Lyssa Friedman.

Erik K. Alexander, M .D., Giulia C. Kennedy, Ph.D., Zubair W. Baloch, M.D., Ph.D., Edmund S. Cibas, M.D., Darya Chudova, Ph.D., James Diggans, Ph.D., Lyssa Friedman, R.N., M.P.A., Richard T. Kloos, M.D., Virginia A. LiVolsi, M.D., Susan J. Mandel, M.D., M.P.H., Stephen S. Raab, M.D., Juan Rosai, M.D., David L. Steward, M.D., P. Sean Walsh, M.P.H., Jonathan I. Wilde, Ph.D., Martha A. Zeiger, M.D., Richard B. Lanman, M.D., and Bryan R. Haugen, M.D.: Preoperative Analysis of Benign Thyroid Nodules with Indeterminate Cytology Thyroid nodules are normal and so are usually benign.1 However, 5 to 15 percent prove to be malignant; accordingly, identification of a nodule 1 cm or larger in size frequently prompts a diagnostic evaluation.2,3 The cornerstone of thyroid-nodule evaluation is fine-needle aspiration,4 which enables the assessment of cellular morphologic features that cannot be identified by means of clinical assessment or imaging.

Ideally, the function of warfarin in patients with atrial fibrillation who’ve chronic kidney disease should be evaluated in a clinical trial. Our study is limited by its observational cohort design, and there could be residual confounding, although we attempted to adjust the analysis for baseline clinical characteristics. The frequencies of risk factors in the study population may also be underestimated, since we identified individuals with heart failure, hypertension, and diabetes on the basis of filled prescriptions and thus were not able to identify patients who had been treated with lifestyle interventions alone. Although the positive predictive worth of the diagnosis of atrial fibrillation is quite high ,29 the inclusion of only hospitalized patients with atrial fibrillation will probably have led to an overestimate of the proportion of individuals who were at elevated risk for thromboembolism and bleeding.