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Real-world disease activity and sociodemographic,clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil

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World Journal of Gastroenterology 2021年第2期27卷 208-223页

作者： Cyrla Zaltman Rogério Serafim Parra Ligia Yukie Sassaki Genoile Oliveira Santana Maria de Lourdes Abreu Ferrari Sender J Miszputen Heda M B S Amarante Roberto Luiz Kaiser Junior cristina Flores Wilson R Catapani JoséMiguel Luz Parente Mauro Bafutto Odery Ramos Carolina D Gonçalves Isabella Miranda Guimaraes Jose J R da Rocha Marley R Feitosa Omar Feres Rogerio Saad-Hossne francisco Guilherme Cancela Penna Pedro Ferrari Sales Cunha Tarcia NF Gomes Rodrigo Bremer Nones Mikaell Alexandre Gouvea Faria Mírian Perpétua Palha Dias Parente António S Scotton Rosana Fusaro Caratin Juliana Senra Júlio Maria Chebli Department of Internal Medicine Federal University of Rio de JaneiroRio de Janeiro 21941-913Brazil Department of Surgery and Anatomy Ribeirão Preto Medical SchoolUniversity of São PauloRibeirao Preto 14049-900São PauloBrazil Department of Internal Medicine São Paulo State University(UNESP)Medical SchoolBotucatu 18618-687São PauloBrazil IBD Unit Federal University of BahiaSalvador 41150-000BahiaBrazil Department of Clinical Medicine Medical SchoolUniversidade Federal de Minas GeraisBelo Horizonte 30130-100Minas GeraisBrazil Department of Gastroenterology Escola Paulista de MedicinaSão Paulo 04023-900Brazil Hospital de Clinicas Universidade Federal do ParanaCuritiba 80060-900ParanaBrazil Department of Proctology Beneficencia Portuguesa Hospital/Kaiser Day HospitalSao Jose do Rio Preto 15015110São PauloBrazil Department of Gastroenterology and Hepatology Sciences Hospital de ClínicasUniversidade Federal do Rio Grande do SulPorto Alegre 90560002Rio Grande do SulBrazil Department of Gastroenterology Faculdade de Medicina do ABCSanto Andre 09060-870São PauloBrazil Department of General Medicine Gastroenterology UnitUniversity HospitalFederal University of PiauiTeresina 64049-550PiauíBrazil Department of Gastroenterology Faculdade de MedicinaUniversidade Federal de GoiásGoiania 74535-170GoiasBrazil Department of Surgery Botucatu Medical School at São Paulo State University(UNESP)Botucatu 18618687São PauloBrazil Department of Gastroenterology UNIFESPSão Paulo 04040-002Brazil IBD unit Gastroenterology DepartmentHospital Nossa Senhora das GraçasCuritiba 80810-040ParanaBrazil Department of Proctology Kaiser Hospital DiaSao Jose do Rio Preto 15015-110São PauloBrazil Health Sciences Center Epidemiology UnitState University of PiauiTeresina 64001-280PiauíBrazil Department of Gastroenterology CMIP Centro Mineiro de PesquisaJuiz de Fora 36010-570Minas GeraisBrazil Scientific Affairs Takeda Pharmaceuticals BrazilSão Paulo 04709-011Brazil Clinical Research Takeda Pharma

BACKGROUND Understanding the treatment landscape of inflammatory bowel diseases(IBD)is essential for improving disease management and patient *** is the largest Latin American country,and it presents socioeconomic and health care differences across its geographical *** country has the highest increase in IBD incidence and prevalence in Latin America,but information about the clinical and treatment characteristics of IBD is *** To describe the sociodemographic,clinical,and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast,South and Northeast/Midwest *** Multicenter,cross-sectional study with a 3-year retrospective chart review *** with moderate-to-severe Crohn’s disease(CD)or ulcerative colitis(UC)were consecutively enrolled between October 2016 and February *** CD at enrollment was defined as a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or a calprotectin level>200μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year;active UC was defined as a partial Mayo score≥*** statistics were used to analyze all *** In a total of 407 included patients,CD was more frequent than UC,both overall(264 CD/143 UC patients)and by region(CD:UC ratios of 2.1 in the Southeast,1.6 in the South and 1.2 in the Northeast/Midwest).The majority of patients were female(54.2%of CD;56.6%of UC),and the mean ages were 45.9±13.8 years(CD)and 42.9±13.0 years(UC).The median disease duration was 10.0(range:0.5-45)years for both IBD *** enrollment,44.7%[95%confidence interval(CI):38.7-50.7]of CD patients and 25.2%(95%CI:18.1-32.3)of UC patients presented with active *** than 95%of IBD patients were receiving treatment at enrollment;CD patients were commonly treated with biologics(71.6%)and immunosuppressors(67.4%),and UC patients were commonly treated with mesalazine[5-Aminosalicylic acid(5-ASA)]derivates(69.9%)and

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Disease activity Epidemiology Treatment

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WJD 5^(th) Anniversary Special Issues(2): Type 2 diabetes Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?

