Medicine
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Observational Study
Ultrasound risk evaluation of thyroid nodules that are "unspecified" in the 2015 American Thyroid Association management guidelines: A retrospective study.
This study sought to assess the malignant risks of "unspecified" thyroid nodules; that is, nodules that were not of a type described in the 2015 American Thyroid Association (ATA) guidelines. We retrospectively reviewed medical records and ultrasound (US) data for 1808 consecutive patients with 2614 thyroid nodules who underwent thyroidectomy between January 2015 and December 2015. Nodules with US features that did not satisfy the criteria for any risk category in the 2015 ATA guidelines were defined as "unspecified" nodules. ⋯ The percentages of nodules with ACR-TIRADS grades TR2, TR3, TR4, and TR5 were 5.7%, 2.9%, 70.0%, and 21.4%, respectively. Among the "unspecified" nodules, there were significantly more nodules in Kwak-TIRADS categories 4b and 4c in the malignant pathology group than in the benign pathology group (P <.01). Our results imply that "unspecified" thyroid nodules based on the ATA guidelines could partly be evaluated using the Kwak-TIRADS and that the ATA guidelines could incorporate more accurate malignant risk stratification.
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The purpose of this study was to evaluate the accuracy of a retrograde transpubic screw fixation assisted by a screw-view model of navigation in treating a pelvic fracture. ⋯ The outcome of our study suggests that the screw-view model of navigation maximizes the retrograde transpubic screw insertion accuracy in the treatment of a pubic ramus fracture, which is made efficient by pain relief and early out-of-bed mobilization. Our suggestion is, therefore, that the relative position between the pubic ramus and the patient tracker must be static to ensure the accuracy of the entire system throughout the operation.
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Case Reports
Successful pregnancy and delivery in uremic patients with maintenance hemodialysis: A case report.
It is reported that successful pregnancies in dialyzed uremic women are rare. Over the past years, despite advances in clinical management and technology in dialysis for pregnancy in patients receiving maintenance hemodialysis, uremia remains a high risk factor for adverse outcomes in mother and fetus. ⋯ Intensive dialysis, detailed management and multidisciplinary approaches are necessary for optimal outcomes in uremic pregnant mother and fetus.
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The aim of this systematic review is to investigate the effects of perioperative intravenous administration of MgSO4 on postoperative pain, analgesic consumption and adverse effects in patients undergoing orthopedic surgery. ⋯ Perioperative intravenous administration of MgSO4 in orthopedic surgery could reduce postoperative analgesic consumption and adverse effects such as vomiting, nausea, and shivering. These trials do not provide convincing evidence of beneficial effects on postoperative pain intensity and the time to first analgesic request. More trials should be conducted for the roles of MgSO4 in pain management for orthopedic surgery. However, intravenous MgSO4 administration should be considered as a strategy to relieve postoperative pain in orthopedic surgery patients.
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Case Reports
Case report: an intriguing sign in a patient with an inferior rectus muscle granular cell tumor.
Occurrence of granulosa cell tumors (GCTs) in the eye are rare and may be diagnosed by imaging examination and immune-histochemical studies. Two common signs of a rectus muscle tumor are the proptosis of the eye ball and the complaint of bi-ocular diploma. ⋯ Ophthalmologists should be aware that when a patient's visual acuity is normal when looking forward but severely low when gazing upward, it may be a sign of a GCT of the inferior rectus muscle.