Factors Predicting Hypothyroidism in Long-Term Follow-Up after131I Therapy

1988 ◽  
Vol 27 (04) ◽  
pp. 135-139 ◽  
Author(s):  
M. Critchley ◽  
C. R. Squire ◽  
T. M. D. Gimlette
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Elevated Serum ◽  
Thyroid Autoantibodies ◽  
Radioiodine Treatment ◽  
Long Term Follow Up ◽  
Serum Tsh

187 patients, euthyroid for more than a year after radioiodine treatment for hyperthyroidism, were studied for 10 years; 81 (43%) became hypothyroid. The incidence of hypothyroidism was lower in patients initially presenting with large thyroids (28%) or with nodular thyroids (22%) and in those without thyroid autoantibodies (31 %). During follow-up, an elevated serum TSH was present in all 81 patients when they became hypothyroid (sensitivity and negative predictive value 100%), and was present for at least a year in 98% of these. However, an elevated serum TSH was also present in 48% of 106 patients remaining euthyroid (positive predictive value 61 %). FT4I was low in 94% of patients who became hypothyroid and normal in 80% of patients who remained euthyroid (positive predictive value 78%, negative predictive value 93%). Serum TSH and FT4I were the best biochemical predictors. FT3I and serum cholesterol were less satisfactory. A palpable thyroid becoming impalpable, though readily assessed, was limited in usefulness. Clinical appraisal remains important and a progressive, though perhaps less rapid, later increase in the incidence of hypothyroidism appears likely.

Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

2020 ◽  
Vol 33 (11) ◽  
pp. 1431-1441
Author(s):  
Montserrat Negre Busó ◽  
Amparo García Burillo ◽  
Marc Simó Perdigó ◽  
Pere Galofré Mora ◽  
Maria Boronat de Ferrater ◽  
...  
Keyword(s):  
Complete Remission ◽  
Thyroid Carcinoma ◽  
Children And Adolescents ◽  
Differentiated Thyroid Carcinoma ◽  
Radioiodine Treatment ◽  
Persistent Disease ◽  
Stage 4 ◽  
Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

scholarly journals Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis

2015 ◽  
Vol 75 (3) ◽  
pp. 526-531 ◽  
Author(s):  
Farah Tamirou ◽  
David D'Cruz ◽  
Shirish Sangle ◽  
Philippe Remy ◽  
Carlos Vasconcelos ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Positive Predictive Value ◽  
Maintenance Therapy ◽  
Early Response ◽  
Renal Outcome ◽  
Proliferative Lupus Nephritis ◽  
Long Term Follow Up

ObjectiveTo report the 10-year follow-up of the MAINTAIN Nephritis Trial comparing azathioprine (AZA) and mycophenolate mofetil (MMF) as maintenance therapy of proliferative lupus nephritis, and to test different definitions of early response as predictors of long-term renal outcome.MethodsIn 2014, data on survival, kidney function, 24 h proteinuria, renal flares and other outcomes were collected for the 105 patients randomised between 2002 and 2006, except in 13 lost to follow-up.ResultsDeath (2 and 3 in the AZA and MMF groups, respectively) and end-stage renal disease (1 and 3, respectively) were rare events. Time to renal flare (22 and 19 flares in AZA and MMF groups, respectively) did not differ between AZA and MMF patients. Patients with good long-term renal outcome had a much more stringent early decrease of 24 h proteinuria compared with patients with poor outcome. The positive predictive value of a 24 h proteinuria <0.5 g/day at 3 months, 6 months and 12 months for a good long-term renal outcome was excellent (between 89% and 92%). Inclusion of renal function and urinalysis in the early response criteria did not impact the value of early proteinuria decrease as long-term prognostic marker.ConclusionsThe long-term follow-up data of the MAINTAIN Nephritis Trial do not indicate that MMF is superior to AZA as maintenance therapy in a Caucasian population suffering from proliferative lupus nephritis. Moreover, we confirm the excellent positive predictive value of an early proteinuria decrease for long-term renal outcome.Trial registration numberNCT00204022.

