Annals of Saudi medicine最新文献

{"title":"Predicting COVID-19 outcomes with the Edmonton Obesity Staging System.","authors":"Sajjad Ali, Omar Sufyan Khan, Amira M Youssef, Iram Saba, Leena Alqahtani, Renad Abdulaziz Alduhaim, Renad Almesned","doi":"10.5144/0256-4947.2024.116","DOIUrl":"https://doi.org/10.5144/0256-4947.2024.116","url":null,"abstract":"<p><strong>Background: </strong>Multiple studies have demonstrated a correlation between a high body mass index and discriminatory COVID-19 outcomes. Studies appear to indicate that there is a correlation between obesity-related comorbidities and less favorable outcomes.</p><p><strong>Objectives: </strong>The primary aim of the current investigation is to conduct a thorough assessment of the correlation between BMI and comorbidities associated with obesity, and their potential impact on the severity and consequences of COVID-19 infection among patients receiving care in a tertiary healthcare setting.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Settings: </strong>Tertiary rehabilitation center, Riyadh, Saudi Arabia.</p><p><strong>Patients and methods: </strong>The study included all individuals who received medical treatment and tested positive for COVID-19 by means of RT-PCR during the period from March to September 2020. COVID-19 patients were classified using Edmonton Obesity Staging System (EOSS).</p><p><strong>Main outcome measures: </strong>COVID-19-related complications, including pneumonia and cytokine release syndrome, as well as the time length to COVID-19 negativization.</p><p><strong>Sample size: </strong>315 patients.</p><p><strong>Results: </strong>The median (25th-75th percentiles) age of the patients was 38 (31.5-49) years old. Males outnumbered females, and 66% of patients were non-Saudis. Forty-eight patients (15.2%) had obesity class I, whereas 13 patients (4.1%) had class II. Thirty-two patients (10.2%) were classified as EOSS stage 1, 105 patients (33.3%) were classified as EOSS stage 2, and 25 patients (7.9%) were assigned to EOSS stage 3. Males predominated in EOSS stages 1 and 2, whereas females predominated in stage 3. In EOSS stage 3, 52% of cases had moderate severity and 48% had severe illness.</p><p><strong>Conclusions: </strong>EOSS distinguishes the COVID-19 risks of poor outcomes beyond BMI. Patients who were overweight or obese but remained in the stage 1 of the EOSS had a lower risk of a poor COVID-19 outome than normal-weight patients. The health status of obese patients is a more precise indicator of the progression of COVID-19 during hospitalization than BMI alone.</p><p><strong>Limitations: </strong>Given the limited capacity of urgent care facilities to conduct a comprehensive evaluation of comorbidities and other relevant outcomes in all patients, it is plausible that certain patients may have been erroneously classified with an EOSS stage 2 diagnosis, when in fact they ought to have been assigned a stage 3 diagnosis.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 2","pages":"116-125"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile of functional constipation in Saudi children.","authors":"Mohammad El Mouzan, Mohammed Kambal, Hayfa Alabdulkarim, Nawaf Rahi Alshammari, Rehab Alanazi, Ahmed Al Sarkhy, Nouf Alhamid, Asaad Muhammed Assiri, Alhanouf Alzahrani, Shaffi Ahamed Shaik, Mona Alasmi","doi":"10.5144/0256-4947.2024.111","DOIUrl":"https://doi.org/10.5144/0256-4947.2024.111","url":null,"abstract":"<p><strong>Background: </strong>Functional constipation (FC) is a common condition in children, and information on the clinical characteristics of FC in Saudi children is scarce.</p><p><strong>Objective: </strong>Describe the clinical profile of FC in Saudi children.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>Hospital that provides primary, intermediate and tertiary care.</p><p><strong>Patients and methods: </strong>All children diagnosed with FC according to the Rome IV criteria were included and had at least one follow-up clinic visit. Demographic and clinical data collected from medical records included the age at onset, duration of constipation, clinical features, treatment modalities, and factors associated with clinical response. Descriptive statistics and Pearson's chi-squared test were used in the statistical analysis to see how categorical study variables were linked to clinical response. A P value of ≤.05 was used to report statistical significance.