Aims: We aimed to investigate fertilization rates, quality of embryo, pregnancy and live birth rates, endocrine, sexual function, psychological status and quality of life of cases diagnosed with Klinefelter syndrome (KS). Methods: Clinical findings, hormone values and semen analyses in patients with nonmosaic KS (Group 1, n=121) and those with non-genetic nonobstructive azoospermia (NOA) (Group 2, n=178) were retrospectively analyzed. Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE), fertilization rates and embryo quality, pregnancy, abortion, and live birth rates were compared. Sexual functions were assessed using IIEF-15, quality of life was evaluated, and psychological status was assessed. Results: There was no difference in terms of age between groups. Sperm retrieval rates was 38% and 55.6% in Group 1 and 2, respectively (p=0.012). Sperm retrieval rates were higher in Group 1 before 31.5 years than in Group 2 (AUC=0.620, 0.578). Compared to Group 2, the fertilization rate was low in Group 1, whereas embryo quality was similar. Live birth rates were 12.5% and 23% in Group 1 and 2, respectively (p=0.392). The education level, libido, erectile functions, and general health satisfaction were lower in Group 1 than in Group 2 (buraya p değeri yaz). Depression and anxiety levels were higher in Group 2 than Group 1 (p değeri yaz). Conclusion: Higher sperm retrieval rate has been achieved in group 1 younger than 31.5 years. Similar embryo quality is provided between groups. Sexual dysfunction and psychiatric problems were higher in Group 1, with lower satisfaction and general health than Group 2. Patients with KS should be monitored not only with their reproductive functions but also with their general health status.
Introduction: Following the Covid-19 pandemic, the face-to-face meetings are delayed to a future date , which is still not clear. However, seminars, meetings, and conferences are necessary for updating our knowledge and skills. The web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behavior when webinars present at the Covid-19 pandemic era. Methods: Between December 2017 – July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviors such as content views, engagement time, total unique attendees, average engagement time, and the number of audience to leads. Data were split into two groups; group-1 is webinars before Covid-19 (before March 2020), group-2 is the webinars during Covid-19. Results: Total broadcast time and total page view number were found to be 112.6 hours (6761 min.) and 15919, respectively. The median participant age was 40.1 years. Median content view and median engagement time were found to be 261.0 min., and 12.2 min., respectively. Comparison of two groups revealed a significant increment in the content views (group 1;134.0 range=86.0-87.0 and group 2; 414.0 range=296.0-602.0, p<0.001) and the number of the unique attendees (group 1; 18.0 range=10.0-26.0 and group 2; 57.0 range=27.0-100.0, p<0.001) following Covid-19. However, the median engagement time of the audience did not seem to change with the Covid-19 pandemic (group 1; 11.5 range=10.0-13.3 min. and group 2; 13.2 range=9.4-18.1 min., p=0.12). Conclusion: The webinars are effective ways to share information and have many advantages, including low cost, reaching the high number of audiences. Audience number and page visits seemed to increase following the Covid-19 pandemic. However, The engagement time did not seem to affect a critical attitude of the audience
Introduction: Trauma is the most common cause of death in childhood. Tissue damage, ischemia-reperfusion injury and inflammatory response are mainly responsible for increasing serbest oxiygen radicals. In this study, we aimed to investigate the use of thiol-disulfide and ischemia-modified albumin levels as a diagnostic laboratory parameter in trauma children. Method: Of 202 children, 101 of them were hospitalized in pediatric surgical intensive care unit with trauma and 101 of others were healthy children. Levels of native thiol (-SH), total thiol (SH + SS), dynamic disulfide (SS), dynamic disulfide (SS) / total thiol (SH + SS), albumin and ischemic modified albumin (IMA) were measured from the sera of patients and healthy volunteers. For statistical analyses, SPSS 17.0 was used. Mann-Whitney U and paired correlation test were used where appropriate. p <0.05 was considered significant. Results: The mean age of the patients in the trauma group (Boys: 61 Girls: 40) was 7,88 years and the control group was 8,00 years. In trauma group, 86 of children were exposed to blunt trauma, 15 of children had penetrating trauma and 54 patients had multiple trauma. Surgical procedures were performed in 17 patients. In the trauma group, native thiol, total thiol, dynamic disulfide / total thiol, albumin and IMA levels were significantly lower than that of control (p <0.001) and their dynamic disulfide (p = 0.001) was higher compared to the control. There was no difference thiol-disulfide parametres in trauma groups sub-division as surgery(n=17) vs. follow-up(n=84) groups or multiple trauma(n=54) vs. isolated organ trauma(n=47) groups, or penetrating(n=15) or blunt trauma(n=86) groups. Conclusion: Thiol-disulfide balance and IMA levels show changes in favor of oxidative stress in children with trauma, however, it cannot be used as a laboratory marker that helps to show the system and organ affected by the trauma and to decide the surgical intervention.
