Prevalence Of Nodules Research Articles

Analysis of factors influencing prevalence and malignancy of thyroid nodules in various iodine uptake areas

Analysis of factors influencing prevalence and malignancy of thyroid nodules in various iodine uptake areas

Analysis of Prevalence of Thyroid Nodules and Related Factors in Physical Examination Population in a Hospital in Jinan [Letter]

Analysis of Prevalence of Thyroid Nodules and Related Factors in Physical Examination Population in a Hospital in Jinan [Letter]

12529 Pre And Post-operative Evaluation And Outcomes After Adrenalectomy At A Tertiary Referral Center

Abstract Disclosure: C. Hung: None. L.M. Fishbein: None. M.R. Clay: None. M.B. Albuja-Cruz: None. C. Raeburn: None. K. Kiseljak-Vassiliades: None. M.E. Wierman: None. Introduction: The prevalence of adrenal nodules has increased over time due to increased abdominal CT imaging. Laboratory evaluation to screen for hypercortisolism, primary aldosteronism, or pheochromocytoma is recommended depending on nodule appearance and clinical risk factors. Our aim was to retrospectively determine the preoperative hormonal workup prior to adrenalectomy and to identify the postoperative comorbidities as they relate to preoperative hypercortisolism. Methods: From May 2017-March 2023, 205 adrenalectomies were performed for adrenal nodules. Preoperative and postoperative comorbidities, medications, laboratory results, imaging and pathology were assessed up to 1 year post surgery. Patients were stratified by degree of hypercortisolism, based on 1 mg dexamethasone suppression test, into cortisol 1.8-5 μg/dL (DST 1.8-5) or cortisol >5 μg/dL (DST >5). Statistical analysis included Fischer’s exact test and two-sample proportion test. Results: Of 205 adrenalectomies, 51 patients had primary aldosteronism (24.9%), 51 had pheochromocytoma (24.9%), 23 had ACC (11.2%), 15 had non-functional adrenal adenomas (7.3%), and 65 had adenomas associated with hypercortisolism (31.7%)—42 with DST 1.8-5 (20.5%), 23 with DST >5 (11.2%). Preoperatively 9 (17.6%) patients with PA underwent 1 mg DST, while 54 (83.1%) patients with hypercortisolism (DST >1.8) had aldosterone measured. Overall, 183/205 patients (89.3%) had hypertension preoperatively. Of the patients with hypercortisolism (DST>1.8), 58 (89.2%) had hypertension, without a difference in prevalence between DST 1.8-5 and DST >5 groups. For those with abnormal DST, no significant reduction in hypertension was observed within 2 months following adrenalectomy, but at 1 year postop, prevalence was reduced (89.2% preop vs 71.9% postop, p=0.03). There was no significant reduction in the prevalence of type 2 diabetes (p=0.78), prediabetes (p=0.48), hyperlipidemia (p=0.33), osteoporosis (p=0.53), or osteopenia (p=0.67) at 1 year postop in those with hypercortisolism. After adrenalectomy, 42.9% patients in the DST1.8-5 and 73.9% in the DST >5 group were discharged on glucocorticoids. Many patients were lost to long-term follow up. In those remaining, at 1 year postop, 14.3% patients in the DST1.8-5 and 50% in the DST >5 group still required steroids for adrenal insufficiency. Conclusions Not all patients with adrenal nodules are being screened for excess hormone production. Hypercortisolism is prevalent in patients undergoing adrenalectomy. Preoperative workup is essential to identify these patients before surgery as adrenal insufficiency can persist postoperatively. Adrenalectomy for hypercortisolism is associated with a reduction in hypertension at 1 year postoperatively. Presentation: 6/3/2024