Predictive value of short-term migration in determining long-term stable fixation in cemented and cementless total knee arthroplasties

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 55-60 ◽  
Author(s):  
E. K. Laende ◽  
C. G. Richardson ◽  
M. J. Dunbar
Keyword(s):  
Predictive Value ◽  
Predictive Ability ◽  
Porous Metal ◽  
Short Term ◽  
Long Term Follow Up ◽  
Total Knee ◽  
Total Point ◽  
Cementless Components

Aims Early implant migration measured with radiostereometric analysis (RSA) has been proposed as a useful predictor of long-term fixation of tibial components in total knee arthroplasty. Evaluation of actual long-term fixation is of interest for cemented components, as well as for cementless fixation, which may offer long-term advantages once osseointegration has occurred. The objective of this study was to compare the long-term migration with one- and two-year migration to evaluate the predictive ability of short-term migration data and to compare migration and inducible displacement between cemented and cementless (porous metal monoblock) components at least ten years postoperatively. Patients and Methods Patients who had participated in RSA migration studies with two-year follow-up were recruited to return for a long-term follow-up, at least ten years from surgery. Two cemented tibial designs from two manufacturers and one porous metal monoblock cementless tibial design were studied. At the long-term follow-up, patients had supine RSA examinations to determine migration and loaded examinations (single leg stance) to determine inducible displacement. In total, 79 patients (54 female) returned, with mean time since surgery of 12 years (10 to 14). There were 58 cemented and 21 cementless tibial components. Results Migration at one year and two years was significantly correlated with long-term migration (p < 0.001). Median migration at the long-term follow-up was 0.6 mm (maximum total point motion; interquartile range (IQR) 0.4 to 0.9) for the cemented group and 0.6 mm (IQR 0.3 to 1.1) for the cementless group with no difference between groups (p = 0.99). Inducible displacement was significantly lower for the cementless components (p < 0.001). Conclusion Long-term migration was strongly correlated with two-year migration. Although long-term migration was not different for cemented or cementless tibial components, inducible displacement at the long-term visit was significantly lower for these cementless components, suggesting superior fixation. These findings support the predictive value of short-term migration in determining long-term fixation. Cite this article: Bone Joint J 2019;101-B(7 Supple C):55–60

scholarly journals The Predictive Value of Depression in the Years After Heart Transplantation for Mortality During Long-Term Follow-Up

2019 ◽  
Vol 81 (6) ◽  
pp. 513-520 ◽  
Author(s):  
Britta S. Bürker ◽  
Lars Gullestad ◽  
Einar Gude ◽  
Odd E. Havik ◽  
Anne Relbo Authen ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Predictive Value ◽  
Long Term Follow Up

Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

2001 ◽  
Vol 7 (6) ◽  
pp. 359-363 ◽  
Author(s):  
M Tintoré ◽  
A Rovira ◽  
L Brieva ◽  
E Grivé ◽  
R Jardí ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Oligoclonal Bands ◽  
High Negative Predictive Value ◽  
Csf Oligoclonal Bands ◽  
Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

scholarly journals Predictive value of lung biopsy in ventricular septal defect: Long-term follow-up

1986 ◽  
Vol 8 (5) ◽  
pp. 1113-1118 ◽  
Author(s):  
Elizabeth A. Braunlin ◽  
James H. Moller ◽  
Ceeya Patton ◽  
Russell V. Lucas ◽  
C. Walton Lillehei ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Predictive Value ◽  
Lung Biopsy ◽  
Septal Defect ◽  
Long Term Follow Up

Long-term follow-up results of a phase I/II study of concurrent chemoradiotherapy for localized nasal NK/T-cell lymphoma (NKTCL): JCOG0211.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8050-8050
Author(s):  
Motoko Yamaguchi ◽  
Kensei Tobinai ◽  
Masahiko Oguchi ◽  
Naoki Ishizuka ◽  
Yukio Kobayashi ◽  
...  
Keyword(s):  
Phase I ◽  
Concurrent Chemoradiotherapy ◽  
Elevated Serum ◽  
Progression Free Survival ◽  
Disease Recurrence ◽  
Newly Diagnosed ◽  
Long Term Follow Up ◽  
Grade 3

