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Colorectal Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Jennie Grainger, Samson Tou, Steve Schlichtemeier, William Speake, Fung Joon Foo, Frank McDermott
Surveillance: Annual colonoscopy once polyps detected with chromoendoscopy/dye spray (should be at specialist centre).Once APC confirmed and colonic adenomas – needs gastroduodenoscopy (OGD) with forward and side viewing scope (to view ampulla). If no polyps detected – 5 yearly. If polyps detected – Spigelman criteria to determine screening intervals – anything from immediate surgery to 5 years.Small bowel screening with enteroclysis, CT or MR enterography or video capsule endoscopy if family history of small bowel disease.Annual physical exam for thyroid nodules.Regular physical exam to look for desmoid tumours using CT/USS – most common cause of death.
Thyroid cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Gitta Madani, Polly S Richards
The incidence of malignancy in thyroid nodules is reported as 3%–7% (4). Although tumour size guides staging and influences prognosis of thyroid cancer, the size of a thyroid nodule correlates poorly with the risk of malignancy. The US morphology of the nodule is the best indicator of malignancy and should guide the decision to perform a fine-needle aspiration (FNA) procedure. Nodules with benign US features do not require FNA, except occasionally in patients with a high risk of thyroid malignancy (4). Nodules that have indeterminate or suspicious US features should be considered for FNA.
Regulation of the Pituitary Gland by Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
In some types of thyroid disorders, such as subacute thyroiditis or postpartum thyroiditis, symptoms can subside after a few months and laboratory tests may return to normal. However, most thyroid diseases do not resolve on their own. Common hypothyroid symptoms include fatigue, low energy, weight gain, inability to tolerate cold, slow heart rate, dry skin and constipation. Common hyperthyroid symptoms include irritability, anxiety, weight loss, fast heartbeat, inability to tolerate heat, diarrhea, and enlargement of the thyroid. Tumors, often called thyroid nodules, can have many different symptoms ranging from hyperthyroidism to hypothyroidism to swelling in the neck and compression of the structures in the neck.
Clinical and ultrasound characteristics distinguishing benign and malignant thyroid nodules in Johannesburg, South Africa
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Kershlin Naidu, Victoria Saksenberg, Nasrin Goolam Mahyoodeen
Thyroid nodules have a prevalence of up to 65% in the general population.2 Approximately 90–95% of these nodules are benign and asymptomatic at diagnosis and during follow-up,3 therefore, most can be monitored without intervention. The need to evaluate further is based on excluding thyroid cancer, which is present in 5–15% of cases. Only a minority of thyroid nodules are malignant (10%),4 symptomatic (5%) and cause thyroid dysfunction (5%). Symptoms of thyroid nodules include dysphagia, odynophagia, hoarse voice, dysphonia, dyspnoea and pain.5 Thyroid nodules that are firm on palpation, fixed to surrounding tissues and exhibit rapid growth are concerning and need to be evaluated as soon as possible.6 Increased focal uptake of thyroid nodules on 18FDG PET scanning is associated with an estimated fivefold increased risk of malignancy.7
A practical approach to the management of thyroid dysfunction during pregnancy
Published in Gynecological Endocrinology, 2022
Costanzo Moretti, Natalia Lazzarin, Elena Vaquero, Alessandro Dal Lago, Luisa Campagnolo, Herbert Valensise
Ultrasound scans represent the best approach for the diagnosis and characterization of thyroid nodules. Through this technique it is possible to evaluate their growth and risk, as well as excluding the presence of suspicious lymph nodes [59]. In addition, it is important to obtain the ultrasound characteristics of the nodules, and eventual cytological characterization, to facilitate the correct management. A nodule characterized by hypo echogenicity, blurred and irregular margins and micro calcifications should be considered as high risk. In contrast, mixed solid-cystic or spongiform nodules are generally considered as low risk lesions. During pregnancy scintigraphy and pentagastrin stimulation test are contraindicated. Moreover, various contradictory factors can interfere with a biochemical evaluation. For example, low TSH levels, generally associated with a functioning adenoma, are often found during the first trimester of pregnancy. Likewise, the evaluation of plasma thyroglobulin levels it is not recommended. Plasma calcitonin assessment, aimed at the diagnosis of medullary K, should be used in pregnancy only in women with a family history of medullary thyroid carcinoma, with MEN 2 or with RET gene mutations.
Comparison of the Effectiveness of Ethanol and Radiofrequency Ablation in the Treatment of Thyroid Nodules and Their Effects on Cosmetic Scoring
Published in Journal of Investigative Surgery, 2022
Emrah Karatay, Mirkhalig Javadov
Thyroid nodules are one of the most common clinical problems. Clinically, palpable nodules are detected in 5% of the population, and patients are likely to develop new thyroid nodules during lifetime at a rate of up to 10% [1–3]. Non-palpable nodules are more likely to be detected by ultrasound (US), and the probability of nodule detection in screening tests may exceed 50%. Similar data are obtained in the postmortem series, and even higher rates of thyroid nodules have been shown [4]. The possibility of nodules in the thyroid gland increases with age, and it is more common in females. In addition, it is more common in areas with iodine deficiency and individuals exposed to ionizing radiation [5, 6]. The prevalence of malignancy reported as a result of biopsy in thyroid nodules is about 5% and is mostly not related to the size of the nodule [7].