Publications by authors named "Hughes Elena"
Background: Patients residing in rural and frontier areas experience worse thyroid cancer outcomes than those in urban areas. This novel qualitative study sought the perspectives of rural surgeons to identify practical measures that could mitigate the disparities in thyroid cancer care between rural and urban contexts.
Methods: We contacted general and head and neck surgeons at all of California's Critical Access Hospitals (n = 35), which are remote, rural hospitals, and requested self-referral to our study through the American College of Surgeons.
Article Synopsis
- The study examines thyroid tumors with isolated RAS mutations, comparing their oncologic outcomes to tumors with isolated BRAF mutations using comprehensive molecular testing.
- A total of 368 patients with Bethesda III-VI thyroid nodules were reviewed, revealing that 14% had isolated RAS mutations, with a 46% malignancy rate but no instances of structural recurrence after 5 years.
- The findings suggest that isolated RAS-mutated tumors have lower aggressive characteristics, indicating that thyroid lobectomy may be an adequate treatment option for these patients.
Context: Molecular testing can refine the risk of malignancy in thyroid nodules with indeterminate cytology to decrease unnecessary diagnostic surgery.
Objective: This study was performed to evaluate the outcomes of cytologically indeterminate thyroid nodules managed with Afirma genomic sequencing classifier (GSC) testing.
Methods: Adult patients who underwent a biopsy at 3 major academic centers between July 2017 and June 2021 with Bethesda III or IV cytology were included.
Extent of Surgery for Medullary Thyroid Cancer and Prevalence of Occult Contralateral Foci.
JAMA Otolaryngol Head Neck Surg
March 2024
Article Synopsis
- The standard treatment for medullary thyroid cancer (MTC) is total thyroidectomy with central neck dissection, but reasons for this approach in patients with only one affected side are not well-defined.
- A study aimed to find hidden contralateral MTC lesions, which weren't visible through ultrasounds, to justify the total thyroid removal.
- From 176 patients studied, 26% had contralateral disease, and 5% had undetected lesions, suggesting genetic background influences the likelihood of hidden cancer in the other thyroid lobe.
Article Synopsis
- Indeterminate thyroid nodules with Hürthle cell cytology pose diagnostic challenges, prompting a study on the effectiveness of molecular tests like Afirma Gene Sequencing Classifier and Thyroseq v3.
- In a trial with 140 nodules, Afirma showed a higher benign call rate (84%) compared to Thyroseq (56%), indicating better reliability in identifying non-cancerous nodules.
- The results suggest that these molecular tests can significantly help patients avoid unnecessary surgeries, highlighting their importance in managing Hürthle cell nodules.
Several hypotheses have been tested to understand whole organ regulation in other organs such as the brain and kidney, but no such hypothesis has yet been proposed for ocular circulations. To some extent resolve this deficit our ex vivo mouse eye perfusion model takes the first step in elucidating the mechanisms controlling the individual components of the ocular circulation. Various isolated ocular vascular preparations have been utilized in studies of ocular vascular biology, physiology, and pharmacology, including studies on both normal and pathological conditions.
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- Molecular testing plays a significant role in diagnosing thyroid nodules, particularly those with indeterminate cytology, but its effectiveness in predicting outcomes for nodules that are already suspicious or malignant remains uncertain.
- This study aimed to assess whether molecular profiling of Bethesda V and VI thyroid nodules can improve the prognostication of oncological outcomes and aid in determining initial treatment strategies.
- Among 105 patients studied, ThyroSeq identified genomic alterations in 95% of samples, revealing that patients classified as low risk did not experience recurrence, while those at intermediate risk had some recurrence, and high-risk patients had multiple concerning mutations.
Context: Molecular testing has improved risk stratification and increased nonoperative management for patients with indeterminate thyroid nodules, but data on the long-term outcomes of current molecular tests Afirma Gene Sequencing Classifier (GSC) and Thyroseq v3 are limited.
Objective: To determine the rate of delayed operation and the false negative rate of the Afirma GSC and Thyroseq v3 in Bethesda III and IV thyroid nodules.
Methods: Prospective follow-up of a single center, randomized, clinical trial comparing the performance of Afirma GSC and Thyroseq v3 in the diagnosis of indeterminate thyroid nodules at the University of California, Los Angeles (UCLA).
Purpose: This study evaluates the differences in periodic leg movement (PLM) rates for Restless Legs Syndrome (RLS) and healthy controls when using the updated PLM scoring criteria developed by IRLSSG in 2016 versus the prior PLM scoring criteria developed by IRLSSG in 2006. Four major problems with the prior standards had been objectively identified, i.e.
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