Temperament and Voice Quality in Patients With Vocal Fold Nodules

BackgroundVocal fold nodules are most common in women and patients with vocal fold nodules represent the largest group in voice clinics. The prevalence of vocal fold nodules is particularly high in professions where the voice is used on a regular basis. The quality of the voice is influenced by a number of factors, including temperament, stress, and emotional state. These factors can influence the physiological conditions of phonation.The objective of this study was to assess the acoustic parameters of voice in patients with vocal nodules in comparison to healthy controls, and to determine whether voice quality is influenced by emotional state and coping with stress. MethodsA total of 32 patients admitted to the ENT Department of the University Medical School with voice disorders between March and June 2007 constituted the study group. All patients were found to have a vocal nodules on physical and stroboscopic examination. The control group consisted of 30 healthy individuals who did not report any voice disorders. All subjects underwent voice recordings in the voice laboratory. Following the completion of the voice evaluation form, anaerodynamic assessment (a, s, s/z-time), an index of vocal impairment, the Rosenbaum Schedule of Learned Resourcefulness (RLRS) and the Temperament and Characteristics Inventory (TEMPS-A), all subjects underwent further assessment. Acoustic analysis was conducted using the CSL program in MDVP and the Vocal Assessment component of Dr. Speech. ResultsThe decrease in MPT in the study group was statistically significant. There were statistically significant differences in the parameters MFo, Jitt, RAP, PPQ, SHdB, Shim, APQ, NHR, SPI from the MDVP, Jitter, Shim% from the voice assessment, and the perceptual rating (H, R, B) from Dr. Speech’s voice assessment analysis. The differences in the dimensions of anxious temperament and the examination of stress problem-solving strategies were significant between the study group and the control subjects. Differences in aerodynamic and acoustic parameters were found between disordered and healthy groups, as well as between individuals with different personalities. Overall, those with nodules were less likely to manage stress well than those without nodules. ConclusionThe study group and the control subjects showed significant differences in anxious temperament dimensions and stress problem-solving strategies. There were also differences in aerodynamic and acoustic parameters between the disordered and healthy groups, as well as between the groups with and without personality temperament differences. Overall, those with nodules were less likely to manage stress well than those without nodules. This finding indicates that stress management options are not effectively utilized in patients with vocal fold nodules. So, it might be a good idea to look into some kind of therapeutic approach and patient education for stress management.

Gender-specific outcomes of low-dose computed tomography screening for lung cancer detection: A retrospective study in Chinese never-smoker population.

Low-dose computed tomography (LDCT) has emerged as a pivotal tool for detecting lung cancer among ever-smokers. This study aims to evaluate the gender-specific outcomes of LDCT screening within the Chinese never-smoking population. We conducted a single-center, retrospective cohort study, which analyzed LDCT screening outcomes for 42,018 asymptomatic participants. Specifically, we focused on assessing gender-specific differences in the prevalence of pulmonary nodules, and the incidence of lung cancer diagnosis among never-smokers. Among the 42,018 eligible participants, 41.50% were females and 58.50% were males. Most participants were non-smokers (77.57%), with a significantly higher proportion of non-smokers among females than males (99.33% vs. 62.14%). Pulmonary nodules were identified in 2.66% of participants, with a higher prevalence in females (2.99%) than males (2.43%) (p < 0.001). Non-smoking females had a higher incidence of positive nodules than non-smoking males (2.98% vs. 2.38%, p < 0.001). Invasive biopsies were performed in 334 individuals with nodules, confirming lung cancer in 258 cases. The majority of these cancer cases were non-smokers (212), with non-smoking females showing a higher incidence (0.85%) compared to males (0.43%) (p < 0.001). There was no significant difference in the false-positive rates between non-smoking females (0.14%) and males (0.13%). Multivariate analysis showed that never-smoking women were more likely to undergo biopsies (OR 1.65, p = 0.0016) and had a higher, though not statistically significant, probability of lung cancer diagnosis (OR 1.84, p = 0.06). This study elucidates sex-based differences within the Chinese population, revealing a higher prevalence of pulmonary nodules and lung cancers among non-smoking females. These findings offer valuable reference for both clinical practice and future research initiatives.

Prevalence of malignancy in thyroid nodules with AUS cytopathology: A retrospective cross-sectional study.