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World Journal of Diabetes 2014年第4期5卷 444-470页

作者： Iciar Martín-Timón cristina Sevillano-Collantes Amparo Segura-Galindo francisco Javier del Caizo-Gómez Section of Endocrinology Hospital Universitario Infanta Leonor Facul-tad de Medicina Universidad Complutense Madrid 28031 Spain

Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of *** with individuals without diabetes,patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality,and are disproportionately affected by cardiovascular *** of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension,dyslipidaemia and obesity in these *** the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk *** other non-traditional risk factors may be important in people with type 2 diabetes *** disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical *** of these risk factors could be common history for both di-abetes mellitus and cardiovascular disease,reinforcing the postulate that both disorders come independently from"common soil".The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.

关键词： Type 2 diabetes mellitus Cardiovascular disease Dyslipidaemia Blood pressure Obesity Microalbuminuria Inflammation Insulin resistance Postprandial Hyperglycaemia Homocysteine

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Limitations of multimodality imaging in the diagnosis of pannus formation in prosthetic aortic valve and review of the literature

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World Journal of Cardiology 2015年第4期7卷 224-229页

作者： Juan Bautista Soumoulou Tomás francisco Cianciulli Andrea Zappi Alberto Cozzarin María cristina Saccheri Jorge Alberto Lax Robert Guidoin Ze Zhang Department of Cardiology Hospital "Dr.Cosme Argerich"Ciudad Autónoma de Buenos Aires C1155 AHDArgentina Researcher of the Ministry of Health Government of the City of Buenos Aires Department of Pathology Hospital "Dr.Cosme Argerich"Ciudad Autónoma de Buenos Aires C1155AHDArgentina Department of Surgery and Radiology Laval University and Québec Biomaterials InstituteCHUQQuebec G1K 7P4Canada

Pannus formation is a rare complication and occurs almost exclusively in mechanical prosthetic *** consists of fibrous tissue that covers the surface of the prosthesis either concentrically or eccentrically,resulting in valve *** pathophysiology seems to be associated to a chronic inflammatory process that explains the late and insidious clinical *** diagnosis should be considered in patients with high transvalvular gradients on transthoracic echo,and workup should be completed with fluoroscopy and transesophageal *** is always surgical and recurrence is *** present a case of pannus formation in a prosthetic aortic valve and a review of the literature regarding this disorder.

关键词： Pannus formation Prosthetic aortic valve Fluoroscopy Transthoracic echocardiography Transesophageal echocardiography

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Non-Polar Chemical Constituents of Atemoya and Evaluation of the Cytotoxic and Antimicrobial Activity

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Phyton-International Journal of Experimental Botany 2021年第3期90卷 921-931页

作者： Suzana Vieira Rabêlo Fernanda Granja da Silva Oliveira Michele Miriam Calixto de Lira Livia Macedo Dutra Adilson Sartoratto Marta cristina Teixeira Duarte Maria Claudia dos Santos Luciano Maria Francilene Souza Silva Cláudia doÓPessoa Manoel Odorico de Moraes Filho Emmanoel Vilaça Costa Jackson Roberto Guedes da Silva Almeida Post-Graduate Program in Biotechnology(RENORBIO) Federal Rural University of PernambucoRecifePernambuco52171-900Brazil Post-Graduate Program in Biotechnology State University of Feira de SantanaFeira de SantanaBahia44036-900Brazil Center for Studies and Research of Medicinal Plants(NEPLAME) Federal University of San Francisco ValleyPetrolinaPernambuco56304-205Brazil Multidisciplinary Center of Chemical Biological and Agricultural Research(CPQBA)Campinas State UniversityCampinasSão Paulo13083-970Brazil National Laboratory of Experimental Oncology(LabNOE) Federal University of CearáFortalezaCeará60020-181Brazil Departament of Chemistry Federal University of AmazonasManausAmazonas69067-005Brazil

This study aimed to identify the chemical composition of essential oil from fruits(EOAF)and the hexanic crude extract from aerial parts(At-Hex)of atemoya(Annona cherimola x Annona squamosa),a hybrid belonging to the Annonaceae *** and antimicrobial activity was also *** was obtained by hydrodistillation using a Clevenger apparatus,and their composition was analyzed by gas chromatography-mass spectrometry(GC-MS)*** was tested against human tumor cell lines HCT-116(colon carcinoma),SF-295(glioblastoma),OVCAR-8(ovarian carcinoma)and HL60(leukemia)using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide(MTT)assay,while antimicrobial activity was conducted by bioauthography method against eleven microorganisms ***-four compounds were identified in the EOAF and twenty-nine in *** monoterpenes linalool(25.70%),α-pinene(10.38%),β-pinene(9.12%),transocimene(7.43%),and the sesquiterpene bicyclogermacrene(12.58%)were the major constituents of EOAF,whereas the sesquiterpene spathulenol(13.91%)was the main compound of ***-Hex showed a high cytotoxicity against SF-295(glioblastoma).These findings show an important chemotaxonomic contribution for the Annonaceae family,mainly for the Annona *** proved to be a promising source of substances with potential cytotoxic activity.

