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  1. Article ; Online: Radiofrequency Ablation for Benign Thyroid Nodules.

    Noel, Julia E / Sinclair, Catherine F

    The Journal of clinical endocrinology and metabolism

    2023  Volume 109, Issue 1, Page(s) e12–e17

    Abstract: Context: Thermal ablative techniques of the thyroid have recently gained clinical traction as a therapeutic alternative that provides symptomatic relief and confers potential advantages over surgery. A truly multidisciplinary technique, thyroid ablation ...

    Abstract Context: Thermal ablative techniques of the thyroid have recently gained clinical traction as a therapeutic alternative that provides symptomatic relief and confers potential advantages over surgery. A truly multidisciplinary technique, thyroid ablation is currently performed by endocrinologists, interventional radiologists, otolaryngologists, and endocrine surgeons. Radiofrequency ablation (RFA), specifically, has seen widespread adoption, particularly in the treatment of benign thyroid nodules. This review summarizes current evidence on the application of RFA in benign thyroid nodules, and provides a start to finish overview of procedural preparation, performance, and outcomes.
    Evidence acquisition: A narrative review of literature focusing on RFA in the treatment of benign nodular disease was performed. Emphasis was placed on consensus statements, best practice guidelines, multi-institutional studies, and systematic reviews to summarize key concepts in candidacy, techniques, expectations, and outcomes.
    Findings: RFA is increasingly recognized as a first-line treatment strategy in the management of symptomatic nonfunctional benign thyroid nodules. It can also be considered in functional thyroid nodules with small volumes or in patients ineligible for surgery. A targeted and efficacious technique, RFA results in gradual volume reduction that preserves the function of the surrounding thyroid parenchyma. Proper procedural technique, proficiency in ultrasound, and experience in ultrasound-guided procedures are instrumental to maintaining low complication rates and achieving successful ablation outcomes.
    Conclusions: In pursuit of a personalized approach, physicians across disciplines are increasingly incorporating RFA into their treatment algorithms, most commonly for benign nodules. As with any intervention, thoughtful selection and implementation ensure a safe procedure with optimal patient benefit.
    MeSH term(s) Humans ; Thyroid Nodule/surgery ; Catheter Ablation/methods ; Treatment Outcome ; Radiofrequency Ablation/methods
    Language English
    Publishing date 2023-07-04
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/clinem/dgad357
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Enantioselective Access to Tetrahydroxanthones via Copper-

    Attard, Jonathan W / Noel, Julia R / Guan, Yong / Mattson, Anita E

    Organic letters

    2023  Volume 25, Issue 14, Page(s) 2450–2455

    Abstract: Highly enantioselective access to tetrahydroxanthone compounds was achieved through copper- ...

    Abstract Highly enantioselective access to tetrahydroxanthone compounds was achieved through copper-
    Language English
    Publishing date 2023-04-05
    Publishing country United States
    Document type Journal Article
    ISSN 1523-7052
    ISSN (online) 1523-7052
    DOI 10.1021/acs.orglett.3c00612
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Time-Driven Activity-Based Cost Comparison of Thyroid Lobectomy and Radiofrequency Ablation.

    Ayoub, Noel F / Balakrishnan, Karthik / Orloff, Lisa A / Noel, Julia E

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2023  Volume 169, Issue 4, Page(s) 830–836

    Abstract: Objective: Radiofrequency ablation (RFA) of benign thyroid nodules has gained traction for its therapeutic effectiveness, thyroid function preservation, and minimally invasive nature. While a growing body of evidence reports positive outcomes from ... ...

    Abstract Objective: Radiofrequency ablation (RFA) of benign thyroid nodules has gained traction for its therapeutic effectiveness, thyroid function preservation, and minimally invasive nature. While a growing body of evidence reports positive outcomes from thyroid RFA, financial comparisons between both procedures remain limited. This analysis aims to more accurately measure the direct cost of thyroid RFA in comparison to thyroid lobectomy.
    Study design: Bottom-up financial cost analysis.
    Setting: Tertiary endocrine head and neck surgery center.
    Methods: Time-driven activity-based costing was utilized to obtain unit-based cost estimates. The care cycles for thyroid lobectomy and RFA were defined, and process maps were developed comprising all personnel and work in the care cycle. Time estimates were calculated for all personnel involved, and public government data were used to obtain capacity cost rates for each component of the care cycle. Consumable supply and overhead costs were obtained for both procedures, and overall costs were compared.
    Results: For thyroid lobectomy, total personnel costs were $1087.97, consumable supplies were $942.68, and overhead costs $17,199.10. For thyroid nodule RFA performed in an office setting, the total personnel cost calculated was $379.90, consumable supplies $1315.28, and overhead $7031.20. Overall, the total cost for thyroid lobectomy was $19,229.75 compared to $8726.38 for RFA.
    Conclusion: In-office thyroid nodule RFA is associated with lower direct costs than thyroid lobectomy, and overhead is the greatest cost driver for both procedures. If clinical and patient-centered outcomes are comparable, then RFA may provide higher value for appropriately selected patients.
    MeSH term(s) Humans ; Thyroid Nodule/surgery ; Catheter Ablation/methods ; Treatment Outcome ; Retrospective Studies ; Radiofrequency Ablation/methods ; Costs and Cost Analysis
    Language English
    Publishing date 2023-05-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.360
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  4. Article: Prognostication of papillary thyroid microcarcinoma based on preoperative ultrasound.

