The M.O.S.CA.TI. (Metastases of the Skeleton from CArcinoma of the ThyroId) is a multicenter, retrospective study investigating the real-life outcome and management of bone metastases (BM) in 143 patients (63 M, 80 F; median age 64 years, range 11–87) with differentiated thyroid carcinoma (DTC).
AIM:Treatment of toxic nodular goiter with ¹³¹I is a first-line therapy for hyperthyroidism. To avoid a thyrotoxic storm, ¹³¹I is usually administered after pretreatment with antithyroid drugs, with thyroid-stimulating hormone (TSH) increase and functional recruitment of inhibited normal tissue. Therefore, both autonomous nodule(s) and normal tissue are irradiated. This may be a reason for late hypothyroidism occurring in 15-25% of patients. This study aimed at assessing different pretreatment modalities with combined methymazole and triiodothyronine, achieving euthyroidism with suppressed TSH.METHODS:After diagnosis of autonomously functioning toxic nodule, patients were subjected to thyrostatic medication. Two months later, TSH was checked; if >0.5 mU/L triiodothyronine treatment was associated. After 2 more months, if the TSH level was suppressed, patients received ¹³¹I-therapy. A total of 149 patients were consecutively enrolled, 41 of whom with uninodular and 108 with multinodular goiter. They were evaluated at diagnosis, pretreatment, 3 and 6 months after therapy and at late follow-up (6.8+/-4.2 years; range: 1-22 years).RESULTS:Administered activity was calculated according to ¹³¹I uptake and gland weight. Methymazole was discontinued 6 days before treatment and T3 was maintained until administration of ¹³¹I-therapy. Euthyroidism was achieved in 88% of patients. At late follow-up, subclinical hypothyroidism was observed in 10 patients (6.7%) and overt hypothyroidism in 5 patients (3.3%). No pathological consequences or side effects of ¹³¹I-therapy were found during the 6.8+/-4.2 year follow-up period.CONCLUSION:Treatment of toxic nodular goiter with ¹³¹I-therapy, under combined thyrostatic-thyromimetic treatment is a simple, safe, well-tolerated, and effective procedure.
Background. Although endoscopy with biopsy is the gold standard for the diagnosis of inflammatory bowel disease (IBD), this procedure is invasive and its repetition becomes stressful for many patients and especially for children.
Pain control in patients bearing osseous metastases is often difficult. Pain may become the most important symptom and have severe negative effects on the quality of life. Intractable pain, reduction of all kind of activity and mental depression increasingly worsen the patient's status. Traditional approaches to bone pain, such as radiotherapy, hormonal manipulation, chemotherapy, analgesic medication ranging from weak to strong opiates, can provide high response rates, but are in many cases hampered by acute or late adverse effects and toxicity. Radionuclide therapy of painful bone metastases using bone-seeking isotopes has recently gained wide consensus and a sound role, mainly for metastases from prostate or breast cancer. 89-strontium, as chloride C89Sr), is the most widely used radionuclide in this field",
To evaluate the prevalence and predictors of long-term impairment, epilepsy, mortality, and recurrences after the first stroke in a cohort of Chilean children.A prospective study involving 98 children who suffered a first stroke and underwent follow-up for at least 3 years in a single center. Functional outcome was measured using the modified Rankin Scale for children. We utilized multivariate logistic regression models to estimate the odds ratios (ORs) for outcomes while adjusting for age, sex, and underlying conditions (significance
Measurement of radioactivity levels in the urine of patients undergoing strontium-89 therapy can be used to evaluate the efficacy of therapy or for patient's management (radiation protection rules and waste disposal). The complex beta counting procedures require extensive sample manipulation during preparation of the liquid scintillation cocktail. The high activity levels that may be found permit one to measure 89Sr activity sample by counting the low yield gamma emission (909 keV) of the radionuclide. However, the contamination of 85Sr due to the reaction for producing 89Sr, if measured with sufficient precision, could be used to evaluate 89Sr activity in urine samples. In other words, the contaminant 85Sr can be used as a tracer of 89Sr. This method was tested in four patients and the accuracy was found to be sufficient to obtain the individual time-activity curves of the urinary excretion.
The results obtained with [131I]metaiodobenzylguanidine (131I-MIBG) treatment in 6 patients affected by metastatic phaeochromocytoma are reported. Single doses of 3.7-7.4 GBq were given, in 1-6 courses, up to cumulative doses of 5.4-37.8 GBq. Objective responses were observed in 5 patients (2 tumour shrinkages, even if small; 5 lowering of blood pressure), which were only temporary in 3 patients and stable in 2. Complete disappearance of pain was obtained in 2/2 patients. No adverse side-effects were observed. The problem of treatment strategy in situations of stable disease deserves further study.