Category III (AUS; Atypia of Undetermined Significance) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was established to describe thyroid nodule features that are neither benign nor cancerous. This study aims to evaluate the rate of thyroid malignancy in patients diagnosed with AUS at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia. The patients (508) diagnosed with AUS in their thyroid nodules underwent fine-needle aspiration cytology (FNAC). Data were collected through a chart-based approach, reviewing patients' medical records and relevant information. Among the cases, the majority were females (84.6%). Among the different age groups, individuals between 40 and 50 years had the highest prevalence of thyroid nodules (32.5%). Approximately 27% of patients exhibited tumor sizes larger than 4 cm. FNAC results revealed 16.5% benign, 26% AUS, and 22.4% follicular neoplasm cases. Histopathology indicated 54.1% of benign and 37.2% of malignant cases. Papillary carcinoma accounts for 80.4% of all malignant cases. A significant correlation was observed between FNAC and postoperative histopathology (P value < 0.05). Hypoechoic nodules exhibited 33.9% of malignant cases, and calcification was observed in 25% of the cases. A significant association was found between malignancy and echogenicity and between malignancy and calcification (P value = 0.003 and 0.001, respectively). The findings of this study identify malignancy in thyroid nodules with AUS cytopathology, particularly in the Southern region of Saudi Arabia. The correlation between pre-surgery FNAC and postoperative histopathology supports FNAC's diagnostic value. Additionally, echogenicity and calcification can potentially contribute to predicting nodule malignancy.

Predicting Indeterminate Lesion Turned to Distance Metastasis in Patients with Rectal Cancer Undergoing Curative Resection after Preoperative Chemoradiotherapy

Objectives: It is controversial about factors associated with indeterminate lesion turned to be malignant lesion after preoperative concurrent chemoradiotherapy(CCRT) in rectal cancer that may cause over-treating and over-diagnosing. So, The aim of this study was to evaluate the prevalence of indeterminate pulmonary nodules or liver nodule at primary staging CT and risk of indeterminate lesion being malignant to help better understanding of indeterminate lesion in rectal cancer undergoing preoperative CCRT and proper treatment. Methods: A total of 679 patients with rectal cancer were assessed from January 2015 to December 2019. 152 patients with rectal cancer undergoing curative resection after preoperative CRT were included. Associated factors were reviewed for their effect on metastasis. The median follow-up time was 28 months. Results: Of 152 patients, The prevalence of indeterminate lesion was 3.29% and turned to be malignant around 40% of patients. The clinical N2, preoperative FOLFOX regimen, No clinical response were significantly higher in malignant group (p 0.03, &lt;0.001 and 0.003, respectively). Conclusions: Such a low incidence of indeterminate lesion should not cause further preoperative diagnostic workup besides routine regimens. In addition, it is not necessary to perform excessive surveillance routinely for all rectal cancer patients underwent preoperative CCRT who have indeterminate lesion. Intensive follow up chest CT or invasive diagnosis modalities should be considered in patients who had clinical stage N2, receiving preoperative FOLFOX4 regimen and no clinical response after preoperative CCRT.

Prevalence of pulmonary nodules detected incidentally on noncancer-related imaging: a review.

Pulmonary nodules are common incidental findings requiring surveillance. Follow-up recommendations vary depending on risk factors, size and solid or subsolid characteristics. This review aimed to evaluate the prevalence of clinically significant nodules detected on noncancer-dedicated imaging and the prevalence of part-solid and ground-glass nodules. We conducted a systematic search of literature and screened texts for eligibility. Clinically significant nodules were noncalcified nodules >4-6 mm. Prevalence estimates were calculated for all studies and risk of bias was assessed by one reviewer. Twenty-four studies were included, with a total of 30 887 participants, and 21 studies were cross-sectional in design. Twenty-two studies used computed tomography (CT) imaging with cardiac-related CT being the most frequent. Prevalence of significant nodules was highest in studies with large field of view of the chest and low size thresholds for reporting nodules. The prevalence of part-solid and ground-glass nodules was only described in two cardiac-related CT studies. The overall risk of bias was low in seven studies and moderate in 17 studies. While current literature frequently reports incidental nodules on cardiovascular-related CT, there is minimal reporting of subsolid characteristics. Unclear quantification of smoking history and heterogeneity of imaging protocol also limits reliable evaluation of nodule prevalence in nonscreening cohorts.

