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Sample records for complicaciones postoperatorias graves

  1. Factores pronósticos de complicaciones postoperatorias en el trasplante hepático Prognostic factors associated with postoperative complications in liver transplantation

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    A. Rodríguez-Ariza

    2008-03-01

    Full Text Available Objetivo: la evolución postoperatoria de los pacientes sometidos a trasplante hepático ortotópico (THO se encuentra frecuentemente asociada a la aparición de diversas complicaciones tales como disfunción renal, rechazo agudo, infecciones y complicaciones neurológicas. Estas complicaciones constituyen las causas más significativas de morbilidad y mortalidad tempranas en pacientes que reciben un THO. El propósito del presente estudio es la identificación de factores relacionados con las distintas complicaciones postoperatorias del THO. Diseño experimental: se llevó a cabo un estudio prospectivo. Pacientes: se analizaron 78 variables en 32 pacientes consecutivos sometidos a THO. Utilizando un análisis de regresión logística se identificaron aquellos factores asociados de forma independiente con la aparición de complicaciones postoperatorias. Resultados: el análisis multivariante demostró que los niveles pretrasplante en suero de malondialdehído y creatinina estaban asociados con el desarrollo de disfunción renal. Los niveles pretrasplante de hemoglobina y las unidades de plaquetas administradas durante la cirugía fueron factores pronósticos de infecciones. El rechazo agudo fue pronosticado por los niveles séricos de γ-glutamil transpeptidasa y de bilirrubina total. Los niveles pretrasplante de sodio y glutaredoxina en suero estuvieron asociados con complicaciones neurológicas. Conclusiones: proponemos estos marcadores para la identificación de pacientes de alto riesgo, permitiendo una vigilancia y/o tratamiento anticipados que mejorarán la morbilidad y la supervivencia en pacientes sometidos a THO.Objectives: the postoperative evolution of patients submitted to orthotopic liver transplant (OLT is frequently associated with the appearance of different types of complications such as renal failure, graft rejection, infections, and neurological disorders. These complications are the most significant causes of early morbidity

  2. Abordaje biauricular transeptal superior en el tratamiento quirúrgico del mixoma auricular izquierdo de gran tamaño

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    Salvador Torregrosa

    2009-01-01

    Full Text Available Evitar la fragmentación del tejido mixoide durante el acto quirúrgico y resecar todo el espesor del septo interauricular con implantación tumoral son las dos claves para evitar las graves complicaciones de embolia peroperatoria y recidiva postoperatoria en el tratamiento quirúrgico del mixoma auricular izquierdo. La vía transeptal superior nos ha permitido, en tres pacientes, la extirpación en bloque de mixomas de gran tamaño con facilidad y sin complicaciones.

  3. Complicaciones en las puérperas laparotomizadas de urgencia

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    Victor Manuel Sierra Alfonso

    2014-11-01

    Full Text Available La presencia de una complicación intrabdominal postoperatoria después de una laparotomía agrava el estado de salud del paciente y ensombrece el pronóstico, a pesar del uso adecuado de antimicrobianos, de la correcta nutrición y de las ventajas de los cuidados intensivos. Se realizó un estudio retrospectivo descriptivo, con el objetivo de caracterizar las complicaciones en las puérperas, a las que se les practicaron laparotomías de urgencia. Se analizaron las referidas pacientes atendidas en el Hospital Ginecoobstétrico “Piti Fajardo” y en el Hospital General Docente “Aleida Fernández Chardiet”, en el periodo comprendido entre enero del 2010 y diciembre del 2012. La muestra quedó conformada por nueve pacientes. Las complicaciones más presentadas fueron los trastornos hidroelectrolíticos y los trastornos del equilibrio ácido básico. No hubo muerte materna ni fetal. Las puérperas que más complicaciones presentaron fueron las de 35 años y más, con diagnóstico de placenta acreta, hematoma de la cúpula vaginal y atonía uterina. El tiempo de evolución hasta el tratamiento definitivo fue menor de 12 horas

  4. Frecuencia y severidad de complicaciones de 1,056 broncoscopías en la edad pediátrica

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    Ambrosio Aguilar-Aranda

    2017-06-01

    Full Text Available INTRODUCCIÓN: la endoscopía constituye uno de los avances más grandes en el diagnóstico de enfermedades pulmonares. Ésta ha sido considerada como un procedimiento seguro debido al bajo índice de complicaciones relacionadas con el procedimiento, la enfermedad de origen y el manejo anestésico. OBJETIVO: describir la frecuencia y severidad de las complicaciones de broncoscopías en edad pediátrica. MATERIALES Y MÉTODOS: estudio transversal descriptivo de marzo del 2006 adiciembre del 2014, en un hospital de tercer nivel, a quienes se les realizó broncoscopía flexible de fibra óptica. Se identificaron complicaciones menores o mayores agrupadas en fisiológicas, infecciosas, mecánicas y anestésicas. Los resultados se presentaron con frecuencias y porcentajes para variables cualitativas y medianas y rangos para cuantitativas. RESULTADOS: el estudio incluyó 1059 pacientes, sexo masculino 648 (61%, con un rango de edad de 0 a 192 meses, con patología respiratoria de base n = 842 (80%. Estudio diagnóstico n = 898 (85%, terapéutico n = 161 (15%. Complicaciones menores n = 69 (6.5% y mayores n = 14 (1.5%; estas últimas sólo en estudios diagnósticos.De las complicaciones menores en 55 pacientes (5.2% se presentó por lo menos una complicación aislada y en 14 (1.3% se presentaron más de una complicación. Complicaciones mayores más frecuentes: arritmia n = 7 y desaturación grave n = 7. En cinco pacientes con complicaciones mayores se requirieron maniobras de reanimación; cuatro ingresaron a la unidad de terapia intensiva pediátrica y sólo uno requirió traqueotomía urgente. CONCLUSIONES: la broncoscopía es un procedimiento seguro con una frecuencia baja de complicaciones.

  5. Complicaciones del trauma craneoencefálico severo en la unidad de cuidados intensivos pediátricos

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    Andrés Andrés Matos

    2011-09-01

    Full Text Available Introducción: el trauma craneoencefálico severo es responsable de serias complicaciones médicas que exacerban la lesión cerebral secundaria, y frecuentemente son la causa de muerte. Ojetivo: conocer las particularidades de las complicaciones médicas en pacientes con trauma craneoencefálico severo en la unidad de cuidados intensivos del hospital pediátrico "Octavio de la Concepción y de la Pedraja" durante los años comprendidos entre 2007-2009. Métodos: estudio descriptivo en pacientes con trauma craneoencefálico, durante el período comprendido entre los años 2007-2009, para analizar las complicaciones que influyeron en su evolución clínica. Resultados: la edad más representada fue la comprendida entre los 11-15 años (56,90 %; los pacientes incluidos en el grupo de 1-5 años resultaron más vulnerables a las complicaciones médicas. Las fracturas inestables (62,96 %, la rotura de vísceras macizas (51,85 % y la insuficiencia respiratoria (44,44 % fueron las manifestaciones clínicas más evidentes al momento del ingreso. En la Unidad de Cuidados Intensivos las complicaciones médicas frecuentes resultaron ser los trastornos hidroelectrolíticos (94,28 % y la desnutrición (77,14 %. La hiperglicemia y el distrés respiratorio se relacionaron de manera significativa con la mortalidad. El 92,59 % de los fallecidos sumaron 3 puntos en la escala de Glasgow. La ventilación mecánica fue independiente de las complicaciones médicas. Conclusiones: los traumas de cráneo severos son la base para el desarrollo de varias y graves complicaciones que plantean muchos problemas en la práctica médica.

  6. 233. Explante emergente de una corevalve por leak grave objetivo

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    F. Gomera

    2012-04-01

    Conclusiones: La implantación de TAVI está demostrando ser una buena opción para el tratamiento de la estenosis aórtica grave no susceptible de sustitución quirúrgica. Sin embargo, está terapia aún está lejos de estar libre de complicaciones que requieran cirugía urgente de rescate.

  7. Reporte de cinco casos de malaria neonatal grave por Plasmodium vivax en Urabá, Colombia

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    Juan Gabriel Piñeros

    2008-12-01

    Conclusión. Se trata de un reporte de cinco casos de malaria neonatal grave por P. vivax, especie que habitualmente no se relaciona con complicaciones, sin que existiera en ningún caso la sospecha clínica y con tratamiento inadecuado.

  8. Postoperative radiotherapy-induced morbidity in rectal cancer Morbilidad de la radioterapia postoperatoria en el cáncer de recto

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    M. Garay Burdeos

    2004-11-01

    ón curativa y con una evolución mínima de 3 años. Se dividen en dos grupos: 14 tratados con quimio-radioterapia postoperatoria, 5-fluoracilo más ác. folínico y 45 Gy más "boost" de 5 Gy y 23 no tratados utilizados como grupo control. Se realizó una encuesta sobre su funcionalismo rectal y se analizó la morbilidad detectada en el seguimiento. Resultados: el grupo tratado con quimio-radioterapia postoperatoria presentaba mayor frecuencia defecatoria diaria (p=0,03 y nocturna (p=0,04; incontinencia en el 69,2% frente al 17,4% del grupo control (p=0,002 y mayor irritación perianal (p=0,04. Aunque sin diferencias significativas, el grupo tratado precisó usar más frecuentemente compresas, tenía más urgencia defecatoria, diferenciaba peor gases y heces y precisó más medidas antidiarreicas. El 28,6% del grupo tratado presentaron complicaciones mayores: 3 resecciones intestinales por estenosis actínicas quedando uno con una fístula estercorácea residual; otro tuvo varias crisis suboclusivas resueltas con tratamiento conservador. Conclusiones: la quimio-radioterapia postoperatoria tiene una alta tasa de morbilidad, que condiciona una alteración importante de la calidad de vida por lo que es necesario sopesar bien la indicación y tener presente las posibilidades que se abren con la quimio-radioterapia preoperatoria y la excisión mesorrectal total.

  9. RECONSTRUCCIÓN MAMARIA POST-MASTECTOMÍA EN EL SISTEMA SANITARIO PÚBLICO DE ANDALUCÍA

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    Alberto Jiménez-Puente

    2016-01-01

    Full Text Available La reconstrucción mamaria (RM post-mastectomía está ampliamente recomendada pero hay importantes variaciones en su aplicación. El objetivo fue conocer la la frecuencia de complicaciones postoperatorias en el Sistema Sanitario Público de Andalucía (SSPA, el momento de su realización (inmediata o diferida, las técnicas aplicadas, la frecuencia de reingresos por complicaciones postoperatorias y sus características. Métodos: Se utilizó el Conjunto Mínimo Básico de Datos del SSPA con los datos identificativos de pacientes y hospitales encriptados. Se selec - cionaron las altas por cáncer de mama y mastectomía de 2010-2013 y los reingresos relacionados de las mismas mujeres de 2010-2014. Se calcularon las tasas de RM según edad y tipo de mastectomía. Se describió el momento de su realización (inmediata o diferida y las técnicas quirúrgicas empleadas. Las complicaciones postoperatorias se analizaron en el episodio inicial y en los reingresos ocurridos en un plazo mínimo de 2 años. Se hizo un análisis específico de los fallos de RM. Resultados: Se analizó la información de 6.026 mujeres, de las que 4.412 cumplían los criterios de inclusión y tenían un seguimiento superior a 2 años. La tasa de realización de RM se situó en el 29% (22% inmediata y 7% diferida, alcanzando el 58% entre las mujeres menores de 46 años. Realizaron RM 27 de los 36 hospitales que practicaron mastectomías. El porcentaje global de complicaciones postoperatorias fue del 18,6% tras RM inmediata; 12,1% tras la diferida y 7,9% en mujeres sin RM. Se produjo fracaso de la RM en un 12,7% de las inmediatas y en 7,2% de las RM diferidas. Conclusiones: La tasa de reconstrucción mamaria, la de reingresos y com - plicaciones en el SSPA se sitúa en un nivel similar al comunicado a nivel nacional y en otros países.

  10. Complicaciones cronicas de la diabetes mellitus

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    Isla Pera, Ma. Pilar (María Pilar)

    2012-01-01

    La diabetes mellitus (DM) es una de las enfermedades con mayor impacto sociosanitario, no sólo por su elevada prevalencia, sino, sobre todo, por las consecuencias de las complicaciones crónicas que genera. La hiperglucemia ocasiona daño tanto en el ámbito de la microcirculación como en los grandes vasos provocando lesiones macroangiopáticas y microangiopáticas. Las complicaciones macroangiopáticas se originan a partir de alteraciones o lesiones en los grandes vasos arteriales siendo las más i...

  11. Complicaciones agudas del síndrome nefrótico

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    Sandalio Durán Álvarez

    1999-01-01

    Se hace una breve revisión de las complicaciones del síndrome nefrótico que se presentan a veces en forma súbita e inesperada y que pueden poner en riesgo la vida del paciente. Las infecciones son las complicaciones más frecuentes y se destaca la peritonitis primaria como la primera causa. Se analizan las infecciones que se pueden presentar en los pacientes "inmunosuprimidos". Se revisan las complicaciones tromboembólicas y se destaca la importancia de los traumatismos como precipitantes de l...

  12. Introducción a las complicaciones graves de la quimioterapia que debe enfrentar un cardiólogo

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    Patricia Avellana

    2007-01-01

    Full Text Available La aplicación de diferentes esquemas farmacológicos para el tratamiento oncológico ha tenido en los últimos años un gran crecimiento, en muchos casos con efectos curativos o claramejoría de la sobrevida y la calidad de vida. Algunos esquemas incluyen drogas que pueden provocar efectos cardiotóxicos graves, lo que motiva la consulta a los cardiólogos que en la mayor parte de los casos no hemos tenido entrenamiento en esta complicación. En estarevisión se resumen mecanismos de acción y efectos adversos de diferentes drogas de uso frecuente en patología oncológica y se exponen casos clínicos con reacciones adversas graves, con dificultades en la toma de decisiones. Finalmente, se discuten los aspectos para tener en cuenta para la prevención, el control y el tratamiento de la cardiotoxicidad por agentes quimioterapéuticos.

  13. Síntomas y complicaciones posfunduplicatura: abordaje diagnóstico y tratamiento

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    S. Sobrino-Cossío

    2017-07-01

    Full Text Available En la actualidad la funduplicatura laparoscópica tipo Nissen se considera el tratamiento quirúrgico de elección para la enfermedad por reflujo gastroesofágico (ERGE y su efectividad a largo plazo es mayor del 90%. Dentro de los factores predictores de buena respuesta clínica están la adecuada selección del paciente y la experiencia del cirujano. Sin embargo, la prevalencia de síntomas nuevos, persistentes y recurrentes posteriores al procedimiento antirreflujo puede ser de hasta un 30%. Las causas son múltiples pero en general se deben a una o más alteraciones en la anatomía y en la función esofagogástrica. Ante la persistencia de los síntomas posterior al procedimiento quirúrgico se debería de utilizar el término «falla». En el caso de que un paciente inicialmente manifieste control de sus síntomas y posteriormente estos reaparezcan, se pudiera emplear el término «disfunción». Por otra parte, ante el empeoramiento de los síntomas o la aparición de síntomas o situaciones clínicas que no existían antes de la cirugía, debe de considerarse una «complicación». La disfagia postoperatoria y los síntomas dispépticos son muy frecuentes y requieren un abordaje integral para poder determinar el mejor tratamiento posible. En esta revisión se detallan los aspectos fisiopatológicos, de diagnóstico y tratamiento de los síntomas y las complicaciones posteriores a la funduplicatura para el manejo de la ERGE.

  14. La cirugía valvular mínimamente invasiva

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    Orlando Santana

    2014-05-01

    Conclusiones: La cirugía de mínimo acceso se relaciona con recuperación más rápida y mayor satisfacción para el paciente, así como con reducción de complicaciones postoperatorias y de la mortalidad en pacientes de riesgo alto.

  15. COMPLICACIONES MÉDICAS DE LOS TRASTORNOS DE LA CONDUCTA ALIMENTARIA

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    Dr. Guillermo Gabler

    2017-11-01

    Full Text Available Los trastornos de la conducta alimentaria presentan una amplia variedad de complicaciones médicas que deben ser consideradas a la hora de la evaluación y que en caso de no ser detectadas precozmente pueden conducir a la muerte del paciente. En el caso de la anorexia nerviosas las complicaciones dependen del bajo peso y la desnutrición; en la bulimia, en cambio, del tipo de purga utilizado; y en el caso del trastorno por atracones se asocian a la obesidad principalmente. El propósito del presente artículo es revisar las principales complicaciones médicas de estas entidades clínicas.

  16. Complicaciones microvasculares en niños con diabetes mellitus tipo I

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    Machado1, Karina; Freire, María Victoria; Pérez, María del Luján; Montano4, Alicia

    2013-01-01

    Introducción: la diabetes mellitus (DM1) es la enfermedad crónica endocrinológica más frecuente en pediatría y de mayor repercusión sanitaria por la gravedad de sus complicaciones. Dentro de estas complicaciones tienen especial relevancia la afectación de la microvasculatura, que causa retinopatía, neuropatía y nefropatía. Estas complicaciones, si bien se manifiestan durante la edad adulta, comienzan a desarrollarse en la niñez. Existen normas internacionales para su identificación. Se citan ...

  17. Guia de atencion integral para la prevencion, deteccion temprana y tratamiento de las complicaciones del embarazo: Sección de Toxoplasmosis

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    Jorge Alberto Cortes

    Full Text Available Resumen Como parte de la Guia de atencion integral para la prevencion, deteccion temprana y tratamiento de las complicaciones del embarazo, desarrollada y financiada por el Departamento de Ciencia, Tecnologia e Innovacion, Colciencias, y el Ministerio de Salud y Proteccion Social de Colombia, se seleccionó a la infeccion por Toxoplasma para el desarrollo de recomendaciones para su prevencion, diagnostico y tratamiento. La infeccion por Toxoplasma gondii (T. gondii durante el embarazo puede resultar en graves complicaciones para el feto y dejar importantes secuelas al recien nacido. Se realizo una guia basada en la mejor evidencia disponible en la literatura cientifica, con especial pertinencia a la informacion colombiana. Un consenso de expertos en parasitologia, ginecologia, neonatologia e infectologia, tanto de adultos como pediatrica, desarrollo las recomendaciones. Se propone que las recomendaciones de esta guia de atencion integral sean utilizadas por los profesionales de salud de los programas de atencion del embarazo del pais con el fin de disminuir la morbilidad y mortalidad atribuible a esta enfermedad. Se formulan recomendaciones especificas para el diagnostico desde el primer trimestre, consejos de prevencion en las mujeres no infectadas, identificacion de la infeccion del feto o del recien nacido y recomendaciones de tratamiento en estos escenarios.

  18. Taquiarritmias postoperatorias en la cirugía cardíaca pediátrica

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    Fernando Enríquez

    2010-10-01

    Full Text Available Las arritmias postoperatorias son frecuentes en la cirugía de las cardiopatías congénitas. Esta revisión actualiza y expone la evidencia científica sobre la incidencia, fisiopatología, profilaxis y tratamiento de las taquiarritmias en la cirugía cardíaca pediátrica. Existe muy poca información basada en estudios aleatorizados en pediatría, siendo la mayoría de las publicaciones series de diversos centros quirúrgicos.

  19. Complicaciones tardías de la radioterapia ocular

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    González García, Julio Lázaro; Santos Silva, Dania; Abreu Perdomo, Franklyn Alain; Melgares Ramos, María de los Ángeles; Valdivia Bregado, Yamelyn Tania

    2016-01-01

    La radioterapia es uno de los pilares terapéuticos utilizados en la oncología, no exenta de producir daño ocular, lo que constituye un fenómeno bien establecido. La aparición de complicaciones continúa siendo la principal preocupación de la aplicación de la radioterapia, a pesar del empleo de nuevas estrategias que buscan reducir las complicaciones y mejorar el índice terapéutico. Se presenta una paciente femenina de 63 años con diagnóstico de carcinoma epidermoide de la conjuntiva, moderadam...

  20. Complicaciones mecánicas de los accesos venosos centrales

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    Rodrigo Rivas, T.

    2011-01-01

    Las complicaciones mecánicas de los accesos venosos centrales son frecuentes, 2 a 15% y en ocasiones pueden comprometer la vida del paciente. Hay factores que determinan el riesgo de una u otra, que pueden ser modificados o enfrentados de diferente forma para minimizarlo. En esta puesta al día se describen las complicaciones más frecuentes o de mayor gravedad como son: el neumotórax, la embolia aérea, mal-posición del catéter, perforación de grandes venas, punción arterial, arritmias, trom...

  1. Calidad de vida y complicaciones en el paciente diabético. Estudio descriptivo en farmacia comunitaria

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    Mateos Sánchez M

    2013-05-01

    Full Text Available INTRODUCCIÓN La investigación de la percepción de la calidad de vida en relación con las complicaciones de la diabetes permite identificar necesidades en estos pacientes. El objetivo de este trabajo es detectar cómo influyen las complicaciones crónicas de la DM2 en la calidad de vida del paciente en el medio rural. MATERIAL Y MÉTODOS Estudio observacional transversal en la zona básica de salud de Lumbrales (Salamanca. Se elaboró un cuestionario dividido en cuatro bloques: variables sociodemográficas, situación clínica de la diabetes (pacientes con complicaciones, número de complicaciones, tipo de complicaciones, retinopatía, neuropatía, cardiopatía, nefropatía, calidad de vida general y calidad de vida del paciente diabético (EsDQOL, validado del DQOL. RESULTADOS 156 pacientes con DM2: 63 hombres y 93 mujeres. Edad media, 73 años; 121 pacientes (80% sin certificado de estudios y 46 (29% presentan alguna complicación. Los cuatro bloques del EsDQOL (satisfacción,impacto, preocupación socio / vocacional, preocupación relacionada con la diabetes presentan valores superiores para los pacientes con complicaciones. Esta tendencia es igual para todas las complicaciones. DISCUSIÓN Los resultados apuntan a que los pacientes del medio rural con DM2 que presentan complicaciones crónicas perciben peor calidad de vida. También que cada una de las complicaciones crónicas estudiadas individualmente afectan negativamente en la calidad de vida. Se debe tener en cuenta que la información de complicaciones diabéticas está basada en la historia clínica y no se determinó su severidad. Es necesario investigar de qué modo afecta a la calidad de vida de los pacientes diabéticos el grado de cada complicación.

  2. Apendicitis aguda en el paciente senil: Factores asociados a una mayor morbimortalidad post operatoria

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    Víctor Eduardo Chian Chang

    1996-04-01

    Full Text Available Objetivo: Definir los factores asociados a una mayor morbilidad y mortalidad en pacientes seniles con apendicitis aguda. Material y métodos: Se realizó un estudio retrospectivo con 100 pacientes intervenidos en el Hospital Nacional Arzobispo Loayza, durante el período comprendido entre 1984 a 1994. Resultados: Se asociaron a una mayor frecuencia de complicaciones postoperatorias: edad mayor o igual a 70 años, tiempo de enfermedad mayor de 48 horas, presencia de apendicitis perforada con peritonitis localizada o generalizada (p<0.05. Además la presencia de apendicitis perforada se asoció significativamente a la presencia de absceso residual y/o fístula estercorácea (p=0.027 y la presencia de AA gangrenosa o perforada a mayor frecuencia de infección de herida operatoria (p<0.05. El antecedente de patología cardiovascular previa se asoció a mayor frecuencia de complicaciones cardiovasculares (p<0.05. Se asociaron a mayor mortalidad en AA, pacientes con intervención quirúrgica adicional a la apendicetomía (p=0.016 y presencia de AA perforada (p=0.027. Conclusiones: Los estadios avanzados de AA, así como la presencia de problema cardiovascular al momento del diagnóstico se asociaron con una mayor frecuencia de complicaciones post-operatorias. La presencia de peritonitis se asocia con la mortalidad. (Rev Med Hered 1996; 7: 62-67.

  3. COMPLICACIONES MÉDICAS DE LOS TRASTORNOS DE LA CONDUCTA ALIMENTARIA

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    Dr. Guillermo Gabler; Dr. Pablo Olguín; Dr. Alejandra Rodríguez

    2017-01-01

    Los trastornos de la conducta alimentaria presentan una amplia variedad de complicaciones médicas que deben ser consideradas a la hora de la evaluación y que en caso de no ser detectadas precozmente pueden conducir a la muerte del paciente. En el caso de la anorexia nerviosas las complicaciones dependen del bajo peso y la desnutrición; en la bulimia, en cambio, del tipo de purga utilizado; y en el caso del trastorno por atracones se asocian a la obesidad principalmente. El propósito del prese...

  4. Factores asociados a insuficiencia renal postoperatoria en cirugía de revascularización miocárdica

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    Albert F. Guerrero B.

    2016-05-01

    Conclusiones: En quienes se realizó revascularización miocárdica los factores asociados a la presentación de insuficiencia renal postoperatoria fueron comorbilidades que se relacionaron con daño renal progresivo dentro y fuera del contexto de la cirugía. Esto implica que las estrategias para minimizar este evento estarán enfocadas a identificar de manera oportuna a estos pacientes y proporcionarles nefroprotección adecuada.

  5. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

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    Palazón Sánchez C

    2000-01-01

    Full Text Available Fundamento: Conocer la epidemiología de las intoxicaciones agudas graves en un servicio de medicina intensiva y evaluar el pronóstico de la PCR y mortalidad asociada a los distintos tóxicos Métodos: Estudio retrospectivo realizado en el servicio de medicina intensiva polivalente de 10 camas, ubicado en un Hospital General de adultos. Período de estudio 12 años. Revisión de las historias clínicas de las personas ingresadas en el servicio de medicina intensiva por intoxicaciones agudas graves. Se recogieron datos demográficos, existencia de PCR al ingreso, necesidad de VM, complicaciones de las intoxicaciones agudas graves y mortalidad de la serie. Se realizó un análisis global y por año de estudio. El tratamiento estadístico de los datos se realizó con el paquete SPSS mediante la "t" de Student o la "chi" cuadrado, considerando valores significativos si p<0,05 Resultados: Se han incluido 233 sujetos, de los que 130 fueron varones. La estancia media fue de 4 días. El 63% de los pacientes fueron menores de 40 años (p<0,05. La intoxicación más frecuente fue la medicamentosa debida a un solo producto (72%. La supervivencia tras la PCR fue del 40% (4/10. La mortalidad global se situó en el 5,6% (n=13, habiendo precisado el 92% de los sujetos que posteriormente murieron, VM en algún momento de su ingreso en la unidad de cuidados intensivos. Conclusiones: En nuestro medio, la intoxicación más frecuente es la medicamentosa. La mortalidad se muestra dependiente del carácter de voluntariedad, pero independiente del tipo de tóxico (medicamentoso o no. La PCR asociada a las intoxicaciones agudas graves tiene, en nuestra serie, un mejor pronostico que la asociada a otras patologías. La VM asociada a las intoxicaciones agudas graves tiene una mortalidad baja (15,7%

  6. Antibióticos para prevenir las complicaciones posteriores a la extracción de dientes

    Directory of Open Access Journals (Sweden)

    2014-05-01

    Hay pruebas de que los antibióticos profilácticos reducen el riesgo de infección, alveolitis y dolor posterior a la extracción del tercer molar y dan lugar a un aumento de los efectos adversos leves y transitorios. No está claro si las pruebas de esta revisión son generalizables a los pacientes con enfermedades concomitantes o inmunodeficiencia, o a los pacientes sometidos a la extracción de dientes debido a la caries grave o a la periodontitis. Sin embargo, los pacientes en mayor riesgo de infección presentan mayor probabilidad de beneficiarse con los antibióticos profilácticos debido a que es probable que las infecciones en este grupo sean más frecuentes, se asocien con complicaciones y sean más difíciles de tratar. Debido al aumento de la prevalencia de bacterias resistentes al tratamiento con los antibióticos disponibles actualmente, los médicos deben considerar cuidadosamente la probabilidad de que el tratamiento de 12 pacientes sanos con antibióticos para prevenir una infección cause más daños que beneficios.

  7. Resultados del tratamiento con implantes dentales osteointegrados en la fase quirúrgica

    Directory of Open Access Journals (Sweden)

    Oviedo Pérez Pérez

    Full Text Available Objetivo: evaluar los resultados del tratamiento con implantes dentales osteointegrados en la fase quirúrgica. Métodos: se realizó un estudio longitudinal y prospectivo en 802 pacientes en quienes se colocaron 2 165 implantes, en la Clínica Estomatológica Provincial Docente de Santiago de Cuba y la Facultad de Estomatología de La Habana en el decenio 20002009. Se evaluaron las variables: técnica quirúrgica, longitud y diámetro de los implantes, complicaciones intraoperatorias y complicaciones postoperatorias, los resultados del tratamiento se evaluaron en supervivencia y fracaso. Resultados: se logró la supervivencia de los implantes en 705 pacientes para el 87,9 % y se produjo el fracaso en 97 pacientes para el 12,1 %. Se colocaron 2 165 implantes, se logró efectividad de 2 055 para el 94,9 % y fracasaron 110 que representan el 5,08 %. No existen diferencias significativas de los resultados de acuerdo a la técnica quirúrgica empleada. Los implantes que más fracasaron fueron los de 10 mm, para el 34,9 % y 8 mm con el 13,1 %. La efectividad se incrementa a medida que aumenta el diámetro. En las complicaciones intraoperatorias el fracaso fue mayor en relación con la perforación de la tabla ósea con el 92,9 %, inestabilidad con el 86 % y la dehiscencia ósea con el 57,4 %. En el postoperatorio fue notable que en el 100 % de los casos con dolor existió fracaso de los implantes. Conclusiones: en la etapa quirúrgica existe una fuerte asociación de los resultados con la longitud, diámetro de los implantes y la presencia de complicaciones intraoperatorias y postoperatorias.

  8. Lesiones torácicas graves y el enfoque del control de daños Severe thoracic lesions and the damage control approach

    OpenAIRE

    Mario Miguel Morales Wong; Mario Michel Gómez Hernández; Alexander Ramos Godines; Rolando González Folch

    2008-01-01

    En los últimos años se han desarrollado nuevas estrategias para el tratamiento del trauma grave con lesiones exanguinantes o sin ellas, pero son estas últimas las que más requieren un cambio de la forma de actuar en aras de mejorar la supervivencia. Tales estrategias quirúrgicas se han denominado cirugía de control de daños, que en esencia evita complicaciones como la tríada letal de acidosis, hipotermia y coagulopatía. A diferencia del control de daños en el abdomen, existen lesiones torácic...

  9. Complicaciones neurológicas de la endocarditis infecciosa: controversias

    Directory of Open Access Journals (Sweden)

    Federico A. Silva, MD., MSc

    2011-07-01

    Full Text Available En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia.

  10. Relación entre las complicaciones y la calidad de vida del paciente en hemodiálisis

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Cuevas-Budhart

    Full Text Available Resumen Introducción: Los pacientes con Enfermedad Renal Crónica (ERC son tratados con terapias de diálisis. Dentro de este tipo de tratamiento se encuentran la Diálisis Peritoneal (DP y Hemodiálisis (HD. Los pacientes sometidos a HD tienen una evolución imprevisible por las complicaciones del tratamiento y/o complicaciones propias de la ERC. Estas aumentan el número de hospitalizaciones y deterioran la calidad de vida (CV. Objetivos: Evaluar la calidad de vida de pacientes en hemodiálisis y determinar la asociación entre las complicaciones y la CV. Material y Método: Estudio transversal analítico en 157 pacientes en HD (75 hombres, 82 mujeres, mayores de 18 años y con más de 3 meses en tratamiento. La CV se evaluó con el instrumento KDQOL-36, el cual, mide 5 dimensiones en escala del 0 al 100. Se realizó un análisis bivariado, ANOVA y regresión múltiple para evaluar la relación de cada una de las dimensiones con edad, sexo, ocupación, estado civil, escolaridad, tipo de acceso venoso, tiempo con la ERC, con la HD y complicaciones de la ERC y la HD. Resultados: La edad promedio fue de 50.9 años. El 77% de los participantes presentaron complicaciones, 69.4% por HD, 5% por evolución de la ERC y 25.6% ambas complicaciones. En el análisis multivariado se encontró que la presencia de ambas complicaciones deteriora más la calidad de vida que las ocasionadas únicamente por el tratamiento de HD. Conclusión: Las complicaciones del tratamiento de hemodiálisis aunadas a las de la ERC deterioran en gran medida la calidad de vida del paciente.

  11. Complicaciones tardías de la radioterapia ocular

    Directory of Open Access Journals (Sweden)

    Julio Lázaro González García

    Full Text Available La radioterapia es uno de los pilares terapéuticos utilizados en la oncología, no exenta de producir daño ocular, lo que constituye un fenómeno bien establecido. La aparición de complicaciones continúa siendo la principal preocupación de la aplicación de la radioterapia, a pesar del empleo de nuevas estrategias que buscan reducir las complicaciones y mejorar el índice terapéutico. Se presenta una paciente femenina de 63 años con diagnóstico de carcinoma epidermoide de la conjuntiva, moderadamente diferenciado G-II, invasor (T3N0M0 en ojo izquierdo, que llevó tratamiento quirúrgico y radioterapia superficial complementaria. Como complicación tardía, la paciente presentó catarata radiógena, que recibió tratamiento quirúrgico, además de aneurismas conjuntivales en el área tratada.

  12. Complicaciones y costos asociados a la varicela en niños inmunocompetentes

    Directory of Open Access Journals (Sweden)

    Sáez-Llorens Xavier

    2002-01-01

    Full Text Available Objetivos. La varicela es una infección común de la infancia en países que no han incorporado la vacunación correspondiente en sus calendarios vacunales. Generalmente es benigna en niños inmunocompetentes y no necesita tratamiento. Los objetivos de este estudio consistieron en investigar la frecuencia y características de las complicaciones de la varicela que requieran tratamiento hospitalario en niños inmunocompetentes y el curso clínico de los hijos de madres con varicela perinatal. Además, se calculó el gasto hospitalario asociado a la varicela en los niños estudiados. Métodos. Estudio retrospectivo de los expedientes clínicos de niños con varicela ingresados en el Hospital del Niño de Panamá, de enero de 1991 a diciembre de 2000. Se analizaron el tipo de complicaciones, el curso clínico y los costos hospitalarios de los pacientes afectados por varicela. Resultados. De 5 203 niños atendidos en consultas externas, 568 (11% fueron hospitalizados. En el estudio se incluyeron 513 niños: 381 (74% con varicela adquirida en la comunidad, 92 (18% hijos de madres con varicela y 40 (8% con varicela nosocomial. Las complicaciones más frecuentes fueron las infecciones cutáneas y subcutáneas (45%, las infecciones respiratorias (25% y las alteraciones neurológicas (7%. Las complicaciones respiratorias y cutáneas ocurrieron a menor edad y en fases más tempranas de la varicela que las alteraciones neurológicas. Trece niños (2,5% fallecieron, con una letalidad del 8% para la varicela con complicaciones respiratorias y neurológicas y nula para las complicaciones cutáneas. Sesenta de los 92 (65% hijos de madres con varicela no desarrollaron la enfermedad y ninguno falleció. En cambio, 2 de los 32 neonatos (6% con varicela perinatal fallecieron. La duración media de la hospitalización fue de 8,9 (1 a 27 días. Se utilizó farmacoterapia parenteral en una gran proporción de los niños, especialmente antibióticos (54%, aciclovir

  13. Infección odontogénica grave: Posibles factores predictores

    Directory of Open Access Journals (Sweden)

    Oscar García-Roco Pérez

    2003-04-01

    Full Text Available Se analizaron factores que pudieran predisponer a una infección odontogénica grave que requiera cuidados intensivos. Se realizó un estudio observacional descriptivo a 100 pacientes ingresados consecutivamente con infección odontogénica severa en el Hospital "Manuel Ascunce Domenech" de Camagüey desde 1999 al 2001. A partir de las historias clínicas se estudiaron diferentes variables que incluyeron parámetros médicos, sociales y procedimientos dentales previos. Se prestó particular atención al resultado de los cultivos bacterianos. La edad media de los 59 pacientes masculinos y 41 femeninos fue de 41 ± 15,8 años; 18 pacientes requirieron cuidados intensivos. El 41 % de los pacientes era de bajo nivel de escolaridad; 11 pacientes graves (61,1 % y 42 no graves (51,2 % eran fumadores. Dos pacientes (11,1 % de los graves y 8 (9,8 % de los no graves referían consumo excesivo de bebidas alcohólicas. La prevalencia de enfermedades crónicas fue mayor entre los no graves (31,7 %. La afección subyacente más común fue la osteítis periapical (70 % de los episodios infecciosos, seguido por la extracción dental en el 27,5 % de los graves y 10,9 % de los no graves. Ninguno de estos factores predijo la necesidad de cuidados intensivos. No existieron diferencias significativas en cuanto a síntomas, demora en solicitar atención médica, procedimientos dentales previos o terapéutica antimicrobiana. Predominaron los estreptococos aerobios (grupo S. milleri asociados con bacterias anaerobias variadas. No se encontraron variables sociales o clínicas predictoras de un curso grave en infecciones odontogénicas. Todos los pacientes deben ser cuidadosamente monitoreados para evitar complicaciones severas.Those factors that may predispose to a severe odontogenic infection requiring intensive care were analyzed. An observational descriptive study was conducted among 100 patients that were consecutively admitted with severe odontogenic infection at

  14. Miastenia grave y miastenia grave ocular

    Directory of Open Access Journals (Sweden)

    Rosa María Naranjo Fernández

    Full Text Available La miastenia grave es una enfermedad caracterizada por debilidad y fatiga de los músculos voluntarios debido a una trasmisión anómala a nivel de la unión neuromuscular. La prevalencia es aproximadamente de 5 casos/100 000 personas. La miastenia grave puede ser bulbar, ocular o generalizada.Existen formas clínicas en la infancia como son la miastenia neonatal transitoria, la miastenia congénita y la miastenia juvenil. Los músculos oculares, faciales y bulbares son los más frecuentes afectados por la enfermedad. Cuando los síntomas se limitan a la musculatura cercana al ojo se denomina miastenia grave ocular. Una vez el oftalmólogo diagnostica o sospecha la miastenia grave, un neurólogo generalmente dirige la comprobación y tratamiento. El papel del oftalmólogo continúa siendo importante, además de chequear la motilidad y disfunción palpebral y proporcionar el alivio sintomático para estos desórdenes, debe estar alerta a la posibilidad de ambliopía.

  15. Biopsia Renal en receptores de Trasplante Renal: cuidados de enfermería y complicaciones

    Directory of Open Access Journals (Sweden)

    Esther Sanz Izquierdo

    Full Text Available Introducción: La biopsia renal percutánea es una herramienta fundamental para el manejo del paciente trasplantado renal. La prueba es primordial para detectar y/o prevenir cualquier disfunción en el injerto, siendo un procedimiento tanto diagnóstico como preconizador. Objetivo: Describir los cuidados de enfermería e identificar las complicaciones derivadas de la biopsia renal en los receptores de Trasplante Renal. Material y métodos: Estudio cuantitativo, descriptivo y transversal realizado en la Unidad de Trasplante Renal, Servicio de Nefrología, del 2008 al 2014. La población objeto de estudio son los receptores de Trasplante Renal (TR. La muestra está compuesta por 368 biopsias renales de seguimiento que ingresan para someterse a una biopsia renal. Los criterios de inclusión son ser mayores de 18 años, trasplantados y que han firmado el consentimiento informado. Se recogen datos sociodemográficos, clínico-asistenciales y complicaciones post-biopsia renal. Resultados: Desde 1980 hasta el 2014 se han llevado a cabo 1868 TR, de 2008 a 2014 se estudiaron 368 biopsias de seguimiento. Se monitoriza la Tensión Arterial y la coagulación pre biopsia. Tras el procedimiento, se controla la presencia de sangrado por micción y constantes vitales. Inicialmente el reposo absoluto era de 24 h, a partir de 2014 se reduce a 6 horas, recomendando reposo relativo al alta, las complicaciones fueron mínimas. Conclusiones: Los resultados indican que la biopsia renal es un procedimiento eficaz, con escasas complicaciones. Destacar el papel de enfermería en la detección precoz de complicaciones.

  16. Temporal relationship between onset of Graves' ophthalmopathy and onset of thyroidal Graves' disease

    NARCIS (Netherlands)

    Wiersinga, W. M.; Smit, T.; van der Gaag, R.; Koornneef, L.

    1988-01-01

    The temporal relationship between the onset of Graves' ophthalmopathy and the onset of thyroidal Graves' disease was evaluated in 125 consecutive patients with Graves' ophthalmopathy. Thyroidal Graves' disease--past or present--was clinically evident in 99 patients (79%): hyperthyroidism in 3 cases.

  17. 248. Reemplazo de raíz de aorta según técnica de david y de arco aórtico con injerto trifurcado, en un paciente diagnosticado de síndrome de loeys-dietz

    Directory of Open Access Journals (Sweden)

    A. Forteza Gil

    2010-01-01

    Resultado y conclusiones: No hubo complicaciones postoperatorias. El tratamiento quirúrgico precoz en los pacientes afectos de síndrome de Loeys-Dietz es imprescindible. La experiencia acumulada hasta el momento revela la agresividad de esta enfermedad. Por ello, es necesario un abordaje completo cuando existe afectación a distintos niveles. El empleo de técnicas de preservación valvular permite además disminuir la morbimortalidad asociada a las prótesis valvulares.

  18. Reparación endovascular torácica aórtica (TEVAR: un enfoque sobre complicaciones

    Directory of Open Access Journals (Sweden)

    Ali Azizzadeh

    2010-01-01

    Full Text Available La reparación endovascular torácica (TEVAR se ha constituido como una alternativa válida para la reparación de los aneurismas torácicos, al ser menos agresiva. Una reciente revisión sistemática y metaanálisis de estudios comparativos confirma que TEVAR, cuando se compara con la cirugía abierta, puede reducir la muerte precoz, la paraplejía, insuficiencia renal, transfusiones, reoperación por hemorragia, complicaciones cardíacas, neumonía y estancia hospitalaria. Esta revisión se referirá a algunas de las complicaciones del procedimiento. Éstas incluyen: mortalidad, accidente cerebrovascular, isquemia medular, disección retrógrada, disfunción del dispositivo, complicaciones del acceso, endofuga y migración.

  19. Complicaciones del tratamiento de incontinencia urinaria y prolapso de la pelvis

    Directory of Open Access Journals (Sweden)

    Chasta Bacsu, MD

    2013-03-01

    Full Text Available Este artículo tiene como objetivo proporcionar una visión general de las complicaciones asociadas al tratamiento quirúrgico por incontinencia urinaria y prolapso pélvico relacionado con el uso de mallas quirúrgicas. Asimismo, otro de sus objetivos es revisar la nueva clasificación de complicaciones relacionadas con la inserción de prótesis o injertos en la cirugía de piso pélvico femenino otorgada por la Asociación Uroginecológica Internacional (IUGA, por su sigla en inglés / Sociedad de Continencia Internacional (ICS, por su sigla en inglés y por las recientes notificaciones proporcionadas por la Administración de Medicamentos y Alimentación (FDA, por su sigla en inglés.

  20. Factores asociados a complicaciones de yeyunostomía

    Directory of Open Access Journals (Sweden)

    H. Medina-Franco

    2013-04-01

    Conclusiones: La yeyunostomía se asocia a una elevada frecuencia de complicaciones, tanto médicas como quirúrgicas. Si bien se ha establecido como una mejor alternativa a nutrición parenteral, deberá tomarse en cuenta la morbilidad asociada a la misma antes de establecer su utilización rutinaria como medio de aporte nutricional, particularmente en pacientes con factores asociados al desarrollo de las mismas.

  1. Death by suicide in Graves' disease and Graves' orbitopathy

    DEFF Research Database (Denmark)

    Ferløv-Schwensen, Charlotte; Brix, Thomas Heiberg; Hegedus, Laszlo

    2017-01-01

    BACKGROUND: Graves' disease is associated with excess morbidity and mortality, but little is known about unnatural manners of death and the potential relation with Graves' orbitopathy. Here we investigate the risk of unnatural death in Graves' patients with orbitopathy (GO) and without (GD), comp...... in the pathophysiological mechanisms of suicidal behavior. Beyond independent confirmation, reasons for this need to be explored in order to introduce preventive measures....... with GD, and 3,965 with GO were identified and matched for age and gender with four subjects from the background population. Manner of death was identified and hazard ratios (HR) for mortality due to unnatural deaths (accident, suicide, violence/homicide, and unknown) were calculated using Cox regression...... analyses, adjusted for pre-existing somatic and psychiatric morbidity. RESULTS: In Graves' disease overall there was an increased risk of death from unknown unnatural manners [HR: 2.01 (95% confidence interval: 1.17-3.45); P=0.012] and of suicide, although the latter difference was not with certainty...

  2. Celulitis orbitaria, celulitis frontal y empiema como complicaciones de sinusitis

    Directory of Open Access Journals (Sweden)

    Felipa Elena García García

    Full Text Available La celulitis orbitaria usualmente ocurre como complicación de infecciones de los senos para nasales, y la etiología es principalmente bacteriana. Para realizar un diagnóstico e implantar terapéutica temprana tiene gran importancia reconocer las manifestaciones clínicas de la sinusitis y las edades más afectadas, pues dada su ubicación anatómica, pueden complicarse también con infecciones del sistema nervioso central, que en la edad pediátrica tienen una connotación especial. Se presentan aquí dos pacientes de 10 y 14 años de edad respectivamente, que desarrollaron celulitis orbitaria en un caso, y celulitis frontal y empiema en el otro; así mismo, se muestran los medios diagnósticos utilizados para identificar signos tempranos de posibles complicaciones, con el objetivo que el pediatra pueda identificarlos, así como la terapéutica implantada para dar solución o evitar estas complicaciones.

  3. Complicaciones mecánicas del infarto agudo de miocardio: aunque infrecuentes, potencialmente letales

    Directory of Open Access Journals (Sweden)

    Jerson Quitian Moreno

    2017-09-01

    Full Text Available Aunque la incidencia de complicaciones mecánicas en el infarto agudo de miocardio ha descendido después de la era de la intervención coronaria percutánea, la mortalidad sigue siendo significativa. La ruptura septal ventricular, la regurgitación mitral aguda y la ruptura de la pared libre del ventrículo izquierdo conforman el espectro de complicaciones mecánicas posteriores al infarto agudo de miocardio. La reparación quirúrgica es el pilar del tratamiento; sin embargo, como puente para la cirugía, el manejo médico permite estabilizar al paciente.

  4. Tratamiento y complicaciones de las fracturas de seno frontal Frontal sinus fracture treatment and complications

    Directory of Open Access Journals (Sweden)

    S. Heredero Jung

    2007-06-01

    Full Text Available Introducción. Las fracturas de seno frontal se producen como resultado de impactos de alta energía. Un tratamiento inadecuado puede conducir a complicaciones serias incluso muchos años después del traumatismo. Objetivos. Evaluar los datos epidemiológicos y revisar las complicaciones asociadas. Estandarizar el protocolo de tratamiento. Materiales y métodos. Se revisaron 95 pacientes diagnosticados de fracturas de seno frontal pertenecientes al servicio de Cirugía Oral y Maxilofacial del Hospital Universitario 12 de Octubre de Madrid, entre enero de 1990 y diciembre de 2004. Resultados. La edad media de los pacientes revisados es de 34 años. La mayoría son hombres (78% y la causa más frecuente del traumatismo, los accidentes de tráfico. El patrón de fractura más común es el que afecta únicamente a la pared anterior del seno frontal. Las complicaciones descritas son: deformidad estética frontal, sinusitis frontal, mucocele frontal, celulitis fronto-orbitaria, intolerancia al material de osteosíntesis, complicaciones infecciosas del SNC y persistencia de fístula de líquido cefalorraquídeo. Conclusiones. El objetivo ha de estar encaminado a prevenir las complicaciones asociadas a los pacientes con fracturas de seno frontal. Hay que individualizar el protocolo de tratamiento en cada caso. Es recomendable un seguimiento a largo plazo para identificar precozmente las posibles complicaciones.Introduction. Frontal sinus fractures are caused by high velocity impacts. Inappropriate treatment can lead to serious complications, even many years after the trauma. Objectives. To evaluate epidemiological data and associated complications. To standardize the treatment protocol. Materials and methods. the clinical records of 95 patients with frontal sinus fractures treated between January 1990 and December 2004 at the Oral and Maxillofacial Surgery Department, "12 de Octubre" Hospital (Madrid, Spain, were reviewed. Results. The average age of

  5. Graves' disease following subacute thyroiditis.

    Science.gov (United States)

    Nakano, Yoshishige; Kurihara, Hideo; Sasaki, Jun

    2011-12-01

    Subacute thyroiditis is a painful, inflammatory disease frequently accompanied with fever. It is suspected to be a viral infectious disease, while Graves' disease is an autoimmune disease. Thus, there appears to be no etiological relationship between the two diseases. A total of 25,267 thyroid disease patients made their first visits to our thyroid clinic during a period of 24 years between 1985 and 2008. Among them, subacute thyroiditis and Graves' disease accounted for 918 patients (3.6%) and 4,617 patients (18.2%), respectively. We have encountered 7 patients (one male and six female) with subacute thyroiditis followed by Graves' disease in this period (0.15% of the 4,617 patients with Graves' disease and 0.76% of the 918 patients with subacute thyroiditis). The age ranges were 40~66 years (mean 48.7 years) at the onset of subacute thyroiditis. The intervals between the onsets of subacute thyroiditis and Graves' disease were 1~8 months (mean 4.7 months). Because Graves' disease was preceded by subacute thyroiditis, the signs and symptoms of both diseases were evident together in the intervening period. The diagnosis of Graves' disease in those patients is always difficult because of atypical signs and symptoms and an unclear onset time. The causes of the Graves'disease that followed subacute thyroiditis are still unknown. However, the inflammatory nature of subacute thyroiditis may lead to the activation of the autoimmune response in susceptible subjects, resulting in the onset of Graves' disease. Graves' disease should be suspected when a high blood level of thyroid hormone persists after subacute thyroiditis.

  6. Genetics Home Reference: Graves disease

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Graves disease Graves disease Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Graves disease is a condition that affects the function of ...

  7. Thyroid surgery for Graves' disease and Graves' ophthalmopathy.

    Science.gov (United States)

    Liu, Zi Wei; Masterson, Liam; Fish, Brian; Jani, Piyush; Chatterjee, Krishna

    2015-11-25

    Graves' disease is an autoimmune disease caused by the production of auto-antibodies against the thyroid-stimulating hormone receptor, which stimulates follicular cell production of thyroid hormone. It is the commonest cause of hyperthyroidism and may cause considerable morbidity with increased risk of cardiovascular and respiratory adverse events. Five per cent of people with Graves' disease develop moderate to severe Graves' ophthalmopathy. Thyroid surgery for Graves' disease commonly falls into one of three categories: 1) total thyroidectomy, which aims to achieve complete macroscopic removal of thyroid tissue; 2) bilateral subtotal thyroidectomy, in which bilateral thyroid remnants are left; and 3) unilateral total and contralateral subtotal thyroidectomy, or the Dunhill procedure. Recent American Thyroid Association guidelines on treatment of Graves' hyperthyroidism emphasised the role of surgery as one of the first-line treatments. Total thyroidectomy removes target tissue for the thyroid-stimulating hormone receptor antibody. It controls hyperthyroidism at the cost of lifelong thyroxine replacement. Subtotal thyroidectomy leaves a thyroid remnant and may be less likely to lead to complications, however a higher rate of recurrent hyperthyroidism is expected and revision surgery would be challenging. The choice of the thyroidectomy technique is currently largely a matter of surgeon preference, and a systematic review of the evidence base is required to determine which option offers the best outcomes for patients. To assess the optimal surgical technique for Graves' disease and Graves' ophthalmopathy. We searched the Cochrane Library, MEDLINE and PubMed, EMBASE, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). The date of the last search was June 2015 for all databases. We did not apply any language restrictions. Only randomised controlled trials (RCTs) involving participants with a diagnosis

  8. Hashimoto's thyroiditis following Graves' disease.

    Science.gov (United States)

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen

    2010-01-01

    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  9. Fiebre postoperatoria en cirugía ortopédica y urológica Postoperative fever in orthopedic and urologic surgery

    Directory of Open Access Journals (Sweden)

    Federico Saavedra

    2008-02-01

    Full Text Available La incidencia de fiebre en el postoperatorio varía ampliamente. En la cirugía limpia y la limpia-contaminada, la fiebre no infecciosa es más frecuente que la infecciosa. Fueron estudiados prospectivamente 303 pacientes operados en forma programada de cirugía ortopédica y urológica. Se investigó la incidencia de fiebre postoperatoria, su etiología, la relación entre el momento de su aparición y su origen y la utilidad del pedido empírico de estudios para determinar infección postoperatoria. El 14% (42/303 de los pacientes tuvieron fiebre postoperatoria. En el 81% (34/42 su etiología fue no infecciosa y en el 19% (8/42 infecciosa. Su origen fue siempre no infeccioso dentro de las primeras 48 horas del postoperatorio (pPost-operative fever incidence varies widely. In clean and clean-contaminated surgery the non-infectious fever is more frequent than the infectious fever. We performed a prospective study including 303 patients who underwent orthopedic and urologic elective surgery. The aims of our study were to investigate the incidence of post-operative fever, its etiology, the relationship between time of onset and the etiology, and the usefulness of extensive fever work-up to determine post-operative infection. The incidence of post-operative fever was 14% (42/303 of which 81% (34/42 was noninfectious and 19% (8/42 was infectious. The etiology of the fever in the first 48 hours after surgery was always non-infectious (p<0.001. An extensive fever work-up was performed in patients who presented fever only after the initial 48 hours of surgery with normal physical examination (n=19 consisting of chest x-ray, blood (2 and urine cultures. The chest x-ray was normal in all the patients, the urine cultures were positive in four cases (21%, IC 95%: 6-45 and the blood cultures in only one case (5%, IC 95%: 0.1-26. Seven patients had post-operative infections without fever as a clinical sign. The most frequently observed etiology of post

  10. Calidad de vida y complicaciones en el paciente diabético. Estudio descriptivo en farmacia comunitaria

    OpenAIRE

    Mateos Sánchez M

    2013-01-01

    INTRODUCCIÓN La investigación de la percepción de la calidad de vida en relación con las complicaciones de la diabetes permite identificar necesidades en estos pacientes. El objetivo de este trabajo es detectar cómo influyen las complicaciones crónicas de la DM2 en la calidad de vida del paciente en el medio rural. MATERIAL Y MÉTODOS Estudio observacional transversal en la zona básica de salud de Lumbrales (Salamanca). Se elaboró un cuestionario dividido en cuatro bloques: variables sociod...

  11. Calidad de vida y complicaciones en el paciente diabético. Estudio descriptivo en farmacia comunitaria

    OpenAIRE

    Mateos Sánchez, Mercedes

    2013-01-01

    INTRODUCCIÓN La investigación de la percepción de la calidad de vida en relación con las complicaciones de la diabetes permite identificar necesidades en estos pacientes. El objetivo de este trabajo es detectar cómo influyen las complicaciones crónicas de la DM2 en la calidad de vida del paciente en el medio rural.MATERIAL Y MÉTODOS Estudio observacional transversal en la zona básica de salud de Lumbrales (Salamanca). Se elaboró un cuestionario dividido en cuatro bloques: variables sociodemog...

  12. Complicaciones neurológicas en pacientes con leucemias y linfomas

    OpenAIRE

    Gatti, Carolina; Russo, M. J.; Pazos, M.; Tizio, S.; Bunzel, S.; Borzi, A.

    2010-01-01

    Las leucemias y linfomas pueden afectar el sistema nervioso (SN) por invasión directa o indirecta del tumor. Se ha reportado en 5 a 29% de pacientes con linfomas y en 13% de leucemias agudas. Objetivos: Conocer las complicaciones neurológicas con el fin de implementar un diagnóstico y tratamiento adecuados, mejorar la calidad de vida y el tiempo de supervivencia.

  13. Thyroid cancer in Graves' disease: is surgery the best treatment for Graves' disease?

    Science.gov (United States)

    Tamatea, Jade A U; Tu'akoi, Kelson; Conaglen, John V; Elston, Marianne S; Meyer-Rochow, Goswin Y

    2014-04-01

    Graves' disease is a common cause of thyrotoxicosis. Treatment options include anti-thyroid medications or definitive therapy: thyroidectomy or radioactive iodine (I(131) ). Traditionally, I(131) has been the preferred definitive treatment for Graves' disease in New Zealand. Reports of concomitant thyroid cancer occurring in up to 17% of Graves' patients suggest surgery, if performed with low morbidity, may be the preferred option. The aim of this study was to determine the rate of thyroid cancer and surgical outcomes in a New Zealand cohort of patients undergoing thyroidectomy for Graves' disease. This study is a retrospective review of Waikato region patients undergoing thyroid surgery for Graves' disease during the 10-year period prior to 1 December 2011. A total of 833 patients underwent thyroid surgery. Of these, 117 were for Graves' disease. Total thyroidectomy was performed in 82, near-total in 33 and subtotal in 2 patients. Recurrent thyrotoxicosis developed in one subtotal patient requiring I(131) therapy. There were two cases of permanent hypoparathyroidism and one of permanent recurrent laryngeal nerve palsy. Eight patients (6.8%) had thyroid cancer detected, none of whom had overt nodal disease. Five were papillary microcarcinomas (one of which was multifocal), two were papillary carcinomas (11 mm and 15 mm) and one was a minimally invasive follicular carcinoma. Thyroid cancer was identified in approximately 7% of patients undergoing surgery for Graves' disease. A low complication rate (<2%) of permanent hypoparathyroidism and nerve injury (<1%) supports surgery being a safe alternative to I(131) especially for patients with young children, ophthalmopathy or compressive symptoms. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  14. La diabetes mellitus y las complicaciones cardiovasculares

    Directory of Open Access Journals (Sweden)

    Olga Lidia Pereira Despaigne

    2015-05-01

    Full Text Available Las enfermedades cardiovasculares en las personas con diabetes mellitus son más precoces, y suelen presentarse con síntomas y signos atípicos. Igualmente, se ha demostrado que la hiperglucemia es un importante factor de riesgo para las complicaciones microangiopáticas y macroangiopáticas en la diabetes mellitus, y la hiperglucemia posprandial, con glucemia en ayunas normal, es una condición clínica frecuente y un factor de riesgo cardiovascular independiente. Así, en el presente trabajo se exponen algunas consideraciones relacionadas con el control de las dislipidemias, la hipertensión arterial y la antiagregación plaquetaria en el paciente con diabetes mellitus

  15. Current Concepts in Graves' Disease

    Science.gov (United States)

    Girgis, Christian M.; Champion, Bernard L.; Wall, Jack R.

    2011-01-01

    Graves' disease is the most common cause of hyperthyroidism in the developed world. It is caused by an immune defect in genetically susceptible individuals in whom the production of unique antibodies results in thyroid hormone excess and glandular hyperplasia. When unrecognized, Graves' disease impacts negatively on quality of life and poses serious risks of psychosis, tachyarrhythmia and cardiac failure. Beyond the thyroid, Graves' disease has diverse soft-tissue effects that reflect its systemic autoimmune nature. Thyroid eye disease is the most common of these manifestations and is important to recognise given its risk to vision and potential to deteriorate in response to radioactive iodine ablation. In this review we discuss the investigation and management of Graves' disease, the recent controversy regarding the hepatotoxicity of propylthiouracil and the emergence of novel small-molecule thyroid-stimulating hormone (TSH) receptor ligands as potential targets in the treatment of Graves' disease. PMID:23148179

  16. SÍNDROMES HIPERTENSIVAS GRAVES – ESTUDO DESCRITIVO COM ADOLESCENTES ATENDIDAS EM MATERNIDADE ESCOLA

    Directory of Open Access Journals (Sweden)

    Andreia Gregório Lima

    2012-01-01

    Full Text Available Estudio exploratorio y descriptivo, con objetivo de analizar los datos clínicos y obstétricos relacionados a síndromes hipertensivos graves en adolescentes asistidas en maternidad escuela de Recife-PE, Brasil. La población fue de 186 adolescentes embarazadas con preeclampsia severa y/o eclampsia entre 2003 y 2008. La edad varió entre 15 y 19 años, eran negras, solteras y con baja escolaridad. La mayoría era primíparas, pero la recurrencia del embarazo fue de 16% de los casos. Realizaran seis o más consultas de prenatal, el embarazo avanzó a término y el tipo de parto más frecuente fue la cesárea. Las comorbidades identificadas fueron alteraciones de volumen del líquido amniótico, cuadros hemorrágicos e infecciosos. Fueron identificados también casos de retraso del crecimiento intrauterino, prematuridad, ictericia, hipoxia y bajo peso al nacer. El embarazo en la adolescencia asociado con los síndromes hipertensivos severos posee relación con complicaciones maternas, fetales y neonatales.

  17. Auto-estima na forma inativa da oftalmopatia de Graves Inactive Graves' ophthalmopathy and self-esteem

    Directory of Open Access Journals (Sweden)

    Carlos Henrique de Toledo Magalhães

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar a auto-estima dos pacientes com oftalmopatia de Graves na fase inativa. MÉTODOS: Foram avaliados 30 pacientes portadores de oftalmopatia de Graves, eutireoideanos, na fase inativa, com idade variando entre 26 e 65 anos, média 43 ± 11,0 anos, denominado grupo estudo e 39 indivíduos que não apresentavam oftalmopatia de Graves, com idade variando entre 18 e 67 anos, média de 41 ± 13,4 anos, selecionados na população geral denominado grupo controle. Para avaliar a auto-estima foi utilizada a escala de auto-estima Rosenberg Unifesp-EPM aplicada por meio de entrevista. Os valores dos escores de auto-estima nos dois grupos estudados foram comparados pelo teste não paramétrico de Mann-Whitney. O mesmo teste foi aplicado com objetivo de comparar os resultados obtidos no grupo oftalmopatia de Graves considerando a gravidade da doença. RESULTADOS: Não foi observada alteração com significância estatística na auto-estima dos pacientes com oftalmopatia de Graves (p=0,057. O grupo estudo apresentou, em média, valores inferiores de auto-estima, comparado ao grupo controle. Não houve diferença da auto-estima entre os pacientes dos subgrupos leve e moderado-grave (P=0,2710. CONCLUSÃO: A oftalmopatia de Graves na fase inativa não afetou a auto-estima dos pacientes, no grupo estudado.PURPOSE: To assess the self-esteem of Graves' ophthalmopathy patients in the inactive phase. METHODS: Thirty euthyroid patients were evaluated in the inactive phase of disease with age ranging from 26 to 65 years, average of 43 ± 11,0 years, called study group and 39 individuals without Graves' ophthalmopathy with age ranging from 18 to 67 years, average of 41 ± 13,4 years, selected from the general population called control group. To evaluate the self-esteem the Rosenberg UNIFESP/EPM self-esteem scale, applied by means of an interview, was utilized. The self-esteem scores in the two studied groups were compared by means of the non

  18. Condición laboral asociada a complicaciones en el embarazo en noreste de México

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    Edgar Taboada Aguirre

    2014-12-01

    Full Text Available Introducción: Las complicaciones clínicas en el embarazo son predictores importantes para la mortalidad materna y desenlace del embarazo dependiendo de la atención que reciban las mujeres en este periodo trascendental de la vida. Algunos de los determinantes asociados con el problema están ligados a la situación laboral y la ocupación de la madre durante el embarazo. Material y métodos: Se realizó un estudio transversal en el año 2012, en la Unidad de Medicina Familiar # 43 del Instituto Mexicano del Seguro Social. Se realizó un muestreo aleatorio de un total de 2314 se seleccionaron 318 mujeres que accedieron a participar. El objetivo principal del estudio de analizar la asociación del estatus laboral con las complicaciones durante la gestación (definidas como cualquier paciente que durante la gestación haya padecido preeclampsia, eclampsia, amenaza de aborto, amenaza de parto prematuro, infección de vías urinarias se incluyeron además variables sociodemográficas conocidas por su relación con las complicaciones prenatales. Resultados: La media de la edad fue de 26 años. La media del índice de masa corporal fue de 27. Las mujeres trabajadoras presentaron una probabilidad 64 % más alta que las no trabajadoras de presentar complicaciones en el embarazo (OR=1.64; IC95 %: 1.04-2.58. La infección de vías urinarias en las mujeres trabajadoras fue un 75 % más probable (OR=1.75; IC 95 %: 1.12-2.73, las mujeres trabajadoras tuvieron 2.72 veces más probabilidad de padecer una amenaza de aborto que las no trabajadoras (OR=2.72; IC 95 %:1.36-5.45, las trabajadoras tuvieron 2.20 veces mayor probabilidad de padecer amenaza de parto prematuro que las no trabajadoras (OR=2.20; IC 95 %: 0.91-5.29. Además las trabajadoras tuvieron una probabilidad 96 % más alta de que su embarazo terminara en cesárea (OR=1.96; IC 95 %:1.25-3.07. Conclusiones: Los resultados sugieren que la actividad laboral es un factor importante para la presentaci

  19. Caracterización de pacientes diabéticos de tipo 2 con complicaciones vasculares y riesgo de ateroesclerosi

    Directory of Open Access Journals (Sweden)

    Milagros Violeta Font Difour

    2014-12-01

    Full Text Available Se realizó un estudio observacional, descriptivo y prospectivo para caracterizar a 200 pacientes diabéticos de tipo 2, diagnosticados con complicaciones vasculares y riesgo de ateroesclerosis, los cuales fueron ingresados en el Servicio de Medicina Interna del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde junio del 2010 hasta igual mes del 2011. Entre las complicaciones más frecuentes figuraron: enfermedades cardiovasculares (29,5 %, neuropatía (21,5 % y retinopatía (19,5 %. Prevalecieron los afectados con 3 complicaciones (40,5 %, los que tenían un tiempo de evolución de la enfermedad de 11-15 años (38,0 %; además de la hiperlipidemia (35,0 %, la hipertensión arterial (32,0 % y el tabaquismo (26,5 % como factores de riesgo. Se concluye que con un enfoque multidisciplinario en el tratamiento y control de esta enfermedad se logra mejorar el pronóstico de los afectados.

