Assessment of Knowledge, Attitude and Practices among Healthcare Workers in a Tertiary Care Hospital on Needle Stick Injury

Purpose: Needle-stick injury (NSI) is one of the most potential occupational hazards for healthcare workers because of the transmission of blood-borne pathogens. As per recent data, around 30 lakh healthcare workers sustain Needle stick injuries each year. This study was conducted to assess healthcare workers’ knowledge, attitude and practices regarding needle stick injury. Materials & Methods: A cross-sectional study was conducted in a Tertiary Care Hospital over the period of 3 months. The study population consisted of Intern Doctors, Post Graduate resident Doctors, Staff Nurses, laboratory technicians of Government Medical College and New Civil Hospital, Surat (n = 300). The data were collected using a self-administered questionnaire via the means of Google Forms. Questionnaire was made with prior review literature. The data obtained were entered and analysed in Microsoft Excel. Results: The prevalence of NSI in our study was 46%, with a higher prevalence among the PG residents (72%). Overall scores regarding knowledge and attitude were better in PG residents (knowledge score > 7 in 71% and Attitude Score > 7 in 68% of PG Residents). Even though the PG residents scored highest in the knowledge category, the majority of them suffered needle stick injuries as a result of poor practice scores. Among those who had NSI (n = 139/300), 70% of study participants had superficial injuries, only 9% reported the incident, 18% got medical attention within 2 hours of the incident, and 7% followed up to recheck their viral markers status. Most incidents of NSI were due to hypodermic needles while recapping needles. Conclusion: Exposure to needle stick injuries and their underreporting remains a common problem. It is imperative that healthcare workers receive regular training on the proper handling of sharp objects. We can also draw the conclusion that preventing NSIs requires putting knowledge into practice.

MXene Enhanced 3D Needled Waste Denim Felt for High‑Performance Flexible Supercapacitors

MXene,a transition metal carbide/nitride,has been prominent as an ideal electrochemical active material for supercapacitors.However,the low MXene load limits its practical applications.As environmental concerns and sustainable development become more widely recognized,it is necessary to explore a greener and cleaner technology to recycle textile by-products such as cotton.The present study proposes an effective 3D fabrication method that uses MXene to fabricate waste denim felt into ultralight and flexible supercapacitors through needling and carbonization.The 3D structure provided more sites for loading MXene onto Z-directional fiber bundles,resulting in more efficient ion exchange between the electrolyte and electrodes.Furthermore,the carbonization process removed the specific adverse groups in MXenes,further improving the specific capacitance,energy density,power density and electrical conductivity of supercapacitors.The electrodes achieve a maximum specific capacitance of 1748.5 mF cm-2 and demonstrate remarkable cycling stability maintaining more than 94%after 15,000 galvanostatic charge/discharge cycles.Besides,the obtained supercapacitors present a maximum specific capacitance of 577.5 mF cm^(-2),energy density of 80.2μWh cm^(-2)and power density of 3 mW cm^(-2),respectively.The resulting supercapacitors can be used to develop smart wearable power devices such as smartwatches,laying the foundation for a novel strategy of utilizing waste cotton in a high-quality manner.

Is magnesium deficiency the major cause of needle chlorosis of Pinus taeda in Brazil?

Needle chlorosis(NC)in Pinus taeda L.systems in Brazil becomes more frequent after second and third harvest rotation cycles.In a study to identify factors contributing to yellowing needle chorosis(YNC),trees were grown in soils originating from contrasting parent materials,and soils and needles(whole,green and chlorotic portions)from 1-and 2-year-old branches and the first and second needle flush release at four sites with YNC on P.taeda were analyzed for various elements and properties.All soils had very low base levels(Ca^(2+),Mg^(2+)and K^(+))and P,suggesting a possible lack of multiple elements.YNC symptoms started at needle tips,then extended toward the needle base with time.First flush needles had longer portions with YNC than second flush needles did.Needles from the lower crown also had more symptoms along their length than those higher in the canopy.Symptoms were similar to those reported for Mg.In chlorotic portions,Mg and Ca concentrations were well below critical values;in particular,Mg levels were only one third of the critical value of 0.3 g kg^(-1).Collectively,results suggest that Mg deficiency is the primary reason for NC of P.taeda in various parent soils in Brazil.

