Endocrine surgeon-performed US guided thyroid FNAC is accurate and efficient.

Background: Ultrasound guided fine needle aspiration cytology (US-FNAC) is a key diagnostic technique used to assess thyroid nodules. This procedure has been the domain of radiologists, but it is increasingly performed by endocrine surgeons. In the present study we aimed to assess the accuracy and clinical efficiency of US-FNAC performed by endocrine surgeons.

Computed tomography myocardial perfusion imaging with 320-row detector computed tomography accurately detects myocardial ischemia in patients with obstructive coronary artery disease.

Background: Computed tomography coronary angiography (CTA) has been shown to be accurate in detecting anatomic coronary arterial obstruction, but is limited for the detection of myocardial ischemia. The primary aim of this study was to assess the accuracy of 320-row computed tomography perfusion imaging (CTP) to detect atherosclerosis causing myocardial ischemia.

Methods And Results: Fifty symptomatic patients with recent single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) underwent a comprehensive cardiac computed tomography (CT) protocol that included 320-CTA, followed by adenosine stress CTP.

Molecular microcircuitry underlies functional specification in a basal ganglia circuit dedicated to vocal learning.

Similarities between speech and birdsong make songbirds advantageous for investigating the neurogenetics of learned vocal communication--a complex phenotype probably supported by ensembles of interacting genes in cortico-basal ganglia pathways of both species. To date, only FoxP2 has been identified as critical to both speech and birdsong. We performed weighted gene coexpression network analysis on microarray data from singing zebra finches to discover gene ensembles regulated during vocal behavior.

Diagnostic accuracy of computed tomography coronary angiography according to pre-test probability of coronary artery disease and severity of coronary arterial calcification. The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) International Multicenter Study.

Objectives: The purpose of this study was to assess the impact of patient population characteristics on accuracy by computed tomography angiography (CTA) to detect obstructive coronary artery disease (CAD).

Background: The ability of CTA to exclude obstructive CAD in patients of different pre-test probabilities and in presence of coronary calcification remains uncertain.

Methods: For the CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) study, 371 patients underwent CTA and cardiac catheterization for the detection of obstructive CAD, defined as ≥50% luminal stenosis by quantitative coronary angiography (QCA).

A rare cause of bowel obstruction in pregnancy.

We present the case of a 30-year-old woman admitted at 38 weeks and 3 days gestation with a rare cause of bowel obstruction. Definitive diagnosis was not made until laparotomy. We present the unique management challenges posed and a review of the literature.

Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320 row detector computed tomography: design and implementation of the CORE320 multicenter, multinational diagnostic study.

Multidetector coronary computed tomography angiography (CTA) is a promising modality for widespread clinical application because of its noninvasive nature and high diagnostic accuracy as found in previous studies using 64 to 320 simultaneous detector rows. It is, however, limited in its ability to detect myocardial ischemia. In this article, we describe the design of the CORE320 study ("Combined coronary atherosclerosis and myocardial perfusion evaluation using 320 detector row computed tomography").

Do routinely repeated computed tomography scans in traumatic brain injury influence management? A prospective observational study in a level 1 trauma center.

Objective: To prospectively examine the clinical role of routine repeat computed tomographic scans of the brain (CTB) in patients with traumatic head injury.

Summary Background Data: The use of routine serial CTB after traumatic head injury is recommended by some authors, but remains controversial.

Methods: From March 2007 to October 2008, all patients with traumatic head injury admitted to the Royal Melbourne Hospital, a metropolitan, Level I trauma center, were prospectively studied.

Penetrating liver injury managed with a combination of balloon tamponade and venous stenting. A case report and literature review.

AAST-OIS grade V complex hepatic injuries are often fatal as a result of exsanguination. We report a patient presenting in extremis with a penetrating injury to the right kidney, liver, middle hepatic vein, diaphragm, and lung. A combination of intrahepatic balloon tamponade and hepatic venous stenting was used to control exsanguinating haemorrhage, the first time this combination has been reported.

Coronary artery stenoses: accuracy of 64-detector row CT angiography in segments with mild, moderate, or severe calcification--a subanalysis of the CORE-64 trial.

Purpose: To evaluate the influence of cross-sectional arc calcification on the diagnostic accuracy of computed tomography (CT) angiography compared with conventional coronary angiography for the detection of obstructive coronary artery disease (CAD).