  20. Relación entre estado nutricional y complicaciones posoperatorias en cardiopatías acianóticas y flujo pulmonar aumentado

    Directory of Open Access Journals (Sweden)

    Raquel Maciques Rodríguez

    Full Text Available Introducción: los primeros trabajos que asocian desnutrición y cardiopatías se reportaron en los años 50. Los lactantes cardiópatas presentan alteraciones en el crecimiento y desarrollo, y es más severo el compromiso en aquellos que se presentan con insuficiencia cardiaca y cianosis. Se describen patrones de desnutrición de acuerdo con el tipo de cardiopatía, la que puede ser aguda o crónica. Objetivos: evaluar el impacto de la intervención nutricional, como medida que contribuye a disminuir las complicaciones posoperatorias, en lactantes con cardiopatías congénitas acianóticas y desnutridos, así como relacionar la presencia de infecciones posoperatorias con hipoalbuminemia. Métodos: estudio prospectivo que incluyó a 28 lactantes con cardiopatías congénitas acianóticas, flujo pulmonar aumentado y desnutridos, en el Cardiocentro Pediátrico "William Soler", desde septiembre de 2008 hasta agosto de 2010. Fueron divididos en 2 grupos: Grupo I, no recibieron intervención nutricional; y Grupo II, recibieron intervención nutricional. El estado nutricional se determinó por el índice peso para la talla en ambos sexos. Se analizó la asociación de complicaciones posoperatorias y estado nutricional, así como la relación entre infección e hipoalbuminemia. Se aplicaron técnicas estadísticas descriptivas, se utilizaron los porcentajes y construyeron distribuciones de frecuencias absolutas y relativas. Resultados: el 69,2 % de los niños del Grupo I se encontraron desnutridos en el momento de la cirugía, y las complicaciones infecciosas estuvieron presente en el 73,3 % de los casos. En el Grupo II las complicaciones infecciosas se presentaron en el 13,3 % de los pacientes. Conclusiones: el grupo de niños desnutridos presentó mayor número de complicaciones infecciosas, las que estuvieron relacionadas a hipoalbuminemia. La intervención nutricional preoperatoria favorece una menor incidencia de complicaciones posoperatorias.

  1. Derrame pericárdico grave. Ventana pericárdica percutánea con balón

    Directory of Open Access Journals (Sweden)

    Carlos A. Bruno

    2008-01-01

    Full Text Available La mayoría de los pacientes con derrame pericárdico crónico son mujeres y mayores de 50 años. En esta presentación se describe el caso de una paciente de 63 años con derrame pericárdico crónico grave, con antecedente de carcinoma de mama izquierda irradiado, diagnóstico presuntivo no confirmado de tuberculosis pulmonar e hipotiroidea sustituida. Ante la recurrencia del derrame luego de pericardiocentesis y el fracaso del tratamiento antiinflamatorio con AINE se decidió realizar una ventana pericárdica percutánea, sin que se presentaran complicaciones técnicas. Se inició tratamiento con colchicina y se evaluaron las posibles causas: tuberculosa, oncológica, secundaria a hipotiroidismo o por radiación. Por exclusión se llegó a la etiología radiante. Al mes de la realización de la ventana pericárdica no se observaba derrame pericárdico en el ecocardiograma.

  2. Virus Zika en Centroamérica y sus complicaciones

    OpenAIRE

    Núñez, Eduardo; Vásquez, Marilin; Beltrán-Luque, Briana; Padgett, Denis

    2016-01-01

    El virus Zika (ZIKV) es un arbovirus, aislado por primera vez en Zika Uganda, reportándose el primer caso en humanos en 1954, desde entonces se han descrito casos en África, Asia, Oceanía y en América. Centroamérica ha sido afectada, por cambios climáticos, pobreza y mal saneamiento ambiental. Su transmisión es vectorial y puede tener transmisión perinatal, transfusiones sanguíneas o por semen infectado. Clínicamente se diferencian poco de Dengue y Chikungunya. Sus complicaciones son principa...

  3. Complicaciones mecánicas de los accesos venosos centrales

    Directory of Open Access Journals (Sweden)

    Dr. T. Rodrigo Rivas

    2011-05-01

    En esta puesta al día se describen las complicaciones más frecuentes o de mayor gravedad como son: el neumotórax, la embolia aérea, mal-posición del catéter, perforación de grandes venas, punción arterial, arritmias, trombosis venosa asociada a catéter venoso central (CVC y oclusión del CVC; algunos elementos de prevención, diagnóstico y tratamiento así como el impacto que puede tener la ultrasonografía rutinaria para instalar un CVC.

  4. Optimal management of Graves orbitopathy: a multidisciplinary approach

    NARCIS (Netherlands)

    Soeters, M. R.; van Zeijl, C. J. J.; Boelen, A.; Kloos, R.; Saeed, P.; Vriesendorp, T. M.; Mourits, M. P.

    2011-01-01

    Graves' thyroid disease is a relatively common disorder in endocrinology and general internal medicine practice. Graves' hyperthyroidism is mediated by circulating stimulating autoantibodies. Up to 60% of patients with Graves' hyperthyroidism develop some form of Graves' orbitopathy. Immune

  5. 135. Mediastinitis postoperatoria: factores de riesgo, supervivencia y estancia hospitalaria

    Directory of Open Access Journals (Sweden)

    L. Riesco de la Vega

    2010-01-01

    Conclusiones: La incidencia de mediastinitis en nuestra población de pacientes es de un 2,2%. Edad, EPOC, obesidad, uso de arteria mamaria y reintervención son factores de riesgo independientes de esta complicación. La mediastinitis es una complicación grave, con una alta mortalidad (25,4%, y que conlleva una prolongación de la estancia en UCI y hospitalaria, con el consecuente consumo de recursos sanitarios.

  6. Complicaciones tardías en diabetes mellitus tipo 2 en el Hospital II Essalud - Cañete

    Directory of Open Access Journals (Sweden)

    Charlton Fernando Untiveros Mayorga

    2004-04-01

    Full Text Available Objetivo: Determinar las características clínicas y las complicaciones tardías en los pacientes con diabetes tipo 2 atendidos en los consultorios de medicina general y del Programa de Diabetes del Hospital II EsSALUD-Cañete. Material y Métodos: Se realizó un estudio descriptivo de serie de casos en el que se evaluaron 94 pacientes con diabetes tipo 2 elegidos aleatoriamente durante su control ambulatorio, realizándose una entrevista y evaluación clínica durante los meses de junio y julio del 2001. Resultados: La población de pacientes estudiada tuvo una edad promedio de 64.56 + 11.61. Cincuenta y tres pacientes eran mujeres (56.4%. El 68.1% de los pacientes recibían hipoglicemiantes orales y el 11.7% requerían del uso de insulina. Los transtornos lipídicos predominantes fueron la elevación del LDL-Colesterol y disminución del HDL-Colesterol. La retinopatía diabética (88.9% e hipertensión arterial (61.3% fueron las complicaciones más frecuentes. Vasculopatía periférica, neuropatía periférica y neuropatía autonómica fueron otras complicaciones crónicas frecuentes halladas en la población de estudio. Conclusiones: Las complicaciones cardiovasculares (micro y macrovasculares en la población de pacientes con diabetes tipo 2 atendidos ambulatoriamente en el Hospital II EsSALUD-Cañete fueron las más frecuentes. (Rev Med Hered 2004; 15:64-69.

  7. Complicaciones en el uso del colgajo TRAM pediculado para reconstrucción mamaria por cáncer

    Directory of Open Access Journals (Sweden)

    J.L. López-Robles

    2013-12-01

    Full Text Available Las opciones en reconstrucción mamaria tras tratamiento oncoquirúrgico incluyen el uso de técnicas con implantes, el uso de colgajos autólogos y la combinación de ambos métodos. A nivel internacional, la reconstrucción con tejidos autólogos es el estándar de oro para la reconstrucción mamaria y específicamente, la utilización del colgajo miocutáneo de recto abdominal (colgajo TRAM pediculado es una de las opciones más empleadas. El presente estudio define con qué frecuencia se presentaron complicaciones tras la cirugía con colgajo TRAM pediculado para reconstrucción mamaria por cáncer en el Servicio de Cirugía Plástica y Reconstructiva del Hospital Central Sur de Alta Especialidad (PEMEX de la Cuidad de México (México, en un periodo de estudio de 7 años. Además, se identifican los factores de riesgo que influyeron sobre la aparición de dichas complicaciones. Diseñamos un estudio descriptivo, observacional y retrospectivo, que incluyó a 71 pacientes, de las cuales el 59.15 % presentaron alguna complicación. La mayoría de dichas complicaciones fueron menores (54.9 % y tan solo 3 pacientes presentaron alguna complicación mayor (4.2 %. La complicación del sitio donante del colgajo más frecuente fue la aparición de hernia abdominal (9.86 %. La complicación más frecuente del colgajo y del sitio receptor fue la necrosis grasa parcial (23.94 %. Las únicas complicaciones sistémicas fueron atelectasia y tromboembolismo pulmonar, con 1 caso de cada. En el análisis bivariado, las pacientes fumadoras tuvieron un 40 % más riesgo de presentar una complicación del colgajo en comparación con las no fumadoras (p=0.041. Las pacientes sometidas a radioterapia tuvieron un incremento del 30 % en las complicaciones totales en comparación con las no radiadas (p=0.021. Al comparar el hecho de recibir quimioterapia o no y la presencia de necrosis grasa, el 32 % de las pacientes tuvo esta complicación en comparación con el 10

  8. Grave's disease 1835-2002.

    Science.gov (United States)

    Weetman, A P

    2003-01-01

    This brief review describes the history of Graves' disease, starting with the original descriptions by Parry, Graves and von Basedow. The true aetiology of the disorder was uncovered in the 1950s and 1960s, based on the search for a novel thyroid stimulator which turned out to be an immunoglobulin G autoantibody. Assays for these thyroid stimulatory antibodies have been continually refined and their epitopes on the thyroid stimulating hormone receptor are increasingly well characterized. We also understand far more about the genetic and environmental susceptibility factors that predispose to disease, and even thyroid-associated ophthalmopathy has now been better defined as primarily a T-cell-mediated disease resulting from cytokine stimulation of orbital fibroblasts. These advances should improve treatment options for Graves' disease in the foreseeable future.

  9. Follow up of Graves' Opthalmopathy after radioiodine therapy

    International Nuclear Information System (INIS)

    Miah, M.S.R.; Paul, A. K.; Rahman, H.A.

    2002-01-01

    Graves' ophthalmopathy may first appear or worsen during or after treatment for hyperthyroidism. We followed up 158 Graves' hyperthyroid patients treated with radioiodine of which 49 had Grave's' ophthalmopathy during presentation in Nuclear Medicine Centre, Khulna during the period from 1995 to 2000. The aim of our study is to see the effect of radioiodine in Graves' ophthalmopathy. All the patients received radioiodine at fixed dose regime ranged from 7 mCi to 12 mCi. The duration of follow up was at least 12 months Graves' ophthalmopathy patients, 4 (4/49 i.e., 8.2%) showed exaggeration of ophthalmopathy and the rest (45/49 i.e., 91.8%) remained unchanged. None of ophthalmopathy developed among any of Graves' hyperthyroid or disappeared after radioiodine treatment during follow up period. From the study we concluded that eye changes in Graves' hyperthyroidism remain unchanged or exaggerated after radioiodine therapy and needs ophthalmologist care.(author)

  10. [Thyroid cancer in patients with Grave's Disease].

    Science.gov (United States)

    Mssrouri, R; Benamr, S; Essadel, A; Mdaghri, J; Mohammadine, El H; Lahlou, M-K; Taghy, A; Belmahi, A; Chad, B

    2008-01-01

    To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

  11. Hiperparatiroidismo primario: Evolución postoperatoria a largo plazo

    Directory of Open Access Journals (Sweden)

    Francisco R. Spivacow

    2010-10-01

    Full Text Available Presentamos la evolución postoperatoria a largo plazo de 87 pacientes con hiperparatiroidismo primario. Del total, 78 mujeres y 9 varones, relación: 8.7:1. Edad media 55.3 ± 10.2 años. Antes de la cirugía el 44% presentó litiasis renal, el 70% osteopenia u osteoporosis y un 71.2% tuvo hipercalciuria. Se encontró disminución del filtrado glomerular en el 12.6%. Del total, 72 pacientes presentaron un adenoma único, dos un doble adenoma, dos hiperplasia, cuatro histología normal y en siete no se pudo disponer del resultado. El calcio sérico, el calcio iónico, el fósforo y la parathormona intacta se normalizaron en todos los pacientes postcirugía. La densitometría ósea aumentó un 6.9% en columna lumbar y un 3% en cuello de fémur. Los marcadores del remodelado óseo se normalizaron y persistieron normales a los 23 meses del seguimiento, coincidiendo con la parathormona intacta. Lo mismo sucedió con los valores de 25 OH D. Cuando se compararon pacientes con hipercalciuria inicial vs. aquellos con normocalciuria, no se encontraron diferencias en los valores basales y postcirugía en ambos grupos. En 11 pacientes con filtrado glomerular previo < 60 ml/min, encontramos una parathormona intacta más elevada que el resto y menor densidad mineral ósea. El filtrado glomerular no cambió en forma significativa luego de la cirugía. En conclusión, el hiperparatiroidismo primario operado por cirujanos especializados tiene una excelente evolución a largo plazo, con normalización de todos los parámetros del metabolismo fosfocálcico y del remodelado óseo y mejoría significativa en la densidad mineral ósea. Los efectos adversos son escasos y de resolución espontánea.

  12. Edad, aprendizaje, tiempo quirúrgico y complicaciones en la cirugía videolaparoscópica

    Directory of Open Access Journals (Sweden)

    Luis Miguel Pita Armenteros

    1999-12-01

    Full Text Available El tiempo quirúrgico es un factor de riesgo menos importante en las operaciones electivas, mucho menos si existe gentileza quirúrgica y control anestésico. El método videolaparoscópico exige de mayor monitoreo en la anestesia y es de mínimo traumatismo. Sin embargo, se habla de tiempos quirúrgicos muy elevados en la fase de aprendizaje como limitante en la productividad quirúrgica con aumento del costo quirófano y de complicaciones, en particular en cirujanos mayores. Este trabajo desmitifica edad, aprendizaje, tiempo quirúrgico y complicaciones en la cirugía videolaparoscópica. La prudencia influye en el tiempo quirúrgico, pero disminuye conversión y complicaciones. Obtener la calificación básica en cirugía videolaparoscópica requiere de 40 a 50 operacionesSurgical time is not very significant risk factor in elective surgery. It is much less important when there is an adequate surgical management and anesthetic control. The videolaparoscopic method demands a greater anesthetic monitoring and produces minimun traumatism. However, reference is made to extremely elevated surgical times during training that limit surgical productivity and increase the cost of the operation and the number of complications particularly among major surgeons. This paper considers age, training, surgical time and complications in videolaparoscopic surgery. Prudence influences on the surgical time but reduces conversion and complications. To obtain the basic qualification in videolaparoscopic surgery, it is necessary to perform 40 or 50 operations

  13. Notes on Glasinac: The chronology of princely graves

    Directory of Open Access Journals (Sweden)

    Vasić Rastko

    2009-01-01

    Full Text Available Princely graves of the Iron Age represent a particular phenomenon in archaeology, which is constantly the subject of interest. They are usually dated to the end of the 6th and the beginning of the 5th century. The author discusses the chronology of princely graves in the Central Balkans and analyses their appearance in each part of this territory: on the Glasinac plateau, in Serbia, Kosovo and Metohija, Montenegro, North Albania and Nordwest Bulgaria. He concludes that they date from the middle of the 7th to the middle of the 4th century, depending on the cultural and socio-economic situation in the respective area. In the middle of the 7th century princely graves in the true sense of the word were known only on the Glasinac plateau, in the Ilijak necropolis. At the end of the 7th and in the beginning of the 6th century they still appear on Glasinac, though in greater number and in various parts of the plateau. In northwest Bulgaria a grave dating to the second half of the 7th century was found, which would, according to grave goods, correspond to the Glasinac princely graves. On the other hand, there are no princely graves in Serbia and north Albania from that time but some outstanding warrior graves are known, belonging possibly to the chiefs of smaller warlike bands, whose power was limited. Princely graves from Arareva gromila on Glasinac, Pilatovići by Požega and Lisijevo Polje by Berane date to the beginning of the second half of the 6th century, and according to their characteristics represent princes, whose power and wealth were considerable and known to the neighbours. Culmination of the rise of the princes in this region was demonstrated by the graves from Novi Pazar, Atenica, and Pećka banja, which date to the end of the 6th and the first quarter of the 5th century. Some decades later there are several rich graves, e.g. the recently discovered grave from Velika Krsna, which could belong to a prince, but can not be compared with the

  14. Effect of 131I therapy on outcomes of Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Wang Renfei; Tan Jian; Zhang Guizhi; Yin Liang

    2011-01-01

    Objective: To analyze the correlation between the therapeutic effect of Graves' hyperthyroidism and the outcomes of Graves' ophthalmopathy after 131 I therapy, and to explore the effect of 131 I treatment on turnout of Graves' ophthalmopathy. Methods: Six hundreds and fifty-two patients of Graves' disease accompanied with Graves' ophthalmopathy, received one-time 131 I treatment according to routine procedure. We recorded exophthalmometer readings, the signs and symptoms of eyes before therapy. Regular follow-up and appraisal of curative effect were carried out. Results: At least six months after 131 I therapy, the effective rate of Graves' hyperthyroidism and Graves' ophthalmopathy were 94.3% and 73.3% respectively. The total effective rate of hyperthyroidism with ophthalmopathy was 71.2%. There was a significant correlation between the prognosis of Graves' ophthalmopathy and therapeutic efficacy of hyperthyroidism (r=0.302, P 131 I therapy (χ 2 =0.296, P>0.05). Conclusions: The key to treat Graves' ophthalmopathy is the cure of Graves' hyperthyroidism through 131 I therapy. The timely diagnosis and replacement treatment of hypothyroidism can effectively avoid the aggravation of Graves' ophthalmopathy after 131 I therapy. (authors)

  15. [Serum glycosaminoglycans in Graves' disease patients].

    Science.gov (United States)

    Winsz-Szczotka, Katarzyna B; Olczyk, Krystyna Z; Koźma, Ewa M; Komosińska-Vassev, Katarzyna B; Wisowski, Grzegorz R; Marcisz, Czesław

    2006-01-01

    The aim of the study was to determine the blood serum sulfated glycosaminoglycans (GAGs) and hyaluronic acid (HA) concentration of Graves' disease patients before treatment and after attainment of the euthyroid state. The study was carried out on the blood serum obtained from 17 patients with newly recognised Graves' disease and from the same patients after attainment of the euthyroid state. Graves' patients had not any clinical symptoms neither of ophthalmopathy nor pretibial myxedema. GAGs were isolated from the blood serum by the multistage extraction and purification using papaine hydrolysis, alkali elimination, as well as cetylpyridium chloride binding. Total amount of GAGs was quantified by the hexuronic acids assay. HA content in obtained GAGs sample was evaluated by the ELISA method. Increased serum concentration of sulfated GAGs in non-treated Graves' disease patients was found. Similarly, serum HA level in untreated patients was significantly elevated. The attainment of euthyroid state was accompanied by the decreased serum sulfated GAGs level and by normalization of serum HA concentration. In conclusion, the results obtained demonstrate that the alterations of GAGs metabolism connected with Graves' disease can lead to systemic changes of the extracellular matrix properties.

  16. Antiphospholipid antibody syndrome complicated by Grave's disease.

    Science.gov (United States)

    Takahashi, Ayumi; Tamura, Atsushi; Ishikawa, Osamu

    2002-12-01

    The report describes a woman with primary antiphospholipid antibody syndrome complicated with Grave's disease. Developing symptoms included a small cutaneous nodule on her finger and subsequently ecchymotic purpura on the cheeks, ears, buttocks and lower legs. Histological examinations showed thrombosed vessels in the dermis without or with hemorrhage, respectively. Laboratory investigation revealed positive lupus anticoagulant and immunogenic hyperthyroidism due to Grave's disease. There is a close relationship between the cutaneous manifestation of antiphospholipid antibody syndrome and the activities of Grave's disease and a possible link of antiphospholipid antibody syndrome with Grave's disease was suggested both by the etiology of the disease as well as the disease activity.

  17. Graves' disease and Thyroid anaplasic carcinoma

    International Nuclear Information System (INIS)

    Guerrero E, Helena; Quintero A, Flor Maria; Carmona C, Antonio

    1992-01-01

    A case of a 34 year-old patient is presented, who was diagnosed with Graves' disease and developed a thyroid anaplastic carcinoma from a clinically detected nodular mass. The incidence of thyroid cancer associated with Graves' disease is revisited

  18. Outcome of very long-term treatment with antithyroid drugs in Graves' hyperthyroidism associated with Graves' orbitopathy

    NARCIS (Netherlands)

    Elbers, Laura; Mourits, Maarten; Wiersinga, Wilmar

    2011-01-01

    It is still debated which treatment modality for Graves' hyperthyroidism (GH) is most appropriate when Graves' orbitopathy (GO) is present. The preference in our center has been always to continue antithyroid drugs for GH (as the block-and-replace [B-R] regimen) until all medical and/or surgical

  19. Postoperative hypocalcemia after thyroidectomy for Graves' disease.

    Science.gov (United States)

    Pesce, Catherine E; Shiue, Zita; Tsai, Hua-Ling; Umbricht, Christopher B; Tufano, Ralph P; Dackiw, Alan P B; Kowalski, Jeanne; Zeiger, Martha A

    2010-11-01

    It is believed that patients who undergo thyroidectomy for Graves' disease are more likely to experience postoperative hypocalcemia than patients undergoing total thyroidectomy for other indications. However, no study has directly compared these two groups of patients. The aim of this study was to determine whether there was an increased incidence or severity of postoperative hypocalcemia in patients who underwent thyroidectomy for Graves' disease. An institutional review board-approved database was created of all patients who underwent thyroidectomy from 1998 to 2009 at the Johns Hopkins Hospital. There were a total of 68 patients with Graves' disease who underwent surgery. Fifty-five patients who underwent total thyroidectomy were randomly selected and served as control subjects. An analysis was conducted that examined potential covariates for postoperative hypocalcemia, including age, gender, ethnicity, preoperative alkaline phosphatase level, size of goiter, whether parathyroid tissue or glands were present in the specimen, and the reason the patient underwent surgery. Specific outcomes examined were calcium levels on postoperative day 1, whether or not patients experienced symptoms of hypocalcemia, whether or not Rocaltrol was required, the number of calcium tablets prescribed upon discharge, whether or not postoperative tetany occurred, and calcium levels 1 month after discharge. Each outcome was analyzed using a logistic regression. Graves' disease patients had a significantly (p-value Graves' disease and no patient in the control group were readmitted with tetany (p = 0.033). There was a trend, though not significant, toward patients with Graves' disease having a higher prevalence of hypocalcemia the day after thyroidectomy and 1 month later. Patients with Graves' disease are more likely to require increased dosages of calcium as well as experience tetany postoperatively than patients undergoing total thyroidectomy for other indications. This suggests that

  20. Síndrome metabólico durante el embarazo: Complicaciones materno-fetales

    OpenAIRE

    Yépez, Mayel Cristina; Zeppenfel, María Eugenia; Colón, José Antonio; Zimmer, Eveline

    2011-01-01

    Objetivo: Determinar la asociación entre el síndrome metabólico y las complicaciones maternas, fetales y neonatales, en un grupo de embarazadas entre agosto 2008 y septiembre 2009. Ambiente: Servicio Prenatal de la Maternidad “Concepción Palacios”. Métodos: Estudio prospectivo, longitudinal, comparativo, con una muestra de 130 embarazadas, 38 cumplieron los criterios de la Federación Internacional de Diabetes para síndrome metabólico y 92 fueron el grupo control. Resultados: El promedio de ed...

  1. Nutritional support in patients with severe acute pancreatitis Soporte nutricional en pacientes con pancreatitis aguda grave

    Directory of Open Access Journals (Sweden)

    Mónica Marcela Peláez Hernández

    2007-04-01

    Full Text Available Severe acute pancreatitis is associated with a systemic inflammatory response leading to a hypermetabolic, hypercatabolic condition; for those reasons, patients suffering from this disease require an excellent artificial nutritional support in order to maintain the structural integrity and the function of vital organs with minimal pancreatic secretion. Total parenteral nutrition has been the standard practice in the treatment of patients with severe acute pancreatitis because of the favorable outcomes of early nutritional support while avoiding pancreatic stimulation; however, recent evidence suggests there are potentially greater benefits with enteral as compared with parenteral nutrition, including fewer septic and metabolic complications and lesser costs. That is why present guidelines for the management of acute pancreatitis recommend that enteral instead of parenteral nutrition be used in patients with severe acute pancreatitis. La pancreatitis aguda, especialmente en su forma grave, está asociada con una respuesta inflamatoria sistémica que lleva a un estado de hipermetabolismo e hipercatabolismo, en el que se requiere un excelente soporte nutricional que permita mantener la integridad estructural y la función de los órganos vitales con un estímulo mínimo de la secreción pancreática. La nutrición parenteral total era el soporte de elección, que permitía obtener todos los beneficios de la nutrición temprana sin estimular la secreción pancreática; pero la evidencia actual muestra mayores beneficios con la nutrición enteral, porque se asocia con menos complicaciones infecciosas y metabólicas y con disminución en los costos. Por ello las guías actuales de tratamiento de la pancreatitis aguda grave recomiendan como primera elección el soporte nutricional enteral.

  2. Thyroid carcinoma in Graves' disease: A meta-analysis.

    Science.gov (United States)

    Staniforth, Joy U L; Erdirimanne, Senarath; Eslick, Guy D

    2016-03-01

    The incidence of thyroid carcinoma is increasing worldwide. Graves' disease is the most common hyperthyroid disease. Studies have suggested an increased risk of thyroid malignancy in Graves' disease: there has not yet been a meta-analysis to allow quantitative comparison. The purpose of this study was to determine the risk of thyroid carcinoma in Graves' disease, and to gather information on the histological subtypes of carcinoma and the co-existence of thyroid nodules. Several databases and article reference lists were searched. Inclusion criteria included appropriate diagnostic criteria for thyroid conditions and a diagnoses of carcinoma based on histology. 33 studies were selected, all reporting on surgically-resected specimens. The event rate of thyroid carcinoma in Graves' disease was 0.07 (95% CI 0.04 to 0.12). There was no data to allow comparison with patients without hyperthyroid diseases. There was no increase in the odds of developing carcinoma in Graves' disease compared to toxic multinodular goitre and toxic uninodular goitre. 88% of thyroid carcinomas in Graves' disease were papillary, with solitary papillary micro-carcinoma (diameter 10 mm or less) comprising 23% of all detected thyroid carcinomas. Patients with Graves' disease and co-existing thyroid nodules were almost 5 times more likely to be diagnosed with thyroid carcinoma than those without nodules. Thyroid malignancy in Graves' disease requiring surgical treatment should be considered as likely as in other hyperthyroid diseases needing surgical treatment. Clinicians should consider screening selected patients with Graves' disease for nodules whilst being aware of potentially over-diagnosing papillary micro-carcinoma. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  3. PREGO (presentation of Graves' orbitopathy) study

    DEFF Research Database (Denmark)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio

    2015-01-01

    BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. METHODS: Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres...

  4. Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism

    DEFF Research Database (Denmark)

    Wiersinga, Wilmar; Žarković, Miloš; Bartalena, Luigi

    2018-01-01

    OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH). DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers f...

  5. Epidemiology and prevention of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.; Bartalena, Luigi

    2002-01-01

    Graves' ophthalmopathy is clinically relevant in approximately 50% of patients with Graves' disease, severe forms affecting 3%-5% of patients. Two age peaks of incidence are observed in the fifth and seventh decades of life, with slight differences between women and men. The disease is more frequent

  6. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

    NARCIS (Netherlands)

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J.; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M.; Adamidou, Fotini; Anagnostis, Panagiotis; Ayvaz, Goksun; Azzolini, Claudio; Boschi, Antonella; Bournaud, Claire; Clarke, Lucy; Currò, Nicola; Daumerie, Chantal; Dayan, Colin; Fuhrer, Dagmar; Konuk, Onur; Marinò, Michele; Morris, Daniel; Nardi, Marco; Pearce, Simon; Pitz, Susanne; Rudovsky, Gottfried; Vannucchi, Guia; Vardanian, Christine; von Arx, Georg

    2016-01-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mech anisms of the disease. Treatment should rely on a thorough assessment of the

  7. Graves' Disease

    Science.gov (United States)

    ... 2011 survey of clinical practice patterns in the management of Graves' disease. Journal of Clinical Endocrinology and Metabolism. 2012 Dec;97( ... 30 a.m. to 5 p.m. eastern time, M-F Follow Us NIH… Turning Discovery Into ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  8. Mouse Models of Graves' Disease

    OpenAIRE

    Nagayama, Yuji

    2005-01-01

    Graves' disease is characterized by overstimulation of the thyroid gland with agonistic autoantibodies against the thyrotropin (TSH) receptor, leading to hyperthyroidism and diffuse hyperplasia of the thyroid gland. Our and other laboratories have recently established several animal models of Graves' hyperthyroidism with novel immunization approaches, i.e., in vivo expression of the TSH receptor by injection of syngeneic living cells co-expressing the TSH receptor and major histocompatibility...

  9. TSHR intronic polymorphisms (rs179247 and rs12885526) and their role in the susceptibility of the Brazilian population to Graves' disease and Graves' ophthalmopathy.

    Science.gov (United States)

    Bufalo, N E; Dos Santos, R B; Marcello, M A; Piai, R P; Secolin, R; Romaldini, J H; Ward, L S

    2015-05-01

    Intronic thyroid-stimulating hormone receptor polymorphisms have been associated with the risk for both Graves' disease and Graves' ophthalmopathy, but results have been inconsistent among different populations. We aimed to investigate the influence of thyroid-stimulating hormone receptor intronic polymorphisms in a large well-characterized population of GD patients. We studied 279 Graves' disease patients (231 females and 48 males, 39.80 ± 11.69 years old), including 144 with Graves' ophthalmopathy, matched to 296 healthy control individuals. Thyroid-stimulating hormone receptor genotypes of rs179247 and rs12885526 were determined by Real Time PCR TaqMan(®) SNP Genotyping. A multivariate analysis showed that the inheritance of the thyroid-stimulating hormone receptor AA genotype for rs179247 increased the risk for Graves' disease (OR = 2.821; 95 % CI 1.595-4.990; p = 0.0004), whereas the thyroid-stimulating hormone receptor GG genotype for rs12885526 increased the risk for Graves' ophthalmopathy (OR = 2.940; 95 % CI 1.320-6.548; p = 0.0083). Individuals with Graves' ophthalmopathy also presented lower mean thyrotropin receptor antibodies levels (96.3 ± 143.9 U/L) than individuals without Graves' ophthalmopathy (98.3 ± 201.9 U/L). We did not find any association between the investigated polymorphisms and patients clinical features or outcome. We demonstrate that thyroid-stimulating hormone receptor intronic polymorphisms are associated with the susceptibility to Graves' disease and Graves' ophthalmopathy in the Brazilian population, but do not appear to influence the disease course.

  10. Nodular Graves' disease with medullary thyroid cancer.

    Science.gov (United States)

    Khan, Shoukat Hussain; Rather, Tanveer Ahmed; Makhdoomi, Rumana; Malik, Dharmender

    2015-01-01

    Co-existence of thyroid nodules with Graves' disease has been reported in various studies. 10-15% of such nodules harbor thyroid cancer with papillary thyroid cancer being the commonest. Medullary thyroid cancer (MTC) in nodules associated with Graves' disease is rare. On literature survey, we came across 11 such cases reported so far. We report a 62-year-old female with Graves' disease who also had a thyroid nodule that on fine-needle aspiration cytology and the subsequent postthyroidectomy histopathological examination was reported to be MTC.

  11. Temperatura, Oximetría Cerebral y Disfunción Cognitiva Postoperatoria (DCPO) en pacientes intervenidos de Prótesis Total de Rodilla (PTR) con anestesia intradural. Estudio prospectivo

    OpenAIRE

    Salazar Garcia, Fátima

    2015-01-01

    Introducción: La Disfunción cognitiva postoperatoria (DCPO) tiene una alta incidencia en pacientes de cirugía ortopédica. Durante la anestesia y la cirugía se produce un descenso progresivo de la temperatura. Esta hipotermia tiene efectos deletéreos pero también puede tener un efecto protector cerebral. Nosotros planteamos la hipótesis que la temperatura perioperatoria puede tener un impacto sobre la aparición de DCPO. Por otro lado, la monitorización de la saturación regional cerebral de...

  12. [Association Budd Chiari syndrome, antiphospholipid syndrome and Grave's disease].

    Science.gov (United States)

    Mouelhi, Leila; Chaieb, Mouna; Debbeche, Radhouane; Salem, Mohamed; Sfar, Imene; Trabelsi, Sinda; Gorgi, Yosr; Najjar, Taoufik

    2009-02-01

    Antiphospholipid syndrome is revealed by Budd Chiari syndrome in 5% of the cases. Antiphospholipid syndrome is characterized by venous or arterial thrombosis, foetal loss and positivity of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I. Anticardiolipin antibodies was reported in auto-immune thyroid disorders, particularly in Grave's disease. Antiphospholipid syndrome associated to Grave's disease was reported in only three cases. To describe a case report of association of Grave's disease and antiphospholipid syndrome. We report the first case of Grave's disease associated with antiphospholipid syndrome, revealed by Budd Chiari syndrome. Our observation is particular by the fact that it is about a patient presenting a Grave's disease associated with antiphospholipid syndrome revealed by Budd Chiari syndrome. This triple association has never been reported in literature. Although association between antiphospholipid syndrome and Grave's disease was previously described, further studies evaluating the coexistence of these two affections in the same patient would be useful.

  13. Complicaciones de las otitis medias agudas y crónicas en el niño Complications of acute and chronic otitis media in the child

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa

    2013-03-01

    Full Text Available Gracias al descubrimiento de los antibióticos, la incidencia de complicaciones en las otitis medias agudas y crónicas ha descendido significativamente, aunque continúan siendo un peligro potencial de morbilidad y mortalidad. La disminución de las complicaciones puede condicionar retrasos diagnósticos por falta de sospecha clínica, enmascaramiento por tratamientos antibióticos previos y mal pronóstico, por lo cual siguen siendo procesos graves que ponen en peligro la vida del enfermo. Se definen actualmente con igual sistema de clasificación: extracraneales e intracraneales. Las primeras se subdividen en extratemporal e intratemporal, y constituyen un problema de salud en la población pediátrica a pesar del uso extendido de antibióticos. La evaluación clínico-otomicroscópica e imaginológica se reporta como criterio diagnóstico predictivo de sospecha y de confirmación. La parálisis facial, el vértigo, los vómitos, la cefalea, el dolor irradiado a la mastoides o a la región temporoparietal, y la hipertermia, deben alertar al médico sobre la presencia de una complicación supurada.Thanks to the discovery of antiobiotics, the incidence of complications in the chronic and acute otitis media has significantly decreased, though they remain a potential mortality and morbidity risk. The reduction of complications can be conditional on some diagnostic delays, on account of lack of clinical suspicions, symptoms disguised by previous antibiotic treatments and wrong prognosis; therefore, the complications continue to be severe processes that endanger the patient's life. They are currently classified as extracranial and intracranial. The former are divided into extratemporal and intratemporal and represent a health problem for the pediatric population despite the extended use of antibiotics. The clinical, otomicroscopic and imaging assessment is reported as a diagnostic criterion predictive of suspicions and of confirmation. Facial

  14. Effect of abnormal thyroid function on the severity of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Prummel, M. F.; Wiersinga, W. M.; Mourits, M. P.; Koornneef, L.; Berghout, A.; van der Gaag, R.

    1990-01-01

    Many clinicians have the impression that treatment of thyroid dysfunction ameliorates ophthalmopathy in Graves' disease. The aim of our study was to relate thyroid function to the severity of Graves' ophthalmopathy. We studied 90 patients with Graves' ophthalmopathy and Graves' hyperthyroidism in

  15. Ultrasonographic Features of Papillary Thyroid Carcinoma in Patients with Graves' Disease

    Science.gov (United States)

    Chung, Jin Ook; Cho, Dong Hyeok; Chung, Dong Jin

    2010-01-01

    Background/Aims To characterize ultrasonographic findings in papillary thyroid carcinoma (PTC) combined with Graves' disease. Methods Medical records and ultrasonographic findings of 1,013 patients with Graves' disease and 3,380 patients without Graves' disease were analyzed retrospectively. A diagnosis of PTC was based on a pathologic examination. Results The frequency of hypoechogenicity was lower in patients with PTC and Graves' disease than in patients with PTC alone (p Graves' disease was significantly higher than in those with PTC alone (p Graves' disease was characterized by more ill-defined borders and less frequency of overall calcification, punctate calcification, and heterogeneous echogenicity, although the difference was not statistically significant. Conclusions Our results suggest that patients with Graves' disease more frequently have atypical PTC findings on ultrasonography. PMID:20195406

  16. The Eye/Brain Radioactivity Ratio for Assessment of Graves Ophthalmopathy

    International Nuclear Information System (INIS)

    Lee, B. W.; Sung, S. K.; Suh, K. S.; Park, W.; Choi, D. J.; Kim, J. S.

    1988-01-01

    In Graves' disease, changes in orbital tissue and structure are caused by inflammatory infiltration, which induces increase of capillary permeability and breakdown of blood-tissue barriers. Using the uptake of 99m Tc-DTPA in inflammatory lesion, Eye/Brain radioactivity ratios in brain scintigraphy were evaluated in 15 normal controls and 40 Graves' patients. The results were as follows; 1) Eye/Brain radioactivity ratio was significantly higher in Graves' ophthalmopathy group than in control group (p 99m Tc-DTPA brain scintigraphy may be useful to determine the activity of Graves' ophthalmopathy and whether treatment of Graves' ophthalmopathy is necessary or not.

  17. Complicaciones infecciosas de la diálisis peritoneal ambulatoria en niños

    Directory of Open Access Journals (Sweden)

    Diana Patricia Durán Casal

    Full Text Available Introducción: la diálisis peritoneal es la mejor alternativa terapéutica para los niños con enfermedad renal crónica terminal, y en las modalidades de diálisis peritoneal ambulatoria ha permitido el tratamiento fuera del hospital, lo que proporciona un mejor estilo y calidad de vida. No es un método exento de riesgos. Las complicaciones infecciosas relacionadas a la diálisis peritoneal son la causa más importante de morbilidad y es la peritonitis su principal complicación. Objetivo: determinar retrospectivamente la frecuencia y las características de complicaciones infecciosas relacionadas al proceder dialítico. Métodos: nuestro hospital es referente como unidad de diálisis pediátrica del país, así que recibe la mayoría de los niños con enfermedad renal crónica terminal de Cuba. Se revisaron los expedientes clínicos de niños con enfermedad renal crónica terminal en programa de diálisis peritoneal ambulatoria en el Hospital Pediátrico de Centro Habana durante el período 2008-2011. Resultados: se estudiaron 12 pacientes con un promedio de edad de 11 años, 58 % del sexo femenino. Se documentaron 24 episodios infecciosos. Las complicaciones encontradas fueron infección del sitio de salida del catéter, con 62,5 %, peritonitis 33,3 % e infección del túnel submucoso 4,2 %. Predominaron cultivos positivos a bacterias grampositivas (66,7 %. Las bacterias más comunes fueron: Staphylococcus coagulasa positivo (48 % y Staphylococcus coagulasa negativo (22 %. Otros gérmenes identificados fueron E. coli, Enterobacter spp. y Candida spp., con 8,3 % respectivamente. Conclusiones: la infección del sitio de salida del catéter fue la complicación infecciosa más frecuente en nuestra serie. Las bacterias grampositivas son los gérmenes más comunes que causan infección del sitio de salida y peritonitis en pacientes en diálisis peritoneal ambulatoria.

  18. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    International Nuclear Information System (INIS)

    Takamatsu, J.; Hosoya, T.; Naito, N.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients

  19. Embarazo adolescente como factor de riesgo para complicaciones obstétricas y perinatales en un hospital de Lima, Perú

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    Javier A. Okumura

    2014-12-01

    Full Text Available Objetivos: analizar el riesgo de complicaciones obstétricas y perinatales en adolescentes embarazadas en un hospital de Lima, Perú. Métodos: estudio de cohorte retrospectiva de 67.693 gestantes atendidas en el período 2000-2010. Se evaluó complicaciones obstétricas y perinatales. Las adolescentes se clasificaron en tardías (15-19 años y tempranas (< 15 años y se compararon con las adultas (20-35 años. Se calculó OR ajustados por educación, estado civil, control prenatal, gestaciones previas, paridad e IMC pregestacional. Resultados: se encontró mayor riesgo de cesárea (OR=1,28; IC95%=1,07-1,53 e infección puerperal (OR=1,72; IC95%=1,17-2,53 en las adolescentes menores de 15 años, así como mayor riesgo (OR=1,34; IC95%=1,29-1,40de episiotomía en las adolescentes tardías. Asimismo, se identificó un menor riesgo del embarazo adolescente para preeclampsia (OR=0,90; IC95%=0,85-0,97, hemorragia de la 2da mitad del embarazo (OR=0,80; IC95%=0,71-0,92, ruptura prematura de membranas (OR=0,83; IC95%=0,79-0,87, amenaza de parto pretérmino (OR=0,87; IC95%=0,80-0,94 y desgarro vaginal (OR= 0,86; IC95%=0,79-0,93. Conclusión: el embarazo se comporta como factor de riesgo para ciertas complicaciones obstétricas en la población adolescente, especialmente en las adolescentes tempranas. Existen además otros factores, que sumados a la edad materna, constituyen la necesidad de formar equipos multidis-ciplinarios para reducir complicaciones obstétricas en esta población.

  20. Death by Suicide in Graves' Disease and Graves' Orbitopathy: A Nationwide Danish Register Study.

    Science.gov (United States)

    Ferløv-Schwensen, Charlotte; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2017-12-01

    Graves' disease (GD) is associated with excess morbidity and mortality, but little is known about unnatural manners of death and the potential relation with Graves' orbitopathy (GO). This study investigated the risk of unnatural death in Graves' patients with and without orbitopathy compared to matched control populations. This was a cohort study covering all adult Danes (≥18 years) diagnosed with GD or GO during 1995-2012. Median follow-up time was 7.9 years (range 0-17.5 years). Utilizing the Danish Register of Causes of Death and the Danish National Patient Registry, 28,461 subjects with GD and 3965 with GO were identified and matched for age and sex with four subjects from the background population. The manner of death was identified, and hazard ratios (HR) for mortality due to unnatural deaths (accident, suicide, violence/homicide, and unknown) were calculated using Cox regression analyses, adjusted for pre-existing somatic and psychiatric morbidity. In Graves' disease overall (GD + GO), there was an increased risk of death from unknown unnatural manners (HR = 2.01 [confidence interval (CI) 1.17-3.45], p = 0.012) and of suicide, although the latter difference was not with certainty statistically significant (HR = 1.43 [CI 1.00-2.04], p = 0.053). There was no significant difference in risk of death from suicide in GD subjects compared to their controls (HR = 1.27 [CI 0.85-1.89], p = 0.253). However, GO patients had a significantly higher risk of death from suicide (HR = 2.71 [CI 1.16-6.32], p = 0.022). Mortality by suicide was increased in Graves' disease overall, most significantly in patients with GO, also after adjustment for pre-existing somatic and psychiatric disease. These findings indicate that GD and GO may have a significant role in the pathophysiological mechanisms of suicidal behavior. Beyond independent confirmation, reasons for this need to be explored in order to introduce preventive measures.

  1. Tratamiento de la Enfermedad de Graves con I131: Primeros casos en la Unidad de Endocrinología Pediátrica del Hospital Nacional Cayetano Heredia, Lima-Perú: Case Report.

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    Javier Ernesto SÁNCHEZ POVIS

    2006-01-01

    Full Text Available Objetivo: Describir la respuesta al tratamiento con I131 y sus complicaciones, en niños y adolescentes con enfermedad de Graves. Material y Métodos: Se estudiaron retrospectivamente las historias clínicas de los pacientes con diagnóstico de enfermedad de Graves y que recibieron tratamiento con I131 atendidos hasta 1999 en la Unidad de Endocrinología Pediátrica del Hospital Nacional Cayetano Heredia. Se registraron datos demográficos, peso tiroideo, captación de yodo, dosis de I131 recibida y evolución clínica y de función tiroidea. Resultados: Se incluyeron 13 pacientes: 1 varón y 12 mujeres. El peso glandular promedio obtenido fue 47,56 +10,70 gramos. La dosis inicial calculada fue 3,92 + 0,95 mCi, con un total de 4,47 + 1,66 mCi y tiempo medio de seguimiento de 2,76 años. Diez pacientes recibieron 1 sola dosis, 2 pacientes dos dosis y un paciente tres dosis, remitiendo el 100%. Los pacientes que recibieron una sola dosis, mostraron remisión del cuadro en 13,13 semanas y el tiempo promedio de remisión de toda la muestra fue 24,62 semanas. La prevalencia de hipotiroidismo a los 6 meses de iniciado el tratamiento fue 66,66%, y 83,33% a las 257 semanas. Conclusión: I131 fue 100% eficaz en el tratamiento de la enfermedad de Graves de los niños y adolescentes en esta pequeña serie de casos. (Rev Med Hered 2006;17:8-14.

  2. Significance of changes of serum FT3, FT4, s-TSH, TGA, TPO-Ab levels in patients with non-Graves' hyperthyroidism and Graves' disease

    International Nuclear Information System (INIS)

    Zhang Lindi; Xu Changde; Xu Huogen; Wang Wei; Zhang Jie; Nie Shufen; Gu Zhenqi; Zeng Jihua

    2006-01-01

    Objective: To investigate the clinical significance of the changes of thyroid-related hormones (FT 3 , FT 4 , s-TSH, TGA, TPO-Ab) levels in patients with Graves' and non-Graves' hyperthyroidism. Methods: Serum FT 3 , FT 4 , TGA, TPO-Ab (with RIA) and s-TSH (with IRMA) were determined in 43 patients with non-Graves' hyperthyroidism, 29 patients with Graves' disease and 40 controls. Results: In both groups of hyperthyroid patients, the serum levels of FT 3 (15.01 ± 11.01 pg/ml in the non - Graves' group and 15.23 ± 9.57pg/ml in the Graves' group), FT 4 (38.30 ± 19.82, 38.87 ± 17.39pg/ml), TGA(33.89 ± 22. 43%, 49.72 ± 20.55% ) and TPO-Ab (1319.24 ± 1037.78, 2023.24 ± 621.00IU/ml) were significantly higher than those (FT 3 , 6.76 ± 2.01pg/ml, FT 4 16.16 ± 2.58pg/ml, TGA 6.76 ± 2.01%, TPO-Ab 0.01 ± 0.01IU/ml) in the controls (all P 3 , FT 4 and s-TSH levels in both groups were not significantly different from each other. Conclusion: In this study, serum TGA and TPO -Ab levels were lower in patients with non-Graves' hyperthyroidism than those in patients with Graves' disease. (authors)

  3. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer.

    Science.gov (United States)

    Yu, Hea Min; Park, Soon Hyun; Lee, Jae Min; Park, Kang Seo

    2013-09-01

    Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  4. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  5. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  6. Hyperparathyroidism after radioactive iodine therapy for Graves disease

    International Nuclear Information System (INIS)

    Esselstyn, C.B. Jr.; Schumacher, O.P.; Eversman, J.; Sheeler, L.; Levy, W.J.

    1982-01-01

    The association of external ionizing radiation to the head and neck and the subsequent development of hyperfunctioning parathyroid glands has been documented in recent years. This also has been demonstrated experimentally in animals. Despite the numbers of patients with Graves disease who have been treated with radioactive iodine, there are no reports in the literature of parathyroid surgery for hyperparathyroidism secondary to earlier treatment with radioactive iodine for Graves disease. This report describes the operative and pathologic findings in four patients with hyperparathyroidism. These patients had previously been treated with radioactive iodine for Graves disease. The pathologic findings at surgery included in three cases a single enlarged hyperplastic gland consistent with a parathyroid adenoma. One patient had hyperplasia of all four glands. The two largest glands and halves of the two remaining glands were removed. In a long-term follow-up of children and adolescents treated with radioactive iodine for Graves disease, Levy and Schumacher found calcium elevations in 10 of 159 patients. The increased incidence of hyperparathyroidism following radioactive iodine treatment for Graves disease in children and adolescents would seem several times higher than normal. Whether adults who have radioactive iodine treatment for Graves disease have a similar increase incidence is not known. Meanwhile it would seem reasonable to suggest that patients whose hyperthyroidism is treated with radioactive iodine should have their serum calcium levels determined at 5-year intervals

  7. Graves' disease: diagnostic and therapeutic challenges (multimedia activity).

    Science.gov (United States)

    Kahaly, George J; Grebe, Stefan K G; Lupo, Mark A; McDonald, Nicole; Sipos, Jennifer A

    2011-06-01

    Graves' disease is the most common cause of hyperthyroidism in the United States. Graves' disease occurs more often in women with a female:male ratio of 5:1 and a population prevalence of 1% to 2%. A genetic determinant to the susceptibility to Graves' disease is suspected because of familial clustering of the disease, a high sibling recurrence risk, the familial occurrence of thyroid autoantibodies, and the 30% concordance in disease status between identical twins. Graves' disease is an autoimmune thyroid disorder characterized by the infiltration of immune effector cells and thyroid antigen-specific T cells into the thyroid and thyroid-stimulating hormone receptor expressing tissues, with the production of autoantibodies to well-defined thyroidal antigens, such as thyroid peroxidase, thyroglobulin, and the thyroid-stimulating hormone receptor. The thyroid-stimulating hormone receptor is central to the regulation of thyroid growth and function. Stimulatory autoantibodies in Graves' disease activate the thyroid-stimulating hormone receptor leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Below-normal levels of baseline serum thyroid-stimulating hormone receptor, normal to elevated serum levels of T4, elevated serum levels of T3 and thyroid-stimulating hormone receptor autoantibodies, and a diffusely enlarged, heterogeneous, hypervascular (increased Doppler flow) thyroid gland confirm diagnosis of Graves' disease (available at: http://supplements.amjmed.com/2010/hyperthyroid/faculty.php). This Resource Center is also available through the website of The American Journal of Medicine (www.amjmed.com). Click on the “Thyroid/Graves' Disease” link in the “Resource Centers” section, found on the right side of the Journal homepage. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Resolution of Graves' disease after renal transplantation.

    Science.gov (United States)

    Lee, Yvonne; Butani, Lavjay; Glaser, Nicole; Nguyen, Stephanie

    2016-06-01

    We report a case of an adolescent boy with Down's syndrome and ESRD on hemodialysis who developed mild Graves' disease that was not amenable to radioablation, surgery, or ATDs. After 14 months of observation without resolution of Graves' disease, he successfully received a DDRT with a steroid minimization protocol. Thymoglobulin and a three-day course of steroids were used for induction and he was started on tacrolimus, MMF, and pravastatin for maintenance transplant immunosuppression. One month after transplantation, all biochemical markers and antibody profiling for Graves' disease had resolved and remain normal one yr later. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Graves disease hyperthyroidism and glycometabolism

    International Nuclear Information System (INIS)

    Sun Qiting; Zhao Deshan

    2010-01-01

    The Patients with Graves disease hyperthyroidism are often accompanied by disorder of glycometabolism. β-cell dysfunction and insulin resistance play a main role in this disease, while the immune and genetic factors are also relevant with the disease. The blood glycose level can become normal gradually with the recovery of thyroid hormone after 131 I and antithyroid drug treatment. Therefore, the blood glycose level could be improved and complications could be prevented by early treatment in the patients with Graves disease hyperthyroidism accompanied with glycometabolism disorder is helpful for improving the blood glycose level. (authors)

  10. Microchimerism in Graves' Disease

    Science.gov (United States)

    Galofré, Juan C.

    2012-01-01

    Microchimerism is the presence of cells from one individual in another genetically distinct individual. Pregnancy is the main cause of natural microchimerism through transplacental bidirectional cell trafficking between mother and fetus. The consequences of pregnancy-related microchimerism are under active investigation. However, many authors have suggested a close relationship linking fetal microchimerism and the development of autoimmune diseases. It has been more than ten years now since the demonstration of the presence of a significant high number of fetal microchimeric cells residing in thyroid glands from operated patients with Graves' disease. This intrathyroidal fetal microchimerism is an attractive candidate mechanism for the modulation of Graves' disease in pregnancy and the postpartum period. PMID:22577597

  11. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hea Min Yu

    2013-09-01

    Full Text Available Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  12. Laparoscopic treatment of cholelithiasis in cirrhotic patients Experiencia en el tratamiento laparoscópico de la colelitiasis del cirrótico

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    M. Flores Cortés

    2005-09-01

    Full Text Available Objective: to assess the safety and efficacy of laparoscopy in the treatment of symptomatic cholelithiasis in patients with Child´s Class A and Class B cirrhosis. Study design: descriptive and retrospective study. Patients: we studied 14 patients (mean age 60 yrs with Child´s Class A and Class B hepatic cirrhosis who underwent laparoscopic cholecystectomy. We analyzed the occurrence of intraoperative and postoperative complications. Results: eight patients were women (57.14% and 6 were men (42.85%. Eight of the 14 patients presented with Child's Class B cirrhosis and 6 patients with Class A. Cholecystectomy was programmed for all patients. The average duration of surgery was 77 min. Intraoperative complications occurred in 2 patients (14.28% in the form of liver bed bleeding. Postoperative complications were observed in 3 patients (21.42%, 2 presented with ascites which led to a worsening of Child's Class in one of them, and the third patient presented with angina-like symptoms (acute, sharp pain in the chest irradiating to the back. Mean length of hospital stay was 3 days. No postoperative morbidity or mortality occurred, and there were no conversions. Conclusions: LC (laparoscopic cholecystectomy is a safe and effective alternative for the treatment of symptomatic cholelithiasis in patients with well-compensated Child's Class A and Class B cirrhosis. Postoperative morbi-mortality is low, bleeding is unimportant, and both duration of surgical procedure and hospital stay are short.Objetivo: evaluar la seguridad y eficacia del uso de la laparoscopia en pacientes cirróticos en estadio A y B de Child-Pugh con colelitiasis sintomática. Diseño del estudio: estudio descriptivo, retrospectivo. Pacientes: catorce pacientes con una edad media de 60 años diagnosticados de cirrosis hepática en estadios A y B que se les practicó colecistectomía laparoscópica. Se estudia la aparición de complicaciones intraoperatorias y postoperatorias tras la

  13. Manifestaciones clínicas y complicaciones de la fase aguda de bartonelosis o Fiebre de la Oroya en pacientes atendidos en el Hospital Nacional Cayetano Heredia.

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    Ciro Peregrino Maguiña Vargas

    2008-07-01

    Full Text Available Objetivos: Determinar las características clínicas, epidemiológicas y de laboratorio de la bartonelosis aguda, así como las complicaciones en una serie de pacientes atendidos en el Hospital Nacional Cayetano Heredia. Material y métodos: Estudio descriptivo de tipo serie de casos de pacientes mayores de 15 años con bartonelosis aguda hospitalizados en el Hospital Nacional Cayetano Heredia entre 1993 y 2006. Resultados: La edad promedio fue 27,8 años, 72,7% fueron varones, 51,5% procedía de Lima y 33,3% de Ancash. Los síntomas principales fueron: fiebre 90,9%, cefalea 87,9%, hiporexia 75,5%, baja de peso 63,6%, e ictericia 57,6%. Dos pacientes presentaron alteraciones en el fondo de ojo: retinitis exudativa y retinopatía hemorrágica. El hematocrito promedio fue 20,8% y 63,6% cursaron hematocrito £20%. Hubo desviación izquierda en 24,2%, hiperbilirrubinemia a predominio indirecto 62,5% e hipoalbuminemia (< 3mg/dl 56,5%. Se presentaron complicaciones en 84,8%, el 27,2% requirió internamiento en UCI. Las complicaciones no infecciosas ocurrieron en 84,8%, hematológicas 81,8% y gastrointestinales 78,7%. Las complicaciones infecciosas se presentaron en 12,1%. Los antibióticos más utilizados fueron ciprofloxacina 66,6% y cloranfenicol 42,4%, se administró corticoides en 9,1% y se transfundió paquete globular en 42,4%. Conclusiones: Los pacientes de UCI tuvieron más complicaciones cardiovasculares, trombocitopenia y mayor severidad de la anemia. No se registró mortalidad. (Rev. Med Hered 2008;19:87-95

  14. Neonatal Graves' Disease with Maternal Hypothyroidism.

    Science.gov (United States)

    Akangire, Gangaram; Cuna, Alain; Lachica, Charisse; Fischer, Ryan; Raman, Sripriya; Sampath, Venkatesh

    2017-07-01

    Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes as it is a rare, severe, presentation of an uncommon neonatal disease, signs, symptoms, and clinical history presented a diagnostic challenge for neonatologists and endocrinologists, normal newborn screen was misleading, and yet timely treatment led to a full recovery.

  15. [Neonatal hyperthyroidism and maternal Graves disease].

    Science.gov (United States)

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

    2015-04-01

    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

    Science.gov (United States)

    Bunevicius, Robertas; Prange, Arthur J

    2006-01-01

    Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

  17. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

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    Miloš Žarković

    2012-01-01

    Full Text Available Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS. Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1 involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo.

  18. Caracterización clínico-epidemiológica de las complicaciones crónicas en pacientes diabéticos, tipo 2

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    Jorge Enrique Agüero Batista

    2015-11-01

    Full Text Available Se realizó un estudio descriptivo, prospectivo, con el objetivo de caracterizar las principales complicaciones crónicas que se presentan en pacientes diabéticos tipo 2, del policlínico “Dr. Gustavo Aldereguía Lima” del municipio Las Tunas, así como determinar el nivel de conocimientos de los mismos en aspectos relacionados con su enfermedad, en el período comprendido de enero a diciembre del 2011. Los resultados obtenidos a través de los cuestionarios elaborados fueron analizados por el método porcentual comparativo. En los 484 pacientes estudiados existió un predominio del sexo femenino y el grupo etáreo de mayor incidencia fue el de 60 a 79 años. Las complicaciones crónicas estuvieron presentes en un considerable número de pacientes, las lesiones macroangiopáticas fueron las más relevantes, dentro de ellas, la vasculopatía periférica. La neuropatía diabética fue la más frecuente de las complicaciones microangiopáticas; así como los pacientes con un inadecuado nivel de conocimientos de su enfermedad.

  19. Hickam's dictum: Myasthenia Gravis presenting concurrently with Graves' disease.

    Science.gov (United States)

    Sehgal, Shekhar; Rebello, Roshan; Wolmarans, Louise; Elston, Marianne

    2017-09-07

    We present two patients with Graves' disease and concurrent myasthenia gravis. The impact of the dual diagnosis on the clinical course and the potential for a delayed diagnosis of myasthenia gravis is discussed. Patient 1, a 28-year-old man was diagnosed with Graves' disease following his second respiratory arrest. His history was strongly suggestive of a second pathology. Patient 2, a 66-year-old Cantonese woman with established Graves' disease presented with thionamide-related neutropaenia. Examination revealed bilateral ptosis and right lateral rectus palsy. Both patients had thyrotoxicosis secondary to Graves' disease with concurrent myasthenia gravis. Although neuromuscular weakness is common in Graves' disease, coexisting myasthenia gravis (MG) is rare and can cause profound morbidity. Ocular signs in both diseases may cause diagnostic confusion although ptosis suggests coexisting MG. In both cases, the thyrotoxicosis delayed the diagnosis of MG. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Vitamin D and Graves' disease: a meta-analysis update.

    Science.gov (United States)

    Xu, Mei-Yan; Cao, Bing; Yin, Jian; Wang, Dong-Fang; Chen, Kai-Li; Lu, Qing-Bin

    2015-05-21

    The association between vitamin D levels and Graves' disease is not well studied. This update review aims to further analyze the relationship in order to provide an actual view of estimating the risk. We searched for the publications on vitamin D and Graves' disease in English or Chinese on PubMed, EMBASE, Chinese National Knowledge Infrastructure, China Biology Medical and Wanfang databases. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for the vitamin D levels. Pooled odds ratio (OR) and 95% CI were calculated for vitamin D deficiency. We also performed sensitivity analysis and meta-regression. Combining effect sizes from 26 studies for Graves' disease as an outcome found a pooled effect of SMD = -0.77 (95% CI: -1.12, -0.42; p Graves' disease were more likely to be deficient in vitamin D compared to the controls (OR = 2.24, 95% CI: 1.31, 3.81) with a high heterogeneity (I2 = 84.1%, p Graves' disease.

  1. Thymic hyperplasia in a patient with Grave's disease.

    Science.gov (United States)

    Hamzaoui, Amira A; Klii, Rim R; Salem, Randa R; Kochtali, Ines I; Golli, Mondher M; Mahjoub, Silvia S

    2012-02-09

    Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia.

  2. Papel de los macrófagos en la patogénesis de la arteriosclerosis

    Directory of Open Access Journals (Sweden)

    María del Pilar Quintana Varón

    2007-08-01

    eventualmente entra en apoptosis y necrosis, haciendo cada vez más grande e inestable la lesión arteriosclerótica, lo que en último momento es el detonante de las complicaciones clínicas graves que pueden terminar en la muerte del paciente.

  3. The clinical value of serum thyrotrophin receptor antibody level in patients with Graves ophthalmopathy

    International Nuclear Information System (INIS)

    Wang Chaodian; Shi Yuhong; Yan Bing

    2013-01-01

    Objective: To explore the value of serum thyrotrophin receptor antibody (TRAb) on the pathological mechanism of Graves ophthalmopathy. Methods: Two hundred and nineteen newly diagnosed Graves disease patients who were divided into Graves ophthalmopathy group (n=121) and without Graves ophthalmopathy group (n=98) were tested serum concentration with thyroid function, thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and TRAb. According to the consensus statement of the European Group on Graves ophthalmopathy, clinical activity score (CAS) and severity evaluation were carried out on Graves ophthalmopathy patients. Results: There was no significant difference in serum concentration of free thyroxine (FT 4 ), free triiodothyronine (FT 3 ), TPOAb and TRAb between the Graves ophthalmopathy group and the without Graves ophthalmopathy group. Serum concentration of TRAb was not correlated with the severity and CAS of Graves ophthalmopathy. Conclusions: The CAS and the severity of Graves ophthalmopathy were irrelevant to the serum concentration of TRAb. Therefore, the correlation between TRAb and Graves ophthalmopathy still needs further study. (authors)

  4. Thymic hyperplasia in a patient with Grave's disease

    Directory of Open Access Journals (Sweden)

    Hamzaoui Amira A

    2012-02-01

    Full Text Available Abstract Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia.

  5. Standardization of 131I therapy for Graves disease

    International Nuclear Information System (INIS)

    Tang Jianlin; Li Yuying; Gao Liuyan; Tang Xiuping; Hu Hongyong

    2011-01-01

    Objective: To establish the normative and standard measures, to ensure medical safety and quality of care of the patients with Graves disease treated by 131 I therapy. Methods: Formulating and strictly implementing the medical organizational and technical measures of 131 I therapy for Graves disease and regular follow-up. Results: Receiving 131 I treatment of 104 patients, follow-up 6-36 months, no adverse events, the cure rate of 59.6%, the efficient rate is 99.9%. Conclusion: It is important guarantee for the medical quality and safety to standardize the 131 I therapy of Graves disease. (authors)

  6. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  7. Graves' disease in Albanian children.

    Science.gov (United States)

    Gjikopulli, A; Tomori, Sonila; Kollçaku, L; Hoxha, P; Grimci, Lindita; Ylli, Zamira

    2014-01-01

    Graves' disease (GD) accounts for 10-15% of thyroid disorders in patients less than 18 years of age. It is the most common cause of thyrotoxicosis in children and accounts for at least 95% of cases in children. Pediatric Treatment of Graves' disease consists of anti-thyroid drugs, radioactive iodide and thyroidectomy but the optimal treatment of GD in children is still controversial. To review treatment outcome of pediatric Graves' disease in Albania. Descriptive review of 15 children with Graves' disease, diagnosed from Jan.2007 to Dec. 2013, at the Division of Pediatric Endocrinology, Department of Pediatrics, University Hospital Centre "Mother Teresa", Albania was performed. All patients, mean age 10.56 ± 3.37 years, (range 2.02-16.09 years) were presented with goiter and increased serum FT4, mean 39.80 ± 16.02 ng/mL, (range 21.0-74.70 ng/mL), serum FT3, mean 12.98 ± 3.45 pg/mL, (range 6.90 -17.90 pg/mL) and suppressed TSH levels, mean 0.02 ± 0.01 mUI/L, (range 0.01-0.05 mUI/L). Anti TSH Receptor were positive in 100% of patients mean value 6.51 ± 3.61 UI/mL (range 1.63 - 14.10 UI/mL). Anti-thyroglobulin and Anti-TPO antibodies were positive in 60% and 46.6% respectively. Clinical course of 15 patients after treatment with anti-thyroid drugs mainly MMI for 3.19 ± 1.48 (range 0.60 - 6.20) years is as follows: seven (46.66%) underwent remission, five out of seven (71.41%) who underwent remission, relapsed. Three of them (20%) were treated with I(131), and two (13.3%) underwent to total thyroidectomy. MMI was the most common first line therapy in the presented patients with Graves' disease. Remission rate was 46.66% after an average 1.48 ± 0.71 years (range 0.60 - 2.70 years) of treatment with anti-thyroid drugs. Remission period was 2.70 ± 0.36 years (2.1 - 3.1 years) Relapse occurred in 71.41% of patient. I(131) and thyroidectomy were used as second line therapy in the present study.