Background: Covid-19 is an extremely contagious illness caused by the severe acute respiratory syndrome (SARS-CoV-2) virus. Although this disease primarily involves pulmonary tissue, rapidly advancing research has established cardiac involvement in Covid-19 patients. Objective: This systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of acute myocarditis. Results: Data from 41 studies describing myocarditis in 42 Covid-19 patients was obtained. The median age of these patients was 43.4 years, with 71.4% of them being male. Fever was the most prevalent presenting symptoms seen in 57% of patients. Hypertension was the most pervasive comorbidity accompanying these patients. Cardiac biomarkers troponin and Brain natriuretic peptide (BNP) were raised in almost 90% and 87% of patients, respectively. Electrocardiogram findings were Non-specific and included ST-segment and T-wave changes. The most prevalent histopathological feature appreciated was diffuse lymphocytic inflammatory infiltrates. Antivirals and corticosteroids were the most frequently used medications. About 38% of patients also needed vasopressor assistance. Out of 42 patients, 67% recovered, and eight died. Conclusion: Due to the risk of a sudden worsening of patients conditions and myocarditis association with considerable mortality and morbidity, a knowledge of this cardiac complication of Covid-19 disease is crucial for healthcare professionals.
Background: Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19. Methods: We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (i.e. at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (OR) and their 95% confidence intervals (CI). Small study effects were assessed with the Egger’s test. Results: Twenty studies, 19 cohorts and one case-control were included. An increase of one unit of NLR was associated with a higher odds of COVID-19 severity (OR 6.6, 95% CI: 4.71 - 7.19; p<0.001) and higher odds of all-cause mortality (OR 12.7, 95% CI: 1.32, 123.36; p=0.025). No differences were found in subgroup analyses by study design. The subgroup analysis of the studies, by country of origin, showed that the strength of the association between NLR and mortality was greater in Chinese studies (OR 31.1; 95%CI 19.57 to 49.3; p<0.0001) with moderate heterogeneity (I2 =43%). In our sensitivity analysis, we found that 7 studies with low risk of bias maintained strong association between both outcomes and the NLR values (severity: OR 4.7; 95% CI 3.5 to 6.34; p < 0.001 vs mortality: OR 31.1; 95% CI 19.57 to 49.3; p <0.0001), with low (I2 = 37%) and moderate (I2 = 43%) heterogeneity for severity and mortality outcomes, respectively. No publication bias was found for studies that evaluated effects for the severity of disease. Conclusions: Higher values of NLR were associated with severity and all-cause mortality in hospitalized COVID-19 patients.
Aims Delay and false positivity in PCR test results have necessitated accurate chest CT reporting for management of patients with COVID-19 suspected symptoms. Pandemic related workload and level of experience on covid-dedicated chest CT scans might have effected diagnostic performance of on-call radiologists. The aim of this study is to reveal the interpretation errors in chest-CT reports of COVID-19 suspected patients admitted to the ER. Methods COVID-19 dedicated chest-CT scans which were performed between March and June 2020 were re-evaluated and compared with the former reports of these scans and PCR test results. CT scan results were classified into four groups. Parenchymal involvement ratios, radiology departments’ workload, COVID-19 related educational activities have examined. Results Out of 5721 Chest-CT scans, 783 CTs belonging to 664 patients (340 female, 324 male) were included to this study. RT-PCR test was positive in 398; negative in 385 cases. PCR positivity was found to be highest in “normal” and “typical for covid” groups whereas lowest in “atypical for covid” and “not covid” groups. 5-25% parenchymal involvement ratio was found in 84.2% of the cases. Regarding number of chest CT scans performed, radiologists’ workload have found to be increased six-folds compared to the same months of the former year. With the re-evaluation, a total of 145 IEs (18.5%) have been found. IEs were mostly precipitated in the first two months (88.3%) and mostly in “not covid” class (60%) regardless of PCR positivity. COVID-19 and radiology entitled educational activities along with the ER admission rates within the first two months of pandemic have seem to be related with the decline of IEs within time. Conclusion COVID-19 pandemic made a great impact on radiology departments with an inevitable burden of daily chest-CT reporting. This workload and concomitant factors have possible effects on diagnostic challenges in COVID-19 pneumonia.
