Publications by authors named "Grani G"

Purpose: Although thyroid nodules are less common in the pediatric population, the risk of malignancy is higher than in adult patients. The aim of this study was to evaluate the ultrasonographic predictive factors of malignancy in thyroid nodules and to validate American College of Radiologists (ACR) TI-RADS performance in transition age patients.

Methods: One hundred forty-two patients aged between 14 and 21 years referred to the participating centers for FNA biopsy of a thyroid nodule between 2007 and 2022 were included and ultrasound reports and sonographic images were retrospectively analyzed.

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  • Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and this study examined the potential of two microRNAs, miR-146a-5p and miR-221-3p, as biomarkers for diagnosing and monitoring PTC.
  • The researchers conducted an observational study with PTC patients and healthy controls, analyzing levels of these microRNAs through digital PCR before and after surgery.
  • Results showed that both microRNAs are effective in differentiating PTC patients from healthy individuals, with specific fold changes indicating disease progression, making them useful for ongoing patient monitoring.
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Purpose: Multitarget kinase inhibitors (MKIs) are effective options in the treatment of cancer, significantly increasing the progression-free survival (PFS) of many tumors. Data about severity and prevalence of metabolic adverse events is scarce and may be significant in patients with a better survival. The aim of this study was to investigate glucose and lipids values of patients treated with lenvatinib.

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  • * Recent advancements in diagnostic methods, like TIRADS, help predict the risk of malignancy, potentially reducing the need for biopsies, though larger nodules still require cytological evaluation.
  • * Management strategies now include options like active surveillance and local treatments instead of solely relying on surgery, supported by shared decision-making tools for better clinician-patient communication.
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Context: The utility of thyroglobulin (Tg) in the follow-up of differentiated thyroid cancer (DTC) patients has been well-documented. Although third-generation immunoassays have improved accuracy, limitations persist (interfering anti-Tg antibodies and measurement variability). Evolving treatment strategies require a reevaluation of Tg thresholds for optimal patient management.

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: Effective pre-surgical planning is crucial for achieving successful outcomes in endocrine surgery: it is essential to provide patients with a personalized plan to minimize operative and postoperative risks. Preoperative lymph node (LN) mapping is a structured high-resolution ultrasonography examination performed in the presence of two endocrinologists and the operating surgeon before intervention to produce a reliable "anatomical guide". Our aim was to propose a preoperative complete model that is non-invasive, avoids overdiagnosis of thyroid microcarcinomas, and reduces medical expenses.

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  • Various US-based risk stratification systems for thyroid nodules are used globally, but inconsistent definitions and malignancy ratings create confusion and complicate comparisons between studies.
  • Interobserver variability in identifying ultrasound characteristics also hinders the consistent application of these systems.
  • In 2018, an international group of 19 experts formed the International Thyroid Nodule Ultrasound Working Group to develop the International Thyroid Imaging Reporting and Data System (I-TIRADS), starting with a lexicon and atlas of ultrasound descriptors for thyroid nodules.
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There is some controversy on the potential relationship between autoimmune processes and clinicopathologic features as well as prognosis of differentiated thyroid cancer (DTC), and the evidence is limited by its largely retrospective nature. We examined the relationship between the presence of autoimmune thyroiditis (AT) and 1-year thyroid cancer treatment outcomes in a large multicenter study using prospectively collected data. We included data from consecutive DTC patients enrolled in the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339).

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Incidental sonographic discovery of thyroid nodules is an increasingly common event in clinical practice. Less frequently, patients with cytological benign thyroid nodules have suspicious cervical lymph nodes detected by ultrasound examination or by cytological exam. Here, we discuss an intriguing case of cervical lymph node metastasis with a probable thyroid origin in a 65-year-old asymptomatic male smoker.

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Purpose: Multitargeted kinase inhibitors (MKIs) are used for the treatment of several cancers. By targeting multiple signaling pathways, MKIs have become cornerstones of the oncologic treatment. Although their use leads to important results in terms of survival, treatment with MKIs can determine important side effects the clinician must be aware of.

