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In this paper, we determined the rates of Bethesda IV thyroid nodules and calculated the malignancy rates of these nodules in a university hospital located in an endemic area for thyroid diseases. We aimed to define the predictive factors for malignancy to select patients who need surgery. We included in the study 221 patients who had a preoperative biopsy for follicular neoplasm or because of suspicion for follicular neoplasm and underwent thyroidectomy between January 2012 and December 2018. We evaluated the data about patient characteristics, preoperative ultrasound results, indications for operation and postoperative pathological valuation results and calculated ratio of Bethesda Category IV nodules and incidental malignancy rates. The malignancy rate of Bethesda Category IV nodules was 48.9 %, while the incidental malignancy rate was 30.7 %. There was no statistical difference between patients with benign and malignant pathology results in terms of gender, age, preoperative diagnosis, size of the index nodule, number and results of biopsies and the thyroidectomy performed. The most important risk factor among all parameters was hypoechogenicity of the nodule. The solid structure increases this risk. Ultrasonographic hypoechogenicity is the most important risk factor for preoperative malignancy risk assessment for Bethesda Category IV thyroid nodules. Centers should determine their malignancy rates with particular risk factors and surgical approaches in endemic regions. [ABSTRACT FROM AUTHOR]

Purpose: Prolonged surgical procedures and some clinical conditions such as surgeries of thoracoabdominal aorta, mesenteric ischemia, cardiopulmonary bypass, strangulated hernias and neonatal necrotizing enterocolitis may cause decreased perfusion and injury of relevant organs and tissues. After reperfusion, injuries may get worse, leading to ischemia–reperfusion (I/R) injury. Reperfusion following arterial clamping allows oxygen to ischemic tissues and produce injury by multiple mechanisms, including neutrophilic infiltration, intracellular adhesion molecules, and generation of reactive oxygen radicals. In this study with the analysis of SOD, MDA and Caspase-3 levels, we aimed to investigate the effect of topiramate on the outcome of I/R occured after abdominal aorta clamping on rats. Materials and Methods: Totaly 24 Sprague–Dawley male rats were randomly divided into three experimental groups; the control group (n = 8), I/R (n = 8) and I/R+ topiramate (n = 8). Topiramate (100 mg/kg/day); 50 mg/kg (single dose) was administered intraperitoneally after being diluted with saline 5 days before I/R. Results: The intestinal tissue of the ischemia group displayed hemorrhage, Crypts of Lieberkuhn degeneration, ulceration, vascular congestion and edematous fields as a result of aortic occlusion. We also observed that MDA levels and Caspase-3 positivity increased and SOD levels decreased in the small intestine. However, topiramate administration decreased Crypts of Lieberkuhn degeneration, ulceration, vascular congestion and edematous fields, Caspase-3 positivity, and MDA levels. Conclusion: Our findings suggest that topiramate is effective against aortic occlusion-induced intestinal injury by reducing oxidative stress and apoptosis. [ABSTRACT FROM AUTHOR]