Introduction: As COVID-19 disease has rapidly spread across the world, its impact has grown with increasing number of cases and mortality rate in Turkey. Aim: The aim of this study is to examine epidemiologic and clinical features of the patients that admitted to the hospital with the pre-diagnosis of coronavirus disease-2019 (COVID-19) in Turkey. Method: In this retrospective study, epidemiologic and clinical features, laboratory findings, radiologic features, therapeutic approaches and survival conditions of the patients with the pre-diagnosis of COVID-19 from March 11th to June 30th, 2020. The all data of the cases were compared in 4 groups: 1st group for the confirmed cases reverse transcriptase polymerase chain reaction (RT-PCR) +, chest computed tomography (CT) +, 2nd group for the clinically diagnosed cases (RT-PCR- CT +), 3rd group for the mild and asymptomatic cases (RT-PCR + CT-), 4th group for the suspected cases (RT-PCR - CT -). Post-hoc analysis was performed to evaluate the differences among the groups. Results: In total, 3334 patients with the pre-diagnosis of COVID-19 admitted to the emergency department. Based on the post-hoc analyses, significant differences were found among the four groups in terms of their test results of leucocytes, hemoglobin, platelets, neutrophils, urea and C-reactive protein (CRP) (p<0.001). Furthermore, the factors of age groups, hospitalization, intensive care follow-up and mortality rate of the four groups showed a significant difference among the groups (p=0.001). Conclusion: Mean of leucocytes, neutrophile and platelet values of the patients with tested positive for the RT-PCR was found lower compared to the ones with tested negative for the RT-PCR. Mean of CRP values was found higher in patients with lung involvement compared to other patient groups.
Background and aim: Peptic ulcer is considered an important public health problem and generally associated with complicated conditions such as bleeding and perforation. The aim of this study is to reflect the rate of oxidative damage in the body among patients with H. pylori positive peptic ulcer by measuring serum 8-hydroxy-2p-deoxyguanosine (8-OHdG) and its association with the level of bacterial endotoxin. Methods Patients applied to Harran University Gastroenterology Outpatient Clinic with dyspeptic complaints were enrolled in this study. According to gastrointestinal endoscopy findings, 43 patients with H.pylori positive peptiv ulcer patients and 43 healthy volunteers were included in this study. H.pylori diagnosis was detemined by H.pylori urea breath and stool antigen tests. Serum 8-OHdG and endotoxins were measued by ELISA. Results A total of 43 patients with peptic ulcer (13 females 30 males), 43 healthy individuals (16 females 27 males) ages (18- 70) years in the study. In biopsies taken endoscopically; Hp severity was mild in 19 patients (43.9%), moderate in 21 patients (48.5%), and severe in 3 patients (7.6%). 8-OHdG which has the potential to mark DNA damage level in serum samples of patients with H.pylori positive peptic ulcer, was compared with the healthy and patient group. It was observed that there was a statistically significant difference (p <0.01). In addition, a weak correlation was found between OHdG and endotoxin. Conclusion: Reactive oxygen species (ROS) produced due to increased endotoxin as a result of H. pylıori infection can attack nucleic acid in infected cells resulting in an increased in serum 8-OHdG level. H.pylori and its endotoxin had a significant in peptic ulcer pathogensis.
