Thyroid nodules are common in the general population, with higher prevalence in women and with advancing age. Approximately 5% of thyroid nodules are malignant; the majority of this subset represents papillary thyroid cancer. Ultrasonography is the standard technique to assess the underlying thyroid parenchyma, characterize the features of thyroid nodules, and evaluate for abnormal cervical lymphadenopathy. Various risk stratification systems exist to categorize the risk of malignancy based on the ultrasound appearance of a thyroid nodule. Nodules are selected for fine-needle aspiration biopsy on the basis of ultrasound features, size, and high-risk clinical history. Cytology results are classified by the Bethesda system into six categories ranging from benign to malignant. When cytology is indeterminate, molecular testing can further risk-stratify patients for observation or surgery. Surveillance is indicated for nodules with benign cytology, indeterminate cytology with reassuring molecular testing, or non-biopsied nodules without a benign sonographic appearance.
Objective:To determine whether changes in neonatal practice and morbidity since 2000 have improved the growth attainment of infants with bronchopulmonary dysplasia (BPD).Study Design:We compared the respective z-scores of the weight, length and head circumference of extremely low-gestational-age infants (aged <28 weeks) with BPD at birth, 40 weeks and 20 months corrected age (CA) during two time periods, namely period I, 1996–1999 (n=117) and period II, 2000–2003 (n=105), and examined the effects of significant changes in neonatal practice, morbidities and neurosensory outcome on 20-month growth outcomes.Result:During the most recent period (2000–2003), there was a significant increase in mean weight z-scores (−1.60 vs −1.22) and decrease in rates of subnormal weight (40 vs 21%), P<0.05 at 20 months CA but not in those of length or head circumference. Significant predictors of the 20-month weight z-score included time period (period I vs II), duration of ventilator dependence and 20-month neurosensory abnormality (all P<0.05).Conclusion:Despite an improvement in weight since 2000, poor growth attainment remains a major problem among infants with BPD.
There was a sex difference in the parental metabolic phenotype with fathers having an increased risk of fasting dysglycemia and evidence for pancreatic β-cell dysfunction compared with mothers. However, only maternal heritability had significant effects on the prevalence of fasting dysglycemia in women with PCOS. Furthermore, there were maternal parent-of-origin effects on transmission of D19S884-A8 probands with fasting dysglycemia. These findings suggest that maternal factors, genetic and perhaps epigenetic, contribute to the metabolic phenotype in affected women.
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