Navegando por Palavras-chave "radioiodo"

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    Avaliação ultrassonográfica com doppler da tiroide e sua importância na definição da dose de radioiodo no tratamento da tirotoxicose
    (Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Orlandi, Denise Mazo [UNIFESP]; Martins, Joao Roberto Maciel Martins [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Radioiodine (131I) is an effective treatment for Basedow-Graves’ Disease (BGD). Failure in this treatment may occur in up to 10-20% of cases and is associated with various factors such as sex, age and severity of thyrotoxicosis. In hiperthyroidism, the vascular overflow has been related to disease activity and its measurement can be easily made by modern techniques of ultrasound. Objectives: To evaluate the usefulness of thyroid blood flow at the inferior thyroid artery (ITA) in determining therapeutic efficacy of 131I. Methods: We evaluated 48 patients with BGD who were submitted to treatment with 131I. Clinical and laboratory evaluation was performed five days before (time 0) and 1, 2, 3 and 6 months after 131I. All patients received a fixed dose of 15 mCi. The blood flow at ITA was measured at time 0 and 6 months. Results: Before treatment, there was correlation between the higher flow at ITA and thyroid volume. Over 90% of patients were cured after 6 months of follow up. Relapse or persistance of thyrotoxicosis tended to occur in younger individuals, with lower TSH and higher flow velocity at ATI before treatment. However, the higher thyroid volume was the only factor significantly associated with therapeutic failure. On the other hand, a reduction of serum FT4 to <1.0 ng/dL, at the second month of follow up, was an excellent predictor of cure. Conclusion: Increased blood flow velocity at ATI and especially the higher thyroid volume pre-treatment can be used as a predictor of relapse of thyrotoxicosis and could be used as a criterion for selection of higher doses of 131I to increase the therapeutic efficacy.
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    A influência da iodúria na resposta ao tratamento com radioiodo em pacientes com tirotoxicose
    (Universidade Federal de São Paulo (UNIFESP), 2014-05-26) Santarosa, Vanessa Aoki [UNIFESP]; Martins, Joao Roberto Maciel Martins [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Low iodine diet before radioiodine (131I) evaluation for benign and malign thyroid diseases is a practice commonly accepted. Although this procedure has shown advantages in the efficacy of treatment of thyroid remnants after total thyroidectomy in patients with differentiated thyroid carcinoma, it is not well established when it comes to the treatment of benign diseases, particularly the Basedow-Graves´ Disease (BGD) . Objective: To evaluate the efficacy of iodine-restricted diet in the fall of urinary iodine - parameter indicative of low iodine intake - in response to 131I therapy for patients with BGD. Patients and methods: We evaluated 67 patients (59 women) with BGD who were divided into two groups, one in which was guided iodine-restricted diet for 2 weeks and the other instructed to maintain usual diet. Results: The group-oriented restrictive diet showed a 23% decreasing in the level of urinary iodine after 1 week after diet and 42% after 2 weeks. The majority (53%) of those who were on iodine restriction diet had urinary iodine levels consistent with deficiency of iodine intake. However, there was no statistical difference in the cure rate of hyperthyroidism when restrictive diet and usual diet groups were compared at 6 months after 131I. Furthermore, the therapeutic efficacy was not different when patients with different degrees of sufficiency of iodine intake (deficiency, <10 μg/dL, sufficiency, 10 to 29.9 μg/dL; excess, > 30 μg/dL) were compared. Conclusion: This study showed, for the first time, that although the low iodine diet leads to falling levels of urinary iodine, even values compatible with sufficiency or mild excess iodine intake does not compromise the therapeutic efficacy of 131I for BGD.