Objective: SARS-CoV-2 has caused nearly 4 million confirmed cases of COVID-19 worldwide in the approximately 4 months since it emerged in Wuhan, China in December 2019. Comorbidities increase morbidity and mortality in COVID-19, and many laboratory parameters have been associated with mortality. The aim of the present study was to identify the relationship between endogenous carboxyhemoglobin (COHb) level and the clinical course and prognosis of COVID-19. Methods: The study included 48 non-smokers or ex-smokers aged 18 years or older who presented to the emergency department, were diagnosed with COVID-19 by real-time PCR analysis of nasopharyngeal swab sample, and were treated in the pulmonary diseases ward of the Atatürk University hospital after between March 24, 2020 and April 15, 2020. The patients’ laboratory parameters and demographic data were analyzed retrospectively. Results: Prothrombin time and C-reactive protein (CRP), troponin-I, and D-dimer levels decreased in COVID-19 patients during follow-up (p=0.024, p=0.001, p=0.001, p=0.001), while PaO2/FiO2 ratio and COHb increased (p=0.002, p=0.001). COHb level at admission was significantly lower in patients who developed macrophage activation syndrome (MAS), acute respiratory distress syndrome (ARDS), and those who died compared to the other patients (p=0.002, p=0.001). COHb level on day 5 of treatment was significantly higher in patients with ARDS and patients who died (p=0.001, p=0.001).Significant correlations were detected between COHb level and CRP (r=-0.425, p=0.001), ferritin (r=-0.395, p=0.001) and PaO2/FiO2 ratio (r=0.431, p=0.001). Conclusions: COHb level may be an easily accessible biomarker that guides early follow-up and treatment planning to avoid ARDS, MAS, and mortality in COVID-19.
Aim: The present study compares the effectiveness of four different remineralization agents on the demineralized enamel of permanent human incisors. The purpose of this study is to evaluate the effectiveness of remineralization agents on the initial enamel lesion. Material- Methods: Crowns affected by demineralization were divided into two equal parts. The right halves of the teeth were subjected to no other processes after demineralization for control purposes and were kept in artificial saliva for the duration of the experiment. The left halves of the crowns were remineralized using a 5% NaF-containing fluoride varnish (GC MI Varnish GC Corp, Tokyo, Japan), a casein phosphopeptide and amorphous calcium toothpaste (GC Tooth Mousse, GC Corp, Tokyo, Japan), fluoride, hydroxyapatite, and xylitol, containing a water-soluble remineralization paste (Remin Pro™, Voco, Germany) and calcium, magnesium and phosphate-containing gel (Medical Remineralizing gel (R.O.C.S. Trading GmbH, Munich, Germany). After a 21-day remineralization process, and SEM/EDX analysis was performed, and a One Way Anova was used for statistical analysis. Results: According to EDX analysis, the R.O.C.S. medical remineralizing gel was found to have a lower Ca/P ratio than the other material groups (p =0.04). Remin Pro™, Voco, and the R.O.C.S. were higher than the control group in evaluating the Ca / P ratio (p=0.014), (p=0.025). Conclusions: The R.O.C.S group, treated with fluoride-free xylitol-containing, a remineralization agent, showed the lowest Ca/P ratio. Compared to demineralized halves of the teeth (control groups), Remin Pro™, Voco, and R.O.C.S. medical remineralizing gel may be considered as affecting on initial enamel lesions. Key Words: Remineralizing Agents, EDX, SEM, Enamel,
Purpose To evaluate the effect of risk factors and selected surgical methods on operative and oncological results of patients undergoing radical prostatectomy (RP) with high-risk prostate cancer (HRPC). Methods Retrospective analysis of patients, who underwent RP for HRPC from 13 urology centers between 1990 to 2019, was performed. Groups were created according to the risk factors of D’Amico classification. Patients with one risk factor were included in group 1 where group 2 consisted of patients with two or three risk factors. Results A total of 1519 patients were included in this study and 1073 (70.6%) patients assigned to group 1 and 446 (29.4%) patients to group 2. Overall (biochemical and/or clinical and/or radiological) progression rate was 12.4% in group 1 and 26.5% in group 2 (p =0.001). Surgical procedure was open RP in 844 (55.6%) patients and minimally invasive RP in 675 (44.4%) patients (laparoscopic and robot-assisted RP in 230 (15.1%) and 445 (29.3%) patients, respectively). Progression rates were similar in different types of operations (p=0.22). Progression rate was not significantly different in patients who either underwent pelvic lymph node dissection (PLND) or not in each respective group. Conclusion RP alone is an effective treatment in the majority of patients with HRPC and PLND did not affect the progression rates after RP. According to the number of preoperative high-risk features, as the number of risk factors increases, there is a need for additional treatment.
