BACKGROUND: Micropapillary Thyroid Cancer (MPTC) is defined as papillary thyroid cancer measuring less than one centimeter in size. Although there have been many studies involving MPTC, there is still a gap in the understanding of the behavior of MPTC in the Filipino population.

OBJECTIVES: This study aims to determine risk factors and prevalence of locoregional and distant metastasis upon diagnosis and the risk factors for persistent disease after thyroidectomy among patients with MPTC.

METHODS: This is a retrospective study that included all patients with histopathology result of MPTC from January 1, 2004 to December 31, 2012. Patients who had accompanying well differentiated thyroid tumors other than MPTC and those patients with a diagnosis of MPTC with no follow up after the surgery were excluded.

RESULTS: A total of 109 patients were eligible for the study. The mean age was 46.06 years with majority being female (96.3%). The average tumor size was 0.502 cm. Seventy-five  (68.81%) received Radioactive Iodine Therapy (RAI) after thyroidectomy. Nineteen patients (17.92%) had multifocal disease while 11 (10.09%) had multicentric disease. Fifteen patients (13.76%) had locoregional metastasis while eight (7.34%) had distant metastasis on diagnosis. Out of the 91 patients included for analysis of persistent disease, eight patients (8.79%) had persistent disease. Exact logistic regression showed that locoregional metastasis (p=0.0044) is a risk factor for distant metastasis at diagnosis. Age, sex, tumor size, multifocality, multicentricity, RAI, and extent of surgery did not reach statistical significance as independent risk factor for locoregional, distant metastasis on diagnosis, and persistent disease.

CONCLUSION: Although MPTC is considered an indolent type of well differentiated thyroid cancer, there are certain patients who may present with metastasis at diagnosis. Our data showed that locoregional metastasis is a risk factor for distant metastasis on diagnosis in patients having MPTC. 

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Thyroidectomy ; Iodine ; Prevalence ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; Adenocarcinoma

BACKGROUND AND OBJECTIVE

There is a call for changes in health professions education to help address current and future challenges. For the effective management of change in institutions involved with health professions education, it is important to consider organizational readiness for change and psychological safety. In organizations, the presence of psychological safety facilitates learning that is integral in organizational development, especially those undergoing changes. There are tools available to measure organizational readiness to change and psychological safety but they are separate and tend to be lengthy. The study developed and validated a brief, straightforward tool that integrates psychological safety in the measurement of organizational readiness for change. It can be useful in the assessment of academic organizations undergoing change in order to facilitate implementation and promote effective change.

METHODS

The study used a sequential exploratory mixed methods design. A conceptual framework on organizational readiness to change which included psychological safety was developed from a review of literature. Relevant constructs were defined and corresponding questions were constructed and scaled. Five content experts qualitatively assessed the scale and removed items which were redundant, lacked clarity, or were irrelevant. The items were then reviewed by selected participants to ensure face validity. Finally, the questionnaire was administered to members of a unit (N=89) which was undergoing organizational change to ensure construct validity. Construct validity, internal consistency, convergent validity, and discriminant validity were determined using PLS-SEM and yielded acceptable results.

RESULTS

The scale developed addressed components of organizational readiness to change and psychological safety. The scale was deemed to have good content validity by five experts, good face validity as tested by a small pilot group, and acceptable construct validity, internal consistency, convergent validity, and discriminant validity.

CONCLUSION

The quantitative scale developed for measuring readiness to change was assessed qualitatively and quantitatively, and deemed to have relevance and validity. It can be used by academic units embarking on change initiatives to assess organizational readiness with due consideration for psychological safety. Quantitative results from the tool can be supplemented with qualitative measures such as observations, interviews or focused group discussions to better identify and address areas needing attention. The study has the potential to make a significant contribution to both the theory and practice of change management.

Psychological Safety

Objective: This study describes the clinical data of adult patients who underwent Fine Needle Aspiration Biopsy (FNAB) of thyroid nodule(s) with a cytologic diagnosis of Atypia or Follicular Lesion of Undetermined Significance (AUS or FLUS) at St. Luke’s Medical Center from January 2012 to October 2013. Methodology: Adult patients who underwent FNAB of the thyroid nodule with a cytologic diagnosis of AUS or FLUS were studied retrospectively using the ultrasound result, initial consultation form and operative techniques of these patients. The cytologic and histopathologic diagnoses were retrieved through the electronic Healthcare-Results Management System. Results and Conclusion A third (34%) of the patients with a cytologic diagnosis of AUS or FLUS (8.9%) underwent surgery. Of the 68 patients who underwent surgery, 44 were benign and 24 were malignant with a malignancy rate of 35.3%. Preoperatively, there were no ultrasound characteristics or microscopic descriptions significantly associated with malignancy. The recommendation of the Bethesda System to do a repeat FNAB in these thyroid nodules should, therefore, be reconsidered.
Biopsy, Fine-Needle ; Thyroid Nodule ; Cytology