Time-resolved characteristics of a nanosecond pulsed multi-hollow needle plate packed bed dielectric barrier discharge

In this paper,self-designed multi-hollow needle electrodes are used as a high-voltage electrode in a packed bed dielectric barrier discharge reactor to facilitate fast gas flow through the active discharge area and achieve large-volume stable discharge.The dynamic characteristics of the plasma,the generated active species,and the energy transfer mechanisms in both positive discharge(PD)and negative discharge(ND)are investigated by using fast-exposure intensified charge coupled device(ICCD)images and time-resolved optical emission spectra.The experimental results show that the discharge intensity,number of discharge channels,and discharge volume are obviously enhanced when the multi-needle electrode is replaced by a multihollow needle electrode.During a single voltage pulse period,PD mainly develops in a streamer mode,which results in a stronger discharge current,luminous intensity,and E/N compared with the diffuse mode observed in ND.In PD,as the gap between dielectric beads changes from 0 to250μm,the discharge between the dielectric bead gap changes from a partial discharge to a standing filamentary micro-discharge,which allows the plasma to leave the local area and is conducive to the propagation of surface streamers.In ND,the discharge only appears as a diffusionlike mode between the gap of dielectric beads,regardless of whether there is a discharge gap.Moreover,the generation of excited states N_(2)^(+)(B^(2)∑_(u)^(+))and N2(C^(3)Π_(u))is mainly observed in PD,which is attributed to the higher E/N in PD than that in ND.However,the generation of the OH(A^(2)∑^(+))radical in ND is higher than in PD.It is not directly dominated by E/N,but mainly by the resonant energy transfer process between metastable N_(2)(A^(3)∑_(u)^(+))and OH(X^(2)Π).Furthermore,both PD and ND demonstrate obvious energy relaxation processes of electron-to-vibration and vibration-to-vibration,and no vibration-to-rotation energy relaxation process is observed.

A Set of Acupuncture Needles in the Late Qing Dynasty Collected by George Souliéde Morant

In the early 20th century,French vice-consul George Souliéde Morant encountered acupuncture during his visit to China,and then brought it back to France.After more than a century,his collection was transported from Paris,France to Kunming,China,and later recognized as a Chinese national third-class precious cultural heritage.Currently housed in the Museum of Western Studies on Chinese Medicine at Yunnan University of Chinese Medicine,this set of instruments includes one needle holder converted from a fan-shaped holder,ten acupuncture needles,and eleven paper tags handwritten in English with names of diseases and body parts.This article attempts to present the foundational information and historical significance of this collection of this set of late Qing dynasty acupuncture instruments by reviewing the collection and related research on acupuncture instruments,consulting acupuncture professionals,measuring the detailed information of the set of instruments,and employing a method of translating and summarizing the content of the attached tags.

Formation of diffuse and spark discharges between two needle electrodes with the scattering of particles

The development of a nanosecond discharge in a pin-to-pin gap filled with air at atmospheric pressure has been studied with high temporal and spatial resolutions from a breakdown start to the spark decay.Positive and negative nanosecond voltage pulses with an amplitude of tens of kilovolts were applied.Time-resolved images of the discharge development were taken with a fourchannel Intensified Charge Coupled Device(ICCD)camera.The minimum delay between the camera channels could be as short as≈0.1 ns.This made it possible to study the gap breakdown process with subnanosecond resolution.It was observed that a wide-diameter streamer develops from the high-voltage pointed electrode.The ionization processes near the grounded pin electrode started when the streamer crossed half of the gap.After bridging the gap by the streamer,a diffuse discharge was formed.The development of spark leaders from bright spots on the surface of the pointed electrodes was observed at the next stage.It was found that the rate of development of the spark leader is an order of magnitude lower than that of the wide-diameter streamer.Long thin luminous tracks were observed against the background of a discharge plasma glow.It has been established that the tracks are adjacent to brightly glowing spots on the electrodes and are associated with the flight of small particles.