</p><p><strong>Main outcome measure: </strong>Compliance and clinical response to polyethylene glycol (PEG) compared with lactulose.</p><p><strong>Sample size: </strong>370 children from 0.1 to 13 years of age.</p><p><strong>Results: </strong>The median (IQR) age of onset was 4 (5) years and less than one year in 14%. The median (IQR) duration of constipation was 4 months (11) and less than two months in 93/370 (25%). Abdominal pain was the most commonly associated feature (44%). Screening for celiac disease and hypothyroidism was negative. A Fleet enema was the most common disimpaction method (54%) and PEG was the most common maintenance medication (63.4%). PEG was significantly better tolerated (<i>P</i>=.0008) and more effective than lactulose (<i>P</i><.0001). Compliance was the only variable significantly associated with clinical response.</p><p><strong>Conclusions: </strong>PEG was better tolerated and more effective than lactulose in our study, a finding in agreement with the literature. Therefore, PEG should be the drug of choice in the initial management of FC in Saudi children. Prospective studies on the causes of noncompliance are needed to improve the response to treatment.</p><p><strong>Limitations: </strong>The limitations of retrospective design are missing data, recall bias, and hospital-based limitation, such as missing milder cases treated at the outpatient level. However, the sample size of 370 may have minimized these limitations.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 2","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin and risk of hematological cancers in patients with diabetes: a systematic review and meta-analysis.","authors":"Min Wang, Giti Noghabaei, Tahereh Raeisi, Dandan Li, Hamzeh Alizadeh, Mohammad Alizadeh","doi":"10.5144/0256-4947.2024.126","DOIUrl":"10.5144/0256-4947.2024.126","url":null,"abstract":"<p><strong>Funding: </strong>No external funding.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 2","pages":"126-134"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The variation in preventable hospitalization in patients with type 2 diabetes in Kentucky before and after the Medicaid expansion.","authors":"Turky Arbaein, Bert Little, Sarah Monshi, Ahmed M Al-Wathinani, Amal Zaidan","doi":"10.5144/0256-4947.2024.73","DOIUrl":"https://doi.org/10.5144/0256-4947.2024.73","url":null,"abstract":"<p><strong>Background: </strong>Hospitalizations are more resource intensive and expensive than outpatient care. Therefore, type 2 diabetes-related preventable hospitalization are a major topic of research efficiency in the healthcare system.</p><p><strong>Objectives: </strong>Analyze county level variation in type 2 diabetes-related preventable hospitalization rates in Kentucky before the Medicaid expansion (2010-2013) and after the Medicaid expansion (2014-2017).</p><p><strong>Design: </strong>Geographic mapping and cluster analysis.</p><p><strong>Setting: </strong>Data for a state of the United States of America.</p><p><strong>Methods: </strong>We used the KID data to generate geographic mapping for type 2 diabetes-related preventable hospitalizations to visualize rates. We included all Kentucky discharges of age 18 years and older with the ICD9/10 principal diagnosis code for type 2 diabetes. Then, we conducted cluster analysis techniques to compare county-level variation in type 2 diabetes-related preventable hospitalization rates across Kentucky counties pre- and post-Medicaid expansion.</p><p><strong>Main outcome and measures: </strong>County type 2 diabetes-related preventable hospitalization pre- and post-Medicaid expansion.</p><p><strong>Results: </strong>From 2010-2017, type 2 diabetes-related preventable hospitalization discharge rates reduced significantly in the period of the post-Medicaid expansion (<i>P</i>=.001). The spatial statistics analysis revealed a significant spatial clustering of counties with similar rates of type 2 diabetes-related preventable hospitalization in the south, east, and southeastern Kentucky pre- and post-Medicaid expansion (positive z-score and positive Moran's Index value (<i>P</i>>.05). Also, there was a significant clustering of counties with low type 2 diabetes-related preventable hospitalization rates in the north, west, and central regions of the state pre-Medicaid expansion and post-Medicaid expansion (positive z-score and positive Moran's Index value (<i>P</i>>.05).