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Clinical Trial 2013; 34(8): 798-801 PubMed PMID: 24522016 Citation  Keywords:  Acute Pain:diagnosis, Biopsy, Fine-Needle, Biopsy, Large-Core Needle, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care:psychology, Preoperative Care, Thyroid Neoplasms:diagnosis, Thyroid Nodule:diagnosis,.   

OBJECTIVE: A crucial problem in the non-operative diagnosis of thyroid nodules is the significant amount of non-diagnostic biopsies. This is a challenge for practicing endocrinologists especially when the results of the repeated biopsies remain non-diagnostic. The lack of a concrete preoperative diagnosis may result in unnecessary thyroidectomies in patients. Alternatively, it may also lead to the delayed diagnosis of cancer. One method of biopsy specimen acquisition that could potentially increase the diagnostic accuracy of thyroid biopsies is the application of core-needles. The aim of the study was to compare the diagnostic value and patient tolerability of core-needle aspiration biopsies (CNAB) with fine-needle aspiration biopsies (FNAB).

PATIENTS AND METHODS: The study included patients with thyroid nodular goiter in whom previous conventional FNAB yielded non-diagnostic results. CNABs were performed using 22G core-needles. The control group consisted of patients undergoing conventional FNAB with 25G fine-needles. Pain during core-needle biopsies of thyroid nodules was assessed using the 10-point visual analog scale.

RESULTS: There were a total of 30 lesions in 26 patients undergoing CNAB (22 women, 4 men, mean age 48.3) and a total of 59 lesions in 40 patients undergoing FNAB (34 women, 6 men, mean age 57.3). 56.6% of CNABs and 50.8% of FNABs were diagnostic (p=0.60). When assessing pain via the visual analog scale, the median score for biopsies performed with core-needles was four. 60.0% of patients considered the pain of core-needle aspiration biopsies to be similar to the pain experienced during the previous conventional fine-needle aspiration biopsies, while 40% of patients claimed that the pain was more intense.

CONCLUSIONS: CNAB did not prove to be superior to FNAB. Despite the larger needle gauge used during core-needle biopsies, the patients' tolerability was comparable to conventional fine-needle biopsies....

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Clinical Trial 2005; 26(6): 839-842 PubMed PMID: 16380701 Citation  Keywords:  Antioxidants:administration & dosage, Copper:blood, Coronary Artery Bypass, Extracorporeal Circulation:adverse effects, Humans, Inflammation:blood, Leptin:blood, Preoperative Care, Stress, Physiological:blood, Zinc:administration & dosage,.   

OBJECTIVE: The role of leptin in the acute stress response to extracorporeal circulation has been well documented, however, the relationship between leptin and zinc has not been investigated previously. We aimed to research the circulating leptin, zinc, and copper levels before, during, and after the extracorporeal circulation, and effect of preoperative zinc administration to these.

METHODS: Twenty patients who were taken to elective coronary artery bypass grafting operations using extracorporeal circulation were taken to this research and divided into two equal groups (n1, n2). In both groups blood samples were taken just before the operation (T0), at the end of operation (T1), and at the first postoperative day (T2). In the second group (n2) oral zinc (50 mg, once a day) was administered to patients for 5 days, preoperatively. The serum leptin, zinc, and copper levels were studied.

RESULTS: In group n1 circulating leptin levels were significantly increased at T2 when compared to T0 and T1 (p<0.05); zinc levels were decreased at T2 when compared to T0 and T1 (p<0.05); copper levels were decreased at T2 when compared to T0 (p<0.05), and decreased at T1 when compared to T0 (p<0.05). In group n2 circulating leptin levels were significantly increased at T2 when compared to T0 and T1 (p<0.05); zinc levels were decreased at T2 when compared to T0 and T1 (p<0.05); copper levels were increased at T2 when compared to T1 (p<0.05).

CONCLUSIONS: These results indicate that circulating leptin levels increase after the extracorporeal circulation as an acute response, while zinc and copper levels decrease at the same period. Preoperative zinc administration does not prevent the leptin response after extracorporeal circulation....

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