Objective: To present an alternative surgical technique in treating cases of Chiari I Malformation with mild-to-moderate syringomyelia after decompressive suboccipital craniectomy: incising only the outer layer of the dura mater, then dissecting it from the inner layer without opening the latter. Methods and Results: We utilized this technique in a short series of three cases who were admitted in our department for mild symptoms such as intermittent headache and dissociated sensory loss in the upper limbs, caused by a Chiari Malformation Type I. The patients were placed in the sitting position. We performed a reduced median suboccipital craniectomy and resection of the posterior arch of C1 adapted to the level of tonsil descent, from a limited superior half to a complete resection. Afterwards, we incised the outer dural layer, while sparing the inner one. Using a fine dissector, we then split apart the outer and inner layers to the margin of the craniectomy. Through the transparency of the inner layer and the arachnoid, the cerebellum and the medulla were visible and pulsating. An autologous fascia duraplasty was then performed. The postoperative course was favorable in all cases, patients being discharged without any deficits and with complete symptom resolution. Conclusions: Interlayer dural split technique can be used effectively in treating symptomatic cases of type I Chiari malformation in adults, with mild-to-moderate syringomyelia. It is less invasive than opening the dura and possibly more effective than decompressive craniectomy and C1 laminectomy alone. This technique must be validated in a larger case-control series.
Objective: This study aimed to investigate the association between carotid intima-media changes that play a part in the atherosclerotic process in childhood obesity and fibrin monomers as an important indicator of fibrin plaque. Methods: This is a cross-sectional study of obese children and non-obese healthy control subjects. Height, weight, body mass index, waist/hip ratio, systolic/diastolic blood pressures were recorded, in addition, biochemistry, hemogram, fibrin monomers and d-dimer were measured in both groups. Right and left common carotid intima-media thicknesses were measured by ultrasonography and mean carotid intima-media thickness was calculated. Results: Obese children (n=89, 46.1% girls, median age: 12.6±2.3 years) and healthy control group (n=40, 52.5% girls, median age: 13.2±2.2 years) were comparable in terms of gender, age and puberty stage. Mean carotid intima-media thickness was higher in obese children than the healthy control group (p=0.002). There was no difference between the two groups in terms of fibrin monomers and D-dimer levels. In obese children, there was a weak negative correlation between mean carotid intima-media thickness and fibrin monomers (p=0.030, r=-0.233). Conclusion: In obese children, mean carotid intima-media thickness was determined higher, as an early indicator of atherosclerosis. We want to emphasize that obese children are at risk for cardiovascular disease and should be evaluated in terms of atherosclerosis. This study investigates the relation between increased carotid intima-media thickness and fibrin monomers, in children, the first time in Literature. What’s already known about this topic? It is possible to reveal the early period of the atherosclerosis process by showing carotid intima medial thickness. Fibrin is a major component of many atherosclerotic plaques. What does this article add? Our study investigated the relationship between mean carotid intima-media thickness in childhood obesity and fibrin monomers. But no positive correlation was found between fibrin monomers and the carotid intima-media thickness.
Objectives: Multimorbidity and polypharmacy in older adults always increase the prevalence of potentially inappropriate medications (PIMs) and affect the quality of life of the older adults. The purposes of this study were aimed to investigate the prevalence of PIMs prescription and the most frequent PIMs among outpatients according to Beers criteria and to explore related risk factors for PIMs prescription. Methods: The cross-sectional retrospective study was conducted among elderly outpatients in Chengdu (a city in China) from January 2018 to December 2018. The 2015 Beers criteria was used to assess PIMs in elderly outpatients. Univariate analysis and multivariate logistic regression analysis were adopted to determine the factors that may affect the prevalence of PIMs in elderly outpatients. Results: A total of 15523 patient prescriptions were enrolled, of which 4654 (29.98%) were identified with at least one PIM based on Beers criteria, and 6460 PIMs were detected. Of these PIM prescriptions, 76.32% were detected to receive 1 PIM, 16.54% were detected to receive 2 PIMs, and only 7.13% were found to have at least 3 PIMs. Benzodiazepines (2371, 50.95%), diuretics (1197, 25.72%), and selective serotonin reuptake inhibitors (439, 9.43%) were three common types of drugs that were the most frequent PIMs used. Sex, age, number of diseases, number of medications, and diseases or disease states were risk factors for PIMs in outpatients. Conclusion: The results of the study showed that the phenomenon of PIM was common among elderly outpatients in Chengdu. Risk factors for PIM in elderly outpatients include gender, age, number of diseases, number of medications, and sleep disorder.