Materials And Methods: Institutional Review Board approval and written informed consent were obtained from all centers and participants for this HIPAA-compliant study. Overall, 4511 segments from 371 symptomatic patients (279 men, 92 women; median age, 61 years [interquartile range, 53-67 years]) with clinical suspicion of CAD from the CORE-64 multicenter study were included in the analysis.

Outcomes of screening-detected ductal carcinoma in situ treated with wide excision alone.

Background: Ductal carcinoma in situ (DCIS) is commonly identified on screening mammography. Standard treatment for localized DCIS is wide local excision (WLE) and adjuvant radiotherapy. This approach represents overtreatment in many cases, where the DCIS would never have become clinically significant, or where less intensive treatment would have been satisfactory.

Coronary artery distensibility assessed by 3.0 Tesla coronary magnetic resonance imaging in subjects with and without coronary artery disease.

Coronary vessel distensibility is reduced with atherosclerosis and normal aging, but direct measurements have historically required invasive measurements at cardiac catheterization. Therefore, we sought to assess coronary artery distensibility noninvasively using 3.0 Telsa coronary magnetic resonance imaging (MRI) and to test the hypothesis that this noninvasive technique can detect differences in coronary distensibility between healthy subjects and those with coronary artery disease (CAD).

Mapping the NPHP-JBTS-MKS protein network reveals ciliopathy disease genes and pathways.

Nephronophthisis (NPHP), Joubert (JBTS), and Meckel-Gruber (MKS) syndromes are autosomal-recessive ciliopathies presenting with cystic kidneys, retinal degeneration, and cerebellar/neural tube malformation. Whether defects in kidney, retinal, or neural disease primarily involve ciliary, Hedgehog, or cell polarity pathways remains unclear. Using high-confidence proteomics, we identified 850 interactors copurifying with nine NPHP/JBTS/MKS proteins and discovered three connected modules: "NPHP1-4-8" functioning at the apical surface, "NPHP5-6" at centrosomes, and "MKS" linked to Hedgehog signaling.

Clinicopathologic and molecular profiles of microsatellite unstable Barrett Esophagus-associated adenocarcinoma.

Microsatellite instability (MSI) has been reported in various tumors, with colon cancer as the prototype. However, little is known about MSI in Barrett esophagus (BE)-associated adenocarcinoma. Thus, the aim of this study was to compare the clinicopathologic and molecular features of BE-associated adenocarcinomas with and without MSI.

Use and wear of anti-embolism stockings: a clinical audit of surgical patients.

The objective of this study was to determine if anti-embolism stockings are fitted and worn according to evidence-based guidelines in surgical patients. The methodology is that an observational study was undertaken during January and February, 2010. An audit tool was constructed for the recording of information on a variety of parameters relating to the correct fitting and wearing of anti-embolism stockings.

Risk factors for invasive breast cancer when core needle biopsy shows ductal carcinoma in situ.

Hypothesis: A core needle biopsy (CNB) diagnosis of ductal carcinoma in situ (DCIS) may be associated with a final diagnosis of invasive cancer. Preoperative radiologic, clinical, and pathological features may identify patients at high risk of diagnostic upstaging, who may be appropriate candidates for sentinel node biopsy at initial surgery.

Design: Review of prospectively collected database.

Hormone replacement therapy among postmenopausal women presenting with acute myocardial infarction: insights from the GUSTO-III trial.

Background: The role of hormone replacement therapy (HRT) in the prevention of cardiovascular disease has been controversial. In large observational studies, HRT appears to lower cardiovascular disease risk. However, prospective randomized trials do not substantiate this.

An ECG index of myocardial scar enhances prediction of defibrillator shocks: an analysis of the Sudden Cardiac Death in Heart Failure Trial.

Background: Only a minority of patients receiving implantable cardioverter-defibrillators (ICDs) for the primary prevention of sudden death receive appropriate shocks, yet almost as many are subjected to inappropriate shocks and device complications. Identifying and quantifying myocardial scar, which forms the substrate for ventricular tachyarrhythmias, may improve risk stratification.

Objective: This study sought to determine whether the absence of myocardial scar detected by novel 12-lead electrocardiographic (ECG) Selvester QRS scoring criteria identifies patients with low risk for appropriate ICD shocks.