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Purpose: Screening programs that target healthy populations are an important tool for identifying unrecognized, asymptomatic disease. However, ultrasound screening for thyroid cancer has no obvious advantage in terms of cost-effectiveness in asymptomatic adults. There is far less consensus (and data) on the indications for screening in high-risk individuals.

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Purpose: Radioiodine I-131 (RAI) is the therapy of choice for differentiated thyroid cancer (DTC). Between 5% and 15% of DTC patients become RAI refractory, due to the loss of expression/function of iodide metabolism components, especially the Na/I symporter (NIS). We searched for a miRNA profile associated with RAI-refractory DTC to identify novel biomarkers that could be potential targets for redifferentiation therapy.

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Context: For the correct clinical application of the sonographic risk-stratification systems, the definition of independent risk features that are foundational to each system is crucial.

Objective: The aim of this study was to identify the gray-scale sonographic features independently associated with malignancy, and to compare different definitions.

Methods: This prospective, diagnostic accuracy study took place in a single thyroid nodule referral center.

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  • Recent research highlights the importance of improving risk stratification for patients with differentiated thyroid cancer (DTC) beyond the existing 2015 American Thyroid Association (ATA) guidelines.
  • A study utilizing the Italian Thyroid Cancer Observatory database analyzed 4,773 DTC cases to develop a decision tree model that predicts persistent/recurrent disease by considering a range of predictive factors.
  • The new model demonstrated better performance than the ATA guidelines by increasing sensitivity and predictive accuracy, suggesting that incorporating additional variables like age and tumor size can enhance patient risk assessment.
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Introduction: The expectation of armed confrontation is among the most stressful elements in police work. Knowledge about perceived stress and cardiovascular markers in police officers comes from simulations. However, to date, information about psychophysiological responses during high-risk occurrences is scarce.

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Background: Mountain hiking is an unpredictable activity for firefighters during the search, rescue, and firefighting. Could the quality of the uniform worn by firefighters affect psychophysiological variables?

Objective: The objective of this study was to monitor the responses of perceived exertion (RPE), musculoskeletal pain (MP), and heart rate variability (HRV) responses in firefighters using different uniforms on a 5 km mountain walking activity. The feeling of comfort, safety, and ergonomic adjustment of the two types of uniforms also was verified.

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The actual rates of suspicious thyroid nodules (TNs) and confirmed thyroid cancer (TC) in putatively "at-risk" selected populations (e.g., individuals with family history of TC) are still uncertain.

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  • * While multikinase inhibitors for RET mutations initially showed limited effectiveness and high toxicity, newer selective inhibitors like selpercatinib and pralsetinib demonstrate better efficacy and tolerability, although direct comparisons with older multikinase drugs are lacking.
  • * Advancements in high-throughput technology have uncovered rare cancer alterations, such as deletions and insertions, prompting further investigation into their functional impact and potential responsiveness to RET inhibitors. *
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Machine learning (ML) is an interdisciplinary sector in the subset of artificial intelligence (AI) that creates systems to set up logical connections using algorithms, and thus offers predictions for complex data analysis. In the present review, an up-to-date summary of the current state of the art regarding ML and AI implementation for thyroid nodule ultrasound characterization and cancer is provided, highlighting controversies over AI application as well as possible benefits of ML, such as, for example, training purposes. There is evidence that AI increases diagnostic accuracy and significantly limits inter-observer variability by using standardized mathematical algorithms.

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  • A protocol is outlined for creating organoids from human thyroid cancer cells using patient-derived cells.
  • Both organoids and primary cell lines are established, with the organoid medium enhanced by conditioned medium from the primary line.
  • This approach allows organoids to be cultured for up to 10 months while preserving their original genetic and phenotypic traits.
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  • There is significant uncertainty regarding the accuracy of ultrasound features used to predict thyroid cancer in children and young adults, particularly those in the transition age (12-21 years).
  • This meta-analysis examined 14 studies with over 1,300 thyroid nodules, revealing that certain ultrasound characteristics like suspicious lymph nodes, a 'taller than wide' shape, microcalcifications, and irregular margins are strongly associated with a higher likelihood of cancer.
  • The findings suggest that after identifying a thyroid nodule, a comprehensive ultrasound examination is critical to determine the need for further investigation, such as a biopsy, especially for nodes with those concerning features.
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