The sonographical and functional sequelae of de Quervain's subacute thyroiditis: long-term follow-up

Abstract. Fifty-three patients with subacute thyroiditis (SAT) were seen during the acute stage of the disease. HLA-Bw 35 was positive in 33 out of 39 tested patients. At first presentation, all examined patients (N = 23) had ultrasound abnormalities (generalized hypodensity, single or multiple hypodense areas). Serum T4 and/or T3 were increased in 24/52, free T4 in 11/23, and the TSH response to TRH was flat in 8/11 patients. Six of 12 in whom volumetry was performed had goitres. Thirty-seven patients were re-examined after a mean follow-up interval of 46.5 months. At this follow-up, serum T4, free T4 and T3 levels as well as the sonographically determined thyroid volume had decreased, but there was still abnormalities by ultrasound detected in 14/36 patients; 19.4% had focal sonolucent lesions, whereas the prevalence of such lesions was only 3.1% in asymptomatic controls. Three patients were subclinically hypothyroid at the follow-up, whereas all others were euthyroid. Patients with abnormal ultrasound findings were of the same age and had a similar thyroid size, but a slightly higher TSH and a significantly (P<0.02) lower free T4 than those with normal ultrasound findings. They also had a higher prevalence of thyroid autoantibodies in low titres. Serum thyroglobulin was elevated in more than half of the patients during the acute phase, but only in 1 out of 11 patients during follow-up. Thyroglobulin at the follow-up was not related to TSH, but there was a correlation with thyroid volume (r = 0.57). In conclusion, thyroid abnormalities regarding both function and ultrasound findings are sufficiently frequent after SAT to warrant close observation of the patient. Conversely, abnormal ultrasound findings and diminished thyroid function, when not explained by other factors, should suggest the possibility of past SAT.

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Fifteen-minute consultation: how to identify and treat children with acute kidney injury

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2020-319928 ◽

2021 ◽

pp. edpract-2020-319928

Author(s):

Maura Scott ◽

Grace McCall

Keyword(s):

Acute Kidney Injury ◽

Fluid Management ◽

Kidney Injury ◽

Case Presentation ◽

Mortality And Morbidity ◽

Fluid Status ◽

Close Observation ◽

Long Term Follow Up

Acute kidney injury (AKI) is under-recognised in children and neonates. It is associated with increased mortality and morbidity along with an increased incidence of chronic kidney disease in adulthood. It is important that paediatricians are able to recognise AKI quickly, enabling prompt treatment of reversible causes. In this article, we demonstrate an approach to recognising paediatric AKI, cessation of nephrotoxic medication, appropriate investigations and the importance of accurately assessing fluid status. The mainstay of treatment is attempting to mimic the kidneys ability to provide electrolyte and fluid homeostasis; this requires close observation and careful fluid management. We discuss referral to paediatric nephrology and the importance of long-term follow-up. We present an approach to AKI through case-presentation.

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Thyroiditis de Quervain

Nuklearmedizin ◽

10.3413/nukmed-0536-12-10 ◽

2013 ◽

Vol 52 (04) ◽

pp. 137-140 ◽

Cited By ~ 4

Author(s):

R. Klett ◽

S. Braun ◽

M. Zimny ◽

S. Schenke

Keyword(s):

Predictive Factors ◽

Hormone Replacement ◽

Thyroid Volume ◽

Subacute Thyroiditis ◽

Overt Hypothyroidism ◽

Morphological Parameters ◽

De Quervain ◽

Overt Hyperthyroidism

SummaryBackground: Subacute thyroiditis is a usually self-limiting disease of the thyroid. However, approximately 0.5–15% of the patients require permanent thyroxine substitution. Aim was to determine predictive factors for the necessity of long-term hormone-replacement (LTH). Patients, methods: We retrospectively reviewed the records of 72 patients with subacute thyroiditis. Morphological and serological parameters as well as type of therapy were tested as predictive factors of consecutive hypothyroidism. Results: Mean age was 49 ± 11 years, f/m-ratio was 4.5 : 1. Thyroid pain and signs of hyperthyroidism were leading symptoms. Initial subclinical or overt hyperthyroidism was found in 20% and 37%, respectively. Within six months after onset 15% and 1.3% of the patients developed subclinical or overt hypothyroidism, respectively. At latest follow-up 26% were classified as liable to LTH. At onset the thyroid was enlarged in 64%, and at latest follow-up in 8.3%, with a significant reduction of the thyroid volume after three months. At the endpoint the thyroid volume was less in patients in the LTH group compared with the non-LTH group (41.7% vs. 57.2% of sex-adjusted upper norm, p = 0.041). Characteristic ultrasonographic features occurred in 74% of the patients in both lobes. Serological and morphological parameters as well as type of therapy were not related with the need of LTH. Conclusions: In this study the proportion of patients who received LTH was 26%. At the endpoint these patients had a lower thyroid volume compared with euthyroid patients. No predictive factors for LTH were found.

