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.     

Exploring neglected narratives: understanding vulnerability in narrative inquiry

Framed by a question around vulnerability in narrative inquiries, we show the multiple ways that vulnerability is evident in narrative inquiry. We take up the concerns around vulnerability to show how, as narrative inquirers, we are searching to find ways to think with vulnerability and with what others have called neglected narratives. Drawing on one study with Aboriginal youth and their families, we make visible how questions of vulnerability need to be considered in framing of research puzzles, selecting participants, and moving from field to field texts to interim and final research texts. In composing final research texts, we struggled with the notions of vulnerability that are placed on Aboriginal youth by labels and single stories. These assigned vulnerabilities lead to interpretations that could create experiences of judgment. We returned again to the importance of making experiences visible, in order to shift understandings of who Aboriginal youth are, and are becoming, in a complex world that will not write over or ‘erase their Indianness’ nor their or our vulnerabilities. We showed the ways questions of vulnerability are inextricably interwoven into narrative inquiry.     

Body composition and nutritional profile of male adolescent tennis players

Abstract

In this cross-sectional study, we evaluated the body composition and dietary intake of 44 adolescent tennis players. After being divided into two groups (age 10–13 years and age 14–18), the players had their weight, height, and sexual maturation assessed. Dual-energy X-ray absorptiometry was used to assess body composition. Food intake was obtained from a non-consecutive 4-day food record. The data were analysed using the Virtual Nutri v.1.0 software and compared with the present recommendations for adolescent athletes or dietary reference intakes. Body mass index and body fat for tennis practice were adequate for 89% and 71% of the tennis players respectively, regardless of age group. A calorie deficit greater than 10% of energy expenditure was observed in 32% of the sample. Fifty percent of the athletes consumed carbohydrates in accordance with recommended values. Protein and lipid intakes were above recommended values, while fibre, calcium, potassium, magnesium, and folic acid intakes were below recommendation for 98%, 80%, 100%, 100%, and 98% of the tennis players respectively. The observed nutritional deficiencies represent an additional barrier for adolescents engaged in competitive sports to achieve an optimum nutrition to maintain growth, health, and performance.     

Special educational needs support and consultancy in European schools

ABSTRACT

This article outlines the current state of development of special needs support and consultancy in four European countries: Holland, the Czech Republic, England and Wales, and Germany. Models of consultancy particular to the individual countries are also described. An attempt is made by the authors to determine the key features which allow for a common development in special needs support and consultancy work. They suggest that this might provide the basis for further critical     

Young primary students making sense of text and illustrations about how refuse can become soil

Explanatory pictures and models are frequently used in teaching and learning situations. However, it seems to be simply assumed that they are always beneficial. In this article results from an investigation with 16 Swedish pupils aged 7–9 year are presented based on an analysis that has examined how well this assumption holds up. Concepts from multi-modal theory have been used to investigate how young learners deal with illustrations and text from an early reader booklet about composting domestic refuse. The analysis suggests that expectations that illustrations facilitate the meaning-making of young pupils may be exaggerated. Although the booklet claimed to provide interactive support between image and text most of the examples show pupils ignoring pictures or misinterpreting vital information about composting in both the verbal and non-verbal material. The illustrations did not compensate for the most crucial deficiencies in the written text.