    Cohen, Samuel M / Noel, Julia E / Baroody, Michael / Orloff, Lisa A

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1101705

    Abstract: Background: Diagnosis of papillary thyroid microcarcinoma, defined as papillary thyroid carcinoma measuring 1cm or less in greatest diameter, has increased with improvements in ultrasound technology and widespread familiarity and utilization. Given the ... ...

    Abstract Background: Diagnosis of papillary thyroid microcarcinoma, defined as papillary thyroid carcinoma measuring 1cm or less in greatest diameter, has increased with improvements in ultrasound technology and widespread familiarity and utilization. Given the indolent course of papillary thyroid carcinoma, active surveillance is considered an acceptable alternative to surgical resection for select patients. Candidacy for active surveillance is determined by a number of patient and tumor characteristics. Specifically, the location of the tumor within the thyroid gland plays one of the key roles in decision making. Here we evaluate characteristics of the primary tumor and distance to the thyroid capsule in association with locoregional metastases to help guide risk assessment.
    Methods: Retrospective chart review of all thyroid surgeries performed by two surgeons at one medical center from 2014-2021 to evaluate characteristics of papillary thyroid microcarcinoma on preoperative ultrasound that are associated with locoregional metastatic disease.
    Results: Our data show a sensitivity of 65% and specificity of 95% for identifying regional metastases in papillary thyroid microcarcinoma using preoperative ultrasound. We found no correlation between regional metastasis and size of tumor, distance to thyroid capsule or trachea, tumor contour, or presence of autoimmune thyroiditis. Nodules in the superior or midpole were associated with central or lateral neck metastases, whereas nodules in the isthmus or inferior pole were only associated with central neck metastases.
    Conclusions: Active surveillance may be a reasonable option for even those papillary thyroid microcarcinomas adjacent to the thyroid capsule.
    MeSH term(s) Humans ; Thyroid Cancer, Papillary/diagnostic imaging ; Thyroid Cancer, Papillary/surgery ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/surgery ; Thyroid Neoplasms/pathology ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/surgery ; Carcinoma, Papillary/pathology
    Language English
    Publishing date 2023-01-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1101705
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  5. Article ; Online: Opioid-Sparing Protocol for Endocrine Surgery (OSPREY): A Prospective Study.

    Kligerman, Maxwell P / Austerlitz, Joaquin / Orloff, Lisa A / Noel, Julia E

    Journal of the American College of Surgeons

    2023  Volume 237, Issue 4, Page(s) 655–662

    Abstract: Background: Thyroid and parathyroid operations are among the most commonly performed surgeries in the world; however, there remains a paucity of prospective clinical trials evaluating the efficacy of opioid-sparing protocols after surgery.: Study ... ...

    Abstract Background: Thyroid and parathyroid operations are among the most commonly performed surgeries in the world; however, there remains a paucity of prospective clinical trials evaluating the efficacy of opioid-sparing protocols after surgery.
    Study design: This prospective nonrandomized study was performed between March and October 2021. Participants self-selected their cohort of either an opioid-sparing protocol of acetaminophen/ibuprofen or a treatment-as-usual protocol with opioids. Primary endpoints were Overall Benefit of Analgesia Scores (OBAS) and opioid use as reported in daily medication logs. Data were recorded for 7 days. Multivariable regression, pooled variance t -tests, Mann-Whitney test, and chi-square tests were used to evaluate the results.
    Results: A total of 87 participants were recruited; 48 participants opted for the opioid-sparing arm, and 39 participants opted for the treatment-as-usual arm. Patients in the opioid-sparing arm used significantly fewer opioids (morphine equivalents 0.77 ± 1.71 vs 3.34 ± 5.87, p = 0.042) but had no significant difference in OBAS (p = 0.37). Multivariable regression analysis demonstrated no significant difference in mean OBAS between treatment arms when controlling for age, sex, and type of surgery (p = 0.88). There were no major adverse events in either group.
    Conclusions: An opioid-sparing treatment algorithm based on the use of acetaminophen/ibuprofen may offer a safe and effective treatment algorithm compared to a primary opioid-focused treatment pathway. Randomized adequately powered studies are needed to confirm these findings.
    MeSH term(s) Humans ; Analgesics, Opioid/therapeutic use ; Ibuprofen/therapeutic use ; Acetaminophen/therapeutic use ; Prospective Studies ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control
    Chemical Substances Analgesics, Opioid ; Ibuprofen (WK2XYI10QM) ; Acetaminophen (362O9ITL9D)
    Language English
    Publishing date 2023-06-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1097/XCS.0000000000000782
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  6. Article: Transcuticular calcium imaging as a tool for the functional study of insect odorant receptors.

