Color Duplex Doppler US can Follow up the Response of Radioiodine in Graves' Disease by Evaluating the Thyroid Volume and Peak Systolic Velocity.

PURPOSE: The objective of this study was to prove the efficacy of Doppler ultrasonography (US-Doppler) in the follow-up of patients with GD treated with radioactive iodine. METHODS: 97 patients (77 female and 20 male) with a mean age of 42 years (SD ±â€Š15) and with prior diagnosis of GD were treated with radioiodine. In total, 88.5 % achieved euthyroidism or hypothyroidism after treatment. The study was documented before treatment and one, three, and six months after treatment with radioactive iodine (131I) by a single investigator. The volume, echogenicity, echotexture and vascularization of the glands as well as the peak systolic velocity (PSV) of the inferior thyroid arteries were evaluated and compared with the laboratory data. RESULTS: Thyroid volume and PSV had a statistically significant correlation with hormone levels (p < 0.05). The mean pre-dose therapeutic thyroid volume was 43.01 ±â€Š3.88 cm3 and was 11.58 ±â€Š11.26 cm3 6 months after treatment. The mean PSV before 131I was 90.06 ±â€Š44.13 cm/s and decreased significantly over time (p < 0.001). Six months after the therapeutic dose, the mean PSV was 32.95 ±â€Š16.36 cm/s. However, the subjective parameters did not have a significant correlation with the normalization of the thyroid hormones. CONCLUSION: Doppler US was useful for monitoring the therapeutic response of GD patients after treatment with radioiodine by evaluating the thyroid volume and peak systolic velocity.

[Factors associated with treatment failure of cutaneous leishmaniasis with meglumine antimoniate]. / Fatores associados ao insucesso do tratamento da leishmaniose cutânea com antimoniato de meglumina.

We investigated factors associated with treatment failure in the treatment of cutaneous leishmaniasis with meglumine antimony in a reference service in Mato Grosso State. A retrospective cohort of 151 patients with cutaneous leishmaniasis was built using medical records. The incidence of therapeutic failure was 47% (IC95%=39.2%-55%). Antimoniate doses below 10 mg/kg/day (RR=1.8; IC95: 1.1-3.0), previous leishmaniasis treatment (RR=1.7; IC95: 1.3-2.4), 3 or more skin lesions (RR=1.9; IC95: 1.4-2.5), incomplete treatment (RR=1.9; IC95: 1.3-2.6) and body weight above 68 kg (RR=1.7; IC95: 1.1-2.5) were associated with therapeutic failure. After adjustment, therapeutic failure was associated with having 3 or more cutaneous lesions (OR=4.6; IC95%=1.2-17.4), reports of previous leishmaniasis treatment (OR=4.5; IC95%=1.1-17.5), body weight above 68 kg (OR=4.3; IC95=1.5-11.9) and incomplete treatment schedule (OR=12.5; IC95%=2.1-75.4), although body weight is possibly associated with treatment failure due to the limitation of the maximum daily dose. These results help to identify patients at risk of treatment failure of cutaneous leishmaniasis with antimony therapy.

Fatores associados ao insucesso do tratamento da leishmaniose cutânea com antimoniato de meglumina / Factors associated with treatmet failure of cutaneous leishmaniasis with meglumine antimoniate

Foram investigados os fatores associados ao insucesso do tratamento da leishmaniose cutânea com antimoniato de meglumina num servico de referência para leishmanioses, em Mato Grosso. Uma coorte histórica de 151 pacientes com diagnóstico de leishmaniose cutânea foi construída com informacões dos prontuários. A incidência de insucesso após o primeiro ciclo de antimonial foi 47 por cento (IC95 por cento=39,2 por cento-55 por cento). Dose de antimonial inferior a 10mg/kg/dia (RR=1,8; IC95:1,1-3,0), tratamento prévio para leishmaniose (RR=1,7; IC95:1,3-2,4), três ou mais lesões (RR=1,9; IC95:1,4-2,5), tratamento irregular (RR=1,9; IC95:1,3-2,6) e peso maior que 68kg (RR=1,7; IC95:1,1-2,5) foram associados ao insucesso terapêutico. Após ajuste, permaneceram associados ao insucesso os seguintes fatores: 3 ou mais lesões cutâneas (OR=4,6; IC95 por cento=1,2-17,4), tratamento anterior para leishmaniose tegumentar americana (OR=4,5; IC95 por cento=1,1-7,5), peso maior que 68kg (OR=4,3; IC95 por cento=1,5-11,9) e irregularidade no tratamento (OR=12,5; IC95 por cento=2,1-75,4), embora o peso possivelmente tenha sido associado ao insucesso devido à limitacão da dose máxima. Estes achados auxiliam na identificacão de pacientes com maior risco de insucesso no tratamento da leishmaniose cutânea com antimonial.