  8. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    International Nuclear Information System (INIS)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa

    1994-01-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after 131 I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after 131 I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after 131 I therapy.(author)

  9. [Diagnostic difficulties in Grave's orbitopathy--case report].

    Science.gov (United States)

    Jedrzejowski, Maciej; Grzesiuk, Wiesław; Szwejda, Elzbieta; Bar-Andziak, Ewa

    2004-03-01

    Graves' orbitopathy is caused by intraorbital inflammatory reaction due to autoimmune thyroid disease. In most cases the diagnosis is based on the coexistence of typical eye signs and hyperthyroidism symptoms. In presented case, the absence of thyroid dysfunction implicated performance of differential diagnosis. Among many available diagnostic tools nuclear magnetic resonance seems to be the most accurate in confirmation of diagnosis of Graves' orbitopathy.

  10. Detección de las complicaciones en los pacientes diabéticos que asisten a la unidad básica la libertad, durante los meses de abril y mayo del año 2006

    Directory of Open Access Journals (Sweden)

    Elisa Katie Vergel-Arevalo

    2006-12-01

    Full Text Available La diabetes continua siendo uno de los mayores problemas de salud pública en el mundo, coma consecuencia de complicaciones tales como neuropatías, oftalmopatias, nefropatías, Hipertensión Arterial (HTA, alteraciones micro y macrovasculares. La presente revisión pretende exponer las complicaciones encontradas en una muestra de 14 pacientes diabéticos de la Unidad Básica la Libertad de la ciudad de Cúcuta (Colombia, con el objetivo de detectar tempranamente las complicaciones propias de la Diabetes. El principal respaldo de esta investigación se basa en los grandes estudios epidemiológicos que han demostrado que el control adecuado de la glicemia previene o retarda las complicaciones. Al valorar los pacientes diabéticos se tomaron variables sociodemográficas como sexo, edad, estrato, ocupación y nivel educativo; alteraciones en los niveles de glicemia casual en sangre, en el estado neurológico, oftalmológico, factores que puedan propiciar pie diabético, antecedentes de complicaciones agudas, valores de presión arterial y prácticas como dieta balanceada y ejercicios

  11. Graves disease with ophthalmopathy following radiotherapy for Hodgkin's disease

    International Nuclear Information System (INIS)

    Jacobson, D.R.; Fleming, B.J.

    1984-01-01

    The number of patients achieving long-term survival following neck irradiation for Hodgkin's disease and other malignancies is increasing. Paralleling this increase in survivors is the development of late complications of the therapy itself. Eleven patients have previously been reported who developed Graves ophthalmopathy 18 months to seven years after receiving neck radiotherapy for nonthyroidal malignancies. The seven patients who had HLA typing were all HLA-B8 negative, despite the reported association of the HLA-B8 antigen with Graves disease. A patient who is HLA-B8 positive who developed Graves ophthalmopathy and hyperthyroidism nine years after receiving mantle radiotherapy for Hodgkin's disease is reported. It is recommended that Graves disease be included among the thyroid diseases that receive consideration during follow-up of patients who have received mantle radiotherapy

  12. Diagnosis of Grave's disease with pulmonary hypertension on chest CT.

    Science.gov (United States)

    Lee, Hwa Yeon; Yoo, Seung Min; Kim, Hye Rin; Chun, Eun Ju; White, Charles S

    To evaluate the diagnostic accuracy of chest CT findings to diagnose Grave's disease in pulmonary hypertension. We retrospectively evaluated chest CT and the medical records of 13 patients with Grave's disease with (n=6) or without pulmonary hypertension (n=7) and in 17 control patients. Presence of iso-attenuation of diffusely enlarged thyroid glands compared with adjacent neck muscle on non-enhanced CT as a diagnostic clue of Grave's disease, and assessment of pulmonary hypertension on CT has high diagnostic accuracy. Chest CT has the potential to diagnose Grave's disease with pulmonary hypertension in the absence of other information. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Graves' disease with special reference to radiation therapy

    International Nuclear Information System (INIS)

    Seegenschmidt, M. H.; Heyd, R.; Esser, J.; Mould, R.F.

    2006-01-01

    Graves' disease, although not malignant, nevertheless can lead to serious events such as permanent loss of vision if it remains untreated. This review article describes the clinical symptoms of the disease, includes a commentary on the Graves' disease subgroup of thyroid-associated orbitipathy (TAO), and defines clinical activity scoring systems which grade the severity of the disease in patients (clinical activity, NOSPECS and LEMO scoring ). An review of radiotherapy in the 1980s is followed by a summary of the 2003 German national survey on radiotherapy for Graves' disease. Radiation therapy technique is then described and discussed. Case histories are from the Alfred Krupp Hospital in Essen. (author)

  14. Højfolkets Grave

    DEFF Research Database (Denmark)

    2007-01-01

    For the special exhibition 'Højfolkets Grave - Oak Coffins from Borum Eshøj' on Moesgaard Museum in 2007: The development of 3D graphics which was displayed on a big screen in the exhibition. The animation shows - in a very stylistic way - the design principles behind the construction of Bronze Age...

  15. Guidelines for the treatment of childhood-onset Graves' disease in Japan, 2016.

    Science.gov (United States)

    Minamitani, Kanshi; Sato, Hirokazu; Ohye, Hidemi; Harada, Shohei; Arisaka, Osamu

    2017-01-01

    Purpose behind developing these guidelines: Over one decade ago, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (Japan Thyroid Association (JTA)) were published as the standard drug therapy protocol for Graves' disease. The "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" were published to provide guidance on the treatment of pediatric patients. Based on new evidence, a revised version of the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (JTA) was published in 2011, combined with the "Handbook of Radioiodine Therapy for Graves' Disease 2007" (JTA). Subsequently, newer findings on pediatric Graves' disease have been reported. Propylthiouracil (PTU)-induced serious hepatopathy is an important problem in pediatric patients. The American Thyroid Association's guidelines suggest that, in principle, physicians must not administer PTU to children. On the other hand, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2011" (JTA) state that radioiodine therapy is no longer considered a "fundamental contraindication" in children. Therefore, the "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" required revision.

  16. Premature hair greying may predict reduced bone mineral density in Graves' disease.

    LENUS (Irish Health Repository)

    Leary, A C

    2012-02-03

    BACKGROUND: Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves\\' disease. AIMS: To determine whether premature greying is associated with reduced BMD in women with Graves\\' disease and in control women, and to examine whether premature greying is more common in Graves\\' disease. METHODS: Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves\\' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS: Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves\\' disease, but not among control women. Multiple regression confirmed this difference between Graves\\' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves\\' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION: Premature greying may be a weak marker for reduced BMD in women with a history of Graves\\' disease, but it is not a marker in normal women.

  17. Predictive factors of thyroid cancer in patients with Graves' disease.

    Science.gov (United States)

    Ren, Meng; Wu, Mu Chao; Shang, Chang Zhen; Wang, Xiao Yi; Zhang, Jing Lu; Cheng, Hua; Xu, Ming Tong; Yan, Li

    2014-01-01

    The best preoperative examination in Graves' disease with thyroid cancer still remains uncertain. The objectives of the present study were to investigate the prevalence of thyroid cancer in Graves' disease patients, and to identify the predictive factors and ultrasonographic features of thyroid cancer that may aid the preoperative diagnosis in Graves' disease. This retrospective study included 423 patients with Graves' disease who underwent surgical treatment from 2002 to 2012 at our institution. The clinical features and ultrasonographic findings of thyroid nodules were recorded. The diagnosis of thyroid cancer was determined according to the pathological results. Thyroid cancer was discovered in 58 of the 423 (13.7 %) surgically treated Graves' disease patients; 46 of those 58 patients had thyroid nodules, and the other 12 patients were diagnosed with incidentally discovered thyroid carcinomas without thyroid nodules. Among the 58 patients with thyroid cancer, papillary microcarcinomas were discovered in 50 patients, and multifocality and lymph node involvement were detected in the other 8 patients. Multivariate regression analysis showed younger age was the only significant factor predictive of metastatic thyroid cancer. Ultrasonographic findings of calcification and intranodular blood flow in thyroid nodules indicate that they are more likely to harbor thyroid cancers. Because the influencing factor of metastatic thyroid cancers in Graves' disease is young age, every suspicious nodule in Graves' disease patients should be evaluated and treated carefully, especially in younger patients because of the potential for metastasis.

  18. Complicaciones de la apendicectomía en mayores de 65 años y su asociación con enfermedades sistémicas en el servicio de emergencia. Hospital Luis Vernaza, enero 2010 - diciembre 2012.

    OpenAIRE

    Guarquila Macías, César

    2015-01-01

    Determinar si la presencia de una patología sistémica aumenta el riesgo de sufrir una complicación en pacientes geriátricos con diagnóstico de apendicitis aguda; enumerar las complicaciones postquirúrgicas más frecuentes de la apendicectomíaen pacientes geriátricos; relacionar las complicaciones postquirúrgicas de la apendicectomía en pacientes geriátricos con el tiempo de evolución de la enfermedad y demostrar las complicaciones post-quirúrgicas de la apendicetomí...

  19. Immunoreactive 'TSH' in urinary concentrates of Graves' disease patients

    International Nuclear Information System (INIS)

    Van Herle, A.; Orgiazzi, J.; Greipel, M.A.; Slucher, J.A.; Honbo, K.S.; Hopital de l'Antiquaille, 69 - Lyon

    1978-01-01

    A double antibody radioimmunoassay was used to analyse immunoreactive thyrotrophin in urinary concentrates from fourteen patients with hyperthyroidism due to Graves' disease, in three subjects with primary hypothyroidism, and in six normal subjects. Immunoreactive thyrotrophin was detectable in eleven subjects with Graves' disease, in one subject with primary hypothyroidism, and in four normal subjects. The mean urinary thyrotrophin concentration was significantly higher in Graves' disease (492+-99.9μU/24h(SEM)(n=11)) than in normal subjects (177+-26.4μU/24h(SEM)(n=4)(P [de

  20. Rituximab in relapsing Graves' disease, a phase II study

    NARCIS (Netherlands)

    Heemstra, Karen A.; Toes, Rene E.; Sepers, Jan; Pereira, Alberto M.; Corssmit, Eleonora P.; Huizinga, Tom W. J.; Romijn, Johannes A.; Smit, Johannes W.

    2008-01-01

    Conventional therapies for Graves' disease, consisting of medical therapy or radioiodine are unsatisfactory, because of limited efficacy and adverse events. Interventions aimed at the underlying autoimmune pathogenesis of Graves' disease may be worthwhile to explore. We therefore performed a

  1. Graves' Disease Pharmacotherapy in Women of Reproductive Age.

    Science.gov (United States)

    Prunty, Jeremy J; Heise, Crystal D; Chaffin, David G

    2016-01-01

    Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine. In this article, we review guideline recommendations for Graves' disease treatment in women of reproductive age including the recent guideline from the American College of Obstetricians and Gynecologists. Controversy regarding appropriate thioamide therapy before, during, and after pregnancy is reviewed. Surgical and radioactive iodine therapy considerations in this patient population are also reviewed. In patients who may find themselves pregnant during therapy or develop Graves' disease during their pregnancy, consideration should be given to the most appropriate treatment course for the mother and fetus. Thioamide therapy should be used with either propylthiouracil or methimazole at appropriate doses that target the upper range of normal to slightly hyperthyroid to avoid creating hypothyroidism in the fetus. Consideration should also be given to the adverse effects of thioamide, such as agranulocytosis and hepatotoxicity, with appropriate patient consultation regarding signs and symptoms. Individuals who wish to breastfeed their infants while taking thioamide should receive the lowest effective dose. Surgery should be reserved for extreme cases and limited to the second trimester, if possible. Radioactive iodine therapy may be used in nonpregnant individuals, with limited harm to future fertility. Radioactive iodine therapy should be withheld in pregnant women and those who are actively breastfeeding. Clinicians should keep abreast of developments in clinical trials and evidence-based recommendations regarding Graves' disease in reproductive-age women for any changes in evidence

  2. Hipertensión arterial sistémica en el embarazo

    OpenAIRE

    Rosas,Martín; Lomelí,Catalina; Mendoza-González,Celso; Lorenzo,José Antonio; Méndez,Arturo; Férez Santander,Sergio Mario; Attie,Fause

    2008-01-01

    La evidencia acumulada indica que la hipertensión en el embarazo es una entidad sub-diagnosticada y frecuentemente no bien tratada, dando origen a complicaciones cardiovasculares graves. La hipertensión que ocurre durante la gestación puede dar lugar a pree-clampsia o a situaciones graves como la eclampsia y el síndrome de HELLP. Además se reconoce que las mujeres que desarrollaron hipertensión durante la gestación, tienen incremento en la posibilidad de desarrollar eventos cardiovasculares m...

  3. [Rituximab: a new therapeutic alternative in Grave's disease].

    Science.gov (United States)

    Tello-Winniczuk, Nina; Díaz-Jouanen, Efraín

    2011-01-01

    Graves' disease is the most frequent cause of hyperthyroidism, affecting mainly young aged women, with an etiology of autoimmune basis. One of its manifestations, Graves' ophthalmopathy whose pathophysiology is unknown, represents one of the greatest therapeutic challenges in these patients, because they require aggressive treatment with steroids and multiple subsequent reconstructive surgeries in certain cases. It also represents a high burden to the health system. Drugs targeting B cells have been very effective for many autoimmune diseases. Rituximab is a murine humanized monoclonal antibody against CD20 + cells currently being studied in various autoimmune diseases including Graves' disease. The objective of this paper is to expose possible mechanisms by which rituximab could act in both hyperthyroidism and ophthalmopathy of Graves' disease, as well as the experience with its use acquired so far. The employment of rituximab in recently diagnosed patients or with mild ophthalmopathy is questionable with the evidence available today however, we think that it may have a role in refractory cases or those who have a contraindication for steroid use.

  4. Management of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.

    2007-01-01

    Management of Graves' ophthalmopathy is preferably done in a multidisciplinary setting. Smoking is associated with worse disease outcome. (131)I therapy for hyperthyroidism can also worsen ophthalmopathy, especially if administered during active disease or to patients who smoke or have severe

  5. Complicaciones de los accesos vasculares centrales en los recién nacidos del Instituto Nacional de Perinatología

    Directory of Open Access Journals (Sweden)

    S. Carrera Muiños

    2016-10-01

    Conclusión La incidencia de complicaciones relacionadas con el catéter continúa siendo un problema en todas las unidades de cuidados intensivos neonatales; la sepsis en particular es la principal complicación y la que mayor impacto tiene sobre la morbimortalidad neonatal.

  6. Hallazgos cuantitativos y cualitativos en la OCTA en pacientes con y sin retinopatía diabética en el servicio de oftalmología del área este de Valladolid

    OpenAIRE

    Radoslaw Szewc, Marcin

    2017-01-01

    La retinopatía diabética (RD) es una de las complicaciones microvasculares más frecuentes de la diabetes mellitus (DM). La detección precoz de la RD permite evitar en numerosas ocasiones la aparición de complicaciones graves y ceguera. El diagnóstico es clínico y apoya en pruebas de imagen complementarías, entre ellas la angiofluoresceingrafía (AFG) y la tomografía de coherencia óptica (OCT) y un nuevo método de diagnóstico OCT Angiografía (OCTA) que permite visualizar las estr...

  7. Enhancement of soluble CD28 levels in the serum of Graves' disease.

    Science.gov (United States)

    Sun, Zhongwen; Yi, Lixian; Tao, Hong; Huang, Jingfang; Jin, Zhenghong; Xiao, Yang; Feng, Caiyun; Sun, Jing

    2014-01-01

    Graves' disease is an autoimmune disease of the thyroid gland mediated by T cells. CD28, a member of costimulatory molecules, plays a pivotal role in regulating T-cell responses. Plasma-soluble CD28 is one form of CD28 in peripheral blood. To investigate the concentrations of soluble CD28 in patients with Graves' disease, we used a sensitive dual monoclonal antibody sandwich enzyme-linked immunosorbent assay (ELISA) to detect the soluble form of CD28. Our results suggested that mean concentrations of soluble CD28 in plasma of patients with Graves' disease were 1.79 ±1.52 ng/ml, and levels of soluble CD28 in healthy subjects were only 0.83 ±1.35 ng/ml. Concentrations of soluble CD28 detected in patients with Graves' disease were significantly higher than those of healthy subjects (p Graves' disease. Therefore, aberrant elevation of plasma-soluble CD28 in patients with Graves' disease may reflect the dysregulation of immune system, and may serve as a useful biomarker in Graves' disease diagnosis.

  8. Complicaciones de la apendicectomía por apendicitis aguda Complications of the appendicectomy due to acute appendicitis

    Directory of Open Access Journals (Sweden)

    Zenén Rodríguez Fernández

    2010-06-01

    Full Text Available INTRODUCCIÓN. La apendicectomía por apendicitis aguda es la operación de urgencia más común en los servicios quirúrgicos, pero no está exenta de complicaciones condicionadas por factores poco conocidos, cuya determinación podría disminuir la morbilidad y mortalidad por esta causa. Fue objetivo de esta investigación identificar algunos factores relacionados con la aparición de complicaciones en los pacientes apendicectomizados por apendicitis aguda. MÉTODOS. Se realizó un estudio descriptivo, observacional y prospectivo de 560 pacientes apendicectomizados, con diagnóstico histopatológico de apendicitis aguda, egresados del Servicio de Cirugía General del Hospital Provincial Docente «Saturnino Lora» de Santiago de Cuba durante el 2006. RESULTADOS. El 21,6 % de la serie sufrió algún tipo de complicación, principalmente la infección del sitio operatorio. Las complicaciones aumentaron en relación con la edad y se presentaron más frecuentemente en los pacientes con enfermedades asociadas, estado físico más precario, mayor tiempo de evolución preoperatoria, así como en las formas histopatológicas más avanzadas de la afección (en las que se incluyen los 4 pacientes fallecidos. La aparición de tales complicaciones puede ser causa de reintervenciones y de aumento de la estadía hospitalaria. CONCLUSIONES. El diagnóstico precoz de la enfermedad y la apendicectomía inmediata con una técnica quirúrgica adecuada previenen la aparición de complicaciones posquirúrgicas y determinan el éxito del único tratamiento eficaz contra la afección más común que causa el abdomen agudo, cuyo pronóstico depende en gran medida y entre otros factores, del tiempo de evolución preoperatoria y de la fase en que se encuentre el proceso morboso al realizar la intervención.INTRODUCTION. Appendicectomy due to acute appendicitis is the commonest urgency operation in surgical services but it is not exempt from complications conditions by

  9. Hemangioblastomas de fosa posterior: Reporte de 16 casos y revisión de la literatura

    Science.gov (United States)

    Campero, Alvaro; Ajler, Pablo; Fernandez, Julio; Isolan, Gustavo; Paiz, Martin; Rivadeneira, Conrado

    2016-01-01

    Resumen Objetivo: El propósito del presente trabajo es presentar los resultados de 16 pacientes con diagnóstico de hemangioblastoma de fosa posterior (HBFP), operados con técnicas microquirúrgicas. Método: Desde junio de 2005 a diciembre de 2015, 16 pacientes con diagnóstico de HBFP fueron intervenidos quirúrgicamente. Se evaluó: sexo, edad, tipo de lesión (quística con nódulo, quística sin nódulo, sólida y sólida-quística), sintomatología y resultados postoperatorios. Resultados: De los 16 pacientes intervenidos, 11 fueron varones y 5 mujeres. La edad promedio fue de 44 años. La forma más frecuente fue quística con nódulo (57%), seguida por forma sólida (31%). Un solo caso presentó la forma quística sin nódulo (6%), y uno solo la forma sólido-quística (6%). La sintomatología más frecuente fue cefalea acompañada de síndrome cerebeloso (43%), seguido de síndrome de hipertensión endocraneana (25%). En todos los casos la resección fue completa, siendo necesario en un caso una embolización previa. Como complicaciones postoperatorias, 2 pacientes presentaron ataxia (mejoró al cabo de 3 meses), y 1 paciente presentó una fístula de LCR (se solucionó con un drenaje espinal externo). Se registró un óbito por complicaciones postoperatorias. Conclusión: Lo más frecuente de ver en pacientes con HBFP es la forma quística con nódulo, siendo su sintomatología predominante la cefalea acompañada de síndrome cerebeloso. La resección quirúrgica completa es posible, con una baja tasa de morbimortalidad. PMID:27999708

  10. Epidemiological survey of graves' disease in Tianjin area

    International Nuclear Information System (INIS)

    Gao Shuo; Fang Peihua; Lai Zemin; Chen Bingzhong; Lu Tizhang; Zhou Yinbao; Tan Jian; Ni Xiaoyan

    2002-01-01

    Objective: To study the incidence of Graves' disease and associated factors. Methods: From 1997.4 to 1999.12, by using cluster and stratified sampling, total of 31530 people aged 6 years and over were surveyed epidemiologically for Graves' disease in five districts and one county of Tianjin area where the study subjects had been resided for at least one year. The researching team consisted of endocrinologists, epidemiologists and technicians and was divided into three branches, they served as investigators, professional experts and technicians, respectively. The serum thyroid hormones, thyroid antibodies, iodine in table salt, urine iodine and B-US were examined for the suspected cases, the final diagnoses were concluded by the professional experts. Results: Eighty-nine patients with Graves' disease were confirmed, 26 (0.166%) of them were males and 63(0.397%) of them were females, the total incidence was 0.282%. The incidence significantly associated with sex (female higher than male, P<0.001), age (50-60 group for male and 30-40 group for female higher than others, P<0.001) and family history (the patients with vs without family history, P<0.001). The survey showed an ascending trend of incidence of Graves' disease, along with decreasing of goiter rate and increasing of iodine contents in table salt and in urine. Further research work should be pursued. Conclusion: This study may provide some theoretical basis for prevention and treatment of Graves' disease

  11. Changes of hepatofibrosis markers in Graves' disease

    International Nuclear Information System (INIS)

    Zhou Feihua; Xu Haifeng; Zhou Runsuo; Gao Feng; Wang Lei

    2006-01-01

    Objective: To study the changes of hepatofibrosis markers (IV-C, PC III, HA, LN) in Graves' disease. Methods: Serum levels of hepatofibrosis were measured with RIA in 40 patients with Graves' disease (CD) before any treatment and 35 patients with Graves' disease after successful anti-thyroid drug therapy as well as in 30 controls. Results: The serum IV-C and PC III levels in GD patients were significant higher than those in controls before treatment (P<0.01). After successful treatment, the IV-C, PC III levels dropped markedly (vs before treatment, P<0.01). However, there were no significant differences among the serum HA, LN levels in all the subjects tested. Conclusion: Serum levels of IV-C and PC III increased markedly with hyperthyroidim. When IV-C and PC III levels were taken for assessment of degree of hepatofibeosis, GD must be ruled out first. (authors)

  12. Grave's Disease and Primary Biliary Cirrhosis—An Unusual and Challenging Association

    OpenAIRE

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2013-01-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial.

  13. Grave's Disease and Primary Biliary Cirrhosis-An Unusual and Challenging Association.

    Science.gov (United States)

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2014-03-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial.

  14. Analgesia epidural para el alivio del dolor después del reemplazo de cadera o de rodilla

    Directory of Open Access Journals (Sweden)

    2014-07-01

    Conclusiones de los autores: La analgesia epidural puede ser útil para el alivio del dolor postoperatorio después de reemplazos importantes de articulaciones de los miembros inferiores. Sin embargo, los efectos beneficiosos pueden estar limitados al período postoperatorio temprano (cuatro a seis horas. Una infusión epidural de anestésico local o una mezcla de anestésico-narcótico local puede ser mejor que un narcótico epidural solo. La magnitud del alivio del dolor se debe sopesar contra la frecuencia de eventos adversos. Las pruebas actuales no son suficientes para establecer conclusiones sobre la frecuencia de complicaciones poco frecuentes de la analgesia epidural, la morbilidad o mortalidad postoperatorias, los resultados funcionales o la duración de la estancia hospitalaria.

  15. Smoking and other lifestyle factors and the risk of Graves' hyperthyroidism.

    Science.gov (United States)

    Holm, Ingrid A; Manson, Joann E; Michels, Karin B; Alexander, Erik K; Willett, Walter C; Utiger, Robert D

    2005-07-25

    Hyperthyroidism caused by Graves' disease is common in women, yet little is known about risk factors for the disease. We sought to determine whether lifestyle factors, including smoking, alcohol consumption, physical activity level, and body mass index, are risk factors for Graves' hyperthyroidism. This analysis was conducted using data from the Nurses' Health Study II, among 115109 women aged 25 to 42 at entry. Incident reports of women with Graves' hyperthyroidism, confirmed to have the disorder, were included. During 1 328 270 person-years of follow-up, incident diagnoses of Graves' hyperthyroidism were confirmed in 543 women; the 12-year incidence was 4.6 per 1000 women. Cigarette smoking was a predictor of Graves' hyperthyroidism. The hazard ratio among current smokers was 1.93 (95% confidence interval [CI], 1.54-2.43), and among past smokers it was 1.27 (95% CI, 1.03-1.56), after adjusting for recent pregnancy, parity, and other variables. Among current smokers, the hazard ratio increased with the intensity of smoking and was 2.63 (95% CI, 1.71-4.04) among women who smoked 25 or more cigarettes daily. Obesity was associated with a decreased risk of Graves' hyperthyroidism. The hazard ratio for the disorder among women with a body mass index of 30 kg/m(2) or higher was 0.68 (95% CI, 0.49-0.92). Alcohol intake and physical activity level were not associated with risk of Graves' hyperthyroidism. Smoking is a risk factor for Graves' hyperthyroidism in women. Obesity may be associated with a reduced risk, although weight loss as the first manifestation of hyperthyroidism cannot be excluded.

  16. Primary biliary cirrhosis associated with Graves' disease in a male patient.

    Science.gov (United States)

    Suzuki, Yuji; Ishida, Kazuyuki; Takahashi, Hiroshi; Koeda, Norihiko; Kakisaka, Keisuke; Miyamoto, Yasuhiro; Suzuki, Akiko; Takikawa, Yasuhiro

    2016-04-01

    Primary biliary cirrhosis (PBC), which predominantly affects women, has been associated with various autoimmune diseases. Although hypothyroidism accompanying PBC is well documented, the concomitance of PBC and hyperthyroidism is rare. Herein, we report the case of a 62-year-old man who was diagnosed with PBC several years after the development of Graves' disease. This is the first case of a male patient developing PBC with Graves' disease. Both serum alanine aminotransferase levels and serum thyroid hormone levels were normalized after the administration of thiamazole for Graves' disease. However, the cholestatic liver enzyme abnormalities continued, indicating that the PBC was actualized by the administration of thiamazole. After starting ursodeoxycholic acid treatment, cholestatic liver enzyme abnormalities improved. Taken together, when a cholestatic pattern of liver enzymes is observed during follow-up for Graves' disease, an association between Graves' disease and PBC should be considered as a differential diagnosis.

  17. Resultados preliminares de la hemorroidectomía circular mecánica según técnica de Longo Preliminary results of circular mechanical hemorrhoidectomy according to Longo's technique

    Directory of Open Access Journals (Sweden)

    Francisco Menárguez Pina

    2008-06-01

    Full Text Available INTRODUCCIÓN. La mucosectomía circunferencial con máquina de autosutura descrita por Longo como técnica para el tratamiento de las hemorroides de grado III y IV se ha extendido en los últimos años. El objetivo del presente estudio es analizar los resultados preliminares obtenidos con esta técnica. MÉTODOS. Durante un período de 16 meses fueron intervenidos 50 pacientes con patología hemorroidal sintomática de grado III-IV, y se analizó el tiempo quirúrgico y las complicaciones posoperatorias. Para la medición del dolor se recurrió a una escala analógica visual. RESULTADOS. El tiempo quirúrgico medio fue de 22 min y la estancia media postoperatoria de 2,3 días. Entre las complicaciones posoperatorias, se registraron 2 pacientes (4 % reintervenidos por sangrado y 4 pacientes (8 % precisaron sondaje vesical por retención urinaria. La intensidad del dolor en el primer día posoperatorio fue: intenso en 6 pacientes (12 %, medio en 10 (20 %, leve en 30 (60 % y nulo en los 4 restantes (8 %. Durante el tiempo de seguimiento ningún paciente ha referido incontinencia postoperatoria, ni se ha encontrado estenosis en la línea de grapado. CONCLUSIONES. Nuestra experiencia a corto plazo ha sido satisfactoria. Es una técnica sencilla y segura, con una curva de aprendizaje corta. La principal complicación postoperatoria, el dolor, se comportó de forma similar a lo que han publicado otros autores y fue fácilmente controlado con antiinflamatorios no esteroideos. Sin embargo, es necesario un seguimiento a largo plazo para la valoración de complicaciones tardías, tales como la estenosis y la recurrencia de los síntomas hemorroidales.INTRODUCTION. Circumferencial mucosectomy with autosuture stapler described by Longo as a technique for treating grade III and IV hemorrhoids have extended in the last years. The objective of the present study was to analyze the preliminary results obtained with this technique. METHODS. 50 patients with grade

  18. Grave's Disease and Primary Biliary Cirrhosis—An Unusual and Challenging Association

    Science.gov (United States)

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2013-01-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. PMID:25755537

  19. SUBTOTAL THYROIDECTOMY IN THE MANAGEMENT OF GRAVE'S DISEASE.

    Science.gov (United States)

    Vincent, P J; Garg, M K; Singh, Y; Bhalla, V P; Datta, S

    2001-07-01

    Treatment options for Grave's disease include radio-iodine ablation, which is the standard treatment in the USA, antithyroid drug therapy, which is popular in Japan, and surgery, which is commonly employed in Europe and India. There are very few reports about the outcome of surgery in Grave's disease in the Indian setting. Surgery for Grave's disease is an attractive option in under developed countries to cut short prolonged drug treatment, costly follow up and avoid the need for radio-isotope facilities for 1311 ablation. Aim of the present study was to assess the result of subtotal thyroidectomy in 32 cases of Grave's Disease referred for surgery by the endocrinologist in a teaching hospital. Patients were prepared for surgery with Lugol's iodine and propranalol. Subtotal thyroidectomy was performed by a standard technique, which included dissection and exposure of recurrent laryngeal nerves and parathyroid glands. Actual estimation of weight of the remnant gland was not part of the study. Duration of follow up ranged from 6 months to 4 years. 13 of 32 cases were males. Age ranged from 20 to 57 years. There was 1 death in the immediate post-operative period. There were no cases of permanent hypoparathyroidism or recurrent laryngeal nerve palsy. 1 patient developed temporary hypoparathyroidism. 1 patient developed recurrence of hyperthyroidism and 3 cases developed hypothyroidism all within 2 years of surgery. The study has demonstrated the safety and effectiveness of surgery for Grave's Disease in comparison to the reported high incidence of hypothyroidism following radio-iodine therapy and high recurrence rate after anti thyroid drug therapy.

  20. Prevention of Graves' ophthalmopathy.

    Science.gov (United States)

    Bartalena, Luigi

    2012-06-01

    Smoking is the most important risk factor for the occurrence/progression of Graves' ophthalmopathy (GO), as well as for its lower/slower response to immunosuppression. Accordingly, refrain from smoking should be urged, both as primary prevention (removal of risk factors in Graves' patients without GO), secondary prevention (early detection and treatment of asymptomatic/very mild GO) and tertiary prevention (reduction of complications/disability of overt GO). A 6-month course of 200 μg/day sodium selenite can prevent progression of mild GO to more severe GO and is, therefore, a form of secondary prevention and, probably, primary prevention. Correction of thyroid dysfunction and stable maintenance of euthyroidism are important preventive measures. The optimal treatment for hyperthyroidism in patients with GO is uncertain, because evidence demonstrating the superiority of antithyroid drugs over thyroid ablation (radioiodine, thyroidectomy, or both) is lacking. If radioiodine is used, low-dose steroid prophylaxis is recommended, particularly in smokers, to prevent radioiodine-associated GO progression. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Growth hormone and insulin-like growth factor 1 affect the severity of Graves' disease.

    Science.gov (United States)

    Di Cerbo, Alfredo; Pezzuto, Federica; Di Cerbo, Alessandro

    2017-01-01

    Graves' disease, the most common form of hyperthyroidism in iodine-replete countries, is associated with the presence of immunoglobulins G (IgGs) that are responsible for thyroid growth and hyperfunction. In this article, we report the unusual case of a patient with acromegaly and a severe form of Graves' disease. Here, we address the issue concerning the role of growth hormone (GH) and insulin-like growth factor 1 (IGF1) in influencing thyroid function. Severity of Graves' disease is exacerbated by coexistent acromegaly and both activity indexes and symptoms and signs of Graves' disease improve after the surgical remission of acromegaly. We also discuss by which signaling pathways GH and IGF1 may play an integrating role in regulating the function of the immune system in Graves' disease and synergize the stimulatory activity of Graves' IgGs. Clinical observations have demonstrated an increased prevalence of euthyroid and hyperthyroid goiters in patients with acromegaly.The coexistence of acromegaly and Graves' disease is a very unusual event, the prevalence being Graves' disease associated with acromegaly and show that surgical remission of acromegaly leads to a better control of symptoms of Graves' disease.

  2. Total thyroidectomy: is morbidity higher for Graves' disease than nontoxic goiter?

    Science.gov (United States)

    Welch, Kellen C; McHenry, Christopher R

    2011-09-01

    Total thyroidectomy for treatment of Graves' disease is controversial and much of the debate centers on the concern for complications. The purpose of this study was to evaluate the morbidity of total thyroidectomy for Graves' disease and determine if it is different than for patients with nontoxic nodular goiter. The rates of life threatening neck hematoma, recurrent laryngeal nerve (RLN) injury, transient hypocalcemia, and hypoparathyroidism were determined for consecutive patients with Graves' disease treated with total thyroidectomy from 1996 to 2010. Results were compared with patients who underwent total thyroidectomy for nontoxic nodular goiter during the same period, matched for the weight of the excised thyroid gland. Total thyroidectomy was performed in 111 patients with Graves' disease (group I) and 283 patients with nontoxic nodular goiter (group II). Parathyroid autotransplantation was performed in 31(28%) patients in group I and 98 (35%) patients in group II (P = NS). Comparative analysis of morbidity revealed no significant difference in neck hematoma, 0(0%) (I) versus 3(1%) (II); permanent RLN injury, 0(0%) (I) versus 2(1%) (II); and permanent hypoparathyroidism in 1(1%) (I) versus 1 (0.4%) (II) (P = NS). Transient hypocalcemia was more common in patients with Graves' disease, 80(72%) (I) versus 170 (60%) (II) (P Graves' disease; only transient hypocalcemia occurred more often than in patients with nodular goiter. Total thyroidectomy should be presented as a therapeutic option for all patients with Graves' disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Reintervenciones por complicaciones después de realizada colecistectomía laparoscópica Reinterventions in complications of the laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Rosalba Roque González

    2011-09-01

    Full Text Available Durante estos años varios centros con experiencia en colecistectomía laparoscópica han publicado sus complicaciones y tratamiento a estas. El objetivo de este estudio es describir la experiencia en 23 pacientes reintervenidos por complicaciones posoperatorias de la colecistectomía laparoscópica realizadas en el Centro Nacional de Cirugía de Mínimo Acceso, según el reporte de los resultados obtenidos. Se realizó un estudio descriptivo, retrospectivo y longitudinal, en el que se revisaron las historias clínicas de los pacientes reintervenidos por sospecha de complicaciones después de la colecistectomía laparoscópica, en el período comprendido de enero de 1998 a junio de 2010. Durante el período de la investigación se realizaron 10 039 colecistectomías laparoscópicas. Fueron reintervenidos 23 pacientes (0,2 %, con una edad media de 49 años (rango 22 a 73 años, DE ± 10. La relaparoscopia fue la vía para la reintervención (70 % y solo 3 (13 % requirieron cirugía abierta. Fue la colangiopancreatografía retrógrada endoscópica un procedimiento útil para complementar la solución de algunas de estas complicaciones. El tiempo quirúrgico medio en las reintervenciones fue de 67 min (rango 30-120 min, la estadía hospitalaria tuvo una media de 4 y 5 días respectivamente. Hubo 2 pacientes (9 % que se reintervinieron tardíamente, a las 72 h de la colecistectomía, que fallecieron con cuadros de shock séptico. La laparoscopia es un procedimiento adecuado para las reintervenciones en pacientes con sospecha de complicaciones después de colecistectomía laparoscópica, con menor morbilidad y mortalidad sobre otros procederes, y su eficacia para el tratamiento de estas complicaciones está demostrada.Over past years some centers with experience in laparoscopic cholecystectomy have published the complications and treatment of this procedure. The aim of present paper is to describe the experience in 23 patients re-operated on due to

  4. Simultaneous induction of Graves' hyperthyroidism and Graves' ophthalmopathy by TSHR genetic immunization in BALB/c mice.

    Directory of Open Access Journals (Sweden)

    Nan Xia

    Full Text Available Graves' disease is the most common form of autoimmune thyroid disorder, characterized by hyperthyroidism due to circulating autoantibodies. To address the pathological features and establish a therapeutic approach of this disease, an animal model carrying the phenotype of Graves' disease (GD in concert with Graves' Ophthalmopathy (GO will be very important. However, there are no ideal animal models that are currently available. The aim of the present study is to establish an animal model of GD and GO disease, and its pathological features were further characterized.A recombinant plasmid pcDNA3.1- T289 was constructed by inserting the TSHR A-subunit gene into the expression vector pcDNA3.1, and genetic immunization was successfully performed by intramuscular injection of the plasmid pcDNA3.1-T289 on female 8-week-old BALB/c mice. Each injection was immediately followed by in vivo electroporation using ECM830 square wave electroporator. Morphological changes of the eyes were examined using 7.0T MRI scanner. Levels of serum T4 and TSHR antibodies (TRAb were assessed by ELISA. The pathological changes of the thyroid and orbital tissues were examined by histological staining such as H&E staining and Alcian blue staining.More than 90% of the immunized mice spontaneously developed goiter, and about 80% of the immunized mice manifested increased serum T4 and TRAb levels, combined with hypertrophy and hyperplasia of thyroid follicles. A significantly increased synthesis of hyaluronic acid was detected in in the immunized mice compared with the control groups.We have successfully established an animal model manifesting Graves' hyperthyroidism and ophthalmopathy, which provides a useful tool for future study of the pathological features and the development of novel therapies of the diseases.

  5. Graves, Ancestors and Cement in Land disputes in Acholi and Ikland, Uganda

    DEFF Research Database (Denmark)

    Meinert, Lotte; Willerslev, Rane; Seebach, Sophie Hooge

    2017-01-01

    graves are made concrete and increasingly cemented indices of belonging in wrangles over land. Belonging is often justified through the presence of ancestor graves on land. The cementing of graves turns them into more concrete and durable proofs of ownership, and the reburial of relatives to disputed......The paper explores the roles of graves, ancestors and concrete pillars in disputes over land across different land-systems, -conflicts, and territory making in northern Uganda by comparing extended cases between Acholi in Gulu district and Ik in Kaabong district . In the post-conflict Acholi region...

  6. Pretibial myxedema without ophthalmopathy: an initial presentation of Graves' disease.

    Science.gov (United States)

    Lohiya, Sheela; Lohiya, Vipin; Stahl, Elizabeth J

    2013-07-01

    To report a rare case of Graves' disease without ophthalmopathy presenting with pretibial myxedema (PM) as an initial presentation. We present the clinical history, physical findings, laboratory studies and biopsy data of a 62-year-old man with a history of uncontrolled type 2 diabetes (DM2) presenting with arm and leg skin lesions in the absence of other physical findings. Histopathology confirmed PM. Graves' disease and its association with PM without Graves' ophthalmopathy and the pertinent literature are reviewed. A 60-year-old man with a history of uncontrolled DM2 presented for glycemic management. He described symptoms of anxiety, insomnia and fatigue for the last 5 to 6 months. He described diffuse chest pain, occasionally associated with palpitations, and a 50-pound weight loss. He also complained of severe itching and burning of his arms and legs for the past several months. Subsequent thyroid studies revealed hyperthyroidism suggestive of Graves' disease. In the interim, he was hospitalized for atrial flutter and was cardioverted. After being started on methimazole, his symptoms abated. His skin lesions were biopsied, and the leg biopsy was consistent with PM. He however had no lid lag or proptosis characteristic of Graves' disease. He subsequently underwent radioiodine ablation. His hyperglycemia was better control led after treatment of his hyperthyroidism. PM is an autoimmune manifestation of Graves' disease. Almost all cases of thyroid dermopathy are associated with relatively severe ophthalmopathy. Usually ophthalmopathy appears first and dermopathy much later. However, this case represents a rare initial presentation of Graves' disease with PM without ophthalmologic symptoms or findings. Hyperthyroidism is typically associated with worsening glycemic control and increased insulin requirements. In patients with diabetes having hyperthyroidism, deterioration in glycemic control should be anticipated and treatment should be adjusted accordingly

  7. Pancytopenia in a Patient with Grave's Disease.

    Science.gov (United States)

    Loh, Huai Heng; Tan, Florence

    2013-08-01

    Pancytopenia can rarely complicate Grave's disease. It can be due to uncontrolled thyrotoxicosis or as a result of rare side effect of antithyroid medication. Pernicious anemia leading to Vitamin B12 deficiency is another rare associated cause. We report a case of a patient with Grave's disease and undiagnosed pernicious anemia whom was assumed to have antithyroid drug induced pancytopenia. Failure to recognize this rare association of pernicious anemia as a cause of pancytopenia had resulted in delay in treatment and neurological complication in our patient.

  8. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    Energy Technology Data Exchange (ETDEWEB)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

    1994-09-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  9. Genetic susceptibility to Grave's disease.

    Science.gov (United States)

    Li, Hong; Chen, Qiuying

    2013-06-01

    The variety of clinical presentations of eye changes in patients with Graves' disease (GD) suggests that complex interactions between genetic, environmental, endogenous and local factors influence the severity of Graves' ophthalmopathy (GO). It is thought that the development of GO might be influenced by genetic factors and environmental factors, such as cigarette smoking. At present, however, the role of genetic factors in the development of GO is not known. On the basis of studies with candidate genes and other genetic approaches, several susceptibility loci in GO have been proposed, including immunological genes, human leukocyte antigen (HLA), cytotoxic T-lymphocyte antigen-4 (CTLA-4), regulatory T-cell genes and thyroid-specific genes. This review gives a brief overview of the current range of major susceptibility genes found for GD.

  10. Development of Graves' disease following radiation therapy in Hodgkin's disease

    International Nuclear Information System (INIS)

    Loeffler, J.S.; Tarbell, N.J.; Garber, J.R.; Mauch, P.

    1988-01-01

    Radiation-related thyroid dysfunction is a common occurrence in patients with Hodgkin's disease treated with mantle field radiation. Although chemical and clinical hypothyroidism are most commonly seen, Graves' disease has also been described. We have examined the records of 437 surgically staged patients who received mantle field irradiation between April 1969 and December 1980 to ascertain the frequency of manifestations of Graves' disease. Within this group, seven patients developed hyperthyroidism accompanied by ophthalmic findings typical of those seen in Graves' disease. The actuarial risk of developing Graves' disease at 10 years following mantle irradiation for Hodgkin's disease was 3.3% in female patients and 1% in male patients in this study. The observed/expected ratios were 5.9 and 5.1 for female and male patients, respectively. This observed risk significantly exceeded that seen in the general population

  11. Persistent hyperthyroidism and de novo Graves' ophthalmopathy after total thyroidectomy.

    Science.gov (United States)

    Tay, Wei Lin; Loh, Wann Jia; Lee, Lianne Ai Ling; Chng, Chiaw Ling

    2017-01-01

    We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy.TSH receptor antibody may persist after total thyroidectomy and may potentially contribute to the development of de novo Graves' ophthalmopathy.

  12. Applied anatomy of thyroid arteries for interventional embolization of Graves' disease

    International Nuclear Information System (INIS)

    Ding Zhongxiang; Zhao Wei; Hou Jialin; Xiang Shutian; Li Liyuan; Zou Zhirong; Li Xingguo; Song Dianping; Yuan Jianhua

    2007-01-01

    Objective: To explore the anatomy and imaging manifestations of thyroid arteries for improving the efficiency and lowering the complication in interventional embolization of Graves' disease. Methods: Thyroid arteries were investigated, including 16 adult cadavers (Cadaver group), 8 non-thyropathic patients (Normal group)and 17 Graves patients (Graves group). The inner diameters of the trunk and supplying branches of thyroid artery, the angles between the origination of branches and the beginning of the trunk, and the angles between the trunk of thyroid artery and carotid or subclavian artery were measured. In addition, data of the three groups were statistically analyzed. Results: Many non-thyroid arterial branches arose from thyroid artery, with no statistical difference in their indexes between Cadaver group and Normal group. The thyroid arteries showed much longer, obviously wider in diameter, and larger angles between the trunk of thyroid artery and carotid artery in Graves group than those of Cadaver group and Normal group; outcoming with significant statistical differences; and furthermore, with increase of interglandular branches and dangerous internal and external anastomoses. Conclusions: The specific thyroid arterial changes of Graves' disease are helpful for the interventional embolization. Non-thyroid branches and dangerous anastomoses should not be embolized as far as possible, for decreasing the complications of the interventional procedure for Graves' disease. (authors)

  13. Complicaciones por rotura de aneurismas cerebrales en pacientes operados Hospital Nacional Alberto Sabogal Sologuren 2006 - 2014

    OpenAIRE

    Coasaca Torres, Juan Amilcar

    2016-01-01

    Determinar las complicaciones que se presentan en el periodo preoperatorio, intraoperatorio y postoperatorio de los pacientes operados de aneurisma cerebral roto en el Hospital Nacional Alberto Sabogal Sologuren de 2006 a 2014. Para lo que se realizó un estudio cuantitativo, observacional, descriptivo, transversal y retrospectivo. Se revisaron las Historias Clínicas de los pacientes operados (clipaje) de aneurisma cerebral roto, que reunían los criterios de inclusión. La data obtenida fue eva...

  14. Serum immunoglobulin G4 levels and Graves' disease phenotype.

    Science.gov (United States)

    Martin, Carmen Sorina; Sirbu, Anca Elena; Betivoiu, Minodora Andreea; Florea, Suzana; Barbu, Carmen Gabriela; Fica, Simona Vasilica

    2017-02-01

    We investigated, at diagnosis, the relationship between serum immunoglobulin G4 levels and the main characteristics of Graves' disease: hyperthyroidism severity, goiter size, presence of active Graves' ophthalmopathy, antithyroid antibodies status, and titer. This prospective study included 80 newly diagnosed Graves' disease patients. The main parameters measured at diagnosis: thyroid-stimulating hormone, free thyroxine, free triiodothyronine, total triiodothyronine, thyroglobulin, antithyroid peroxidase antibodies, anti-thyroglobulin antibodies, thyroid-stimulating hormone receptor antibodies, immunoglobulin G4. In Graves' disease patients, serum immunoglobulin G4 levels were higher than in general population (p = 0.028) and higher in men compared to women (p = 0.002). Only one female patient with intense hypoechoic goiter, high anti-thyroglobulin antibody, and antithyroid peroxidase antibody titers had an elevated serum immunoglobulin G4 level at diagnosis. Patients with immunoglobulin G4 levels above the 75th percentile (>237.52 mg/dl, N = 20) were younger at Graves' ophthalmopathy onset (p 286.28 mg/dl, N = 8) had lower total triiodothyronine values (p = 0.001) than patients with IgG below the 90th percentile. No significant correlations were found between smoking status (p = 0.58), goiter size (p = 0.50), the presence of ophthalmopathy (p = 0.42) or thyroid-stimulating hormone receptor antibody titers (p = 0.45) and the mean value of immunoglobulin G4 levels at diagnosis. Our data suggest that Graves' disease patients with elevated immunoglobulin G4 levels at diagnosis have a phenotype characterized by higher anti-thyroglobulin antibody and antithyroid peroxidase antibody titers, less severe T3 hyperthyroidism, younger age at ophthalmopathy onset and require a shorter duration of the first methimazole treatment cycle.

  15. Clinical significance of determination of serum TRAb levels in patients with relapsing graves' disease

    International Nuclear Information System (INIS)

    Guo Chunlei; Zhou Jiaqiang; Li Wenpeng

    2004-01-01

    Objective: To explore the clinical significance of changes of serum TRAb levels in patients with relapsing Graves' disease. Methods: Serum TRAb (with RRA) and several other thyroid-related hormones (TT 4 , TT 3 , TSH, FT 3 , with CLIA) were determined in the following subjects: 1. 25 cases of relapsing Graves' disease after previous successful treatment; 2. 18 cases of recently diagnosed Graves' disease; 3. 31 cases of successfully treated Graves' disease; 4. 15 cases of simple goiter; 5. 10 cases of nodular goiter; 6. 18 cases of hypothyroidism due to Hashimoto disease. Results: Positive rate of TRAb was 76.00% in patients with relapsing Graves' disease and 77.78% in recently diagnosed Graves' disease cases, both being significantly higher than that in all the other sets of patients studied (P<0.01). Conclusion: Determination of serum TRAb levels was helpful for the diagnosis of relapse in Graves' disease

  16. Complicaciones pulmonares asociadas a ventilación mecánica en el paciente neonatal

    OpenAIRE

    Cristabel Torres-Castro; Jaime Valle-Leal; Alba J. Martínez-Limón; Zaira Lastra-Jiménez; Lesvia Carmina Delgado-Bojórquez

    2016-01-01

    Introducción: Se buscó determinar la incidencia de complicaciones pulmonares asociadas a ventilación mecánica en pacientes ingresados a un servicio de cuidados intensivos neonatales (UCIN) en un hospital de 2° nivel. Metodología: Estudio analítico retrospectivo en expedientes de recién nacidos ingresados a una sala de UCIN y que recibieron ventilación mecánica en un hospital de segundo nivel de atención médica. Se recabaron datos demográficos, de la ventilación mecánica, la intubación y co...

  17. Postoperative Outcomes in Graves' Disease Patients: Results from the Nationwide Inpatient Sample Database.

    Science.gov (United States)

    Rubio, Gustavo A; Koru-Sengul, Tulay; Vaghaiwalla, Tanaz M; Parikh, Punam P; Farra, Josefina C; Lew, John I

    2017-06-01

    Current surgical indications for Graves' disease include intractability to medical and/or radioablative therapy, compressive symptoms, and worsening ophthalmopathy. Total thyroidectomy for Graves' disease may be technically challenging and lead to untoward perioperative outcomes. This study examines outcomes in patients with Graves' disease who underwent total thyroidectomy and assesses its safety for this patient population. A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample database from 2006 to 2011. Total thyroidectomy performed in patients with Graves' disease, benign multinodular goiter (MNG), and thyroid cancer was identified. Demographic factors, comorbidities, and postoperative complications were evaluated. Chi-square, one-way analysis of variance, and risk-adjusted multivariable logistic regression were performed. Of 215,068 patients who underwent total thyroidectomy during the study period, 11,205 (5.2%) had Graves' disease, 110,124 (51.2%) MNG, and 93,739 (43.6%) thyroid malignancy. Patients with Graves' disease were younger than MNG and thyroid cancer patients (M age  = 42.8 years vs. 55.5 and 51.0 years; p Graves' disease group included a higher proportion of women (p Graves' disease was independently associated with a higher risk of vocal-cord paralysis (odds ratio [OR] = 1.36 [confidence interval (CI) 1.08-1.69]), tracheostomy (OR = 1.35 [CI 1.1-1.67]), postoperative hypocalcemia (OR = 1.65 [CI 1.54-1.77]), and hematoma requiring reoperation (OR = 2.79 [CI 2.16-3.62]) compared to MNG patients. High-volume centers for total thyroidectomy were independently associated with lower risk of postoperative complications, including in patients with Graves' disease. Despite low overall morbidity following total thyroidectomy, Graves' disease patients are at increased risk of postoperative complications, including bleeding, vocal-cord paralysis, tracheostomy, and hypocalcemia. These risks appear

  18. Characteristics of patients with graves disease and intrathyroid hypovascularity compared to painless thyroiditis.

    Science.gov (United States)

    Uchida, Toyoyoshi; Shigihara, Nayumi; Takeno, Kageumi; Komiya, Koji; Goto, Hiromasa; Abe, Hiroko; Sato, Junko; Honda, Akira; Fujitani, Yoshio; Watada, Hirotaka

    2014-10-01

    The purpose of this study was to assess the frequency and sonographic and laboratory characteristics of Graves disease with intrathyroid hypovascularity in Japanese patients and to compare these characteristics in patients with painless thyroiditis. A total of 194 consecutive patients with Graves disease and 21 patients with painless thyroiditis were enrolled. The patients underwent thyroid volume measurement, mean superior thyroid artery peak systolic velocity (PSV) measurement, power Doppler sonography, and proper blood testing to discriminate between Graves disease and painless thyroiditis. Based on the power Doppler sonographic findings, they were divided into 4 groups: from pattern 0 (most hypovascular thyroid) to pattern III (most hypervascular thyroid). Comparisons of multiple thyroid parameters were made among the groups. The prevalence of Graves disease with pattern 0 (n = 27) was 13.9% among the patients with Graves disease. The sonographic and laboratory data for patients with Graves disease and pattern 0 were compared to those of the 21 patients with painless thyroiditis, which typically shows intrathyroid hypovascularity. Free triiodothyronine and thyroxine levels and the superior thyroid artery PSV were significantly lower in patients with Graves disease and pattern 0 than those with patterns I, II, and III (P thyroid volume and thyrotropin receptor antibody level were significantly lower in patients with Graves disease and pattern 0 than those with pattern III. In the comparison between patients with Graves disease and pattern 0 and those with painless thyroiditis and pattern 0, apart from thyrotropin receptor antibody, only the superior thyroid artery PSV was different. Although the clinical features of patients with Graves disease and intrathyroid hypovascularity were similar to those patients with painless thyroiditis, the superior thyroid artery PSV showed a moderate ability to discriminate these patients. © 2014 by the American Institute of

  19. Complicaciones neurológicas de la endocarditis infecciosa: controversias Neurological complications of infective endocarditis: controversies

    Directory of Open Access Journals (Sweden)

    Federico A Silva

    2011-07-01

    Full Text Available En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia.Neurological complications of acute infective endocarditis are described in 20%-40% of cases, representing an important predictive factor of morbidity, mortality, sequels and disability. Acute endocarditis is characterized by a wide clinical spectrum due to its complex physiopathology that involves inflammatory, immune, infectious and embolic phenomena. Despite the remarkable frequency of neurological complications in the infective endocarditis especially by cerebrovascular disease and neuroinfections, there are still some controversies about some diagnostic and therapeutic aspects, partly because of the little evidence available. This paper describes a number of cases seen in the Fundación Cardiovascular de Colombia and discusses some aspects related with the diagnosis and treatment of the neurological complications of acute endocarditis.

  20. Radiation retinopathy after orbital irradiation for Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Kalina, R.E.; Brower, S.A.; Mills, R.P.; Johnson, R.H.

    1984-01-01

    Recent reports indicate that orbital irradiation for Graves' ophthalmopathy is sometimes beneficial, particularly for dysthyroid optic neuropathy, and is not associated with serious complications. We are aware, however, of four patients who were found to have radiation retinopathy after orbital irradiation for Grave's ophthalmopathy. All four patients have decreased central acuity, and three of the four are legally blind in one or both eyes. Computer reconstruction of the dosimetry, based on computed tomography and beam profiles, shows that errors in dosage calculations and radiotherapy technique probably account for the radiation retinopathy in three of the four patients. Radiotherapy for Graves' ophthalmopathy should be administered only by competent radiotherapists who are experienced in the treatment of this disease. Similar errors in dosage calculations and treatment techniques may account for other reports of radiation retinopathy after reportedly safe dosages

  1. Thyrotoxic Graves' disease with normal thyroidal technetium-99m pertechnetate uptake

    Energy Technology Data Exchange (ETDEWEB)

    Ikekubo, Katsuji; Hino, Megumu; Ito, Hidetomi; Koh, Toshikiyo; Ishihara, Takashi; Kurahachi, Hiroyuki (Kobe City General Hospital (Japan)); Kasagi, Kanji; Hidaka, Akinari; Mori, Toru

    1990-07-01

    We saw 24 thyrotoxic Graves' patients with normal thyroidal uptake of technetium-99m pertechnetate ({sup 99m}Tc) out of 201 untreated thyrotoxic Graves' patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analyzed. Thyroid uptake and scintigraphic examinations by means of {sup 99m}Tc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands. These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high {sup 99m}Tc uptake groups with Graves' disease, and their condition could be easily controlled with small amounts of antithyroid drugs. Our study indicates that thyrotoxic Graves' disease with normal {sup 99m}Tc uptake exists and {sup 99m}Tc uptake study and TBII activity measurement is very useful for the diagnosis. The normal {sup 99m}Tc uptake thyrotoxic Graves' patient might be early stage patients with general Graves' disease and their early discrimination from general Graves' patients is very advantageous for treatment and prognosis. (author).

  2. The observation on plasma endothelin levels in patients with graves' disease

    International Nuclear Information System (INIS)

    Hao Xiaojun; Liu Changshan; Yang Lianrong; Zhang Qiliang; Wang Honggang; Liu Xudong

    2002-01-01

    Observing the plasma endothelin levels in patients with Graves' disease to probe its clinical significance, plasma endothelin levels were measured in 55 cases of Graves' disease before and after treatment respectively, and these were compared with that of 23 health subjects. Results: plasma endothelin levels in patients with Graves' disease significantly increase, compared with heath subjects (150.4 +- 29.31 ng/L vs 42.80 +- 7.58 ng/L, P < 0.01); post-treatment endothelin levels apparently decrease (97.61 +- 15.99 ng/L vs 150.4 +- 29.31 ng/L, P < 0.01). Plasma endothelin levels in patients with Graves' disease significantly increase, and after treatment the endothelin levels decrease following decreasing of thyroid hormone level and high hemodynamics

  3. Thyroid Ultrasonography in Differentiation between Graves' Disease and Hashimoto's Thyroiditis.

    Science.gov (United States)

    Pishdad, P; Pishdad, G R; Tavanaa, S; Pishdad, R; Jalli, R

    2017-03-01

    Graves' disease and Hashimoto's thyroiditis are the most common causes of hyper and hypothyroidism, respectively. Differentiation of these 2 diseases, if the patient is euthyroid, may sometimes be extremely difficult on the basis of clinical and laboratory findings. The purpose of this study was to determine the sensitivity and specificity of gray scale sonography in differentiation of Graves' disease from Hashimoto's thyroiditis. This study included 149 patients divided into three groups, patients with Graves' disease (34 patients, mean age = 36.8 ± 10.17 years), Patients with Hashimoto's thyroiditis (62 patients, mean age = 33.4 ± 12.16 years) and control group (53 healthy people, mean age = 34.74 ± 16.87 years). Members of all groups were referred to a single radiologist for thyroid sonography for evaluation of thyroid echogenicity pattern. A total of 117 women and 32 men were examined by sonography. The most common sonographic pattern in Hashimoto and Graves' was homogenous hypo-echogenicity which was observed in 45.2% and 47.1% of cases, respectively. Peripheral hypo-echogenicity pattern was seen in 40.3% of Hashimoto's group with 100% specificity and 40.3% sensitivity. Central-hypoechogenic pattern was observed in 17.6% of Graves' group with 100% and 17.6% specificity and sensitivity, respectively. Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves' disease or Hashimoto's thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed.

  4. Hypocalcaemia after total thyroidectomy for Graves' disease and for benign atoxic multinodular goitre.

    Science.gov (United States)

    Hallgrimsson, Páll; Nordenström, E; Bergenfelz, A; Almquist, M

    2012-10-01

    Postoperative hypocalcaemia has been reported to be more common after total thyroidectomy (TT) for Graves' disease than after TT for benign atoxic multinodular goitre (MNG). The reasons for this potential association are not clear. In the present study, the frequency and risk factors of hypocalcaemia after TT for Graves' vs MNG were compared. Between January 1999 and October 2009, patients with first-time surgery for Graves' disease or MNG treated with a TT were included in the study. Postoperative hypocalcaemia was defined by symptoms, calcium levels and treatment with calcium and/or vitamin D analogues during postoperative hospital stay, at discharge, and at the 6-week and 6-month follow-ups. Outcomes were compared with Mann-Whitney, chi(2) and Fishers' exact test where appropriate and by multivariable logistic regression analysis. There were 128 patients with Graves' disease and 81 patients with MNG. Patients with Graves' disease were younger than patients with MNG (median age, 35 vs 51 years, p Graves' disease (p Graves' disease, there was no difference in the overall frequency of biochemical hypocalcaemia, low levels of PTH and/or treatment with calcium and vitamin D.

  5. Condición laboral asociada a complicaciones en el embarazo en noreste de México

    OpenAIRE

    Edgar Taboada Aguirre; Eduardo Manzanera Balderas; Maria Mercedes Dávalos Torres

    2014-01-01

    Introducción: Las complicaciones clínicas en el embarazo son predictores importantes para la mortalidad materna y desenlace del embarazo dependiendo de la atención que reciban las mujeres en este periodo trascendental de la vida. Algunos de los determinantes asociados con el problema están ligados a la situación laboral y la ocupación de la madre durante el embarazo. Material y métodos: Se realizó un estudio transversal en el año 2012, en la Unidad de Medicina Familiar # 43 del Instituto Mexi...

  6. Análisis de los factores que influyen en la aparición de complicaciones y supervivencia de los catéteres venosos centrales para hemodiálisis

    Directory of Open Access Journals (Sweden)

    Gabriel Eduardo Rajoy Fernández

    2014-03-01

    Full Text Available Una de las principales actividades de enfermería nefrológica en las unidades de hemodiálisis, es el cuidado de catéteres venosos centrales mediante el cumplimiento de un protocolo que hace especial hincapié en las medidas universales de asepsia durante su manipulación. Además existen otras variables que pueden influir en la aparición de complicaciones del catéter limitando su supervivencia. Objetivo: Los objetivos de este estudio fueron analizar los factores que pudieran influir en la aparición de complicaciones del catéter venoso central para hemodiálisis, y valorar las tasas de infección en nuestro centro. Material y método: Se realizó un estudio descriptivo de una cohorte, en la Unidad de Diálisis del Hospital Meixoeiro, entre enero de 1991 y octubre de 2012, con una muestra formada por 1231 catéteres. Resultados: Fueron implantados 1231 catéteres (1187 temporales y 44 tunelizados tipo Hikman. Los temporales, 78% en femoral, 18% en yugular, y 4 % en subclavia. Los Hikman, 40 en lado derecho y 4 en lado izquierdo. La duración media de los catéteres implantados fue de 17,7 ± 30,8 días (mediana 8 días. 88% no presentaron incidencias durante su colocación. Las principales causas de colocación fueron la IRA (56% y el fallo de acceso vascular previo (30%. La principal complicación dentro de las causas de retirada fue la obstrucción del catéter (15%, siendo la más grave la infección (6%. De los 1231 catéteres, 70 presentaron un episodio de infección a los 19,1±33,0 días de media, (mediana 1 días. Tasa de infección (2010-2012 de 0,75/1000 días de catéter. Conclusión: Concluimos que la aplicación de cuidados continuos y estandarizados mediante un protocolo que hace especial hincapié en la asepsia durante la conexión y desconexión del CVC da como resultado un bajo índice de infecciones en esta unidad.

  7. Magnetic Ghosts: Mineral Magnetic Measurements On Roman and Anglo-saxon Graves

    Science.gov (United States)

    Linford, N.

    The location of inhumations, in the absence of ferrous grave goods, often presents a considerable challenge to archaeological geophysics given the small physical size of the features and the slight contrast between the fill of the grave and the surround- ing subsoil. Even during excavation, the identification of graves may be complicated where site conditions do not favour the preservation of human skeletal remains and often only a subtle soil stain is likely to survive. A recent initiative in the United King- dom has seen the formation of the Buried Organic Matter Decomposition Integrated with Elemental Status (BODIES) research group, to examine the decomposition of organic artefacts in ancient graves with respect to localised changes in pH, redox po- tential and nutrient status. This paper presents initial results from a limited mineral magnetic study of two grave sites in an attempt to ascertain whether the decomposi- tion of organic remains may lead to a detectable magnetic signature within the soil. Results from a series of isothermal, hysteresis and magneto-thermal experiments will be presented together with surface magnetometer and topsoil susceptibility surveys.

  8. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  9. Grave's disease associated with immunoglobulin A nephropathy: A rare association.

    Science.gov (United States)

    Khan, I; Bhat, R A; Khan, I; Hameed, I

    2015-01-01

    Immunoglobulin A (Ig A) nephropathy is the most common form of primary glomerulonephritis. The association of Ig A nephropathy with Grave's disease has not been reported so far. We report a case of 20-year-old female with Grave's disease who presented with edema, facial puffiness, and decreased urine output. She was found to be hypertensive with renal failure and nephrotic range proteinuria. Renal biopsy revealed features of Ig A nephropathy. The patient was treated with oral corticosteroids (1 mg/kg/day). To our knowledge, this is the first case showing association of Grave's disease with Ig A nephropathy.

