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Abstract: Due to the frequent diagnosis of benign thyroid nodules, it is necessary to deviate from the traditional paradigm based on frequent surgical treatment. This article highlights the evolution of diagnosis and treatment in recent years, beginning from standardization of ultrasound assessment of nodules and cytology results to minimally invasive techniques to reduce the size of symptomatic thyroid nodules. These achievements reduce the number of surgeries, enable more individualized care for patients with benign thyroid disease, reduce long-term complications, and promote cost-effectiveness within healthcare systems. Furthermore, although the use of minimally invasive techniques significantly decreases thyroid nodule volume, the thyroid nodule usually does not disappear and the challenges in this field are discussed (the efficacy of thermal ablation, a variable part of thyroid nodules that remains viable after thermal ablation, some of the nodules treated with thermal ablation may require a second treatment over time and the efficacy of thermal ablation in nodules with different phenotypes). However, although surgery still represents the "gold standard" for establishing the final histopathologic diagnosis, it is associated with lifelong thyroid hormone substitution need and serious complications in rare cases. Therefore, it should represent the ultima ratio only after a detailed diagnostic procedure. In the future, artificial intelligence-assisted programs for the evaluation and management of nodules are expected.
Keywords: laser ablation, minimally invasive techniques, thyroid nodules, thyroid ultrasound
Published in DiRROS: 16.03.2026; Views: 5; Downloads: 5
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Abstract: None declared.Conflict of interestHigh-resolution carbon isotope ratio (δ13C) measurements of tree rings have the potential to provide seasonal environmental information. However, due to the complexity of the wood formation processes, the reliability of this method for intra-seasonal reconstruction of growing conditions remains unclear. We, therefore, investigated the intra-annual variation of δ13C in tree rings of three conifer species (Pinus sylvestris, Picea abies, Abies alba) across sites from the Swiss Alps to assess their response to seasonal variation of soil water potential (SWP) and vapour pressure deficit (VPD). Intra-annual δ13C values at a resolution of 10 points per year were assessed using laser-ablation isotope-ratio mass spectrometry. Seasonal δ13C patterns were analyzed for synchronicity across trees and species, and their correlation with on-site environmental variables was used to determine the driving factors of δ13C, to reconstruct growing season dynamics, and to estimate timings of the growth dynamics and allocation of carbon to xylem formation. The δ13C patterns showed high synchronicity between species, with characteristic maxima in wet and dry years occurring in the middle of the ring and at the end of the ring, respectively. Seasonal δ13C variations reliably reflected atmospheric dryness. Higher than normal soil dryness hindered integration of further fresh assimilates into the xylem, thus allowing the identification of species- and site-specific threshold conditions that disrupt wood formation. The δ13C of Scots pine shows the strongest correlations with VPD and SWP, making it an excellent indicator of environmental variability. Silver fir appears to integrate carbon into xylem structural material over a longer season than the other conifers, whilst Norway spruce shows more plastic site-specific responses to environmental conditions. In conclusion, we identify how atmospheric and soil drought jointly impact tree growth and intra-annual δ13C patterns across conifer species, offering valuable insights for climate reconstructions and wider applications on forest dynamics.
Keywords: water availability, annual growth, laser ablation, tree-ring isotopes, carbon isotopes
Published in DiRROS: 01.10.2025; Views: 411; Downloads: 228
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