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1.
West Indian med. j ; 49(Suppl.3): 14, July 2000.
Artigo em Inglês | MedCarib | ID: med-691

RESUMO

It is mandatory to determine whether the patient with thyroid eye disease is in the acute, sub-acute (inflammatory) phrase or the chronic (burnt out) phrase. Patients in the inflammatory phrase are best treated with either anti-flammatory drugs (steroids, immunosuppressives), or radiotherapy. Patients in the burnt-out (fibrotic) phrase are best treated with surgery if required. There are three types of surgery in thyroid eye disease: 1. Eye lid surgery (lid lengthening, blepharoplasty, tarsorrhaphy) which may be performed for cosmetic purposes, or, more frequently, to protect the cornea. 2. Strabismus surgery, mainly recessions of the inferior rectus and/or medial rectus muscles, if the patient is unhappy with prisms. 3. Orbital decompression either via the trans-ethmoidal route for unremitting optic neuropathy, or the lateral route for exophthalmos without optic neuropathy.(AU)


Assuntos
Humanos , Doença de Graves/cirurgia , Doença de Graves/tratamento farmacológico , Doença de Graves/radioterapia , Doenças Palpebrais/cirurgia
2.
West Indian med. j ; 48(Suppl. 3): 18, July 1999.
Artigo em Inglês | MedCarib | ID: med-1543

RESUMO

Hyperthyroidism refers to a group of disorders characterized by over-production of thyroid hormone by the thyroid gland. Of these disorders, toxic diffuse goiter or Graves' disease is most frequently associated with ocular complications. Graves' disease is an auto-immune process that has a predilection for middle-aged women. Thyroid opththalmopathy may reflect increased sympathetic tone and/or an infiltrative immune mediated process. Lid retraction, proptosis, chemosis, injection and ocular discomfort are relatively benign signs of thyroid eye disease, but may cause significant emotional and functional disturbances. More advanced disease characterized by keratopathy, motility restriction, and optic nerve compression represent greater threats to ocular function and may require intensive therapy. Thyroid management, systemic steroids, local irradiation and surgery represent the cornerstones of management for thyroid associated ophthalmopathy. Ocular therapy should be used judiciously as the disease is associated with a good functional and cosmetic outcome for most individual. However, those with sight threatening diesease or severe cosmetic alterations should be treated agressively and, preferably, before fibrosis leads to permanent orbital abnormalities.(AU)


Assuntos
Pessoa de Meia-Idade , Feminino , Humanos , Doença de Graves
3.
Hum Antibodies ; 9(3): 161-4, 1999.
Artigo em Inglês | MedCarib | ID: med-708

RESUMO

The clinical usefulness of commercially prepared haemagglutination kits for thryro peroxidase (TPO) antibody and thyroglobulin (TG) antibody was evaluated in 145 consecutive Jamaicans with Graves' disease. Sixty two (43 percent) of the patients were newly diagnosed, 12 (8 percent) were in remission and 71 (49 percent) had relapsed. Sera from 65 (45 percent) patients were positive for thyroid antibodies. The TPO antibodies were found in 43 percent (63/145), thyroglobulin antibodies in 12 percent (17/145) fifteen (10 percent) patients had both anti-TPO and TG antibodies. Similar prevalences of TPO antibody were found in newly diagnosed patients and those who had relapsed (44 percent v. 41 percent) but the prevalence in the patients in remission was significantly higher (75 percent; X2 = 4.8, P <0.05). The prevalence of TPO antibody increased significantly with age at onset before age 35 years compared to later onset (56 percent v. 32 percent; X2 = 8.09, P <0.005). The presence of both TPO antibody (64 percent v. 31 percent; X2 = 13.1, P <0.001) and TG antibody (22 percent v. 6 percent; X2 = 8.8, P <0.005) correlated positively with Graves' opthalmopathy. Neither of the tests was adequately sensitive in detecting GD in Jamaicans. (AU)


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Adolescente , Pessoa de Meia-Idade , Autoanticorpos/sangue , Doença de Graves/diagnóstico , Iodeto Peroxidase/imunologia , Tireoglobulina/imunologia , Estudo de Avaliação , Doença de Graves/imunologia , Doença de Graves/patologia , Testes de Hemaglutinação , Jamaica , Estudos Prospectivos , Kit de Reagentes para Diagnóstico , Glândula Tireoide/imunologia
4.
In. University of the West Indies, Mona, Jamaica. Faculty of Medical Sciences. Eighth Annual Research Conference 1999. Kingston, s.n, 1999. p.1. (Annual Research Conference 1999, 8).
Monografia em Inglês | MedCarib | ID: med-1449

RESUMO

The prevalence of thyroid antibodies varies with the population studied. It has been suggested that the presence of anti-thyroid microsomal (TMAb)/thyroid peroxidase (TPO) antibodies and anti-thyroglobulin antibodies (TgAB) may predict clinical parameters including anti-thyroid drug therapy outcome in Graves' disease. Commercially available kits were used to measure anti-TPO and Tgab titres. Antibody titres were compared in the following clinical groups: newly diagnosed (n=21), treated with radioactive iodine (n=2), remission (n=22), relapse (n=27), chronic (n=44). Anti-thyroglobulin antibodies were present in 10.3 percent (10/97) of the patients with titres ranging from 40 to 320 with a geometric mean titre of 80. Ant-TPO antibodies were found in 49.4 percent (48/97) with titres ranging from 100 to 102, 400 and a geometric mean titre of 1,800. The presence and titres of thyroid antibodies did not correlate with age at diagnosis, duration of disease, cardiac complications, other concommitant autoimmune diseases, antithyroid drug therapy or the relapse or remission rate. The results of this study did not indicate any clinical usefulness of thyroglobulin and thyroid peroxidase beyond diagnosis in Graves' disease.(AU)


Assuntos
Adulto , Humanos , Imunoglobulinas Estimuladoras da Glândula Tireoide , Doença de Graves/etiologia , Doença de Graves/diagnóstico , Iodeto Peroxidase , Jamaica
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