Bot fly parasitism in mantled howler monkeys (Alouatta palliata): General patterns and climate influences.

Parasitism is a strong selective pressure, and its study is crucial for predicting the persistence of host species. Mantled howler monkeys are infected by the larvae of the bot fly Cuterebra baeri. This parasitosis produces myiasis and may have negative impacts on host health, although systematic information on the dynamics of this host-parasite relationship is very limited. Currently, all available information on infection patterns of C. baeri comes from a single mantled howler monkey population (Barro Colorado Island, Panama). Therefore, in this study we describe temporal variation in infection patterns for a newly mantled howler monkey population and analyze the relationship between climate and infection likelihood. We assessed the presence of C. baeri nodules in 17 adult individuals in Los Tuxtlas for 10 months through direct observation and compiled data on ambient temperature and rainfall. Most subjects had nodules during the study and there were no differences between sexes in the number of nodules. Nodules were usually located in the neck. Prevalence and abundance of nodules peaked thrice during the study (February, April, and September), a pattern that was very similar to that of parasitism intensity (February, April, and August). Incidence closely tracked these peaks, increasing before and decreasing after them. The likelihood of nodule appearance increased when both mean and minimum temperature decreased in the 24-21 prior days to nodule appearance. It also increased with decreased rainfall in the 5-2 prior days to nodule appearance. Although only three of the eight analyzed climate variables had a significant effect on parasitosis, these results suggest that climate may affect pupal development and the access of larvae to hosts. Besides contributing data on C. baeri parasitism for a new mantled howler monkey population, our study provides novel information on the influence of environmental factors on the dynamics of host-parasite systems.

Clinical application of convolutional neural network lung nodule detection software: An Australian quaternary hospital experience.

Early-stage lung cancer diagnosis through detection of nodules on computed tomography (CT) remains integral to patient survivorship, promoting national screening programmes and diagnostic tools using artificial intelligence (AI) convolutional neural networks (CNN); the software of AI-Rad Companion™ (AIRC), capable of self-optimising feature recognition. This study aims to demonstrate the practical value of AI-based lung nodule detection in a clinical setting; a limited body of research. One hundred and eighty-three non-contrast CT chest studies from a single centre were assessed for AIRC software analysis. Prospectively collected data from AIRC detection and characterisation of lung nodules (size: ≥3 mm) were assessed against the reference standard; reported findings of a blinded consultant radiologist. One hundred and sixty-seven CT chest studies were included; 52% indicated for nodule or lung cancer surveillance. Of 289 lung nodules, 219 (75.8%) nodules (mean size: 10.1 mm) were detected by both modalities, 28 (9.7%) were detected by AIRC alone and 42 (14.5%) by radiologist alone. Solid nodules missed by AIRC were larger than those missed by radiologist (11.5 mm vs 4.7 mm, P < 0.001). AIRC software sensitivity was 87.3%, with significant false positive and negative rates demonstrating 12.5% specificity (PPV 0.6, NPV 0.4). In a population of high nodule prevalence, AIRC lung nodule detection software demonstrates sensitivity comparable to that of consultant radiologist. The clinical significance of larger sized nodules missed by AIRC software presents a barrier to current integration in practice. We consider this research highly relevant in providing focus for ongoing software development, potentiating the future success of AI-based tools within diagnostic radiology.

Associations between thyroid function, thyroid diseases, and primary aldosteronism.