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T1 Top Line Results of the DETECT Enzymatic Debridement Multicenter Randomized Controlled Trial

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.000 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S1-S1

Author(s):

William L Hickerson ◽

Jeremy Goverman ◽

Sigrid A Blome-Eberwein ◽

Adam Singer ◽

Lucy Wibbenmeyer

Keyword(s):

Median Time ◽

Wound Closure ◽

The United States ◽

Acute Stage ◽

Phase Iii ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial ◽

Long Term Follow Up

Abstract Introduction Bromelain Based Debridement (BBD) of deep burns is approved for use in Europe, Argentina, Russia, South Korea, Peru and Israel. In the United States it is an investigational product and currently there are 2 multicenter RCTs (DETECT – adults, CIDS – children). Patient enrollment in the DETECT adult trial has been completed. The aim of this abstract is to present the acute stage top line results of the DETECT trial. Methods 175 adult patients suffering from deep burns were included in a phase III multicenter, multinational, randomized, controlled, assessor blinded trial. Patients were randomized to 3 arms – BBD, Standard of Care (SOC), or Gel vehicle (Placebo control) in a 3:3:1 ratio (75 BBD, 75 SOC, 25 Gel). The primary endpoint was the incidence of complete eschar removal (BBD vs Gel). Additional acute stage endpoints included the time to complete eschar removal, incidence of surgical eschar removal and eschar removal associated blood loss.Time to complete wound closure (BBD vs SOC) was assessed as a safety endpoint. Following the acute stage, a long-term follow up period of 2 years is being conducted. Results Patient demographics and wound baseline characteristics were comparable across study arms.The incidence of complete eschar removal was significantly higher for BBD vs Gel patients (93.3% vs 4%, p< 0.0001). The incidence of surgical eschar removal was significantly lower for BBD vs SOC patients (4% vs 72%, p< 0.0001). The median time to complete eschar removal was significantly shorter for BBD vs SOC patients (1 day vs 3.8 days, p< 0.0001). Calculated eschar removal associated blood loss was significantly lower for BBD vs SOC patients (14ml vs 815ml, p< 0.0001). The median time to complete wound closure was similar for BBD and SOC patients (27 and 28 days). The overall safety profile of BBD treated patients was good and consistent with the safety data known from previous studies.The results of the long term follow up period are not yet available. Conclusions The acute stage results of this robust phase III RCT demonstrate the safety and efficacy of BBD and are in line with previous trial results. Applicability of Research to Practice The results of this trial may help pave the way for US approval of BBD.

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Long-term follow-up using serial serum thyroglobulin determinations in patients with differentiated thyroid carcinoma

Cancer ◽

10.1002/1097-0142(19831115)52:10<1856::aid-cncr2820521016>3.0.co;2-1 ◽

1983 ◽

Vol 52 (10) ◽

pp. 1856-1859 ◽

Cited By ~ 10

Author(s):

H. Botsch ◽

J. Glatz ◽

E. Schulz ◽

K.-W. Wenzel

Keyword(s):

Thyroid Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

Serum Thyroglobulin ◽

Long Term Follow Up ◽

Serial Serum

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Development, characterization and clinical validation of new sensitive immunofluorometric assay for the measurement of serum thyroglobulin

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302012000900010 ◽

2012 ◽

Vol 56 (9) ◽

pp. 658-665 ◽

Cited By ~ 6

Author(s):

Cláudia C. D. Nakabashi ◽

Rosa Paula M. Biscolla ◽

Teresa S. Kasamatsu ◽

Teresinha T. Tachibana ◽

Rafaela N. Barcelos ◽

...

