Follicular variant of papillary thyroid cancer typically favors nodal spread. We report a case with hematogenous spread including multi-organ involvement and describe our staged management approach. This is the first case to report follicular variant of papillary thyroid cancer with simultaneous adrenal and renal involvement.

Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and ...

We present an unusual case of syphilis that despite starting treatment with penicillin has evolved with renal complications. Due to glomerulonephritis with nephrotic syndrome the case required shared care between the renal physician and dermatologist. Doctors of different specialties need to keep in mind that early syphilis can have visceral involvement and patients might need prompt, specific ...

Complications following surgery are common, predictable and often preventable. New preoperative assessment optimisation guidance recommends clear pathways with triggers for interventions, patient involvement, shared decision making team education, to help both patients service efficiency.

Conflicts arise within teams and with family members in end-of-life decision-making in critical care. This creates unnecessary discomfort for all involved, including the patient. Treatment plans driven by crisis open the team up to conflict, fragmented care and a lack of focus on the patient’s wishes and realistic medical outcomes. Methods to resolve these issues involve planned ethical reviews...

We provide some of the most reliable evidence to date on the direct impact of employee involvement through participatory arrangements such as teams on business performance. The data we use are extraordinary --daily data for rejection, production and downtime rates for all operators in a single plant during a 35 month period, more than 77,000 observations. Our key findings are that: (i) membersh...

the purpose of the present study was to provide empirical support for the construct of the involvement load hypothesis (ilh ) in an efl context. to fulfill the purpose of the study, 4 intact groups consisting of 126 intermediate-level students participated in this experiment. in order to ensure that the participants were at the same level of english language proficiency, the nelson test was adm...