Percutaneous ultrasound-guided coaxial core needle biopsy for the diagnosis of multiple splenic lesions: A case report

BACKGROUND The overlap of imaging manifestations among distinct splenic lesions gives rise to a diagnostic dilemma.Consequently,a definitive diagnosis primarily relies on his-tological results.The ultrasound(US)-guided coaxial core needle biopsy(CNB)not only procures sufficient tissue to help clarify the diagnosis,but reduces the incidence of puncture-related complications.CASE SUMMARY A 41-year-old female,with a history of pulmonary tuberculosis,was admitted to our hospital with multiple indeterminate splenic lesions.Gray-scale ultrasono-graphy demonstrated splenomegaly with numerous well-defined hypoechoic ma-sses.Abdominal contrast-enhanced computed tomography(CT)showed an en-larged spleen with multiple irregular-shaped,peripherally enhancing,hypodense lesions.Positron emission CT revealed numerous abnormal hyperglycemia foci.These imaging findings strongly indicated the possibility of infectious disease as the primary concern,with neoplastic lesions requiring exclusion.To obtain the precise pathological diagnosis,the US-guided coaxial CNB of the spleen was ca-rried out.The patient did not express any discomfort during the procedure.CONCLUSION Percutaneous US-guided coaxial CNB is an excellent and safe option for obtaining precise splenic tissue samples,as it significantly enhances sample yield for exact pathological analysis with minimum trauma to the spleen parenchyma and sur-rounding tissue.

Study on Antibacterial Effects of Extracts from Pinus massoniana Lamb.Needles

[Objectives]To study the antibacterial effects of extracts from Pinus massoniana Lamb.needles.[Methods]In this experiment,the components from Pinus massoniana Lamb.needles were extracted by systematic solvent extraction method,and the antibacterial activity against four common bacteria,Escherichia coli,Staphylococcus aureus,Bacillus subtilis,Aspergillus flavus and the antibacterial active component were examined for by punch method.[Results]Different solvent extraction rate was different,the rates of petroleum ether,chloroform,ethyl acetate,n-butanol,water extracts were 4.2%,16.7%,17.4%,21.1%,40.6%.All extracts showed inhibitory effect against test bacteria.It was observed that the inhibition of G+was stronger than G-,and the extracts had the best antibacterial activity to Staphylococcus aureus while the weakest to Aspergillus flavus.The antibacterial activity of the components decreased in the order:ethyl acetate extract>n-butanol extract>chloroform extract>petroleum ether extract>aqueous phase.The extracts were stable under ultraviolet radiation(UV)light and long term storage.The antibacterial activity of the extracts was weaker with the increase of pH value when the pH value≤8.[Conclusions]It is inferred that the antibacterial components in the extract of Pinus massoniana needles are widely distributed,and the components with medium polarity or above are the main antibacterial components.

Needle arthroscopic-assisted repair of tibio-fibular syndesmosis acute injury:A case report

BACKGROUND Acute injuries to the tibiofibular syndesmosis,often associated with high ankle sprains or malleolar fractures,require precise diagnosis and treatment to prevent long-term complications.This case report explores the use of needle arthroscopy as a minimally invasive technique for the repair of tibiofibular syndesmosis injuries.CASE SUMMARY We report on a 40-year-old male patient who presented with a trimalleolar fracture and ankle subluxation following a high ankle sprain.Due to significant swelling and poor soft tissue quality,initial management involved external stabilization.Subsequently,needle arthroscopy was employed to assess and treat the tibiofibular syndesmosis injury.The procedure,performed under spinal anesthesia and fluoroscopic control,included nanoscopic evaluation of the ankle joint and reduction of the syndesmosis using a suture button.Follow-up assessments showed significant improvement in pain levels,range of motion,and functional scores.At 26 weeks post-procedure,the patient achieved full range of motion and pain-free status.Needle arthroscopy offers a promising alternative for the management of acute tibiofibular syndesmosis injuries,combining diagnostic and therapeutic capabilities with minimal invasiveness.CONCLUSION This technique may enhance clinical outcomes and reduce recovery times,warranting further investigation and integration into clinical practice.

