BackgroundRadioactive iodine (I131) is a common definitive treatment for Graves’ Disease. Potential complications include worsening, or new development of Graves’ eye disease and development of a radiation thyroiditis. The purpose of the present study was to assess outcomes of patients treated with I131 in an Australian tertiary centre over 10 years.MethodsData from 101 consecutive patients treated with I131 for a diagnosis of Graves’ disease between 2005 to 2015 was collected and reviewed retrospectively. Baseline TSH receptor antibody titre, pre-treatment free thyroxine (FT4), technetium scan uptake, initial treatment, duration of treatment, reason for definitive therapy, complications, and time to remission (defined as euthyroidism or hypothyroidism after 12 months) were recorded.ResultsOf the 92 patients with adequate outcome data, 73 (79.3%) patients achieved remission with a single dose of I131. Of the remaining 19 patients, 12 had a second dose and became hypothyroid. TSH receptor antibody titre at diagnosis was significantly lower in the group that achieved remission with the first dose compared with those who did not (P = 0.0071). There was no difference in technetium uptake, I131 dose, duration of therapy or pre-treatment free thyroxine (FT4). I131 was complicated by development of eye disease in 3 patients and 1 (of 11 with pre-existing eye disease) had worsening eye disease. A clinically apparent flare of hyperthyroidism following I131 was evident in 8 patients (8.6%).ConclusionRadioiodine is an effective therapy for Graves’ Disease with few complications. The majority of patients achieve remission with a single dose. Those who require a second dose are more likely to have higher TSH receptor antibody titres at diagnosis. To the best of our knowledge, this is the first study to report outcomes from radioiodine treatment for Graves’ disease in an Australian population.
Summary: A retrospective study is reported of all Franzen fine-needle aspiration cytology undertaken at Southmead Hospital between January 1978 and December 1981.A total of 1043 aspirates were examined from 753 patients. The diagnosis of carcinoma of the prostate was missed in 2 patients. Twenty-one patients with cytologicallyproven carcinoma in histologically-benign prostates were detected, and the role of the Franzen needle in the diagnosis of early prostatic cancer is discussed. Of'the 218 patients proceeding to prostatectomy, there were 91 patients with carcinoma and in 65 (72%) the cytological and histological grading was identical. A significant disparity occurred in 8 cases and the reasons are discussed.
accurately estimated to 4.466.2 mmHg of the intra-aortic reference value. Carotid waveforms underestimated cAIx by-25.0623.4 %. Conclusions: Carotid artery tonometry can be used to accurately estimate cSBP in children if correctly calibrated to diastolic and mean blood pressure values. However, it systematically underestimates and predicts negative cAIx values, and may not be an appropriate surrogate for assessment of central augmentation in children.
Background: Acoustic shadowing from prosthetic valves provides challenges in the assessment of prosthetic mitral dysfunction (PMD) by transthoracic echocardiography (TTE). We aimed to assess the utility of Doppler parameters, including the ratio of mitral prosthetic to LVOT TVI (MV index) for the detection of PMD.Methods: Retrospective TTE assessment of mitral prostheses was performed. PMD was defined by transoesophageal echocardiography (TEE) performed within 30 days of TTE. Patients with significant LVOT obstruction and ≥moderate aortic regurgitation were excluded.Results: 1088 studies were evaluated including 710 mechanical valves (672 bileaflet, 37 tilting disc and 1 unclassified) and 378 bioprosthetic valves (297 porcine, 63 pericardial and 18 unclassified). The mean heart rate was 79 ± 16bpm, with 58% of TTE studies performed sinus rhythm, 33% in an atrial arrhythmia and 9% in a paced rhythm. Mean left ventricular ejection fraction was 54% ± 14%. Study results are as displayed in table.Conclusions: In this large study cohort, MV index was significantly elevated in patients with significant PMD. Pressure half-time was a marker of prosthetic stenosis and remained normal in patients with isolated regurgitation. When used in combination with pressure half-time, E-velocity and mean gradient, MV index improves the diagnostic yield for PMR by TTE and should allow more appropriate patient selection for TEE evaluation.
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