Translational Health Reports

Abstract Thyroid carcinoma encompasses a spectrum of malignancies with distinct clinical characteristics, management strategies, and prognoses. This narrative review article provides an in-depth examination of anaplastic thyroid carcinoma (ATC), papillary thyroid carcinoma (PTC), Hurthle cell carcinoma (HCC), and medullary thyroid carcinoma (MTC), offering insights into their epidemiology, diagnostic and treatment modalities. Anaplastic thyroid carcinoma is a highly aggressive and undifferentiated form of thyroid cancer, often associated with poor prognosis. Treatment strategies include combined resection and radiotherapy, but late-stage cases exhibit limited therapeutic options, emphasizing the need for novel therapeutic approaches. Papillary thyroid carcinoma, the most common thyroid cancer, generally carries a favorable prognosis. The article discusses surgical interventions like total thyroidectomy and lobectomy, along with minimally invasive techniques such as transoral endoscopic thyroidectomy vestibular approach (TOETVA) and robotic thyroidectomy. The importance of considering health-related quality of life in the treatment decision-making process is highlighted. Hurthle cell carcinoma, a rare and aggressive subtype, is explored with a focus on factors influencing prognosis. Surgical management, including thyroid lobectomy, completion thyroidectomy, and iodine-131 therapy, is discussed in detail. Medullary thyroid carcinoma is categorized into hereditary and sporadic forms, each requiring specific approaches. The review emphasizes the significance of genetic testing for patients at risk of multiple endocrine neoplasia syndrome (MEN2) and the need for early thyroidectomy in genetic RET mutation carriers. Furthermore, the article evaluates the extent of surgery, the role of radioiodine therapy, and the significance of follow-up in treating differentiated thyroid carcinomas (DTC). Surgical approaches for follicular thyroid carcinoma (FTC) and factors influencing the decision for total thyroidectomy versus lobectomy are elaborated upon. In summary, this narrative review provides a comprehensive overview of thyroid carcinoma subtypes, their epidemiology, surgical interventions, and postoperative management, offering valuable insights for clinicians and researchers in the field.
 

Abstract Background: Spinal injuries are a significant cause of morbidity and mortality globally. Trauma-related spinal fractures contribute to the burden on healthcare systems and significantly affect the quality of life. Although substantial progress has been made in trauma care, spinal fractures, particularly those associated with spinal cord injuries (SCI), remain a leading cause of long-term disability. The epidemiology of spinal fractures varies regionally due to demographic, trauma mechanisms, and healthcare factors. In Iran, motor vehicle accidents and falls from heights are prominent causes of spinal injuries, but regional data on the epidemiology of these injuries, particularly from smaller cities, is scarce.


Materials and Methods: This retrospective cohort study was conducted at Imam Khomeini Hospital in Sari, Mazandaran province, Iran, reviewing the records of 288 patients with spinal fractures treated between March 2014 and March 2018. Data collected included demographic characteristics (age and gender), injury mechanisms, fracture locations, fracture types, presence of spinal cord injuries, and clinical outcomes. The analysis also included the association between injury mechanisms and fracture types using statistical tests.


Results: The study included 288 patients, with 75% being male and a mean age of 39.21 years. The most common mechanisms of injury were motor vehicle accidents (47.2%) and falls from height (35.4%). Cervical spine fractures were the most common, accounting for 49% of cases. Burst fractures were the most prevalent type of fracture (40.5%). Spinal cord injuries were present in 21.2% of the patients, with a higher incidence in those injured by vehicle accidents. The mortality rate was 3.1%, and 42.4% of patients underwent surgical intervention. The average hospital stay was 7.53 days.


Conclusion: This study provides a comprehensive epidemiological profile of spinal fractures in a regional Iranian hospital. It highlights the high incidence of spinal fractures due to motor vehicle accidents and falls from height, with cervical spine fractures and burst fractures being the most common. The presence of spinal cord injury is significant and underscores the need for early diagnosis and effective treatment. . Further studies, particularly prospective ones, are needed to better understand the long-term outcomes of spinal injuries and SCI in Iran.