  10. Resultados do tratamento da pancreatite aguda grave

    Directory of Open Access Journals (Sweden)

    Franz Robert Apodaca-Torrez

    Full Text Available OBJETIVO: Avaliar os resultados do Protocolo de Atendimento de pacientes com diagnóstico de pancreatite aguda grave. MÉTODOS: Foram analisados, consecutivamente, a partir de janeiro de 2002, idade, sexo, etiologia, tempo de internação, tipo de tratamento e mortalidade de 37 pacientes portadores de pancreatite aguda grave. RESULTADOS: A idade dos pacientes variou de 20 a 88 anos (média de 50 anos; 27% foram do sexo feminino e 73% do masculino. O tempo médio global de internação foi 47 dias. Treze pacientes foram tratados cirurgicamente; a média de operações realizadas foi duas por paciente. Ocorreram seis óbitos dentre os pacientes submetidos ao tratamento cirúrgico (46% e dois óbitos no grupo submetido somente ao tratamento clínico (8,3%. A mortalidade global foi 21% CONCLUSÃO: Após a modificação na forma de abordagem dos pacientes com pancreatite aguda grave, houve diminuição da mortalidade e uma tendência para a conduta expectante.

  11. Grave Tending: With Mom at the Cemetery

    Directory of Open Access Journals (Sweden)

    Carolyn Ellis

    2003-05-01

    Full Text Available This autoethnographic story shows the process of tending the graves of family members. In the past, the author reluctantly accompanied her mother on her visits to the family cemetery. Once there, she took on the role of distant observer as her mother took care of the family cemetery plots. When her mother becomes disabled, the author begins to arrange the flowers on the graves. Doing so leads her to examine the meaning of visiting the cemetery, feel and connect with her losses, and consider the customs she wants to be part of her own death. When her mother dies, the next generation of women in the family—the author, her sister, and sister-in-law—take on the role of tending the graves, connected in their love and respect for their mother and their feelings of family and family responsibility. This story examines the meanings of family rituals around death and how they are passed from generation to generation. URN: urn:nbn:de:0114-fqs0302285

  12. Thyroid Follicular Carcinoma in a Fourteen-year-old Girl with Graves' Disease.

    Science.gov (United States)

    Kojima-Ishii, Kanako; Ihara, Kenji; Ohkubo, Kazuhiro; Matsuo, Terumichi; Toda, Naoko; Yamashita, Hiroyuki; Kono, Shinji; Hara, Toshiro

    2014-04-01

    Here we present the case of a 14-yr-old girl who developed thyroid follicular carcinoma accompanied by Graves' disease. She was diagnosed with Graves' disease at 10 yr of age and soon achieved a euthyroid state after starting treatment. When she was 13 yr of age, her hyperthyroidism and goiter worsened despite medical therapy. Multiple nodules were found in her enlarged thyroid gland by ultrasonography. Her serum Tg level seemed within the normal range. She underwent near-total thyroidectomy for control of thyroid function. Histopathological study demonstrated that multiple oxyphilic follicular neoplasms were surrounded by the thyroid tissue compatible with Graves' disease. Capsular invasion was identified in one of the nodules, and thus the histological diagnosis was minimally invasive follicular carcinoma. She did not have signs suggesting metastasis, and has had no relapse for 18 mo after the operation. Although some previous studies showed a high prevalence of thyroid cancer with an aggressive nature in adult patients with Graves' disease, few reports about thyroid cancer accompanied by Graves' disease are available in children. The present case, however, suggests that careful investigation is needed when we detect thyroid nodules or progressive thyroid enlargement, especially in children with Graves' disease.

  13. Significance of changes of serum TPOAb and TRAb levels in patients with Graves' disease (GD)

    International Nuclear Information System (INIS)

    Zhang Zhongshu Xu Ruiji; Wang Guohong

    2006-01-01

    Objective: To investigate the significance of changes of serum TPOAb and TRAb levels in patients with Graves' dis- ease (GD). Methods: Serum TPOAb (with RIA) and TRAb (with RRA) levels were determined in 27 patients with Graves' disease, before treatment 10 patients with Graves' disease clinically cured and 35 controls. Results: The serum levels and positive rates of TPOAb and TRAb in patients with Graves' disease before treatment were significantly higher than those in the patients with Graves' disease clinically cured and controls (P<0.01). Conclusion: TPOAb and TRAb were involved in the pathogenesis of Graves' dis- ease and could be used as diagnostic and treatment indicators. (authors)

  14. Biologiske behandlingsmuligheder ved Graves' oftalmopati

    DEFF Research Database (Denmark)

    El Fassi, Daniel; Nielsen, Claus Henrik; Hegedüs, Laszlo

    2008-01-01

    The current medical treatment options for Graves' ophthalmopathy (GO) are unsatisfactory. Recent treatment of GO patients with the B-lymphocyte depleting monoclonal antibody rituximab or with the anti-tumor necrosis factor-alpha agents etanercept and infliximab has shown promising results. We...

  15. Study progress on free radicals and graves disease

    International Nuclear Information System (INIS)

    Zhang Ruiguo; Jin Jianhua

    2009-01-01

    Free radical-mediated oxidative injury has been closely implicated in the occurrence and development of many diseases. Graves disease was also accompanied by changes of the free radicals, especially for reactive oxygen species and reactive nitrogen, et al, and the oxidative stress can cause a certain degree of injury on the thyroid and other human important organs. Antithyroid drug and 131 I treatment of Graves disease, the oxidative and antioxidative parameters can also be changed. (authors)

  16. Transient hypothyroidism after 131I treatment of Graves disease

    International Nuclear Information System (INIS)

    Liu Jianfeng; Fang Yi; Zhang Xiuli; Ye Genyao; Xing Jialiu; Zhang Youren

    2003-01-01

    Objective: To evaluate the results of the transient hypothyroidism after 131 I treatment of Graves disease. Methods: A total of 32 transient hypothyroidism patients treated with 131 I for Graves disease were studied and followed up. Results: Transient hypothyroidism occurred within 2-6 months after 131 I treatment and 19 patients were symptomatic. At diagnosis of transient hypothyroidism, T 3 and T 4 levels were decreased had normal, TSH levels were increased, normal or low. Follow-up examination found that 20 patients were normal and 12 patients had relapse of hyperthyroidism. Conclusions: Therapy of Graves disease with low doses of 131 I causes a high incidence of transient hypothyroidism. After recovery of transient hypothyroidism, some patients have relapse of hyperthyroidism

  17. 131I-therapy of graves' disease and non-immunogenic thyrotoxicosis

    International Nuclear Information System (INIS)

    Hoeschel, M.; Heinze, H.G.

    1984-01-01

    From 1977 to 1982, 315 patients suffering from thyrotoxicosis with diffuse and/or nodular goitre or Graves' disease were treated with 131 I. In 246 patients, the results of treatment after 7 months to 5 1/2 years could be evaluated. After a single treatment with 131 I, 72% of the patients with hyperthyroid nodular goitre and 61% of those with diffuse goitre, but only 36% of the patients with Graves' disease showed normal thyroid function. By repeated 131 I treatments - as many as 5 for those with Graves' disease - normal thyroid function could be achieved in nearly all patients examined. Patients with immune thyrotoxicosis, type Graves' disease, showed a high resistance to therapy. A dependence was found between the results of these treatments and previous antithyroidal drug therapy or surgery. The rate of hypothyroidism varied between 4 and 15%. The highest rate of hypothyroidism was observed in operated patients with persistent or recurring thyrotoxicosis. (orig.) [de

  18. Graves hyperthyroidism and pregnancy: a clinical update.

    Science.gov (United States)

    Patil-Sisodia, Komal; Mestman, Jorge H

    2010-01-01

    To provide a clinical update on Graves' hyperthyroidism and pregnancy with a focus on treatment with antithyroid drugs. We searched the English-language literature for studies published between 1929 and 2009 related to management of hyperthyroidism in pregnancy. In this review, we discuss differential diagnosis of hyperthyroidism, management, importance of early diagnosis, and importance of achieving proper control to avoid maternal and fetal complications. Diagnosing hyperthyroidism during pregnancy can be challenging because many of the signs and symptoms are similar to normal physiologic changes that occur in pregnancy. Patients with Graves disease require prompt treatment with antithyroid drugs and should undergo frequent monitoring for signs of fetal and maternal hyperthyroidism and hypothyroidism. Rates of maternal and perinatal complications are directly related to control of hyperthyroidism in the mother. Thyroid receptor antibodies should be assessed in all women with hyperthyroidism to help predict and reduce the risk of fetal or neonatal hyperthyroidism or hypothyroidism. The maternal thyroxine level should be kept in the upper third of the reference range or just above normal, using the lowest possible antithyroid drug dosage. Hyperthyroidism may recur in the postpartum period as Graves disease or postpartum thyroiditis; thus, it is prudent to evaluate thyroid function 6 weeks after delivery. Preconception counseling, a multidisciplinary approach to care, and patient education regarding potential maternal and fetal complications that can occur with different types of treatment are important. Preconception counseling and a multifaceted approach to care by the endocrinologist and the obstetric team are imperative for a successful pregnancy in women with Graves hyperthyroidism.

  19. Modelo para abordar integralmente la mortalidad materna y la morbilidad materna grave

    Directory of Open Access Journals (Sweden)

    Ariel Karolinski

    2015-05-01

    Full Text Available La mortalidad materna es un importante problema de salud pública y de derechos humanos y refleja los efectos de los determinantes sociales sobre la salud de las mujeres. El conocimiento de la magnitud y las causas de las muertes maternas ha sido insuficiente para intervenir efectivamente en el alcance de los Objetivos de Desarrollo del Milenio. Por ello, se plantea un modelo para abordar integralmente la mortalidad materna, con siete campos: priorización y definición del problema, caracterización contextual, amplitud metodológica, gestión del conocimiento, innovación, implementación, y un sistema de monitoreo y evaluación. Este modelo permite abordar los problemas asociados con la mortalidad materna y la morbilidad materna grave mediante la integración, desde una perspectiva anticipatoria, de las complicaciones potencialmente fatales asociadas con el proceso reproductivo y su vigilancia. Se destaca la importancia de la gestión del conocimiento para la reorientación de políticas, programas y la atención sanitaria. Se debe mejorar la interacción y explotar las sinergias entre las personas, las comunidades y los actores del sistema de salud para potenciar los resultados de los programas sanitarios. Se requiere más información científica validada sobre la forma en que las intervenciones deben aplicarse en diferentes entornos. Para ello, es esencial fortalecer la articulación entre los centros de investigación, las agencias de cooperación y los organismos del Estado y su incorporación a las acciones programáticas y a la definición de una nueva agenda de salud de la mujer para la Región de las Américas.

  20. PREGO (presentation of Graves' orbitopathy) study: changes in referral patterns to European Group On Graves' Orbitopathy (EUGOGO) centres over the period from 2000 to 2012

    NARCIS (Netherlands)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio; Ayvaz, Göksun; Baldeschi, Lelio; Bartalena, Luigi; Boschi, Antonella; Bournaud, Claire; Brix, Thomas Heiberg; Covelli, Danila; Ćirić, Slavica; Daumerie, Chantal; Eckstein, Anja; Fichter, Nicole; Führer, Dagmar; Hegedüs, Laszlo; Kahaly, George J.; Konuk, Onur; Lareida, Jürg; Lazarus, John; Leo, Marenza; Mathiopoulou, Lemonia; Menconi, Francesca; Morris, Daniel; Okosieme, Onyebuchi; Orgiazzi, Jaques; Pitz, Susanne; Salvi, Mario; Vardanian-Vartin, Cristina; Wiersinga, Wilmar; Bernard, Martine; Clarke, Lucy; Currò, Nicola; Dayan, Colin; Dickinson, Jane; Knežević, Miroslav; Lane, Carol; Marcocci, Claudio; Marinò, Michele; Möller, Lars; Nardi, Marco; Neoh, Christopher; Pearce, Simon; von Arx, George; Törüner, Fosun Baloş

    2015-01-01

    The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a

  1. Diabetes Mellitus en el servicio de urgencias: manejo de las complicaciones agudas en adultos

    Directory of Open Access Journals (Sweden)

    Eder A. Hernández-Ruiz

    2008-01-01

    Full Text Available La Diabetes Mellitus (DM es una enfermedad de alta prevalencia, reconocida como un problema de salud pública, debido a sus altas tasas de morbilidad y mortalidad asociadas. Diferentes estudios han documentado que la falta de adherencia al tratamiento, constituye uno de los principales factores desencadenantes para las descompensaciones agudas en el paciente diabético. Dentro del espectro de dichas alteraciones se encuentran las crisis hiperglicémicas agudas, las cuales se han dicotomizado en dos entidades clínicas: la Cetoacidosis Diabética (CAD y el Estado Hiperglicémico Hiperosmolar (EHH, que constituyen complicaciones metabólicas potencialmente fatales en el corto plazo y de las cuales pueden encontrarse cuadros superpuestos. Se han establecido criterios diagnósticos específicos buscando realizar un diagnóstico diferencial acertado, que permita un tratamiento idóneo; sin embargo, las tasas de morbilidad y mortalidad siguen siendo considerables. Por su parte, la Hipoglicemia también constituye una emergencia médica que, de no ser tratada oportunamente, puede ocasionar daño neurológico permanente e incluso la muerte. De lo anterior se deduce la importancia de que existan guías claras de manejo de estas alteraciones en todos los centros y servicios donde se preste atención médica de urgencias. Se siguen realizando investigaciones en busca de nuevas estrategias diagnósticas y terapéuticas que permitan un manejo más integral de la DM y sus complicaciones, en aras de mejorar la calidad de vida de los pacientes.

  2. HEMOGLOBINA GLICOSILADA COMO ELEMENTO PRONÓSTICO EN LAS COMPLICACIONES MACROVASCULARES DE LA DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Agnes Fajardo Matarrita

    2012-04-01

    Full Text Available En este artículo se discute la información obtenida respecto del cuidado enfermero brindado a personas portadoras de Diabetes Mellitus tipo 2 relacionada con la elevación de la hemoglobina glicolisada (Hba1c como factor pronóstico para el desarrollo de complicaciones. Se realizó una búsqueda de la mejor información científica disponible para construir el estado de la cuestión. Posteriormente, se estableció una pregunta en formato PICO (pacientes, intervención, comparación, observación y se procedió a establecer estrategias de búsqueda en las diferentes bases de datos sugeridas en el Curso de Práctica Clínica de Enfermería Basada en la Evidencia impartido por CIEBE-CR, entre las que se encuentran PUBMED, EBSCO HOST, principalmente. El análisis crítico se llevó a cabo mediante las recomendaciones que brinda CASPe y se comparó con la práctica realizada en el Hospital de la Anexión. El control intensivo de la glicemia, el cual incluye agentes orales, la insulina y la intervención cardiovascular múltiple reflejada en hemoglobinas glicosilada menores a 7, indicó que existía una evidente disminución en la incidencia de eventos macrovasculares mayores tales como el infarto agudo al miocardio, el ictus no fatal y el accidente vascular cerebral. De acuerdo con la evidencia, mantener la hemoglobina glicosilada dentro de parámetros normales disminuye el riesgo de sufrir complicaciones macrovasculares de esta patología en comparación con aquellos pacientes que manejan hemoglobina glicosiladaalta.

  3. 77 FR 39406 - Safety Zone; Tom Graves Memorial Fireworks, Port Bay, Wolcott, NY

    Science.gov (United States)

    2012-07-03

    ...-AA00 Safety Zone; Tom Graves Memorial Fireworks, Port Bay, Wolcott, NY AGENCY: Coast Guard, DHS. ACTION..., NY. This safety zone is intended to restrict vessels from a portion of Port Bay during the Tom Graves... necessary to ensure the safety of spectators and vessels during the Tom Graves Memorial Fireworks. This zone...

  4. Personalised immunomodulating treatments for Graves' disease: fact or fiction?

    Science.gov (United States)

    Struja, Tristan Mirko; Kutz, Alexander; Fischli, Stefan; Meier, Christian; Müller, Beat; Schütz, Philipp

    2017-08-14

    Although Graves' disease has been recognised for more than 100 years, its physiopathological mechanisms are incompletely understood. Treatment strategies today mainly focus on suppression of thyroid hormone production by use of antithyroid drugs or radio-iodine, but neglect the underlying immunological mechanisms. Although Graves' disease is often seen as a prototype for an autoimmune mechanism, it is more likely to be a heterogeneous syndrome showing characteristics of both autoimmunity and immunodeficiency. The interplay of these two mechanisms may well characterise the physiopathology of this disease and its complications. Immunodeficiency may be either genetically determined or secondarily acquired. Various triggering events lead to autoimmunity with stimulation of the thyroid gland resulting in the clinical syndrome of hyperthyroidism. Also, relapse risk differs from patient to patient and can be estimated from clinical parameters incorporated into the Graves' Recurrent Events After Therapy (GREAT) score. Accurate risk stratification may help to distinguish high-risk patients for whom a more definitive treatment approach should be used from others where there is a high probability that the disease will recover with medical treatment alone. Several smaller trials having found positive effects of immunosuppressive drugs on recurrence risk in Graves' disease; therefoore, there is great potential in the use of novel immunomodulating drugs in addition to the currently used antithyroid drugs for the successful treatment of this condition. Further in-depth exploration of susceptibility, triggering factors and immunological mechanisms has the potential to improve treatment of Graves' disease, with more personalised, risk-adapted treatment strategies based on the different physiopathological concepts of this heterogeneous condition.

  5. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    Science.gov (United States)

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  6. Análisis de las complicaciones neurológicas en los pacientes diagnosticados de endocarditis infecciosa: 1985-2002

    Directory of Open Access Journals (Sweden)

    Tomasa Centella Hernández

    2007-07-01

    Conclusiones: Las complicaciones neurológicas son una causa frecuente de morbimortalidad en el paciente con EI. Hemos observado un incremento de los casos en las endocarditis sobre válvula na- tiva en los últimos años, sobre todo asociado al incremento de casos producidos por S. aureus. Frecuentemente la complicación neurológica es el evento que conduce al diagnóstico de EI.

  7. Clinical experience of radiation therapy for Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine

    1996-11-01

    The effect of radiation therapy for Graves` ophthalmopathy was evaluated. Ten patients with Graves` ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves` ophthalmopathy. (author)

  8. Clinical experience of radiation therapy for Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo

    1996-01-01

    The effect of radiation therapy for Graves' ophthalmopathy was evaluated. Ten patients with Graves' ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves' ophthalmopathy. (author)

  9. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    Directory of Open Access Journals (Sweden)

    Antonio L. dos Santos Werneck

    1993-11-01

    Full Text Available Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada. O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia grave constituem associação pouco frequente. A presença de esclerodermia e miastenia grave é rara. Não encontramos na literatura a coincidência destas três doenças.

  10. Radioiodine treatment of Graves' disease. An assessment of its potential risks

    International Nuclear Information System (INIS)

    Graham, G.D.; Burman, K.D.

    1986-01-01

    Concern about the side effects of radiation exposure has deterred physicians from using radioiodine treatment for Graves' disease, although the efficacy and safety of this treatment have been established in the 35 years since its introduction. In that time, no significant side effects have been discovered. We believe iodine-131 should be considered the treatment of choice in most patients with Graves' disease. This article reviews the current understanding of the risks in radioiodine treatment of Graves' disease, including the risks for teratogenicity, genetic damage, carcinogenesis, and cellular dysfunction

  11. Medical management of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Prummel, M. F.; Wiersinga, W. M.

    1995-01-01

    In most patients with Graves' hyperthyroidism the eye signs are self-limiting and mostly subclinical. However, about one-third of the patients have clinically relevant ophthalmopathy, which can be disabling and disfiguring. The mechanical causes of the symptoms and signs of the eye disease are

  12. Clinical significance of determination of serum BGP levels in patients with Graves' disease

    International Nuclear Information System (INIS)

    Tu Liping; Zhang Chunyan; Wang Linglong; Yu Yuefang; Zhu Weijie; Cai Ao

    2006-01-01

    Objective: To study the clinical significance of changes of serum BGP levels in patients with Graves' disease. Methods: Serum BOP levels as well as T 3 , T 4 , FT 3 , FT 4 , TSH, TGA, TMA levels were determined with RIA in 158 patients with Graves' disease and 145 controls. Results: The serum BGP levels in patients with Graves' disease were significantly higher than those in controls (P 3 , T 4 , FT 3 , FT 4 levels, but not with TSH, TGA, TMA. Conclusion: Serum BGP levels is a useful marker for monitoring bone metabolism in patients with Graves' disease. (authors)

  13. Nutrición enteral total vs. nutrición parenteral total en pacientes con pancreatitis aguda grave Total enteral nutrition vs. total parenteral nutrition in patients with severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    M. Casas

    2007-05-01

    Full Text Available Objetivo: comparar la eficacia de la instauración precoz de nutrición enteral total (NET frente a nutrición parenteral total (NPT en pacientes con pancreatitis aguda grave (PAG. Métodos: estudio prospectivo aleatorio. Se incluyeron consecutivamente 22 pacientes con PAG aplicando los criterios APACHE II, valores de PCR y graduación de Balthazar en la TC. El grupo I (n = 11 recibió NPT y el grupo II (n = 12 NET. Se valoró la respuesta inflamatoria (PCR, TNF-alfa, IL-6, las proteínas viscerales (pre-albúmina, albúmina, la tasa de complicaciones (síndrome de respuesta inflamatoria sistémica, fallo multiorgánico, infecciones, las intervenciones quirúrgicas, la estancia hospitalaria y la mortalidad. Resultados: no hubo diferencias significativas en los primeros 10 días entre los dos grupos en la evolución de los criterios APACHE II, en las concentraciones de PCR, TNF-alfa e IL-6 ni tampoco en los valores de pre-albúmina y albúmina. Siete pacientes del grupo I presentaron complicaciones graves frente a 4 del grupo II. Requirieron intervención quirúrgica 3 pacientes del grupo I. La estancia hospitalaria fue similar en los dos grupos. Dos pacientes del grupo I fallecieron. Conclusiones: se ha observado una tendencia a una mejor evolución de los pacientes con PAG que utilizaron NET frente a los que utilizaron NPT.Objective: to compare the efficacy of early total enteral nutrition (TEN vs. total parenteral nutrition (TPN in patients with severe acute pancreatitis (SAP. Methods: a total of 22 consecutive patients with SAP were randomized to receive TPN (group I or TEN (group II. SAP was defined applying APACHE II score, C-reactive protein (CRP measurements and/or Balthazar CT scan score. Acute inflammatory response (CRP, TNF-alpha, IL-6, visceral proteins (pre-albumin, albumin, complications (systemic inflammatory response syndrome, multiorgan failure, infections, surgical interventions, length of hospital stay and mortality were

  14. Epidemiology, management and outcomes of Graves' disease-real life data.

    Science.gov (United States)

    Hussain, Y S; Hookham, J C; Allahabadia, A; Balasubramanian, S P

    2017-06-01

    Treatment options in Graves' disease are clearly defined, but management practices and the perceptions of success are varied. The outcomes of treatment in large consecutive cohorts of Graves' disease have not been well characterised. The study describes the epidemiology, management strategies and medium term outcomes following anti-thyroid drug treatment, radio-iodine ablation and surgery in Graves' disease. All patients (n = 659) who received treatment for a new diagnosis of Graves' disease in secondary care over a 5 year period were included with a median (interquartile range) follow-up of 42.9 (29-57.5) months. The age adjusted incidence of adult onset Graves' disease in Sheffield, UK was 24.8 per 100,000 per year. Excluding 35 patients lost to follow-up, 93.1% (n = 581) were controlled on anti-thyroid drug treatment. Of these, 73.6% went into remission following withdrawal of anti-thyroid drugs; 5.2% were still undergoing initial therapy; 13.3% lost control whilst on anti-thyroid drugs; and 7.9% went on to have either surgery or radio-iodine ablation whilst controlled on anti-thyroid drugs. Of the 428 patients who achieved remission, 36.7% relapsed. Of 144 patients who had radio-iodine ablation treatment, 5.6% relapsed and needed further treatment. Of 119 patients having surgery, 5.2% had long-term hypoparathyroidism and none had documented long-term recurrent laryngeal nerve palsy. In the follow-up, 39.9% of patients underwent surgery or radio-iodine ablation with little morbidity. Up to two-thirds of patients who achieved remission did not relapse. Data on effectiveness and risks of treatments for Graves' disease presented in this study will help clinicians and patients in decision making.

  15. Percepciones de los hombres sobre las complicaciones asociadas a la mutilación genital femenina

    Directory of Open Access Journals (Sweden)

    Ismael Jiménez-Ruiz

    2016-07-01

    Conclusiones: Los participantes procedentes de países donde se realiza la mutilación genital femenina, contrarios a mantener esta práctica, muestran un mayor conocimiento de las consecuencias negativas que los que se manifiestan a favor. El diseño de herramientas y programas de sensibilización destinados a la lucha contra la mutilación genital femenina debe visibilizar las complicaciones sobre la salud de las mujeres y las niñas, e incluir intervenciones familiares que impliquen a los hombres en el proceso de erradicación de esta práctica.

  16. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre

    DEFF Research Database (Denmark)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus

    2014-01-01

    BACKGROUND AND OBJECTIVE: Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves......' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.METHODS: 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre......'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression.RESULTS: In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves...

  17. F-18-FDG PET of the thyroid in Graves' disease

    International Nuclear Information System (INIS)

    Boerner, A.R.; Voth, E.; Schicha, H.; Wienhard, K.; Wagner, R.

    1998-01-01

    This study evaluates F-18-FDG PET of the thyroid in Graves' disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves' disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves' disease as well as on early radiation effects. (orig.) [de

  18. Important considerations in the management of Graves' disease in pregnant women.

    Science.gov (United States)

    Okosieme, Onyebuchi E; Lazarus, John H

    2015-01-01

    Graves' disease is an autoimmune disorder in which autoantibodies to the thyroid-stimulating hormone receptor cause hyperthyroidism through unregulated stimulation of the thyroid-stimulating hormone receptor. Effective management of Graves' disease in pregnancy must address the competing fetal and maternal priorities of controlling hyperthyroidism in the mother on the one hand, and on the other, minimizing the impact of maternal disease and antithyroid drugs on the well-being of the fetus. Optimal strategies for achieving this intricate balance are currently a source of continued debate among thyroid experts and studies in recent decades are now providing greater clarity into the risk posed to the unborn baby by the combination of biochemical, immunological and pharmacological hazards arising from Graves' disease and its therapy. This review summarizes the current best practice and highlights important considerations and areas of uncertainty in the management of Graves' disease in pregnant women.

  19. 131I therapy of Graves' disease using lithium

    International Nuclear Information System (INIS)

    Sato, Kenshi

    1983-01-01

    Lithium is known to cause goiter and hypothyroidism. In the mechanism of goitrogenesis, there is general agreement that lithium inhibits the release of the thyroid hormones from the thyroid gland without significantly impairing other thyroid functions. The present study was undertaken, therefore, to investigate the usefulness of lithium in the radioiodine treatment of Graves' disease. Nine patients with Graves' disease who were all, except one, previously treated with antithyroid drugs were studied. 600 mg of lithium carbonate were administered daily to investigate the effects on thyroidal 131 I uptake, disappearance rate of 131 I from the prelabeled thyroid and the serum concentrations of thyroid hormones. Lithium showed no significant effect on the thyroidal 131 I uptake when the 24 hour thyroidal 131 I uptakes were determined both before and during lithium treatment in the five cases. On the other hand, lithium clearly prolonged the mean value of effective half-lives of 131 I to approximately 8 days vs. 5.1 days before lithium treatment (p 4 and T 3 levels significantly decreased during lithium treatment, from 21.3 to 12.4μg/dl (n=9, p 131 I for the Graves' disease can be reduced by using lithium, the radiation exposure to the total body is decreased. Moreover, it is possible to perform the 131 I therapy while improving the thyrotoxicosis with lithium. Finally, it is concluded that lithium is a very useful drug to be combined with the 131 I therapy of Graves' disease. (author)

  20. A mild Grave's ophthalmopathy during pregnancy.

    Science.gov (United States)

    Abbouda, Alessandro; Trimboli, Pierpaolo; Bruscolini, Alice

    2014-01-01

    Thyroid ophthalmopathy is a complication most commonly associated with Grave's disease. The disease course ranges from mild to severe, with severe cases resulting in major visual impairment. A complete ophthalmic examination in a 35-year-old secundigravida to 14 weeks of gestation presented to the hospital for a routine ophthalmological examination with eyelid retraction in the right eye was made. We studied the course of ocular disease through the gestation with orbit ecography and a 3T MRI. A diagnosis of Grave's Ophthalmopathy was made. This case presents an unusual course of the GD during pregnancy and a normal post-partum relapse, according to the Th1/Th2 balance. The frequent follow-up and the use of MRI allowed a prompt identification and complete control of the disease.

  1. Complications of endoscopic retrograde cholangiopancreatography: A study in a small ERCP unit Complicaciones de la colangiopancreatografía retrógrada endoscópica: Estudio en una unidad pequeña de CPRE

    Directory of Open Access Journals (Sweden)

    J García-Cano Lizcano

    2004-03-01

    procedimiento consolidado para el drenaje de la vía biliar y pancreática, que, sin embargo, conlleva complicaciones. El número parece ser mayor en los centros que realizan menos de 200 CPRE anuales. No obstante, en ocasiones, la distribución de los recursos sanitarios hace preciso realizar esta técnica en centros con menor número de procedimientos. Presentamos la experiencia de las complicaciones de la CPRE en una unidad pequeña. Material y métodos: estudio retrospectivo sobre unos datos recogidos de forma prospectiva durante seis años (1997-2002. En este periodo, dos endoscopistas, trabajando conjuntamente, han realizado 507 CPRE, lo que corresponde a una media aproximada de 84 procedimientos anuales. Resultados: en las 507 CPRE se produjeron 55 complicaciones (10,85% y como consecuencia de ellas, cuatro pacientes fallecieron (0,79%. Hubo 28 pancreatitis (5,5%, 8 hemorragias postesfinterotomía (1,6%, 7 perforaciones bilioduodenales (1,4%, 8 sepsis de origen biliar (1,6% y otras 4 complicaciones varias. Las CPRE con éxito diagnóstico y terapéutico -cuando se precisó- fueron 418 (82,4%, y presentaron 46 (11% complicaciones. Hubo 89 (17,6% CPRE con fallo diagnóstico o terapéutico, que presentaron 9 (10,11% complicaciones (p=0,8 entre ambos grupos. Treinta y cinco (7% CPRE fueron exclusivamente diagnósticas, presentando 6 (17% complicaciones. Las 187 CPRE realizadas para extraer coledocolitiasis, con 14 (7,4% complicaciones, fueron el grupo con menor morbilidad (p=0,04. Conclusiones: la tasa de complicaciones en nuestro centro se encuentra dentro de los rangos publicados. La extracción de coledocolitiasis fue el grupo de CPRE con menos complicaciones. Por su morbilidad, debe valorarse cuidadosamente el riesgo-beneficio de las exploraciones que se prevean exclusivamente diagnósticas.

  2. Airway complication occurring during radioiodine treatment for Graves' disease

    International Nuclear Information System (INIS)

    Kinuya, Seigo; Yoneyama, Tatsuya; Michigishi, Takatoshi

    2007-01-01

    Airway complications rarely occur in 131 I radioiodine therapy for Graves' disease. This study presents two cases in which 131 I therapy caused this acute complication. The patients complained of the symptom 6 h and 33 h after administration of 131 I. A histamine H1 receptor antagonist and hydrocortisone rapidly resolved symptoms in both cases. These two cases remind physicians that 131 I therapy for Graves' disease may cause potentially life-threatening complications. (author)

  3. Comparative Study on the Long-Acting Thyroid Stimulator in Graves' Disease

    International Nuclear Information System (INIS)

    Kim, Dong Sup; Koh, Chang Soon; Lee, Mun Ho

    1973-01-01

    In order to study the role of LATS in the pathogenesis of the Graves' disease, the serum activity of the LATS was determined by the bioassay of the modified McKenzie method. The subjects examined in the study consisted of 76 individuals including 12 cases of normal control, 54 cases with typical Graves' disease and 10 cases of chronic thyroiditis. The data observed in the patients with the Graves' disease were analyzed in comparison with the clinical features, laboratory findings, and responsiveness to the treatment. The results obtained are as follows: 1) None of the subjects which did not have the Graves' disease showed a positive LATS activity, except one case with the chronic thyroiditis. 2) Twenty-two oui of the 54 cases with the Graves' disease showed positive results for LATS (40.7%). The positivity was significantly higher in the patients who had been treated with antithyroid regimen but still showed hyperthyroidism than in the patients who had not been treated. 3) The activity of LATS was gradually decreased or even became absent as the hyperthyroidism was corrected after the treatment. 4) No significant difference was noticed in age and-sex between the positive and negative groups of LATS. 5) There was no evidence of significant correlation between the LATS activity and clinical features.

  4. Tratamiento quirúrgico de las complicaciones del shock meningocóccico grave Surgical treatment of the severe meningococcal septic shock complications

    Directory of Open Access Journals (Sweden)

    P. Casteleiro Roca

    2010-06-01

    Full Text Available El shock meningocóccico es una entidad relativamente frecuente y de pronóstico muy grave, que provoca fallo multiorgánico con una alta mortalidad y que precisa ingreso en Unidad de Cuidados Intensivos. En los casos grandes puede provocar necrosis de tejidos mediante una fisiopatología poco clara. En los últimos años la supervivencia de estos pacientes ha aumentado debido al diagnóstico precoz y a medidas de reanimación más agresivas. Como consecuencia encontramos un aumento del número de pacientes con necrosis extensas de tejidos que precisan tratamiento. Lo fundamental ante el diagnóstico de un shock meningocóccico es establecer el tratamiento médico precoz con medidas de reanimación agresivas y antibioterapia. Sugerimos que la necrosis extensa de tejidos que sufren estos pacientes debe tratarse como si se tratase de un paciente quemado, realizando curas diarias con sulfadiacina argéntica y cirugías seriadas (desbridamiento - amputación - cobertura tan pronto como la situación clínica del paciente lo permita. Es necesario un seguimiento muy cercano de estos pacientes, dada la necesidad de cirugías secundarias que van a precisar a lo largo de su vida, así como la realización de pruebas de imagen para descartar la presencia de osteomielitis secundarias.Meningococcal shock is a relatively frequent disease with a serious prognosis, that causes a multiorganic failure with high mortality and Intensive Care Unit admission. Serious meningococcal shock causes tissue necrosis by uncertain physiopathology. In the last years, there is an increase of the survival, as a result of early diagnosis and aggressive resuscitation. So, there is an increase of patient's tissue necrosis that needs surgery. The most important aspect in front of meningococcal shock is to establish early medical treatment with aggressive resuscitation and antibiotics. Tissue necrosis should be treated like burn patient: argentic sulfadiazine daily cure and serial

  5. Causas de reintervenciones quirúrgicas por complicación postoperatoria en pacientes de una unidad de cuidados intensivos quirúrgicos sometidos a cirugía abdominal.

    Directory of Open Access Journals (Sweden)

    Andrea Mendiola

    2012-04-01

    Full Text Available Objetivos: Describir las causas de las reintervenciones luego de una cirugía abdominal en pacientes de una unidad de cuidados intensivos quirúrgicos de un hospital general. Material y métodos: Estudio prospectivo, tipo reporte de casos. Se incluyeron a los pacientes postoperados de cirugía abdominal, hospitalizados en la Unidad de Cuidados Intensivos Quirúrgicos del Hospital Nacional Cayetano Heredia y quienes requirieron de reintervención quirúrgica entre febrero de 2009 y enero de 2010 por una complicación postoperatoria. Resultados: El hallazgo más frecuente fue la perforación en 31,6%, seguido de absceso abdominal 21,1% y dehiscencias 21,1%. Conclusiones: Las perforaciones fueron los hallazgos más frecuentes, siendo su frecuencia mayor a lo reportado en la literatura. La incidencia de reintervención fue de 15%.

  6. Hypocalcaemia following thyroidectomy for treatment of Graves' disease: implications for patient management and cost-effectiveness.

    Science.gov (United States)

    Hughes, O R; Scott-Coombes, D M

    2011-08-01

    No consensus exists on optimal treatment for Graves' disease once anti-thyroid medication fails to induce remission. Total thyroidectomy is a more cost-effective treatment than radioactive iodine or life-long anti-thyroid medication, but hypocalcaemia is an important complication, leading to longer hospital admissions and increased prescription costs. This study aimed to compare the relative risk of hypocalcaemia requiring medical treatment for patients with Graves' disease. Prospective cohort study of patients undergoing total thyroidectomy for Graves' disease and for multinodular goitre, calculating serum calcium levels 24-hours post-operatively and prescription rates. Mean corrected calcium concentrations 24 hours post-operatively were 2.05 mmol/l for Graves' disease patients and 2.14 mmol/l for multinodular goitre patients (p = 0.003). Biochemical hypocalcaemia developed in 92 per cent (n = 34) of Graves' disease patients and 71 per cent (n = 43) of multinodular goitre patients (p = 0.012). Graves' disease patients were more likely to be prescribed calcium supplementation pre-discharge (p = 0.037). Total thyroidectomy for Graves' disease carries an increased risk of hypocalcaemia at 24 hours, and of calcium supplementation pre-discharge. Graves' disease patients should be informed of the increased risk of hypocalcaemia associated with total thyroidectomy, and this risk must be factored into future cost-effectiveness analysis.

  7. Microorganismos patógenos y potencialmente patógenos en secreciones genitales de gestantes a término asociados a complicaciones posnatales

    Directory of Open Access Journals (Sweden)

    Tania Castellanos Medina

    2013-09-01

    Full Text Available Introducción: tanto las infecciones puerperales como las neonatales precoces reflejan probablemente los microorganismos que están presentes en la vagina en el período cercano al parto. Objetivo: establecer la relación entre los microorganismos identificados en las secreciones genitales de las gestantes a término y el desarrollo de sepsis neonatal y puerperal, así como vincular dichas complicaciones con los agentes diagnosticados. Métodos: se realizó un estudio longitudinal y prospectivo en los servicios de microbiología, obstetricia, perinatología y neonatología del Hospital General Docente "Dr. "Juan Bruno Zayas Alfonso", de Santiago de Cuba, desde julio de 2009 hasta marzo de 2010. Se identificaron microorganismos en 179 muestras cervicovaginales, las cuales fueron procesadas en el laboratorio de microbiología según las normas vigentes. Resultados: los microorganismos más identificados resultaron los géneros Mycoplasmas y Chlamydias (78,2 y 69,3%, respectivamente y fueron los que con mayor frecuencia se asociaron. Un porcentaje elevado de las gestantes (67,0 %, tenía más de un agente en sus secreciones genitales. Después del parto hubo un hallazgo mayor de infecciones en el producto de la concepción (21,8 % que en las puérperas (3,9% y la mayoría de estas complicaciones se relacionaron con la presencia de 2 o más microorganismos. Conclusiones: las asociaciones de microorganismos patógenos o potencialmente patógenos en las secreciones genitales de embarazadas a término, aumentan el riesgo de complicaciones posnatales.

  8. Grave pit modifications and wooden structures in the Great Moravian graves and their information potential for cognition of the social structure of the Great Moravian society

    Czech Academy of Sciences Publication Activity Database

    Mazuch, Marian; Hladík, Marek

    2013-01-01

    Roč. 54, č. 2 (2013), s. 45-55 ISSN 1211-7250 R&D Projects: GA ČR GP13-20936P Keywords : Early Middle Ages * Great Moravia * Mikulčice * burial sites * graves * grave pits * burial pits * wooden structures * funeral rite * social structure * GIS * statistics Subject RIV: AC - Archeology, Anthropology, Ethnology

  9. ANÁLISE DAS COMPLICAÇÕES DO USO DA VENTILAÇÃO MECÂNICA EM CRIANÇAS DE UMA UNIDADE DE TERAPIA INTENSIVA PEDIÁTRICA

    Directory of Open Access Journals (Sweden)

    DENIZIELLE DE JESUS

    2008-01-01

    Full Text Available La insuficiencia respiratoria aguda es una de las situaciones que puede provocar la entubación traqueal del niño. Se objetivó analizar las complicaciones de la ventilación mecánica en niños de una Unidad de Terapia Intensiva Pediátrica. Estudio transversal, cuantitativo, con muestra de 72 niños en soporte de ventilación. Los datos se recogieron a través de un formulario de septiembre a diciembre de 2006, presentados en tablas y gráficos. En los resultados, las complicaciones más frecuentes fueron la entubación accidental y la entubación selectiva. El promedio de ventilación mecánica (VM fue de 21 días y 4 horas. Concluimos que la asistencia a la VM aún representa un gran reto para los profesionales que precisan buscar alternativas para minimizar las complicaciones relacionadas al cuidado dado al niño en estado grave.

  10. Graves' disease and toxic nodular goiter - radioiodine therapy

    International Nuclear Information System (INIS)

    Schicha, H.; Dietlein, M.

    2002-01-01

    At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism. (orig.) [de

  11. Regression of the carotid intima media thickness by propylthiouracil therapy in Graves' hyperthyroidism.

    Science.gov (United States)

    Bilir, Cemil; Gökosmanoglu, Feyzi; Caliskan, Mustafa; Cinemre, Hakan; Akdemir, Ramazan

    2012-04-01

    One of the cardiovascular effects of hyperthyroidism is increased carotid intima media thickness (CIMT). The aim of this study is to investigate the CIMT in patients with Graves' hyperthyroidism and the effect of propylthiouracil (PTU) therapy on CIMT. Twenty-six patients with Graves' hyperthyroidism and 33 healthy controls were included in the study. CIMT was measured at the right and left external carotid arteries in every patient in both groups. CIMT was measured before and after the PTU therapy in patients with Graves' hyperthyroidism. There was a significant difference in CIMT between the group of Graves' hyperthyroid patients and the control group (0.72 versus 0.55 mm, P treatment, CIMT decreased significantly compared with the baseline values [0.84 (0.54-1.3) to 0.72 (0.50-1.2), change 0.12 mm, P hyperthyroidism is associated with atherosclerosis as assessed by CIMT. Treatment of Graves' hyperthyroidism with PTU decreases the CIMT.

  12. CD28/CTLA-4/ICOS haplotypes confers susceptibility to Graves' disease and modulates clinical phenotype of disease.

    Science.gov (United States)

    Pawlak-Adamska, Edyta; Frydecka, Irena; Bolanowski, Marek; Tomkiewicz, Anna; Jonkisz, Anna; Karabon, Lidia; Partyka, Anna; Nowak, Oskar; Szalinski, Marek; Daroszewski, Jacek

    2017-01-01

    Graves' disease, an autoimmune disease with heterogeneous symptoms including Graves' orbitopathy, has a combined genetic/environmental background, where variations within CD28/CTLA-4/ICOS genes are considered as disease markers.Association of CD28c.17+3T>C(rs3116496), CTLA-4g.319C>T(rs5742909), CTLA-4c.49A>G(rs231775), CTLA-4g.*642AT(8_33), CT60(rs3087243), Jo31(rs11571302), ICOSc.1554+4GT(8_15) polymorphisms with susceptibility to Graves' disease and clinical outcome was investigated. The study group comprised of 561 Polish Caucasians, including 172 unrelated Graves' disease patients. CTLA-4c.49A>G, CTLA-4g.319C>T, and CT60 were genotyped by PCR-RFLP; Jo31 and CD28c.17+3C>T by minisequencing; CTLA-4g.*642AT(8_33) and ICOSc.1554+4GT(8_15)-PCR and fluorescence-based technique. CD28c.17+3T>C(rs3116496)T/CTLA-4g.319C>T(rs5742909)C/CTLA-4c.49A>G(rs231775)G/CTLA-4g.*642AT(8_33)(AT 16-21 )/CT60(rs3087243)G/Jo31(rs11571302)G/ICOSc.1554+4GT(8_15)(m) and TCA(AT Graves' disease, especially in males, as well as overall Graves' orbitopathy development with severe outcome. TCG(AT 16-21 )GG(l) haplotype increased risk of Graves' disease and reduced the chance of successful medical treatment. Although this haplotype was mainly observed in patients without signs of Graves' orbitopathy, if Graves' orbitopathy developed it favored a Graves' orbitopathy outcome. Haplotype TCA(AT >21 )GT(m) increased Graves' disease risk in women and, in all patients, was linked to Graves' disease without Graves' orbitopathy. TCG(AT Graves' disease risk factor, whereas CT60 was an independent factor for disease progression. Sporadic Graves' disease was related to presence of CTLA-4c.49A>G[A] and the rare CTLA-4g.319C>T[T] allele variant. Familial background of the disease was exclusively associated with CTLA-4g.*642AT(8_33)[AT >21 ]/[AT >21 ] genotype. CD28/CTLA-4/ICOS loci may confer inherited susceptibility to Graves' disease or may be involved in susceptibility to Graves' disease and play a

  13. VARIABLES PREOPERATORIAS PRESENTES EN PACIENTES CON CIRUGÍA CORONARIA SIN CIRCULACIÓN EXTRACORPÓREA Y SU RELACIÓN CON LA EVOLUCIÓN POSQUIRÚRGICA PRECOZ / Preoperative variables present in patients with coronary surgery without extracorporeal circulation and its relationship with early postsurgical evolution

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2010-12-01

    Full Text Available Resumen Introducción y objetivos: El conocimiento de los factores predictores de mortalidad y de complicaciones graves es de gran importancia, ya que permite realizar una evaluación preoperatoria objetiva de los pacientes. El objetivo de este estudio fue determinar los factores de riesgo predictores de mortalidad y de complicaciones graves en los pacientes revascularizados, sin el uso de la circulación extracorpórea, y analizar el comportamiento de dos modelos de estratificación de riesgo preoperatorio en la cirugía cardíaca. Método: Se realizó una investigación no experimental, de seguimiento prospectivo, donde se estudiaron 175 pacientes que recibieron cirugía de revascularización miocárdica sin el uso de la circulación extracorpórea, en el servicio de Cirugía cardíaca del Cardiocentro “Ernesto Che Guevara” de Villa Clara durante los años 2007-2009. Para determinar las variables predictoras se realizaron dos estudios bivariados, donde las variables dependientes fueron la mortalidad y la presencia de complicaciones graves. Para el análisis y validación de las escalas aplicadas a los pacientes operados se utilizaron las curvas de rendimiento diagnóstico. Resultados: Los pacientes estudiados presentaron una media de edad de 58,7, predominó el sexo masculino, y la hipertensión arterial, la angina estable, la dislipidemia y la diabetes mellitus fueron los factores de riesgo más encontrados. En su totalidad, fueron operados de forma electiva, con clase funcional III y hubo un predominio de la enfermedad de tres vasos coronarios principales. Las variables que modificaron significativamente el riesgo de morir y de sufrir complicaciones graves fueron: la enfermedad del tronco y tres vasos, el antecedente de enfermedad vascular periférica, la angina inestable y la enfermedad pulmonar obstructiva crónica. Conclusiones: Las escalas de riesgo utilizadas poseen un buen poder predictivo de mortalidad y complicaciones graves

  14. Hyperthyroidism: diagnosis and management of Graves' disease.

    Science.gov (United States)

    Schilling, J S

    1997-06-01

    Hyperthyroidism, or thyrotoxicosis, results when the body's tissues are exposed to excessive levels of thyroid hormone. Hyperthyroidism affects 2% of women but only one-tenth as many men. Graves' disease is the most common form of hyperthyroidism, often occurring in young adults. It is an autoimmune disorder with an important genetic component. Hyperthyroidism's hallmarks include goiter and myriad signs and symptoms related to increased metabolic activity in virtually all body tissues. Increased sensitivity to circulating catecholamines adds to the clinical picture. Diagnosed by patient history, physical examination, and laboratory tests, Graves' disease is treated with antithyroid drugs, radioactive iodine, and/or surgery, plus supportive therapy. A good treatment outcome can be expected; long-term follow-up is indicated.

  15. An update on the medical treatment of Graves' hyperthyroidism.

    Science.gov (United States)

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  16. Follow-up of newborns of mothers with Graves' disease.

    Science.gov (United States)

    Levy-Shraga, Yael; Tamir-Hostovsky, Liran; Boyko, Valentina; Lerner-Geva, Liat; Pinhas-Hamiel, Orit

    2014-06-01

    Overt neonatal Graves' disease is rare, but may be severe, even life threatening, with deleterious effects on neural development. The main objective of this study was to describe the course of thyrotropin (TSH) and free thyroxin (fT4) levels, as well as postnatal weight gain in relation to fT4 levels, in neonates born to women with Graves' disease without overt neonatal thyrotoxicosis. Such information is important to deduce the optimal schedule for evaluation. We conducted a retrospective chart review of neonates born to mothers with Graves' disease between January 2007 and December 2012. The records were reviewed for sex, gestational age, birth weight, maternal treatment during pregnancy, and maternal thyroid stimulating immunoglobulin (TSI) level. For each visit in the clinic, the data included growth parameters, presence of symptoms suspected for hyperthyroidism, blood test results (levels of TSH, fT4, and TSI), and treatment. Ninety-six neonates were included in the study (49 males), with a total of 320 measurements of thyroid function tests (TSH and fT4). Four neonates (4%) had overt neonatal Graves' disease; one of them along with nine others were born preterm. In 77 (92.9%) of the remaining 83 neonates (the subclinical group), fT4 levels were above the 95th percentile on day 5. All had normal fT4 on day 15. A negative association was found between fT4 and weight gain during the first two weeks. In this cohort, most neonates born to mothers with Graves' disease had a subclinical course with abnormal fT4 levels that peaked at day 5. After day 14, all measurements of fT4 returned to the normal range, although measurements of TSH remained suppressed for up to three months. Elevated fT4 was associated with poor weight gain.

  17. [Grave's disease in 2009].

    Science.gov (United States)

    Philippe, Jacques

    2009-04-08

    Grave's disease is an autoimmune disease of the thyroid gland characterized by hyperthyroidism, a homogenous goiter and occasionally an ophtalmopathy. It occurs in less than 1% of the population with a large predominance in women (10/1). Treatment is directed to inhibit thyroid hormone synthesis with carbimazole during 12-18 months. Recurrence rates after stopping treatment is about 50%; in these patients, radioactive iodine is the preferred treatment.

  18. Quality control of 131I treatment of graves' disease

    International Nuclear Information System (INIS)

    Liu Zeng; Liu Guoqiang

    2009-01-01

    To make a preliminary quality control (QC) criteria and apply on the various stages of clinic 131 I treatment of Graves' disease in order to decrease the early happening of hypothyroidism and enhance the onetime 131 I cure rate of Graves' disease, the quality control criteria in the stochastic outpatient with 131 I treatment, such as plan of the indication, contraindication, method of treatment, matters needing attention, follow-up observation and curative effect appraisal, patient selection, RAIU, thyroid gland weight measurement and 131 I dose criteria for the various steps of 131 I medication were determined. The 131 I treatment effects of Graves' disease including the once-cure rate, the improving rate, duplicate cure rate and the early happening rate of hypothyroidism were analyzed in patients with applying QC and without QC ccriteria. The results showed that the oncecure rate in patients with applying QC criteria was increased from 76.6% to 90.9% (P≤0.01); the improving rate was decreased from 12.2% to 7.0% (P≤0.01); the duplicate cure rate was increased from 90.1% to 93.0% (P>0.05); the early happening rate of hypothyroidism was decreased from 11.0% to 2.1% (P≤0.01). The 131 I treatment of Graves' disease applying with QC criteria had tremendously improved the oncecure rate and decreased the early happening of hypothyroidism rate. (authors)

  19. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    Directory of Open Access Journals (Sweden)

    Enrique Echeburúa

    2008-01-01

    Full Text Available En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas variables. Los resultados ponen de manifiesto que tanto los agresores como las víctimas tienden a ser jóvenes, con una sobrerrepresentación de agresores y víctimas extranjeros inmigrantes. En el caso de los maltratadores graves, tienden a ser celosos o posesivos, a sentirse humillados por la ruptura de la pareja, lo que redunda directamente en un descenso de su autoestima y a consumir abusivamente alcohol o drogas. Por lo que se refiere a las víctimas de la violencia grave, se suelen sentir con frecuencia en peligro de muerte y están más fácilmente en circunstancias de vulnerabilidad, como una edad muy joven, una personalidad muy dependiente, una situación de enfermedad crónica o de dependencia económica, un consumo de drogas o un entorno de soledad. Se comentan las implicaciones de este estudio para la investigación y para la práctica clínica.

  20. A report of three cases of untreated Graves' disease associated with pancytopenia in Malaysia.

    Science.gov (United States)

    Rafhati, Abdullah Noor; See, Chee Keong; Hoo, Fan Kee; Badrulnizam, Long Bidin Mohamed

    2014-01-01

    Generally, clinical presentations of Graves' disease range from asymptomatic disease to overt symptomatic hyperthyroidism with heat intolerance, tremor, palpitation, weight loss, and increased appetite. However, atypical presentation of Graves' disease with hematological system involvement, notably pancytopenia, is distinctly uncommon. Hereby, we present and discuss a series of three untreated cases of Graves' disease clinically presented with pancytopenia and the hematological abnormalities that responded well to anti-thyroid treatment. With resolution of the thyrotoxic state, the hematological parameters improved simultaneously. Thus, it is crucial that anti-thyroid treatment be considered in patients with Graves' disease and pancytopenia after a thorough hematological evaluation.

  1. Graves' ophthalmopathy evaluated by infrared eye-movement recordings

    International Nuclear Information System (INIS)

    Feldon, S.E.; Unsoeld, R.

    1982-01-01

    Thirteen patients with varying degrees of Graves' ophthalmopathy were examined using high-resolution infrared oculography to determine peak velocities for horizontal eye movements between 3 degrees and 30 degrees. As severity of the orbital disease increased, peak velocities became substantially lower. Vertical-muscle surgery failed to have any effect on peak velocity of horizontal eye movements. In contrast, orbital decompression caused notable improvement in peak velocity of eye movements. Eye-movement recordings, which provide a measure of extraocular muscle function rather than structure, may provide a safe, sensitive, and accurate method for classifying and following up patients with Graves' ophthalmopathy

  2. Clinical significance and changes of TRAb and TSI assay in patients with Graves' disease

    International Nuclear Information System (INIS)

    Hu Xiaolin; Zhang Haiyan

    2006-01-01

    Objective: To explore the changes and clinical significance of TRAb and TSI detection in patients with Graves' disease. Methods: Serum TRAb and TSI levels were detected by enzyme-linked immunosorbent assay, and thyroid hormone levels were detected by microparticle enzyme immunoassay, including normal controls, Graves' disease in period of onset, catabsis group and hashimotos thyroiditis group. Results: The positive rate of TRAb and TSI in Graves' in period of onset group is 86.67% and 95.0%, TGA and TMA in hashimotos thyroiditis group is 85.29% and 91.18%, respectively. More importantly these results were significant difference than normal controls. Conclusions: It's very important for Graves' disease patients to detect TRAb, TSI, TGA, TMA and thyroid hormone simulta-neously, especially to the curative effect and prognosis criterin in patients with Graves' disease and antidi-astole in patients with hashimotos thyroiditis. (authors)

  3. Sífilis una enfermedad que puede producir serias complicaciones en el organismo y producir la muerte. Puede detectarse a tiempo y tiene cura

    OpenAIRE

    Portilla, José Luis

    2009-01-01

    La sífilis es una ETS que puede causar complicaciones a largo plazo o la muerte, si no se trata de manera adecuada. Los síntomas en los adultos se dividen en fases. Estas fases son sífilis primaria, secundaria, latente y avanzada.

  4. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    OpenAIRE

    Enrique Echeburúa; Javier Fernández-Montalvo; Paz de Corral

    2008-01-01

    En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas v...

  5. An evaluation of supervoltage orbital irradiation for Graves' opthalmopathy

    International Nuclear Information System (INIS)

    Teng, C.S.; Crombie, A.L.; Hall, R.; Ross, W.M.

    1980-01-01

    Twenty patients with moderately severe ophthalmopathy due to Graves' disease or ophtalmic Graves' disease were treated by supervoltage orbital radiotherapy generated by a linear accelerator. Seven patients (35%) showed some response within 3 weeks of the treatment, four patients (20%) improved minimally while nine patients (45%) were unchanged. Improvement was noted mainly in soft tissue changes while proptosis decreased in only four patients. With one exception, ophthalmoplegia did not improve after the radiotherapy. The benefit obtained with the treatment was not impressive. (author)

  6. Remission of Grave's disease after oral anti-thyroid drug treatment.

    Science.gov (United States)

    Ishtiaq, Osama; Waseem, Sabiha; Haque, M Naeemul; Islam, Najmul; Jabbar, Abdul

    2009-11-01

    To evaluate remission rate of anti-thyroid drug treatment in patients with Grave's disease, and to study the factors associated with remission. A cross sectional study. The Endocrine Department of the Aga Khan University Hospital, Karachi from 1999 to 2000. Seventy four patients of Grave's disease were recruited who were prescribed medical treatment. Grave's disease was diagnosed in the presence of clinical and biochemical hyperthyroidism along with anti-microsomal (AMA) and anti-thyroglobulin antibodies (ATA) and thyroid scan. These patients were prescribed oral anti-thyroid drugs using titration regime and followed at 3, 6, 12 and 18 months. Patients were categorized into two groups: "remission group" and "treatment failure group" and results were compared using a chi-square test, t-test and logistic regression model with significance at p disease on initial presentation.

  7. A case of severe autoimmune hepatitis associated with Graves' disease

    Directory of Open Access Journals (Sweden)

    Samia Abdulla Bokhari

    2016-01-01

    Full Text Available Graves' disease is a common condition and is known to have a wide range of effects on a variety of organs. Hepatic dysfunction ranging from mild to severe due to direct effect of high circulating thyroid hormones as well as a deleterious effect of antithyroid medications (methimazole and propylthiouracil has been well - documented in literature. However, severe autoimmune hepatitis (AIH associated with Graves' disease is rare and limited to few case reports only. A 38-year-old woman presented with abdominal pain and yellowish discolouration of conjunctivae. On investigation, she was found to have Graves' disease and AIH. The liver histopathology showed typical features of AIH. She responded excellently to glucocorticoid therapy with normalisation of thyroid function and liver histology. The case is discussed with relevant literature review.

  8. Secrets of a Mass Grave

    Science.gov (United States)

    Ament, Caitlin Marie; Graham, Theodore J.

    2017-01-01

    This article presents a unit of study in which students examine skeletons and draw conclusions from the evidence they find in a simulated mass grave. The activity involves the foundation of forensic anthropology--interpreting the structure of skeletal remains to determine sex, age, height, and possible cause of death. Working through a series of…

  9. Predictive factors for intraoperative excessive bleeding in Graves' disease.

    Science.gov (United States)

    Yamanouchi, Kosho; Minami, Shigeki; Hayashida, Naomi; Sakimura, Chika; Kuroki, Tamotsu; Eguchi, Susumu

    2015-01-01

    In Graves' disease, because a thyroid tends to have extreme vascularity, the amount of intraoperative blood loss (AIOBL) becomes significant in some cases. We sought to elucidate the predictive factors of the AIOBL. A total of 197 patients underwent thyroidectomy for Graves' disease between 2002 and 2012. We evaluated clinical factors that would be potentially related to AIOBL retrospectively. The median period between disease onset and surgery was 16 months (range: 1-480 months). Conventional surgery was performed in 125 patients, whereas video-assisted surgery was performed in 72 patients. Subtotal and near-total/total thyroidectomies were performed in 137 patients and 60 patients, respectively. The median weight of the thyroid was 45 g (range: 7.3-480.0 g). Univariate analysis revealed that the strongest correlation of AIOBL was noted with the weight of thyroid (p Graves' disease, and preparation for blood transfusion should be considered in cases where thyroids weigh more than 200 g. Copyright © 2014. Published by Elsevier Taiwan.

  10. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre.

    Science.gov (United States)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus; Hegedüs, Laszlo; Bjoerner, Jakob Bue; Groenvold, Mogens; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla

    2014-09-01

    Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease. 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre completed the Hospital Anxiety and Depression Scale (HADS). The differences in the mean HADS scores between the groups were analysed using multiple linear regression, controlling for socio-demographic variables. HADS scores were also analysed dichotomized: a score >10 indicating probable 'anxiety'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression. In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were associated with anxiety and depression symptoms. Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity.

  11. Evaluation of the patients with Grave's ophthalmopathy after the corticosteroids treatment.

    Science.gov (United States)

    Petrović, Mirjana Janićijević; Sarenac, Tatjana; Srećković, Suncica; Petrović, Marko; Vulović, Dejan; Janićijević, Katarina

    2012-03-01

    Graves' ophthalmopthy is one of the most common causes of exophthalmos as well as the most common manifestation of Graves' disease. The treatment of Graves' ophthalmopathy includes ophthalmological and endocrinological therapy. The aim of this study was to clinically evaluate the patients with Graves' ophthalmopathy treated with corticosteroids. Evaluation of 21 patients was performed in the Ophthalmology Clinic and Endocrinology Clinic, Clinical Centre Kragujevac, in the period from 2009 to 2010. They were treated with pulse doses of intravenous corticosteroids. They were referred to ophthalmologist by endocrinologist in euthyroid condition in the active phase of Graves' ophthalmopathy (ultrasonography of orbit findings and positive findings of antithyroid stimulating hormone receptor antibody--anti-TSH R Ab). The clinical activity score (CAS) and NO SPECS classification for evaluation of disease severity were used. Ophthalmological examination includes: best corrected visual acuity, slit-lamp exam, Hertels' test, direct ophthalmoscopy and ultrasonography of the orbit. According to our results 76.19% of the patients were female; mean age of the patients was 35.2 +/- 5.6 years. According to CAS classification after 6 months of the treatment recovery was shown in 23.81% of the patients, partial amelioration in 47.62% and no clinical amelioration in 28.57% of the patients. We achieved better results with male, young patients with high clinical activity score. Good results were observed after the first dose of corticosteroids, much better CAS after the third dose, which maintained until 6 months after the first treatment. Our results signify that intravenous pulse dose of corticosteroids treatment of the patients with Graves' ophthalmopthy is safe, comfortable, clinically justified and accessible for the clinicians and patients. Positive results are achieved after the first dose with increasing trend up to the third dose, which was maintained for the next three months.

  12. Tratamiento de la enfermedad de Graves Basedow

    Directory of Open Access Journals (Sweden)

    Hernando Vargas-Uricoechea

    2014-05-01

    Full Text Available Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatología y el diagnóstico de la Enfermedad de Graves-Basedow son motivo de otra publicación.

  13. Documentation of Urn Graves of Knovíz Culture by RPAS

    Directory of Open Access Journals (Sweden)

    Jaroslav Šedina

    2016-12-01

    Full Text Available This paper deals with the documentation, positional determination of urn graves of the Knovíz culture (1200 - 1000 BC, and geometric and positional determination of tumulus at the archaeological site located near the village Ctiněves, in the Usti region in the Czech Republic. Several hundred urn graves are located in the archaeological site and it is one of the biggest burial sites of Knovíz culture in the Czech Republic. RPAS (Remotely Piloted Aircraft System was used for the documentation and positional determination of urn graves and tumulus. RPAS was equipped by visible spectral range, two near-infrared range, multispectral and thermal camera (one camera for a single flight. The result is a unique data set documenting this archaeological site. Thanks to the suitable winter and spring conditions in 2016 urn graves and tumulus could be detected on the basis of vegetation symptoms. The paper is also focused on how to process the data and creation of a differential digital surface model.

  14. A 3-year-old girl with Graves' disease with literature review

    Directory of Open Access Journals (Sweden)

    Yo Han Ho

    2014-09-01

    Full Text Available Graves' disease, the main cause of hyperthyroidism in the pediatric age group, is very rare in children younger than 4 years old but can seriously interfere with growth and development if not recognized and treated. Here we report a case of a 3-year-old girl with Graves' disease who presented with goiter, exophthalmos, heat intolerance, and hyperactivity. At her first visit, her serum concentrations of triiodothyronine (T3 and free thyroxine (free T4 were normal, whereas that of thyroid-stimulating hormone (TSH was decreased. Antimicrosomal antibody was 7,053.94 IU/mL, and TSH-binding inhibitory immunoglobulin was 31.62%. A thyroid scan showed diffuse enlargement with markedly increased uptake of both thyroid glands. Although T3 and free T4 levels were initially normal, she developed hyperthyroidism 3 months later. She was finally diagnosed with Graves' disease and treated with methimazole for 6 months. This is the first report of Graves' disease in children younger than 4 years old in Korea.

  15. Modified lateral orbital wall decompression in Graves' orbitopathy using computer-assisted planning.

    Science.gov (United States)

    Spalthoff, S; Jehn, P; Zimmerer, R; Rana, M; Gellrich, N-C; Dittmann, J

    2018-02-01

    Graves' orbitopathy, a condition seen in the autoimmune syndrome Graves' disease, affects the fatty tissue and muscles inside the orbit. Graves' orbitopathy is associated with increasing exophthalmos and sometimes leads to compressive dysthyroid optic neuropathy, resulting in progressive vision loss. Dysthyroid compressive optic neuropathy, functional problems, and cosmetic problems are the main indications for surgical decompression of the orbit, especially if conservative treatment has not led to a reduction in symptoms. Many surgical techniques are described in the literature. This article presents a modification of the lateral orbital wall osteotomy, involving the rotation and reduction of the osteotomized bone segment using preoperative planning, intraoperative computed navigation, and piezoelectric surgery. This new method combines the advantages of different techniques and appears to be a valid approach to the treatment of severe cases of Graves' orbitopathy. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Radioiodine therapy of autonomously functioning thyroid nodules and of Graves' disease

    International Nuclear Information System (INIS)

    Guhlmann, C.A.; Rendl, J.; Boerner, W.