Keyword(s):

Polyclonal Antibodies ◽

High Sensitivity ◽

Differentiated Thyroid Carcinoma ◽

Serum Thyroglobulin ◽

Additional Advantage ◽

Highly Sensitive ◽

Long Term Follow Up

OBJECTIVE: In the last decade, data published stressed the role of highly-sensitive thyroglobulin (Tg) assays in the follow-up of differentiated thyroid carcinoma (DTC) patients. The present study describes a new, highly-sensitive Tg assay, compares it with an available commercial assay, and validates it in the follow-up of DTC patients. SUBJECTS AND METHODS: The immunofluorometric high-sensitivity Tg assay is based on monoclonal and polyclonal antibodies produced at our laboratories. It was validated in 100 samples of 87 patients with DTC submitted to total thyroidectomy, 87% of whom also received radioiodine. For correlation, all samples were also tested using a commercial Tg assay (Beckman Access) with functional sensitivity (FS) of 0.1 ng/mL. RESULTS: The new method showed FS of 0.3 ng/mL. The correlation between the two methods was good (r = 0.74; p < 0.0001). The diagnostic sensitivity was 88.9%, and it was increased to 100% when combined with neck US. CONCLUSION: This new, high-sensitivity Tg assay presented a good correlation with Beckman Access assay and with the clinical outcome of the patients. The continuous availability of a validated assay is an additional advantage for long term follow-up of DTC patients. Arq Bras Endocrinol Metab. 2012;56(9):658-65

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Serial Ultrasound Findings After Laser Ablation for Benign Breast Lesions on Long-Term Follow-Up: Implications for Evaluation of Procedural Success

Photomedicine and Laser Surgery ◽

10.1089/pho.2015.3932 ◽

2015 ◽

Vol 33 (8) ◽

pp. 404-408 ◽

Cited By ~ 3

Author(s):

Bo Ra Yang ◽

Hye Jung Kim ◽

Kyung Min Shin ◽

Seung Hyeon Cho ◽

Yun-Jin Jang ◽

...

Keyword(s):

Laser Ablation ◽

Breast Lesions ◽

Ultrasound Findings ◽

Long Term Follow Up ◽

Benign Breast Lesions ◽

Procedural Success

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Alpha-Fetoprotein-Producing Gastric Cancer with Nonbiliary Pancreatitis

Case Reports in Gastroenterology ◽

10.1159/000511294 ◽

2021 ◽

pp. 80-86

Author(s):

Arda Yavuz ◽

Büşra Güleç ◽

Rabia Burçin Girgin ◽

İlyas Tuncer

Keyword(s):

Gastric Cancer ◽

Alpha Fetoprotein ◽

Pancreatic Metastasis ◽

Review Of The Literature ◽

Close Observation ◽

Long Term Follow Up ◽

Aggressive Tumor ◽

Aggressive Subtype

Alpha-fetoprotein (AFP)-producing gastric cancer (AFPGC) is a rare, aggressive tumor. In the absence of metastasis in diagnosis, close observation and long-term follow-up is needed to monitor and slow its progress. We report a young patient who presented with nonbiliary pancreatitis. Upon finding Virchow’s nodule, we conducted tests and observed multiple lymph nodes and liver and pancreatic metastasis. We subsequently made a diagnosis of AFPGC. This study describes the different presentations of this rare but aggressive subtype of gastric cancer with a review of the literature.

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Long-term Follow-up of a Multiloculated Arachnoid Cyst of the Middle Cranial Fossa

Ear Nose & Throat Journal ◽

10.1177/014556130708600611 ◽

2007 ◽

Vol 86 (6) ◽

pp. 338-341 ◽

Cited By ~ 2

Author(s):

Marc A. Cohen ◽

Noam A. Cohen ◽

Gul Moonis ◽

David W. Kennedy

Keyword(s):

Arachnoid Cyst ◽

Radiographic Progression ◽

Middle Cranial Fossa ◽

Arachnoid Cysts ◽

Close Observation ◽

Long Term Follow Up ◽

Intracranial Lesions ◽

Cranial Fossa

Arachnoid cysts are benign intracranial lesions that are typically diagnosed incidentally. We describe the case of a 56-year-old man who presented with a multiloculated arachnoid cyst of the middle cranial fossa that extended into the sphenoid sinus. The lesion was identified on computed tomography of the head, which had been obtained for an unrelated investigation. However, establishing a definitive diagnosis proved to be difficult. Because the cyst had caused extensive skull base erosion, the patient was managed conservatively with close observation. We report the radiographic progression of this lesion during more than a decade of follow-up, and we review the literature pertaining to the presentation, pathophysiology, and treatment of arachnoid cysts.

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