Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyper-parathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45%, 30%, 17%, 4%, and 4% of cases, respectively. In 47% of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94% for FNAB and 71% for scintigraphy, while sen-sitivity was 83% and 69%, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.     

Challenging Educational Assumptions: Lessons from an Italian-American collaboration

In this paper, the authors argue that in order to create a curriculum of the future, we need to re-evaluate at least four key assumptions about teaching and learning that have guided educational decisions in the past. These assumptions are: learning is the result of individual, rather than group, activity; teachers are consumers, rather than generators, of theory; assessment is concerned with evaluating learning outcomes, rather than learning processes; teaching and learning are primarily cognitive, rather than aesthetic, ethical or affective, acts. Drawing on recent cross-cultural research, the authors use the example of the municipal pre-schools and infant-toddler centres of Reggio Emilia, Italy, to challenge these assumptions and suggest alternative ways for imagining classrooms of the future.     

Linkages Between Children's and Their Friends' Social and Physical Aggression: Evidence for a Gene–Environment Interaction?

Based on a sample of 406 seven-year-old twins, this study examined whether exposure to friends' social or physical aggression, respectively, moderates the effect of heritability on children's own social and physical aggression. Univariate analyses showed that children's own social and physical aggression were significantly explained by genetic factors, whereas friends' social and physical aggression represented "true" environmental factors that were unrelated to children's genetic dispositions. Multivariate analyses further suggested a possible gene–environment interaction in the link between friends' and children's physical aggression but not in the link between friends' and children's social aggression. Instead, friends' social aggression was directly related to children's social aggression, in addition to genetic effects on this behavior. Theoretical and practical implications of these results are discussed.