关键词： Annona GC-MS volatile compounds terpenoids biologic activities

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Selective Fetal Growth Restriction in Monochorionic Diamniotic Twins: Diagnosis and Management

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Maternal-Fetal Medicine 2022年第4期4卷 268-275页

作者： Alicia Mazer Zumaeta Maria Mar Gil Miguel Rodriguez-Fernandez Pilar Carretero JoséHector Ochoa Maria cristina Casanova Francisca Sonia Molina Department of Obstetrics and Gynecology Hospital Universitario Clinico San CecilioGranada 18016Spain Department of Obstetrics and Gynecology Hospital Matemo Provincial Dr.Raul Felipe LuciniCordoba 500oArgentina Diagnus SA Prenatal Diagnosis and Fetal Medicine CenterCordoba 5000Argentina Obstetrics and Gynecology Department Hospital Universitario de TorrejonTorrejon de Ardoz 28223MadridSpain School of Medicine Universidad Francisco de VitoriaPozuelo de Alarcon 28223MadridSpain Instituto de Investigacion Biosanitaria lbs.GRANADA Granada 18016Spain

Selective fetal growth restriction (sFGR) is a severe condition that complicates 10% to 15% of all monochorionic diamniotic (MCDA) twin pregnancies. Pregnancies complicated with sFGR are at high risk of intrauterine demise or adverse perinatal outcome for the twins. Three clinical types have been described according to the umbilical artery (UA) Doppler pattern observed in the smaller twin: type I, when the UA Doppler is normal;type II, when there is persistent absent or reversed end-diastolic blood flow in the UA Doppler;and type III, when there is intermittent absent and/or reversed end-diastolic blood flow in the UA Doppler. Clinical evolution and management options mainly depend on the type of sFGR. Type I is usually associated with a good prognosis and is managed conservatively. There is no consensus on the management of types II and III, but in earlier and more severe presentations, fetal interventions such as selective laser photocoagulation of placental anastomoses or selective fetal cord occlusion of the smaller twin may be considered. This review aims to provide updated information about the diagnosis, evaluation, follow-up, and management of sFGR in MCDA twin pregnancies.

关键词： Twins Monochorionic diamniotic twins Selective fetal growth restriction Birthweight discordance Fetal therapy Placenta

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SHIYINWANG Founder of Kaixin Cooking

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城市漫步（上海版、英文） 2019年第12期 53-53页

作者： cristina Ng 不详

First and foremost,Born in Shanghai but raised in the US,he worked in solar energy and education *** he lived in San francisco,the emphasis on fresh and seasonal whole food ingredients made him passionate about health... 详细信息

关键词： cooking raised education

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Pulmonary arterial hypertension related to human immunodeficiency virus infection:A case series

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World Journal of Cardiology 2014年第6期6卷 495-501页

作者： Inês Araújo cristina Enjuanes-Grau Carmen Jimenez Lopez-Guarch Dariusz Narankiewicz Maria J Ruiz-Cano Teresa Velazquez-Martin Juan Delgado Pilar Escribano 3~(rd) Medicine Department S?o Francisco Xavier HospitalCHLO1449-005 LisboaPortugal Cardiology Department University Hospital of Canarias38320 La LagunaTenerifeSpain Teresa Velazquez-Martin Juan DelgadoPilar EscribanoPulmonary Hypertension UnitUniversity Hospital of 12 de Octubre28041 MadridSpain Internal Medicine Department Carlos Haya Hospital29010 MálagaSpain Pulmonary Hypertension Unit University Hospital of 12 de Octubre28041 MadridSpain

