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Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第3期14卷 195-206页

作者： massimo giusti Davide ORLANDI Giulia MELLE Barbara MASSA Enzo SILVESTRI Francesco MINUTO Gianni TURTULICI Endocrine Unit San Martino University Hospital Radiology Unit Evangelico Hospital Cytopathology and Pathology Unit San Martino University Hospital

Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic *** aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological *** study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo ***-histological correlation was available for 38 *** correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was *** addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were *** showed the best specificity and PPV,and FNAB the best *** was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological *** significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other *** sensitivity of the ELX 2/1 index was high,but its specificity was very *** accuracy and PPV of USE were lower than those of the other *** the correlation between Peak index and cumulative US findings reached a value close to *** ultimate aim is to minimise unnecessary *** and FNAB continue to play a central diagnostic *** use of a US score showed high specificity and *** specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological *** and CEUS are innovative techniques that need to be standa

关键词：甲状腺疾病治疗疗效临床

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Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2009年第5期10卷 323-330页

作者： massimo giusti Mara DOLCINO Lara VERA Carla GHIARA Francesca MASSARO Laura FAZZUOLI Diego FERONE Michele MUSSAP Francesco MINUTO Department of Endocrinology San Martino University Hospital Analysis Laboratory San Martino University Hospital

Assaying parathyroid hormone(PTH) in the washing liquid after fine-needle aspiration biopsy(FNAB) seems to be a valid approach to locate parathyroid ***-FNAB was evaluated in 47 patients with a clinical picture of primary hyper-parathyroidism(PHP) and ultrasonography(US) suggestive of parathyroid *** patients were subdivided into two groups on the basis of the absence or presence of US thyroid *** result of PTH-FNAB was compared with those of cytology,scintigraphy and,in 24 patients,surgical ***-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid *** proved diagnostic for benign thyroid lesions,non-diagnostic for thyroid lesions,hyperplastic parathyroid tissue,undetermined or malignant thyroid lesions and other lesions in 45%,30%,17%,4%,and 4% of cases,*** 47% of cases,PTH-FNAB indicated that the sample had been taken in parathyroid *** patients without US alterations,the diagnostic accuracy of PTH-FNAB was greater than that of *** surgery,comparison between the results of PTH-FNAB and scintigraphy,in terms of positive predictive value(PPV),revealed the superiority of PTH-FNAB;PPV was 94% for FNAB and 71% for scintigraphy,while sensitivity was 83% and 69%,***-FNAB evaluation after FNAB appears to be more diagnostic than cytology and *** all the procedures used,PTH-FNAB appears to be the method of choice when the target is US suggestive and ***-FNAB appears to be a useful method of guiding surgical intervention.

关键词：甲状旁腺激素组织活检评价洗手抽吸机构手术治疗

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Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2011年第3期12卷 163-173页

作者： massimo giusti Giulia MELLE Monica FENOCCHIO Lorenzo MORTARA Francesca CECOLI Valeria CAORSI Diego FERONE Francesco MINUTO Elda RASORE Department of Endocrine and Medical Sciences University of Genoa Department of Psychiatric Sciences University of Genoa

Differentiated thyroid carcinoma(DTC) generally has a favorable *** disease,treatments,stress,and comorbidity can compromise health-related quality of life(QoL) and indirectly weigh upon the outcome. From 2004 to 2008,we evaluated QoL longitudinally in 128 DTC *** scheduled examinations,subjects were asked to undergo a semi-structured psychiatric interview and five rated *** same examination was conducted in 219 subjects after surgery for benign thyroid *** scores represent a better *** and control subjects were similar in terms of age,male/female ratio,concomitant psychopharmacological treatments,and frequency of psychiatric *** DTC subjects,Billewicz scale(BS) scores showed an increasing trend over time,especially among *** ad hoc thyroid questionnaire(TQ) scores were similar in both groups and did not change over time,but at the end of the study ad hoc TQ and BS were significantly *** hoc TQ scores were also related to age on entry to the *** both male and female DTC subjects,Hamilton's tests for anxiety(HAM-A) ,but not for depression(HAM-D),showed an improving *** the end of the study,HAM-A and HAM-D scores were comparable to those of the control ***-A and HAM-D were both positively correlated with the stage of cancer and the time between diagnosis and *** HAM-D correlated with age on entry to the *** symptom questionnaire(KSQ) item scores were higher in DTC subjects than in *** change over time in the items including anxiety,somatization,depression,and hostility was *** and hostility were more significantly reduced in DTC females than in DTC *** scores were significantly lower in DTC subjects than in controls at the end of the *** and depression were significantly related to staging on diagnosis and age on entry to the *** study confirms a wide variation of illness perception in DTC subjects

