Carlos Villabona

TRANSIENT HYPOTHYROIDISM AFTER IODINE-131 THERAPY FOR GRAVES' DISEASE

We studied 355patients withGraves disease tocharacterize transient hypothyroidism andits prognostic valuefollowing 1311 therapy. Methods:Thepatients received therapeutic 1311 treat mentasfollows:333received a dose 10mCi(12.8± 2.9mCi).Diagnosis of transienthypothyroidism wasbasedon lowT4, regardless of TSHwithinthefirstyearafter1311 followed byrecovery ofT4and normalTSH.Results:Afteradministration of 10 mCi)of 1311. lodine-131 uptake >70% at 2 hr before treatment was a risk factorfor developing transienthypothyroidism (Oddsratio2.8, 95%confidence interval0.9—9.4). At diagnosis of transient hy pothyroidism, basalTSHlevelswerehigh(51%),normal(35%) or low (14%);therefore, thetransienthypothyroidism wasnot Centralized. If hypothyroidism developed duringthefirst6 mo afterbasalTSH>45mUiliter ruledouttran&ent hypothyrokfism. Conclusion:Thedevelopment oftransient hypothyroidism and itshormonal pattern didnotinfiuenoe long-term thyroid function. Sincenoprognostic factorsreliably predicted transient hypothy roidism before1311 oratthetimeof diagnosis, Ifhypothyroidism appearswithin the first monthsafter 1311, the reevaluationof thyroidfunctionlateriswarranted to avoidunnecessary chronic re@acement therapy.

Pituitary apoplexy into nonadenomatous tissue : case report and review

Pituitary apoplexy into nonadenomatous tissue is extremely rare. The authors describe a 20-year-old woman with symptomatic pituitary hemorrhage into an apparently intrasellar malignant teratoma, which caused headache, visual impairment, involvement of III, IV, VI, and 1st division of the V cranial nerves, and hypopituitarism. Diabetes insipidus had developed previously. Magnetic resonance scans had a high-intensity signal in the pituitary on T1- and T2-weighted images, and lack of the signal of the posterior pituitary. Transsphenoidal approach, radiotherapy, and chemotherapy management did not preclude a fatal outcome.

Salivary excretory pattern of testosterone in substitutive therapy with testosterone enanthate

OBJECTIVE To determine salivary and serum T levels by an RIA method after a single injection of 250 mg IM of commercially available T enanthate. DESIGN Research study. SETTING Patients attended in a hospital environment. PATIENTS Sixteen men with secondary hypogonadism. INTERVENTIONS Testosterone enanthate was administered, and salivary samples were taken before the injection. Thereafter, these samples were obtained daily until day 7 and then on alternate days until day 28 after injection. Blood samples were taken previously and after the injection (5 samples during the month). MAIN OUTCOME MEASURE Salivary and serum T. RESULTS Salivary T levels rose from 3.46 +/- 3.16 to 13.82 +/- 7.78 ng/100 mL (0.12 +/- 0.11 to 0.48 +/- 0.27 nmol/L) within 24 hours and remained in that range until day 7. From day 9, 7.20 +/- 2.88 ng/100 mL (0.25 +/- 0.10 nmol/L), a progressive decrease of these values was observed until day 14: 5.18 +/- 2.88 ng/100 mL (0.18 +/- 0.10 nmol/L). From day 16 until day 28, salivary concentrations returned to hypogonadal levels. CONCLUSION We conclude that T salivary concentrations may be applied to assess the effectiveness of T substitutive therapy in hypogonadal men and could replace serum in the monitoring of this type of therapy.

Clinical and Pathological Behavior of Well-Differentiated Pancreatic Neuroendocrine Tumors

Well-differentiated (WD) pancreatic neuroendocrine tumors (pNET) are uncommon neoplasms and one of the challenges lies in predicting tumor behavior and managing these patients. The aim of this study is to evaluate patient outcomes associated with the surgical management of WD pNET and to assess the prognostic and biological behavior differences between the two grades of WD …