Previous studies focusing on primary aldosteronism (PA) and thyroid diseases were controversial. Hence, this study aimed to examine associations between thyroid function, thyroid diseases, and PA and its subtypes. This was a cross-sectional study, which enrolled 1023 patients with PA and 6138 patients with essential hypertension (EH) admitted to Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region from August 2011 to June 2022. All patients with PA were accurately classified into aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) by adrenal vein sampling (AVS). Multivariate logistic regression analysis was used to assess the relationship of thyroid function, thyroid nodules, and PA and its subtypes. A total of 7161 patients (327 APA and 696 IHA, and 6138 EH) were included with a mean age of 48.20 ± 8.83 years. PA patients and PA subtypes showed lower FT4, FT3, TT4, TT3, and prevalence of positive TPOAb, meanwhile higher prevalence of thyroid nodules than EH patients (PA: 56.10%, IHA: 56.90%, APA: 54.80%, and EH: 48.90%, respectively). PA (adjusted OR: 1.290, 95% CI: 1.035-1.607, P = .02) and its subtype (IHA) (adjusted OR: 1.316, 95% CI: 1.005-1.724, P = .04) were significantly associated with thyroid nodules. Compared to patients with lower plasma aldosterone concentration (PAC) levels (<12 ng/dL), patients with PAC levels ≥ 12 ng/dL presented a higher prevalence of thyroid nodules. PA patients had lower thyroid function and higher prevalence of thyroid nodules compared to EH patients. Therefore, the screening of thyroid function and thyroid nodules may be indispensable for PA patients.

Distribution of Solid Lung Nodules Presence and Size by Age and Sex in a Northern European Nonsmoking Population.

Background Most of the data regarding prevalence and size distribution of solid lung nodules originates from lung cancer screening studies that target high-risk populations or from Asian general cohorts. In recent years, the identification of lung nodules in non-high-risk populations, scanned for clinical indications, has increased. However, little is known about the presence of solid lung nodules in the Northern European nonsmoking population. Purpose To study the prevalence and size distribution of solid lung nodules by age and sex in a nonsmoking population. Materials and Methods Participants included nonsmokers (never or former smokers) from the population-based Imaging in Lifelines study conducted in the Northern Netherlands. Participants (age ≥ 45 years) with completed lung function tests underwent chest low-dose CT scans. Seven trained readers registered the presence and size of solid lung nodules measuring 30 mm3 or greater using semiautomated software. The prevalence and size of lung nodules (≥30 mm3), clinically relevant lung nodules (≥100 mm3), and actionable nodules (≥300 mm3) are presented by 5-year categories and by sex. Results A total of 10 431 participants (median age, 60.4 years [IQR, 53.8-70.8 years]; 56.6% [n = 5908] female participants; 46.1% [n = 4812] never smokers and 53.9% [n = 5619] former smokers) were included. Of these, 42.0% (n = 4377) had at least one lung nodule (male participants, 47.5% [2149 of 4523]; female participants, 37.7% [2228 of 5908]). The prevalence of lung nodules increased from age 45-49.9 years (male participants, 39.4% [219 of 556]; female participants, 27.7% [236 of 851]) to age 80 years or older (male participants, 60.7% [246 of 405]; female participants, 50.9% [163 of 320]). Clinically relevant lung nodules were present in 11.1% (1155 of 10 431) of participants, with prevalence increasing with age (male participants, 8.5%-24.4%; female participants, 3.7%-15.6%), whereas actionable nodules were present in 1.1%-6.4% of male participants and 0.6%-4.9% of female participants. Conclusion Lung nodules were present in a substantial proportion of all age groups in the Northern European nonsmoking population, with slightly higher prevalence for male participants than female participants. © RSNA, 2024 Supplemental material is available for this article.

Prevalence and management of pulmonary nodules: a systematic review and meta-analysis.