Appropriate Needle Lengths Determined Using Ultrasonic Echograms for Intramuscular Injections in Japanese Infants

Adjuvanted vaccines are recommended for administration through an intramuscular route. The Centers for Disease Control and Prevention (CDC) has recommended the anterolateral thigh using a 22 - 25-G 25-mm (1 inch) needle for infants, injected at a 90° into the skin surface, and using a 16 mm (5/8 inch) for newborns. Appropriate needle lengths may differ depending on racial backgrounds. In the present study, the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone were measured using ultrasonic echograms in order to determine suitable needle lengths for Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months old. The thickness of the epidermis was 1.44 - 1.54 mm (95% CI), and the lengths from the skin surface to the muscle fascia and bone were 11.52 - 12.28 mm (95% CI), and 25.66 - 26.93 mm (95% CI), respectively, at the anterolateral thigh. At the center of the deltoid muscle, skin thickness was similar to that at the thigh, furthermore the lengths from the skin surface to the muscle fascia and bone were 8.49 - 9.10 mm (95% CI), and 17.38 - 18.31 mm (95% CI), respectively. The lengths from the skin surface to the muscle fascia and bone were 1 - 2 mm shorter in 2-month-old infants than those in older generations. Therefore, the appropriate needle length for intramuscular injections in Japanese infants was 16 mm (5/8 inch) at any age and sites, and with 25 mm (1 inch) needles at a 90° angle being associated with the risk of over-penetration.

Phase II Clinical Study of Three-Dimensional Printed Coplanar Template Combined with CT-Guided Percutaneous Core Needle Biopsy of Pulmonary Nodules in Elderly Patients

Background: As the population age structure gradually ages, more and more elderly people were found to have pulmonary nodules during physical examinations. Most elderly people had underlying diseases such as heart, lung, brain and blood vessels and cannot tolerate surgery. Computed tomography (CT)-guided percutaneous core needle biopsy (CNB) was the first choice for pathological diagnosis and subsequent targeted drugs, immune drugs or ablation treatment. CT-guided percutaneous CNB requires clinicians with rich CNB experience to ensure high CNB accuracy, but it was easy to cause complications such as pneumothorax and hemorrhage. Three-dimensional (3D) printing coplanar template (PCT) combined with CT-guided percutaneous pulmonary CNB biopsy has been used in clinical practice, but there was no prospective, randomized controlled study. Methods: Elderly patients with lung nodules admitted to the Department of Oncology of our hospital from January 2019 to January 2023 were selected. A total of 225 elderly patients were screened, and 30 patients were included after screening. They were randomly divided into experimental group (Group A: 30 cases) and control group (Group B: 30 cases). Group A was given 3D-PCT combined with CT-guided percutaneous pulmonary CNB biopsy, Group B underwent CT-guided percutaneous pulmonary CNB. The primary outcome measure of this study was the accuracy of diagnostic CNB, and the secondary outcome measures were CNB time, number of CNB needles, number of pathological tissues and complications. Results: The diagnostic accuracy of group A and group B was 96.67% and 76.67%, respectively (P = 0.026). There were statistical differences between group A and group B in average CNB time (P = 0.001), number of CNB (1 vs more than 1, P = 0.029), and pathological tissue obtained by CNB (3 vs 1, P = 0.040). There was no statistical difference in the incidence of pneumothorax and hemorrhage between the two groups (P > 0.05). Conclusions: 3D-PCT combined with CT-guided percutaneous CNB can improve the puncture accuracy of elderly patients, shorten the puncture time, reduce the number of punctures, and increase the amount of puncture pathological tissue, without increasing pneumothorax and hemorrhage complications. We look forward to verifying this in a phase III randomized controlled clinical study. .

Indications for Renal Needle Biopsy and Histological Spectrum of Kidney Disease in Togo

Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.

Observation on Therapeutic Effect of Lotus Needle Cupping Therapy for Removing Blood Stasis in Zhuang Medicine on PHN and Its Influ-ence on Inflammatory Mediators

[Objectives]To observe the clinical effect of the lotus needle cupping therapy for removing blood stasis in Zhuang medicine in treating PHNand its influence on inflammatory factors.[Methods]96 patients with PHN were randomly divided into three groups:lotus nee-dle cupping therapy group,TCM surrounding acupuncture group and gabapentin group.Venous blood and acupoint blood were collected at 0,21 and 42 d of treatment,and the expression levels of 5-HT,SP and CGRPinflammatory mediators were detected before and after treatment.The changes of VAS scores before,during and after treatment and the clinical efficacy were observed.[Results]The total effective rate of the lotus needle cupping group was 87.50%,which was better than that of the TCM acupuncture group(81.25%)and the gabapentin group(62.50%);after treatment,the VAS scores and the expression of inflammatory mediators in the three groups of patients were lower than those before treatment,and the decrease was more significant in the treatment group(P<0.05).[Conclusions]The lotus needle cupping therapy for removing blood stasis in Zhuang medicine is effective in treating PHN,and its mechanism is to reduce the release of inflammatory media-tors,reduce hyperalgesia,relieve pain and improve the quality of life of patients.