    Mariette, Julia / Noël, Amélie / Louis, Thierry / Montagné, Nicolas / Chertemps, Thomas / Jacquin-Joly, Emmanuelle / Marion-Poll, Frédéric / Sandoz, Jean-Christophe

    Frontiers in molecular neuroscience

    2023  Volume 16, Page(s) 1182361

    Abstract: ... the insect olfactome, many studies focus on the deorphanization of ORs (i.e., identification of their ligand ...

    Abstract The primary actors in the detection of olfactory information in insects are odorant receptors (ORs), transmembrane proteins expressed at the dendrites of olfactory sensory neurons (OSNs). In order to decode the insect olfactome, many studies focus on the deorphanization of ORs (i.e., identification of their ligand), using various approaches involving heterologous expression coupled to neurophysiological recordings. The "empty neuron system" of the fruit fly
    Language English
    Publishing date 2023-08-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2452967-9
    ISSN 1662-5099
    ISSN 1662-5099
    DOI 10.3389/fnmol.2023.1182361
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  7. Article ; Online: Continuous infusion of cefiderocol in a critically ill patient with continuous venovenous haemofiltration.

    Möhlmann, Julia E / van Luin, Matthijs / Uijtendaal, Esther V / Zahr, Noël / Sikma, Maaike A

    British journal of clinical pharmacology

    2023  Volume 89, Issue 12, Page(s) 3753–3757

    Abstract: Cefiderocol is a broad-spectrum cephalosporin antibiotic and is indicated in patients with difficult-to-treat Gram-negative bacterial infections. Cefiderocol is applied as a 2-4-times daily prolonged 3-h infusion. The therapeutic target of cefiderocol ... ...

    Abstract Cefiderocol is a broad-spectrum cephalosporin antibiotic and is indicated in patients with difficult-to-treat Gram-negative bacterial infections. Cefiderocol is applied as a 2-4-times daily prolonged 3-h infusion. The therapeutic target of cefiderocol suggests that continuous infusion (CI) may be advantageous, since it is more likely to achieve 100% of time of the unbound concentration above the minimal inhibitory concentration (MIC). However, limited information on cefiderocol as CI has been assessed. We present a case of a critically ill 37-year-old woman with continuous venovenous haemofiltration (CVVH) treated with a CI of cefiderocol for multidrug-resistant Pseudomonas aeruginosa. She received 4 g per 24 h, in accordance with the recommendations for the total daily dose during CVVH with an effluent flow rate of 2.1-3 L/h. We evaluated intraperitoneal, plasma arterial pre- and postfilter and ultrafiltrate (urine) total cefiderocol concentrations and discussed the pharmacokinetics in respect to the CVVH settings. The predicted unbound plasma concentrations during CI resulted in 6.8-9.5-fold higher concentrations than the adopted MIC of 2 mg/L for cefiderocol against P. aeruginosa. The optimal time of the unbound concentration >MIC target of cefiderocol was met during the sampling period, suggesting adequate exposure during the total treatment period. The obtained intraperitoneal concentration indicated adequate cefiderocol exposure at the site of infection. Continuous infusion of 4 g cefiderocol per 24 h led to sufficient plasma concentrations in our anuric critically ill patient treated with CVVH. This case is supportive to the use of cefiderocol as continuous infusion.
    MeSH term(s) Female ; Humans ; Adult ; Anti-Bacterial Agents ; Critical Illness/therapy ; Continuous Renal Replacement Therapy ; Cephalosporins/pharmacokinetics ; Cefiderocol
    Chemical Substances Anti-Bacterial Agents ; Cephalosporins
    Language English
    Publishing date 2023-09-20
    Publishing country England
    Document type Case Reports
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15901
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  8. Article ; Online: A Closer Look at "Taller-Than-Wide" Thyroid Nodules: Examining Dimension Ratio to Predict Malignancy.

    Mattingly, Aviva S / Noel, Julia E / Orloff, Lisa A

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2021  Volume 167, Issue 2, Page(s) 236–241

    Abstract: Objective: To evaluate nodule height-to-width ratio as a continuous variable predicting likelihood of thyroid malignancy.: Study design: Retrospective cohort study.: Setting: All study information was collected from a single academic tertiary care ...

