Reliability of Aspiration Biopsy in Thyroid Nodes: Study of 2190 Operated Patients

The cytologic finding was negative in 1841 patients; accurate in 1763 (95.8 %). Suspicious cytology proved malignant in 82 of 252 patients (32.5 %). Positive cytology was accurate in 88 out of 97 cases (90.7 %). In 1942 benign goiters, cytology was accurate in 90.8 % of patients, false suspicious in 8.7 % and false positive in 0.5 %; the highest percentage of misdiagnosis was in adenomas (15.8 %) and thyroiditis (19.0 %). In 248 malignant goiters, cytology was accurate in 35.5 % of patients, suspicious in 33.1 %, and false negative in 31.4 %. False-negative cytology was found in 44 % of follicular cancers, 22.2 % of papillary and medullary, and 12.9 % anaplastic. The most frequent false-negative cytologic diagnosis was the adenomatous goiter. The accuracy of cytology was statistically higher in papillary cancers than in follicular (77.8 % vs 56.0 %), in undifferentiated tumors than in differentiated (83.7 % vs 65.0 %), and in adenomatous nontoxic goiters than in adenomas, thyroiditis and toxic goiters (80.3 % vs 42.7 %), 20.1 % and 13.4 %). Positive preoperative fine needle aspiration biopsy cytology is a worthwhile and reliable finding; it fails in less than 10 % of patients. Negative cytology, however, does not exclude malignancy in thyroid nodes; it is false negative in more than 30 % of cancers.

Suicidal ideations and sleep-related problems in early adolescence

AIMS

Suicidal ideation and sleep-related problems are associated with many common psychopathological entities in early adolescence. This study examined possible association between suicidal ideation and sleep-related problems.

METHODS

A cross-sectional study was performed in classroom settings at 840 early adolescents 11-13 years of age. Of those, 791 adolescents fully completed the data and thus represent an actual sample. Suicidal ideations were assessed with three dichotomous (yes/no) items: 'I often think about death'; 'I wish I was dead'; 'I often think about suicide.' A composite measure of perceived sleep-related problems was formed by combining items from the Junior Eysenck Personality Questionnaire (Do you find it hard to sleep at night because you are worrying about things?), Children Depression Inventory (It is hard for me to fall asleep at night), and two additional dichotomous questions (I often was not able to fall asleep because of worrying; At times I was not able to stay asleep because of worrying). This score mainly assessed difficulties in initiating or maintaining sleep.

RESULTS

A total of 7.1% adolescents reported suicidal ideation and 86.7% of them had sleep problems. Sleep-related problems were associated with any suicidal ideation and each type of ideation separately.

CONCLUSION

This study suggests association of sleep problems and suicidal ideations in early adolescence. Therefore, clinicians should evaluate this population for sleep disturbances, as they might be a marker of increased risk for suicidality.

The Croatian version of diagnostic interview for genetic studies

Diagnostic Interview for Genetic Studies (DIGS) is a modern structured interview schedule that has been in use since 1994. Main purpose of the DIGS is to record information regarding to a subject's functioning and psychopathology and it was specifically designed for psychiatric genetic studies. The DIGS is also suitable for making diagnosis, evaluation of comorbidity and other researches. It contents items and sections and has a semi-structured design that gives interviewers the freedom needed to extract the best in formation possible. The validity of a Croatian version of the DIGS was investigated. The original English version was initially translated into Croatian. The Croatian version was then back-translated and compared with the original. In this paper we will describe each item that DIGS contents as well as the use of this diagnostic instrument.

