TIRADS Management Guidelines in the Investigation of Thyroid Nodules; Illustrating the Concerns, Costs, and Performance.

Context: Ultrasound (US) risk-stratification systems for investigation of thyroid nodules may not be as useful as anticipated.

Objective: We aimed to assess the performance and costs of the American College of Radiology Thyroid Image Reporting And Data System (ACR-TIRADS).

Design Settings And Participants: We examined the data set upon which ACR-TIRADS was developed, and applied TR1 or TR2 as a rule-out test, TR5 as a rule-in test, or applied ACR-TIRADS across all nodule categories.

Three-year follow up of adrenal incidentalomas in a New Zealand centre.

Background: The international guidelines for management of adrenal incidentalomas (AI) are becoming more conservative. These changes are based on the growing body of evidence suggesting that non-functioning adenomas have a low likelihood of becoming functional or malignant over time.

Aims: To follow up at least 100 patients for 3 years who were originally found to have benign adrenal adenomas which were non-functional or had subclinical Cushing syndrome (SCS).

Characteristics of adrenal incidentalomas in a New Zealand centre.

Background: Management of adrenal incidentalomas (AI) is becoming more conservative, based on international data showing a low incidence of functional or malignant lesions. The clinical characteristics of AI in New Zealand are unknown. Therefore, whether the AI guidelines apply to the New Zealand population is also unknown.

Impact of the Christchurch earthquakes on hospital staff.

Introduction: On September 4, 2010 a major earthquake caused widespread damage, but no loss of life, to Christchurch city and surrounding areas. There were numerous aftershocks, including on February 22, 2011 which, in contrast, caused substantial loss of life and major damage to the city. The research aim was to assess how these two earthquakes affected the staff in the General Medicine Department at Christchurch Hospital.

The relationship of omental and subcutaneous adipocyte size to metabolic disease in severe obesity.

Objective: Several studies have reported the existence of a subgroup of obese individuals with normal metabolic profiles. It remains unclear what factors are responsible for this phenomenon. We proposed that adipocyte size might be a key factor in the protection of metabolically healthy obese (MHO) individuals from the adverse effects of obesity.

Natural killer cells in obesity: impaired function and increased susceptibility to the effects of cigarette smoke.

Background: Obese individuals who smoke have a 14 year reduction in life expectancy. Both obesity and smoking are independently associated with increased risk of malignancy. Natural killer cells (NK) are critical mediators of anti-tumour immunity and are compromised in obese patients and smokers.

BMI > or = 50 kg/m2 is associated with a younger age of onset of overweight and a high prevalence of adverse metabolic profiles.

Objective: To study the demographic and clinical parameters of three different categories of obesity, with particular focus on a cohort of individuals with BMI > or = 50 kg/m2, the fastest growing category of obesity.

Design: Over 700 obese individuals were studied (186 with BMI = 30-39 kg/m2, 316 with BMI = 40-49 kg/m2 and 290 with BMI > or = 50 kg/m2).

Results: Median BMI was 51 kg/m2 for patients who reported onset of overweight before 15 years of age, 47 kg/m2 for patients who reported onset between 15 and 30 years, and 42 kg/m2 for patients who became overweight after 30 years of age.

Bone mineral density in cystic fibrosis: benefit of exercise capacity.

The aim of this study was to evaluate the association between bone mineral density (BMD) and objective maximal exercise measurements in adults with cystic fibrosis (CF). Twenty-five CF patients (19 males, 6 females, mean age 25.5 yr, range: 17-52) underwent BMD assessment and maximal-cycle ergometer exercise testing.