    1995-01-01

    We studied the effects of radioiodine therapy (RIT) for autonomously functioning thyroid nodules (AFTNs) and Graves' disease on thyroid function and size up to one year after RIT. In 230 patients with AFTNs, a dose of 300 Gy was effective in about 90% of the cases 6 months after RIT. Out of 65 patients suffering from Graves' disease, 5 patients (8%) had persisting hyperthyroidism 6 months after RIT with a dose of 150 Gy. This group consisted exclusively of patients with manifest hyperthyroidism at the time of RIT. As determined by ultrasonography 6 months after RIT, a reduction of thyroid size by about 40% and 60% was observed in patients with AFTNs and Graves' disease, respectively. (orig.) [de

  17. CT volumetric measurements of the orbits in Graves' disease

    International Nuclear Information System (INIS)

    Krahe, T.; Schlolaut, K.H.; Poss, T.; Trier, H.G.; Lackner, K.; Bonn Univ.; Bonn Univ.

    1989-01-01

    The volumes of the four recti muscles and the orbital fat was measured by CT in 40 normal persons and in 60 patients with clinically confirmed Graves' disease. Compared with normal persons, 42 patients (70%) showed an increase in muscle volume and 28 patients (46.7%) an increase in the amount of fat. In nine patients (15%) muscle volume was normal, but the fat was increased. By using volumetric measurements, the amount of fat in the orbits in patients with Graves' disease could be determined. (orig.) [de

  18. Complicaciones usuales post-drenaje pleural con tubos endotorácico en el trauma torácico no

    OpenAIRE

    Juan C Araujo-Cuauro; Fernando Fernández-Parra; Edwinis Garcia-Fontalvo; Milagros Sánchez

    2016-01-01

    Las lesiones por trauma torácico que ameriten hospitalización, y la inserción de un tubo endotorácico El objetivo de la investigación es identificar las complicaciones post-drenaje pleural con tubos endotorácico en el trauma torácico no quirúrgico. Se trata de estudio prospectivo descriptivo y observacional de las historias clínicas de admisión de los pacientes con traumatismo torácico contuso o penetrante no quirúrgico, que ingresaron durante el período co...

  19. Radioiodine therapy versus antithyroid medications for Graves' disease.

    Science.gov (United States)

    Ma, Chao; Xie, Jiawei; Wang, Hui; Li, Jinsong; Chen, Suyun

    2016-02-18

    Graves' disease is the most common cause of hyperthyroidism. Both antithyroid medications and radioiodine are commonly used treatments but their frequency of use varies between regions and countries. Despite the commonness of the diagnosis, any possible differences between the two treatments with respect to long-term outcomes remain unknown. To assess the effects of radioiodine therapy versus antithyroid medications for Graves' disease. We performed a systematic literature search in the Cochrane Library, MEDLINE and EMBASE and the trials registers ICTRP Search Portal and ClinicalTrials.gov. The date of the last search was September 2015 for all databases. Randomised controlled trials (RCTs) comparing the effects of radioiodine therapy versus antithyroid medications for Graves' disease with at least two years follow-up. Two authors independently screened titles and abstracts for relevance. One author carried out screening for inclusion, data extraction and 'Risk of bias' assessment and a second author checked this. We presented data not suitable for meta-analysis as descriptive data. We analysed the overall quality of evidence utilising the GRADE instrument. We included two RCTs involving 425 adult participants with Graves' disease in this review. Altogether 204 participants were randomised to radioiodine therapy and 221 to methimazole therapy. A single dose of radioiodine was administered. The duration of methimazole medication was 18 months. The period of follow-up was at least two years, depending on the outcome measured. For most outcome measures risk of bias was low; for the outcomes health-related quality of life as well as development and worsening of Graves' ophthalmopathy risks of performance bias and detection bias were high in at least one of the two RCTs.Health-related quality of life appeared to be similar in the radioiodine and methimazole treatment groups, however no quantitative data were reported (425 participants; 2 trials; low quality evidence

  20. Treatment choice, satisfaction and quality of life in patients with Graves' disease.

    Science.gov (United States)

    Conaglen, Helen M; Tamatea, Jade A U; Conaglen, John V; Elston, Marianne S

    2018-04-06

    Thyrotoxicosis, most often caused by Graves' disease (GD), when treated inadequately may result in premature mortality. There is little consensus as to which of the 3 treatment options available - antithyroid drugs (ATD), radioactive iodine (RAI) and surgery, is better. (i) To assess factors involved in treatment choice and treatment satisfaction in patients treated for Graves' disease; (ii) To assess quality of life (QoL) following treatment of Graves' disease. Participants were selected from a prospective study cohort assessing thyrotoxicosis incidence and severity. Of the 172 eligible patients with Graves' disease, 123 treated patients participated (64% had received ATD only, 11% RAI and 25% total thyroidectomy, the latter 2 usually after a period of ATD), along with 18 untreated patients with newly diagnosed Graves' disease (overall participation rate, 73%). Consented patients completed a questionnaire detailing factors involved in treatment choice, QoL and satisfaction with treatment. Participants reported that the most important factors in choosing a treatment were the following: the effects on activities of daily living, concern about use of radioiodine, possibility of depression or anxiety, and doctor's recommendations. Satisfaction levels were high across all 3 treatment types. QoL 1-year following treatment was higher than in untreated patients, and comparable with other international studies. Patient satisfaction with therapy and QoL does not differ by treatment type. Therefore, clinical and social factors, in combination with patient choice and resource availability, should determine which treatment modality patients with Graves' disease should receive. © 2018 John Wiley & Sons Ltd.

  1. Measurements of Actual Effective Half - Life in 131I Therapy for Graves' Hyperthyroidism

    International Nuclear Information System (INIS)

    So, Yong Seon; Kim, Myung Seon; Kwon, Ki Hyun; Kim, Seok Whan; Kim, Tae Hyung; Han, Sang Woong; Kim, Eun Sil; Kim, Chong Soon

    1996-01-01

    Radioiodine[131I] has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and read minister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective 131I half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean administered activity and the mean values of absorbed doses wet: 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51 MBq and marked differences of 131I thyroidal uptake between tracer and therapy occurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal 131I uptake measurements after tracer and therapy dose, provides sufficient data about the effective treatment in Graves' hyperthyroidism.

  2. Chylothorax Associated with Substernal Goiter in Graves' Disease Treated with Radioactive Iodine.

    Science.gov (United States)

    Young Oh, Seo; Hyun Kim, Bo; Young Kim, Do; Min Lee, Kyu; Jin Lee, Min; Su Kim, Sung; Ho Kim, Jong; Kyung Jeon, Yun; Soo Kim, Sang; Ki Kim, Yong; Joo Kim, In

    2017-04-01

    We present a rare case of chylothorax associated with an intrathoracic goiter in Graves' disease that was treated with radioactive iodine. A 23-year-old woman with Graves' disease was referred to our clinic with a pleural effusion, dyspnea, characteristic bilateral proptosis, and a diffuse goiter. The pleural fluid biochemistry was consistent with chylothorax. However, the chylothorax did not decrease with conservative therapy. Therefore, RAI was administered. Subsequently, the chylothorax and goiter improved more quickly than expected. This case illustrates that chylothorax associated with a substernal goiter in Graves' disease can be treated successfully with radioactive iodine instead of surgery.

  3. Activation of latent Graves' disease in children. Review of possible psychosomatic mechanisms.

    Science.gov (United States)

    Morillo, E; Gardner, L I

    1980-03-01

    In some children, psychological events have appeared to be important in the triggering of Graves' disease. This report examines the case histories of three children in whom the appearance of symptomatology of Graves' disease was associated with depression following the death of a loved one. An analysis of neuroendocrine and immunologie pathways suggests that depression, set off by bereavement, causes low levels of norepinephrine in the brain. The latter in turn may mediate an increase in ACTH and cortisol, leading to reductions in immune surveillance and resultant production of thyroid-stimulating immunoglobulins, hence the development of Graves' disease.

  4. Efeito da hipertermia na pancreatite aguda grave experimental

    Directory of Open Access Journals (Sweden)

    Maurício Gustavo Ieri Yamanari

    Full Text Available OBJETIVO: O objetivo deste estudo é avaliar os efeitos da hipertermia na pancreatite aguda (PA grave experimental induzida por ácido taurocólico. MÉTODO: A PA grave foi induzida pela injeção retrógrada de ácido taurocólico a 2,5% ou 5% no ducto pancreático principal. Após a indução, os animais foram colocados numa gaiola contendo duas lâmpadas de 100 W. A temperatura corporal foi aumentada para 39,5ºC e mantida neste nível por 45 minutos. Foram estudados taxa de mortalidade em 72 horas, permeabilidade vascular no pâncreas, porcentagem de água no tecido pancreático, amilase sérica, histologia (edema, necrose acinar e infiltrado inflamatório e níveis séricos de IL-6 e IL-10. RESULTADOS: Não houve alteração em nenhum dos parâmetros avaliados. CONCLUSÃO: Não há benefício da hipertermia na PA grave experimental induzida por ácido taurocólico.

  5. Hyperparathyroidism after radioactive iodine therapy for Graves' disease

    International Nuclear Information System (INIS)

    Kawamura, Juichi; Tobisu, Kenichi; Sanada, Shingo

    1983-01-01

    Herein we report a 36-year-old man with hyperparathyroidism and a past history of internal irradiation to the thyroid. Twelve years previously at age 24 years he had received 8 mCi of radioactive iodine for Graves' disease. An additional dose of 4 mCi was required 3 years later. A right lower parathyroid adenoma (28 x 23 x 20 mm, 5.7 g) was found at neck exploration. Although the association of external ionizing radiation to the head and neck and the subsequent development of hyperfunctioning parathyroid glands has been described in recent years, there are only 4 cases in the literature of parathyroid surgery for hyperparathyroidism secondary to earlier treatment with radioactive iodine for Graves' disease. In a long-term follow-up of 180 patients treated with radioactive iodine for Graves' disease, neither hypercalcemia nor hypophosphatemia was found. Whether internal radiation therapy can be a causative factor in the development of hyperparathyroidism should be elucidated in future. However, it seems reasonable to suggest that patients whose hyper-thyroidism has been treated with radioactive iodine should have their scrum calcium levels examined at 5-year intervals. (author)

  6. The curative effect analysis of 131I-therapy on patients with Graves' disease

    International Nuclear Information System (INIS)

    Cui Qin; Lu Shujun; Lu Tianhe

    2002-01-01

    To investigate the curative effect of 131 I-therapy on Graves' disease, the authors analyse conditions of patients who have received 131 I-therapy (n -674). These results showed that the incidence of fully recover, improve, Graves' disease and invalid is 80.11%, 7.28%, 11.87% and 0.74% respectively. Therefore, 131 I-therapy on Graves' disease is convenient. It has little side effect, low cost and better curative effect, it is one of the best therapeutic methods to treat hyperthyroidism

  7. Graves' orbitopathy: Management of difficult cases

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.

    2012-01-01

    Management of Graves' ophthalmopathy (GO) is based on three pillars: to stop smoking, to restore and maintain euthyroidism, and to treat the eye changes according to severity and activity of GO. Difficulties are frequently encountered in each of these three management issues. The advice to

  8. Graves' disease associated with infectious mononucleosis due to primary Epstein-Barr virus infection: report of 3 cases.

    Science.gov (United States)

    Akahori, Hiroshi; Takeshita, Yumie; Saito, Reina; Kaneko, Shuichi; Takamura, Toshinari

    2010-01-01

    Although the etiology of Graves' disease is still not clear, it is generally suggested that environmental factors such as infections contribute to the development of Graves' disease. We report here three cases of Graves' disease which presented simultaneously with infectious mononucleosis due to primary EBV infection. Acute EBV infection might play an important role in the onset of Graves' disease. These three women complained of a sore throat or neck pain, resembling subacute thyroiditis. In the case of thyrotoxicosis accompanied by sore throat or neck pain, Graves' disease must be distinguished from subacute thyroiditis.

  9. p27kip1 expression distinguishes papillary hyperplasia in Graves' disease from papillary thyroid carcinoma.

    Science.gov (United States)

    Erickson, L A; Yousef, O M; Jin, L; Lohse, C M; Pankratz, V S; Lloyd, R V

    2000-09-01

    In most cases, the histopathologic and cytologic distinction between Graves' disease and papillary thyroid carcinoma is relatively easy, but on occasion Graves' disease may simulate a thyroid papillary carcinoma. For example, papillary fronds with fibrovascular cores may be present in both Graves' disease and papillary carcinoma. p27kip1 (p27) is a cyclin-dependent kinase inhibitory protein that has been shown to be an independent prognostic factor in a variety of human tumors. Our previous studies of p27 expression in hyperplastic and neoplastic endocrine lesions showed that the level of p27 was quite different in these two conditions. To determine if this distinction could also be made between Graves' disease and papillary carcinoma, we analyzed expression of p27 and other cell cycle proteins in a series of cases of Graves' disease with papillary hyperplasia and a series of papillary thyroid carcinomas. Formalin-fixed paraffin-embedded tissues from 61 randomly selected patients with thyroid disease, including 29 cases of Graves' disease with papillary architectural features and 32 cases of papillary carcinoma, were analyzed for expression of p27, Ki-67, and DNA topoisomerase II alpha (topo II alpha) by immunostaining. The distribution of immunoreactivity was analyzed by quantifying the percentage of positive nuclei that was expressed as the labeling index (LI) plus or minus the standard error of the mean. The papillary hyperplasia of Graves' disease had a p27 LI of 68.2 +/- 3.1 (range, 24 to 88), whereas papillary carcinomas had a LI of 25.6 +/- 2.5 (range, 12 to 70) (P hyperplasia in Graves' disease and papillary carcinoma. These results indicate that p27 protein expression is significantly higher in papillary hyperplasia of Graves' disease compared to papillary carcinoma, which may be diagnostically useful in difficult cases.

  10. Change in Practice over Four Decades in the Management of Graves' Disease in Scotland.

    Science.gov (United States)

    Smith, D M; Dutta, S; Ahmed, F; Thaha, M A

    2016-01-01

    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The "Scottish automated follow-up register" (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ (2) test and ANOVA using SPSS v15.0. A p value of Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates.

  11. Treating the thyroid in the presence of Graves' ophthalmopathy

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo; Bonnema, Steen J; Smith, Terry J

    2012-01-01

    The etiology of Graves' orbitopathy (GO) remains enigmatic. Optimal therapeutic choices for the hyperthyroidism associated with Graves' disease (GD) in the presence of GO remain controversial. Whether antithyroid drugs (ATDs), radioiodine (RAI), or thyroidectomy should be favored in such patients...... - independent of extent - do not influence the natural course of GO. RAI can cause de novo development or progression of GO, which is largely preventable with oral steroid prophylaxis. In patients with mild GO, the thyroid treatment is largely independent of GO. Moderate to severe GO should be treated promptly...

  12. Dissociative disorder due to Graves' hyperthyroidism: a case report.

    Science.gov (United States)

    Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

    2014-01-01

    We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. La enfermedad de Graves, signos y síntomas

    OpenAIRE

    Young, P.; Finn, B. C.; Bruetman, J. E.

    2007-01-01

    La enfermedad de Graves es la causa más común de hipertiroidismo, es de patogenia autoinmune. Se distingue clínicamente de otras formas de hipertiroidismo por la presencia de bocio difuso, oftalmopatía y ocasionalmente mixedema pretibial. En este artículo describimos la vida y obra de Robert Graves, realizando posteriormente una revisión de los signos y síntomas de la enfermedad. En el mundo de la medicina actual, en donde la tecnología juega un rol preponderante, queremos recordar la importa...

  14. Grave's Eye disease developing following radioiodine treatment for toxic nodular goitre.

    Science.gov (United States)

    Tahrani, A A; Rangan, S; Moulik, P

    2007-07-01

    The development of Grave's ophthalmopathy (GO) following radioiodine (RI) treatment for Grave's thyrotoxicosis, though controversial, is well described. The development of ophthalmopathy following RI treatment for toxic nodular goitre is much less recognised. We report a 49 year-old female patient who developed thyrotoxicosis and GO after receiving RI treatment for toxic nodular goitre and we also review the relevant literature.

  15. Immunological response in cases of complicated and uncomplicated bartonellosis during pregnancy Respuesta inmunologica en casos de bartonelosis con y sin complicaciones durante el embarazo

    Directory of Open Access Journals (Sweden)

    Erick Huarcaya

    2007-10-01

    Full Text Available Bartonellosis (Carrion's Disease during pregnancy is associated with high rates of maternal and perinatal mortality. We report the immunological patterns in two cases of human bartonellosis during pregnancy. One patient had an uncomplicated course while the second patient developed life threatening anasarca and cardiac tamponade. The patient with a complicated course had a Th1 response with a higher elevation of IL-10. This elevation has been associated with poor outcome pregnancies during bacterial infections.Bartonelosis (Enfermedad de Carrión durante el embarazo esta asociado a una alta tasa de mortalidad maternal y perinatal. Reportamos el perfil inmunológico de dos casos de Bartonelosis humana en el embarazo. Una paciente tuvo un curso sin complicaciones, mientras la segunda presento complicaciones severas de anasarca y tamponamiento cardiaco. La paciente con curso complicado tuvo un patrón de repuesta Th1, con una elevación de IL-10, que se ha asociado a mal pronóstico en infecciones durante embarazo.

  16. Factores causales en las complicaciones de estomas intestinales en cirugía de emergencia. Hospital Luis Vernaza, 2013.

    OpenAIRE

    Morán Mancero, María Cristina

    2014-01-01

    El estoma intestinal es una apertura del intestino en la superficie del abdomen. Las estadísticas según diversos autores indica que hay aproximadamente unas 32.000 personas ostomizadas, de las cuales el 75% presentan una colostomía y el 10% una ileostomía. Objetivo:Determinar los factores causales en las complicaciones tempranas y tardías de los estomas intestinales en la cirugía de emergencia.Metodología:Estudio de tipo Retrospectivo, Observacional, Transversal, de nivel Descriptivo y diseño...

  17. Pooled genome wide association detects association upstream of FCRL3 with Graves' disease.

    Science.gov (United States)

    Khong, Jwu Jin; Burdon, Kathryn P; Lu, Yi; Laurie, Kate; Leonardos, Lefta; Baird, Paul N; Sahebjada, Srujana; Walsh, John P; Gajdatsy, Adam; Ebeling, Peter R; Hamblin, Peter Shane; Wong, Rosemary; Forehan, Simon P; Fourlanos, Spiros; Roberts, Anthony P; Doogue, Matthew; Selva, Dinesh; Montgomery, Grant W; Macgregor, Stuart; Craig, Jamie E

    2016-11-18

    Graves' disease is an autoimmune thyroid disease of complex inheritance. Multiple genetic susceptibility loci are thought to be involved in Graves' disease and it is therefore likely that these can be identified by genome wide association studies. This study aimed to determine if a genome wide association study, using a pooling methodology, could detect genomic loci associated with Graves' disease. Nineteen of the top ranking single nucleotide polymorphisms including HLA-DQA1 and C6orf10, were clustered within the Major Histo-compatibility Complex region on chromosome 6p21, with rs1613056 reaching genome wide significance (p = 5 × 10 -8 ). Technical validation of top ranking non-Major Histo-compatablity complex single nucleotide polymorphisms with individual genotyping in the discovery cohort revealed four single nucleotide polymorphisms with p ≤ 10 -4 . Rs17676303 on chromosome 1q23.1, located upstream of FCRL3, showed evidence of association with Graves' disease across the discovery, replication and combined cohorts. A second single nucleotide polymorphism rs9644119 downstream of DPYSL2 showed some evidence of association supported by finding in the replication cohort that warrants further study. Pooled genome wide association study identified a genetic variant upstream of FCRL3 as a susceptibility locus for Graves' disease in addition to those identified in the Major Histo-compatibility Complex. A second locus downstream of DPYSL2 is potentially a novel genetic variant in Graves' disease that requires further confirmation.

  18. Histological Changes in Autoimmune Hepatitis with Graves' Disease: A Child Case Report.

    Science.gov (United States)

    Yamada, Mamiko; Shibata, Hironori; Masugi, Yohei; Ishi, Tomohiro; Kameyama, Kaori; Ebinuma, Hirotoshi; Hasegawa, Tomonobu

    2017-08-15

    We herein report a child case of autoimmune hepatitis (AIH) accompanied with Graves' disease. Elevated aminotransferase levels were found in a 12-year-old Japanese girl with Graves' disease. In her first liver biopsy, necrosis and inflammation was limited to the centrilobular area, while the second biopsy showed different findings. Namely, portal injury newly appeared, including interface hepatitis, which represents the histological characteristics of AIH. As the histological findings at the onset of AIH do not always show typical findings, a re-biopsy is considered to be important in individuals suspected to have AIH. AIH should be included in the differential diagnosis of liver dysfunction in Graves' disease, even in children.

  19. Incapacidad laboral por diabetes mellitus: características epidemiológicas y complicaciones macro y microangiopáticas más frecuentes

    Directory of Open Access Journals (Sweden)

    Raúl Jesús Regal Ramos

    2014-03-01

    Full Text Available La diabetes mellitus (DM es la enfermedad metabólica más frecuente y conlleva la disminución en la calidad de vida de los sujetos que la padecen, así como la pérdida de años de vida productiva a consecuencia de las complicaciones crónicas o de la mortalidad. Objetivo: Conocer las características epidemiológicas de los pacientes con invalidez permanente (IP debida a DM y conocer cuáles son las complicaciones más frecuentes que motivaron la IP y su relación con las distintas ocupaciones. Método: Se realizó un estudio descriptivo en el que se recogieron pacientes valorados en la Unidad Médica de la Dirección Provincial del INSS de Madrid entre los años 2005 a 2011 con el diagnóstico de diabetes. Se excluyeron aquellos expedientes que no fueron calificados como IP, aquellos que presentaban otras patologías no relacionadas con la diabetes subsidiarias de probable incapacidad (como procesos oncológicos, demencia, esclerosis múltiple,.. y los casos de diabetes secundarias. Se estudian las variables edad, sexo, estado civil, profesión, régimen de afiliación a la Seguridad Social, y las recogidas en el apartado diagnóstico del informe médico de síntesis (tipo de diabetes, complicaciones derivadas de la DM y factores de riesgo cardiovascular. Resultado: El total de pacientes estudiados fue de 896. Respecto a la población general ocupada de nuestro entorno observamos un 31% más de varones (p< 0,0005; Razón de prevalencia =1,56 y un 28% más de ocupaciones del grupo VII de la CNO-11 (industria y construcción (p < 0,005; Razón de prevalencia =2,3. El 48% de las profesiones científicas y el 36 % de las administrativas estaban diagnosticados de oftalmopatía. El 39% de trabajadores de industria y construcción estaban diagnosticados de algún grado de coronariopatía. Conclusión: Nuestros resultados permiten objetivar que la oftalmopatía es la complicación que más se asocia a invalidez permanente en profesiones de alta

  20. Comparison of Bilateral Axillo-Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves' Disease.

    Science.gov (United States)

    Kwon, Hyungju; Yi, Jin Wook; Song, Ra-Yeong; Chai, Young Jun; Kim, Su-jin; Choi, June Young; Lee, Kyu Eun

    2016-03-01

    There is an ongoing debate about whether robotic thyroidectomy (RT) is appropriate for Graves' disease. The aim of this study was to compare the safety of bilateral axillo-breast approach (BABA) RT with that of open thyroidectomy (OT) in patients with Graves' disease. From January 2008 to June 2014, 189 (44 BABA RT and 145 OT) patients underwent total thyroidectomy for Graves' disease. Recurrence of Graves' disease, intraoperative blood loss, hospital stay, and complication rates including recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism were analyzed between BABA RT and OT groups, after propensity score matching according to age, gender, body mass index, surgical indication, the extent of operation, excised thyroid weight, and follow-up period. No patient experienced recurrence of Graves' disease after median follow-up of 35.0 months. Intraoperative blood loss (151.8 ± 165.4 mL vs. 134.5 ± 75.4 mL; p = 0.534) and hospital stay (3.4 ± 0.7 day vs. 3.3 ± 0.7 day; p = 0.564) were not different between BABA RT and OT groups. Complication rates including transient RLN palsy (11.4 vs. 11.4%; p = 1.000), transient hypoparathyroidism (18.2 vs. 20.5%; p = 0.787), permanent RLN palsy (0 vs. 2.3%; p = 0.315), and permanent hypoparathyroidism (2.3 vs. 2.3%; p = 1.000) were also comparable between groups. BABA RT for Graves' disease showed comparable surgical completeness and complications to conventional OT. BABA RT can be recommended as an alternative surgical option for patients with Graves' disease who are concerned about cosmesis.

  1. The clinical experience of interventional embolization in treatment of graves disease

    International Nuclear Information System (INIS)

    Di Zhenhai; Wang Xiaochuan; Liu Longtu; Wang Xiuhua; Wang Zubin

    2002-01-01

    Objective: To evaluate the method and result of thyroid artery embolization as a new therapy for Graves disease. Methods: Ten patients with Graves disease underwent selective thyroid artery embolization. Totally 25 thyroid arteries were embolized with PVA microspheres. The indications to this therapy were as following: Graves disease with recurrent clinical symptoms or with leucopenia during the period of treating with administration of antithyroid drugs or recurrence after subtotal thyroidectomy. Results: Serum level of thyroid hormones dropped significantly [median FT 3 from 20.90 pmol/L (13.36-50.92 pmol/L) to 7.81 pmol/L (3.67-35.3 pmol/L), median FT 4 from 57.9 pmol/L (30.96-57.9 pmol/L) to 28.13 pmol/L (20.44-39.60 pmol/L), (P < 0.005)] and then followed-up for 5-8 months. The symptoms of hyperthyroidism were controlled in 7 patients and the remaining 3 cases were treated with lower dosage of antithyroid drug therapy. None serious complications were found. Conclusions: thyroid artery embolization represents a promising new method for treating Graves disease with safety and good clinical results. Further investigation would be required to assess its long-term effect

  2. Graves' orbitopathy as a rare disease in Europe: a European Group on Graves' Orbitopathy (EUGOGO) position statement

    NARCIS (Netherlands)

    Perros, P.; Hegedüs, L.; Bartalena, L.; Marcocci, C.; Kahaly, G. J.; Baldeschi, L.; Salvi, M.; Lazarus, J. H.; Eckstein, A.; Pitz, S.; Boboridis, K.; Anagnostis, P.; Ayvaz, G.; Boschi, A.; Brix, T. H.; Currò, N.; Konuk, O.; Marinò, M.; Mitchell, A. L.; Stankovic, B.; Törüner, F. B.; von Arx, G.; Zarković, M.; Wiersinga, W. M.

    2017-01-01

    Graves' orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this disease are sparse.

  3. Two adolescent patients with coexistent Graves' disease and Moyamoya disease in Korea.

    Science.gov (United States)

    Cheon, Chong Kun; Kim, Su Yung; Yoo, Jae-Ho

    2014-06-01

    Moyamoya disease is a cerebrovascular condition that results in the narrowing of the vessels of the circle of Willis and collateral vessel formation at the base of the brain. Although relationships between Graves' disease and cerebrovascular accidents in Moyamoya disease are obscure, the coexistence of the two diseases is noteworthy. Moyamoya disease has been rarely reported in adolescent patients with thyrotoxicosis. Recently, we encountered two adolescent Korean patients with Moyamoya disease associated with Graves' disease who presented with episodic right-sided hemiparesis and syncope. These two girls who had Graves' disease had no history of other diseases or head trauma. A thyroid function test revealed a euthyroid state and a high thyroid-stimulating hormone (TSH) receptor antibody titer at that time. The patients were diagnosed with Moyamoya disease based on brain magnetic resonance angiography and cerebral four-vessel angiography. The patients underwent cranial revascularization by encephalo-duroarterio-synangiosis as soon as a diagnosis was made, which resulted in successful symptom resolution. They fared well and had no additional neurological symptoms as of their last follow-up visits. Here, we report these two cases of confirmed Moyamoya disease complicated by Graves' disease with a review of the literature, and discuss the possible association between the two diseases. To our knowledge, this is the first report in South Korea on Moyamoya disease associated with Graves' disease in adolescents with a euthyroid.

  4. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  5. Complicaciones maternas de la cesárea en gestantes a término en periodo expulsivo en un hospital general de Lima, Perú

    Directory of Open Access Journals (Sweden)

    Javier Puma

    2015-01-01

    Full Text Available Objetivo: Describir las complicaciones maternas de la cesárea en gestantes a término en periodo expulsivo en un hospital general. Material y métodos: Estudio descriptivo, observacional, retrospectivo, tipo serie de casos, realizado en el Hospital Nacional Cayetano Heredia entre el 1 de enero de 2011 hasta el 31 diciembre de 2012. Se incluyeron 67 gestantes a término operadas en periodo expulsivo. Se revisaron las historias clínicas de las pacientes, se registraron las características clínicas y las complicaciones maternas. Resultados: En el periodo de estudio se realizaron 4 218 cesáreas, siendo el 1,84% hechas en periodo expulsivo. En general, 59/ 67 (88,1% presentaron algún tipo de complicación. Se observaron 8 casos de hipotonía uterina (11,9% y 2 (2,9% de atonía. En 5 (7,4% pacientes ocurrieron desgarros de segmento adyacente a la histerotomía, siendo 2 de ellos asociados a compromiso de cuerpo uterino y vagina, y 4 (5,9% casos a laceración de arteria uterina, uno fue bilateral. No se produjeron lesiones en tracto urinario ni digestivo y tampoco hubo necesidad de reintervención quirúrgica. Cuatro pacientes presentaron hemorragia puerperal, dos asociados a hipotonía uterina post cesárea. En 56 (83,5% casos ocurrió anemia post operatoria. Hubo 1 (1,5% caso de endometritis, 3 (4,5% infecciones de herida operatoria. Conclusiones: La cesárea realizada en período expulsivo ocasiona complicaciones frecuentes, algunas muy severas.

  6. Fatal and non-fatal adverse events of glucocorticoid therapy for Graves' orbitopathy

    DEFF Research Database (Denmark)

    Marcocci, Claudio; Watt, Torquil; Altea, Maria Antonietta

    2012-01-01

    The objective of this study was to investigate the side effects of glucocorticoid (GC) therapy observed by European thyroidologists during the treatment of Graves' orbitopathy (GO).......The objective of this study was to investigate the side effects of glucocorticoid (GC) therapy observed by European thyroidologists during the treatment of Graves' orbitopathy (GO)....

  7. [Echo-tracking technology for evaluating femoral artery endothelial function in patients with Grave's disease].

    Science.gov (United States)

    Wei, Wei; Wang, Jingyuan; Zhao, Qiaoling; Yang, Jinru

    2012-10-01

    To assess the value of echo-tracking technology in evaluating endothelial function of the femoral artery in patients with Grave's disease. Thirty-four patients with Grave's disease patients and 30 normal adults as controls were recruited in this study. The intima-media thickness (IMT), arterial stiffness (β), pressure strain elastic modulus (Ep), arterial compliance (AC), pulse wave conducting velocity (PWVβ) and augmentation index (AI) parameters were examined using echo-tracking technology for evaluating the right femoral arterial elasticity. Compared with the control subjects, the patients with Grave's disease showed significantly increased β, Ep, and PWVβ and significantly decreased AC (P0.05). In patients with Grave's disease, β and Ep were positively correlated with FT3, FT4, TT3, TT4, and PWVβ was positively correlated with FT3 and FT4. Echo-tracking technology can provide more accurate quantitative evidences for early diagnosis of femoral artery endothelial dysfunction in patients with Grave's disease, but the influence of procedural factors on the measurement accuracy should be considered in the evaluation.

  8. Ecocardiograma e fatores de risco cardiovascular em obesos graves

    OpenAIRE

    Elaine Gonçalves Moreira Rocha, Isaura

    2003-01-01

    Introducão: Alterações em parâmetros hemodinâmicos e na função cardíaca ocorrem na obesidade grave, em associação a outros fatores de risco cardiovascular, como dislipidemia, hipertensão arterial e diabete melito. Material e métodos: Foi descrito o perfil clínico, metabólico, ecocardiográfico e o risco de doença cardiovascular, avaliado através do escore de Framingham, em 32 obesos graves candidatos à gastroplastia, no Hospital das Clínicas da Universidade Federal de Pernambuco, entre jane...

  9. Thyrotropin-producing pituitary adenoma simultaneously existing with Graves' disease: a case report.

    Science.gov (United States)

    Arai, Nobuhiko; Inaba, Makoto; Ichijyo, Takamasa; Kagami, Hiroshi; Mine, Yutaka

    2017-01-06

    Thyrotropin-producing pituitary tumor is relatively rare. In particular, concurrent cases associated with Graves' disease are extremely rare and only nine cases have been reported so far. We describe a case of a thyrotropin-producing pituitary adenoma concomitant with Graves' disease, which was successfully treated. A 40-year-old Japanese woman presented with mild signs of hyperthyroidism. She had positive anti-thyroid-stimulating hormone receptor antibody, anti-thyroglobulin antibody, and anti-thyroid peroxidase antibody. Her levels of serum thyroid-stimulating hormone, which ranged from low to normal in the presence of high levels of serum free thyroid hormones, were considered to be close to a state of syndrome of inappropriate secretion of thyroid-stimulating hormone. Magnetic resonance imaging showed a macropituitary tumor. The coexistence of thyrotropin-producing pituitary adenoma and Graves' disease was suspected. Initial therapy included anti-thyroid medication, which was immediately discontinued due to worsening symptoms. Subsequently, surgical therapy for the pituitary tumor was conducted, and her levels of free thyroid hormones, including the thyroid-stimulating hormone, became normal. On postoperative examination, her anti-thyroid-stimulating hormone receptor antibody levels decreased, and the anti-thyroglobulin antibody became negative. The coexistence of thyrotropin-producing pituitary adenoma and Graves' disease is rarely reported. The diagnosis of this condition is complicated, and the appropriate treatment strategy has not been clearly established. This case suggests that physicians should consider the coexistence of thyrotropin-producing pituitary adenoma with Graves' disease in cases in which thyroid-stimulating hormone values range from low to normal in the presence of thyrotoxicosis, and the surgical treatment of thyrotropin-producing pituitary adenoma could be the first-line therapy in patients with both thyrotropin-producing pituitary adenoma

  10. Como Lo Hago Yo: Mielomeningocele En Bolivia

    Science.gov (United States)

    Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

    2014-01-01

    Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusi

  11. Clinical value of serum TRAb levels determination in diagnosis of Graves's disease

    International Nuclear Information System (INIS)

    Huang Zhaosui; Huang Chunhong; Liu Kaiyuan; Huang Shengli

    2005-01-01

    Objective: To investigate the clinical diagnostic value of serum TRAb levels determination in patients with Graves' disease. Methods: Serum TRAb (with RRA), FT 3 , FT 4 , TSH (with CLIA) levels were measured in 223 patients with Graves' disease both before and 6, 12, 36 months after treatment with antithyroid drugs (ATD) as well as in 50 controls. Results: Positive rate of serum TRAb was 93.3% in patients with Graves' disease before treatment. Six months after ATD therapy the positive rate dropped to 41.3%, being still significantly higher than that in controls (P<0.05). The TRAb positive rate dropped steadily with 12 (18.3% ), 24 (8.9% ) and 36 months (4.9%) of ATD treatment. In the 21 patients who had hyperthyroidism recurred after the course of treatment, TRAb remained positive in 18 of them (80.7%). Conclusion: Persistent positive TRAb despite euthyroid status in patients with Graves' disease after seemingly successful ATD treatment donates persistent immunodysfunction and possible recurrence. It is mandatory to continue ATD treatment until TRAb negative. (authors)

  12. Clinical studies on thyroid CT number in Graves' disease and destructive thyrotoxicosis

    International Nuclear Information System (INIS)

    Kamijo, Keiichi

    1994-01-01

    The purpose of the present study was to investigate CT Hounsfield unit (H.U.) of the thyroid in hyperthyroid and euthyroid Graves' disease and destructive thyrotoxicosis. The mean thyroid CT number in 95 controls was 122±18 H.U.(±SD) and did not change significatly with advancing age. The mean thyroid CT number (±SD) of 85±22 H.U. in 60 patients with hyperthyroid Graves' disease was significantly lower than either in normal controls or 116±22 H.U. in 11 patients with euthyroid Graves' disease. Comparison of thyroid hormones and TSH receptor Ab values of untreated patients with a normal and an abnormally low thyroid CT number showed that serum total and free T 3 were significantly higher in the latter group than the former group. With respect to the effect of methimazol (MMI) on the thyroid CT number, in the untreated 10 patients with a low thyroid CT number, the initial mean CT number was 65±11 H.U. and increased significantly to 76±14 H.U. after treatment with MMI. In contrast, in 6 patients with a normal thyroid CT number prior to therapy, the initial mean thyroid CT number was 102±11 H.U. and fell significantly to 84±16 H.U. after treatment with MMI. The thyroid CT number in destructive thyrotoxicosis is markedly decreased to less than 70 H.U. and the mean values of 57±7 H.U. in 6 patients with silent thyroiditis and of 61±5 H.U. in 7 with subacute thyroiditis differ significantly from Graves' disease. In conclusion, the thyroid CT number is significantly reduced in hyperthyroid Graves' disease, normal in euthyroid Graves' disease and markedly decreased in destructive thyrotoxicosis. The high T-3 value seemed to play an important role in the pathogenesis of a decline in the thyroid CT number in Graves' disease. An antithyroid drug therapy caused two different changes in the thyroid CT number, depending on whether the thyroid CT number prior to therapy was normal or low. (author)

  13. A 27-year-old woman diagnosed as polycystic ovary syndrome associated with Graves' disease.

    Science.gov (United States)

    Jung, Jung Hwa; Hahm, Jong Ryeal; Jung, Tae Sik; Kim, Hee Jin; Kim, Ho Soo; Kim, Sungsu; Kim, Soo Kyoung; Lee, Sang Min; Kim, Deok Ryong; Choi, Won Jun; Seo, Yeong Mi; Chung, Soon Il

    2011-01-01

    Polycystic ovary syndrome (PCOS) and Graves' disease are the common causes of menstrual irregularity leading to infertility in women of child-bearing age. A 21-year-old female patient visited us with complaints of oligomenorrhea and hand tremor. She was diagnosed as having PCOS and hyperthyroid Graves' disease, simultaneously. She had low body weight (BMI: 16.4 kg/m(2)), mild hirsutism, and thyrotoxicosis. The patient was treated with anti-thyroid drug and beta-blocker for about two years, and then recovered to normal thyroid function. Although some studies have suggested a connection between PCOS and autoimmune thyroiditis, no study indicated that PCOS is associated with Graves' disease until now. Here, we describe the first case report of a lean woman with normal insulin sensitivity presenting PCOS and Graves' disease simultaneously.

  14. Doença de Graves associada à artrite idiopática juvenil Graves' disease associated with juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Vanessa de Matos Santos Mendonça Marques

    2011-04-01

    Full Text Available Os autores relatam o caso de uma menina de 10 anos de idade com diagnóstico de doença de Graves (DG, em tratamento com propiltiouracil, que desenvolveu uveíte e artrite poliarticular e cuja mãe também tem DG e lúpus discoide. São discutidos os diagnósticos diferenciais de artrite inflamatória que surge em uma criança com doença tireoidiana autoimune medicada com drogas antitireóideas.The authors report the case of a 10-year-old girl with Graves' disease (GD, treated with propylthiouracil, who developed uveitis and polyarticular arthritis, and whose mother also had GD and discoid lupus. The differential diagnosis of inflammatory arthritis that appears in a child with autoimmune thyroid disease managed with antithyroid drugs is discussed.

  15. Raman spectroscopy of gemstones on the necklaces from ancient graves at the Castle of Devin

    International Nuclear Information System (INIS)

    Gregor, M.; Vanco, L.; Kadlecikova, M.; Breza, J.

    2013-01-01

    The subjects of Raman and X-ray analyses were the beads from two necklaces found in ancient graves from the 11'"t"h and 12"t"h centuries at the Castle of Devin. One of the necklaces, consisting of 23 beads, was found in tomb 12/1980. Inside the grave, an incomplete skeleton of a woman was found, oriented in the west - east direction. The skull, shoulder blades and lower limbs were preserved in good condition. The grave contained a rich inventory: a silver ear-ring at the left side of the skull, a necklace between the shoulder blades and a ring on the right side at the height of the right hand. The other necklace, consisting of six stones, was found in grave 145/1985 in which, similarly like in the first grave, a woman's skeleton was discovered. The stones were found below the mandible. All beads are drilled through axially. (authors)

  16. Generalised pruritus as a presentation of Grave's disease.

    Science.gov (United States)

    Tan, Ce; Loh, Ky

    2013-01-01

    Pruritus is a lesser known symptom of hyperthyroidism, particularly in autoimmune thyroid disorders. This is a case report of a 27-year-old woman who presented with generalised pruritus at a primary care clinic. Incidental findings of tachycardia and a goiter led to the investigations of her thyroid status. The thyroid function test revealed elevated serum free T4 and suppressed thyroid stimulating hormone levels. The anti-thyroid antibodies were positive. She was diagnosed with Graves' disease and treated with carbimazole until her symptoms subsided. Graves' disease should be considered as an underlying cause for patients presenting with pruritus. A thorough history and complete physical examination are crucial in making an accurate diagnosis. Underlying causes must be determined before treating the symptoms.

  17. Clinical studies on thyroid CT number in Graves' disease and destructive thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamijo, Keiichi (Kamijo Thyroid and Pituitary Clinic, Sapporo (Japan))

    1994-02-01

    The purpose of the present study was to investigate CT Hounsfield unit (H.U.) of the thyroid in hyperthyroid and euthyroid Graves' disease and destructive thyrotoxicosis. The mean thyroid CT number in 95 controls was 122[+-]18 H.U.([+-]SD) and did not change significatly with advancing age. The mean thyroid CT number ([+-]SD) of 85[+-]22 H.U. in 60 patients with hyperthyroid Graves' disease was significantly lower than either in normal controls or 116[+-]22 H.U. in 11 patients with euthyroid Graves' disease. Comparison of thyroid hormones and TSH receptor Ab values of untreated patients with a normal and an abnormally low thyroid CT number showed that serum total and free T[sub 3] were significantly higher in the latter group than the former group. With respect to the effect of methimazol (MMI) on the thyroid CT number, in the untreated 10 patients with a low thyroid CT number, the initial mean CT number was 65[+-]11 H.U. and increased significantly to 76[+-]14 H.U. after treatment with MMI. In contrast, in 6 patients with a normal thyroid CT number prior to therapy, the initial mean thyroid CT number was 102[+-]11 H.U. and fell significantly to 84[+-]16 H.U. after treatment with MMI. The thyroid CT number in destructive thyrotoxicosis is markedly decreased to less than 70 H.U. and the mean values of 57[+-]7 H.U. in 6 patients with silent thyroiditis and of 61[+-]5 H.U. in 7 with subacute thyroiditis differ significantly from Graves' disease. In conclusion, the thyroid CT number is significantly reduced in hyperthyroid Graves' disease, normal in euthyroid Graves' disease and markedly decreased in destructive thyrotoxicosis. The high T-3 value seemed to play an important role in the pathogenesis of a decline in the thyroid CT number in Graves' disease. An antithyroid drug therapy caused two different changes in the thyroid CT number, depending on whether the thyroid CT number prior to therapy was normal or low. (author).

  18. A controlled monitoring study of simulated clandestine graves using 3D ground penetrating radar

    CSIR Research Space (South Africa)

    van Schoor, Michael

    2017-06-01

    Full Text Available A controlled three-dimensional ground penetrating radar monitoring study over simulated clandestine graves was conducted near Pretoria, South Africa, in which the detectability of graves as a function of post-burial interval was assessed...

  19. Graves' disease presenting as right heart failure with severe pulmonary hypertension

    OpenAIRE

    Furqan Mohd Akram Khan; Anannya Mukherji; Shekhar T. Nabar; Ashwini G

    2016-01-01

    We report a patient who presented to our institution with clinical features of right sided heart failure and hyperthyroidism. Diagnosis of grave's disease induced reversible severe pulmonary hypertension leading to severe tricuspid regurgitation and right sided heart failure was made after all the common causes were ruled out using the biochemical and radiological investigations and review of literature. Graves disease is a common cause hyperthyroidism, is an immune system disorder that resul...

  20. First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

    Science.gov (United States)

    Chen, Louis C; Green, Jennifer B

    2011-06-01

    Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

  1. The microclimate within a Neolithic passage grave

    DEFF Research Database (Denmark)

    Klenz Larsen, Poul; Aasbjerg Jensen, Lars; Ryhl-Svendsen, Morten

    2017-01-01

    Microclimate measurements in a Neolithic passage grave in Denmark have shown that natural ventilation through the open entrance destabilizes the relative humidity (RH), whereas a sealed entrance gives a much more stable RH, above 90%. Episodes of condensation occur on the stone surfaces in summer...... with too much ventilation and in winter with too little ventilation. Soil moisture measurements above, below, and beside the grave mound indicate that rainfall on the mound is not a significant source of moisture to the chamber, whereas the ground below the sealed chamber is constantly moist. The chamber...... can be kept dry all year by putting a moisture barrier membrane over the floor. Apart from the more variable climate within the open chamber, there is also a significant penetration of ozone, which is absent in the sealed chamber. The ozone may have deteriorated the folds of birch bark put between...

  2. Graves' disease presenting as pseudotumor cerebri: a case report

    Directory of Open Access Journals (Sweden)

    Freitas Cláudia

    2011-02-01

    Full Text Available Abstract Introduction Pseudotumor cerebri is an entity characterized by elevated intracranial pressure with normal cerebrospinal fluid and no structural abnormalities detected on brain MRI scans. Common secondary causes include endocrine pathologies. Hyperthyroidism is very rarely associated and only three case reports have been published so far. Case presentation We report the case of a 31-year-old Luso-African woman with clinical symptoms and laboratory confirmation of Graves' disease that presented as pseudotumor cerebri. Conclusion This is a rare form of presentation of Graves' disease and a rare cause of pseudotumor cerebri. It should be remembered that hyperthyroidism is a potential cause of pseudotumor cerebri.

  3. Severe aplastic anaemia and Grave's disease in a paediatric patient.

    Science.gov (United States)

    Kumar, Manjusha; Goldman, Jeffrey

    2002-07-01

    Severe aplastic anaemia (SAA) is considered to be an autoimmune disorder affecting the haematopoietic cells and most often is idiopathic. An association between SAA and other autoimmune diseases is rare and has been described in adults for eosinophilic fasciitis, thymomas, systemic lupus erythematosus and thyroid disorders. We describe the first paediatric patient with chronic relapsing SAA and Grave's disease. We discuss the difficulty in diagnosis of Grave's disease, the possibility of its manifestation due to withdrawal of immunosuppressants, and issues to consider in the treatment of this disease in the setting of bone marrow failure.

  4. Análisis de costo de la enfermedad, del tratamiento, las complicaciones e intervenciones de la hipercolesterolemia en México en 2016.

    Science.gov (United States)

    Baeza-Cruz, German; Peniche-Otero, Gustavo; Alva-Esqueda, Mónica E; Naranjo-Muedano, Mariana; Soria-Suárez, Noé; Morales-Flores, Héctor J

    2018-04-20

    Describir los costos y el impacto económico de la atención de pacientes diagnosticados con hipercolesterolemia en México en el año 2016. METODOLOGíA: Se desarrolla una evaluación económica del tipo análisis de costo de la enfermedad donde se cuantifican los recursos médicos utilizados para el tratamiento de la hipercolesterolemia así como para sus complicaciones. Los costos de los recursos médicos utilizados son obtenidos de los costos unitarios por nivel de atención del Instituto Mexicano del Seguro Social (IMSS) así como de las licitaciones publicadas en el portal de compras del IMSS. El uso de recursos se obtiene mediante un panel de expertos y para el porcentaje de presencia de las complicaciones se efectúa una revisión de literatura. Los costos médicos directos son estimados multiplicando la frecuencia de uso por el costo unitario, agrupándolos y obteniendo así los costos individuales de cada recurso médico. Los casos de hipercolesterolemia en prevención secundaria con enfermedad coronaria y enfermedad cardiovascular representan un mayor costo promedio anual ($111,835.19, D.E. $84,276.37), seguido de la hipercolesterolemia en prevención secundaria con enfermedad coronaria sin enfermedad cardiovascular ($56,352.13, D.E. $29,004.04), los cuales no incluyen los costos generados por las complicaciones. El resto de los grupos de hipercolesterolemia representan una carga económica menor. La carga económica de la hipercolesterolemia representa en promedio por caso al año $258,761.37, esto traducido a los aproximadamente 445,075 de casos diagnosticados y tratados al año representaría un impacto económico en el sistema de salud de más de ciento quince mil millones ($115,168,331,355.11). Copyright © 2018. Published by Elsevier Inc.

  5. Genotypes in relation to phenotypic appearance and exposure to environmental factors in Graves' hyperthyroidism

    NARCIS (Netherlands)

    Vos, Xander G.; Endert, Erik; Tijssen, Jan G. P.; Wiersinga, Wilmar M.

    2012-01-01

    Background: Genetic polymorphisms and environmental factors are both involved in the pathogenesis of Graves' disease, but their interaction and effect on Graves' phenotypes have scarcely been investigated. Objective: To test the hypothesis that subjects with susceptibility genotypes develop more

  6. Complicaciones en la hemodiálisis y evaluación de la salud de los pacientes renales crónicos

    Directory of Open Access Journals (Sweden)

    Daiana Coitinho

    2015-09-01

    Full Text Available Objetivo: Identificar las complicaciones clínicas y evaluar la percepción de salud general de los pacientes renales crónicos en hemodiálisis. Metodología: Estudio transversal, con enfoque cuantitativo-descriptivo, realizado en 77 pacientes en hemodiálisis en una Unidad Nefrológica del noroeste de Rio Grande do Sul. La recolección de datos se realizó durante los meses de mayo, junio y julio de 2010 con un formulario de características sociodemográficas/clínicas, también denominado Kidney Disease and Quality of Live-Short Form (kdqol-sftm. Los datos se analizaron mediante estadística descriptiva. El proyecto de investigación fue aprobado por el Comité de Ética en el Consejo nº 02780243000-09. Resultados: La mayoría de los pacientes eran varones (70,1%, adultos mayores (45,4%, casados (59,7%. Los eventos que se produjeron con mayor frecuencia durante la hemodiálisis fueron: debilidad, calambres e hipotensión. En cuanto a la evaluación de la salud general en comparación con la de hace un año, el 39% lo calificó como mucho mejor ahora y el 33,8% como un poco mejor ahora. Conclusiones: A pesar de las complicaciones, actualmente los pacientes valoran mejor su salud.

  7. Multiple Fractures in Patient with Graves' Disease Accompanied by Isolated Hypogonadotropic Hypogonadism.

    Science.gov (United States)

    Yi, Hyon-Seung; Kim, Ji Min; Ju, Sang Hyeon; Lee, Younghak; Kim, Hyun Jin; Kim, Koon Soon

    2016-02-01

    Isolated hypogonadotropic hypogonadism (IHH) is known to decrease bone mineral density due to deficiency of sex steroid hormone. Graves' disease is also an important cause of secondary osteoporosis. However, IHH does not preclude the development of primary hyperthyroidism caused by Graves' disease, leading to more severe osteoporosis rapidly. Here, we describe the first case of 35-year-old Asian female patient with IHH accompanied by Graves' disease and osteoporosis-induced multiple fractures. Endocrine laboratory findings revealed preserved anterior pituitary functions except for secretion of gonadotropins and showed primary hyperthyroidism with positive autoantibodies. Sella magnetic resonance imaging showed slightly small sized pituitary gland without mass lesion. Dual energy X-ray absorptiometry revealed severe osteoporosis in lumbar spine and femur neck of the patient. Plain film radiography of the pelvis and shoulder revealed a displaced and nondisplaced fracture, respectively. After surgical fixation with screws for the femoral fracture, the patient was treated with antithyroid medication, calcium, and vitamin D until now and has been recovering fairly well. We report a patient of IHH with Graves' disease and multiple fractures that is a first case in Korea.

  8. Ausentismo y complicaciones de salud en usuarios de programas de hipertensión arterial de Santa Marta (Colombia

    Directory of Open Access Journals (Sweden)

    Brigith Sánchez Serrano

    2017-01-01

    Full Text Available Objetivo:Identificar los factores presentes y las complicaciones de pacientes inscritos en losprogramas de hipertensión arterial de ocho centros ambulatorios de Santa Marta.Metodología:Estudio descriptivo, ambispectivo y multicéntrico; población conformada por24 programas de prevención y control de hipertensión arterial, seleccionados aleatoriamenteocho de ellos (30 %. De los 750 casos de inasistentes se calculó un tamaño muestral de 254,valor elevado a 300 para reducir el error de estimación. La información se recolectó medianteun cuestionario de identificación de condiciones de habilitación de programas, base de datos deinasistentes y aplicación de entrevista semiestructurada.Resultados:El porcentaje de incumplimiento de las condiciones de los programas de hipertensiónfue de (9 %; el récord de ausentismo de pacientes inscritos fue de 35,62 %. Mientras que losprincipales factores que motivaron el ausentismo fueron de orden institucional (32,6 %, personal(26,3 %, socioeconómicos (8.5 %, otras alternativas de tratamiento (9,4 %; las complicacionesmanifestadas sobresalientes se relacionaron con angina de pecho (34,1 %, alteraciones renales(29,2 % e infartos (9.7 %.Conclusiones:A pesar de los esfuerzos que llevan a cabo los organismos de salud para laprevención y el control de la hipertensión, aún es necesario desarrollar nuevas estrategias quereduzca el índice de ausentismo de los pacientes inscritos a dichos programas, y de esa maneracontribuir positivamente en la reducción de las tasas de complicaciones en la salud.

  9. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves' ophthalmopathy the latest addition to an expanding family

    DEFF Research Database (Denmark)

    Nielsen, Claus H; El Fassi, Daniel; Hasselbalch, Hans K

    2007-01-01

    In this review, the authors summarise the clinical results obtained after therapy with rituximab in autoimmune diseases, including Graves' disease and Graves' ophthalmopathy. On the basis of qualitative and quantitative analyses of B- and T-cell subsets, and autoantibody levels obtained in other...... diseases before and after rituximab therapy, the authors interpret the results of the only two clinical investigations of the efficacy of rituximab in the treatment of Graves' disease and Graves' opthalmopathy reported so far. No significant effect on autoantibody levels was observed. Nonetheless, 4 out...... of 10 Graves' disease patients remained in remission 400 days after rituximab treatment versus none in the control group, and remarkable improvements in the eye symptoms of patients with Graves' ophthalmopathy were observed. This supports a role for B cells in the pathogenesis of Graves' ophthalmopathy...

  10. Outcomes analysis of radioactive iodine and total thyroidectomy for pediatric Graves' disease.

    Science.gov (United States)

    Cohen, Reuven Zev; Felner, Eric I; Heiss, Kurt F; Wyly, J Bradley; Muir, Andrew B

    2016-03-01

    The majority of pediatric patients with Graves' disease will ultimately require definitive therapy in the form of radioactive iodine (RAI) ablation or thyroidectomy. There are few studies that directly compare the efficacy and complication rates between RAI and thyroidectomy. We compared the relapse rate as well as the acute and long-term complications of RAI and total thyroidectomy among children and adolescents with Graves' disease treated at our center. Medical records from 81 children and adolescents with a diagnosis of Graves' disease who received definitive therapy over a 12-year period were reviewed. Fifty one patients received RAI and 30 patients underwent thyroidectomy. The relapse rate was not significantly different between RAI and thyroidectomy (12.1% vs. 0.0%, p=0.28). There were no acute or long-term complications in the RAI group, but there were eight cases of hypoparathyroidism (two transient and six permanent) in the thyroidectomy group. None of the patients developed a recurrent laryngeal nerve injury. RAI is a safe and effective option for treatment of children and adolescents with Graves' disease. In light of the rate of permanent hypoparathyroidism seen at our center with thyroidectomy and previously published long-term safety of RAI, we recommend RAI as the first line treatment for children and adolescents with Graves' disease. For those centers performing thyroidectomies, we recommend that each center select 1-2 high-volume pediatric surgeons to perform all thyroid procedures, allowing individuals to increases case volume and potentially decrease long-term complications of thyroidectomy.

  11. Prenatal diagnosis and management of fetal goiter caused by maternal Grave's disease.

    Science.gov (United States)

    Hadi, H A; Strickland, D

    1995-07-01

    We present a case of maternal Grave's disease associated with fetal goitrous hyperthyroidism. Fetal goiter was diagnosed by ultrasound and diagnosis of fetal hyperthyroidism was established by umbilical blood sampling. Fetus was successfully treated by increasing maternal propylthiouracil dosage. Fetal thyroid status was normal at birth. Role of sonography and umbilical blood sampling in management of fetal goiter complicated with maternal Grave's disease is discussed.

  12. Existen ventajas en el abordaje extraperitoneal para el tratamiento del aneurisma de aorta abdominal? Are there advantages in the extraperitoneal approach for the treatment of abdominal aortic aneurysm?

    Directory of Open Access Journals (Sweden)

    Heinz Hiller

    2010-02-01

    Full Text Available Existen controversias acerca de las posibles ventajas del abordaje transperitoneal vs. extraperitoneal en la cirugía de aneurisma de aorta abdominal; con este último, algunos estudios reportan menor morbilidad y complicaciones operatorias. Este estudio describe los resultados que se obtuvieron con los dos abordajes en un solo centro de referencia. Es un estudio retrospectivo, descriptivo, de doce años, en un grupo de 299 pacientes con diagnóstico de aneurisma de aorta abdominal que fueron intervenidos de manera electiva y distribuidos en dos grupos según el abordaje (transperitoneal = grupo 1, extraperitoneal = grupo 2. En total se operaron 93 pacientes en el grupo 1 y 206 pacientes en el 2. En ambos predominaron pacientes del sexo masculino. La edad media fue de 68 años. Las frecuencias de co-morbilidades fueron similares en los dos grupos. Se registró una tendencia a menor número de reoperaciones en el grupo 2 (12,9% vs. 5,8%, De otra parte, se observó una tendencia de mayores complicaciones post-operatorias en el grupo 1 con una frecuencia de 30,1% vs. 12,6% en el grupo 2; sin embargo, el tipo de complicaciones fue similar. Los resultados mostraron una estancia hospitalaria media de 13,3 días (DE ± 10,4 vs. 7,19 días (DE ± 4,20 p= 0,00001, estancia post-operatoria media de 9,16 días (DE ± 8,1 vs. 5,62 días (DE ± 3,46 p= 0,001 y estancia en la unidad de cuidados intensivos media de 2,76 días (DE ± 4,19 vs. 1,56 días (DE ± 1,86 p= 0,00001 en los grupos 1 y 2 respectivamente. La mortalidad inmediata total fue de 3,3%. La frecuencia de mortalidad para los grupos fue de 6,5% (n= 6 vs. 1,9% (n= 4 respectivamente. En nuestra experiencia el abordaje por la vía extraperitoneal presenta una tendencia favorable para los pacientes en cuanto a la estancia hospitalaria, la estancia en la unidad de cuidados intensivos, la frecuencia de complicaciones post-operatorias y la frecuencia de re-intervenciones en el post-operatorio inmediato

  13. The role of radiation therapy in Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Chowdhury, A.D.; Moriaty, M.J. [Saint Luke`s Hospital, Dublin (Ireland)

    1996-11-01

    Graves` ophthalmopathy can occur in 25-30% of patients with hyperthyroidism. This condition can result in serious visual disturbance and disfigurement. The treatment options for symptomatic disease are oral corticosteroids or orbital irradiation. Ten patients with Graves` ophthalmopathy were treated with external beam radiotherapy at Saint Lukes Hospital from March 1991 to February 1994. Eight of these patients had excellent response with minimal morbidity. A dose of 2000 cGy in 10 fractions over 2 weeks is considered to be sufficient to alleviate symptoms in most patients. It is concluded that orbital radiotherapy is effective and well tolerated, and should replace corticosteroid therapy as the initial treatment modality in these patients. A minimum follo-up of 6 months is considered adequate for detecting radiation-induced complications. 7 refs., 1 fig.

  14. [Orbital decompression in Grave's disease: comparison of techniques].

    Science.gov (United States)

    Sellari-Franceschini, S; Berrettini, S; Forli, F; Bartalena, L; Marcocci, C; Tanda, M L; Nardi, M; Lepri, A; Pinchera, A

    1999-12-01

    Grave's ophthalmopathy is an inflammatory, autoimmune disorder often associated with Grave's disease. The inflammatory infiltration involves the retrobulbar fatty tissue and the extrinsic eye muscles, causing proptosis, extraocular muscle dysfunction and often diplopia. Orbital decompression is an effective treatment in such cases, particularly when resistant to drugs and external radiation therapy. This work compares the results of orbital decompression performed by removing: a) the medial and lateral walls (Mourits technique) in 10 patients (19 orbits) and b) the medial and lower walls (Walsh-Ogura technique) in 17 patients (31 orbits). The results show that removing the floor of the orbit enables better reduction of proptosis but more easily leads to post-operative diplopia. Thus it proves necessary to combine the two techniques, modifying the surgical approach on a case-by-case basis.

  15. Case report of recurrent atrial fibrillation induced by thyrotropin-secreting pituitary adenoma with Graves' disease.

    Science.gov (United States)

    Li, Jiaqi; Tan, Huiwen; Huang, Juan; Luo, Dan; Tang, Ying; Yu, Ruichao; Huang, Hui

    2018-06-01

    Thyrotropin-secreting adenoma (TSHoma) is rare. Even though the thyrotoxicosis is mild in patients with TSHoma, it is still a rare cause of arrhythmia, ignore of mild disfunction of thyroid function of TSHoma can lead to the delayed diagnosis of pituitary tumor or leading to recurring of complications. Graves' disease is an auto-immue endocrinological disorder. Association of TSHoma and Graves's disease is extremely rare. Coexistence of these two diseases made the diagnosis and treatment complicated. This patient was a 55-year-old man who had been referred to the department of endocrinology and metabolism of the West China Hospital due to recurrent atrial fibrillation (AF) and thyroxicosis. Examinations revealed pituitary thyrotropin-secreting macroadenoma with Graves' disease. We conducted transsphenoidal surgery. Thyrozol was used to treat the recurrence of Graves' disease after pituitary surgery. The TSHoma was successfully cured, and recurrent Graves' disease was controlled very well. The association of TSHoma and Graves' disease is extremely rare. Even though the clinical features of thyrotoxicosis are milder in patients with TSHoma, thyroid function tests are still important clinical assessment of patients with AF, which is an arrhythmia associated with hyperthyroidism. TSHoma is a rare cause of thyrotoxicosis; however, ignoring of the mild disfunction caused by TSHoma can lead to the delayed diagnosis of pituitary tumors or to recurring of complications of TSHoma.

  16. The role of diffusion weighted MR imaging for differentiation between Graves' disease and Hashimoto thyroiditis.

    Science.gov (United States)

    Ozturk, T; Bozgeyik, Z; Ozturk, F; Burakgazi, G; Akyol, M; Coskun, S; Ozkan, Y; Ogur, E

    2015-08-01

    The aim of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWMRI) for differentation between Graves' disease and Hashimoto's thyroiditis. Fifty patients (27 Graves diseases and 23 Hashimoto thyroiditis) and twenty healthy volunteers were examined using T1, T2 and DWMRI. The patients were diagnosed on the basis of physical findings and the results of thyroid function tests and serological tests. Circular ROIs were positioned on the bilateral thyroid lobes and isthmus. All measurements were repeated three different b values including 100, 600 and 1000 s/mm2 in all cases. ADC (Apparent diffusion coefficient) maps were calculated automatically with the MR system. Mean ADC values were 2.93 × 10-3, 1.97 × 10-3 and 1.62 × 10-3 mm2/s in the healthy volunteers; 3.47 × 10-3, 2.25 × 10-3 and 1.64 × 10-3 mm2/s in Graves' disease; 2.53 × 10-3, 1.76 × 10-3, 1.28 × 10-3 mm2/s in Hashimoto thyroiditis for b100, b600 and b1000, respectively. The ADC values of the Graves diseases were higher than healty volunteers and Hashimoto thyroiditis. ADC values were statistically significant for differentation between Hashimoto thyroiditis and Graves' disease all b values (p Hashimoto thyroiditis and Graves' disease.

  17. Measurements of Actual Effective Half - Life in {sup 131}I Therapy for Graves' Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    So, Yong Seon; Kim, Myung Seon; Kwon, Ki Hyun; Kim, Seok Whan; Kim, Tae Hyung; Han, Sang Woong; Kim, Eun Sil; Kim, Chong Soon [Hanil General Hospital, Seoul (Korea, Republic of)

    1996-03-15

    Radioiodine[131I] has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and read minister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective 131I half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean administered activity and the mean values of absorbed doses wet: 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51 MBq and marked differences of 131I thyroidal uptake between tracer and therapy occurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal 131I uptake measurements after tracer and therapy dose, provides sufficient data about the effective treatment in Graves' hyperthyroidism.

  18. Complicaciones de la Ventilación Mecánica. Unidad de Cuidados Intensivos Pediátricos Holguín

    OpenAIRE

    Carlos Alberto Córdova-Vega; Hèctor Pupo-Rodríguez; Andrés Andrés-Matos

    2013-01-01

    Se realizó un estudio prospectivo, descriptivo en pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Pediátrico de Holguín y que necesitaron ventilación mecánica por un tiempo mayor a las 24 horas, durante el año 2010, con el objetivo de conocer las complicaciones relacionadas con este proceder. Dentro de los resultados encontramos que las afecciones neurológicas (35,29%), las respiratorias y las malformaciones congénitas (17,64%) fueron las principales causas que llevaron ...

  19. Treatment of Graves' disease and the course of ophthalmopathy

    International Nuclear Information System (INIS)

    Sridama, V.; DeGroot, L.J.