Shelton Vision pushes the needle on Al-assisted quality control

MANCHESTER,UK-Having successfully demonstrated its WebSpector automated fabric inspection system detecting faults on camouflage fabrics at speeds of up to 100metres a minute during ITMA 2023,BTMA member Shelton Vision has secured an unprecedented number of new orders in many fields of the textile industry.The company has subsequently been recruiting additional staff in order to beef up its operations to meet delivery times and to grow capacity for the ongoing increased demand.

Response of Pinus koraiensis seedling growth to different light conditions based on the assessment of photosynthesis in current and one-year-old needles

As one of the three major five-leaved pines in the northern hemisphere, Pinus koraiensis is the most important dominant tree species in the natural mixed-broadleaved Korean pine forests. However, the regeneration of P koraiensis under the canopy of secondary forest stands is poor because of the light limitation. This study was conducted to understand how P koraiensis seedlings adapt to different light intensities and what would be the optimum light level for their establishment and growth. Three repetition plots with four light intensities （15%, 30%, 60% and 100% of the natural incident irradiances, achieved by suspending layers of black nylon net above and surrounding the plots） were set up under natural climate conditions in a montane region in eastern Liaoning Province, Northeast China. A total of 80 P koraiensis seedlings with similar height and root collar diameter were transplanted into four plots. After one year of acclimation to the specific light conditions, the seasonal variations of the photosynthetic variables and needle traits of the current and one-year-old needles, and the growth parameters were observed under four light intensities. The results indicated that： （1） The seedling at 60% treatment exhibited the greatest growth, which agreed with the response of the light-saturated photosynthetic rates （Amax） and the dark respiration rate （Rd） in the current and one-year-old needles, i.e., Rd at 60% treatment was significantly lower than that at 100% treatment, but Amax did not differ between the seedlings at 100% and 60% treatments. （2） The P. koraiensis seedlings have a certain photosynthetic plasticity to adapt the light conditions by adjusting their needle traits and regulating the physiological processes, because Amax, Rd, light saturation point and compensation point, the needle mass area, needle nitrogen and chlorophyll contents were significantly （p〈0.05） correlated with the light intensities. Especially, Am,x at 100% and 60% treatments was significantly higher （p〈0.05） than that at 30% and 15% treatments for both current and one-year-old needles. （3） The needles of different ages played a commutative role during the growing season, i.e., the one-year-old needles played a major role for the photosynthesis in the early growing season; the current year needles did in the later growing season. This ensured the effective photosynthesis throughout the growing season. These findings suggest that P. koraiensis is the in-between heliophilous and shade-tolerant tree species at least for the seedlings up to 8 years.

Needle Steering for Robot-Assisted Insertion into Soft Tissue:A Survey

Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on needle insertion.It is necessary to summarize and analyze the existing results to promote the future development of theories and applications of needle insertion.Thus,a survey of the state of the art of research is presented on algorithms of needle steering techniques,the surgical robots and devices.Based on the analysis of the needle insertion procedure,the concept of needle steering is defined as a kinematics problem,which is to place the needle at the target and avoid the obstacles.The needle steering techniques,including the artificial potential field method and the nonholonomic model,are introduced to control the needles for improving the accuracy.Based on the quasi-static thinking,the virtual spring model and the cantilever-beam model are developed to calculate the amount of needle deflection and generate the needle path.The phantoms instead of the real tissue are used to verify the models mentioned in most of the experimentations.For the desired needle trajectories,the image-guided robotic devices and some novel needles are presented to achieve the needle steering.Finally,the challenges are provided involving the controllability of the long flexible needle and the properties of soft tissue.The results and investigations can be used for further study on the precision and accuracy of needle insertion.