</p><p><strong>Conclusion: </strong>Kentucky counties in the southeast have experienced a significant clustering of highly avoidable hospitalization rates during both periods. Focusing on the vulnerable counties and the economic inequality in Kentucky could lead to efforts to lowering future type 2 diabetes-related preventable hospitalization rates.</p><p><strong>Limitations: </strong>We used de-identified data which does not provide insights into the frequency of hospitalizations per patient. An individual patient may be hospitalized several times and counted as several individuals.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 2","pages":"73-83"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does red blood cell transfusion affect clinical outcomes in critically ill patients? A report from a large teaching hospital in south Iran.","authors":"Vida Naderi-Boldaji, Farid Zand, Naeimehossadat Asmarian, Mahsa Banifatemi, Mansoor Masjedi, Golnar Sabetian, Maryam Ouhadian, Najmeh Bayati, Hamideh Saeedizadeh, Nima Naderi, Leila Kasraian","doi":"10.5144/0256-4947.2024.84","DOIUrl":"https://doi.org/10.5144/0256-4947.2024.84","url":null,"abstract":"<p><strong>Background: </strong>Despite the beneficial effects, RBC transfusion can be associated with infectious and non-infectious complications in critically ill patients.</p><p><strong>Objectives: </strong>Investigate current RBC transfusion practices and their effect on the clinical outcomes of patients in intensive care units (ICUs).</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Three mixed medical-surgical adult ICUs of a large academic tertiary hospital.</p><p><strong>Patients and methods: </strong>From March 2018 to February 2020, all adult patients admitted to medical or surgical ICU. Patients who received one or more RBC transfusions during the first month of ICU admission were included in the \"transfusion\" group, while the remaining patients were assigned to the \"non-transfusion\" group.</p><p><strong>Main outcome measures: </strong>Mortality and length of ICU and hospital stay.</p><p><strong>Sample size: </strong>2159 patients.</p><p><strong>Results: </strong>Of 594 patients who recieved transfusions, 27% of patients received red blood cell (RBC) products. The mean pre-transfusion hemoglobin (Hb) level was 8.05 (1.46) g/dL. There was a significant relationship between higher APACHE II scores and ICU mortality in patients with Hb levels of 7-9 g/dL (OR adjusted=1.05). Also, ICU mortality was associated with age (OR adjusted=1.03), APACHE II score (OR adjusted=1.08), and RBC transfusion (OR adjusted=2.01) in those whose Hb levels were >9 (g/dl).</p><p><strong>Conclusion: </strong>RBC transfusion was associated with an approximately doubled risk of ICU mortality in patients with Hb>9 g/dL. High APACHE II score and age increase the chance of death in the ICU by 8% and 3%, respectively. Hence, ICU physicians should consider a lower Hb threshold for RBC transfusion, and efforts must be made to optimize RBC transfusion practices.</p><p><strong>Limitations: </strong>Single-center and retrospective study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 2","pages":"84-92"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Genetic Polymorphisms Associated with COVID-19 Disease Susceptibility and Mortality in a Kurdish Population.","authors":"Mostafa Hadat","doi":"10.5144/0256-4947.2024.66","DOIUrl":"10.5144/0256-4947.2024.66","url":null,"abstract":"","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 1","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"West Nile virus seropositivity in Alanya, a coastal city in the Mediterranean region of Turkey.","authors":"Bayhan Bektore, Bora Dogan, Akyut Ozkul, Aysegul Gozalan","doi":"10.5144/0256-4947.2024.48","DOIUrl":"10.5144/0256-4947.2024.48","url":null,"abstract":"<p><strong>Background: </strong>West Nile virus (WNV)-related illness is a global health problem. Understanding the seropositivity rates and identifying the risk factors related to WNV in various animal species including humans is crucial for the implementation of effective prevention strategies.</p><p><strong>Objectives: </strong>Assess the rate of seropositivity and the risk factors associated with WNV seropositivity.</p><p><strong>Design: </strong>Descriptive, cross-sectional.