed by chi-square test and logistic regression, and its diagnostic value was evaluated. Read More

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Submandibular lymph node metastasis of occult thyroid carcinoma first suspected to be a salivary gland tumor: a case report.

J Med Case Rep 2021 Jul 23;15(1):402. Epub 2021 Jul 23.

Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10, Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.

Background: When diagnosing and treating neck masses, various diseases need to be considered, including benign or malignant tumors, lymph node-related diseases, and cysts. Thus, there may be cases in which making a definitive diagnosis is difficult on the basis of blood testing and imaging alone.

Case Presentation: The patient was an 80-year-old Japanese female who presented with swelling in the right submandibular area. Read More

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Central Pontine Myelinolysis in a Normonatremic Patient with Depression.

Clin Psychopharmacol Neurosci 2021 Aug;19(3):564-567

Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

A 76-year-old male presented with a recurrent depressive episode, an unsteady gait and cognitive impairment. Extensive blood tests, including hemogram, biochemical tests, folic acid, vitamin B12, and thyroid hormone, showed normal results. With the exception of the unsteady gait, neurological examination was negative. Read More

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Two Cases of Atraumatic Laryngeal Fractures.

J Voice 2021 Jul 19. Epub 2021 Jul 19.

European Institute for ORL-HNS, Department of ENT-HNS, Sint-Augustine's, GZA Hospital, Antwerp, Belgium.

Introduction And Aim: Atraumatic laryngeal fractures are extremely rare and are most commonly provoked by sneezing or coughing. Only seven cases have been described in medical literature, and only one case described a fracture after swallowing. We present two cases of atraumatic laryngeal fracture after swallowing. Read More

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Clinical significance and cytological detection of tracheal puncture following thyroid fine-needle aspiration: A retrospective study.

Diagn Cytopathol 2021 Jul 21. Epub 2021 Jul 21.

Department of Surgery, Kuma Hospital, Kobe, Japan.

Background: There have been no detailed reports on tracheal puncture after thyroid fine-needle aspiration (FNA). This study aimed to discuss the cytological differential diagnoses of tracheal puncture after thyroid FNA and clarify its clinical significance.

Methods: Tracheal puncture was defined as aspiration of tracheal components, including ciliated cells, chondrocytes, and goblet cells. Read More

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Giant plurihormonal pituitary adenoma in a child - case study.

J Pediatr Endocrinol Metab 2021 Jul 21. Epub 2021 Jul 21.

Department of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland.

Objectives: To describe the case of a 12-year-old girl with a rare plurihormonal pituitary macroadenoma secreting prolactin (PRL), growth hormone (GH), thyroid-stimulating hormone (TSH), and alpha subunit (α-SU).

Case Presentation: The patient experienced recurrent headaches and progressing loss of vision in one eye. During the examination, abnormalities such as tall stature, coarse facial features, enlarged feet and hands, tachycardia, hand tremor, hyperhidrosis, galactorrhea, and goiter were observed. Read More

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Total thyroidectomy can still remain the method of choice in some Bethesda III cases.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021 Jul 20. Epub 2021 Jul 20.

Institute of Pathology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.

Background: The latest WHO classification of tumours of endocrine organs defines new units of borderline thyroid tumours (BTT). The aim of our study was to evaluate ultrasonographic and cytological features, mutation profile and surgery treatment in rare thyroid tumours.

Methods: An analysis of 8 BTT out of 487 patients, who underwent thyroid surgery between June 2016 and June 2020. Read More

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Misdiagnosis of asymptomatic intrathyroidal pyriform sinus fistula: a case report.

J Int Med Res 2021 Jul;49(7):3000605211031430

Department of Pathology, 12553Hebei Medical University, The Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, P. R. China.

Pyriform sinus fistula is uncommon and easily misdiagnosed. Most reported cases occur in children and are associated with either acute suppurative thyroiditis or deep neck infection. Asymptomatic pyriform sinus fistula is difficult to diagnose because it can manifest as an incidental thyroid nodule with highly suspicious malignant features on ultrasonography. Read More

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Metabolic and Hormonal Profile of Adolescent Girls With Polycystic Ovary Syndrome With Concomitant Autoimmune Thyroiditis.

Front Endocrinol (Lausanne) 2021 2;12:708910. Epub 2021 Jul 2.

Department of Pediatrics and Pediatric Endocrinology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.

Introduction: Both polycystic ovary syndrome (PCOS) and autoimmune thyroiditis (AT) are considered to be among the most common endocrinopathies in young women, and they are classified as diseases that affect many processes in the human body. Their role in the development of metabolic disorders and diseases of the cardiovascular system in adult women is also emphasized. However, there are no data available to assess such risk in the teenage girl population. Read More

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Hijacking of the aircraft OK ADN L410 TURBOLET on June 8, 1972 - Forensic Medical Notes.

Soud Lek 2021 ;66(1):11-16

On 8 June 1972, the Czechoslovak OK DNN aircraft carrier L410 Turbolet was delivered to the regular line Marianske Lazne - Prague to the Federal Republic of Germany. About 8 minutes after the launch from Marianske Lazne Airport, the likely head of the group of kidnappers threw the captain of the plane. During the fight with one of the passenger, the head of the group of kidnappers killed the captain of the aircraft by a shot from 7. Read More

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Obesity-associated lymphedematous mucinosis and stasis mucinosis.

Clin Dermatol 2021 Mar-Apr;39(2):229-232. Epub 2020 Oct 16.

Unit of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Italy.

Cutaneous dermal mucinoses are a group of conditions characterized by abnormal deposition of mucin (hyaluronic acid and sulfated glycosaminoglycans) in the dermis. They can be classified either as localized or generalized forms and occur primarily or secondarily to systemic disorders. Obesity-associated lymphedematous mucinosis and pretibial stasis mucinosis are uncommon and relatively newly recognized disorders occurring in obese patients or in patients with venous insufficiency. Read More

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October 2020

Thyroid Disruptors: Extrathyroidal Sites of Chemical Action and Neurodevelopmental Outcome-an Examination Using Triclosan and Perfluorohexane Sulfonate (PFHxS).

Toxicol Sci 2021 Jul 16. Epub 2021 Jul 16.

Center for Computational Toxicology and Exposure Chemical Characterization and Exposure Division US Environmental Protection Agency, Research Triangle Park, NC, USA.

Many xenobiotics are identified as potential thyroid disruptors due to their action to reduce circulating levels of thyroid hormone, most notably thyroxine (T4). Developmental neurotoxicity is a primary concern for thyroid disrupting chemicals yet correlating the impact of chemically-induced changes in serum T4 to perturbed brain development remains elusive. A number of thyroid-specific neurodevelopmental assays have been proposed, based largely on the model thyroid hormone synthesis inhibitor propylthiouracil (PTU). Read More

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