AIM: To present 18 new cases of human immunodeficiency virus(HIV)-related pulmonary arterial hypertension(PAH) with presenting features,treatment options and follow-up ***: This is a single-centre,retrospective,observational study that used prospectively collected data,conducted during a 14-year period on HIV-related PAH patients who were referred to a pulmonary hy-pertension unit. All patients infected with HIV were consecutively admitted for an initial evaluation of PAH during the study period and included in our study. Right heart catheterisation was used for the diagnosis of PAH. Specific PAH treatment was started according to the physician's judgment and the recommendations for idiopathic PAH. The data collected included demographic characteristics,parameters related to both HIV infection and PAH and disease ***: Eighteen patients were included. Intravenous drug use was the major risk factor for HIV infection. Risk factors for PAH,other than HIV infection,were present in 55.5% patients. The elapsed time between HIV infection and PAH diagnoses was 12.2 ± 6.9 years. At PAH diagnosis,94.1% patients had a CD4 cell count > 200 cells/μL. Highly active antiretroviral therapy(present in 47.1% patients) was associated with an accelerated onset of PAH. Survival rates were 93.8%,92.9% and 85.7% at one,two and three years,respectively. Concerning specific therapy,33.3% of the patients were started on a prostacyclin analogue,and the rest were on oral drugs,mainly phosphodiesterase-5 inhibitors. During the follow-up period,specific therapy was de-escalated to oral drugs in all of the living ***: The survival rates of HIV-related PAH patients were higher,most likely due to new aggressive specific therapy. The majority of patients were on oral specific therapy and clinically stable. Moreover,sildenafil appears to be a safe therapy for less severe HIVrelated PAH.

关键词： Human immunodeficiency virus infection Pulmonary arterial hypertension Treatment

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Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： Alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-Rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-Leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar Sotomayor cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-Rivas Alberto Fernández-Villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel Ruiz-Mateos JoséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez JoséManuel Lomas Claudio Bueno Rosario Amaya JoséAntonio Lepe Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-Lara cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado Antonio Domínguez-Petit Alejandro Deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González Rocío González-León Carmen Grande-Cabrerizo Sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero Luis Jara Carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés Rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-Villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín francisco Ortega María Paniagua-García Amelia Peña-Rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain Department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology Service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of Virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of Seville(IBiS) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-Surgical Unit of Respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain Department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular Surgery Unit Virgen del Rocío University HospitalSevilleSpain Rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SARS-CoV-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COVID-19.

关键词： SARS-CoV-2 COVID-19 Dendritic cell Long-COVID

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Pulmonary vein stenosis:Etiology,diagnosis and management

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World Journal of Cardiology 2016年第1期8卷 81-88页

作者： Pablo Pazos-López cristina García-Rodríguez Alba Guitián-González Emilio Paredes-Galán María ángel De La Guarda álvarez-Moure Marta Rodríguez-álvarez José Antonio Baz-Alonso Elvis Teijeira-Fernández francisco Eugenio Calvo-Iglesias Andrés íniguez-Romo Department of Cardiology Complexo Hospitalario Universitario de Vigo Hospital álvaro Cunqueiro Department of Radiology Complexo Hospitalario Universitario de Vigo Hospital álvaro Cunqueiro Diagnostic Imaging Unit Galaria Empresa Pública de Servicios Sanitarios Hospital do Meixoeiro

Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.

关键词： Pulmonary vein stenosis Pulmonary vein stenosis etiology Pulmonary vein stenosis causes Pulmonary vein stenosis diagnosis Pulmonary vein stenosis management Pulmonary vein stenosis treatment

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Thyroid Nodule: Alpha Score 2.0 Classification for FNAB Selection, Multicentric Study in Latin America

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Open Journal of Radiology 2021年第4期11卷 160-174页

作者： Glenn Mena Maria cristina Chammas Carlos Mario Gonzalez Vasquez Lylian Rocío Villagómez Marco Alfredo Muñoz Pico Patricio Alejandro Montalvo Santiago Mena-Bucheli Julio Olmedo Elizabeth Quintero Pedro Henrique de Marqui Moraes Osmar Cassio Saito Hubertino Diaz Denise Romero Gabriela Velalcazar Angel Ramón Sosa Fleitas Yamil Oliver Quevedo Ontaneda Victor Ricardo Chara Alpha Imagen Radiología e Intervencionismo Quito Ecuador Hospital das Clínicas Faculdade de Medicina da Universidade de Sã o Paulo S&#227 o Paulo Brasil Hospital Pablo Tobón Uribe Medellin Colombia Hospital del Instituto Ecuatoriano de Seguridad Social Quito Sur Quito Ecuador Hospital San francisco de Quito Quito Ecuador Hospital Edgardo Rebagliati Martins Lima Perú Hospital Carlos Andrade Marín Quito Ecuador Hospital de Clínicas San José de San Martín Buenos Aires Argentina Hospital Universitario de Los Andes Mérida Venezuela Hospital de la Policía Quito Ecuador Hospital Sisol Tacna Perú

Introduction: To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. Materials and Methods: A prospective multicentric study in 10 radiological hospitals and institutions of Latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIRADS® and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. Results: Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides TNs into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIRADS of 0.77 and Bethesda of 0.91. Conclusions: Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign TN in a precise, safe and accurate way, avoiding unnecessary FNABs or determining the necessity of FNAB in cases of moderate to high suspicion of malignancy.

关键词： Thyroid Cancer-Clinical Radiology-Imaging Thyroid Nodule Alpha Score TIRADS® Thyroid Ultrasonography

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