Objective: Cervical ultrasound (US) scan is a key tool for detecting metastatic lymph nodes (N1) in patients with papillary thyroid cancer (PTC). N1-PTC patients are stratified as intermediate-risk and high-risk (HR) patients, according to the American Thyroid Association (ATA) and European Thyroid Association (ETA) respectively. The aim of this study was to assess the value of post-operative cervical US (POCUS) in local persistent disease (PD) diagnosis and in the reassessment of risk stratification in N1-PTC patients.
View Article and Find Full Text PDFBull Acad Natl Med
January 2014
Context: Papillary thyroid microcarcinomas (PMC) defined as tumors ≤10 mm in diameter (including pT1a and pT3 according to the latest pTNM classification) have good prognosis, although recurrence is possible. Clinicians are interested in using a scoring system for predicting recurrences.
Objective: To identify the prognostic factors for recurrence in patients with PMC and to develop a scoring system based on lymph node involvement, multifocality, and sex.
This is the third of a series of articles targeted at biomedical physicists providing educational services to other healthcare professions, whether in a university faculty of medicine/health sciences or otherwise (e.g., faculty of science, hospital-based medical physics department).
View Article and Find Full Text PDFBackground: Riedel's thyroiditis (RT) is a rare disease characterized by a chronic inflammatory lesion of the thyroid gland with invasion by a dense fibrosis. Publications of the imaging features of RT are scarce. To our knowledge, ultrasound elastography (USE) findings have not been previously reported.
View Article and Find Full Text PDFJ Occup Environ Med
April 2010
Objective: To perform a quantitative estimate of the proportion of cancers attributable to occupational exposures in France in 2000.
Methods: Exposure data for established carcinogens were obtained from a 1994 survey and other sources. Relative risks for 23 exposure-cancer combinations were derived from meta-analyses and pooled analyses.
Although biomedical physicists provide educational services to the healthcare professions in the majority of universities in Europe, their precise role with respect to the education of the healthcare professions has not been studied systematically. To address this issue we are conducting a research project to produce a strategic development model for the role using the well-established SWOT (Strengths, Weaknesses, Opportunities, Threats) methodology. SWOT based strategic planning is a two-step process: one first carries out a SWOT position audit and then uses the identified SWOT themes to construct the strategic development model.
View Article and Find Full Text PDFPatients with acquired immunodeficiency syndrome (AIDS) have an increased risk of malignancies such as Kaposi's sarcoma, primary central nervous system lymphoma, non-Hodgkin's lymphoma, and cervical cancer, but the relative risk of other malignancies such as papillary thyroid carcinoma (PTC) is not well documented. The report describes the case of a 52-year-old HIV-infected Haitian male who presented with PTC. A post (131)I therapy whole body scan (WBS) showed abnormal uptake in several areas indicating the presence of a number of micro-metastases.
View Article and Find Full Text PDFTechniques of body scanning and imaging each give a partial picture of the cases under study, with technical limitations connected to translation parameters, scanning frequency, etc. 3D imaging can analyze foetuses, "dedicated" imaging can detect focus of inflammation(?). Will today's techniques such as scintiscanning or scanning become obsolete within the coming decade? The protection of medical personnel and patients must be improved.
View Article and Find Full Text PDFThe role of the biomedical physicist in the education of the healthcare professions has not yet been studied in a systematic manner. This article presents the first results of an EFOMP project aimed at researching and developing this important component of the role of the biomedical physicist. A background to the study expands on the reasons that led to the need for the project.
View Article and Find Full Text PDFBackground: While external factors are responsible for many human cancers, precise estimates of the contribution of known carcinogens to the cancer burden in a given population have been scarce.
Methods: We estimated the proportion of cancer deaths which occurred in France in 2000 attributable to known risk factors, based on data on frequency of exposure around 1985.
Results: In 2000, tobacco smoking was responsible for 23.
J Radiol Prot
September 2006
From December 2004 to July 2005, three reports on the effects of low doses of ionising radiation were released: ICRP (2004), the joint report of the French Academies of Science and Medicine (Tubiana et al 2005), and a report from the American Academy of Sciences (BEIR VII 2005). These reports quote the same recent articles on the biological effects of low doses, yet their conclusions diverge. The French report concludes that recent biological data show that the efficacy of defense mechanisms is modulated by dose and dose rate and that linear no threshold (LNT) is no longer plausible.
View Article and Find Full Text PDFRadiat Environ Biophys
March 2006
Recently, the risk associated with low doses of ionizing radiation has gained new interest. Here, we analyze and discuss the major differences between two reports recently published on this issue; the report of the French Academy of Sciences and of the French Academy of Medicine published in March 2005, and the BEIR VII-Phase 2 Report of the American National Academy of Sciences published as a preliminary version in July 2005. The conclusion of the French Report is that the linear no-threshold relationship (LNT) may greatly overestimate the carcinogenic effect of low doses (<100 mSv) and even more that of very low doses (<10 mSv), such as those delivered during X-ray examinations.
View Article and Find Full Text PDFSince 15 years, the indications of thyroid scintigrams have been dramatically reduced. This examination appeared useless in most cases of hypothyroidism and for the evaluation of thyroid cysts or for infracentimetric nodules. For greater solid nodules, its poor sensibility and bad specificity have resulted in its replacement by echography and fine needle biopsy.
View Article and Find Full Text PDFAim: The aim of our study was to define the usefulness of fine needle aspiration cytology (FNAC) in the assessment of loco-regional recurrence of differentiated thyroid carcinoma (DTC).
Methods: Among 1182 consecutive patients treated and followed for DTC from 1992 to 2001, we retrospectively analysed 65 FNAC results of patients presenting a suspicion of loco-regional recurrence. Recurrences were proved at histology in 35 cases and by cervical radioiodine uptake on post-therapeutic WBS (whole body scan) in nine cases.
To estimate survival of patients with loco-regional recurrences (LRRs) of differentiated thyroid carcinomas (DTCs) and to identify factors associated with survival after LRRs, we analyzed retrospective data of the 172 patients treated and followed up in our institution from 1958 to 2000 who had developed LRRs (6% of DTC patients). Ultrasound, when used, picked up 95% of the recurrences. Survival was estimated with the method of Kaplan-Meier, and associated prognostic features were studied in univariate and multivariate Cox model-based analyses.
View Article and Find Full Text PDFIodine is an essential element for thyroid hormone synthesis. Iodine disorders induced biological and/to clinical expression of thyroid dysfunction. Inappropriate iodine intake (by default or by excess) is worrying in terms of public health in France regarding the iodine deficiency and the frequency of iatrogen iodine overloads.
View Article and Find Full Text PDFNORMALLY: The production of thyroid hormones is normally stable, despite iodine supplies that may vary widely and even on sudden excess iodine. The metabolism of iodine is characterised by adapted thyroid uptake, the requirements varying on the age and physiological status of the individual (pregnancy, breastfeeding) and by insufficient supplies in several areas in France. IN THE CASE OF EXCESS: The mechanisms that permit the thyroid to adapt to a sudden or chronic excess of iodine are immature in the newborn and sometimes deficient in adults, and may lead to iodine-induced dysthyroidism.
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