Objective: The novel coronavirus SARS-CoV-2 (COVID-19) rapidly escalated from its origin in an animal market in Wuhan, China in December 2019 to a global pandemic, and the lungs are the most frequently affected organ. The aim of this study was to investigate the relationship between pulmonary function test parameters and laboratory parameters in COVID-19. Method: A total of 60 patients who were admitted to the chest diseases department and intensive care unit of our hospital and were diagnosed with COVID-19 by real-time PCR analysis of nasopharyngeal swabs were evaluated. Pulmonary function tests and laboratory parameters at admission and on day 7 of treatment were analyzed. Results: On day 7 of treatment, white blood cell count, CRP, and fibrinogen level were significantly lower than at admission (p=0.002, 0.001, and 0.001, respectively), while forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) values were significantly higher compared to admitting values (p=0.001 for both). Correlation analysis of the changes in respiratory function values and laboratory parameters during follow-up (day 1 to day 7 of treatment) revealed that CRP level was positively correlated with FEV1 (r=0.616, p=0.01) and FVC values (r=0.51, p=0.01). Fibrinogen level was also positively correlated with FEV1 (r=0.345, p=0.01) and FVC (r=0.357, p=0.01). Conclusion: Fibrinogen and CRP levels are easily accessible parameters that may help identify improvement or deterioration in pulmonary function in COVID-19 patients during follow-up and discharge while reducing the risk of transmission.
Aim: In this feasibility study, we aimed to implement a pilot telemedicine service at our healthcare facility in Faisalabad, Pakistan, and describe our experience. Methods: Telemedicine service was established by Faisalabad Medical University at two of its affiliated locations: 1) A 24-hour COVID-19 Telephone Helpline was established at Director Emergency Office, Allied Hospital and District Headquarter (DHQ) Hospital. 2) A Telemedicine Clinic comprising consultants and postgraduate residents from different specialties was established at Chief Office, Allied Hospital. The data related to the number and categories of calls and advice provided was collected from 27th March 2020 till 31st July 2020. Results: A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male, and 2257 (49%) were females. At Allied Hospital, 172 patients were advised accordingly for their complaints, whereas, at DHQ Hospital, 320 patients were advised accordingly for their complaints. At the telemedicine clinic only, a total of 2436 calls were received during the study period, 1474 (60%) callers were male, and 962 (40%) were female. The majority of the calls were received by medicine (43%), dermatology (21%), and pediatrics (11%) specialties, respectively. Conclusion: Despite some limitations, the benefits of telemedicine in this COVID-19 era are enormous and it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e-health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic.
Purpose: It has been suggested, on a theoretical basis, that ultrasound screening of thyroid nodules in obese patients with additional risk factors (family history, thyroiditis or high thyrotropin) might be cost-effective for the early detection and treatment of thyroid cancer. The present study evaluates if this approach can be validated in a real clinical setting. Methods: Patients with obesity attended in hospital-based clinics were evaluated for risk factors of thyroid cancer and ultrasound screened for thyroid nodularity. Detected nodules were evaluated according to current guidelines. Results: A total of 429 patients were evaluated (70.2% women, mean age 49.1±11.0, mean body mass index 42.6±5.8 kg/m2). Risk factors were present in 129 (30.1%) patients. Thyroid nodules with indication for fine needle aspiration biopsy were detected in 69 (16.1%). We did not find differences in the risk of harbouring thyroid nodules according to the presence of risk factors (no risk factors 16.6%, risk factors 14.1%, p = 0.64). No single risk factor conferred an increased risk for thyroid nodules During the screening procedure 4 cases of thyroid cancer were detected, none of them with the evaluated risk factors. Conclusion: The present study, has been unable to demonstrate that the use of known risk factors for thyroid cancer is helpful to discriminate obese patients with higher risk of harbouring thyroid nodules.