Pulmonary nodules are small, focal lesions often identified via computed tomography (CT) scans. Although the majority are benign, a small percentage of them may be malignant or potentially become malignant, underscoring the importance of early detection and effective management. This study systematically reviews the epidemiology, risk factors, and management strategies for pulmonary nodules, comparing findings across Chinese and non-Chinese populations to better inform the actuarial calculations for predicting the demand of medical services for patients with pulmonary nodules. We performed a systematic analysis of the PubMed and China Knowledge Infrastructure (CNKI) databases for studies reporting the detection rate of pulmonary nodules through CT scans. Both cross-sectional studies and the baseline data from longitudinal studies were included. A modified version of the Newcastle-Ottawa Scale was used to assess the risk of bias and random effect models were used to estimate the overall prevalence. We identified 32 studies and included 24 of them in our meta-analysis. Pooled analysis showed that the overall prevalence of pulmonary nodules was 0.27 (95% confidence interval: 0.25-0.29) after outliers removal. Subgroup analysis showed that there was no significant difference for prevalence between Chinese and non-Chinese populations. Males (0.38) were shown to have slightly higher prevalence compared to females (0.36), but not significant (P=0.88). Age and smoking are the most frequently reported risk factors by studies. Overall, 27% of participants were positive for pulmonary nodules. Advancing age and smoking were consistently identified as a key risk factor for the incidence of pulmonary nodules. Although the management strategies are different across studies, recent guidelines recommend personalized management strategies, prioritizing nodule size, characteristics, and individual risk factors to optimize outcomes.

The Efficacy of a Named Entity Recognition AI Model for Identifying Incidental Pulmonary Nodules in CT Reports.

Purpose: This study evaluates the efficacy of a commercial medical Named Entity Recognition (NER) model combined with a post-processing protocol in identifying incidental pulmonary nodules from CT reports. Methods: We analyzed 9165 anonymized CT reports and classified them into 3 categories: no nodules, nodules present, and nodules >6 mm. For each report, a generic medical NER model annotated entities and their relations, which were then filtered through inclusion/exclusion criteria selected to identify pulmonary nodules. Ground truth was established by manual review. To better understand the relationship between model performance and nodule prevalence, a subset of the data was programmatically balanced to equalize the number of reports in each class category. Results: In the unbalanced subset of the data, the model achieved a sensitivity of 97%, specificity of 99%, and accuracy of 99% in detecting pulmonary nodules mentioned in the reports. For nodules >6 mm, sensitivity was 95%, specificity was 100%, and accuracy was 100%. In the balanced subset of the data, sensitivity was 99%, specificity 96%, and accuracy 97% for nodule detection; for larger nodules, sensitivity was 94%, specificity 99%, and accuracy 98%. Conclusions: The NER model demonstrated high sensitivity and specificity in detecting pulmonary nodules reported in CT scans, including those >6 mm which are potentially clinically significant. The results were consistent across both unbalanced and balanced datasets indicating that the model performance is independent of nodule prevalence. Implementing this technology in hospital systems could automate the identification of at-risk patients, ensuring timely follow-up and potentially reducing missed or late-stage cancer diagnoses.

Prevalence of thyroid nodule and relationship with physiological and psychosocial factors among adults in Zhejiang Province, China: a baseline survey of a cohort study

BackgroundThyroid nodules have attracted much attention due to their high incidence and potential for malignant transformation. Compared with the clinical assessment and diagnosis of thyroid nodules, there are relatively few studies on the epidemiological risk factors for thyroid nodules. The aim of this study was to investigate the prevalence of thyroid nodule among adults in Zhejiang province and to explore their relationship with physiological and psychosocial factors.MethodsThe data used in this study were obtained from the baseline survey of the Zhejiang Provincial Cohort Study on Environment and Health. From June 2022 to December 2023, a total of 21,712 participants from five representative cities in Zhejiang were recruited for the baseline survey. Based on the inclusion and exclusion criteria, 15,595 adults were included in the analysis. The data were collected via self-report questionnaires and physical examinations. Multivariate logistic regression analysis was subsequently performed.ResultsThe detection rate of thyroid nodules was 50.98% among adults in Zhejiang province. Age, gender, education level, BMI, tea and alcohol consumption all had a statistically significant association with thyroid nodules (p < 0.05). After adjusting for sociodemographic factors, results of logistic regression analysis showed that good life satisfaction (OR = 0.854, 95% CI: 0.780–0.934) had a lower risk of thyroid nodules, however, poor life satisfaction (OR = 1.406, 95% CI: 1.014–1.951), social isolation (OR = 1.294, 95% CI: 1.089–1.538) and a family history of thyroid nodules (OR = 1.334, 95% CI: 1.064–1.672) had a greater risk of thyroid nodules.ConclusionThe detection rate of thyroid nodules in adults of Zhejiang province was an increasing trend compared with that in previous years. In addition to the sensitive thyroid nodule screening technology, influencing factors mentioned in this study might also represent credible candidates for this increase. As variable influence factors, weight management, good interpersonal relationships and life satisfaction should be the focus of health interventions.