关键词： Thyroid cancer Outcome Psychological evaluation Quality of life Longitudinal study

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甲状腺不确定结节的回顾性细胞学评估研究（英文）

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第7期18卷 555-566页

作者： massimo giusti Barbara MASSA Margherita BALESTRA Paola CALAMARO Stefano GAY Simone SCHIAFFINO Giovanni TURTULICI Simonetta ZUPO Eleonora MONTI Gianluca ANSALDO Endocrinology Unit San Martino University Hospital I-16100 Genoa Italy Cytopathology and Pathology Unit San Martino University Hospital I-16100 Genoa Italy Radiology Unit Evangelico Hospital I-16100 Genoa Italy Molecular Diagnostic Unit San Martino University Hospital I-16100 Genoa Italy Endocrinology Surgery Unit San Martino University Hospital I-16100 Genoa Italy

目的:回顾性分析了130例甲状腺不确定结节的临床评估和预后,以及组织细胞学检测结果,为甲状腺结节的治疗提供合理的治疗方法。方法:根据英国甲状腺协会2014年分类,回顾性分析了2011年1月至2014年12月130例甲状腺不确定结节(Thy 3)的细... 详细信息

目的:回顾性分析了130例甲状腺不确定结节的临床评估和预后,以及组织细胞学检测结果,为甲状腺结节的治疗提供合理的治疗方法。方法:根据英国甲状腺协会2014年分类,回顾性分析了2011年1月至2014年12月130例甲状腺不确定结节(Thy 3)的细胞学检查。将结节分为Thy 3a(非典型特征)和Thy 3f(滤泡病变)两类。比较评估术前生物化学检查、彩色多普勒超声检查(US)、半定量弹性超声成像(USE)、超声造影(CEUS)、细胞学、组织学以及分子生物学突变分析等结果。结论:Thy 3结节的恶性肿瘤发生率较低,且在Thy 3a和Thy 3f之间没有显著差异。使用基于组织学的截取值作为参考可以降低采用手术的治疗方案。在阴性突变的Thy 3a和Thy 3f结节中,当不是所有的仪器检测结果都疑是阳性时,组织学观察应该作为首选。

关键词：不确定性甲状腺结节英国甲状腺协会2014年分类临床评价预后

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Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第9期 716-716页

作者： massimo giusti Giulia MELLE Monica FENOCCHIO Lorenzo MORTARA Francesca CECOLI Valeria CAORSI Diego FERONE Francesco MINUTO Elda RASORE