Variation in needle and cone traits in natural populations of Pinus yunnanensis

Pinus yunnanensis Franch. is a major component of coniferous forests in southwestern China. Little is known about its intraspecific variation. Morphological variations in needle and cone traits of P. yunnanensis were analyzed to quantify variability among and within natural populations. Seven traits were measured on 10 needles collected from 30 trees in each of the 18 sampled populations of P. yunna- nensis. Four cone traits were measured in 221 individual trees from nine populations. The results showed that there were significant differences （p 〈 0.01） both among popu- lations and within populations in each needle and cone trait. The proportion of phenotypic variation of nearly all needle and cone traits was over 50 % within populations, which showed trees within populations accounted for a majority of the total variation. The needle traits showed higher vari- ability within population than cone traits. Variability in theneedle traits was correlated with geo-climatic parameters （longitude, latitude, altitude, temperature, and precipitation）. Needle length and the ratio of needle length to fascicle sheath length showed clinal variation in response to latitudinal and altitudinal gradients. A hierarchical classification of all populations based on needle traits led to the formation of four major groups. The findings provide important genetic information for the evaluation of variation. Moreover, it will assist in management of genetic diversity of P. yunnanensis.

Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis

AIM: To clarify the effectiveness and safety of endo- scopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC). METHODS: Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events. RESULTS: Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P=0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P=0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%). CONCLUSION: EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC.

Cytopathologic diagnosis of fine needle aspiration biopsies of thyroid nodules

Fine-needle aspiration(FNA) cytology is an important diagnostic tool in patients with thyroid lesions.Several systems have been proposed for the cyropathologic diagnosis of the thyroid nodules.However cases with indeterminate cytological findings still remain a matter of debate.In this review we analyze all literature regarding Thyroid Cytopathology Reporting systems trying to identify the most suitable methodology to use in clinical practice for the preoperative diagnosis of thyroid nodules.A review of the English literature was conducted,and data were analyzed and summarized and integrated from the authors' perspective.The main purpose of thyroid FNA is to identify patients with higher risk for malignancy,and to prevent unnecessary surgeries for benign conditions.The Bethesda System for Reporting Thyroid Cytopathology is the most widely used system for the diagnosis of thyroid FNA specimens.This system also contains guidelines for the diagnosis and treatment of indeterminate or suspicious for malignancy cases.In conclusion,patients who require repeated FNAs for indeterminate diagnoses will be resolved by repeat FNA in a percentage of 72%-80%.

Ultrasound-guided fine needle biopsy of intra- hepatic nodules and low elevation of AFP in early diagnosis of hepatocellular carcinoma

BACKGROUND: With the progress in early clinical treat- ment of hepatocellular carcinoma (HCC), early detection and diagnosis of HCC have been increasingly pressing. Combined alpha-fetoprotein ( AFP) determination and ul- trasonography has become the main method for the detec- tion of small HCC; but the relationship between low eleva- tion of AFP and pathologic findings of small HCC has not been well defined. The aim of this study was to assess the value of ultrasound-guided fine needle biopsy of intrahe- patic nodules and low elevation of serum AFP in the early diagnosis of HCC. METHODS; Fifty-nine patients with serum AFP exceeding 20 ng/ml and intrahepatic nodules varying from 0.8 cm to 5.0 cm in diameter who had been detected by ultrasonogra- phy underwent ultrasound-guided percutaneous fine needle biopsy, and cytological staining and histological sectioning were performed at the same time. RESULTS: Among the 59 patients, 11 patients (18.6%) showed AFP level above 400 ng/ml, 5 (8. 5%) from 200 ng/ml to 400 ng/ml, 18 (30. 5%) from 50 ng/ml to 200 ng/ml and 25 (42. 4% ) from 20 ng/ml to 50 ng/ml. Fol- low-up demonstrated that 53 patients (89.8%) had a pro- gressive increase of AFP level. In 58 patients (98.3%) cancer cells were found by cytological staining and/or his- tological sectioning. CONCLUSIONS: In those patients with slightly increased or continuously positive AFP, hepatic carcinoma should be highly suspected when AFP increases gradually and intrahe- patic nodules are detected by ultrasonography in follow-up. Once intrahepatic carcinoma nodules are suspected, ultra- sound-guided fine needle biopsy should be performed as early as possible for early diagnosis and treatment.