    1989-01-01

    Contradictory results have been obtained with regards to the effect of various treatment modes on the exacerbation of Graves' ophthalmopathy, probably because the number of patients in each study was small and some studies were analyzed only in relation to one type of treatment. To circument these problems, we studied the course of Graves' ophthalmopathy after various modes of therapy for thyrotoxicosis among 537 patients with Graves' disease. A total of 537 patients with Graves' disease were prospectively studied over an 11-year period. Thirty-one patients were lost to follow-up during the first six months after treatment and were excluded from the study. Of those remaining, 426 received one form of treatment, 79 received two kinds of therapy, and one received three kinds of therapy. Thus, surgical treatments numbered 164, radioactive iodine-131 ( 13 1I) treatments numbered 241, and medical treatments numbered 182. Ocular signs were considered improved or exacerbated by the following criteria: decrement or increment of the exophthalmos of 2 mm or more, improvement or deterioration of visual acuity, and regression or progression of extraocular muscle involvement causing diplopia. Among patients who did not have infiltrative ophthalmopathy before treatment, there was no difference in the occurrence of posttreatment exophthalmos in the surgically, medically, and 131I-treated patients (7.1%, 6.7%, and 4.9%, respectively). The incidence and the degree of progression of ophthalmopathy in patients who already had exophthalmos before treatment were similar in the medically, surgically, and 131I-treated groups (19.2%, 19.8%, and 22.7%, respectively). Most of the progression occurred in the posttreatment euthyroid stage. The incidence of improvement of ophthalmopathy was also similar 14.1%, 12.6%, and 12.3% in the medically, surgically, and 131I-treated patients

  20. Radioiodine therapy in patients with Graves' disease and the effects of prior carbimazole therapy.

    Science.gov (United States)

    Karyampudi, Arun; Hamide, Abdoul; Halanaik, Dhanapathi; Sahoo, Jaya Prakash; Kamalanathan, Sadishkumar

    2014-09-01

    The use of radioiodine as the first line of treatment in Graves' disease is restricted in India because of its limited availability and an unrealistic risk perception associated with it. Additionally, the effectiveness of radioiodine ablation in Graves' disease is influenced by many factors. Prior medical antithyroid therapy is one such important factor. To analyze the efficacy of low dose radioiodine therapy (5 mCi) in treatment of naive patients of Graves' disease in comparison to that in which it was already primed with an antithyroid drug, carbimazole. A non-randomized, interventional study conducted in the Department of Medicine and Endocrinology of a tertiary care institute in South India. The study had two groups; Group A (36 treatment naive, uncomplicated Graves' disease patients) and B (34 Graves' disease patients on carbimazole prior to radioiodine therapy). Both groups had baseline clinical, biochemical evaluation and were reassessed at 3 and 6 months for evaluating the clinical status for possible documentation of cure. The cure rate was 61.1% in drug naive group and 58.8% in pretreated group at 6 months following radioiodine (P = 0.845). Higher baseline 999m technicium (99m Tc) uptake, male gender, BMI and higher baseline free thyroxine (fT4) level predicted treatment failure following radioiodine therapy. Administration of carbimazole prior to low dose radioiodine therapy does not alter the efficacy of radioiodine. Low fixed dose (5 mCi) of radioactive iodine may be a safe and effective primary therapeutic option in Graves' disease patients pretreated with antithyroid drugs.

  1. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    Science.gov (United States)

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie

    2016-09-01

    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  2. Graves' disease in children: long-term outcomes of medical therapy.

    Science.gov (United States)

    Rabon, Shona; Burton, Amy M; White, Perrin C

    2016-10-01

    Management options are limited for the treatment of Graves' disease, and there is controversy regarding optimal treatment. We describe the demographic and biochemical characteristics of children with Graves' disease and the outcomes of its management. This is a retrospective study reviewing medical records from 2001 to 2011 at a tertiary-care paediatric hospital. Diagnostic criteria included elevated free T4 and total T3, suppressed TSH, and either positive thyroid-stimulating immunoglobulin or thyroid receptor antibodies or clinical signs suggestive of Graves' disease, for example exophthalmos. Patients were treated with antithyroid drugs (ATD), radioactive iodine, or thyroidectomy. The main outcome measures were remission after medical therapy for at least 6 months and subsequent relapse. A total of 291 children met diagnostic criteria. A total of 62 were male (21%); 117 (40%) were Hispanic, 90 (31%) Caucasian, and 59 (20%) African American. Mean age (±standard deviation) at diagnosis was 12·3 ± 3·8 (range 3-18·5) years. At diagnosis, 268 patients were started on an antithyroid drug and 23 underwent thyroid ablation or thyroidectomy. Fifty-seven (21%) children achieved remission and 16 (28%) of these patients relapsed, almost all within 16 months. Gender and ethnicity did not affect rates of remission or relapse. Of 251 patients treated with methimazole, 53 (21%) had an adverse reaction, including rash, arthralgias, elevated transaminases, or neutropenia. Most children with Graves' disease treated with ATD do not experience remission, but most remissions do not end in relapse. Adverse reactions to methimazole are common but generally mild. © 2016 John Wiley & Sons Ltd.

  3. Rectus extraocular muscle paths and decompression surgery for Graves orbitopathy: mechanism of motility disturbances

    NARCIS (Netherlands)

    Abràmoff, Michael D.; Kalmann, Rachel; de Graaf, Mieke E. L.; Stilma, Jan S.; Mourits, Maarten P.

    2002-01-01

    PURPOSE: To study possible causes of motility disturbances that may result from orbital decompression surgery in patients with Graves orbitopathy and especially the role of rectus extraocular muscle paths. METHODS: Sixteen patients with Graves orbitopathy were studied before and 3 to 6 months after

  4. Remission of aplastic anemia induced by treatment for Graves disease in a pediatric patient.

    Science.gov (United States)

    Das, Prabodh Kumar; Wherrett, Diane; Dror, Yigal

    2007-08-01

    Aplastic anemia (AA) is mediated by T-cell autoimmunity in the majority of cases; it is rare and mostly idiopathic in children. We describe a child, who developed AA following Graves' disease which could not be attributed to antithyroid drugs. We hypothesized that both diseases were caused by similar autoimmune process. We monitored the blood counts and did not administer any conventional treatment for AA assuming that the existing anti- hematopoietic stem cell humoral and cellular immunity might subside with induction of remission of Grave's disease. The child went into complete remission with the treatment of the Graves' disease.

  5. Effects of radioiodine on thyrotrophin binding inhibiting immunoglobulins in Graves' disease

    International Nuclear Information System (INIS)

    McGregor, A.M.; Petersen, M.M.; Capiferri, R.; Evered, D.C.; Rees Smith, B.; Hall, R.

    1979-01-01

    The effects of 131 I therapy on thyrotrophin binding inhibiting immunoglobulins (TBII) were studied in fifty-five patients with Graves' disease and five patients with toxic multinodular goitre (MNG). A group of forty patients with Graves' disease and four patients with toxic MNG were treated with drugs and acted as controls. In 78% of patients treated with 131 I there was a dramatic increase in serum TBII activity during the 3 months following therapy, whereas drug-treated patients showed a decrease (77%) or no change in TBII activity over the same period. TBII activity was not detectable in patients with toxic MNG before or after drug or 131 I therapy. Consideration of the mechanisms involved in the changes in serum TBII activity after 131 I treatment or during drug treatment provide insight into the basic defects responsible for the development of Graves' disease and suggest that both the thyroid and immune system are involved. (author)

  6. Thyroxine, shape, and weight: interaction of Graves' disease and bulimia nervosa.

    Science.gov (United States)

    Teufel, Martin; Giel, Katrin Elisabeth; Lehr, Jule; Becker, Sandra; Muthig, Michaela; Zipfel, Stephan; Kuprion, Jürgen

    2013-03-01

    A case of a 25-year-old woman with bulimia nervosa and Graves' disease is presented. Graves' disease is the cause of 50-80 % of hyperthyroidism. The disease is characterized by increases of thyroid hormone production, activation of the metabolism, and successive weight loss. Bulimia nervosa is characterized by purging behavior after binge eating episodes. We report a patient suffering from both entities. A pronounced non-compliance to the intake of antithyroid drugs (Carbimazole) correlated with eating disorder symptoms like negative evaluation of the body and fear of weight gain. Thus, elevated hyperthyroidism due to Graves' disease served as a purging method. During 8 weeks of inpatient psychotherapy, the patient adapted to a structured eating behavior. Self-esteem was less influenced by body shape and body weight, and compliance to endocrinological recommendations improved. Non-compliance to antithyroid drugs may be a symptom of an eating disorder. A careful and primarily non-confronting interdisciplinary diagnostic and treatment approach is required.

  7. Tratamento cirúrgico da laringomalácia grave: estudo retrospectivo de 11 casos

    Directory of Open Access Journals (Sweden)

    José Antonio Pinto

    2013-10-01

    Full Text Available A laringomalácia é a anomalia congênita da laringe mais frequente, sendo responsável por cerca de 60% a 75% dos casos de estridor congênito. Apesar de seu curso benigno e autolimitado, 10% dos casos necessitam de intervenção. Atualmente, as supraglotoplastias são consideradas o tratamento padrão da laringomalácia grave. OBJETIVO: Descrever a experiência adquirida pelos autores no tratamento cirúrgico dos pacientes com laringomalácia grave. Metodologia: Estudo retrospectivo. MÉTODO: Os prontuários de 11 casos consecutivos de laringomalácia grave, submetidos ao tratamento cirúrgico entre 2003 e 2012, foram analisados quanto à idade, gênero, sintomas, doenças associadas, técnica cirúrgica adotada, tempo de extubação, complicações cirúrgicas, tempo de internação e evolução clínica. RESULTADOS: Dos 11 casos de laringomalácia grave, seis pacientes (54,5% foram operados com o uso do laser de CO2 e em cinco pacientes (45,5% foram realizadas a técnica a frio. Apenas um paciente (9,1% necessitou reabordagem cirúrgica. Não foram observados casos de complicações cirúrgicas. Todos os pacientes apresentaram melhora clínica importante. CONCLUSÃO: A supraglotoplastia mostrou-se um procedimento eficaz e seguro no tratamento da laringomalácia grave.

  8. Las adicciones en México: una visión terapéutica de sus mitos y metas

    OpenAIRE

    Souza y Machorro, Mario

    2014-01-01

    Resumen Las adicciones producen cuadros clínicos diversos causantes de graves complicaciones de salud, legales y socioeconómicas. No obstante, muchas permanecen sin diagnosticar. La pobre respuesta terapéutica mundial deriva de la naturaleza heterogénea del problema, gravedad, comorbilidad, motivación, duración del tratamiento, estados emocionales afectivos, rasgos de personalidad, habilidades para la adaptación, impulsividad, etc. La oferta comunitaria de servicios debe considerar la histori...

  9. Treatment of Grave's hyperthyroidism-prognostic factors for outcome

    International Nuclear Information System (INIS)

    Alfadda, A.; Malabu, Usman H.; El-Desouki, Mahmoud I.; Al-Rubeaan, Khalid A.; Al-Ruhaily, Atallah D.; Fouda, Mona A.; Al-Maatouq, Mohamed A.; Sulimani, Riad A.

    2007-01-01

    To determine clinical and biochemical features of Grave's disease at presentation predict response to medical and radioiodine treatment. We carried out a retrospective 10-year study of 194 consecutive Saudi subjects with Grave's disease who was treated with antithyroid drugs, radioiodine therapy, or both, between January 1995 and December 2004 at King Khalid University Hospital, Riyadh, Saudi Arabia. At diagnosis, the mean age was 32+-0.9 years. Only 26% of patients had successful outcome after a course of antithyroid medication. None of the clinical or biochemical factors were associated with a favorable outcome of antithyroid treatment. One dose of radioiodine [13-15 mCi (481-555 MBq)] cured hyperthyroidism in 83% of patients. Presence of ophthamopathy at presentation was shown to be a significant contributing factor to failure to respond to a single dose of radioiodine (odds ratio, 6.4; 95%CI, 1.51-24.4; p<0.01). Failure of radioiodine treatment was also associated with higher serum free T3 concentration at presentation (p=0.003). In patients with Grave's hyperthyroidism, radioiodine treatment is associated with higher success rate than antithyroid drugs. A dose of 13-15 mCi (481-555 MBq) seems to practical and effective, and should be considered as first line therapy. Patients with high free T3 concentration and, those with ophthalmopathy at presentation were more likely to fail radioiodine treatment. A higher dose of radioiodine may be advisable in such patients. (author)

  10. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    OpenAIRE

    Singh, S.K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I.

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms.

  11. Preeclampsia grave: características y consecuencias

    Directory of Open Access Journals (Sweden)

    Arturo Pérez de Villa Amil Álvarez

    2015-07-01

    Full Text Available Fundamento: la preeclampsia es un trastorno hipertensivo del embarazo y es una de las principales causas de morbimortalidad perinatal y materna. Objetivo: identificar los factores maternos, terapéuticos, y daños asociados a la preeclampsia grave en gestantes. Método: estudio de serie de casos, que incluyó 69 pacientes diagnosticadas con preeclampsia grave en el período del 1ro de enero de 2012 al 31 de diciembre de 2013, atendidas en el Hospital General Universitario Dr. Gustavo Aldereguía Lima. Se clasificaron en dos grupos correspondiendo ambos a los criterios de preeclampsia grave con y sin asociación de factores agravantes. Se evaluaron variables relacionadas a: características maternas, características de atención médica, características neonatales y fetales. Se aplicó un formulario confeccionado según los datos obtenidos de las historias clínicas, acorde a la Clasificación Internacional de Enfermedades Décima Revisión. Las comparaciones entre grupos se efectuaron por el estadístico X2 aceptándose como significativo una p<0,05. Resultados: la frecuencia de preeclampsia grave fue de 0,8x100 partos. La mayor frecuencia correspondió al rango de edad de 31-35 años. La eclampsia se observó en 0,91x1000 partos. El daño materno ascendió a 30,4 %. El sulfato de magnesio se utilizó como profilaxis en el 89 % de los casos. La frecuencia de eclampsia en las que no se usó fue del 50 %, mientras que en las que se usó fue de solo 6,4 %. La cesárea se realizó en el 85,5 % de las pacientes. El daño neonatal se asoció al 52,3 %. La mortalidad fetal tardía fue de 4,6x100 nacimientos. En las diferencias intergrupos se observaron divergencias significativas respecto al daño neonatal. Conclusión: es evidente la alta asociación de restricción del crecimiento intrauterino con la prematuridad inducida, alto índice de cesárea primitiva y el elevado daño materno, neonatal y fetal. El uso del sulfato de magnesio impresiona con

  12. Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease.

    Science.gov (United States)

    Bunevicius, Robertas; Velickiene, Dzilda; Prange, Arthur J

    2005-01-01

    To evaluate the prevalence of mood and anxiety disorders in women with treated hyperthyroidism caused by Graves' disease and to compare them with the prevalence of such findings in women without past or present thyroid disease. Thirty inpatient women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease and 45 women hospitalized for treatment of gynecologic disorders such as abnormal vaginal bleeding, benign tumors or infertility were evaluated for the prevalence of mood and anxiety diagnoses using a standard Mini-International Neuropsychiatric Interview and for mood and anxiety ratings using the Profile of Mood States (POMS). At the time of assessment, it was discovered that 14 of 30 women with treated hyperthyroidism caused by Graves' disease were still hyperthyroid, while 16 women were euthyroid. Significantly greater prevalence of social anxiety disorder, generalized anxiety disorder, major depression and total mood and anxiety disorders, as well as higher symptom scores on the POMS, was found in hyperthyroid women with Graves' disease in comparison with the control group. A prevalence of total anxiety disorder, as well as history of mania or hypomania and lifetime bipolar disorder, but not lifetime unipolar depression, was more frequent in both the euthyroid and the hyperthyroid subgroups of study women in comparison with the control group. These results confirm a high prevalence of mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease. Hyperthyroidism plays a major role in psychiatric morbidity in Graves' disease.

  13. Analysis of adverse reactions and complications of Graves' disease after thyroid arteries embolization

    International Nuclear Information System (INIS)

    Zhuang Wenquan; Chen Wei; Yang Jianyong; Xiao Haipeng; Huang Yonghui; Li Jiaping; Guo Wenbo

    2003-01-01

    Objective: To retrospectively analyse the adverse reactions and complications of Graves' disease after thyroid arteries embolization. Methods: 41 patients of Graves' disease underwent interventional embolization have been analysed with its adverse reactions and complications. Polyvinyl alcohol or bletilla microspheres and micro-coils were used in these patients. Results: Laryngopharyngeal and neck pain occurred in all patients. T 3 and T 4 increased in 3 days to one week after the procedure. Thirty of them showed fever. Dystopia embolism happened in two cases with one of transitory hypoparathyroidism. No hypothyroidism or hypoparathyroidism or hoarseness occur during long term follow up. Conclusions: The adverse reactions and complications of Graves disease after thyroid arteries embolization may occur. Some of them are preventable and curable

  14. Secondary Pulmonary Hypertension and Right-Sided Heart Failure at Presentation in Grave's Disease.

    Science.gov (United States)

    Ganeshpure, Swapnil Panjabrao; Vaidya, Gaurang Nandkishor; Gattani, Vipul

    2012-01-01

    A young female presented with evidence of right-sided heart failure and was subsequently found to have significant pulmonary artery hypertension (PAH). Because of her normal left ventricular function and pulmonary capillary wedge pressure, the most probable site of etiology seemed to be the pulmonary vasculature. All the common possible secondary causes of PAH were ruled out, but during the investigations, she was found to have elevated thyroid function tests compatible with the diagnosis of Grave's disease. The treatment of Grave's disease, initially by medications and subsequently by radioiodine therapy, was associated with a significant reduction in the pulmonary artery systolic pressure. The purpose of this case report is to highlight one of the unusual and underdiagnosed presentations of Grave's disease.

  15. The mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization

    International Nuclear Information System (INIS)

    Li Weiduo; Yang Jianyong; Zhuang Wenquan; Chen Wei; Li Heping

    2002-01-01

    Objective: To explore the mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization. Methods: Twenty-five patients of Graves' disease treated with interventional embolization were followed up for 24-57 months. T 3 and T 4 were monitored at pre-operation, six months, 12 months, 2, 3 and 4 years after operation, respectively. Other references included pulse, thyroid size, and vessel's murmur. Results: Twenty-two patients completely relieved from the hyperthyroidism during the follow-up. Only one patient suffered from recurrence. Other two patients were still on maintaining dosage of antithyroid drug therapy. No hypothyroidism or hypoparathyroidism was found during this term. Conclusion: Mid-to-long term follow-up showed satisfactory efficacy of interventional therapy, offering another alternative for treatment of refractory Graves' disease

  16. 139. Complicaciones Neurológicas Mayores en Octogenarios Tras Cirugía Cardíaca: ¿Es la Edad un Factor Limitante?

    Directory of Open Access Journals (Sweden)

    G. Laguna

    2012-04-01

    Conclusiones: la incidencia de complicación neurológica mayor no es significativamente superior en nuestra población de octogenarios. Mientras en menores de 80 años la existencia de enfermedad vascular es el principal factor determinante, la inadecuada oxigenación cerebral, derivada de situaciones de anemia preoperatoria, parece influir más en la presencia de complicaciones neurológicas en los mayores de 80 años.

  17. Introduction to Special Issue "War Graves / Die Bauaufgabe Soldatenfriedhof, 1914-1989"

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    Fuhrmeister, Christian

    2017-07-01

    Full Text Available Commemoration of the dead is intricately linked to the history of civilization itself. Consequently, art history (understood in a broad sense, encompassing architectural history, social history of art, aesthetics, political iconography, etc. is characterized by a long tradition of paying minute attention to Christian and profane iconography of chapels, epitaphs, and death dances; and to memorials, tombs, and other manifestations, particularly with regard to the Middle Ages and Early Modern Times. Twentieth century war graves, war cemeteries, memorial shrines, and burial sites of the fallen, however, have received only little attention. This assessment was the starting point of our joint endeavor: If the history of conflicts and wars, and the history of war death in particular, is such a major topic for the humanities at large, and especially for contemporary and cultural history, memory studies, etc., then the question arises to what degree art history can contribute to that ongoing discourse. Sketching a Potentially Global Field of Research Table of Contents Acknowledgements Sources and Materials Basic Research on War Graves and War Cemeteries in The Political Archive of the Federal Foreign Office in Berlin / Kriegsgräber im Politischen Archiv des Auswärtigen Amtes in Berlin The Archive of the German War Graves Commission in Kassel / Das Archiv des Volksbundes Deutsche Kriegsgräberfürsorge e. V. in Kassel War Graves, War Cemeteries, and Memorial Shrines since 1914: A Selected Bibliography Selected Printed Source Material

  18. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    Science.gov (United States)

    Singh, S.K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I.

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms. PMID:21927380

  19. Cuidados de enfermería en las principales complicaciones de las quemaduras 2012-2013

    OpenAIRE

    Tapia Arroyo, Lucía

    2013-01-01

    Las quemaduras representan una de las patologías más frecuentes, graves e incapacitantes, siendo los accidentes domésticos, de tráfico y laborales sus principales causas. Las quemaduras están influidas por la interacción de los factores biológicos, psicológicos, sociales, económicos, políticos, culturales, éticos, legales, históricos, religiosos y espirituales

  20. Caracterización de pacientes con paludismo grave por Plasmodium falciparum en una unidad de cuidados intensivos

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    Alberto García Gómez

    2017-12-01

    Full Text Available Introducción: el paludismo es la enfermedad parasitaria más importante del ser humano, causa anualmente entre uno y tres millones de muertes. Objetivos: caracterizar a los pacientes con paludismo grave por Plasmodium falciparum ingresados en una unidad de cuidados intensivos. Métodos: se realizó un estudio observacional, descriptivo en una Unidad de Cuidados Intensivos en Angola, de julio de 2014 hasta julio de 2016. La serie quedó constituida por 485 pacientes. Resultados: la serie representó el 99,6 % de los ingresos. La edad media fue de 23,4 ± 11,2 años. Predominaron el sexo masculino (66,4 % y los grupos de edades de 30 años o menos (83,6 %. La proporción del sexo masculino/femenino fue de 1,97:1. La mortalidad fue de 43,1 %. El sexo femenino tuvo mayor proporción de fallecidos (61 %. Fue más alto el por ciento de fallecidos en los que presentaron parasitemia >= 50000 x mm3. La media del valor del Acute Physiology, Age, Chronic Health Evaluation II fue de 14,8 ± 5,4; en los fallecidos fue superior que en los vivos (17,6 vs 12,3. Las complicaciones más frecuentes fueron de tipo neurológicas (90,1 %, hematológicas (77 %, respiratorias (61,8 %, hepáticas (58,7 %, y renales (40,3 %. El 51,6 % de los pacientes recibieron ventilación mecánica. Conclusiones: los jóvenes representaron la mayor parte de los ingresos por malaria en la unidad de cuidados intensivos, un porcentaje alto requirió ventilación mecánica, la mortalidad en las mujeres fue mayor y la global elevada.

  1. Facts and fallacies about radioactive iodine therapy for Graves' disease

    International Nuclear Information System (INIS)

    Miller, J.L.

    1982-01-01

    The therapeutic options available in the hyerthyroidism of Graves' disease are two basic treatments. Firstly antithyroid drugs and secondly one can 'ablate' the thyroid gland by means of thyroidectomy or radioactive iodine ( 131 I). At present 131 I is the current treatment of chioce for Graves' disease. In a follow-up study of 21 714 patients who were treated with 131 I and observed for a period of 8 years, there was no increase in the incidence of thyriod carcinoma. A possible explanation for this is that the dose of 131 I used destroys the ability of the thyroid cells to replicate and thus transmit genetically damaged material

  2. Circulating microRNA-1a is a biomarker of Graves' disease patients with atrial fibrillation.

    Science.gov (United States)

    Wang, Fang; Zhang, Sheng-Jie; Yao, Xuan; Tian, Dong-Mei; Zhang, Ke-Qin; She, Dun-Min; Guo, Fei-Fan; Zhai, Qi-Wei; Ying, Hao; Xue, Ying

    2017-07-01

    It has been increasingly suggested that specific microRNAs expression profiles in the circulation and atrial tissue are associated with the susceptibility to atrial fibrillation. Nonetheless, the role of circulating microRNAs in Graves' disease patients with atrial fibrillation has not yet been well described. The objective of the study was to identify the role of circulating microRNAs as specific biomarkers for the diagnosis of Graves' disease with atrial fibrillation. The expression profiles of eight serum microRNAs, which are found to be critical in the pathogenesis of atrial fibrillation, were determined in patients with Graves' disease with or without atrial fibrillation. MicroRNA expression analysis was performed by real-time PCR in normal control subjects (NC; n = 17), patients with Graves' disease without atrial fibrillation (GD; n = 29), patients with Graves' disease with atrial fibrillation (GD + AF; n = 14), and euthyroid patients with atrial fibrillation (AF; n = 22). Three of the eight serum microRNAs,i.e., miR-1a, miR-26a, and miR-133, had significantly different expression profiles among the four groups. Spearman's correlation analysis showed that the relative expression level of miR-1a was positively correlated with free triiodothyronine (FT3) and free thyroxine (FT4), and negatively related to thyroid stimulating hormone. Spearman's correlations analysis also revealed that the level of miR-1a was negatively correlated with a critical echocardiographic parameter (left atrial diameter), which was dramatically increased in GD + AF group compared to GD group. Furthermore, the receiver-operating characteristic curve analysis indicated that, among the eight microRNAs, miR-1a had the largest area under the receiver-operating characteristic curves not only for discriminating between individuals with and without Graves' disease, but also for predicting the presence of atrial fibrillation in patients with Graves' disease. Our findings

  3. Evolución clínico-radiológica de la neumonía grave adquirida en la comunidad

    Directory of Open Access Journals (Sweden)

    Juana María Rodríguez Cutting

    Full Text Available Introducción: la neumonía es una de las causas más importantes de mortalidad entre la población menor de 5 años en los países en desarrollo. Objetivo: analizar la expresión clínico-radiológica y la evolución de los pacientes en un quinquenio. Métodos: se realizó un trabajo prospectivo descriptivo de corte transversal, con los pacientes que ingresaron con neumonía grave adquirida en la comunidad en el Servicio de Enfermedades Respiratorias, en un quinquenio (2003-2007, que fueron seguidos por consulta externa al egreso, hasta su alta médica. Se practicó un análisis de las variables clínico-radiológicas. Se procesaron los datos utilizando la prueba de chi cuadrado. Resultados: de los 217 pacientes analizados, 149 (68,6 % tenían de 1 a 4 años, y el 53 % era del sexo masculino. La fiebre, la polipnea y el tiraje estuvo presente en todos los pacientes. Las complicaciones más frecuentes fueron: el derrame pleural y el absceso pulmonar en 60,7 y 27,6 % respectivamente. El pulmón derecho resultó el más afectado, pero el que más se complicó fue el izquierdo. Conclusiones: todos los pacientes tuvieron una evolución favorable, a pesar de que más de la mitad se complicaron. Se encontró que los pacientes con afectación en un solo pulmón, tienen más posibilidades de complicarse que cuando la afectación es bilateral.

  4. Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

    NARCIS (Netherlands)

    Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB

    2000-01-01

    Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with

  5. Síndrome del Outlet Torácico: ¿Una Patología Siempre Quirúrgica? Análisis de una Serie de 31 Cirugías Realizadas por Vía Supraclavicular Serie clínica

    Science.gov (United States)

    Socolovsky, Mariano; Di Masi, Gilda; Binaghi, Daniela; Campero, Álvaro; Páez, Miguel Domínguez; Dubrovsky, Alberto

    2014-01-01

    Introducción: El síndrome de outlet torácico es una compresión del plexo braquial que suscita polémica. Se clasifica en Outlet Torácico Verdadero o neurogénico (OTV) y Outlet Torácico Disputado o no neurogénico (OTD). El primero presenta síntomas motores en la mano, mientras que el segundo sólo síntomas sensitivos en el miembro superior. El objetivo de este trabajo es analizar los resultados obtenidos en una serie de 31 cirugías. Métodos: Se analizaron las cirugías de nervios efectuadas entre 2003-2012, tomando los diagnósticos de outlet torácico cuyo período de seguimiento post-operatorio mínimo fuera de 6 meses. Se buscaron los siguientes datos: edad, sexo, presencia de síntomas sensitivos y/o motores, clasificación, resultado de los estudios neurofisiológicos y de imágenes, resultado de la cirugía, complicaciones post-operatorias y recidivas. Resultados: Se incluyeron 31 cirugías realizadas en 30 pacientes, 9 OTV (8 mujeres) de 24.3 años, y 21 con OTD (18 mujeres) de 37.4 años de edad en promedio. Un 90% presentaron alteraciones neurofisiológicas preoperatorias, y 66,6% imagenológicas. En el intraoperatorio, el 100% de los OTV presentó una alteración anatómica relacionada con la sintomatología, hecho observado sólo en el 36.7% de los OTD operados. El 87,5% de los OTV mejoraron sensitivamente, mientras que 77,7% mejoraron la atrofia. Por el contrario, 45.4% de los OTD mejoraron permanentemente, 36.3% no tuvieron cambios, 13.6% mejoraron transitoriamente y 4.5% (un caso) empeoró. Las complicaciones post-operatorias fueron más frecuentes aunque transitorias en el grupo de OTV (3 casos sobre 9 operados, 33.3%) que en los OTD (3 casos sobre 22, un 13.6%). Conclusión: El OTV suele mayormente mejorar luego de la cirugía, igual que el OTD aunque en una proporción mucho menor. Estos hallazgos coinciden con otros reportes recientes de esta patología. PMID:25165614

  6. Preoperative management in patients with Graves' disease.

    Science.gov (United States)

    Piantanida, Eliana

    2017-10-01

    Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones). Graves' disease is treated with any of three effective and relatively safe initial treatment options: antithyroid drugs (ATDs), radioactive iodine ablation (RAIU), and surgery. Total thyroidectomy is favored in several clinical situations, such as intolerance, ineffectiveness or recurrence after ATD treatment, radioiodine therapy contraindicated, documented or suspected thyroid malignancy, one or more large thyroid nodules, coexisting moderate-to-severe active Graves' orbitopathy, women planning a pregnancy within 6 months. Whenever surgery is selected as treatment, selection of an expert high-volume thyroid surgeons is fundamental and careful preoperative management is essential to optimize surgical outcomes. Pretreatment with ATDs in order to promptly achieve the euthyroid state is recommended to avoid the risk of precipitating thyroid storm during surgery. For the majority of patients, euthyroidism is achieved after few weeks of ATD treatment. Beta-blockers, such as propranolol, are often added effectively to control hyperthyroid symptoms. Saturated solution of potassium iodide (SSKI) or potassium iodine (Lugol's solution), given for a short period prior to surgery, in order to reduce both thyroid hormone release and thyroid gland

  7. Reacciones adversas graves y mortales a los antimicrobianos. Sistema Cubano de Farmacovigilancia, 2003-2012

    Directory of Open Access Journals (Sweden)

    Ismary Alfonso Orta

    Full Text Available Introducción: las reacciones adversas a los antimicrobianos ocasionan más de 142 000 visitas a las salas de urgencias hospitalarias por año en los Estados Unidos. En Cuba han ocupado el primer lugar en el reporte, por ejemplo, en el año 2008 representaron el 31,4 % del total de las reacciones adversas graves y el 25 % de las reacciones adversas mortales. Objetivo: caracterizar las reacciones adversas graves y mortales a los antimicrobianos notificadas a la Unidad Nacional Coordinadora de Farmacovigilancia, durante el periodo 2003-2012. Métodos: se realizó un estudio de farmacovigilancia, observacional, descriptivo y transversal, utilizando la base de datos nacional de farmacovigilancia durante el periodo 2003-2012. Se trabajó con el total de reportes de reacciones adversas graves y mortales a los antimicrobianos. Las reacciones adversas se clasificaron según tipo de reacción, sistema de órgano afectado, imputabilidad y frecuencia. Se identificaron los principales antimicrobianos sospechosos y se estudiaron los pacientes que presentaron reacciones adversas según sexo y edad. Resultados: se detectaron 631 sospechas de reacciones adversas graves y mortales a los antimicrobianos, de ellas fueron 550 graves y 81 mortales. Predominaron el sexo femenino con 60,1 % y 405 adultos. Las reacciones adversas comprometieron los sistemas: general (30,4 %, respiratorio (25,2 % y cardiovascular (14,9 %. El shock anafiláctico fue la reacción más reportada y la penicilina el fármaco más relacionado con esta. El 73,5 % fueron probables y el 58,9 % ocasionales. Conclusiones: las reacciones adversas graves y mortales predominaron en el sexo femenino y en los adultos. La penicilina fue el fármaco más relacionado. Las reacciones adversas probables y ocasionales fueron la mayoría en el estudio.

  8. Effectiveness and Mechanism of Preoperative Lugol Solution for Reducing Thyroid Blood Flow in Patients with Euthyroid Graves' Disease.

    Science.gov (United States)

    Huang, Shih-Ming; Liao, Wei-Ting; Lin, Chiou-Feng; Sun, H Sunny; Chow, Nan-Haw

    2016-03-01

    To reduce intraoperative and postoperative complications, using Lugol solution to preoperatively prepare patients with Graves' disease has (1) rapidly reduced the severity of thyrotoxicosis and (2) reduced the vascularity of the thyroid gland. The vascularity reduction normally accompanies reducing the severity of thyrotoxicosis. However, the effects and mechanism of Lugol solution for reducing blood flow have not been well investigated in the patients with euthyroid (normally functioning thyroid) Graves' disease. Twenty-five patients with euthyroid Graves' disease being preoperatively treated with Lugol solution for 10 days were measured, at baseline and on the operative day, for (1) superior thyroid artery blood flow; (2) systemic angiogenic factor (VEGF); and (3) systemic inflammatory factor [interleukin (IL)-16]. All three parameters were significantly (p Graves' disease. We recommend routine preoperative Lugol solution treatment for all patients with Graves' disease.

  9. Mortality in Graves' orbitopathy is increased and influenced by gender, age and pre-existing morbidity

    DEFF Research Database (Denmark)

    Schwensen, Charlotte F; Hjelm Brandt Kristensen, Frans; Hegedüs, Laszlo

    2017-01-01

    INTRODUCTION: It is unclear whether the excess mortality associated with Graves' disease differs between individuals with Graves' orbitopathy (GO) or without (GD). SUBJECTS AND METHODS: A nationwide, register-based cohort study in which all adult Danes diagnosed with GD (n = 28 461) and GO (n......-existing morbidity using the Charlson score. RESULTS: Adjusted mortality in Graves' disease overall (GD + GO) was significantly increased compared to that in the background population (HR = 1.18 (95% confidence interval: 1.15-1.21)). In GD and GO separately, adjusted mortality was also significantly higher than...

  10. Aesthetic refinements in the treatment of graves ophthalmopathy.

    Science.gov (United States)

    Doumit, Gaby; Abouhassan, William; Yaremchuk, Michael J

    2014-09-01

    Graves ophthalmopathy is a chronic, multisystem, autoimmune disorder characterized by increased volume of intraorbital fat and hypertrophic extraocular muscles. Proptosis, impaired ocular motility, diplopia, lid retraction, and impaired visual acuity are treated with orbit decompression and fat reduction. The authors present the addition of skeletal augmentation to further improve periorbital aesthetics. Through a transconjunctival with lateral canthotomy incision, a balanced orbital decompression was executed, removing medial and lateral walls and medial floor. Intraorbital fat was excised. All patients underwent placement of porous polyethylene infraorbital rim implants and midface soft-tissue elevation, increasing inferior orbital rim projection and improving the globe-cheek relationship. From 2009 to 2012, 13 patients (11 female and two male; 26 eyes) with Graves ophthalmopathy underwent surgery at two institutions. Outcomes were evaluated for improvements of proptosis, diplopia, dry eye symptoms, and cosmetic satisfaction. Postoperative follow-up ranged from 0.5 to 3 years (median, 1.5 years). The mean improvement on Hertel exophthalmometry was 5.4 mm. Diplopia resolved in three patients (23 percent). No patients had worsening diplopia, and 12 (92 percent) discontinued use of eye lubricants. All patients had cosmetic satisfaction. One patient suffered temporary inferior orbital nerve paresthesia. There were no infections, hematomas, or ocular complications. Skeletal augmentation is a useful adjunct to orbital decompression and fat excision for treating Graves ophthalmopathy. Balanced orbital decompression with infraorbital rim implants is reliable, effective, and safe, with good, lasting results. Resolution of ocular symptoms is improved, as are the patient's personal well-being and social life, with a high-benefit-to-low-risk. Therapeutic, IV.

  11. Avaliação e tratamento da hiperglicemia em pacientes graves

    Directory of Open Access Journals (Sweden)

    Marina Verçoza Viana

    2014-03-01

    Full Text Available A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse. Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento da hiperglicemia no paciente graves. Na prática clínica, devem ser levados em consideração diversos aspectos para o controle desses pacientes, inclusive os alvos de glicemia, o histórico de diabetes mellitus, a via de nutrição (enteral ou parenteral e o equipamento de monitoramento disponível, o que aumenta substancialmente a carga de trabalho dos profissionais envolvidos nesse tratamento. Esta revisão descreveu a epidemiologia, a fisiopatologia, o tratamento e o monitoramento da hiperglicemia no paciente adulto grave.

  12. Complicaciones orales en pacientes sometidos a radioterapia: revisión de literatura / Oral Complications in Patients Undergoing Radiotherapy: A Review of Literature

    OpenAIRE

    Hurtado Redondo, Diana Carolina; Universidad Nacional de Colombia sede Bogotá; Estrada Montoya, John Harold; Universidad Nacional de Colombia sede Bogotá

    2013-01-01

    Objetivo: Presentar los principales conceptos de radiobiología, radioterapia en cavidadoral y complicaciones asociadas, para llevar a cabo acciones seguras de tipo preventivo yterapéutico por parte del profesional o del equipo tratante. Método: La revisión se llevó acabo en diferentes bases de datos y revistas acerca del manejo odontológico de pacientessometidos a radioterapia. Resultados: Actualmente, el tratamiento para el cáncer tiene unenfoque multidisciplinario, en el cual participan dis...

  13. Graves' orbitopathy as a rare disease in Europe

    DEFF Research Database (Denmark)

    Perros, Petros; Hegedüs, L; Bartalena, L.

    2017-01-01

    BACKGROUND: Graves' orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this dise...

  14. Sjiele sacrifices, Odin treasures and Saami graves?

    Directory of Open Access Journals (Sweden)

    Inger Zachrisson

    1987-01-01

    Full Text Available This paper presents archaeological findings described as Saami metal deposits. These well-known "Finds from Lapp Places of Sacrifice", objects from the Viking Age and Early Middle Ages, were mostly found in northern Sweden. The author also presents a research project dealing with prehistoric and medieval Saami graves from the south Saami area.

  15. The observation of the therapeutic effectiveness of 131I on 260 youngster with Grave's hyperthyroidism

    International Nuclear Information System (INIS)

    Liu Binwen; Gao Xiusheng; Zhang Yahua; Pu Dongli

    2003-01-01

    Objective: To study the therapeutic effect and find new ways on treatment of Grave's hyperthyroidism in youngsters. Methods: 260 Grave's hyperthyroidism patients (age under 21 years) treated with 131 I were followed up 1-16 years later. Results: 118 of all patients were cured and 55 cases improved, failed treatment 2 cases, subclinical hypothyroidism 9 cases, clinical hypothyroidism 6 cases. 35 cases were treated with 131 I two or three times. All the patients with subclinical hypothyroidism and clinical hypothyroidism caused by 131 I were cured with medicine. 131 I treatment had no effect on growth and mentality and didn't cause leukemia nor thyroid cancer. Conclusions: The therapy of youngsters with Grave's hyperthyroidism with 131 I has the same effectiveness as adult. To the youngster Grave's patients who failed medical treatment, therapy with 131 I is safe and effective. It leads to temporary hypothyroidism which can be cured with medicine, no delayed hypothyroidism has been found

  16. Paradoxical euthyroid hormone profile in a case of Graves' disease with cardiac failure

    Directory of Open Access Journals (Sweden)

    Kapoor Aditya

    2011-07-01

    Full Text Available Abstract Cardiac failure is an uncommon complication of juvenile hyperthyroidism. We describe an adolescent boy with Graves' disease who developed manifestations of heart failure while on antithyroid medications. There was no evidence of any underlying cardiac disease. He had paradoxical euthyroid hormone profile which rose to hyperthyroid range when the manifestations of the cardiac failure subsided. The case highlights several unusual features of Graves' disease.

  17. Prevalencia de disfagia orofaríngea en ancianos institucionalizados y su relación con síndromes geriátricos

    OpenAIRE

    Fernández-Getino Sallés, Cristina

    2016-01-01

    Oropharyngeal dysphagia (OD) is an often underestimated symptom, with clinical significance because of the severe complications it may cause. The main objective of this project is to estimate the prevalence of OD among institutionalized elderly people and, specifically, to determine its relationship with geriatric syndromes or giants. La disfagia orofaríngea (DOF) es un síntoma, a menudo infravalorado, con una gran trascendencia clínica por las graves complicaciones que puede provocar. El ...

  18. Hyperthyroidism in Patients with Graves' Ophthalmopathy, and Thyroidal, Skeletal and Eye Muscle Specific Type 2 Deiodinase Enzyme Activities.

    Science.gov (United States)

    Molnár, Ildikó; Szentmiklósi, József A; Somogyiné-Vári, Éva

    2017-09-01

    Graves' ophthalmopathy is characterized by hyperthyroidism, which is associated with higher serum T 3 levels than T 4 due to deiodinase enzymes.The effect of Graves' patient's sera (n=52) with elevated thyroid hormone and TSH receptor or thyroid peroxidase antibody (anti-TPO) levels was investigated on thyroidal, skeletal and eye muscle type 2 deiodinase enzyme (DII) activities. DII activities were measured with 125 I-T 4 substrate, while thyroid hormone and antibody levels with immunoassays.In Graves' ophthalmopathy, sera with elevated FT 4 or FT 3 levels reduced DII activites remarkably in all tissue fractions. Thyroidal DII activities were lower than those using eye muscle fraction (0.6±0.22 vs 1.14±0.43 pmol/mg/min, PEffect of sera with increased FT 3 levels demonstrated also reduced DII activities in patients with Graves' ophthalmopathy after methimazole therapy compared to those who had no ophthalmopathy (2.88±2 vs 20.42±11.82 pmol/mg/min, PHyperthyroid sera with TSH receptor antibodies resulted in increased DII activities, while sera with anti-TPO antibodies were connected to lower DII activities in Graves' ophthalmopathy.In summary, the actions of hyperthyroid sera derived from patients with Graves' disease were tested on tissue-specific DII activities. Elevated FT 4 level-induced DII inactivation is present in Graves' ophthalmopathy, which seems to be also present at the beginning of methimazole therapy. Stimulating TSH receptor antibiodies increased DII activities via their nongenomic effects using sera of hyperthyroid Graves' ophthalmopathy, but anti-TPO antibodies could influence DII activities via altering FT 4 levels. © Georg Thieme Verlag KG Stuttgart · New York.

  19. A study of the effect of seasonal climatic factors on the electrical resistivity response of three experimental graves

    Science.gov (United States)

    Jervis, John R.; Pringle, Jamie K.

    2014-09-01

    Electrical resistivity surveys have proven useful for locating clandestine graves in a number of forensic searches. However, some aspects of grave detection with resistivity surveys remain imperfectly understood. One such aspect is the effect of seasonal changes in climate on the resistivity response of graves. In this study, resistivity survey data collected over three years over three simulated graves were analysed in order to assess how the graves' resistivity anomalies varied seasonally and when they could most easily be detected. Thresholds were used to identify anomalies, and the ‘residual volume' of grave-related anomalies was calculated as the area bounded by the relevant thresholds multiplied by the anomaly's average value above the threshold. The residual volume of a resistivity anomaly associated with a buried pig cadaver showed evidence of repeating annual patterns and was moderately correlated with the soil moisture budget. This anomaly was easiest to detect between January and April each year, after prolonged periods of high net gain in soil moisture. The resistivity response of a wrapped cadaver was more complex, although it also showed evidence of seasonal variation during the third year after burial. We suggest that the observed variation in the graves' resistivity anomalies was caused by seasonal change in survey data noise levels, which was in turn influenced by the soil moisture budget. It is possible that similar variations occur elsewhere for sites with seasonal climate variations and this could affect successful detection of other subsurface features. Further research to investigate how different climates and soil types affect seasonal variation in grave-related resistivity anomalies would be useful.

  20. Comparison of curative effect of 131I and antithyroid drugs in Graves' disease: a meta analysis.

    Science.gov (United States)

    Yuan, Ju; Lu, Xiuqing; Yue, Yan

    2017-03-01

    Radioactive 131I is currently reported to be a potential effective intervention for Graves' Disease treatment in China. Whether 131I treatment was associated with effective outcome or reduced risk of side effects, reccurence rate remained unknown. Eligible studies were selected from Chinese VIP, Wangfang, CNKI databases using the keywords "Iodine" and "Graves Disease". Finally, 13 clinical trials met the inclusion criterion and were included this meta-analysis. Our meta-analysis included 1355 patients diagnosed of Graves' Disease with regular anti-thyroid drugs oral administration and 1320 patients with 131I therapy. The results showed that there was significant symptom improvement with radioactive iodine intervention (Odd Ratio (OR)=4.50, 95% CI [3.55, 5.71], PGraves' Disease. Treatment with 131I was associated with better clinical outcome; it reduced side effects and reccurence rate but increased hypothyroidism in Graves' Disease.

  1. Atresia biliar: una enfermedad grave

    OpenAIRE

    Ramonet, Margarita; Ciocca, Mirta; Alvarez, Fernando

    2014-01-01

    La atresia biliar es una grave enfermedad que se manifiesta en los recién nacidos, y se desconoce su causa. La inflamación y destrucciónprogresiva de los conductos biliares conducen a la aparición de ictericia, coluria y acolia entre la segunda y sexta semana de vida. Como existen múltiples causas de colestasis neonatal en esta etapa de la vida, es necesario realizar un diagnóstico y derivación precoz para ofrecer un tratamiento quirúrgico, con el fin de restablecer el flujo biliar. Alrededor...

  2. Classification of the eye changes of Graves' disease

    NARCIS (Netherlands)

    Wiersinga, W. M.; Prummel, M. F.; Mourits, M. P.; Koornneef, L.; Buller, H. R.

    1991-01-01

    Classification of the eye changes of Graves' disease may have clinical use in the description of the present eye state, in the assessment of treatment results, and in the choice of therapy. Requirements for any classification system should include simplicity, clinical nature (i.e., easily carried

  3. Relationship between the management of Graves' disease and the course of Graves' ophthalmopathy: a systematic review

    International Nuclear Information System (INIS)

    Li Suping; Kuang Anren

    2008-01-01

    Objective: To perform literature search and review on the controversial relationship between therapies of hyperthyroidism due to Graves' disease (GD) and the course of Graves' ophthalmopathy (GO). Methods: We searched the database of MEDLINE (1966-2006.3), EMBASE (1984-2005), Cochrane Library(2006 No. 1), CBMdisc (1978.1-2006.4) and CNKI (1994-2006). The methodological quality of the studies selected for review was assessed according to the quality assessment criteria suggested by the Cochrane systematic review guideline. Meta-analysis was performed by RevMan 4.2 software. Results: Eight studies were included in the systematic review. Meta-analysis showed that there was statistically significant difference between mi and other forms of therapy [surgery or antithyroid drugs (ATD)] (test value: 2.31, 5.97, 3.70, 5.55; all P 0.05). There were not yet any studies on the impact between early prevention of hypothyroidism after mi therapy and GO. Conclusions: Based on meta-analysis on literature data, if early measures are not performed to prevent hypothyroidism after mi therapy, it may induce or aggravate GO more frequently than ATD or surgical treatment. Symptomatic relief of GO after 131 I therapy is also less effective than the other 2 forms of therapy. Therefore, 131 I therapy should be delivered carefully in those patients with GO. (authors)

  4. The experience of gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves' disease.

    Science.gov (United States)

    Hong, Yun; Yu, Shi-Tong; Cai, Qian; Liang, Fa-Ya; Han, Ping; Huang, Xiao-Ming

    2016-10-01

    The aim of this study was to evaluate the safety, feasibility, effectiveness, and cosmesis of a gasless endoscopic-assisted thyroidectomy via the anterior chest in patients with Graves' disease. We retrospectively reviewed 38 patients with Graves' disease treated with thyroidectomy from November 2007 to June 2015. We analyzed clinical characteristics of patients, type of operation, operative indications, operative duration, length of postoperative hospital stay, and postoperative complications. The thyroidectomies were classified as total thyroidectomy (n = 12) or near-total thyroidectomy with a remnant of Graves' disease is a safe, feasible, and effective and provides an excellent cosmetic outcome procedure. It is a valid option in appropriately selected patients.

  5. Hypothyroid Graves' disease complicated with elephantiasis nostras verrucosa (ENV): a case report and review of the literature.

    Science.gov (United States)

    Ukinç, Kubilay; Bayraktar, Miyase; Gedik, Arzu

    2009-08-01

    Thyroid dermopathy is not a frequent feature of hyperthyroid Graves' disease, being present in less than 5% of the patients. Graves' disease has been shown to exist in euthyroid or hypothyroid forms in untreated patients. Here, we describe a case of hypothyroid Graves' disease with elephantiasis nostras verrucosa (ENV), which is an extreme form of thyroid dermopathy (TD). A 58-year-old female patient was admitted to the emergency department with somnolence, hypothermia, and bradycardia. Her mental status gradually worsened, resulting in a deep coma. She was intubated and followed in the intensive care unit, as she needed mechanical ventilatory assistance due to respiratory failure. She also had bilateral non-pitting edema, a cobblestone-like appearance, and hyperkeratotic greenish-brown-colored lesions in the pretibial and dorsal regions of the feet that were compatible with ENV. Hypothyroid Graves' disease is a very rare condition among autoimmune thyroid disorders, and ENV is an extremely rare form of TD. Here, we present a patient with hypothyroid Graves' disease and ENV.

  6. Age and stress as determinants of the severity of hyperthyroidism caused by Graves' disease in newly diagnosed patients.

    Science.gov (United States)

    Vos, Xander G; Smit, Natalie; Endert, Erik; Brosschot, Jos F; Tijssen, Jan G P; Wiersinga, Wilmar M

    2009-02-01

    The evidence that stress may provoke Graves' hyperthyroidism in genetically susceptible subjects is substantial. Whether exposure to stress is related to the severity of thyrotoxicosis has not been studied. Advancing age is associated with not only less severe Graves' hyperthyroidism but also self-reported stress. We tested the hypothesis whether advancing age is associated with less exposure to stress, resulting in a lower immunological response, and less severe Graves' hyperthyroidism. Cross-sectional multicenter study. Two hundred and sixty-three consecutive untreated patients with a first episode of Graves' hyperthyroidism were included. The severity of Graves' hyperthyroidism was evaluated biochemically (freeT(4)-index and freeT(3)-index, thyrotropin-binding inhibitory immunoglobulin (TBII)) and clinically by the hyperthyroid symptom scale score (HSS score). Stress exposure was quantitated by three questionnaires. Advancing age was associated with less severe Graves' hyperthyroidism, both biochemically by lower serum freeT(3)-index and freeT(4)-index (Phyperthyroidism. Advancing age was associated with lower scores for stress exposure. Multivariate regression analysis showed that HSS score was independently related to the tendency to report negative feelings (Phyperthyroidism. Because no direct relationship exists between stress exposure and TBII or freeT(3)-index and freeT(4)-index, we reject our hypothesis that less stress is causally related to biochemically less severe Graves' hyperthyroidism in old age. HSS score is primarily determined by negative feelings and not by age.

  7. [Grave's disease in children with 22q11 deletion. Report of three cases].

    Science.gov (United States)

    Gosselin, J; Lebon-Labich, B; Lucron, H; Marçon, F; Leheup, B

    2004-12-01

    Hypothyroidism is a well recognized complication of 22q11.2 deletion syndrome. Auto-immune hyperthyroidism is less common. We report three patients with a 22q11.2 deletion and Graves' disease diagnosed at age 17, 14 and 11 years, respectively. The clinical and biological presentation was typical for auto-immune hyperthyroidism. Graves' disease should be periodically sought during the follow-up program of patients with 22q11.2 deletion syndrome.

  8. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves' ophthalmopathy the latest addition to an expanding family

    DEFF Research Database (Denmark)

    Nielsen, Claus H; El Fassi, Daniel; Hasselbalch, Hans K

    2007-01-01

    of 10 Graves' disease patients remained in remission 400 days after rituximab treatment versus none in the control group, and remarkable improvements in the eye symptoms of patients with Graves' ophthalmopathy were observed. This supports a role for B cells in the pathogenesis of Graves' ophthalmopathy...

  9. Characterization of radioiodine therapy failures in Graves' disease

    International Nuclear Information System (INIS)

    Sabri, O.; Zimny, M.; Schreckenberger, M.; Reinartz, P.; Nowak, B.; Ostwald, E.; Schaefer, W.; Block, S.; Setani, K.; Buell, U.

    2001-01-01

    Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves' disease without simultaneous carbimazole. Method: 226 patients with a confirmed diagnosis of Graves' disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), I-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ± 76.6 Gy vs. 285.2 ± 82.1 Gy, p 0.2). Of the 14 failures, n = 8 reached an absorbed dose 250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p 0.2) or gender (p = 0.13). Two-tailed Fisher's exact test showed no significant influence of gender on success rates (failures/successes: male 1/36, female 13/176, p = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves' disease without simultaneous carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy. (orig.) [de

  10. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Directory of Open Access Journals (Sweden)

    Márcia Lait Morse

    2011-06-01

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary

  11. Paludismo grave y complicado en niños. Hospital regional de Bata. Guinea Ecuatorial. 2003 Severe and complicated malaria in children at “Bata” Regional Hospital- Equatorial Guinea

    Directory of Open Access Journals (Sweden)

    Sandra Hernández García

    2005-09-01

    Full Text Available El paludismo grave es el causado por el Plasmodium falciparum, que cada año cobra millones de vidas en los países del tercer mundo, siendo los niños los más afectados, por este motivo se realizó estudio prospectivo, descriptivo transversal de los pacientes pediátricos que ingresaron con gota gruesa positiva a plasmodium falciparum, del mes de enero a julio del año 2003 en el hospital regional de Bata en Guinea Ecuatorial. Se encontró que el 49% de los ingresos correspondieron a los niños de 1-4 años, siguiendoles los menores de un año con 34,5% de casos. Se encontró que el 24% de los niños solo permanecieron un día en el hospital y el 67% de 2-5 días. Presentaron complicaciones 35,5% de los ingresados, la anemia severa fue la complicación que más se presentó (17,3%, los trastornos hidroelectrolíticos le siguieron con un 10%. Fallecieron 16 niños, de ellos con anemia severa 10 para (62,5%, con estadía de menos de un día fallecieron 7 pacientes y de 2-5 días otros 7 niños y entre los 6-13 días hubo 2 muertes. La principal recomendación fue que los niños con sospecha de paludismo deben ser atendidos inmediatamente para evitar las graves complicaciones de ésta enfermedad.Severe malaria is caused by Plasmodium falciparum taken millions of lives in Third World countries every year and being children the most affected. A descriptive, prospective, cross "sectional and correlational-casual study was carried out with pediatric patients who were admitted at Bata Regional Hospital in Equatorial Guinea after practicing a thick" film method test with positive results of plasmodium falciparum from January to July 2003, aimed at establishing clinical features of children affected by plasmodium falciparum determining the number of admissions, stay in hospital, complications and mortality, scientific methods used were empiric; analyzing documents and verbal interviews, statistic methods were: parametric samples and percentage

  12. Analysis of the factors associated with Tc-99m pertechnetate uptake in thyrotoxicosis and Graves' disease

    International Nuclear Information System (INIS)

    Kidokoro-kunii, Yo; Emoto, Naoya; Cho, Keiichi; Oikawa, Shinichi

    2006-01-01

    To determine the factors associated with 20 minute Tc-99m pertechnetate thyroid uptake, we examined all patients in whom thyrotoxicosis was diagnosed at Chiba-Hokusoh Hospital, Nippon Medical School from 2001 April through 2003 March. Patients with thyrotoxicosis diagnosed during this period were 57 with Graves' disease (76%), 11 with transient hyperthyroxinemia (TH) (14.7%), and 7 with subacute thyroiditis (SAT) (9.3%). The uptake of Tc-99m ranged from 0.97% to 40.1% in Graves' disease and from 0.15% to 0.8% in TH. Although TH may include spontaneous resolution of Graves' disease as well as painless thyroiditis, no treatment was necessary for these patients. Uptake in all patients with SAT was less than 0.5%. There were significant correlations between the level of Tc-99m uptake and the levels of free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH)-binding inhibitory immunoglobulin (TBII), and thyroid stimulating antibody (TSAb) in patients with Graves' disease. Older patients with Graves' disease showed lower uptake than did younger patients. Both Tc-99m pertechnetate uptake and TBII levels, but not fT3, fT4 or TSAb levels, at the beginning of antithyroid drug treatment correlated significantly with the duration of treatment until the daily dose of methimazole reached 5 mg. These data suggest that Tc-99m pertechnetate uptake reflects the severity of Graves' disease and its response to the medical treatment and that antithyroid drug therapy is not necessary when the uptake is less than 0.9%. (author)

  13. Course of depression in Cushing's syndrome: response to treatment and comparison with Graves' disease.

    Science.gov (United States)

    Sonino, N; Fava, G A; Belluardo, P; Girelli, M E; Boscaro, M

    1993-01-01

    Depression in a common, life-threatening complication of Cushing's syndrome and may occur in several other endocrine disorders. It is not clear, however, whether distinct features pertain to hypercortisolism. We studied depression in Cushing's syndrome differentiating pituitary-dependent and pituitary-independent forms, its incidence compared to Graves' disease, and its appearance in the prodromal phase of both conditions. To 66 consecutive patients with Cushing's syndrome and 70 with Graves' disease, after treatment, a semistructured interview for depressive symptoms based on Paykel's clinical interview for depression was administered. In Cushing's syndrome, the response of depression to normalization of urinary cortisol levels was evaluated by Kellner's global rating method. There was a significant difference in the occurrence of depression (p Cushing's syndrome (62%) and Graves' disease (23%). Depression appeared in the prodromal phase in 27% of patients with Cushing's syndrome and in 14% of those with Graves' disease, but the difference was not significant. In Cushing's syndrome, there were no significant differences in depression between patients with pituitary-dependent (n = 41) and pituitary-independent (n = 20) forms, or in their response to treatment. About 70% of patients fully recovered from their depression, whereas there was no substantial change in the others and even worsening in 2. Our findings in Cushing's syndrome and Graves' disease are in agreement with previous investigations using specific diagnostic criteria for depression. We found a tendency for this symptom to manifest in the prodromal phase of both illnesses. An endocrine etiology should be, therefore, considered in depressed patients not responding to standard psychiatric treatment.

  14. Experiencia en la cirugía del bocio tóxico

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    Alberto Casanova Rivero

    Full Text Available Introducción: se hace recuento del hipertiroidismo y sus dos causas principales donde prima la enfermedad de Graves Basedow. Se mencionan su diagnóstico y tratamiento. Objetivo: determinar el comportamiento de la cirugía en el bocio tóxico en un grupo de trabajo del servicio de cirugía del Hospital Universitario "Amalia Simoni" de Camagüey. Métodos: se realizó un estudio retrospectivo transversal sobre bocio tóxico en 12 años con una muestra conformada por 57 pacientes operados en un grupo de trabajo. Se tuvieron en cuenta, aspectos clínicos, de diagnóstico y terapéuticos. Resultados: predominó el sexo femenino en un rango de edades de 21 a 40 años, así como la positividad de los complementarios realizados. Se expuso la preparación preoperatoria más utilizada, la técnica quirúrgica realizada y las complicaciones en el orden del 29,81 %. Conclusiones: la mayoría fueron mujeres, con edad media de 35 años, se subutilizaron algunos medios diagnósticos, la preparación preoperatoria más usada fue propiltiuracilo, propanolol y lugol. El proceder más realizado fue la tiroidectomía subtotal y las complicaciones no fueron ni elevadas ni graves.

  15. Long-term results of radiotherapy for 104 patients with Graves' orbitopathy

    International Nuclear Information System (INIS)

    Qu Baolin; Yang Dong; Feng Linchun; Luo Zhiyuan

    2008-01-01

    Objective: To evaluate the long-term outcome and the sequelae of Graves' orbitopathy treated with radiotherapy, and to specify the prognostic factors. Methods: From 1979 to 1999, 104 patients with progressive Graves' orbitopathy were treated with conventional orbital radiotherapy. Post globe and pituitary irradiation of 25-35 Gy was given to 56 patients, which was followed by a boost of 15-20 Gy to the pituitary. Follow-up time was 7.5 - 25.0 years. The result of radiotherapy was analyzed. Results: Overall response rate was 71.1%. The response rate of patients with soft-tissue infiltration, corneal involvement, proptosis, sight loss and extraocular muscle dysfunction was 88.4%, 75.1%, 55.6%, 68.8% and 64.4%, respectively. Twelve patients (11.5%) developed cataracts 2.5-18.3 years (median 11.2 years) after irradiation. One patient developed left-eye retinopathy 3.2 years after irradiation. No patient developed secondary tumor within the irradiation field. Conclusions: Orbital radiotherapy for progressive Graves' orbitopathy, being effective and safe, can control the disease progression and improve the symptoms. The side effect of radiotherapy is fewer than other treatment modalities. (authors)

  16. Radioreceptor assay study of thyrotropin receptor antibody (TRAb) in Grave's diseases

    International Nuclear Information System (INIS)

    Lu Chao; Lin Xiangtong

    1989-01-01

    Here was reported the assay system using pig thyroid TSH receptor and 125 I-bTSH purified by receptor of thyroid cell membrane for the study of TRAb activity. The binding rate of ASH soluble receptor with 125 I-bTSH was 22.2 ∼ 37.4%, while as the control was only 1.0 ∼ 2.1%. TRAb was measured clinically in 48 cases of Grave's diseases and 25 normal persons. The TSH binding inhabitory index(TRII) was introduced for reflection of TRAb activity. The results showed that TBII was positure in 30 of 48 patients of Grave's diseases, the detctactibility was 79.2%

  17. The change of serum TRAb after 131I radiotherapy in patients of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Cui Bangping; Jiang Changbin; Hu Wei; Yang Jianhua; Guo Zugao

    2007-01-01

    Objective: The clinical value of thyrotrophin receptor antibody (TRAb) in patients with Graves' hyperthyroidism was investigated during 131 I radiotherapy. Methods: A total of 130 patients with Graves' hyperthyroidism and 50 normal controls were included in the study. Serum concentration of TRAb was measured by radioreceptor assay (RRA) before and at 3, 6, 12 and 24 months after 131 I radiotherapy. Results: Abnormally higher TRAb level [(92.93±68.99)U/L] was noted in patients before treatment(P 131 I radiotherapy, the TRAb [(12.99±5.52) U/L] was back to normal with no difference to that of controls (P>0.05). Conclusion: Serum concentration of TRAb was of clinical significance in the diagnosis of Graves' hyperthyroidism and in the monitoring of 131 I radiotherapy. (authors)

  18. Clinical evaluation of the 2nd generation radio-receptor assay for anti-thyrotropin receptor antibodies (TRAb) in Graves' disease

    International Nuclear Information System (INIS)

    Giovanella, L.; Ceriani, L.; Garancini, S.

    2002-01-01

    Full text: Detection of autoantibodies to the TSH receptor by radioreceptorial assays (RRA) is largely requested in clinical practice for the diagnosis of Graves' disease and its differentiation from diffuse thyroid autonomy. Additionally, TRAb measurement during antithyroid drug treatment can be useful to evaluate the risk of disease's relapse alter therapy discontinuation. Nevertheless, some patients affected by Graves' disease are TRAb negative when 1st generation assay is used. Recently a new RRA method for TRAb assay was developed by using human recombinant TSH-receptor and solid-phase technique. Aim of our work was the comparison between 1st and 2nd generation TRAb assays in Graves' disease patients and, particularly, the evaluation of 2nd generation test in a sub-group of patients affected by Graves' disease but with negative 1st generation TRAb assay. We evaluated the diagnostic performance of a newly developed 2nd generation TRAb assay (DYNOtest(r) TRAK human, BRAHMS Diagnostica GmbH, Germany) in 46 patients affected by Graves' disease with negative 1st generation TRAb assay (TRAK Assay(r), BRAHMS Diagnostica GmbH, Germany) . A control groups of 50 Graves' disease patients with positive 1st generation TRAb assay, 50 patients affected by Hashimoto's thyroiditis and 50 patients affected by nodular goiter were also examined. 41 out of 46 patients affected by Graves' disease with negative 1st generation TRAb assay showed a positive 2nd generation test. The overall sensitivity of the 2nd generation test was significantly improved respect the 1st generation assay in Graves' disease patients (χ 2 = 22.5, p<0.0001). 1 and 3 out of 50 patients affected by Hashimoto's thyroiditis were positive by 1st and 2nd generation TRAB assay, respectively. All these patients showed primary hypothyroidism. No differences resulted in euthyroid Hashimoto's thyroiditis sub-group and in nodular goiter control group. The 2nd generation TRAB assay is clearly more sensitive than the 1

  19. Guide-line of the radio-iodine (131I) therapy in Graves' disease and thyroid cancer

    International Nuclear Information System (INIS)

    Mori, Yutaka; Ikekubo, Katsuji

    2005-01-01

    Radio-iodine ( 131 I) therapy has been using in Graves' disease and well differentiated thyroid cancer. The rules of control in the discharge from radio-isotope hospital were notified in 1999 in Japan. Guideline of the 131 I therapy in Graves' disease and thyroid cancer were prepared by sub-group of Japanese Society of Nuclear Medicine. (author)

  20. Dosimetry-based treatment for Graves' disease.

    Science.gov (United States)

    Hyer, Steve L; Pratt, Brenda; Gray, Matthew; Chittenden, Sarah; Du, Yong; Harmer, Clive L; Flux, Glenn D

    2018-06-01

    The aim of this retrospective study was to assess the long-term outcome of a personalized dosimetry approach in Graves' disease aiming to render patients euthyroid from a planned thyroid absorbed dose of 60 Gy. A total of 284 patients with Graves' disease were followed prospectively following administration of radioiodine calculated to deliver an absorbed dose of 60 Gy. Patients with cardiac disease were excluded. Outcomes were analysed at yearly intervals for up to 10 years with a median follow-up of 37.5 months. A single radioiodine administration was sufficient to render a patient either euthyroid or hypothyroid in 175 (62%) patients, the remainder requiring further radioiodine. The median radioactivity required to deliver 60 Gy was 77 MBq. Less than 2% patients required 400-600 MBq, the standard activity administered in many centres. In the cohort receiving a single administration, 38, 32 and 26% were euthyroid on no specific thyroid medication at 3, 5 and 10 years, respectively. Larger thyroid volumes were associated with the need for further therapy. The presence of nodules on ultrasonography did not adversely affect treatment outcome. A personalized dosimetric approach delayed the long-term onset of hypothyroidism in 26% of patients. This was achieved using much lower administered activities than currently recommended. Future studies will aim to identify those patients who would benefit most from this approach.