Hypertension control and management in Slovenia, Yugoslavia

Data were collected from 413 questionnaires sent to general practitioners throughout Slovenia, accounting for half the physicians in this discipline. BP was measured most commonly in the sitting position (72%), mostly on the left arm. Most respondents (93%) used only one cuff size. Correction of BP readings according to the patient's arm circumference was used by 63% of the respondents. Seventy-eight percent of the general practitioners recorded phase V of the Korotkoff sounds for diastolic BP. BP was measured more than once at each examination by 55%. BP measurements were performed by nurses in 27% of cases. Mercury sphygmomanometers were used by 87%. Manometers were calibrated once a year by 73%. Complete diagnostic procedures for the definition of hypertension were conducted in approximately 50% of patients, predominantly in severe cases. Drug treatment was commenced in the range of 'mild hypertension' usually by 93% of the general practitioners. It was started at BP values of 165/99 mmHg and higher. In patients with other risk factors, it was instituted even earlier. General measures (non-drug therapy) were advised by only 30%. Beta-blockers were usually prescribed to younger patients as drug of choice (74%), and diuretic agents to the elderly (48%). General practitioners' sources of new information about hypertension were mainly medical literature, pharmaceutical industry information, and professional meetings. Prevalence of hypertensive BP values in the responding general practitioners themselves was 8%.

[The significance of certain histologic parameters in the differentiation and diagnosis of Hürthle cell adenoma and carcinoma of the thyroid gland]

Hürthle cell tumors of the thyroid gland are rare. Their natural history remains incompletely understood what results in their different classification and therapy. The differentiation of benign from malignant Hürthle cell tumors is possible with classical, traditional histologic methods. Authors have analysed 53 patients with Hürthle cell tumor of the thyroid gland which were diagnostically evaluated and treated at the Central Institute for Tumors and Allied Diseases in Zagreb from 1975 to 1988.

[The importance of clinical and histologic variables in the prognosis of medullary carcinoma of the thyroid gland]

Patients with medullary thyroid carcinoma (MTC) have aroused considerable interest ever since Horn (1951), Hazarde et al. (1959) and Williams (1966) described MTC as a separate clinicopathologic entity, because this tumor occurs both in families and in association with neural and endocrine abnormalities. This interest also underlines our clinicohistologic study of 31 patients with a histologically demonstrated MTC. The patients have been analyzed at the Central Institute for Tumors and Allied Diseases in Zagreb from 1969 to 1988. The youngest patient was 17, and the oldest one 85 (average 45 years). None of the patients had thyroid carcinoma in his/her family history, or any association with pheochromocytoma or multiple skin and mucosal neurinoma. The men to women ratio was 1:0.94. The prognostic significance of some clinical and histologic variables in patients affected by medullary thyroid carcinoma have been studied. Treatment involved total thyroidectomy with or without neck dissection. Some of the patients were subsequently irradiated or administered chemotherapeutic agents. The data obtained in the study were statistically processed and the statistical differences between the survival rates of the various patient groups were determined by the logrank-test. Of the studied variables (sex, age, tumor size, cervical metastases, tumor structure, cell type, stroma, calcification, number of mitoses, necrosis, bleeding, amyloid content), the following were found to have a prognostic significance: age, tumor size and regional lymph node metastases.

[Solitary extramedullary plasmacytoma of the larynx]

Solitary extramedullary plasmacytoma (EMP) is histologically rare larynx tumor. Of the 620 treated larynx carcinomas, extramedullary plasmacytoma makes up 0.1% of larynx carcinomas recorded in our case reports. The symptoms of larynx EMP are like other tumor symptoms of the same site. Clinically, solitary extramedullary plasmacytoma is like a cyst. It is epithelialized and radiates grey light. Findings obtained by biopsy and extemporary histology did not confirm plasmacytoma. The diagnosis was made by histochemical procedure.

Interaction of cadmium, zinc and copper in relation to smoking habit, age and histopathological findings in human kidney cortex

In this study the concentrations of cadmium, zinc and copper were determined by atomic absorption spectrophotometry in 51 post mortem kidney cortex samples. A histopathological examination of the kidney was also performed. These parameters, together with age and smoking habit, were statistically related by means of factor analysis. The results show that the first factor associated smoking habit, cadmium and zinc and the second factor histopathological findings and age.