    Abstract Objective: To evaluate nodule height-to-width ratio as a continuous variable predicting likelihood of thyroid malignancy.
    Study design: Retrospective cohort study.
    Setting: All study information was collected from a single academic tertiary care hospital.
    Methods: Subjects included adult patients with thyroid nodules who underwent thyroid surgery between 2010 and 2020. The following variables were collected: patient demographics, nodule dimensions via ultrasound, fine-needle aspiration biopsy results, and surgical pathology results. Statistical analysis included logistic regression modeling malignancy with variables of interest. We used a receiver operating characteristic curve to assess the discriminatory value of variables.
    Results: Height-to-width ratio, as a continuous variable, was associated with malignancy (with each 0.1 increase in ratio; odds ratio [OR], 1.25; 95% CI, 1.14-1.37). The same relationship was true for height-to-length ratio (OR, 1.36; 95% CI, 1.24-1.56). The area under the receiver operating characteristic curve for height-to-width ratio was 63.7%. In line with current emphasis on the transverse ultrasound view, we determined 4 different height-to-width ratio intervals: <0.8, 0.8 to <1.0, 1.0 to <1.5, and ≥1.5. Likelihood ratios of malignancy for each interval were 0.6, 1.0, 2.3, and 4.9, respectively.
    Conclusion: Our results support the association between greater height-to-width ratio and malignancy but suggest that a multilevel rather than binary variable improves prediction. The likelihood ratios at different intervals give a more nuanced view of how height-to-width ratio predicts malignancy. With continuing review of guidelines for thyroid nodule biopsy, it is important to consider these data for any point total attributed to shape.
    MeSH term(s) Adult ; Biopsy, Fine-Needle ; Humans ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroid Nodule/diagnostic imaging ; Thyroid Nodule/pathology ; Thyroid Nodule/surgery ; Ultrasonography/methods
    Language English
    Publishing date 2021-10-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1177/01945998211051310
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  9. Article ; Online: Recognizing Persistent Disease in Well-Differentiated Thyroid Cancer and Association with Lymph Node Yield and Ratio.

    Noel, Julia E / Orloff, Lisa A

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2019  Volume 162, Issue 1, Page(s) 50–55

    Abstract: Objective: To establish the association between lymph node yield and ratio in neck dissection for well-differentiated thyroid cancer and risk for persistent postoperative disease.: Study design: Retrospective cohort study of patients undergoing ... ...

    Abstract Objective: To establish the association between lymph node yield and ratio in neck dissection for well-differentiated thyroid cancer and risk for persistent postoperative disease.
    Study design: Retrospective cohort study of patients undergoing lymphadenectomy for thyroid carcinoma.
    Setting: Tertiary referral center.
    Subjects and methods: Included patients underwent central and/or lateral neck dissection for papillary thyroid carcinoma at our institution between 1994 and 2015. They were divided into a persistent disease group with biochemical and structural disease (49 patients) and a disease-free group with no disease after a minimum 2 years of follow-up (175 patients). Demographic characteristics, adjuvant therapy, tumor, and lymph node features were compared.
    Results: There were no significant differences in demographic characteristics between the groups. The mean nodal yield of patients with central and lateral neck persistence was significantly lower than that of patients remaining disease free (4.8 vs. 11.9: odds ratio [OR] 0.69; 95% CI, 0.59 to 0.8;
    Conclusions: Lower lymph node yield and higher node ratio from cervical lymph node dissections are associated with persistent disease and have potential applications in surgical adequacy.
    MeSH term(s) Adolescent ; Adult ; Carcinoma, Papillary/mortality ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery ; Cohort Studies ; Databases, Factual ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision/methods ; Lymph Nodes/parasitology ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection/methods ; Neck Dissection/mortality ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/therapy ; Neoplasm Staging ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Tertiary Care Centers ; Thyroid Neoplasms/mortality ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroidectomy/methods ; Thyroidectomy/mortality ; United States
    Language English
    Publishing date 2019-10-29
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1177/0194599819886123
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  10. Article ; Online: Use of Vascular Clues to Locate Ectopic Parathyroid Glands and Predict Anatomic Abnormalities.

    Battista, Rosa Alessia / Noel, Julia E / Orloff, Lisa A

    JAMA otolaryngology-- head & neck surgery

    2020  Volume 147, Issue 2, Page(s) 211–213

    MeSH term(s) Adenoma/diagnostic imaging ; Adenoma/surgery ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Parathyroid Neoplasms/diagnostic imaging ; Parathyroid Neoplasms/surgery ; Parathyroidectomy ; Recurrent Laryngeal Nerve ; Subclavian Artery/abnormalities ; Tomography, X-Ray Computed
    Chemical Substances Contrast Media
    Language English
    Publishing date 2020-10-22
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2701825-8
    ISSN 2168-619X ; 2168-6181
    ISSN (online) 2168-619X
    ISSN 2168-6181
    DOI 10.1001/jamaoto.2020.3749
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