Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy.Methods.All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.).Results.There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs) of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively.Conclusion.Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

PurposeThe current study aimed to identify the overall characteristics of cancer-related emergency department (ED) visits by adult in Korea, including analyses of factors associated with ED stay time and outcomes nationwide. Materials and MethodsWe collected data on cancer-related ED visits from the National Emergency Department Information System (NEDIS) database between 2017 and 2019. ResultsED visits by cancer patients comprised 5.5% (667,935 visits) of total ED visits from 2017 to 2019, which was slightly higher than in other counties. Patients with cancer who visited the ED were over 50 years old, the majority being males, and patients with cancer visited EDs in certified tertiary hospitals more frequently than patients without cancer. In multivariate analyses, the adjusted odds ratio for a length of stay more than 8 hours in the ED of certified tertiary hospitals was 126.34 (95% confidence interval, 1.422 to 1.460) when compared to hospitals. Nevertheless, the longer the patients stayed in the ED, the more likely they were to be admitted. ConclusionThe longer ED stay and higher proportion of cancer patient hospitalizations suggest that cancer patients visit ED to be admitted as well as to receive acute care. The frequency of ED visits and admission may be adjusted to some extent depending on outpatient education, such as self-management of symptoms and situations. Improving cancer care in local communities should be met though provisions such as linking treatment between hospitals or supplying appropriate medical personnel, even for the efficient use of ED resources in hospitals.

Min HS, et al. Infect Chemother. 2021 Nov;53:e61. https://doi.org/10.3947/ic.2021.0094

Lee KS, et al. J Korean Med Sci. 2023 Jan;38(6):e40. https://doi.org/10.3346/jkms.2023.38.e40

Previous studies have obtained conflicting findings regarding possible associations between indices measuring carbohydrate intake and dyslipidemia, which is an established risk factor of coronary heart disease. In the present study, we examined cross-sectional associations between carbohydrate indices, including the dietary glycemic index (GI), glycemic load (GL), total amount of carbohydrates, and the percentage of energy from carbohydrates, and a range of blood lipid parameters. This study included 1530 participants (554 men and 976 women) from 246 families within the Healthy Twin Study. We analyzed the associations using a generalized linear mixed model to control for familial relationships. Levels of the Apo B were inversely associated with dietary GI, GL, and the amount of carbohydrate intake for men, but these relationships were not significant when fat-adjusted values of the carbohydrate indices were used. Triglyceride levels were positively associated with dietary GI and GL in women, and this pattern was more notable in overweight participants (body mass index [BMI] ≥25 kg/m(2)). However, total, low-density lipoprotein and high-density lipoprotein cholesterol levels were not significantly related with carbohydrate intake overall. Of the blood lipid parameters we investigated, only triglyceride levels were positively related with dietary carbohydrate indices among women participants in the Healthy Twin Study, with an interactive role observed for BMI. However, these associations were not observed in men, suggesting that the association between blood lipid levels and carbohydrate intake depends on the type of lipid, specific carbohydrate indices, gender, and BMI.