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  1. Article ; Online: General Principles for the Safe Performance, Training, and Adoption of Ablation Techniques for Benign Thyroid Nodules: An American Thyroid Association Statement.

    Sinclair, Catherine F / Baek, Jung Hwan / Hands, Kathleen E / Hodak, Steven P / Huber, Timothy C / Hussain, Iram / Lang, Brian Hung-Hin / Noel, Julia E / Papaleontiou, Maria / Patel, Kepal N / Russ, Gilles / Russell, Jonathon / Spiezia, Stefano / Kuo, Jennifer H

    Thyroid : official journal of the American Thyroid Association

    2023  Volume 33, Issue 10, Page(s) 1150–1170

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Humans ; Thyroid Nodule/surgery ; Treatment Outcome ; Ablation Techniques/adverse effects ; Consensus ; Catheter Ablation/methods
    Language English
    Publishing date 2023-09-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1086044-7
    ISSN 1557-9077 ; 1050-7256
    ISSN (online) 1557-9077
    ISSN 1050-7256
    DOI 10.1089/thy.2023.0281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3307: Show issues Location:
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    Zs.MO 106: Show issues

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  2. Article ; Online: Enlarged benign-appearing cervical lymph nodes by ultrasonography are associated with increased likelihood of cancer somewhere within the thyroid in patients undergoing thyroid nodule evaluation.

    Hands, Kathleen E / Cervera, Antonio / Fowler, Larry J

    Thyroid : official journal of the American Thyroid Association

    2010  Volume 20, Issue 8, Page(s) 857–862

    Abstract: Background: Benign-appearing cervical lymph nodes (CLN) are easy to assess during an ultrasonography (US) evaluation for a guided fine-needle aspiration biopsy of a suspicious thyroid nodule, but their clinical significance regarding thyroid cancer risk ...

    Abstract Background: Benign-appearing cervical lymph nodes (CLN) are easy to assess during an ultrasonography (US) evaluation for a guided fine-needle aspiration biopsy of a suspicious thyroid nodule, but their clinical significance regarding thyroid cancer risk is not known. Non-malignant-appearing nodes may be an indicator of early malignancy in the thyroid. We hypothesize that there is an increased prediction of thyroid cancer when benign-appearing enlarged CLN (ECLN) > 1 cm in any dimension are present during an US evaluation of thyroid nodules.
    Method: A review of 269 consecutive patients' charts sent for thyroid nodule assessment that underwent thyroidectomy was conducted to compare ECLN, with the presence of thyroid cancer during an ultrasound-guided fine-needle aspiration biopsy of the thyroid nodule. Surgical excision pathology confirmed all abnormal cytology reports.
    Results: From the final 265 charts reviewed, 213 had benign thyroid pathology and 52 had thyroid cancer. Sex, number, and size of the biggest thyroid nodule were not different between groups. Patients with cancer were on average 10 years younger and had higher thyroid-stimulating hormone (TSH) values (p < 0.003) as well as a 10-fold increase in enlarged non-malignant-appearing lymph nodes than their peers without cancer. The presence of ECLN had an 82% sensitivity, 90% specificity, and a 68% positive predictive value for thyroid cancer. There was also an 80% negative predictive value when enlarged lymph nodes were not present. In 8 of the 37 (21.6%) patients with malignancy and ECLN, the primary dominant thyroid nodule was negative on cytologic evaluation, but malignancies were confirmed on surgical specimen, in contralateral nodules on the same side as the ECLN. These nodules were mostly subcentimeric, ranging from 0.2 to 1.14 cm and were not biopsied due to their inconspicuous appearance. After multiple logistic regression analysis, enlarged lymph nodes had a 53.8 odds ratio for cancer (20.49-141.33, p < 0.01).
    Conclusion: Discovering the presence of ECLN in routine assessment of thyroid nodules is an easy and fast surveillance technique that increases the predictive value in diagnosing thyroid cancer, especially when the enlarged lymph nodes are on the same side as the thyroid nodule.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle/methods ; Cross-Sectional Studies ; Female ; Humans ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology ; Thyroid Nodule/metabolism ; Ultrasonography/methods
    Language English
    Publishing date 2010-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1086044-7
    ISSN 1557-9077 ; 1050-7256
    ISSN (online) 1557-9077
    ISSN 1050-7256
    DOI 10.1089/thy.2009.0464
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3307: Show issues Location:
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    Zs.MO 106: Show issues

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  3. Article ; Online: Gonadotropin-releasing hormone agonist-induced pituitary apoplexy in treatment of prostate cancer: case report and review of literature.

    Hands, Kathleen E / Alvarez, Andrea / Bruder, Jan M

    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

    2007  Volume 13, Issue 6, Page(s) 642–646

    Abstract: Objective: To describe a case and review the literature on the rare complication of pituitary apoplexy after administration of a gonadotropin-releasing hormone agonist (GnRHa) for treatment of patients with prostate cancer.: Methods: We present a ... ...

