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Comorbid despression symptoms along with treating panic disorders, OCD, and PTSD: Medical diagnosis compared to seriousness.
The 6-month survival rate was 66.7%, compared to a 1-year survival rate of 25.0%, with a median overall survival time was 10.5 months. Kaplan-Meier analysis showed that the comprehensive treatment was superior to radiotherapy and/or chemotherapy (P=0.003). Conclusions PSCCT is a rare type of thyroid cancer that is highly invasive and has a poor prognosis. We show that a comprehensive treatment plan can significantly improve patient survival. 2019 Gland Surgery. All rights reserved.Background The objective of this study was to evaluate the surgical risk and prognosis between thyroid nodules of size less then 1 and ≥1 cm and to explore whether it is reasonable generally to ignore the diagnosis and treatment of thyroid nodules and thyroid carcinoma less then 1 cm in wide areas of China. Methods A retrospective observational study included all first-time thyroid surgery patients between January 2005 and December 2016 of the First Affiliated Hospital of Harbin Medical University. All patients were divided into two groups (group A less then 1 cm, group B ≥1 cm) according to the maximum diameter of the nodules and demographics, surgery procedure, pathology, postoperative complications, morbidity, and mortality were analyzed. Results A total of 6,317 patients were reviewed and 3,424 (54.20%) of them were malignant; 2,128 patients in group A and 4,189 in group B. Patients in group A had better pathological diagnosis, inferior extent of lymph node metastasis, less surgical complexity, fewer postoperative complications, and longer disease-free survival (DFS). Conclusions Thyroid operations were safer and involved fewer postoperative complications when thyroid nodules were less then 1 cm and patients who were diagnosed with malignant thyroid disease had superior prognoses. Underdeveloped regions of China should diagnose and treat thyroid nodules less then 1 cm early. 2019 Gland Surgery. All rights reserved.Background Giant pituitary adenoma (GPA) (diameter >40 mm) remains challenging to treat, and the radical resection rate is low. The intraoperative multimodal navigation is sometimes used in endoscopic endonasal surgery (EES). However, the effect of this technique on GPA surgical outcomes is not clear. This study aims to explore the surgical and clinical outcomes of the navigation used in EES for GPA. Methods A retrospective review of 60 consecutive patients with GPA who underwent EES was performed. The total resection rate, residual volume, clinical outcomes, and complications were compared. Factors associated with tumor gross total resection (GTR) were analyzed by multinomial logistic regression analysis. Results There were 31 patients in the standard group in which intraoperative multimodal navigation was not used, with a mean maximum tumor diameter of 5.21±1.24 cm; meanwhile, there were 29 patients in the navigation group, in which navigation was used, with a mean maximum tumor diameter of 5.32±1.18 cm. GTR was achieved in 10 patients (32.26%) in the standard group, which was significantly lower than that in the navigation group (18/29=62.07%). learn more The residual volume was 7.93±10.78 cm3 in the standard group which was significantly greater than that in the navigation group (2.44±1.26 cm3, P=0.046). There was no significant difference between the two groups in terms of cerebrospinal fluid (CSF) leak, new pituitary deficit, and postoperative diabetes insipidus (DI). The higher Knosp grade of tumor, lobulated configuration and lack of intraoperative multimodal navigation use were relative risk factors associated with the GTR. Conclusions The intraoperative multimode navigation appeared to be safe and effective when used in EES for GPA with higher GTR and lower residual tumor volume. 2019 Gland Surgery. All rights reserved.Background Our study aims to describe the experience of a single team in terms of the potential and benefits of subxiphoid thymectomy using a double sternum hook retractor. Methods From November 2016 to July 2018, 34 patients have been undergone subxiphoid thymectomy at our Department. Twenty patients were diagnosed with Masaoka Stage I-III thymomas, 12 with thymic hyperplasia or cysts of the thymus, 2 with thymic tumors. All patients underwent a chest computed tomography (CT) with enhancement. 18-Fludeoxyglucose positron emission tomography (18FDG-PET) was performed when recurrence was suspected. Neurological examinations were set. Patients underwent video-assisted thoracoscopic surgery (VATS) subxiphoid thymectomy with a double sternum retractor. A retrospective analysis of clinical, perioperative data, and follow-up was performed. Incidence rates for death or recurrence were calculated. Average pain score (NRS scale), average mental health, and physical health scores (SF-12) were analyzed. Results Thirty-four patients (mean age 54; 12 men and 22 women) with thymic neoformation (from 1.0 cm × 1.0 cm × 1.0 cm to 14.0 cm × 9.0 cm × 4.5 cm) were enrolled. All patients underwent subxiphoid thymectomy. No mortality or recurrence was observed. Median follow-up time was 17.9 months (range, 2.2-23.3 months). The morbidity rate was 9.7 events per 100 person-years. Average pain scores after surgery and after follow-up were 1.7±0.4 and 0.1±0.4, respectively; average mental health and physical health scores on the SF-12 scale were 45.6±2.4 and 33.6±2.4, respectively. Conclusions Subxiphoid thymectomy is a high satisfaction approach with positive aesthetic outcomes and low pain. Double sternum retractors are especially useful for creating space during thymectomy. However, the qualified experience is needed. 2019 Gland Surgery. All rights reserved.Background There is no comprehensive and objective method existing for predicting early recurrence of pituitary adenomas (PAs). The most advanced gene sequencing technology can be applied to build a prognostic model that can effectively predict early recurrence of PAs. Methods In this study, using mRNA-Seq data, the corresponding postoperative early recurrence status, and other clinical features of 107 PA samples were obtained and randomly divided into the training and validation groups. Cox regression and receiver operating characteristic (ROC) analysis accompanied by the risk score method was used to build a seven-gene prediction model. Results Area under curve values was 0.857 in the training group, 0.936 in the validation group, and 0.848 in all patients. Patients with low-risk scores had a significantly lower probability of early postoperative recurrence compared to those acquiring high-risk scores in the training group, validation group, and all patient (P less then 0.0001) groups. In addition, 6 out of these 7 significant genes were highly correlated to the early recurrence of PAs.
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