Lynch Syndrome and Thyroid Nodules: A Single Center Experience.

Lynch syndrome (LS) is a genetic disease with increased risk of colorectal cancer and other malignancies. There are few reported cases of thyroid cancer in LS patients. The aim of this study is to investigate the presence of thyroid nodules in LS patients and to explore their association with the genetic features of the disease. A retrospective and descriptive analysis was conducted to include all LS patients followed at the CEMAD (Centro Malattie Apparato Digerente) of Fondazione Policlinico Universitario A. Gemelli IRCCS. The characteristics of LS disease, gene mutations, and previous history of thyroid disease were evaluated. Majority of patients underwent thyroid ultrasound (US), and nodule cytology was performed when needed. Of a total of 139 patients with LS, 110 patients were included in the study. A total of 103 patients (74%) underwent thyroid ultrasound examinations, and 7 patients (5%) had a previous history of thyroid disease (cancer or multinodular goiter). The mean age was 51.9 years. Thyroid nodules were found in 62 patients (60%) who underwent US, and 9 of them (14%) had suspicious features of malignancy, inducing a fine-needle aspiration biopsy. A cytologic analysis classified 7 of 9 cases (78%) as TIR2 and 2 (22%) as TIR3a. Between patients with nodular thyroid disease (single nodule, multinodular goiter, and cancer), most of them (25 patients, 36% of total) were carriers of the MSH6 mutation, while 22 (32%), 17 (24%), and 5 (7%) had MSH2, MLH1, and PMS2 mutations, respectively. A high prevalence of thyroid nodules was found in patients with LS, especially in MSH6-carrying patients. Performing at least one thyroid ultrasound examination is suggested for the detection of nodular thyroid disease in LS patients. Systematic investigations are needed to estimate their prevalence, features, and risk of malignant transformation.

Prevalence of Thyroid Nodules in Residents of Ukraine Exposed as Children or Adolescents to Iodine-131 from the Chornobyl Accident.

Background: Although childhood exposure to radioactive iodine-131 (I-131) is an established risk factor for thyroid cancer, evidence for an association with thyroid nodules is less clear. The objective of this study is to evaluate the association between childhood I-131 exposure and prevalence of ultrasound-detected thyroid nodules overall and by nodule histology/cytology (neoplastic/suspicious/non-neoplastic), size (<10 mm/≥10 mm), and number (single/multiple). Methods: This is a cross-sectional study of radiation dose (mean = 0.53 gray, range: 0.0003-31 gray) and screen-detected thyroid nodules conducted in 1998-2000 (median population age 21.5 years) in a cohort of 13,243 residents of Ukraine who were under 18 years at the time of the Chornobyl accident on April 26, 1986. Excess odds ratios per gray (excess odds ratio [EOR]/Gy) and confidence intervals (CIs) were estimated using logistic regression. Results: Among 13,078 eligible individuals, we identified 358 (2.7%) with at least one thyroid nodule. Significantly increased dose-response associations were found for all nodules and nodule groups with doses <5 Gy except individuals with non-neoplastic nodules. Among individuals with doses <5 Gy, the EOR/Gy for neoplastic nodules (5.35; CI: 2.19-15.5) was significantly higher than for non-neoplastic nodules (0.24; CI: 0.07-0.74), but the EOR/Gy did not vary by nodule size or number. Conclusions: Childhood exposure to I-131 is associated with an increased risk of thyroid nodules detected 12-14 years following exposure, and the risk for neoplastic nodules is higher than for non-neoplastic nodules. Analyses of incident thyroid nodules may help clarify dose-response patterns by nodule characteristics and provide insights into thyroid nodule etiology.

