Measurement of stimulated Tg combined with neck ultrasonography after total thyroidectomy may exclude the need for ablation in 56% of low-risk patients without TgAb (Tg <1 ng/mL) and permit the administration of an activity of 1.1 GBq ¹³¹I in another 34% with low Tg levels.

rhTSH is as effective as THW for RA in patients with WDTC who are at a high risk of relapse.

Objective: To establish limits of normal serum TSH for the adult (18 to 60 years) Brazilian population according to recommendations of the National Academy of Clinical Biochemistry. Subjects and methods: Healthy volunteers were evaluated and those fulfilling the following clinical criteria were selected: absence of known thyroid disease; no use of any interfering medications; no history of head and neck external radiotherapy, type 1 diabetes or autoimmune disease; no family history of thyroid disease, and absence of goiter or palpable nodules. Subjects with anti-thyroperoxidase antibodies and/or altered free T4 were excluded. The sample consisted of 960 subjects (480 males and 480 females). Results: TSH values corresponding to the 2.5th and 97.5th percentiles of the sample were 0.43 and 3.24 mIU/L, respectively. TSH values > 2.5 mIU/L were observed in 9.15% of the volunteers and levels > 3 mIU/L in 3.11%. Conclusion: The present study suggests an upper limit of normal TSH of approximately 3.5 mIU/L. Arq Bras Endocrinol Metab. 2010;54(7):603-6 Keywords TSH; reference values; adult population RESUMO Objetivo: Estabelecer os limites de normalidade do TSH sérico em uma população adulta (18 a 60 anos) brasileira, conforme as recomendações da National Academy of Clinical Biochemistry. Sujeitos e métodos: Inicialmente foram avaliados voluntários saudáveis e selecionados aqueles sem doença tireoidiana conhecida, uso de medicamentos interferentes, passado de radioterapia externa de cabeça e pescoço, diabetes tipo 1 ou doença autoimune, história familiar de doença tireoidiana, bócio ou nódulos palpáveis. Indivíduos com anticorpos antitireoperoxidase (TPOAb) e/ou T4 livre alterado foram excluídos. A amostra foi composta de 960 participantes (480 de cada sexo). Resultados: Os valores correspondentes aos percentis 2,5 e 97,5 da amostra foram 0,43 e 3,24 mIU/L, respectivamente. TSH > 2,5 mIU/L foi visto em 9,15% dos indivíduos e > 3 mIU/L em 3,11%. Conclusão: Nosso estudo sugere para a população adulta brasileira o limite superior normal do TSH de aproximadamente 3,5 mIU/L. Arq Bras Endocrinol Metab. 2010;54(7):603-6 Descritores TSH; valores de referência; população adulta

Low (131)I activity after rhTSH is effective for remnant ablation in patients who are at low risk of recurrence.

No abstract

Introduction: Failure to accurately estimate energy requirements may result in an impaired recovery. Overfeeding has been associated with increased carbon dioxide production, respiratory failure, hyperglycemia and fat deposits in the liver, while underfeeding can lead to malnutrition, muscle weakness and impaired immunity. Objective: This study aimed to determine the metabolic profile of infant and preschool children submitted to mechanical ventilation in the ICU. Methods: A prospective study was carried out in a pediatric ICU in Rio de Janeiro that included children aged from 1 month to 6 years submitted to mechanical ventilation from June 2013 to May 2015. Indirect calorimetry was used to obtain resting energy expenditure (REE) and oxygen consumption (VO 2) in the first 48 hours of admission. The predicted basal metabolic rate (PBMR) was calculated using the Schofield equation. The metabolic state of each patient was assigned as hypermetabolic (REE/PBMR >110%), hypometabolic (REE/PBMR <90%) or normal (REE/PBMR 90-110%). The ratio of caloric intake to REE was also calculated and ratios of >1.5 and <0.5 were classified as overfeeding and underfeeding respectively. Results: A total of 35 infants and 17 preschool children were included. The male/female ratio was 34/18. In respect of severity of sepsis, 19 patients had septic shock, 24 had sepsis, five had severe sepsis and four had systemic inflammatory response syndrome. We observed a high incidence of hypometabolism (88.5%) and a low incidence of normal metabolism (7.7%) and hypermetabolism (3.8%). A low value of VO 2 was observed in 46.1% of the patients (VO 2 ≤120 ml/minute/m 2), a normal value in 40.4% (VO 2 >120 to ≤160 ml/minute/m 2) and a high value in only 13.5% of the patients (VO 2 > 160 ml/minute/m 2). Among the 52 included patients, 18 were fasting at the moment of the examination. The ratio of caloric intake to REE for the remaining 34 patients showed 38.2% overfeeding, 11.8% underfeeding and 50.0% normal feeding. Conclusion: Predictive equations do not accurately predict REE in critically ill infants and preschool children, resulting in inadequate feeding. Although hypermetabolism and enhanced energy expenditure are the main clinical features of critical illness in adults, the majority of our patients were found to be hypometabolic which reinforces the need for a different approach between adult and pediatric critically ill patients.