</p><p><strong>Setting: </strong>Microbiology and virology departments in a veterinary college.</p><p><strong>Patients and methods: </strong>In a sample of healthy human participants in Alanya, located close to regions where WNV activity has been detected, anti-WNV IgG antibody detection was performed using enzyme-linked immunosorbent assays. The positive results were confirmed by virus neutralization tests (VNTs). The sample was compared with a second group of age- and gender-matched healthy subjects selected from a previous cross-sectional study.</p><p><strong>Main outcome measures: </strong>Determination of the seropositivity and risk factors that were associated with WNV in healthy humans.</p><p><strong>Sample size: </strong>87 in current study; 356 in previous study.</p><p><strong>Results: </strong>The first group of 87, which had a high risk of encountering vector mosquitoes, had a positivity rate of 8% (7/87), whereas positivity in the second group was 4.5% (16/356; <i>P</i>=.181). In the entire sample, the anti-WNV IgG antibody was positive in 23 out of 443 (5.2%) samples by the ELISA test. Among these 23 samples, ten were confirmed as positive using VNTs. Therefore, the WNV IgG seropositivity was 2.3% (10/442). Confirmed IgG seropositivity rates were higher among male (3.8%) than female participants (0.9%; <i>P</i>=.054) and among adults aged ≥45 years (4%) than those aged 18-44 years (0.8%; <i>P</i>=.048).</p><p><strong>Conclusion: </strong>This study highlights the presence of WNV infection in the research region. More comprehensive and multidisciplinary studies are required to increase our knowledge about this zoonotic infection including risk factors in line with the One Health approach.</p><p><strong>Limitations: </strong>Small sample size.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 1","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective review of non-ST segment elevation acute coronary syndrome presenting to the emergency department of a major tertiary center in Saudi Arabia.","authors":"Muhammad Nauman Qureshi, Eman Nayaz Ahmed, Khaled Abdulrahman Ahmed, Eyad Bashtawi","doi":"10.5144/0256-4947.2024.1","DOIUrl":"10.5144/0256-4947.2024.1","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) comprises a spectrum of diseases ranging from unstable angina (UA), non-ST elevation myocardial infarction (non-STEMI) and ST elevation myocardial infarction (STEMI). Treatment of ACS without STEMI (NSTEMI-ACS) can vary, depending on the severity of presentation and multiple other factors.</p><p><strong>Objective: </strong>Analyze the NSTEMI-ACS patients in our institution.</p><p><strong>Design: </strong>Retrospective observational.</p><p><strong>Setting: </strong>A tertiary care institution with accredited chest pain center.</p><p><strong>Patients and methods: </strong>The travel time from ED booking to the final disposition for patients presenting with chest pain was retrieved over a period of 6 months. The duration of each phase of management was measured with a view to identify the factors that influence their management and time from the ED to their final destination. The data was analyzed using descriptive statistics.</p><p><strong>Main outcome measures: </strong>Travel time from ED to final destination.</p><p><strong>Sample size: </strong>300 patients.</p><p><strong>Results: </strong>The majority of patients were males (64%) between 61 and 80 years of age (45%). The median disposition time (from ED booking to admission order by the cardiology team) was 5 hours and 19 minutes. Cardiology admissions took 10 hours and 20 minutes from ED booking to the inpatient bed. UA was diagnosed in 153 (51%) patients and non-STEMI in 52 (17%). Coronary catheterization was required in 79 (26%) patients, 24 (8%) had coronary artery bypass grafting (CABG) and 8 (3%) had both catheterization and CABG.</p><p><strong>Conclusion: </strong>The time from ED booking to final destination for NSTEMI-ACS patients is delayed due to multiple factors, which caused significant delays in overall management. Additional interventional steps can help improve the travel times, diagnosis, management and disposition of these patients.</p><p><strong>Limitations: </strong>Single center study done in a tertiary care center so the results from this study may not be extrapolated to other centers.