Epidemiological exploration of the impact of bluetooth headset usage on thyroid nodules using Shapley additive explanations method

With an increasing prevalence of thyroid nodules globally, this study investigates the potential correlation between the use of Bluetooth headsets and the incidence of thyroid nodules, considering the cumulative effects of non-ionizing radiation (NIR) emitted by these devices. In this study, we analyzed 600 valid questionnaires from the WenJuanXing platform using Propensity Score Matching (PSM) and the XGBOOST model, supplemented by SHAP analysis, to assess the risk of thyroid nodules. PSM was utilized to balance baseline characteristic differences, thereby reducing bias. The XGBOOST model was then employed to predict risk factors, with model efficacy measured by the area under the Receiver Operating Characteristic (ROC) curve (AUC). SHAP analysis helped quantify and explain the impact of each feature on the prediction outcomes, identifying key risk factors. Initially, 600 valid questionnaires from the WenJuanXing platform underwent PSM processing, resulting in a matched dataset of 96 cases for modeling analysis. The AUC value of the XGBOOST model reached 0.95, demonstrating high accuracy in differentiating thyroid nodule risks. SHAP analysis revealed age and daily Bluetooth headset usage duration as the two most significant factors affecting thyroid nodule risk. Specifically, longer daily usage durations of Bluetooth headsets were strongly linked to an increased risk of developing thyroid nodules, as indicated by the SHAP analysis outcomes. Our study highlighted a significant impact relationship between prolonged Bluetooth headset use and increased thyroid nodule risk, emphasizing the importance of considering health impacts in the use of modern technology, especially for devices like Bluetooth headsets that are frequently used daily. Through precise model predictions and variable importance analysis, our research provides a scientific basis for the formulation of public health policies and personal health habit choices, suggesting that attention should be paid to the duration of Bluetooth headset use in daily life to reduce the potential risk of thyroid nodules. Future research should further investigate the biological mechanisms of this relationship and consider additional potential influencing factors to offer more comprehensive health guidance and preventive measures.

Prevalence of Thyroid Nodules in Residents of Ukraine Exposed as Children or Adolescents to Iodine-131 from the Chornobyl Accident

Prevalence of Thyroid Nodules in Residents of Ukraine Exposed as Children or Adolescents to Iodine-131 from the Chornobyl Accident

Distinct Challenges of Eruptive and Non-Eruptive Calcified Nodules in Percutaneous Coronary Intervention.

To provide a summary of prevalence, pathogenesis, and treatment of coronary calcified nodules (CNs). CNs are most frequently detected at the sites of hinge motion of severely calcified lesions such as in the middle segment of right coronary artery and left main coronary bifurcation. On histopathology, CNs exhibit two distinctive morphologies: eruptive and non-eruptive. Eruptive CNs, which have a disrupted fibrous cap with adherent thrombi, are biologically active. Non-eruptive CNs, which have an intact fibrous cap without thrombi, are biologically inactive, representing either healed eruptive CNs or protrusion of calcium due to plaque progression. Recent studies using optical coherence tomography (OCT) have shown a difference in the mechanism of stent failure in the two subtypes, demonstrating early reappearance of eruptive CNs in the stent (at ~ 6months) as a unique mechanism of stent failure that does not seem to be preventable by simply achieving adequate stent expansion. The cause of CN reappearance in stent is not known and could be due to acute or subacute intrusion or continued growth of the CN. Whether modification of CN is needed, the most effective calcium modification modality and effectiveness of stent implantation in eruptive CNs has not been elucidated. In this review, we discuss pathogenesis of CNs and how intravascular imaging can help diagnose and manage patients with CNs. We also discuss medical and transcatheter therapies beyond conventional stent implantation for effective treatment of eruptive CNs that warrant testing in prospective studies.