8050 Background: Concurrent chemoradiotherapy has been regarded as one of the standard management for localized nasal NKTCL. However, its long-term efficacy and toxicity is not known. Methods: The JCOG0211 trial is a phase I/II study of concurrent chemoradiotherapy consisting of radiotherapy (RT) of 50 Gy and 3 cycles of DeVIC (carboplatin, etoposide, ifosfamide, dexamethasone) for newly diagnosed, localized nasal NKTCL (JCO 2009). Patients (Pts) with newly diagnosed, localized diseases (IE & contiguous IIE with cervical node involvement) who were 20-69 yrs of age with PS 0-2 were eligible. 3-D conformal RT planning with a wide margin (+ 2 cm to the gross tumor, the entire nasal cavity and the nasopharynx) and a 2-step cone down were required. 33 pts were enrolled in the study, 27 of whom were treated with RT and a 2/3-dose of DeVIC, which was selected as the recommended phase II dose in the preceding phase I portion of the trial. All pts completed RT without any protocol violations. Long-term follow-up results on overall survival (OS), progression-free survival (PFS) and toxicity were evaluated. Results: The median follow-up was 69 months (range, 62-96). The pt (N=33) characteristics were as follows: median age 54 yrs (range, 21-68); stage IIE 33%; B symptom (+) 36%; elevated serum LDH 21%. %5-yr OS and PFS were 73% (95%CI, 54-85%) and 67% (95%CI, 48-80%), respectively. 11 pts (33%) experienced disease recurrence. Two achieved a 2nd CR by salvage chemotherapies followed by allogeneic stem cell transplantation, and the remaining 9 pts died of disease. There was no observed death and disease progression after 34 and 31 months, respectively. One pt experienced Grade 3 irregular menstruation for 3 years. No other Grade 3 or 4 late non-RT-associated adverse events (AEs) were observed. One pt received plastic surgery due to Grade 4 RT dermatitis. No other Grade 3 or greater RT-associated late AEs were encountered. Conclusions: Both survival benefit and disease control from concurrent chemoradiotherapy with RT and DeVIC are maintained during a 5-yr follow-up, indicating the excellent efficacy of this approach as a first-line therapy for localized nasal NKTCL. Long-term toxicity is acceptable.

Papillary thyroid carcinoma with exuberant nodular fasciitis-like stroma: treatment outcome and prognosis

2006 ◽  
Vol 120 (4) ◽  
pp. 338-342 ◽  
Author(s):  
S Basu ◽  
N Nair ◽  
T Shet ◽  
A M Borges
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Clinical Course ◽  
Nodular Fasciitis ◽  
Rare Entity ◽  
Papillary Thyroid ◽  
Radioiodine Treatment ◽  
Long Term Follow Up

Papillary thyroid carcinoma with nodular fasciitis-like stroma (PTC-NFS) is one of the extremely rare variants of papillary thyroid carcinoma. To date, the majority of reported cases have been published in the surgical pathology and cytopathology literature, addressing the diagnostic difficulties posed by the condition's extensive, reactive stromal proliferation. Because of the rarity of PTC-NFS among papillary thyroid carcinoma variants, it has been unexplored from a clinical viewpoint. A MEDLINE search on the clinical course, role of radioiodine, treatment outcome and long term follow up of this disease yielded no result.We report the clinicoradiologic and histopathologic profile, together with post-treatment long term follow up, in a 35-year-old woman harbouring this rare entity. To the best of our knowledge, this is the first report of a five-year follow up of this rare variant of PTC following total thyroidectomy and radioiodine treatment. Our follow-up findings reiterate the disease's favourable clinical course when managed in the same manner as a classical, differentiated papillary carcinoma of the thyroid, akin to that predicted by the pathologists, and emphasize the importance of differentiating PTC-NFS as a separate entity from the papillary carcinoma variants with aggressive histology. Given the rarity of this condition, the experience gained from the present case is a useful addition to the current knowledge on disease prognostication and management.A systematic review of the existing literature on PTC-NFS, including the case reported in the present paper, is also carried out, aiming to explore the patient characteristics and clinical behaviour pattern of this rare entity and to make appropriate recommendations on management strategy. The age of presentation ranges from 20 to 82 years, with a mean of 44.5 years. Female preponderance was observed, with a female to male ratio of 3[ratio ]1. No racial predilection was observed. Tumour size varied from 2 to 9 cm along its greatest diameter (mean = 4.3 cm). Metastasis to lymph nodes at presentation occurred in 25 per cent of cases. Metastasis to surrounding structures (e.g. parathyroid and skeletal muscle) was observed in 12.5 per cent. There have been no reports of pulmonary or skeletal metastasis at presentation.

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