    Abstract Objective: To describe a case and review the literature on the rare complication of pituitary apoplexy after administration of a gonadotropin-releasing hormone agonist (GnRHa) for treatment of patients with prostate cancer.
    Methods: We present a detailed case report of a patient with immediate signs of pituitary apoplexy after receiving a GnRHa and review the 6 previously reported cases in the literature. A 60-year-old man presented to a local hospital with severe headache, nausea, vomiting, and diplopia. Prostate cancer had recently been diagnosed, and he had received his first dose of a GnRHa 4 hours before this presentation. On physical examination, he was confused and had ptosis of the left eye. A head computed tomographic scan without contrast enhancement showed soft tissue filling the sella, without intracranial hemorrhage or mass effect. He was discharged with the diagnosis of viral meningitis. Three weeks later, he presented again with severe headache and diplopia. He had confusion, lethargy, disorientation, a blood pressure of 88/64 mm Hg, and left cranial nerve III, IV, and VI paralysis. Magnetic resonance imaging of the brain revealed an enhancing pituitary mass with hemorrhage extending to the optic chiasm, consistent with pituitary apoplexy. Laboratory results were consistent with panhypopituitarism. Surgical excision revealed a necrotic pituitary macroadenoma with hemorrhage. Tumor immunohistochemical staining was positive only for luteinizing hormone.
    Conclusion: We describe a rare adverse effect of GnRHa therapy, which unmasked a gonadotropin-secreting pituitary macroadenoma. This case adds to the 6 previously reported cases of GnRHa administration inducing pituitary apoplexy in men with prostate cancer.
    MeSH term(s) Gonadotropin-Releasing Hormone/adverse effects ; Gonadotropin-Releasing Hormone/therapeutic use ; Headache/chemically induced ; Humans ; Male ; Middle Aged ; Nausea/chemically induced ; Pituitary Apoplexy/chemically induced ; Pituitary Apoplexy/diagnosis ; Prostatic Neoplasms/drug therapy ; Vomiting/chemically induced
    Chemical Substances Gonadotropin-Releasing Hormone (33515-09-2)
    Language English
    Publishing date 2007-10
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1473503-9
    ISSN 1934-2403 ; 1530-891X
    ISSN (online) 1934-2403
    ISSN 1530-891X
    DOI 10.4158/EP.13.6.642
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5034: Show issues Location:
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    Zs.MO 508: Show issues

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  4. Article: Detection of subsequent episodes of gestational diabetes mellitus: a need for specific guidelines.

    Maser, Raelene E / Lenhard, M James / Henderson, Bernardine C / Cobb, Rosemary S / Hands, Kathleen E

    Journal of diabetes and its complications

    2004  Volume 18, Issue 2, Page(s) 86–90

    Abstract: Guidelines for detection of individuals with gestational diabetes mellitus (GDM) indicate that glucose testing for women with a history of GDM should occur as soon as feasible with retesting of an initially negative screen to occur between the 24th and ... ...

    Abstract Guidelines for detection of individuals with gestational diabetes mellitus (GDM) indicate that glucose testing for women with a history of GDM should occur as soon as feasible with retesting of an initially negative screen to occur between the 24th and 28th week of gestation. The aim of this study was to evaluate medical records for individuals enrolled in a GDM management program that presented with two subsequent pregnancies with GDM and to determine if more specific guidelines for detection are needed. Records (n=60) from both pregnancies were reviewed for gestational age at enrollment, delivery, and when insulin was started, infant birth weights and complications (e.g., hypoglycemia), and maternal complications (e.g., emergency cesarean section). Over half [33/60 (55%)] of the women required insulin during both pregnancies, while 16.7% (10/60) required insulin during the second enrollment for GDM but not the first. For those requiring insulin during both pregnancies, 88% (29/33) required it earlier during the subsequent pregnancy (31.5+/-2.7 vs. 21.6+/-8.4 weeks of gestation, P<.001). During the subsequent pregnancy, approximately 1/2 of the women requiring insulin needed it before the 24th week of gestation while 1/3 required it by the 15th week. Also during the subsequent pregnancy, neonate birth weights declined (3494+/-521 vs. 3356+/-515 g, P<.05) and there were fewer complications. Given that approximately 70% of the women required insulin therapy during a subsequent GDM pregnancy and that this therapy was on average necessary by the 22nd week of gestation, we recommend that specific guidelines be established with a definitive time frame determined for the detection of repeat episodes of GDM.
    MeSH term(s) Diabetes, Gestational/classification ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/prevention & control ; Female ; Guidelines as Topic ; Humans ; Insulin/therapeutic use ; Medical Records ; Pregnancy ; Pregnancy Complications/classification ; Pregnancy Complications/epidemiology ; Recurrence ; Retrospective Studies
    Chemical Substances Insulin
    Language English
    Publishing date 2004-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1105840-7
    ISSN 1056-8727
    ISSN 1056-8727
    DOI 10.1016/S1056-8727(02)00251-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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