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in Cushing's disease: a systematic review and meta-analysis.","authors":"Basel F Alqeeq, Mohammed Ayyad, Waseem J Almadhoun, Mohammad Aboabdo, Mosheer S Aldahdouh, Mohammed Al-Tawil, Ahmed M Al-Ghazali","doi":"10.5144/0256-4947.2024.55","DOIUrl":"10.5144/0256-4947.2024.55","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cushing's disease is a rare endocrine disorder. This review aimed to examine sex-specific differences in Cushing's disease.</p><p><strong>Design and settings: </strong>A meta-analysis was performed on published articles discussing the gender impact of Cushing's disease.</p><p><strong>Methods: </strong>A systematic search was conducted to identify studies from Medline, Embase, CENTRAL and Scopus. Nine studies enrolling 1047 patients diagnosed with Cushing's disease were included in this meta-analysis.</p><p><strong>Results: </strong>Male patients presented at a younger age (MD [mean difference]=-5.43; 95% CI [-5.78, -5.08]; <i>P</i><.00001) than females. Male patients had a significantly higher prevalence of osteoporosis (RR [risk ratio]=1.75; 95% CI [1.36, 225]; <i>P</i><.0001) and hypokalemia (RR=1.66; 95% CI [1.27, 2.16]; <i>P</i>=.0002). In addition, males had significantly higher rates of negative magnetic resonance imaging (RR=1.53; 95% CI [1.18, 2.0]; <i>P</i>=.002). No sex difference was observed in the prevalence of diabetes (RR=0.92; 95% CI [0.70, 1.22]); <i>P</i>=.57) and dyslipidemia (RR=1.33; 95% CI [0.88, 2.0]; <i>P</i>=.17).</p><p><strong>Conclusion: </strong>Cushing's disease has a worse clinical presentation in males and more diagnostic difficulties compared to females.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 1","pages":"55-65"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid fine-needle aspiration cytology: malignancy rate in the category of indeterminate significant atypia/indeterminate significant follicular lesion.","authors":"Neslihan Kaya Terzi, Tolga Terzi","doi":"10.5144/0256-4947.2024.31","DOIUrl":"10.5144/0256-4947.2024.31","url":null,"abstract":"<p><strong>Background: </strong>Fine needle aspiration cytology (FNAC) is a standard preoperative diagnostic modality for thyroid nodules. The Bethesda Thyroid Cytopathology Reporting System (TBSRTC) defines the FNAC atypia group as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS).</p><p><strong>Objectives: </strong>Determine the risk of malignancy after surgical resection in patients with AUS/FLUS.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>Pathology department of a tertiary care center.</p><p><strong>Patients and methods: </strong>All thyroid FNACs between 2015 and 2023 that were diagnosed as AUS/FLUS in Turkey. Patient demographics, preoperative ultrasonographic features, and follow-up data were collected.</p><p><strong>Main outcome measures: </strong>Relationship between AUS/FLUS diagnosis and final histopathological diagnosis.</p><p><strong>Sample size: </strong>562.</p><p><strong>Results: </strong>In total, 562 thyroid nodules were diagnosed as AUS/FLUS, and 267 (47.5%) were surgically excised. A malignant histopathological diagnosis was given in 28 cases (10.4%). Malignancy risk sensitivity of AUS/FLUS diagnosis was 75.68% (95% CI=58.80-88.23%), specificity was 55.24% (95% CI=50.91-59.52%), positive predictive value was 10.49% (95% CI=8.71-12.58%), and negative predictive value was 97.04% (95% CI=94.86-98.31%). In the ultrasonographic data, having symptomatic nodules, nodule calcification, and irregular nodule borders were all statistically significant signs of cancer in a one-variable analysis (<i>P</i><.01). The presence of a family history emerged as a statistically significant prognostic marker for malignancy (<i>P</i>=.012). Although not statistically significant, the malignancy rate for nodules with nuclear atypia was 11.9%, significantly higher than the rate of 8.3% for nodules with architectural atypia only (<i>P</i>=0.32).</p><p><strong>Conclusions: </strong>The diagnosis of AUS/FLUS has a high rate of predicting the risk of malignancy and should continue to be offered. In addition to cytopathological features, ultrasound data and family history should be taken into consideration when evaluating the case.</p><p><strong>Limitations: </strong>Retrospective design and no molecular studies.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 1","pages":"31-38"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}