Differentiated thyroid carcinoma(DTC) generally has a favorable *** disease,treatments,stress,and comorbidity can compromise health-related quality of life(QoL) and indirectly weigh upon the *** 2004 to 2008,we evaluated QoL longitudinally in 128 DTC *** scheduled examinations,subjects were asked to undergo a semi-structured psychiatric interview and five rated *** same examination was conducted in 219 subjects after surgery for benign thyroid *** scores represent a better *** and control subjects were similar in terms of age,male/female ratio,concomitant psychopharmacological treatments,and frequency of psychiatric *** DTC subjects,Billewicz scale(BS) scores showed an increasing trend over time,especially among *** ad hoc thyroid questionnaire(TQ) scores were similar in both groups and did not change over time,but at the end of the study ad hoc TQ and BS were significantly *** hoc TQ scores were also related to age on entry to the *** both male and female DTC subjects,Hamilton's tests for anxiety(HAM-A),but not for depression(HAM-D),showed an improving *** the end of the study,HAM-A and HAM-D scores were comparable to those of the control ***-A and HAM-D were both positively correlated with the stage of cancer and the time between diagnosis and *** HAM-D correlated with age on entry to the *** symptom questionnaire(KSQ) item scores were higher in DTC subjects than in *** change over time in the items including anxiety,somatization,depression,and hostility was *** and hostility were more significantly reduced in DTC females than in DTC *** scores were significantly lower in DTC subjects than in controls at the end of the *** and depression were significantly related to staging on diagnosis and age on entry to the *** study confirms a wide variation of illness perception in DTC subjects,w

关键词： DTC Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

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Clinical epidemiology of chronic viral hepatitis B:A Tuscany real-world large-scale cohort study

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World Journal of Hepatology 2018年第5期10卷 409-416页

作者： Cristina Stasi Caterina Silvestri Roberto Berni Maurizia Rossana Brunetto Anna Linda Zignego Cristina Orsini Stefano Milani Liana Ricciardi Andrea De Luca Pierluigi Blanc Cesira Nencioni Donatella Aquilini Alessandro Bartoloni Giampaolo Bresci Santino Marchi Franco Filipponi Piero Colombatto Paolo Forte Andrea Galli Sauro Luchi Silvia Chigiotti Alessandro Nerli Giampaolo Corti Rodolfo Sacco Paola Carrai Angelo Ricchiuti massimo giusti Paolo Almi Andrea Cozzi Silvia Carloppi Giacomo Laffi Fabio Voller Francesco Cipriani Observatory of Epidemiology Regional Health Agency of TuscanyFlorence 50141Italy Center for Systemic Manifestations of Hepatitis Viruses(MaSVE) Internal Medicine and Liver UnitDepartment of Experimental and Clinical MedicineCareggi University HospitalFlorence 50134Italy Web Solutions Data Visualization and Scientific DocumentationRegional Health Agency of TuscanyFlorence 50141Italy Hepatology Unit Department of Clinical and Experimental MedicineUniversity Hospital of PisaPisa 56100Italy Gastroenterology Research Unit Department of Experimental and Clinical Biomedical Sciences“Mario Serio”Careggi University HospitalFlorence 50134Italy Infectious Disease Unit Hospital of LuccaLucca 55100Italy Infectious Diseases Unit Department of Medical BiotechnologiesSiena University HospitalSiena 53100Italy Infectious Disease Unit “S.Maria Annunziata”HospitalPonte a Niccheri 50012Italy Infectious Disease Unit Hospital of GrossetoGrosseto 58100Italy Infectious Disease Unit Hospital of PratoPrato 59100Italy Infectious and Tropical Diseases Unit Department of Experimental and Clinical MedicineCareggi University HospitalFlorence 50134Italy Gastroenterology and Metabolic Disorders Department of SurgeryCisanello University HospitalPisa 56100Italy Gastroenterology Unit Department of Translational Research and New Technologies in Medicine and SurgeryCisanello University Hospital of PisaPisa 56100Italy Liver Surgery and Transplantation Unit Department of Surgical PathologyMedicineMolecular and Critical AreaCisanello University HospitalPisa 56100Italy Internal Medicine Unit “San Jacopo”HospitalPistoia 51100Italy Infectious Diseases and Hepatology Unit Department of Internal and Specialized MedicineUniversity Hospital of SienaSiena 53100Italy Gastroenterology Unit San Giuseppe HospitalEmpoli 50053Italy Internal Medicine and Liver Unit Department of Experimental and Clinical MedicineCareggi University HospitalFlorence 50135Italy Department of Prevention Central Tuscany Local UnitFlorence 5

AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care *** This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults.

关键词： Hepatitis B virus infection Liver fibrosis Cirrhosis Public health Epidemiology

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