  1. Orbital flourine-18-fluorodeoxyglucose positron emission tomography in patients with Graves' disease for evaluation of active inflammation.

    Science.gov (United States)

    Uslu-Beşli, Lebriz; Kabasakal, Levent; Sağer, Sait; Cicik, Erdoğan; Asa, Sertaç; Sönmezoğlu, Kerim

    2017-11-01

    Prediction and early diagnosis of orbitopathy is needed in patients with Graves' disease, especially when radioiodine therapy is planned. Positron emission tomography/computerized tomography (PET/CT) using flourine-18-fluorodeoxyglucose (FDG) is an effective imaging modality in detection of inflammation, however, its ability to detect orbital inflammation has not been well studied. The aim of our study is to determine the ability of FDG PET/CT to detect orbital inflammation related with Graves' disease, identify active orbitopathy, predict the radioiodine-triggered orbitopathy, and find out the effects of radioiodine on orbital inflammation. Total 31 Graves' disease patients and 17 controls were included. All Graves' disease patients underwent cranial FDG PET/CT imaging prior therapy. Radioiodine therapy and post-treatment PET/CT study was applied to 21 patients. PET/CT images of all examinees were evaluated, measuring extraocular muscle maximum standard uptake value (SUVmax) and muscle thickness. FDG uptake was increased in the majority of extraocular muscles in Graves' disease patients in comparison to controls and this increase was found to be irrelevant from muscle thickness. Extraocular muscle SUVmax values did not increase in Graves' orbitopathy patients who received radioiodine under corticosteroid prophylaxis. SUVmax level of all orbital rectus muscles were increased after radioiodine therapy in nonsmokers, whereas no increase was detected in smokers. FDG PET/CT may be helpful in detection of extraocular muscle inflammation and it may show ongoing orbitopathy in early stages of inflammation before anatomical changes occur.

  2. James George Frazer’s Anthropologic Heritage in the Work of Robert Graves

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    Tomislav M. Pavlović

    2016-02-01

    Full Text Available The works of Sir James George Frazer had an outstanding influence on the literature of modernism. Among those who benefited from Frazer’s ritualism were W. B. Yeats, T. S. Eliot. James Joyce, Ernest Hemingway, D. H. Lawrence, Ezra Pound, Mary Renault, Joseph Campbell, Robert Graves and many others. Robert Graves was known for his famous adaptation of Frazer’s concept of the sacred king who is sacrificed for the benefit of his subjects thus forming the narrative frame for the one of his most controversial novels. The dying king is also identified with the poet striving to attain the favour of the Triple Muse Goddess - who represents the embodiment of true poetic inspiration. The aforementioned concept is not the only thing that Graves inherited from his famous ancestor. In our analysis we laid stress on the customs, rituals, magic symbols and deities both authors dealt with. We also observed a striking resemblance of the style Greves and Frazer developed and their euchemeristic approach to myths as well.

  3. Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience

    NARCIS (Netherlands)

    Prummel, Mark F.; Bakker, Annemieke; Wiersinga, Wilmar M.; Baldeschi, Lelio; Mourits, Maarten P.; Kendall-Taylor, Pat; Perros, Petros; Neoh, Chris; Dickinson, A. Jane; Lazarus, John H.; Lane, Carol M.; Heufelder, Armin E.; Kahaly, George J.; Pitz, Suzanne; Orgiazzi, Jacques; Hullo, Alain; Pinchera, Aldo; Marcocci, Claudio; Sartini, Maria S.; Rocchi, Roberto; Nardi, Marco; Krassas, Gerry E.; Halkias, A.

    2003-01-01

    To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on

  4. Earliest floral grave lining from 13,700-11,700-y-old Natufian burials at Raqefet Cave, Mt. Carmel, Israel.

    Science.gov (United States)

    Nadel, Dani; Danin, Avinoam; Power, Robert C; Rosen, Arlene M; Bocquentin, Fanny; Tsatskin, Alexander; Rosenberg, Danny; Yeshurun, Reuven; Weissbrod, Lior; Rebollo, Noemi R; Barzilai, Omry; Boaretto, Elisabetta

    2013-07-16

    Flowering plants possess mechanisms that stimulate positive emotional and social responses in humans. It is difficult to establish when people started to use flowers in public and ceremonial events because of the scarcity of relevant evidence in the archaeological record. We report on uniquely preserved 13,700-11,700-y-old grave linings made of flowers, suggesting that such use began much earlier than previously thought. The only potentially older instance is the questionable use of flowers in the Shanidar IV Neanderthal grave. The earliest cemeteries (ca. 15,000-11,500 y ago) in the Levant are known from Natufian sites in northern Israel, where dozens of burials reflect a wide range of inhumation practices. The newly discovered flower linings were found in four Natufian graves at the burial site of Raqefet Cave, Mt. Carmel, Israel. Large identified plant impressions in the graves include stems of sage and other Lamiaceae (Labiatae; mint family) or Scrophulariaceae (figwort family) species; accompanied by a plethora of phytoliths, they provide the earliest direct evidence now known for such preparation and decoration of graves. Some of the plant species attest to spring burials with a strong emphasis on colorful and aromatic flowers. Cave floor chiseling to accommodate the desired grave location and depth is also evident at the site. Thus, grave preparation was a sophisticated planned process, embedded with social and spiritual meanings reflecting a complex preagricultural society undergoing profound changes at the end of the Pleistocene.

  5. Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia?

    Directory of Open Access Journals (Sweden)

    Boyd Jonathan D

    2012-07-01

    Full Text Available Abstract Background Anterior mediastinal masses are a rare but well documented finding in Graves disease. The vast majority of these lesions represents benign thymic hypertrophy and regress after treatment of the hyperthyroidism. A small percentage of these cases however represent neoplastic/malignant diseases which require further treatment. Cases 12 year old boy with one year history of refractory Graves disease was found to have an anterior mediastinal mass and underwent curative thyroidectomy for sustained hyperthyroidism. Cervical lymphadenopathy was detected during the procedure and biopsy was obtained. A 23 year old woman who presented with a one month history of hyperthyroid symptoms, was diagnosed with Graves disease and also was found to have an anterior mediastinal mass on imaging. Biopsy of the anterior mediastinal mass was obtained and subsequently the patient underwent robotic thymectomy. Histologic examination and immunophenotyping of the cervical lymph node in a 12 year old boy revealed neoplastic proliferation of T lymphoblasts diagnostic of T lymphoblastic leukemia/lymphoma. Examination of the anterior mediastinal mass biopsy in the 23 year old woman revealed type B1 thymoma which was confirmed after examination of the subsequent robotic thymectomy specimen. Conclusion This is the first reported case of T cell lymphoblastic lymphoma and the third reported case of thymoma associated with sustained hyperthyroidism due to Graves disease. These cases indicate that an anterior mediastinal mass in a patient with active Graves disease may be due to a neoplastic cause, which may require definitive treatment. Caution should be exercised when dismissing a mediastinal mass as benign thymic hyperplasia in patients with active Graves disease.

  6. Pregnancy after definitive treatment for Graves' disease--does treatment choice influence outcome?

    Science.gov (United States)

    Elston, Marianne S; Tu'akoi, Kelson; Meyer-Rochow, Goswin Y; Tamatea, Jade A U; Conaglen, John V

    2014-08-01

    Women requiring thyroid hormone replacement after definitive therapy (surgery or radioiodine) for Graves' disease who later conceive require an early increase in levothyroxine dose and monitoring of thyroid hormone levels throughout pregnancy. In addition, as TSH receptor antibodies (TRAb) can cross the placenta and affect the fetus, measurement of these antibodies during pregnancy is recommended. To review the management of pregnancies following definitive treatment for Graves' disease in order to assess the rates of maternal hypothyroidism and TRAb measurement. Retrospective chart review of women who had undergone definitive treatment for Graves' disease at a tertiary hospital and subsequently had one or more pregnancies. A total of 29 women were identified, each of whom had at least one pregnancy since receiving definitive treatment for Graves' disease: there were a total of 49 pregnancies (22 in the surgical group and 27 in the radioiodine group). Both groups had high rates of hypothyroidism documented during pregnancy (47 and 50%, respectively). The surgical group was more likely to be euthyroid around the time of conception. Less than half of the women were referred to an endocrinologist or had TRAb measured during pregnancy. Neonatal thyroid function was measured in one-third of live births. One case of neonatal thyrotoxicosis was identified. Adherence to the current American Thyroid Association guidelines is poor. Further education of both patients and clinicians is important to ensure that treatment of women during pregnancy after definitive treatment follows the currently available guidelines. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Modelo de pronóstico de reoperación en cirugía abdominal

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    Caridad de Dios Soler Morejón

    2016-12-01

    Full Text Available Introducción: En presencia de complicaciones infecciosas intrabdominales postoperatorias, la decisión de reoperar es todavía difícil para el cirujano actuante. Los modelos matemáticos representan una buena ayuda al diagnóstico en estas condiciones. Método: Estudio prospectivo observacional de 300 pacientes post-cirugía abdominal ingresados en la unidad de cuidados intensivos del Hospital Calixto García desde enero de 2008 a enero de 2010. Los pacientes fueron aleatoriamente separados (2:1 en dos grupos; estimación (GE y validación (GV. En el GE se desarrollaron tres modelos estadísticos para la reoperación, que fueron validados en el GV .Estos modelos incluyeron variables, que en estudios anteriores demostraron su utilidad en el pronóstico, como el índice predictivo de reoperación aguda (ARPI y la presión intrabdominal (PIA Resultados: El modelo ARPI-PIA fue el mejor de los tres modelos, según el estadígrafo Hosmer-Lemeshow (calibración C=9,976 p=0.267, discriminación área bajo la curva ROC=0,989 IC 95% 0,976-1,000. Conclusión: La inclusión de la PIA junto al ARPI en un modelo matemático puede aumentar la certeza del pronóstico de reoperación en presencia de complicaciones infecciosas intrabdominales tras cirugía abdominal. Este modelo puede ser de utilidad en situaciones de recursos diagnósticos limitados.

  8. A dosimetry based on artificial neural net theory in treatment of Graves disease

    International Nuclear Information System (INIS)

    Yang Ping; Luo Dongyun; Lin Yongxia; Zeng Shiquan

    2002-01-01

    Objective: To study the feasibility of radioactive treatment of Graves disease with dosimetry of 131 I in novel method by computer. Methods: The database comprised 206 selected Graves disease cases and according to this database the nonlinear functions could be inferred consequently, then 206 Graves disease patients were divided into two groups. The group one, 109 patients, was treated with back-propagation (BP) dosimetry method. The group two was treated with traditional method. The results were analyzed. Results: Group one had an effective rate of 93.5%, cure rate of 90.8%, recurrent rate of 3.6% and early stage of hypothyroidism rate of 3.6%. Group two had an effective rate of 90.7%, cure rate of 85.5%, recurrent rate of 5.1% and early stage of hypothyroidism rate of 5.1%. Conclusion: The BP method is efficient and the results reflect that this method might increase the accuracy of the dosimetry of 131 I and reduce recurrent rate and early stage of hypothyroidism occurrence

  9. Graves' hyperthyroidism and moderate alcohol consumption: evidence for disease prevention.

    Science.gov (United States)

    Carlé, Allan; Bülow Pedersen, Inge; Knudsen, Nils; Perrild, Hans; Ovesen, Lars; Rasmussen, Lone Banke; Jørgensen, Torben; Laurberg, Peter

    2013-07-01

    We recently demonstrated that moderate alcohol consumption is associated with a considerable reduction in the risk of autoimmune hypothyroidism, similar to findings in other autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. We aimed to study a possible association between alcohol intake and autoimmune Graves' hyperthyroidism. This is a population-based, case-control study. In a well-defined Danish population (2,027,208 person-years of observation), we prospectively identified patients with new overt thyroid dysfunction and studied 272 patients with Graves' hyperthyroidism. For each patient, we recruited four age-gender-region-matched controls with normal thyroid function (n = 1088). Participants gave detailed information on current and previous alcohol intake as well as other factors to be used for analyses. The association between alcohol intake and development of hyperthyroidism was analysed in conditional multivariate Cox regression models. Graves' patients had a lower reported alcohol consumption than controls (median units of alcohol (12 g) per week: 2 vs 4, P hyperthyroidism. Odds ratios (95% confidence interval) compared with the reference group with a recent (last year) consumption of 1-2 units of alcohol per week were as follows: 0 units/week 1·73 (1·17-2·56), 3-10 units/week 0·56 (0·39-0·79), 11-20 units/week 0·37 (0·21-0·65), ≥21 units/week 0·22 (0·08-0·60). Similar results were found for maximum previous alcohol consumption during a calendar year. No interaction was found with the type of alcohol consumed (wine vs beer), smoking habit, age, gender or region of inhabitancy. Moderate alcohol consumption is associated with a considerable reduction in the risk of Graves' disease with hyperthyroidism--irrespective of age and gender. Autoimmune thyroid disease seems to be much more dependent on environmental factors than hitherto anticipated. © 2012 John Wiley & Sons Ltd.

  10. Efficiency of radioiodine therapy in Graves disease and adenoma toxicum and incidence of hypothyroidism

    International Nuclear Information System (INIS)

    Petrovski, Z.P.

    2002-01-01

    The aim of the this study was to evaluate different states in hyperthyroid patients and incidence of hypothyroidism after I-131 therapy.We observed a total of 184 hyperthyroid pts, from which 108(58,7%)pts with Graves' disease,65(35,3%)pts with single toxicum nodule and 11(6%)pts with toxicum multinodular goitre,treated with radioiodine therapy during the period 1986-2001.Dose of I-131 orally administered ranged 150-1100MBq and was calculated according to the 'MBq/gram' method.The radioiodine-131 therapy was performed once in 69,5%(128/184)pts,twice in 21,2%(39/184)pts and in 9,3%(17/184)pts more than two doses. Completely cured of hyperthyroidism occurred in 61%(66/108)pts with Graves' disease,81,8%(9/11)pts with toxic multinodular goiter and 90,7%(59/65)pts with single toxic nodule. The patients in our study were evaluated 6 months to 15 years after received J-131 therapy. Incidence of early hypothyroidism within one year was 23,1%(25/108) in Graves' disease,9%(1/11) in toxic multinodular goiter and 4,6%(3/65) with single toxicum nodule.Overall incidence of hypothyroidism within one year was 17,6% and had cumulative increase of Graves' disease every following year approximately for 3%,while for adenoma toxicum there was no any significant changes. We concluded that radioiodine therapy is simple,comfortable radical method for medical treatment of hyperthyroidism and indicate higher incidence of hypothyroidism in patients treated with I-131 for Graves' disease than that of patients treated for toxicum multinodular goiters and single toxic nodule

  11. The negative correlation between thyrotropin receptor-stimulating antibodies and bone mineral density in postmenopausal patients with Graves' disease.

    Science.gov (United States)

    Amashukeli, Medea; Korinteli, Maka; Zerekidze, Tamar; Jikurauli, Nino; Shanava, Shorena; Tsagareli, Marina; Giorgadze, Elen

    2013-06-01

    Graves' disease is an autoimmune disorder with various clinical manifestations. Thyrotropin receptor antibodies (TRAbs), the circulating autoantibodies specific to Graves' disease, are the cause for hyperthyroidism, the most prevalent abnormality. Hyperthyroidism leads to increased bone turnover and a negative bone balance. The aims of the present study were to determine the relationship between TRAbs and bone mineral density (BMD), to assess the extent of BMD change in patients with Graves' disease, and to determine the impact of conservative and surgical therapy on BMD. Fifty female postmenopausal patients with Graves' disease were chosen for this study. Twenty women had a recent diagnosis of Graves' disease, 30 women presented with a compensated disease state after either conservative or surgical treatment, and 30 healthy postmenopausal women served as controls. Thyroid parameters were measured, and BMD values were obtained by dual energy x-ray absorptiometry scan.Femoral neck and lumbar spine BMD and T-scores were significantly lower in newly diagnosed patients compared with the control group, but a difference was not observed between the treated and control groups. Statistical analysis revealed a strong and significant negative correlation between femoral neck and lumbar spine BMD and TRAb values.Both surgical and conservative therapies are effective for restoring BMD in postmenopausal patients with Graves' disease, and the increased level of TRAb can be a useful marker of bone density impairment.

  12. A case of metastatic follicular thyroid carcinoma complicated with Graves' disease after total thyroidectomy.

    Science.gov (United States)

    Aoyama, Mariko; Takizawa, Hiromitsu; Tsuboi, Mitsuhiro; Nakagawa, Yasushi; Tangoku, Akira

    2017-12-28

    Thyroid cancer and Graves' disease may present simultaneously in one patient. The incidence of the development of hyperthyroidism from metastatic differentiated thyroid carcinoma is rare. We herein report a case of metastatic follicular carcinoma complicated with Graves' disease after total thyroidectomy. A 57-year-old woman underwent right hemithyroidectomy for follicular carcinoma. Metastatic lesions appeared in the lungs and skull two years after the first surgery, and remnant thyroidectomy was performed for radioactive iodine-131 (RAI) therapy, during which the TSH receptor antibody (TRAb) was found to be negative. The patient was treated with RAI therapy four times for four years and was receiving levothyroxine suppressive therapy. Although radioiodine uptake was observed in the lesions after the fourth course of RAI therapy, metastatic lesions had progressed. Four years after the second surgery, she had heart palpitations and tremors. Laboratory data revealed hyperthyroidism and positive TRAb. She was diagnosed with Graves' disease and received a fifth course of RAI therapy. 131I scintigraphy after RAI therapy showed strong radioiodine uptake in the metastatic lesions. As a result, the sizes and numbers of metastatic lesions decreased, and thyroid function improved. Metastatic lesions produced thyroid hormone and caused hyperthyroidism. RAI therapy was effective for Graves' disease and thyroid carcinoma.

  13. Graves hyperthyroidism 131I treatment the clinical curative effect of observation

    International Nuclear Information System (INIS)

    Duan Yongqiang; Wang Zuobing; Yu Hui; Wang Jing; Li Xiaoqin; Chen Yuanhao; Wu Jiquan

    2012-01-01

    Objective: to study the clinical treatment of 131 I Graves hyperthyroidism curative effect. Methods: the clinical data of Graves hyperthyroidism patients were retrospectively analyzed. Results: 258 cases of patients with hyperthyroidism Graves. 131 I treatment 1∼2 times after healed 200 cases, improvement of 38 patients, a low, 10 cases were invalid 10 cases failure; the total effective 96.12%. 1 year after treatment 131 I thyroid quality by before treatment 43.6 + 20.9 grams shrinks to 1.98 + 18.5 grams (p 131 I before treatment with prominent eyes 68 cases (26.4%) 131 I after treatment, the prominent eyes healed 24 cases (34.8%), improvement 30 patients (43.5%), invalid in 12 cases (17.4%), aggravating in 2 cases (2.9%), efficient for 79.7%. Concurrent hyperthyroidism 131 I before treatment in patients with 31 patients (heart), after the treatment of 131 I 12.0% in 25 patients recovered, 6 patients get better, efficient 100%. After the treatment of 131 I temporary armor low in 25 patients (9.7%) , permanent armour low 27 cases (10.5%). After the treatment of 131 I 15 cases have been reduced to a sex WBC (5.8%), 8 cases of liver function mild damage (3.1%), 13 cases itchy skin (1 case), cholesterol by 5.0% compared appear suspected hyperthyroidism crises (0.4%). 258 patients with thyroid type micronodular 41 cases, treatment cured after 131 I in 25 patients (61.0%), improvement in 16 (39.0%), laseris 100%, Diffuse 217 example, cure 175 cases (80.6%), improvement 22 patients (10%), a low 10 (4.6%), invalid 10 (4.6%), laseris 95.4 percent. Conclusion: 131 I treatment Graves hyperthyroidism is simple, safe, effective, and can be used as the preferred treatment method outperforms that of anti-thyroid drugs. (authors)

  14. Stressful life events and Graves' disease: Results of a case control study

    International Nuclear Information System (INIS)

    Pintor, A.B.; Barrenechea, E.A.; Laureta, E.G.; Ligon, R.A.

    2003-01-01

    Prolonged worry has generally been acknowledged as one of the main precipitating factors of the onset of Graves' disease. A review of literature reveals that emotional stresses of considerable severity precede the onset of hyperthyroidism in about 90% of cases. However, not everyone subscribes to the Stress/Graves' disease hypothesis. Attempts to resolve this issue have tended to focus on whether a correlation can be shown between the magnitude of antecedent life events and the disease. Hence the main objective of the present study was to identify the possible association between stressful life events and Graves' disease. This paper presents the results of a case-control study, involving patents and subjects from the Veterans Memorial Medical Centre of Manila. A total of 224 patients of Graves' disease, newly or previously diagnosed, representing the 'patient's' arm were interviewed. All patients were questioned regarding various stresses, which greatly affected their life style spanning over a 12-month period prior to the onset of the disease. Simultaneously, 224 control subjects were also interviewed, and their stresses spanning over a similar period preceding the dates of interviews were recorded in quantifiable terms. Different stresses were given different intensity scores based on a social readjustment scale taking into consideration the life situations, emotions and diseases. In cases of multiple stresses, intensity scores were added to obtain the total stress intensity. Results were expressed as mean, standard deviation, median, frequency and percent distribution. Scatter plot was also constructed for intensity of stressful life events. To determine association of different factors with Graves' disease, Students t-test and chi-square tests were applied to the data. Odds ratio (OR) was also computed to determine risk attributed to each factor. Since there was significant difference in gender distribution between the patients and controls, stratified Mantel

  15. Thyroidectomy for Graves' disease: is hypothyroidism inevitable?

    OpenAIRE

    Davenport, M.; Talbot, C. H.

    1989-01-01

    The outcome of 234 patients with Graves' disease treated by subtotal thyroidectomy over a 12-year period is analysed with specific reference to hypothyroidism. Of definite hypothyroid cases, 98% occurred within 2 years. Failure to develop hypothyroidism was statistically related to large remnant size and a large goitre preoperatively. Histological review showed that any degree of lymphocytic infiltration was associated with the development of hypothyroidism (50% vs 22%). Late onset hypothyroi...

  16. Periodic Granulocyte Count Measuring Is Useful for Detecting Asymptomatic Agranulocytosis in Antithyroid Drug-Treated Patients with Graves' Disease.

    Science.gov (United States)

    Nakamura, Hirotoshi; Ide, Akane; Kudo, Takumi; Nishihara, Eijun; Ito, Mitsuru; Miyauchi, Akira

    2016-12-01

    Finding agranulocytosis (AG) at an early stage is important to improve outcome, but periodic granulocyte count monitoring is not generally recommended for patients with Graves' disease, because AG develops suddenly. At the Kuma Hospital, Graves' patients under antithyroid drug (ATD) treatment in an outpatient clinic have a granulocyte count examination during each visit, and if it is Graves' disease were 131 I-radioisotope therapy (19 patients), thyroidectomy (2 patients), inorganic iodine (1 patient), or another ATD (1 patient). Among the 33 GP patients, 31 (94%), including 20 asymptomatic cases, were discovered during periodic granulocyte count monitoring. Most of them stopped ATD, and other treatments for Graves' disease were selected. Periodic monitoring of granulocyte counts is useful for identifying AG and GP patients with no or minimum infection symptoms.

  17. Diagnosis and treatment of Graves' disease with particular emphasis on appropriate techniques in nuclear medicine. General state of knowledge.

    Science.gov (United States)

    Prasek, Karolina; Płazińska, Maria Teresa; Królicki, Leszek

    2015-01-01

    Graves' disease is an autoimmune disease. It accounts for 50-80% of cases of hyperthyroidism. Antibodies against the TSH receptor (TRAb) are responsible for hyperthyroidism (TRAB). The key role in monitoring and diagnosis of Graves' disease plays the level of hormones of free thyroxine and triiodothyronine. Helpful is an ultrasound of the thyroid scintigraphy which due to its functional character is both a valuable addition to morphological studies as well as plays an important role in the diagnosis and therapy in patients with Graves' disease. There is no perfect treatment for Graves' disease. The reason for this is the lack of therapy directed against primary pathogenic mechanisms. Currently available treatments need to be thoroughly discussed during the first visit as the patient's understanding of the choice of a treatment constitutes a vital role in the success of therapy. Graves' disease treatment is based on three types of therapies that have been carried out for decades including: pharmacological treatment anti-thyroid drugs, I131 therapy and radical treatment - thyroidectomy. The purpose of the treatment is to control symptoms and patient to return to euthyreosis. Treatment of Graves' disease is of great importance because if left untreated, it can lead to long-term harmful effects on the heart, bone and mental well-being of patients.

  18. Changes and clinical significance of CD4+CD25+CD127- regulatory T cells in Graves disease

    International Nuclear Information System (INIS)

    Zou Jintao; Yu Peiling; Dong Jingwei; Liao Qihong; Liu Dongliang; Zeng Hongyi

    2012-01-01

    Objective: To investigate the mechanism of Graves disease by observing the changes of CD4 + CD25 + CD127 - regulatory T cells (Treg) population in the patients. Methods: Flow cytometry was used to detect the proportion of CD4 + CD25 + CD127 - Treg of CD4 + T cells in 90 Graves disease patients (Graves disease group) and 50 healthy adults (control group). Thyroid function and autoantibody levels were determined simultaneously. The t test was adopted for comparison between groups. The relationship between CD4 + CD25 + CD127 - Treg and thyroid function was analyzed by linear correlation analysis. Results: The percentages of CD4 + CD25 + CD127 - Treg in Graves disease group and control group were 1.39%±1.09% and 4.59%±1.14% separately. There was significant difference between the two groups (t=16.4, P<0.01). There were negative correlation between CD4 + CD25 + CD127 - Treg percentages and total triiodothyronine, total thyroxine,free triiodothyronine, free thyroxine and thyrotropin receptor antibody,thyroglobulin antibody, thyroid microsomal antibody (r=-0.62, -0.65, -0.56, -0.71, -0.50, -0.15, all P<0.01). Conclusions: The reduction of CD4 + CD25 + CD127 - Treg percentages in Graves disease group and close relations of CD4 + CD25 + CD127 - Treg with thyroid function and thyroid autoantibody levels suggest that CD4 + CD25 + CD127 - Treg decrease in the number may be associated with the onset of Graves disease. CD4 + CD25 + CD127 - may be the specific marker of Treg. (authors)

  19. Complicaciones presentadas en pacientes mayores de 65 años ingresados por fractura de cadera en un hospital andaluz de tercer nivel

    OpenAIRE

    López-Hurtado, Felipe; Miñarro del Moral, Rosa María; Arroyo Ruiz, Verónica; Rodríguez Borrego, Mª Aurora

    2015-01-01

    Objetivo: Conocer las complicaciones que se han producido en pacientes mayores de 65 años, ingresados en un hospital andaluz de tercer nivel durante el año 2012, con diagnóstico principal de fractura de cadera. Metodología: Diseño: Se realizó un estudio descriptivo transversal. Ámbito, periodo y sujetos de estudio: Pacientes ingresados en el año 2012 mayores de 65 años con diagnóstico principal de fractura de cadera. Variables principales: Morbimortalidad recogida en el C...

  20. Effect of Selenium Supplementation on Recurrent Hyperthyroidism Caused by Graves' Disease: A Prospective Pilot Study.

    Science.gov (United States)

    Wang, L; Wang, B; Chen, S R; Hou, X; Wang, X F; Zhao, S H; Song, J Q; Wang, Y G

    2016-09-01

    The effect of selenium supplementation on recurrent hyperthyroidism caused by Graves' disease is unclear. Our study aimed to assess the efficacy of selenium supplementation therapy on recurrent Graves' disease. Forty-one patients with recurrent Graves' disease were enrolled in this study. All patients received the routine treatment using methimazole (MMI), while patients allocated to the selenium group received additional selenium therapy for 6 months. The influence of selenium supplementation on the concentrations of thyroid stimulating hormone (TSH), anti-TSH-receptor antibodies (TRAb), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed. The remission rate was also compared between 2 groups. There was no obvious difference in the demographic data and the levels of serum FT4, FT3, TSH, and TRAb between the 2 groups at baseline. Both FT4 and FT3 decreased more at 2 months in the selenium group than the controls, while the TSH level increased more in patients receiving selenium supplementation (pGraves' disease. Randomized trials with large number of participants are needed to validate the finding above. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Occurrence of Type 1 Diabetes in Graves' Disease Patients Who Are Positive for Antiglutamic Acid Decarboxylase Antibodies: An 8-Year Followup Study

    Directory of Open Access Journals (Sweden)

    Matsuo Taniyama

    2011-01-01

    Full Text Available Glutamic acid decarboxylase antibodies (GADAs are one of the markers of islet cell autoimmunity and are sometimes present before the onset of type 1 diabetes (T1D. GADA can be present in Graves' patients without diabetes; however, the outcome of GADA-positive Graves' patients is not fully understood, and the predictive value of GADA for the development of T1D in Graves' patients remains to be clarified. We investigated the prevalence of GADA in 158 patients with Graves' disease and detected GADA in 10 patients. They were followed up to discover whether or not T1D developed. In the course of eight years, 2 patients with high titers of GADA developed T1D, both had long-standing antithyroid drug-resistant Graves' disease. Thus, Graves' disease with high GADA titer seems to be at high risk for T1D.

  2. An assessment of psychiatric disturbances in graves disease in a ...

    African Journals Online (AJOL)

    An assessment of psychiatric disturbances in graves disease in a medical college in eastern India. ... standard error of difference, the chi-square test, and paired Student's T-test. ... The common symptoms were insomnia, irritability, and anxiety.

  3. 78 FR 31570 - Prospective Grant of a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease...

    Science.gov (United States)

    2013-05-24

    ...-Up Exclusive Patent License Agreement: Treatment of Graves' Disease, Hyperthyroidism and Thyroid... Patent License Agreement may be worldwide and the field of use may be limited to: Treatment of Graves' Disease, hyperthyroidism and thyroid cancer. DATES: Only written comments or applications for a license...

  4. Hypofractionated radiotherapy for Graves' orbitopathy

    International Nuclear Information System (INIS)

    Heyd, R.; Herkstroeter, M.; Martin, T.; Zamboglou, N.; Strassmann, G.

    2001-01-01

    Background: Radiotherapy (RT) has been proven effective in the management of Graves' orbitopathy in numerous studies. Most commonly is the use of conventional fractionated RT and the value of hypofractionated irradiation has not been investigated. Materials and methods: The results in 33 euthyroid cases who underwent RT with a total dose of 21.0 Gy given in three weekly fractions of 3.0 Gy are retrospectively analyzed. The duration of symptoms ranged from 1-84 months and all of the cases had treatment failure after previous administration of corticosteroids. After a mean follow-up period of 33.6 months the overall results were assessed according to the criteria by Donaldson et al. and for evaluation of the clinical outcome a classification with the main criteria being eye-lid changes, exophthalmos, myopathy and eye nerve involvement was used. Results: At follow-up, the overall response to RT was 84.8% (28/33 cases). The analysis with the clinical classification demonstrated that in 19/33 (57.6%) cases occurred a decrease of eye lid changes and exophthalmos and 12/33 (36.4%) had a relief of myopathy. 2/33 cases (6.0%) developed an eye nerve compression causing the necessity of surgical decompression. 3/33 cases (9.0%) had a progression of at least of one of the single criteria of the score and therefore they were classified as non-responders. Conclusions: Hypofractionated RT has been proven effective for treatment of severe cases of Graves' orbitopathy in cases with a prolongated duration of symptoms. The comparison with literature data demonstrate that the results after hypofractionated RT are comparable to those obtained after conventional fractionated RT. (orig.)

  5. “Integración de un Paradigma: Mecanismos Biomoleculares y Patogénicos, Precursores de las Complicaciones de la Diabetes”

    Directory of Open Access Journals (Sweden)

    Mario Sánchez Medina

    2005-03-01

    Inmensa cantidad de información científica y periodística hay sobre el tema del progreso de la diabetes en el mundo, particularmente en los países desarrollados, que se refleja también en los países en desarrollo con inquietante incertidumbre, por el incremento vertiginoso de la enfermedad. Uno de los problemas que más concierne a los profesionales de la salud y, desde luego, a las familias que tienen diabetes, obesidad y factores genéticos predisponentes en sus antecedentes, es el hallazgo de la presencia de complicaciones microvasculares antes de que ellos mismos sepan que están desarrollando la enfermedad...

  6. Low-dose radioiodine given six-monthly in Graves' disease

    International Nuclear Information System (INIS)

    Hoskin, P.J.; McCready, V.R.; Harmer, C.L.; Spathis, G.S.; Cosgrove, D.O.

    1985-01-01

    Experience using low-dose radioiodine given six-monthly instead of yearly in hyperthyroid patients with Graves' disease is reported. One hundred and thirty-five patients have been treated over a three-year period with 74 MBq (2 mCi) doses of 131 I. |Thirty-eight|percent| were controlled with a single dose. Those patients requiring more than one dose were treated with a further 74 MBq (2 mCi) 131 I at six-monthly intervals until euthyroid. Using this approach, 46% were euthyroid one year after starting treatment, and 75% were euthyroid at two years. The incidence of hypothyroidism following treatment was 2.2% at one year, with a yearly incidence thereafter of 4-6%. Six-monthly scheduling of low-dose radioiodine in Graves' disease can reduce the time taken to become euthyroid, compared with conventional yearly low-dose treatments. Further follow up is required to confirm the present low incidence of hypothyroidism following treatment. (author)

  7. Hyperthyroidism and Graves' disease: Is an ultrasound examination needed?

    Directory of Open Access Journals (Sweden)

    Lakshminarayanan Varadhan

    2016-01-01

    Full Text Available Aim: The aim of our study was to assess the limitation of clinical examination in determining the morphology of thyroid gland in patients with hyperthyroidism and its implications. Methods: A retrospective analysis of consecutive patients with hyperthyroidism seen in a tertiary endocrine clinic were analyzed. Sub-analysis was performed on patients with proven Graves' disease. Results: Of the 133 patients included in this study with hyperthyroidism, 60 (45% patients had significant nodularity on ultrasound (US. However, only 67% of these were identified on clinical examination. In patients with confirmed Graves' disease (n = 73, the discordance between US and clinical examination was very similar (18 of 30 patients, 60%. Conclusion: US should form an essential part of the evaluation of hyperthyroidism as the morphology of thyroid gland could be variable and nodules in these glands would also need to be appropriately investigated. This would also significantly influence decision-making and appropriate immediate and follow-up management plan.

  8. Graves' ophthalmopathy and 131I therapy

    International Nuclear Information System (INIS)

    Marcocci, C.; Bartalena, L.; Tanda, M.L.; Manetti, L.; Dell'Unto, E.; Mazzi, B.; Rocchi, R.; Barbesino, G.; Pinchera, A.

    1999-01-01

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; i i) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between progression of

  9. [Neonatal hyperthyroidism in a premature infant born to a mother with Grave's disease].

    Science.gov (United States)

    Nicaise, C; Gire, C; Brémond, V; Minodier, P; Soula, F; d'Ercole, C; Palix, C

    2000-05-01

    Neonatal thyrotoxicosis is most commonly due to transplacental transfer of maternal thyroid-stimulating hormone receptor antibodies (TRAb). Bioassay of thyrotropin receptor antibodies may help to determine the risk for neonatal hyperthyroidism. Thyrotoxicosis developed in a premature infant born to a mother with Graves' disease, with a low level of TRAb by bioassay. The infant was treated with carbimazole for two months, until TRAb had disappeared. Bioassay TRAb is not always reliable for predicting the development of neonatal hyperthyroidism in infants born to mothers with Graves' disease. Thyroid function should be measured in all these neonates.

  10. Heterotopic relation between media and materiality in children's online memorials and on children's graves

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Christensen, Dorthe Refslund

    place across media. We show how the death of an infant can lead to mediation, remediation and mediatization strategies which involves both the uses and arrangement of objects on memorial pages and on children’s graves as well as uses of new social technologies, that produce, negotiate and develop social......In this paper we analyze how bereaved parents make use of various media-strategies on online memorial sites and on children’s graves when performing processes of grief and commemoration for their stillborns and infants, and how these processes are not just linked to one particular media but take...... relations with the dead child and the (re)negotiating of parenthood. We understand media as a function of an object reflected in human practices and embedded and structured by the different materialities they are intertwined with. We argue that the use of media and materiality online and on the graves are...

  11. Image and Role of the Queen Mother of the West in Han Grave Art

    Directory of Open Access Journals (Sweden)

    Nataša VAMPELJ SUHADOLNIK

    2015-12-01

    Full Text Available The present article is a detailed study of the image of an ancient Chinese goddess, The Queen Mother of the West, called Xiwangmu 西王母 in Chinese. In the mythological tradition, Xiwangmu is a goddess who possesses the elixir of immortality and dwells in the western paradise, on the magic mountain Kunlun 崑崙. While her image can be found in mural paintings, and on lacquered objects and bronze mirrors, it appears primarily in the form of relief images on the stones and bricks of grave chambers and temples in the Han (206 BCE–220 CE grave complexes. The literary tradition reveals a multifunctional role of the mother, with her many attributes developing in accordance with the changing values of social and mythological concepts. The article concludes with a detailed discussion of her image and role within the wider cosmological context of Han grave art.

  12. Glucocorticoid administration for Graves' hyperthyroidism treated by radioiodine. A questionnaire survey among members of the European Thyroid Association

    NARCIS (Netherlands)

    Lazarus, J. H.; Bartalena, L.; Marcocci, C.; Kahaly, G. J.; Krassas, G.; Wiersinga, W. M.; Baldeschi, L.; Boboridis, K.; Boschi, A.; Currò, N.; Daumerie, C.; Dickinson, A. J.; Eckstein, A.; Kendall-Taylor, P.; Lane, C. M.; Ludgate, M. E.; Mann, K.; Marinò, M.; Mourits, M. P.; Nardi, M.; Neoh, C.; Orgiazzi, J.; Pearce, S.; Perros, P.; Pinchera, A.; Pitz, S.; Salvi, M.; Sivelli, P.; Stahl, M.; von Arx, G.

    2010-01-01

    Background: Glucocorticoid prophylaxis is required in some instances after radioiodine (RAI) treatment for Graves' hyperthyroidism to prevent progression of Graves' orbitopathy (GO). However, no randomized clinical trial has been performed to ascertain the optimum glucocorticoid therapy. Aim and

  13. Persistent Graves' hyperthyroidism despite rapid negative conversion of thyroid-stimulating hormone-binding inhibitory immunoglobulin assay results: a case report.

    Science.gov (United States)

    Ohara, Nobumasa; Kaneko, Masanori; Kitazawa, Masaru; Uemura, Yasuyuki; Minagawa, Shinichi; Miyakoshi, Masashi; Kaneko, Kenzo; Kamoi, Kyuzi

    2017-02-06

    Graves' disease is an autoimmune thyroid disorder characterized by hyperthyroidism, and patients exhibit thyroid-stimulating hormone receptor antibody. The major methods of measuring circulating thyroid-stimulating hormone receptor antibody include the thyroid-stimulating hormone-binding inhibitory immunoglobulin assays. Although the diagnostic accuracy of these assays has been improved, a minority of patients with Graves' disease test negative even on second-generation and third-generation thyroid-stimulating hormone-binding inhibitory immunoglobulins. We report a rare case of a thyroid-stimulating hormone-binding inhibitory immunoglobulin-positive patient with Graves' disease who showed rapid lowering of thyroid-stimulating hormone-binding inhibitory immunoglobulin levels following administration of the anti-thyroid drug thiamazole, but still experienced Graves' hyperthyroidism. A 45-year-old Japanese man presented with severe hyperthyroidism (serum free triiodothyronine >25.0 pg/mL; reference range 1.7 to 3.7 pg/mL) and tested weakly positive for thyroid-stimulating hormone-binding inhibitory immunoglobulins on second-generation tests (2.1 IU/L; reference range hyperthyroidism for more than 8 years, requiring 15 mg/day of thiamazole to correct. During that period, he tested negative on all first-generation, second-generation, and third-generation thyroid-stimulating hormone-binding inhibitory immunoglobulin assays, but thyroid scintigraphy revealed diffuse and increased uptake, and thyroid ultrasound and color flow Doppler imaging showed typical findings of Graves' hyperthyroidism. The possible explanations for serial changes in the thyroid-stimulating hormone-binding inhibitory immunoglobulin results in our patient include the presence of thyroid-stimulating hormone receptor antibody, which is bioactive but less reactive on thyroid-stimulating hormone-binding inhibitory immunoglobulin assays, or the effect of reduced levels of circulating thyroid

  14. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    showed a higher sensitivity to radioiodine, with more cases of early hypothyroidism, than non-operated patients. However, after 50 months of follow-up the outcome was identical. The results indicate that frequent assessment is necessary after radioiodine treatment of previously operated patients, since......Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  15. Piezosurgery in Modified Pterional Orbital Decompression Surgery in Graves Disease.

    Science.gov (United States)

    Grauvogel, Juergen; Scheiwe, Christian; Masalha, Waseem; Jarc, Nadja; Grauvogel, Tanja; Beringer, Andreas

    2017-10-01

    Piezosurgery uses microvibrations to selectively cut bone, preserving the adjacent soft tissue. The present study evaluated the use of piezosurgery for bone removal in orbital decompression surgery in Graves disease via a modified pterional approach. A piezosurgical device (Piezosurgery medical) was used in 14 patients (20 orbits) with Graves disease who underwent orbital decompression surgery in additional to drills and rongeurs for bone removal of the lateral orbital wall and orbital roof. The practicability, benefits, and drawbacks of this technique in orbital decompression surgery were recorded. Piezosurgery was evaluated with respect to safety, preciseness of bone cutting, and preservation of the adjacent dura and periorbita. Preoperative and postoperative clinical outcome data were assessed. The orbital decompression surgery was successful in all 20 orbits, with good clinical outcomes and no postoperative complications. Piezosurgery proved to be a safe tool, allowing selective bone cutting with no damage to the surrounding soft tissue structures. However, there were disadvantages concerning the intraoperative handling in the narrow space and the efficiency of bone removal was limited in the orbital decompression surgery compared with drills. Piezosurgery proved to be a useful tool in bone removal for orbital decompression in Graves disease. It is safe and easy to perform, without any danger of damage to adjacent tissue because of its selective bone-cutting properties. Nonetheless, further development of the device is necessary to overcome the disadvantages in intraoperative handling and the reduced bone removal rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Ines Khochtali

    2010-01-01

    have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  17. Common genetic variants associated with thyroid function may be risk alleles for Hashimoto's disease and Graves' disease.

    Science.gov (United States)

    Campbell, Purdey; Brix, Thomas H; Wilson, Scott G; Ward, Lynley C; Hui, Jennie; Beilby, John P; Hegedüs, Laszlo; Walsh, John P

    2015-02-14

    Recent studies have identified common genetic variants associated with TSH, free T4 and thyroid peroxidase antibodies, but it is unclear whether these differ between patients with Hashimoto's disease and Graves' disease. To examine whether 11 common genetic variants differ between Graves' disease and Hashimoto's disease. We genotyped 11 common variants in a discovery cohort of 203 Australian patients with autoimmune thyroid disease (AITD). Two variants with significant or suggestive associations were analysed in a replication cohort of 384 Danish patients. For rs753760 (PDE10A), the minor allele frequency in Graves' disease and Hashimoto's disease was 0·38 vs. 0·23, respectively, (P = 6·42 × 10 -4 ) in the discovery cohort, 0·29 vs. 0·24 (P = 0·147) in the replication cohort and 0·32 vs. 0·24 in combined analysis (P = 0·0021; all analyses adjusted for sex). In healthy controls from Busselton, the frequency was 0·29, significantly different from Hashimoto's disease but not Graves' disease. For rs4889009 (MAF gene region), the frequency of the minor G-allele in Graves' disease and Hashimoto's disease was 0·48 vs. 0·36 (P = 0·0156) in the discovery cohort, 0·48 vs. 0·34 (P = 1·83 × 10 -4 ) in the replication cohort and 0·48 vs. 0·35 in the combined analysis (P = 7·53 × 10 -6 ); in controls, the frequency was 0·38, significantly different from Graves' disease but not Hashimoto's disease. After further adjustment for smoking, associations with rs4889009 remained significant, whereas those with rs753760 were not. Common variants in PDE10A and MAF gene regions may influence whether patients with AITD develop Graves' disease or Hashimoto's disease. © 2015 John Wiley & Sons Ltd.

  18. The natural history and prognostic factors of Graves' disease in Korean children and adolescents

    Directory of Open Access Journals (Sweden)

    Seung Min Song

    2010-04-01

    Full Text Available Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8% or propylthiouracil (6.2%. Antithyroid drugs had been discontinued in 75 (66.4% of 113 patients. Of these 75 patients, 23 (20.4% relapsed after 25.5¡?#?3.7; months. Thirteen (11.5% of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8% of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission (P =0.034. Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

  19. The role of Tc-99m polyclonal human immunoglobulin G scintigraphy in Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Ortapamuk, H.; Hosal, B.; Naldoken, S.

    2002-01-01

    The aim of this study was to clarify whether Tc-99m HIG (Polyclonal Human Immunoglobulin G) can image and determine the severity of orbital involvement in patients with Graves' ophthalmopathy. Twenty-six patients between 19 and 56 years old with Graves' ophthalmopathy were examined. All patients received approximately 370 MBq Tc-99m HIG by intravenous (i.v.) injection. Planar and SPECT examination were performed 4 hours after the injection. Visual and semiquantitative evaluations were performed for both orbits by two independent observers. Clinically active ophthalmopathy patients had noticeably increased orbital accumulation of Tc-99m HIG. In patients with inactive disease, and 14 of 19 had no uptake, whereas 5 patients had orbital radioactivity accumulation. The duration of Graves' ophthalmopathy did not correlate with the presence of active ophthalmopathy and Tc-99m HIG grade. There was no correlation between clinical classification and clinical activity (r=278). There was a good correlation between clinical activity and the radioactivity grade with r=0.666 (p=0.01). The clinical classification closely correlated with Tc-99m HIG grade (r=0.423, p=0.05) Tc-99m HIG scan can clearly identified clinically active patients, and subclinical inflammation can be shown by this scintigraphic evaluation. The current preliminary results suggested that Tc-99m HIG SPECT might be useful for the assessment of disease activity in Graves' ophthalmopathy. (author)

  20. Thyroid Function after Subtotal Thyroidectomy in Patients with Graves' Hyperthyroidism

    NARCIS (Netherlands)

    Limonard, E. J.; Bisschop, P. H.; Fliers, E.; Nieveen van Dijkum, E. J.

    2012-01-01

    Background. Subtotal thyroidectomy is a surgical procedure, in which the surgeon leaves a small thyroid remnant in situ to preserve thyroid function, thereby preventing lifelong thyroid hormone supplementation therapy. Aim. To evaluate thyroid function after subtotal thyroidectomy for Graves'

  1. The role of nuclear medicine in the management of Graves' disease

    International Nuclear Information System (INIS)

    Freitas, J.E.

    1999-01-01

    1 31 I therapy is safe and effective for most Graves' disease patients. It is being used more frequently in previously restricted populations such as children, adolescents, and women of childbearing age. It affords prompt, consistent relief of hyperthyroidism, but permanent hypothyroidism ensues in almost all patients. This complication is readily diagnosed with modern in vitro assays and inexpensive, life-long replacement therapy renders the patient asymptomatic and able to resume a normal lifestyle. Recent changes in NRC requirements have further liberalized the use of 1 31 I for Graves' disease in the USA, permitting more patients to be treated with effective outpatient therapy. The controversial role of 1 31 I in exacerbation of GO has been further clarified and preventive measures are available

  2. Correlation of stress with outcome of radioiodine therapy for Graves disease

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, T.; Rochon, J.; Lenfestey, R.; Wise, P.

    1985-06-01

    Between November 1965 and December 1983, 293 patients were treated for Graves disease using /sup 131/I. All patients were asked to identify a stressful event antedating the onset of overt clinical symptoms. Eighty-one patients were able to do this (27.6%). Two hundred forty-four patients received a single treatment, 49 required two or more treatments. Patients with stress initiating the symptoms of Graves disease became hypothyroid earlier, 50% at 12 mo compared with 36 mo for the nonstress group. At 10 yr 5% of the stress group remained euthyroid compared with 17% nonstress. The authors conclude that stress in the 12 mo or less before the onset of clinical symptoms potentiates the development of hypothyroidism induced by a standard dose of radioiodine.

  3. Distrofa miotónica congénita en una Unidad de Cuidados Intensivos Neonatales: serie de casos

    OpenAIRE

    Domingues, Sara; Alves Pereira, Clara; Machado, Ángela; Pereira, Sandra; Machado, Leonilde; Fraga, Carla; Oliveira, Abílio; Vale, Isabel; Quelhas, Ilídio

    2014-01-01

    La distrofia miotónica de Steinert es una enfermedad multisistémica, autosómica dominante, con un amplio espectro de gravedad y manifestaciones clínicas. La forma más grave es aquella que se manifesta en el periodo neonatal, llamada distrofa miotónica congénita. Se destaca la hipotonía global al nacer y el compromiso de la función respiratoria. Las complicaciones son frecuentes, principalmente, retraso del desarrollo psicomotor, del crecimiento pondoestatural, difcultades alimentarias y const...

  4. Terapia génica para la diabetes tipo I basada en la administración intramuscular de 18V1 insulina-glucoquinasa.

    OpenAIRE

    Jaén Sitges, Maria Luisa,

    2017-01-01

    La diabetes tipo 1 es una enfermedad metabólica compleja para la cual actualmente no hay cura y está asociada con complicaciones secundarias graves, causadas en gran parte por un control glucémico deficiente. El logro de la normoglucemia con el tratamiento exógeno con insulina requiere el uso de altas dosis de la hormona, lo que aumenta el riesgo de episodios hipoglucémicos potencialmente mortales. En nuestro laboratorio se ha demostrado previamente que una única administración intramuscular ...

  5. Terapia génica para la diabetes tipo I basada en la administración intramuscular de AAV1 insulina-glucoquinasa

    OpenAIRE

    Jaén Sitges, Maria Luisa

    2017-01-01

    La diabetes tipo 1 es una enfermedad metabólica compleja para la cual actualmente no hay cura y está asociada con complicaciones secundarias graves, causadas en gran parte por un control glucémico deficiente. El logro de la normoglucemia con el tratamiento exógeno con insulina requiere el uso de altas dosis de la hormona, lo que aumenta el riesgo de episodios hipoglucémicos potencialmente mortales. En nuestro laboratorio se ha demostrado previamente que una única administración intramuscular ...

  6. Is Graves' disease a primary immunodeficiency? New immunological perspectives on an endocrine disease.

    Science.gov (United States)

    Struja, Tristan; Kutz, Alexander; Fischli, Stefan; Meier, Christian; Mueller, Beat; Recher, Mike; Schuetz, Philipp

    2017-09-25

    Uncertainty about factors influencing the susceptibility and triggers for Graves' disease persists, along with a wide variation in the response to anti-thyroid drugs, currently at approximately 50% of non-responders. The aim of this narrative review is to summarize immunological concepts, with a combined endocrine and immunological perspective, to highlight potential new areas of research. Relevant studies were identified through a systematic literature search using the PubMed and EMBASE databases in March 2016. No cut-offs regarding dates were imposed. We used the terms "Graves' Disease" or "Basedow" or "thyrotoxicosis" together with the terms "etiology", "pathophysiology", "immunodeficiency", "causality", and "autoimmunity". The terms "orbitopathy", "ophthalmopathy", and "amiodarone" were excluded. Articles in English, French, German, Croatian, Spanish, and Italian were eligible for inclusion. While concepts such as the impact of iodine, smoking, human leucocyte antigen, infections, and ethnicity are established, new ideas have emerged. Pertaining evidence suggests the involvement of autoimmunity and immunodeficiency in the pathophysiology of Graves' disease. Recent studies point to specific immunological mechanisms triggering the onset of disease, which may also serve as targets for more specific therapies.

  7. Genetic association between Interleukin-17A gene polymorphisms and the pathogenesis of Graves' disease in the Han Chinese population.

    Science.gov (United States)

    Qi, Yicheng; Zheng, Huan; Liu, Nan; Guo, Ting; Zhu, Wei; Wang, Shu; Cui, Bin; Ning, Guang

    2015-01-19

    Graves' disease, one of the commonest autoimmune disorders, has a complex genetic basis. Interleukin-17A (IL-17A) is an important cytokine involved in innate and adaptive immune responses. This case-control study sought to investigate genetic association between the IL-17A gene and the process of Graves' disease (GD). Our pilot study was performed on a cohort from Shanghai, which included 713 patients with GD and 756 healthy controls. A replicate cohort was from Xiamen, recruiting 444 patients with GD and 427 healthy subjects. Six single nucleotide polymorphisms (SNPs) (rs4711998, rs3819024, rs2275913, rs8193037, rs3819025 and rs3748067) within the IL-17A gene were genotyped by the SNPstream Genotyping Systems and Taqman PCR method. In Shanghai cohorts, the frequencies of rs8193037 alleles were strongly different between patients with Graves' disease (G, 87·6% and A, 12·4%) and healthy controls (G, 91·4% and A, 8·6%) (P = 0·00067). The A carriers were associated with increased Graves' disease risks when compared with the G carriers (OR = 1·51, 95%CI = 1·19-1·92). In replicate cohorts, the proportion of individuals carrying the A allele of rs8193037 was significantly higher in patients with Graves' disease than in controls [Graves' disease vs control, 14·3% vs 9·1%, OR = 1·66 (95% CI: 1·23-2·24), P allele  = 0·0082]. In addition, rs8193037 and rs3748067 were found to be different in both genotype and allele distributions in Graves' disease-associated ophthalmopathy patients and controls in Shanghai cohorts. Haplotype association analysis also identified five main haplotypes of those six SNPs. These results suggested that the polymorphism of IL-17A rs8193037 was strongly associated with Graves' disease susceptibility in the Chinese Han population.z. © 2015 John Wiley & Sons Ltd.

  8. Age and stress as determinants of the severity of hyperthyroidism caused by Graves' disease in newly diagnosed patients

    NARCIS (Netherlands)

    Vos, Xander G.; Smit, Natalie; Endert, Erik; Brosschot, Jos F.; Tijssen, Jan G. P.; Wiersinga, Wilmar M.

    2009-01-01

    Objective: The evidence that stress may provoke Graves' hyperthyroidism in genetically susceptible subjects is substantial. Whether exposure to stress is related to the severity of thyrotoxicosis has not been studied. Advancing age is associated with not only less severe Graves' hyperthyroidism but

  9. Periodic Paralysis and Encephalopathy as Initial Manifestations of Graves' Disease: Case Report and Review of the Literature.

    Science.gov (United States)

    Tsironis, Theocharis; Tychalas, Athanasios; Kiourtidis, Dimitrios; Kountouras, Jannis; Xiromerisiou, Georgia; Rudolf, Jobst; Deretzi, Georgia

    2017-07-01

    Thyrotoxic periodic paralysis (TPP) is an uncommon complication of Graves' disease, characterized by the triad of acute hypokalemia without total body potassium deficit, episodic muscle paralysis, and thyrotoxicosis. Graves' encephalopathy is an extremely rare form of encephalopathy associated with autoimmune thyroid disease (EAATD), characterized by neuropsychiatric symptoms, increased antithyroid antibodies and cerebrospinal fluid protein concentration, nonspecific electroencephalogram abnormalities, and cortico-responsiveness. Coexistence of both these complications in the same patient has not been reported before. We herein present a 48-year-old white male patient with TPP and encephalopathy as initial presentations of Graves' disease. Flaccid tetraparesis was reversed a few hours after potassium level correction and the patient did not suffer any relapse with the successful pharmaceutical management of the thyroid function. One month later, the patient presented with dizziness and behavioral symptoms, such as inappropriate laughter and anger. Brain magnetic resonance imaging revealed meningeal enhancement and cerebrospinal fluid analysis showed a mild protein increase, with a blood-brain barrier disruption. With the suspicion of EAATD, the patient was treated with high doses of corticosteroids and improved dramatically. To our knowledge this is the first reported coexistence of potentially treatable TPP and EAATD as initial neurological manifestations of Graves' disease, thereby underscoring the necessity of suspicion of possible underlying Graves' disease in patients with acute paralysis and encephalopathy of unclear origin.

  10. Regression of Ophthalmopathic Exophthalmos in Graves' Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series.

    Science.gov (United States)

    Bhargav, P R K; Sabaretnam, M; Kumar, S Chandra; Zwalitha, S; Devi, N Vimala

    2017-12-01

    Autoimmune ophthalmopathy is one of the salient clinical features associated with Graves' disease. Exophthalmos is one of the commonest manifestations of Graves' associated ophthalmopathy. It is reported to regress after thyroidectomy favourably compared to radioiodine or antithyroid drug therapy. In this context, we present our experience based on a surgical series of Graves' disease. This is a prospective study of 15 patients of Graves' disease associated with ophthalmopathic exophthalmos. Preoperative and monthly postoperative evaluation of exophthalmos was done with Hertel's exophthalmometer, apart from documenting lid, extra-ocular muscle and orbital involvement. The minimum follow-up of the cohort was 12 months. The female to male ratio was 12:3 and the mean age of the subjects was 33.4 years (18-55). Exophthalmos was bilateral in 13 and unilateral in 2 patients. All the 15 patients underwent total thyroidectomy without any major morbidity. Exophthalmos regressed in 12 patients at a mean follow-up of 15.6 ± 6.4 months (14-38) and was static in 3. None of the cases had worsened ophthalmopathy at the final follow-up. Mean regression of exophthalmos was 2.1 mm (1-5). The regression was statistically significant at P value = 0.035. Surgery has a positive impact on the regression of ophthalmopathic exophthalmos associated with Graves' disease.

  11. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    International Nuclear Information System (INIS)

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo; Monte, Osmar; Silva, Marta Assumpcao de Andrada e; Duprat, Andre; Marone, Marilia; Almeida, Renata de; Iglesias, Alexandre

    2008-01-01

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  12. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    Energy Technology Data Exchange (ETDEWEB)

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP); Monte, Osmar [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Physiology Department; Silva, Marta Assumpcao de Andrada e [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Speech Therapy School; Duprat, Andre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department; Marone, Marilia [Nuclimagem - Irmanity of the Sao Paulo Santa Casa de Misericordia, SP (Brazil). Nuclear Medicine Unit; Almeida, Renata de; Iglesias, Alexandre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department. Endocrinology and Metabology Unit

    2008-07-01

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  13. Clinical investigation of 131I therapy combined with low-dose lithium carbonate for Graves disease

    International Nuclear Information System (INIS)

    Xu Haiqing; Wu Bian

    2006-01-01

    Objective: To investigate the clinical curative effects of 131 I therapy combined with low-dose lithium carbonate for Graves disease. Methods: Patients with Graves disease took lithium carbonate (250 mg, once per day) orally for 5 weeks. Then they were treated with 131 I (doses=3.15 MBq(80 uCi)/g, based on 60%-70% of the thyroid size). We kept track from 6 to 24 months (averaging 14 months) and classified the results into three: cured, improved or no effect. Results: After a single cycle of 131 I therapy combined with low-dose lithium carbonate, 106 patients with Graves disease were cured, 28 were improved and 8 saw no effects, respectively 74.6%, 19.7% and 5.6% among the 142 patients. We then treated 23 of them with another 131 I therapy (without lithium carbonate). 10 of such were cured (43.5%), 8 were improved (34.8%) and the other 5 saw no effects. Among all patients, hypothyroidism was observed from 25(17.6%), 6 months after the first 131 I therapy. Conclusions: Notable curative results were observed from 131 I therapy combined with low-dose lithium carbonate for Graves disease. Moreover, the dosage of 131 I was therefore decreased, which also lowered the toxicity response. (authors)

  14. Reduced parietooccipital white matter glutamine measured by proton magnetic resonance spectroscopy in treated graves' disease patients

    DEFF Research Database (Denmark)

    Danielsen, Else Rubæk; Elberling, T.V.; Rasmussen, Åse Krogh

    2008-01-01

    CONTEXT: Graves' disease is an autoimmune disease of the thyroid gland. Patients often have affective and cognitive complaints, whether these disappear after treatment remains disputed. OBJECTIVE: Our objective was to evaluate cerebral biochemistry in acute and treated Graves' disease. DESIGN: We...... conducted a prospective study, investigating volunteers once and patients before and 1 yr after treatment. SETTING: The study was performed at a radiology department, a memory disorder clinic, and two endocrinology clinics. PATIENTS AND OTHER PARTICIPANTS: Of 53 consecutively referred, newly diagnosed...... and a battery of biochemical, affective, and cognitive tests were used. RESULTS: Previously reported findings of reduced choline and myo-inositol in acute Graves' disease were confirmed and reversibility was demonstrated. Parieto-occipital white matter glutamine was and remained significantly reduced (P

  15. Prediction of remission in Graves' disease after thionamide therapy by technetium-99m early uptake

    International Nuclear Information System (INIS)

    Misaki, Takashi; Dokoh, Shigeharu; Koh, Toshikiyo; Shimbo, Shin-ichiro; Hidaka, Akinari; Iida, Yasuhiro; Kasagi, Kanji; Konishi, Junji.

    1991-01-01

    In the clinical management of Graves' thyrotoxicosis, one of the most important subject is when to stop antithyroid drugs after achieving an euthyroid state. T 3 suppression test and other methods have been used to forecast the outcome after drug cessation, but the results were not always satisfactory. We have attempted to predict remission of Graves' disease by single measurement of early technetium uptake without administration of triiodothyronine. Drugs were discontinued in the seventy-five patients with Graves' disease on maintenance doses of either methimazole or propylthiouracil who showed normalized uptake (4.0% or less). Of 64 patients evaluable after twelve months, 55 (86%) remained euthyroid, 8 relapsed, and 1 became hypothyoid. With its accuracy in prediction of short-term remission comparable or superior to T 3 suppression test, this rapid and simple method seemed suitable for routine use in clinical practice. (author)

  16. Osteogenesis imperfecta in combination with Graves disease

    Directory of Open Access Journals (Sweden)

    Marina S. Sheremeta

    2017-12-01

    Full Text Available Osteogenesis imperfecta (OI – is a group of genetically disorders, which are charaterized by a disturbed bone formation. In turn, the excess of thyroid hormones in Graves' disease (GD also posses a negative effect on bone tissue, thereby aggravating OI. That requires from the endocrinologist the most careful management of patients with the combination of these pathologies. In this article, we present a unique clinical case of a combination of GD and OI.

  17. Variation in the use of definitive treatment options in the management of Graves' disease: a UK clinician survey.

    Science.gov (United States)

    Hookham, Jessica; Collins, Emma E; Allahabadia, Amit; Balasubramanian, Sabapathy P

    2017-04-01

    Graves' disease can be treated with antithyroid drugs (ATDs), radioiodine or surgery. Use of definitive treatments (radioiodine or surgery) varies widely across centres. Specific clinical circumstances, local facilities, patient and clinician preferences and perceptions will affect the choice of treatment. Detailed understanding of UK clinicians' views and their rationale for different treatments is lacking. To study the preferences and perceptions of UK clinicians on the role of surgery and radioiodine in the management of Graves' disease. 'British Thyroid Association' (BTA), 'Society for Endocrinology' (SFE) and 'British Association of Endocrine and Thyroid Surgeons' (BAETS) members were invited to complete an online survey examining their management decisions in Graves' disease and factors that influenced their decisions. 158 responses from UK consultants were included. The ratio of physicians to surgeons was 11:5 and males to females was 12:4. Most clinicians would commence ATDs in uncomplicated first presentation of Graves' disease. A wide range of risk estimates on the effectiveness and risks of treatment was given by clinicians. Radioiodine was used most frequently in relapsed Graves' disease. However, severe eye disease and pregnancy strongly influenced choice in favour of surgery. Surgeons underestimated the success of radioiodine (pGraves' disease. The variation appeared to be dependent on patient and disease-specific factors as well as physician experience, gender and specialty. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Ratio of serum free triiodothyronine to free thyroxine in Graves' hyperthyroidism and thyrotoxicosis caused by painless thyroiditis.

    Science.gov (United States)

    Yoshimura Noh, Jaeduk; Momotani, Naoko; Fukada, Shuji; Ito, Koichi; Miyauchi, Akira; Amino, Nobuyuki

    2005-10-01

    The serum T3 to T4 ratio is a useful indicator for differentiating destruction-induced thyrotoxicosis from Graves' thyrotoxicosis. However, the usefulness of the serum free T3 (FT3) to free T4 (FT4) ratio is controversial. We therefore systematically evaluated the usefulness of this ratio, based on measurements made using two widely available commercial kits in two hospitals. Eighty-two untreated patients with thyrotoxicosis (48 patients with Graves' disease and 34 patients with painless thyroiditis) were examined in Kuma Hospital, and 218 patients (126 with Graves' disease and 92 with painless thyroiditis) and 66 normal controls were examined in Ito Hospital. The FT3 and FT4 values, as well as the FT3/FT4 ratios, were significantly higher in the patients with Graves' disease than in those with painless thyroiditis in both hospitals, but considerable overlap between the two disorders was observed. Receiver operating characteristic (ROC) curves for the FT3 and FT4 values and the FT3/FT4 ratios of patients with Graves' disease and those with painless thyroiditis seen in both hospitals were prepared, and the area under the curves (AUC), the cut-off points for discriminating Graves' disease from painless thyroiditis, the sensitivity, and the specificity were calculated. AUC and sensitivity of the FT(3)/FT(4) ratio were smaller than those of FT(3) and FT(4) in both hospitals. The patients treated at Ito hospital were then divided into 4 groups according to their FT4 levels (A: 2.3 approximately 5.4 ng/dl), and the AUC, cut-off points, sensitivity, and specificity of the FT(3)/FT(4) ratios were calculated. The AUC and sensitivity of each group increased with the FT4 levels (AUC: 57.8%, 72.1%, 91.1%, and 93.4%, respectively; sensitivity: 62.6%, 50.0%, 77.8%, and 97.0%, respectively). The means +/- SE of the FT3/FT4 ratio in the Graves' disease groups were 3.1 +/- 0.22, 3.1 +/- 0.09, 3.2 +/- 0.06, and 3.1 +/- 0.07, respectively, versus 2.9 +/- 0.1, 2.6 +/- 0.07, 2.5 +/- 0

  19. Mortalidad asociada a infección por el virus de Chikungunya

    Directory of Open Access Journals (Sweden)

    Diego Viasus

    2015-01-01

    Full Text Available La infección por el virus de Chikungunya presenta manifestaciones clínicas típicas: fiebre, erupción cutánea y artralgia. La enfermedad es generalmente autolimitada y de evolución benigna. Las complicaciones graves y la muerte ocurren en raras ocasiones y en pacientes con factores de riesgo, principalmente en aquellos con comorbilidades o que se encuentran en edades extremas de la vida. En este artículo describimos un paciente, sin comorbilidades previas conocidas, con infección por el virus de Chickungunya que progresó rápidamente a disfunción orgánica múltiple y murió luego de 36 horas de su ingreso. Este caso ilustra la dificultad del diagnóstico y el tratamiento de la infección grave por el virus de Chikungunya.

  20. Fenotipo grave en dos medio hermanas con síndrome de Adams Oliver

    OpenAIRE

    Sevilla-Montoya, Rosalba; Ríos-Flores, Braulio; Moreno-Verduzco, Elsa; Domínguez-Castro, Mauricio; Rivera-Pedroza, Carlos I; Aguinaga-Ríos, Dra. Mónica

    2014-01-01

    El síndrome de Adams Oliver (AOS) es una entidad heterogénea con defecto transverso terminal de extremidades (TTLD) y aplasia cutis congénita (ACC) con un amplio espectro fenotípico. Se han descrito diferentes modos de herencia en esta enfermedad; los defectos más graves se han asociado a un patrón autosómico recesivo (AR). Objetivo. presentar a una familia con dos medio hermanas con un fenotipo grave de Adams Oliver, con una madre sana. Reporte del caso: una mujer de 27 años de edad fue refe...

  1. Clinical significance of monitoring of serum TRAb in pregnant women with graves' disease treated by propylthiouracil

    International Nuclear Information System (INIS)

    Zou Jinhai; Li Xue; Wang Yansheng; Zhang Qingfeng; Wang Jianchun

    2011-01-01

    Objective: To discuss the change of serum TRAb and changeable regularity of thyroid function and clinical significance of pregnant women with Graves' diease treated by propylthiouracil. Methods: Detecting the serum TRAb, FT 3 , FT 4 , TSH levels of pregnant women with Graves' disease treated by propylthiouracil using radioreceptor assay and electro chemiluminescence. Results: The serum TRAb level of the pregnant women with Graves' disease in early gestation treated by propylthiouracil descended much more than that in the initial diagnosis (P<0.01). The positive rates of TRAb in the women before treated by propylthiouracil and treated 3 months, 6 months, 8 months were 90.2%, 82.9%, 68.2% and 21.9% separately. The activity of TRAb descended slightly 3 months latter after treated. The activity of TRAb descend obviously and the positive rates changed largely 8 months after treated. Conclusion: There is very important clinical significance of monitoring of serum TRAb in pregnant women with Graves' disease in diagnosis and differential diagnosis and observation of therapeutic effects. Also, a favourable prognosis judgement. Meanwhile, provides significant reference index of pathogenetic condition judgement and drug discontinuance whether or not for the clinician. (authors)

  2. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    Science.gov (United States)

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

  3. Case report of Graves' disease manifesting with odynophagia and heartburn.

    Science.gov (United States)

    Evsyutina, Yulia; Trukhmanov, Alexander; Ivashkin, Vladimir; Storonova, Olga; Godjello, Elina

    2015-12-28

    Graves' disease is an autoimmune disease, which can manifest with a variety of extrathyroidal clinical syndromes like ophthalmopathy, pretibial myxedema (dermopathy), acropathy, cardiomyopathy, and encephalopathy. Though quite rare, this disease can also manifest with gastrointestinal symptoms such as dysphagia, heartburn, nausea, vomiting and diarrhea. We report a clinical case of Graves' disease manifesting with dysfunction of the esophagus and heartburn in a 61-year-old man. In the muscular layer of the esophagus we found dystrophic changes led to its atony, which was documented by endoscopy and high-resolution manometry. The pathology features of esophageal symptoms were: focal proliferation of the basal cells, vascular distension, and dystrophy of the epithelial cells. Antithyroid treatment led to decrease of all clinical symptoms after 5 d of Thiamazole administration. Complete restoration of peristalsis in the esophagus, according to manometry, was observed in 1 mo after initiation of treatment.

  4. Does radioiodine cause the ophthalmopathy of Graves' disease?

    International Nuclear Information System (INIS)

    McDougall, I.R.

    1993-01-01

    This editorial briefly reviews studies which might answer the question as to whether radioiodine treatment causes the ophthalmopathy of Graves' disease. However, the data do not allow any conclusion one way or the other. Other possible causal factors are discussed. Further studies are required to define whether treatment of hyperthyroidism aggravates the ophthalmopathy and whether one thereby is worse than the others and by how much. (UK)

  5. Affective symptoms and cognitive functions in the acute phase of Graves' thyrotoxicosis

    DEFF Research Database (Denmark)

    Vogel, Asmus; Elberling, Tina V; Hørding, Merete

    2007-01-01

    of cognitive deficits) had decreased significantly, with further normalisation 1-year after treatment initiation. In conclusion, patients had subjective reports of cognitive deficits in the toxic phase of Graves' thyrotoxicosis but comprehensive neuropsychological testing revealed no cognitive impairment......In the acute phase of Graves' thyrotoxicosis patients often have subjective cognitive complaints. Continuing controversy exists about the nature of these symptoms and whether they persist after treatment. This prospective study included 31 consecutively referred, newly diagnosed, and untreated....... No significant differences between the patient and the control group on neuropsychological test performances were found. Thyroid levels did not correlate with the neuropsychological test performances or psychiatric ratings. After reaching euthyroidism the level of affective symptoms (including reports...

  6. Correlation of orbital muscle changes evaluated by magnetic resonance imaging and thyroid-stimulating antibody in patients with Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Nishikawa, M.; Yoshimura, M.; Inada, M.

    1993-01-01

    To evaluate the relationship between eye changes and autoantibody to the thyrotropin receptor in patients with Graves' disease, the authors evaluated the eye changes using magnetic resonance imaging and the results were correlated with thyroid-stimulating antibody, thyrotropin binding inhibitor immunoglobulin and thyroid growth activity. Subjects were 15 patients with Graves' disease who had Graves' ophthalmopathy, including exophthalmos and other signs and symptoms, and 9 patients without ophthalmopathy; all were maintained in a euthyroid state by antithyroid drugs. The thyrotropin-binding inhibitor imunoglobulin was measured by a kit, and thyroid-stimulating antibody and thyroid growth activity were evaluated by cyclic adenosine 3', 5'-monophosphate production and [ 3 H]thymidine incorporation, respectively, by cultured functional rat thyroid lined cells. The sum of the swelling ratios of the four extraocular muscles correlated well with the degree of exophthalmos. The thyrotropin-binding inhibitor immunoglobulin was positive in 9 out of 15 patients with ophthalmopathy; however, no correlation was observed between the activity and exophthalmos or muscle swelling. No significant correlation was observed between muscle changes and thyroid growth activity either. On the other hand, thyroid-stimulating antibody in Graves' patients with ophthalmopathy was significantly higher than that in patients without ophthalmopathy. Moreover, the level of the stimulating activity in Graves' patients with ophthalmopathy showed a significant positive correlation with the sum of the swelling ratios of the individual eight eye muscles. These results suggest that thyroid-stimulating antibody has a close relation to Graves' ophthalmopathy. 23 refs., 4 figs

  7. Histologic Findings and Cytological Alterations in Thyroid Nodules After Radioactive Iodine Treatment for Graves' Disease: A Diagnostic Dilemma.

    Science.gov (United States)

    El Hussein, Siba; Omarzai, Yumna

    2017-06-01

    Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging. Thus, pathologists should be aware of the existence of these changes in the setting of radiation therapy for Graves' disease. Providing pathologists with appropriate clinical history of Graves' disease treated with radioactive iodine is of paramount importance in order to prevent an overdiagnosis of malignancy.

  8. Place of radiotherapy in the treatment of Graves' orbitopathy

    International Nuclear Information System (INIS)

    Beckendorf, Veronique; Maalouf, Toufic; George, Jean-Luc; Bey, Pierre; Leclere, Jacques; Luporsi, Elisabeth

    1999-01-01

    Purpose: The aim of this study is to evaluate the response of Graves' orbitopathy to irradiation, and to specify the prognostic factors allowing one to better define the indications of orbital radiotherapy. Methods and Materials: From 1977 to 1996, 199 patients received bilateral orbital irradiation delivering 20 Gy in 10 fractions and 2 weeks for a progressive Graves' orbitopathy. 195 patients were seen between 1 and 6 months after radiotherapy. The different symptoms were studied and their response to radiation was analyzed. Factors such as age, sex, evolution of thyroid disease, history of symptoms, and previous or combined treatments were analyzed. Results: The results revealed that 50 patients (26%) had a good or excellent response, 98 (50%) had a partial response, 37 (19%) were stable, 10 (5%) had a progression of disease. The signs that best responded to radiotherapy were the infiltration of soft tissues and the corneal involvement. Responses of proptosis or oculomotor disorders were more complete when these signs were not advanced at the time of treatment. Irradiation seemed to have the same efficacy when applied as first-line treatment or after failure of corticosteroids. Neither modality of treatment of hyperthyroidism nor thyroid status at the time of orbital irradiation modified the results. The best results were recorded for early or moderately advanced presentation (p = 0.05). Patients treated within a delay of 7 months after the beginning of the ophthalmopathy had better responses than patients treated later (p = 0.10). Conclusion: Radiation therapy was successful in Graves' orbitopathy by stopping the progression of disease in almost all cases, by improving the comfort of patients, by obtaining objective responses, and by avoiding surgical treatments particularly when signs were moderate

  9. Regulation mechanisms of pituitary-thyroid axis in normal subjects and patients with Graves' disease

    International Nuclear Information System (INIS)

    Takagi, Shinko; Yamauchi, Kazuyuki; Mori, Yuichi

    1986-01-01

    The regulatory mechanism of the pituitary-thyroid axis in normal subjects and patients with Graves' disease was investigated using a highly sensitive TSH assay based on the immunoradiometric assay. All of the normal subjects had detectable TSH values within the range 0.35 to 6.0 μU/ml. No negative correlations between TSH and free thyroid hormones existed in normal subjects. Patients with thyroid carcinoma who seemed to have normal pituitary-thyroid function showed a rapid increase of TSH after total thyroidectomy. On the other hand, while untreated patients with Graves' disease all had undetectable TSH values, these patients took 1 to 3.5 months longer to normalize their TSH values than to normalize free thyroid hormones on antithyroid drug therapy. During the recovery phase by the treatment with decrease of antithyroid drug or supplement of T 4 from iatrogenic hypothyroid state after treatment for Graves' disease and thyroid carcinoma, normalization of TSH levels was delayed than that of free thyroid hormones. Patients with Graves' disease in remission showed an extremely positive correlation between basal and peak TSH levels in TRH test, and a negative correlation between basal TSH and FT 4 . In conclusion, an individual patient may have a different set point concerning the regulatory mechanism of the pituitary-thyroid axis, and the persistence of the hyperthyroid state would seem to have caused some reversible dysfunction of the pituitary gland. (author)

  10. Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

    Science.gov (United States)

    Yu, Jing; Tian, Ai-Juan; Yuan, Xin; Cheng, Xiao-Xin

    2016-01-01

    Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH) increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression. The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH) levels exceeding 10 mIU/L. Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb) levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L. The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

  11. Contrast sensitivity function in Graves' ophthalmopathy and dysthyroid optic neuropathy

    NARCIS (Netherlands)

    Suttorp-Schulten, M. S.; Tijssen, R.; Mourits, M. P.; Apkarian, P.

    1993-01-01

    Contrast sensitivity function was measured by a computer automated method on 38 eyes with dysthyroid optic neuropathy and 34 eyes with Graves' ophthalmopathy only. The results were compared with 74 healthy control eyes. Disturbances of contrast sensitivity functions were found in both groups when

  12. Effect of radioiodine on stimulatory activity of Graves' immunoglobulins

    International Nuclear Information System (INIS)

    Atkinson, S.; McGregor, A.M.; Kendall-Taylor, P.; Peterson, M.M.; Smith, B.R.

    1982-01-01

    The effects of 131 I therapy on the activity of thyroid stimulating antibody (TSAb) and thyrotrophin binding inhibiting immunoglobulin (TBII) in nineteen patients with Graves' disease have been studied. Prior to 131 I administration, TSAb was detected in 84%, and TBII in 68% of patients. Following 131 I administration TSAb and TBII were detectable in 100% of patients. The elevation 3 months after treatment of the means of both the TSAb and TBII indices for the group of nineteen patients was highly significant compared with pretreatment values. All the patients went into remission during the course of the study and the TSAb index declined in all patients, becoming undetectable in eleven; TBII also declined in most patients but remained detectable in thirteen. The study furthermore afforded the opportunity for a direct comparison of binding with stimulatory activity. These results show that after 131 I therapy for Graves' hyperthyroidism there is a transient increase in TSAb as well as TBII, followed by a decline, and that the measurement of binding and stimulatory activities are in good general agreement. (author)

  13. Study on the relationship between serum IL-6, Sgp80, Sgp130 levels and bone metabolism in patients with Graves' disease

    International Nuclear Information System (INIS)

    Liu Chunyu; Mu Junqing; Zou Jianwen; Liu Songtao

    2007-01-01

    Objective: To investigate the relationship between serum IL-6, Sgp80, Sgpl30 levels and bone metabolism in patients with Graves' disease. Methods: Serum levels of IL-6 (with RIA), Sgp80, Sgpl30 (with ELISA) as well as BMD of proximal femur region were determined in 78 patients with Graves' disease (26 not treated yet, 26 partially remitted and 26 in remission) and 30 controls. Results: The serum IL-6 and Sgpl30 levels in all the patients with Graves' disease were significantly higher than those in controls (P 3 , FT 4 , phosphorous, BGP and urinary hydroxy proline levels. BMD of the proximal femur region in patients partially remitted were much lower than that in controls (P<0.05). Conclusion: Serum Sgp80 level might be taken as an important parameter in studying of Graves' disease. Bone loss, both cortical and trabecular, occurred in patients with Graves' disease. Increase of bone formation as well as bone resorption were primary, not secondary to each other. (authors)

  14. Unfavourable effect of prolonged treatment with antithyroid drugs on radioiodine therapy outcome in Graves' hyperthyroidism

    OpenAIRE

    Rajić, Milena; Vlajković, Marina; Ilić, Slobodan; Stević, Miloš; Sekulić, Vladan; Zečević, Mila

    2014-01-01

    Radioiodine therapy (RIT) of Graves' hyperthyroidism (GH) is usually recommended after failure of primary therapy with antithyroid drugs (ATDs), which are commonly prescribed for up to 18-24 months. However, in our region, the prolonged ATDs treatment of the disease is very common. Thus, we assessed the efficacy of RIT after prolonged continual pretreatment with ATDs in Graves' hyperthyroidism. Therapy outcome using a single dose of radioiodine was evaluated after one year in 91 patients (f/m...

  15. Graves' disease. Manifestations and therapeutic options

    International Nuclear Information System (INIS)

    McFarland, K.F.; Saleeby, G.

    1988-01-01

    Graves' disease is the most common cause of hyperthyroidism. Clinical features include thyroid enlargement, eye signs, tachycardia, heat intolerance, emotional lability, weight loss, and hyperkinesis. Three modes of therapy are available. The preferences of the patient and physician are usually prime considerations in devising the therapeutic plan. Radioactive iodine is the most frequently used and safest method of treatment for adults. Antithyroid drugs are preferred for children and pregnant women. Surgery is usually reserved for patients in whom the other forms of treatment are not acceptable. Considerable patient education during the decision-making process enhances the success of the therapeutic plan

  16. Graves' disease and idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Manish Gutch

    2017-01-01

    Full Text Available Idiopathic intracranial hypertension (IIH is a central nervous system disorder characterized by raised intracranial pressure with normal cerebrospinal fluid composition and absence of any structural anomaly on neuroimaging. Among all endocrine disorders associated with the development of IIH, the association of hyperthyroidism and IIH is very rare with few cases reported till date. Thyroid disturbances have a unique association with IIH. Hypo- and hyper-thyroidism have been reported in association with this disorder. We present a rare case of a 25-year-old man with Graves' disease with intractable headache that was later investigated and attributed to development of IIH.

  17. A grave of a Cuman noble woman in the Kislyakovsky 13 kurgan cemetery (Krasnodar kray

    Directory of Open Access Journals (Sweden)

    Boris Raev

    2017-12-01

    Full Text Available The Kislyakovskiy 13 kurgan cemetery was excavated in 2008 by an expedition of the Southern Scientific Center, RAS. Kurgan 2 contained two graves – one dated to the first centuries AD, the other to the Middle Ages, when the North Black Sea steppes were inhabited by the nomadic Polovеts tribes. This article discusses grave 2. The burial was made in a chamber in the form of a niche. Robbers destroyed one of the grave’s walls but the burial remained undisturbed. The buried woman of 35-40 years old was laying extended on back, head to west. Decayed wood from the funerary stretchers preserved under the skeleton. The rich grave goods included a bronze cauldron, an iron knife, two silver torques, hair rings, and a mirror. Fragments of the wooden frame, felt, textile, and gilded silver foil from a headdress preserved in area of the woman’s chest. The kurgan was encircled by a ditch; its northern part had two ledged niches made in the outer wall. Animal bones and ceramic shards with remains of the funerary feast were unearthed on the ditch bottom. The ditch was thoroughly made and has unique construction features. Judging by its lower layers, the dug-out soil was stacked not only on the kurgan’s surface but also round the ditch’s outer perimeter. The ditch remained opened for a long time and was gradually filled with flooded soil. Grave goods are typical for the Cuman graves of the 12th - early 13th centuries. The assemblage suggests a high social status of the buried woman. It is possible that for some time the area surrounded by the ditch was used as a sanctuary; afterwards the burial of a noble woman was performed, the kurgan was covered with a layer of soil.

  18. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    Science.gov (United States)

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

  19. Cradle to Grave: an Analysis of Female Oppression in Nawal El ...

    African Journals Online (AJOL)

    Cradle to Grave: an Analysis of Female Oppression in Nawal El Saadawi.s Woman ... An International Journal of Language, Literature and Gender Studies ... Women are subjected to male oppression and suppression at various stages of life.

  20. A questionnaire survey on the management of Graves' orbitopathy in Europe

    NARCIS (Netherlands)

    Perros, P.; Baldeschi, L.; Boboridis, K.; Dickinson, A. J.; Hullo, A.; Kahaly, G. J.; Kendall-Taylor, P.; Krassas, G. E.; Lane, C. M.; Lazarus, J. H.; Marcocci, C.; Marino, M.; Mourits, M. P.; Nardi, M.; Orgiazzi, J.; Pinchera, A.; Pitz, S.; Prummel, M. F.; Wiersinga, W. M.

    2006-01-01

    OBJECTIVE: To determine management patterns among clinicians who treat patients with Graves' orbitopathy (GO) in Europe. DESIGN AND METHODS: Questionnaire survey including a case scenario of members of professional organisations representing endocrinologists, ophthalmologists and nuclear medicine

  1. La nutrición enteral precoz en el enfermo grave Early enteral nutrition in the critically-ill patient

    OpenAIRE

    B. García Vila; T. Grau

    2005-01-01

    La nutrición enteral se ha demostrado como un método eficaz y seguro de nutrir a los enfermos graves ingresados en una Unidad de Cuidados Intensivos. Aunque se desconoce cuánto tiempo puede estar un enfermo grave sin nutrición, el catabolismo acelerado y el ayuno pueden ser deletéreos en el enfermo grave y la recomendación más frecuente es la de empezar la nutrición artificial cuando se prevea un período de ayuno superior a los siete días. Las ventajas de la nutrición enteral sobre la nutrici...

  2. Utilidad del test rápido de ureasa para la identificación de Helicobacter pylori en pacientes con hemorragia digestiva de origen péptico. Clínica Ortega de Huancayo 2015

    OpenAIRE

    Trujillo Cunyas, José Antonio

    2016-01-01

    Antecedentes: Helicobacter pylori juega un rol importante en la fisiopatología del desarrollo de la enfermedad ulcero péptica y sus complicaciones graves como la hemorragia digestiva siendo un factor de riesgo independiente que ocasiona el sangrado; la identificación de la bacteria en esta condición clínica se ve limitada por la disminución de la sensibilidad de la histología y test rápido de ureasa métodos utilizados para su diagnóstico. Objetivo: Identificar y valorar los resultados del tes...

  3. Aminoácidos y obesidad: relación de los niveles de homocisteína, aminoácidos de cadena ramificada y citrulina con sobrepeso-obesidad y resistencia insulínica en niños prepuberales

    OpenAIRE

    López García, Rafael

    2016-01-01

    Introducción: la obesidad infantil es uno de los problemas de Salud Pública más graves del s.XXI, sobre todo por las complicaciones cardiovasculares y endocrino-metabólicas asociadas. La prevalencia de obesidad se ha multiplicado por más de dos entre 1980 y 2014, estimándose que, a nivel mundial, más de 42 millones de niños tienen sobrepeso. En adultos hay estudios que reportan que la ingesta proteica conlleva efectos beneficiosos aunque altos niveles de determinados aminoácidos se relacionan...

  4. Genetic manipulation of the pancreas cell and gene therapy approaches for type 1 diabetes /

    OpenAIRE

    Ayuso López, Eduard

    2007-01-01

    Consultable des del TDX La diabetes de tipo 1 resulta de la destrucción autoinmune de las células ß pancreáticas, que conduce a una falta en la producción de insulina y la consiguiente hiperglucemia. La terapia sustitutiva con inyecciones subcutáneas de insulina permite a los pacientes llevar un vida activa, sin embargo esta terapia es imperfecta y no evita la aparición de graves complicaciones secundarias. El transplante de páncreas o islotes pancreáticos se ha realizado con éxito en algu...

  5. Analysis of complications in thyroid arterial embolization for hyperthyroidism caused by Graves' disease

    International Nuclear Information System (INIS)

    Gao Bulang; Zhao Wei; Huang Jianqiang; Xiang Shutian; Li Liyuan; Li Minghua

    2006-01-01

    Objective: To investigate complications and causes of thyroid arterial embolization for hyperthyroidism caused by Graves' disease. Methods: Twenty-eight patients with hyperthyroidism caused by Graves' disease had been treated through transcathter arterial embolization with mid-term follow up. The thyroid angiography, interventional treatment, complications and causes were investigated. Results Followed up for over one year (12-24 months), mid-term rate of efficiency was 78.6% with recurrent rate of one year being 14.2%. Two patients (7.1%) had brain infarction with one partially recovered after proper therapy and the other died due to subsequent hyperthyroidism crisis. One case had temporary hypothyroidism, and another hypoparathyroidism but no permanent hypothyroidism or hypoparathyroidism occurred. One patient suffered relatively severe post-embolization syndrome. All the other complications disappeared after proper treatment. Followed up for more than a year, no other complications occurred. Conclusion: Misembolization due to regurgitation of embolized agent is one of the most important factors leading to complications of arterial embolization for Graves' disease. In order to reduce complications and improve therapeutic efficacy, it is essential to superselectively catheterize the thyroid, avoid dangerous anastomose, prevent regurgitation misembolization and strictly operate under fluoroscopy. (authors)

  6. Sudden unexpected death due to Graves' disease during physical altercation.

    Science.gov (United States)

    Wei, Dengming; Yuan, Xiaogang; Yang, Tiantong; Chang, Lin; Zhang, Xiang; Burke, Allen; Fowler, David; Li, Ling

    2013-09-01

    We report a case of a 30-year-old woman who suddenly collapsed after having a physical altercation with her husband. Despite immediate resuscitation, she died on arrival at the hospital. The victim's parents requested an autopsy because they believed that their daughter was killed by her husband. Postmortem examination revealed that the victim had a diffusely enlarged thyroid gland and cardiomegaly with left ventricular hypertrophy. There was no evidence of significant trauma on the body. Further postmortem thyroid function tests and review of her medical history indicated that her death was due to Graves' disease. To the best of our knowledge, this is the first case reported of sudden death due to cardiac arrhythmia from Graves' disease induced by physical and emotional stress associated with the criminal activity of another person. The autopsy findings are described. In addition, the literature is reviewed and the significance of postmortem evaluation of thyroid hormones in the cases of sudden death is discussed. © 2013 American Academy of Forensic Sciences.

  7. Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids Ligadura de las arterias hemorroidales guiada por Doppler en el tratamiento de las hemorroides sintomáticas

    Directory of Open Access Journals (Sweden)

    J. M. Ramírez

    2005-02-01

    Full Text Available Objective: the aim of this study is to clinically test the efficacy of a new approach for patients having symptomatic grade III and IV hemorrhoids. Material and method: 32 patients (17 females complaining of grade III or IV hemorrhoids were included in the study. A specially designed proctoscope coupled with a Doppler transducer on its tip was used to identify the hemorrhoidal arteries, which were afterwards suture ligated. Operating time as well as per- and post-operative complications were anlyzed. Follow-up was planned following discharge after 1 week, 1 month, 6 months and 1 year. Results: mean operation time was 27 (range 18-43 minutes, and 5 (range 4-7 arteries were located on average. No patient had severe or moderate postoperative pain, with anal discomfort being the main complaint. Rectal bleeding and tenesmus were the commonest post-operative complications. After one year of follow-up, 19 patients were free of symptoms and 6 of them had significant symptom relief. According to grade, the technique failed in just 3 grade III patients, but in as many as 4 grade IV hemorrhoid cases. Conclusions: doppler-guided hemorrhoid artery ligation is an easy-to-perform technique that is well accepted by patients and has good results for grade III hemorrhoids.Objetivo: el objetivo de este trabajo es valorar en la clínica la eficacia de una nueva técnica quirúrgica para el tratamiento de las hemorroides de grado III y IV. Material y método: se incluyen en el estudio 32 pacientes (17 mujeres, 27 presentaban hemorroides de grado III y 5 de grado IV. Para la técnica se utilizó un prostoscopio transparente que incorpora un transductor Doppler en su extremo para localizar las arterias hemorroidales que se ligan mediante puntos que engloban la mucosa y submucosa. Se analizó el tiempo de intervención y las complicaciones intra y postoperatorias, así como las recidivas. Los pacientes fueron controlados al alta, a la semana, mes, 6 meses y al año de

  8. Complicações obstétricas em gestações com feto portador de anomalia incompatível com a sobrevida neonatal Complicaciones obstétricas en gestaciones con feto portador de anomalía incompatible con la sobrevivencia neonatal Obstetric complications in pregnancies with fetal anomalies incompatible with neonatal survival

    Directory of Open Access Journals (Sweden)

    Danila Cristina Paquier Sala

    2010-10-01

    Full Text Available OBJETIVO: Descrever as complicações obstétricas mais comuns encontradas nos períodos gestacional, parto e puerpério imediato de gestantes com fetos portadores de anomalias incompatíveis com a vida. MÉTODOS: Estudo descritivo, onde avaliou-se 78 prontuários de pacientes atendidas no pré-natal da Disciplina de Medicina Fetal da Universidade Federal de São Paulo que tiveram partos nessa mesma instituição, entre 2000 e 2006. RESULTADOS: As principais complicações obstétricas identificadas foram:variação do volume de líquido amniótico em 68%; abortamento, parto pré-termo e a gravidez prolongada estiveram presentes em 6,4%, 55,1% e 3,8% das gestações, respectivamente; óbito fetal intra-uterino em 17,9%; descolamento prematuro da placenta ocorreu em 6,4% e histerectomia em 2,6%. CONCLUSÃO: Estes resultados sugerem aumento de risco materno em gestações com fetos portadores de anomalias graves, fato que demonstra necessidade de avaliação especializada caso a caso.OBJETIVO: Describir las complicaciones obstétricas más comunes encontradas en los períodos de gestación, parto y puerperio inmediato de embarazadas con fetos portadores de anomalías incompatibles con la vida. MÉTODOS: Se trata de un estudio descriptivo, que evaluó 78 fichas médicas de pacientes atendidos en el prenatal de la Disciplina de Medicina Fetal de la Universidad Federal de Sao Paulo que tuvieron partos en esa misma institución, entre 2000 y 2006. RESULTADOS: Las principales complicaciones obstétricas identificadas fueron: variación del volumen de líquido amniótico en 68%; abortamiento, parto pre-término y embarazo prolongado estuvieron presentes en 6,4%, 55,1% y 3,8% de las gestaciones, respectivamente; muerte fetal intra-uterina en 17,9%; desprendimiento prematuro de la placenta ocurrió en 6,4% e histerectomía en 2,6%. CONCLUSIÓN: Éstos resultados sugieren un aumento del riesgo materno en gestaciones con fetos portadores de anomal

  9. Radiotherapy of Graves' ophthalmopathy. State of the art and review of the literature

    International Nuclear Information System (INIS)

    Eich, H.T.; Micke, O.; Seegenschmiedt, M.H.

    2007-01-01

    Graves' ophthalmopathy (GO), the most frequent extrathyroidal manifestation of Graves' disease, is a disorder of autoimmune origin, the pathogenic mechanisms of which are still incompletely understood. Although GO is severe in only 3-5% of affected individuals, quality of life is severely impaired even in patients with mild GO. The role of radiotherapy in the management of GO is discussed controversially. However, recent randomized clinical trials have, with one exception, confirmed that orbital radiotherapy is an effective and safe therapeutic procedure for GO. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. (orig.)

  10. Transconjunctival orbital decompression in Graves' ophthalmopathy: lateral wall approach ab interno

    NARCIS (Netherlands)

    A.D.A. Paridaens (Dion); K. Verhoeff; D. Bouwens; W.A. van den Bosch (Willem)

    2000-01-01

    textabstractAIMS: A modified surgical technique is described to perform a one, two, or three wall orbital decompression in patients with Graves' ophthalmopathy. METHODS: The lateral wall was approached ab interno through a "swinging eyelid" approach (lateral canthotomy

  11. Observation of changes of serum leptin and lipid (TG and TC) levels in patients with graves' disease

    International Nuclear Information System (INIS)

    Wang Zhaobao; Cheng Guanghua

    2008-01-01

    Objective: To investigate the clinical significance of changes of serum leptin (with RIA) and lipid (TG and TC) (with biochemistry) levels in patients with Graves' disease. Methods: Serum Leptin, TG and TC levels were determined in 29 patients with Graves' disease both before and after treatment as well as in 30 controls. Results: Before treatment, serum Leptin, TG and TC levels in the patients were significantly lower than those in the controls. After treatment, serum Leptin, TG and TC levels increased and were significantly higher than those before treatment and were not much different from those in controls. Conclusion: The changes of serum Leptin, TG and TC levels may be of value for outcome prediction in patients with Graves' disease. (authors)

  12. [Atypical subacute thyroiditis in combination with Grave's disease:Diagnostic difficulties in a case report].

    Science.gov (United States)

    Koutouridou, Emmanouela; Planck, Tereza; Uddman, Erik; Lantz, Mikael

    2018-04-13

    Subacute thyroiditis is a common inflammatory disorder of the thyroid gland, possibly of viral etiology, that typically presents with neck pain, fever and tenderness on palpation of the thyroid gland. Graves' disease is an autoimmune thyroid disorder caused by stimulation of the thyroid gland by thyrotropin receptor antibodies (TRAb). The development of Graves´ disease and subacute thyroiditis simultaneously is an uncommon condition and only a few cases have been reported. In this article we present a case of a 46-year old woman diagnosed with Graves´ disease who was started on thiamazole and weeks later developed high fever. Several differential diagnoses were considered such as infection, lymphoma and vasculitis due to thiamazole. Finally, the fine needle aspiration of the thyroid gland displayed histopathological features of subacute thyroiditis. Remarkably, our patient did not have neck pain or tenderness on palpation of the thyroid gland and overall the clinical presentation of subacute thyroiditis was atypical. Thus, subacute thyroiditis may be considered as a potential cause of fever of unknown origin.

  13. Role of Diffusion-Weighted Magnetic Resonance (MR) Imaging in Differentiation Between Graves' Disease and Painless Thyroiditis.

    Science.gov (United States)

    Abdel Razek, Ahmed Abdel Khalek; Abd Allah, Sieza Samir; El-Said, Amr Abd El-Hamid

    2017-01-01

    To assess the role of diffusion-weighted MR imaging in differentiation between Graves' disease and painless thyroiditis. A prospective study was conducted among 37 consecutive patients with untreated thyrotoxicosis (25 female and 12 male; mean age of 44 years) and 15 ageand sex-matched controls. Diffusion-weighted MR imaging of the thyroid gland was performed in patients and controls. The apparent diffusion coefficient (ADC) value of the thyroid gland was calculated and correlated with Tc-99m uptake and thyroid function tests of the patients. There was a significant difference in the ADC value of the thyroid gland between patients and the control group ( P =0.001). The mean ADC value of the thyroid gland in Graves' disease was 2.03±0.28×10 -3 mm 2 /sec, and in patients with painless thyroiditis 1.46±0.22×10 -3 mm 2 /sec, respectively. There was a significant difference in the ADC values between Graves' disease and painless thyroiditis ( P =0.001). When the ADC value of 1.45×10 -3 mm 2 /sec was used as a threshold value for differentiating Graves' disease from painless thyroiditis, the best result was obtained with area under the curve of 0.934, accuracy of 83.8%, sensitivity of 95.8%, and specificity of 61.5%. The mean ADC value of the thyroid gland in patients positively correlated with serum TRAb and Tc-99m uptake ( r =0.57, P =0.001 and r =0.74, P =0.001, respectively). We concluded that ADC values of the thyroid gland can be used to differentiate Graves' disease from painless thyroiditis in patients with untreated thyrotoxicosis.

  14. Detection of erythrovirus B19 in thyroidectomy specimens from Graves' disease patients: a case-control study.

    Science.gov (United States)

    Page, Cyril; Hoffmann, Thomas Walter; Benzerdjeb, Nassim; Duverlie, Gilles; Sevestre, Henri; Desailloud, Rachel

    2013-08-01

    Environmental factors, such as viruses, are thought to contribute to the development of thyroid autoimmunity. Erythrovirus B19 (EVB19) is suspected to be involved in Hashimoto's thyroiditis, but no direct evidence is available concerning the role of EVB19 infection in Graves' disease. The objective of this study was to investigate whether the presence of EVB19 is more frequent in thyroidectomy specimens of patients undergoing thyroidectomy for Graves' disease (cases) than for multinodular thyroid (controls). Serum and thyroidectomy specimens were prospectively collected from 64 patients referred for total thyroidectomy over a 5-year period (2007-2011) and were investigated retrospectively and blindly for circulating EVB19 DNA by q-PCR (Qiagen), and for EVB19 thyrocyte infection by immunochemistry (VP2-Antibody, Dako). EVB19 serology was also determined. General clinical and laboratory data were collected. Twenty patients were referred for Graves' disease and 44 patients were referred for non-autoimmune multinodular thyroid. Patients with thyroid cancer were excluded. Ten percent of Graves' disease patients and 27.7% of control patients had positive staining of thyrocytes for EVB19 antibodies (ns). EVB19-positive and EVB19-negative cases did not differ. EVB19-positive controls were older than EVB19-negative controls (mean age: 57.5 [35-74] vs. 45 [28-80] years, P=0.03) No case of acute EVB19 infection was identified. EVB19-positive serology was more frequent in controls than in Graves' disease patients (88% vs. 45%, PGraves' disease patients than in controls. Further studies are needed to determine the role of EVB19 infection in thyroid diseases. Copyright © 2013 Wiley Periodicals, Inc.

  15. Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention.

    Science.gov (United States)

    Srikant, Banumathy; Balasubramaniam, Srikant

    2013-07-01

    Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome.

  16. El papel de enfermería en atención primaria para prevenir y detectar las complicaciones de los diabéticos tipo 2

    OpenAIRE

    Gomez Marciel, Aitor

    2017-01-01

    El aumento de la población, de la expectativa de vida y de los malos hábitos como el sedentarismo, la dieta inadecuada y la obesidad influyen directamente en la incidencia y prevalencia de diabetes mellitus en el mundo, caracterizándola como epidemia mundial. Según la Organización Mundial de la Salud, 422 millones de adultos tenían diabetes en 2014. El objetivo de este trabajo ha sido conocer el rol de enfermería para evitar y detectar complicaciones y comprobar si los cuidados que efectúa so...

  17. Pancreatitis aguda grave asociada a gangrena vesicular

    OpenAIRE

    Arroyo-Sánchez, Abel S; Aguirre-Mejía, Rosa Y; Echenique-Martínez, Sergio E

    2014-01-01

    Se presenta el caso un paciente diabético que desarrolló un cuadro de pancreatitis aguda grave asociada a gangrena vesicular, en el que se evaluó la aplicabilidad de los criterios de clasificación y manejo de la hoja de ruta para pancreatitis aguda, así mismo se proponen algunos tópicos que pudieran ser investigados a futuro We present a diabetic patient who developed severe acute pancreatitis associated to gallbladder gangrene, in this case we assessed the applicability of classification ...

  18. O mosaico patogênico da pancreatite aguda grave

    Directory of Open Access Journals (Sweden)

    Márcio Cavalcante Carneiro

    Full Text Available A pancreatite aguda tem sido alvo de grandes discussões que vão desde o entendimento de sua fisiopatologia até a investigação de novas modalidades terapêuticas. Reconhece-se que a necrose pancreática e a falência orgânica múltipla - mormente associadas à infecção - representam os principais fatores determinantes da evolução para o óbito, mas, apesar dos grandes avanços em seu estudo, a doença permanece como um desafio para o clínico e o cirurgião. Deste modo, um melhor conhecimento dos mecanismos envolvidos em sua fisiopatologia pode ser a chave para um tratamento mais eficaz, principalmente em relação às formas graves, cuja letalidade ainda encontra-se substancialmente elevada. Baseado nestas considerações, o presente trabalho tem por objetivo a revisão bibliográfica da fisiopatologia, dos fatores patogênicos envolvidos na história natural da pancreatite aguda grave e dos eventos associados à síndrome da resposta inflamatória sistêmica e à sepse, esboçando-se assim o mosaico patogênico desta importante condição.

  19. Application of new therapies in Graves' disease and thyroid-associated ophthalmopathy: animal models and translation to human clinical trials

    DEFF Research Database (Denmark)

    Banga, J Paul; Nielsen, Claus H; Gilbert, Jacqueline A

    2008-01-01

    Most current approaches for treating Graves' disease are based essentially upon regimes developed nearly 50 years ago. Moreover, therapeutic approaches for complications such as thyroid-associated ophthalmopathy (TAO) and dermopathy are singularly dependent on conventional approaches of nonspecific...... immunosuppression. The recent development of an induced model of experimental Graves' disease, although incomplete as it lacks the extrathyroidal manifestations, provided opportunities to investigate immune intervention strategies, including influence upon the autoreactive B and T cell players in the autoimmune...... process. These major advances are generating new possibilities for therapeutic interventions for patients with Graves' disease and TAO....

  20. Diabetes mellitus: a risk factor in patients with Graves' orbitopathy

    NARCIS (Netherlands)

    Kalmann, R.; Mourits, M. P.

    1999-01-01

    AIMS: To assess the prevalence of dysthyroid optic neuropathy (DON) in patients with diabetes mellitus (DM) and Graves' orbitopathy (GO) and to investigate the complications of surgery for GO in these patients. METHODS: The records of 482 consecutive patients with GO referred in a 5 year period were

  1. [Guideline for the treatment of Graves' disease with antithyroid drug].

    Science.gov (United States)

    Nakamura, Hirotoshi

    2006-12-01

    We have published "Guideline for the Treatment of Graves' Disease with Antithyroid Drug in Japan 2006" in the middle of May from the Japan Thyroid Association. The background, working process, composition, aim and significance of this guideline are described. The most remarkable feature of this guideline is "evidence based".

  2. A 33-Year-Old Man with Gynaecomastia and Galactorrhea as the First Symptoms of Graves Hyperthyroidism.

    Science.gov (United States)

    Khoohaphatthanakul, Somdul; Sriwijitkamol, Apiradee

    2016-01-01

    Graves' hyperthyroidism has a various number of well-recognized manifestations. Galactorrhea is a rare manifestation in this disease. We describe a 33-year-old man who presented with the symptoms of hyperthyroidism, gynaecomastia, and galactorrhea for 2 months. Physical examination revealed goitre, gynaecomastia, and galactorrhea, bilaterally. Laboratory investigations demonstrated high free thyroxine with suppressed thyroid-stimulating hormone level together with elevated anti-TSH receptor; therefore, the diagnosis of Graves' disease was confirmed. Other investigations to elucidate the etiology of galactorrhea were normal, so the galactorrhea was hypothesized to be caused by Graves' disease. The gynaecomastia and galactorrhea resolved with the successful treatment of hyperthyroidism. Although the galactorrhea is extremely rare in thyrotoxicosis male patients, to the best of our knowledge, this is the third case which reported gynaecomastia and galactorrhea in male patient who presented with thyrotoxicosis.

  3. Study on the change of hepatic fibrosis indicators in serum before and after I-131 treatment in Graves' Patients

    International Nuclear Information System (INIS)

    Li, L.

    2007-01-01

    Full text: Objective: To explore the change of hepatic fibrosis indicators, i.e., PC-III (type III procollagen), IV-C (type IV collagen), HA (hyaluronic acid), LN (laminin) levels in serum of Graves' patients before and after I-131 treatment. Methods: Control group were 40 healthy cases (female 25, male 15, aged 18-60 years) with normal serum levels of those indicators by medical examination in our hospital. Fifty-five Graves' patients (female 32, male 23, aged 17-58) were diagnosed by thyroid function indicators (TT3, TT4, FT3, FT4, TSH) tests, thyroid iodine intake and clinical symptoms and signs, with normal hepatic function indicators and without combined history of hepatic disease, cardiac disease, diabetes, and rheumatic disease. Three to six months after I-131 treatment these were completely recovered (back to normal thyroid function, shrunken thyroid gland volume from swelling, and disappeared clinical symptoms and signs). In both controls and Graves' patients, 2 ml venous blood was taken at early morning from each case with limosis respectively before and after I- 131 treatment. RIA method was adopted for detection of each serum indicator with reagents kit. Data were analyzed by t test in the SPSS statistical software pack. Results: 1. In Graves' patients, before treatment PC- III (type III procollagen) levels were statistically higher than that in controls (p 0.05). 2. In Graves' patients, PC-III significantly decreased to a lower level after treatment than before (p 05). 3. In Graves' patients, after treatment there is no significant difference of indicator levels when compared with controls (p>0.05). Conclusion: Graves' patients had certain degree of hyperplasia of hepatic connective tissue, and this pathogenesis recovered with healing of Graves' disease. PC-III positive rate and thyroid function indicator positive rate may be better in accordance with the disease process than IV-C, Ha and LN indicators. These data showed that of four serum hepatic

  4. Lesiones torácicas graves y el enfoque del control de daños Severe thoracic lesions and the damage control approach

    Directory of Open Access Journals (Sweden)

    Mario Miguel Morales Wong

    2008-03-01

    Full Text Available En los últimos años se han desarrollado nuevas estrategias para el tratamiento del trauma grave con lesiones exanguinantes o sin ellas, pero son estas últimas las que más requieren un cambio de la forma de actuar en aras de mejorar la supervivencia. Tales estrategias quirúrgicas se han denominado cirugía de control de daños, que en esencia evita complicaciones como la tríada letal de acidosis, hipotermia y coagulopatía. A diferencia del control de daños en el abdomen, existen lesiones torácicas que requieren una reparación inicial durante el acto quirúrgico, pero pueden hallarse otras cuya reparación puede ser secundaria. El método de control de daños en las lesiones torácicas debe llevarse a cabo con procedimientos que sean técnicamente rápidos y simples, para postergar el tratamiento definitivo de las lesiones que no requieran una reparación inmediata en pacientes in extremisNew strategies have been developed in the last years to treat severe trauma with exsanguinating lesions or without them. The latter demand more changes in the way of acting in order to improve survival. Such surgical strategies have been called damage control surgery that in essence prevent complications such as the lethal triad of acidosis, hypothermia and coagulopathy. Unlike the control of abdomen damage, there are thoracic lesions requiring an initial repair during surgery, but there may be found others, whose repair is secondary. The damage control method in the thoracic lesions should be conducted with technically fast and simple procedures to postpone the definitive treatment of the lesions that do not require an immediate repair in patients in extremis

  5. Adolescentes estudantes: conhecimentos das complicações do aborto provocado Adolescentes estudiantes: conocimientos de las complicaciones de abortamiento Female teenager students: knowledge abortion complications

    Directory of Open Access Journals (Sweden)

    Divanise Suruagy Correia

    2011-09-01

    Full Text Available O objetivo deste estudo foi identificar o conhecimento das complicações do aborto provocado e sua relação coma a idade. Estudo transversal, realizado em escolas de Maceió, Alagoas, com estudantes dos 12 aos 19 anos. A amostra foi calculada considerando-se os dados de internação de curetagem pós aborto. Usou-se o programa Epi Info versão 3.6 para análise dos dados. Das 2592 adolescentes estudadas, 65,64% não conheciam nenhuma complicação do aborto provocado e as complicações mais citadas foram morte e esterilidade. Manifestações clínicas do aborto foram incorretamente citadas como complicações. Encontrou-se significação entre o conhecimento das complicações esterilidade e hemorragia e idade. A morte foi significativa para menores de 15 anos e a esterilidade para as maiores. Conclui-se que as adolescentes não conhecem corretamente as complicações do aborto provocado, o que demonstra o risco daquelas que o provocam, verifica-se, portanto, a necessidade de maiores esclarecimentos sobre o tema bem como da educação sexual.El objetivo de este estudio fue identificar el conocimiento de las complicaciones del aborto inducido y su relación con la edad. Estudio transversal, realizado en escuelas, de Maceió, Alagoas, Brasil, con adolescentes de los 12 a los 19 años. La muestra fue calculada a partir de los datos de las internaciones para legrado después del aborto. Fue usado para analiza de los datos el Epi Info. De las 2592 adolescentes estudiadas, 65.64% no sabían de ninguna complicación del aborto inducido y las complicaciones mas citadas fueran muerte y esterilidad. Las manifestaciones clínicas del aborto también fueran citadas como complicaciones. Hube significación entre el conocimiento de la esterilidad y la hemorragia y edad. La muerte fue significativa para las menores de 15 años y la esterilidad para las más grandes. Se concluye que las adolescentes no sabían correctamente las complicaciones del aborto

  6. A Patient with Grave's Disease and Tuberculous Lymphadenitis.

    Science.gov (United States)

    Rahaman, M F; Chowdhury, M H; Khan, A H; Rahman, M; Barman, T K; Chowdhury, M J

    2016-04-01

    Immune reactivity between Mycobacteria and human antigens can play an important role in the pathogenesis of autoimmune disease. We report a case of Graves's disease and tuberculous lymphadenitis to explain the mechanism of correlation between immune-mediated diseases and tuberculosis and to raise awareness of the importance of screening for TB in this context, especially in endemic country. Screening for latent TB at immune mediated disease diagnosis and regular timely screening thereafter may be beneficial.

  7. A note on Robinson-Ursescu and Lyusternik-Graves theorem

    Czech Academy of Sciences Publication Activity Database

    Cibulka, R.; Fabian, Marián

    2013-01-01

    Roč. 139, 1-2 (2013), s. 89- 101 ISSN 0025-5610 R&D Projects: GA ČR(CZ) GAP201/11/0345 Institutional research plan: CEZ:AV0Z10190503 Keywords : open mapping * restrictive metricregularity * graves theorem Subject RIV: BA - General Mathematics Impact factor: 1.984, year: 2013 http://link.springer.com/article/10.1007%2Fs10107-013-0662-z

  8. Infarto esplénico secundario a pancreatitis aguda Splenic infarction secondary to acute pancreatitis

    Directory of Open Access Journals (Sweden)

    J. J. Arenal Vera

    2008-05-01

    Full Text Available Fundamento y objetivo: la estrecha relación anatómica del páncreas con los vasos esplénicos y el bazo es responsable de complicaciones esplénicas en el curso de la pancreatitis aguda. El objetivo es presentar dos casos clínicos de pancreatitis aguda grave que sufrieron infarto esplénico como complicación de la enfermedad pancreática. Pacientes, participantes: en un periodo de tres meses, dos pacientes fueron diagnosticados de infarto esplénico secundario a pancreatitis aguda. En ambos casos el diagnóstico y seguimiento evolutivo del infarto esplénico se hizo a través de tomografía axial computerizada. Resultados: en el primer paciente, las imágenes muestran de forma inequívoca la afectación de la arteria esplénica por el proceso inflamatorio pancreático. En el segundo, no se pudo demostrar afectación de los vasos esplénicos, por lo que la única posible explicación etiológica es un incremento de coagulabilidad intravascular. Conclusiones: sería recomendable añadir las complicaciones esplénicas al conjunto de complicaciones graves extrapancreáticas de la pancreatitis aguda. La tomografía axial computerizada es de gran utilidad para la detección y seguimiento de las complicaciones esplénicas de la pancreatitis aguda.Background and objective: the close anatomic relationship of the pancreas with the splenic vessels and the spleen is responsible for splenic complications in the course of acute pancreatitis. Our objective was to report two cases of severe acute pancreatitis complicated by splenic infarction. Patients: in a three-month period of time two patients were diagnosed with splenic infarction secondary to acute pancreatitis. In both cases splenic infarction diagnosis and follow-up were carried out using computed tomography. Results: in the first case images clearly showed a narrowing of the splenic artery due to the inflammatory pancreatic condition. In the second case no involvement of the splenic vessels could

  9. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    International Nuclear Information System (INIS)

    Eckel, R.H.; Green, W.L.

    1980-01-01

    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone

  10. The plundering of the ship graves from Oseberg and Gokstad

    DEFF Research Database (Denmark)

    Bill, Jan; Daly, Aoife

    2012-01-01

    Not the least of the unusual revelations that have come from the wonderfully preserved ninth-century Norwegian ship burials at Oseberg and Gokstad, is the fact that both had been later broken into-by interlopers who defaced the ship, damaged the grave goods and pulled out and dispersed the bones...

  11. Symmetric increased skeletal muscular uptake of 18F fluoro-deoxyglucose: a clue for the diagnosis of Graves' disease

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Mittal, Bhagwant Rai; Kashyap, Raghava; Bhattacharya, Anish; Singh, Baljinder

    2011-01-01

    18 F fluoro-deoxyglucose (FDG) uptake in the thyroid and thymus is well reported in patients with Grave's disease. Incidental skeletal muscle uptake has also been reported in other non-musculoskeletal (benign and malignant) pathologies. We report a patient of Grave's disease showing symmetrical skeletal muscle uptake but no thyroidal or thymus uptake of FDG. (author)

  12. Tratamiento de la enfermedad de Graves Basedow

    OpenAIRE

    Hernando Vargas-Uricoechea; Carlos Hernán Sierra-Torres; Ivonne Alejandra Meza-Cabrera

    2014-01-01

    Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroid...

  13. Review of Mouse Models of Graves' Disease and Orbitopathy-Novel Treatment by Induction of Tolerance.

    Science.gov (United States)

    Ungerer, Martin; Faßbender, Julia; Li, Zhongmin; Münch, Götz; Holthoff, Hans-Peter

    2017-04-01

    Various approaches have been used to model human Graves' disease in mice, including transfected fibroblasts, and plasmid or adenoviral immunisations with the extracellular A subunit of the human thyrotropin receptor (TSHR). Some of these models were only observed for a short time period or were self-limiting. A long-term model for human Graves' disease was established in mice using continuing immunisations (4-weekly injections) with recombinant adenovirus expressing TSHR. Generation of TSHR binding cAMP-stimulatory antibodies, thyroid enlargement and alterations, elevated serum thyroxin levels, tachycardia and cardiac hypertrophy were maintained for at least 9 months in all Ad-TSHR-immunised mice. Here, we show that these mice suffer from orbitopathy, which was detected by serial orbital sectioning and histomorphometry. Attempts to treat established Graves' disease in preclinical mouse model studies have included small molecule allosteric antagonists and specific antagonist antibodies which were isolated from hypothyroid patients. In addition, novel peptides have been conceived which mimic the cylindrical loops of the TSHR leucine-rich repeat domain, in order to re-establish tolerance toward the antigen. Here, we show preliminary results that one set of these peptides improves or even cures all signs and symptoms of Graves' disease in mice after six consecutive monthly injections. First beneficial effects were observed 3-4 months after starting these therapies. In immunologically naïve mice, administration of the peptides did not induce any immune response.

  14. Radioactive iodine therapy for patients with Graves' disease aged 18 or younger

    International Nuclear Information System (INIS)

    Ogawa, Takahiro; Goshi, Kazuto; Tajiri, Junichi

    2008-01-01

    There have been few reports concerning radioactive iodine therapy (RI therapy) for Graves' disease in children, even in the United States of America (USA), and there have been no reports of such treatment in Japan. We evaluated the short-term results of RI therapy for Graves' disease aged 18 or younger. A total of 36 patients (10 male and 26 female) with Graves' disease, aged 18 and younger (range, 13 to 18 years; mean age, 15.8±1.5 years), received RI therapy on an outpatient basis at our clinic between July 1999 and July 2005. The mean interval from initiation of an antithyroid drug (ATD) to RI therapy was 25.3±21.5 months (range, 1 to 78 months). Twenty patients received therapy once, 14 twice, and 2 three times. The mean initial dose of radioactive iodine was 7.8±2.9 mCi (range, 3.6 to 13.0 mCi) and the mean total dose was 12.3±7.7 mCi (range, 3.6 to 29.8 mCi). The mean estimated weight of the thyroid gland was 42.6±23.4 g (range, 15.5 to 99.4 g) before RI therapy and 7.1±3.0 g (range, 2.0 to 13.6 g) after RI therapy. The mean follow-up period after RI therapy was 41.1±18.0 months (range, 6 to 71 months). Currently, 15 patients (42%) have hypothyroidism, 8 (22%) have subclinical hypothyroidism, 5 (14%) have euthyroidism, and 8 (22%) have subclinical hyperthyroidism. Patients taking thyroid hormone were considered hypothyroid. Patients with subclinical hypothyroidism are currently being monitored without treatment. No patients with subclinical hyperthyroidism are taking an ATD or KI (potassium iodide). A total of 36 patients with Graves' disease, aged 18 and younger, received RI therapy, and the short-term outcome in these patients were favorable. However, prolonged follow-up observation is required to confirm long-term safety. (author)

  15. Clinical study of 1003 cases with Graves' disease treated with 131I

    International Nuclear Information System (INIS)

    Wang Qinfen; Zhang Chenggang; Zhao Xiaobin; Shi Longbao

    2005-01-01

    Objective: To explore the treatment effects of individual 131 I dose treatment of Graves' disease. Methods: Graves' disease patients were given individual 131 I dose ( 131 I MBq/per gram thyroid tissue), which ranged at 1.48-4.07 MBq/g. A total of 1003 cases (76.9%) were successfully followed up. The mean administered dose of 131 I was (329.3 ± 307.1, 44.4-3700) MBq. The term of follow-up was (16.4 ± 10.0, 3.0-44.7) months. Results: After one dose 131 I treatment, 593 patients (59.1%) were with euthyroid, 200 patients (19.9%) hypothyroidism, 190 patients (18.9%) were partially remitted, 20 patients (2.0%) showed no changes; 259 patients (25.8%) suffered from early hypothyroidism, 88 patients were with transient hypothyroidism. Logistic stepwise regression analysis revealed that hard thyroid texture was a risk factor for developing early hypothyroidism, whereas large goiter was a protective factor for developing permanent hypothyroidism. Partial-correlations analysis showed that curative effects correlated negatively with the weight of goiter mass, the course of disease and the use of antithyroid drugs (ATD). After 131 I treatment, for 195 patients (41.7%) the ophthalmopathy was cured, 155 patients (33.1%) were partially remitted, 105 patients (22.4%) showed no effects, 13 patients (2.8%)were deteriorated. For 56 patients (77.8%) their hyperthyroid heart disease was cured, 10 patients(13.9%) were partially remitted, 6 patients (8.3%) were of no effects. For 60 patients (85.7%) periodic paralysis associated with thyrotoxicosis were cured, 2 patients (2.9%) were partially remitted, 8 patients (11.4%) were of no effects. Of 249 patients with large goiter (≥90 g), 219 cases (88.0%) were completely remitted. Conclusions: The individual 131 I dose treatment for Graves' disease exerts good therapeutic efficiencies. 131 I treatment for ophthalmopathy, hyperthyroid heart disease and Graves' disease with lager goiter is effective and safe. (authors)

  16. Factores asociados a complicaciones de la colangiopancreatografía retrógrada endoscópica en un hospital de alta complejidad Factors associated to complications of endoscopic retrograde cholangiopancreatography in a third-level hospital

    Directory of Open Access Journals (Sweden)

    Angel Quispe-Mauricio

    2010-06-01

    Full Text Available El tratamiento endoscópico de las enfermedades de la vía biliar es posible gracias a la colangiopancreatografía retrógrada endoscópica (CPRE; no obstante, no está exenta de complicaciones. Objetivos. Describir las características e indicaciones de la CPRE y determinar los factores asociados al desarrollo de complicaciones tras la realización de este procedimiento. Materiales y métodos. Se realizó un estudio observacional retrospectivo en el Departamento de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen en Lima, Perú; desde marzo de 2002 a junio de 2005. Resultados. Se evaluaron 294 informes en 280 pacientes, la mediana de la edad fue 58 y 155 (52,7% fueron mujeres; cinco procedimientos se efectuaron en la Unidad de Cuidados Intensivos (UCI. La indicación más frecuente fue la coledocolitiasis en el 67,3% de los casos, 205 (69,7% procedimientos fueron exitosos complicándose sólo 33 de ellos. Las complicaciones más frecuentes fueron la pancreatitis aguda y la hemorragia, en 16 y 13 pacientes, respectivamente. No se reportó casos de perforación o defunción. La canulación del conducto pancreático más de una vez fue un factor asociado (OR=2,01; IC95%: 1,11 - 5,92; p=0,03. Conclusiones. El 11,2% de los casos se complicaron, siendo la pancreatitis aguda y la hemorragia leve las complicaciones más frecuentes. Sólo la canulación al conducto pancreático en más de una oportunidad es un factor asociado para tener complicaciones.Endoscopic treatment of the bile duct diseases is possible thanks to the ERCP (endoscopic retrograde cholangio pancreatography, nevertheless, it is not free of complications. Objectives. To describe the characteristics and indications of the ERCP and determine the factors associated to the development of complications after performing the procedure. Materials and methods. An observational retrospective study was done in the Gastroenterology Department of the Hospital Guillermo Almenara

  17. Prediction of remission in Graves' disease after thionamide therapy by technetium-99m early uptake

    Energy Technology Data Exchange (ETDEWEB)

    Misaki, Takashi; Dokoh, Shigeharu; Koh, Toshikiyo; Shimbo, Shin-ichiro (Kyoto City Hospital, Kyoto (Japan)); Hidaka, Akinari; Iida, Yasuhiro; Kasagi, Kanji; Konishi, Junji

    1991-02-01

    In the clinical management of Graves' thyrotoxicosis, one of the most important subject is when to stop antithyroid drugs after achieving an euthyroid state. T{sub 3} suppression test and other methods have been used to forecast the outcome after drug cessation, but the results were not always satisfactory. We have attempted to predict remission of Graves' disease by single measurement of early technetium uptake without administration of triiodothyronine. Drugs were discontinued in the seventy-five patients with Graves' disease on maintenance doses of either methimazole or propylthiouracil who showed normalized uptake (4.0% or less). Of 64 patients evaluable after twelve months, 55 (86%) remained euthyroid, 8 relapsed, and 1 became hypothyoid. With its accuracy in prediction of short-term remission comparable or superior to T{sub 3} suppression test, this rapid and simple method seemed suitable for routine use in clinical practice. (author).

  18. [Severe neonatal hyperthyroidism which reveals a maternal Graves' disease].

    Science.gov (United States)

    Guérin, B; Vautier, V; Boin-Gay, V; Estrade, G; Choulot, J-J; Doireau, V

    2004-04-01

    Two of every thousand pregnancies are complicated by Graves' disease. Diagnosis is suggested by maternal disorders (tachycardia, exophthalmia, weight loss.) or fetal disorders (tachycardia, intra-uterine growth retardation, preterm birth.). Due to transfer into the fetal compartment of maternal antibodies which stimulate the fetal thyroid by binding to the thyroid thyrotropin (TSH) receptor, only 1% of children born to these mothers are described as having hyperthyroidism. Neonatal thyrotoxicosis disappears with clearance of the maternal antibodies; clinical signs usually disappear during the first four Months of life. The most frequent neonatal clinical signs of thyrotoxicosis are tachycardia, goiter, hyperexcitability, poor weight gain, hepatosplenomegaly, stare and eyelid retraction. Diagnosis is based on determination of the blood level of triiodothyronine (T3), thyroxine (T4) and TSH. To confirm the nature of hyperthyroidism, thyroid-stimulating immunoglobulins (TSI) should be assayed. The kinetics of TSI provides a guide for therapeutic adaptation and disappearance of TSI is a sign of recovery. Rare cases of familial non-autoimmune hyperthyroidism have been shown to be caused by germline mutation of the thyrotropin receptor. We report a case of severe neonatal hyperthyroidism which led to the diagnosis of maternal Graves' disease.

  19. Graves' disease: cost-effectiveness of clinical and radioiodine treatments

    International Nuclear Information System (INIS)

    Cruz junior, Antonio F.; Takahashi, Miriam H.; Albino, Claudio C.

    2005-01-01

    Full text: In this study, we set out to evaluate the costs and effectiveness of the two most used therapies in Graves' disease: antithyroid drugs (ATD) and radioiodine (RAI). Twenty-tree patients, 7 men and 16 women, with a mean age of 35.4 years, treated with ATD and 35 patients, 5 men and 30 women, mean age of 39.4 years, treated with RAI were studied. After 2 years receiving ATD, 21 patients achieved euthyroidism and 2 remained hyperthyroid. In the RAI group, 21 patients presented hypothyroidism and 13 became euthyroid. To calculate the costs of each therapy, we analysed the number of visits during this period, the laboratory data and the drugs needed, such as tiamazol and/or thyroxine. The group treated only with ATD needed a higher number of visits and laboratory measurements, with the mean total cost of U$ 791.65, while the RAI group spent a mean amount of U$ 366.44. Therefore, the costs of the RAI treatment were 53,7 % lower than clinical therapy with ATD. Conclusion: The present study demonstrates that RAI treatment has a lower cost than ATD, being very effective in controlling the hyperthyroidism of Graves' disease. (author)

  20. Clinical results of treating Graves's disease with percutaneous intrathyroidal ethanol injection

    International Nuclear Information System (INIS)

    Jiang Guoliang; Li Xiangguo; Qian Zhendong; Wang Cheng; Jiang Zhonglin; Zhang Dengbao; Cheng Qiang; Ye Xianci; Wu Dezhong; Chen Yingzhi; Zhu Shufang; Chen Yong

    2002-01-01

    Objective: To observe the effectiveness of percutaneous intrathyroidal ethanol injection in the treatment of Graves's disease. Methods: 42 patients with Graves' disease were given percutaneous intrathyroidal ethanol injection (PEI) for treatment. The control group consists of 47 patients given per-oral antithyroid drug (PATD). clinical response, levels of serum TT 3 , TT 4 , FT 3 , FT 4 , TSH and size of thyroid were observed and followed up for six months. Results: In PEI group, 17 cases were cured, 24 cases were improved and only one case had no response. Total effective rate was 97.6% with no significant difference from that of PATD (p > 0.05). The size of gland after treatment were significantly smaller in PEI than that of PATD (p < 0.01). No severe adverse effect occurred in the PEI group. Conclusion: PEI is a new way in treating GD which is simple economical and effective